bluuebunny/crossref_metadata_2025 huggingface dataset:
Active caspase‐3 expression in healthy lens epithelium
Authors: TALEBI ZADEH N , YU Z , KRONSCHLÄGER M , SÖDERBERG P
Published: November 2013

Purpose To determine the distribution and localization of active caspase‐3 in normal rat lens epithelium by immunohistochemistry.

Methods Alltogether, 40 Sprague Dawley rats were sacrificed and eye lenses were removed. One eye from each animal was fixed and then stored at ‐80°C. Three mid‐sagittal sections of each lens were processed for immunohistochemistry. Lens epithelial cell position was identified and specified as its consecutive position in relation to the first nucleus counted. The counting started from one nuclear bow and ended in the opposite side nuclear bow. The nuclei labelled with active caspase‐3 and their relative position was identified three times, counts, in each section. Then, each lens was divided into fifteen segments and active caspase‐3 labelling was calculated in each segment.

Results Active caspase‐3 was more expressed in the anterior pole of the lens with the of 37 % active caspase‐3 labelled cells. The variance for animals, sections and countings was estimated to 11, 3 and 83 %, respectively. Fitting the fraction of labelling to a double exponential model, as a function of segment number starting from the anterior pole, assuming an exponential decrease from the anterior pole toward periphery, resulted in a 95 % confidence interval for decrease rate (1/k) = ‐1.5±0.2 segments and inflection point = 7.7±0.2 segments

Conclusion Active caspase‐3 is present in the normal lens, with a maximum activity around the anterior pole that tapers off towards the periphery. Quantitative analysis of immunoflorescence of active caspase‐3 requires at least 3 sections per lens. The number of countings of labelled nuclei is the limiting factor for the precision in an estimate of fraction of labelling.
Elastic properties of human lens zonules as a function of age in presbyopes
Authors: MIKIELEWICZ M , MICHAEL R , MONTENEGRO G , PINILLA CORTES L , BARRAQUER RI
Published: November 2013

Purpose Ex vivo measurement of the elastic properties of human lens zonules as a function of age in presbyopes.

Methods We studied 16 presbyopic human donor eyes (ages 47 to 97). Anterior eye sections with crystalline lens, zonules, ciliary body and sclera were radially stretched. The stretching device consists of a chamber filled with balanced salt solution and eight radial hooks to hold the anterior eye section. Radial stretching was created with a stepper motor connected to a digital outside micrometer for linear displacement and digital balance for force measurement. Three eye globes were used to test our methodology. For 13 eye globes, the spring constant, elastic modulus of the zonular system, and Young's modulus of the zonules were calculated.

Results We found linear dependence for force‐elongation and force‐strain relationships at all ages. In young presbyopic eyes (ages 47 to 60), the Young's modulus of the zonules was 340 mN/mm²; whereas in older eyes (ages 83 to 97), it was significantly lower at 270 mN/mm². However, the correlation coefficient between Young's modulus and age (47 to 97 years) was not significant with p = 0.063.

Conclusion The zonular system in presbyopic eyes is linear elastic, and the Young's modulus of the zonules decreases 20% from presbyopic age to late presbyopic age. However, there was no significant correlation between Young's modulus and age in presbyopes.
Different assessments of immunohistochemically stained Ki‐67 ocular malignancies
Authors: PAULAVICIENE R , PETROSKA D , ASOKLIS R
Published: November 2013

Purpose To investigate a tumor proliferation marker Ki‐67 in conjunctival malignancies and to compare the results of different quantitative assessments.

Methods This study was designed as a pilot study to assess nuclear proliferation protein (Ki 67) in conjunctival malignancies. Immunohistochemical staining of Ki‐67 was evaluated in 8 surgical samples of ocular surface neoplasias: 6 cases of invasive conjunctival squamous carcinoma and 2 of conjuntival melanoma. Ki‐67 counting and evaluation was assessed on selected areas using different methods: manual counting (MC) of >1500 cells;digital image analysis with Nuclear V9 algorithm and digital image analysis using stereology module for ImageScope of Aperio. Ki‐67 values from manual, stereoscopic and automated analyses were compared.

Results The MC, the nuclear V9 algorithm analysis and stereologic method revealed positivity of Ki‐67 in invasive conjunctival squamous carcinoma from 22 to 60%, 21.5 to 43.5 % and from 30.1 to 51.5% respectively; in conjunctival melanomas from 20 to 30 %; from 17.8 to 18%, and from 7.17 to 29.1% respectively. The strongest correlation was observed between Aperio algorithm and stereologic method in conjunctival squamous carcinoma (0.87). Weaker correlation was found between Aperio/manual (0.6) and manual/stereological (0.83) methods.

Conclusion Our data demonstrate that different methods of Ki‐67 evaluation may give dissimilar results, but results of this computer assisted nuclear V9 algorithm correlates strongly with stereoscopic analysis and can be helpful in accurate quantitative evaluation of imunochistochemically stained biomarkers.
Rare iridociliary pediatric tumors and pseudotumors: Cases report and literature review
Authors: HADJISTILIANOU T , TSYGANKOV A , DE LUCA MC , DEFRANCESCO SONIA , MICHELI L , BORRI M , MENICACCI F
Published: November 2013

Purpose Iridociliary tumors are usually uncommon in childhood. Our aim is to describe cases of juvenile xanthogranuloma, iris tuberculoma and medulloepithelioma in young patients and to differentiate them from other similar lesions

Methods Retrospective cases study. Four patients ( two girls and two boys) were referred at the Referral Center for Retinoblastoma of the University of Siena. They underwent all the ophthalmological examination including standard procedures, MRI of the orbits, CT, UBM, immunological and molecular analysis. In three cases organ‐preserving operations were performed.

Results Two tumors were histologically identified as medulloepitheliomae. Two tumor‐like lesions were determined as juvenile xanthogranuloma and iris tuberculous granuloma. In the last case, antituberculous therapy was performed

Conclusion Iridociliary tumors and pseudotumors are rather rare in childhood. Nevertheless, they should be taken in consideration in differential diagnosis with other pediatric intraocular tumors, particularly retinoblastoma, ciliary body adenoma and adenocarcinoma. An executive checkup including pathology, immunohistochemistry and immunology is to be performed.
Expression of stem cell markers in human uveal melanoma
Authors: STEIBER Z , HALMOS G , CSERHATI Z , TRESZL A
Published: November 2013

Purpose Uveal melanoma is a rare but very aggressive malignancy. Independently of the currently available therapies, 50 % of uveal melanoma patients will develop metastasis and the average survival time of these patients is only 2‐8 months. Genetic and epigenetic background of uveal melanoma is not fully understood and useful prognostic markers for metastasis development are not well characterized. It was suggested that in various tumors cancer stem cells are responsible for the development of primary tumors and their metastases. In uveal melanoma, the role of cancer stem cells is not clear that’s why our aim with the present study was to investigate the expression of mRNA of stem cell markers.

Methods Human uveal melanoma specimens were obtained from 31 enucleated patients at the University of Debrecen, Department of Ophthalmology. The expression of stem cell markers was studied by RT‐PCR, using gene specific primers for FZD6, NES, NGFR, PROM1 and SOX10.

Results mRNA for FZD6 and SOX10 could be detected in 100% of the investigated samples. NES, NGFR and PROM1 were present in 94%, 94% and 82%, respectively.

Conclusion Results of our study demonstrate that certain stem cell markers are present in nearly all uveal melanoma specimens. Therefore, they are not suitable as prognostic markers. However, our findings that a high percentage of uveal melanomas express stem cell markers support the view that stem cell genes may play an important role in the development and progression of this aggressive cancer. Further studies are needed to evaluate the exact role of these markers and to explore potential therapeutic approaches to target cancer stem cells in human uveal melanoma. Grant support: TÁMOP 4.2.2.A‐11/1/KONV‐2012‐0025 (G.H.)
Trans‐scleral local resection of toxic choroidal melanoma after proton beam radiotherapy
Authors: KONSTANTINIDIS L , DAMATO B
Published: November 2013

Purpose To report on trans‐scleral local resection of choroidal melanoma as treatment for serous retinal detachment after proton beam radiotherapy (PBR)

Methods Retrospective study of patients underwent trans‐scleral local resection of choroidal melanoma after previous PBR from 2000 to 2008 to the Liverpool Ocular Oncology Service.

Results The 11 patients (5 female, 6 male) had a median age of 48.8 years (range 20 – 76) included in this study. The tumor margins extended anterior to ora serrata in 6 patients. On echography, the largest basal tumor dimension averaged 11.9 mm (range 5.7 – 13.2) and the tumor height averaged 7 mm (range 4.5 – 9.9). The retinal detachment was total in 4 cases. Neovascular glaucoma was present in 4 patients. The time between proton beam radiotherapy and local resection had a mean of 17.4 months (range 1 – 84). The follow‐up time after the local resection procedure had a mean of 96 months (range 60 – 156). At the last known status, the eye was conserved in 9 patients, with a flat retina in all of these patients and visual acuity better than 6/30 in 5 patients. The reasons for enucleation were: retinal detachment (1 patient) and phthisis (1 patient.

Conclusion Serous retinal detachment and neovascular glaucoma after proton beam radiotherapy of a choroidal melanoma can both resolve after trans‐scleral local resection of the tumor. Our findings indicate that these complications are caused by the persistence of the irradiated tumor within the eye (‘toxic tumor syndrome’).
Case of primary neuroendocrine carcinoma in lacrimal gland
Authors: DAISUKE Y , TOSHIYUKI O , SHUICHI Y
Published: November 2013

Purpose Case of primary neuroendocrine carcinoma in lacrimal gland

Methods A 86‐year‐old man noticed a swelling of the left upper eyelid three month earlier. Because the size of the nodule gradually increased, the patient was referred to the Chiba University Hospital. We performed excision biopsy and histopathological examination indicated that the tissue had low‐grade atypical cells which were positive to CD56, CK7, and CKAE1/AE3. Magnetic resonance imaging and positron emission tomography excluded systemic metastasis. The patient was diagnosed with a primary NEC of the left lacrimal gland.

Results He underwent chemotherapy (Carboplatin and etoposide) for four cycles, and the size of the tumor was significantly decreased. A month later, we performed tumor excision including the clinically visible margin, and a month later the patient had 50Gy radiotherapy at the surgical region. After the three‐combination therapy, the tumor was undetectable in the MRI. A month later, however, a metastasis to the parotid lymph node was found, and the patient underwent total lymphadenectomy of the left parotid gland and 46Gy radiotherapy was applied to the left neck. At the last examination, the patient had neither recurrence nor metastasis.

Conclusion Although primary NEC of the lacrimal gland is extremely rare, the tumor has high malignancy and readily metastasizes. Thus, combined surgery, radiotherapy, and chemotherapy are needed for the complete management of NEC.
Mucormycosis is a rare etiology of ophthalmoplegia: How to diagnose and to manage it, about one exceptional case
Authors: LAGENAITE C
Published: November 2013

Purpose Mucormycosis is a rare opportunist infection,characterized by a high mortality rate occurring in immunodeficient patient population.Its rhino‐cerebral form may be complicated by neuro‐ophthalmological and orbital symptomatology.

Methods We report a case of a 57 years old woman, referring because of diplopia associated with a diabetic ketoacidosis .Ocular examination revealed a complete left ophthalmoplegia. Magnetic resonance imaging highlighted a cavernous sinus thrombosis associated with ipsilateral pansinusitis. In this context, mucormycosis diagnosis is discussed and confirmed by anatomopathology analysis after sinusal biopsy.The follow‐up is exceptional in its ophthalmological complications despite antifungal agents and anticoagulant therapy.We observed consecutively a left central retinal artery occlusion (CRAO) then a contralateral central retinal veinous occlusion,and finally a left neovascular glaucoma.

Results Mucormycosis is a fungal opportunist infection that must be very early diagnosed.This pathology is caracterized by sinusal infiltration, necrosis, and bony walls damage. Medical treatment by anti‐fungal agents alone, can not contain it. It must be associated with a wide and repeated surgical debridement of necrotic tissue. Symptomatic ocular treatment (anti‐VEGF, Laser) is needed in order to preserve visual function and anatomical prognosis.Indeed, the extension along blood vessels walls leads to thrombosis and necrosis, that is resistant to systemic therapy. Our patient is still alive after a follow‐up of 24 months.

Conclusion This case illustrates a serious multidisciplinary pathology,that is very difficult to control.The ocular signs were predominant but revealed a large rhino‐cerebral infiltration.
A time‐line model of developmental events within the human fovea based on imaging and histology data
Authors: SJÖSTRAND J , POPOVIC Z
Published: November 2013

Purpose To create a time‐line model of developmental events during normal maturation of the inner and outer foveal layers based on imaging and histological studies.

Methods Data from recently published imaging studies using hand‐held OCT during the period following premature birth (Dubis et al. 2012; Maldonado et al., 2012; Vajkovic et al., 2012) and histology of normal donor eyes (Dubis et al., 2012; Hendrickson et al. 2012; Vajkovic et al., 2012) was used to establish the timing of foveal developmental events from the time of mid‐gestation to early childhood. A model of the onset and maturation of the following foveal developmental events was constructed: Pit formation, extrusion of inner retinal layers, widening of the outer nuclear layer, separation of the hyperreflective inner segment layer from the RPE, and lengthening of the outer segment. Developmental events were graded as incipient, intermediate or mature.

Results The normal developmental events within the central fovea are depicted along a logarithmic time‐line. The developmental models based on OCT or histology of the inner and outer retina show a close correspondence. The structural elements of the inner retina all reach near full to full maturity at term birth. At this time the outer retinal structures are immature and the maturation of the photoreceptor layers starts at an age of some postnatal weeks and reach near full to full maturity at one to three years of age.

Conclusion The inner and outer foveal layers reach maturity within different time frames; the inner layers during the late part of gestation, and the outer layers during the first postnatal years. Our model is of importance when evaluating abnormalities in e.g. prematurity or albinism.
Hypoxia stimulates the release of Brain Natriuretic Peptide (BNP) from RPE cells
Authors: ARJAMAA O , KINNUNEN K , KAARNIRANTA K , AALTONEN V
Published: November 2013

Purpose The natriuretic peptide system (A‐, B‐ and C‐type) has a powerful effect on systemic blood circulation (natriuresis, diuresis ans plasma shift) causing haemoconcentration causing increased oxygen carrying capapcity of blood. A high concentration of a member of the natriuretic peptide family has been found from the vitreous of patients suffering of proliferative diabetic retinopathy (PDR). The stimulus to which the natriuretic peptide system responded in PDR, however, has remained unknown. We tested the hypothesis that hypoxic conditions will increase the release of BNP (B‐type of natriuretic peptides) from human retinal pigment epithelium (RPE) cell culture

Methods Human retinal pigment epithelium cells (ARPE‐19) were exposed to hypoxia for 2h, 4h, 6h, 8h and 24h. The amount of BNP and VEGF (positive control) were measured at different time points in culture media using EIA. Hypoxia‐Inducible Factor (HIF), a protein, which is the master switch in regulating all the responses to hypoxia downstream, was measured using Western blotting.

Results At 24h, the amount of BNP in culture media was significantly higher in hypoxic than in normoxic conditions. Also, the concentration of both VEGF and HIF were significantly higher in hypoxia.

Conclusion Hypoxia increases the release of BNP from RPE cells and the response is mediated by HIF.The present results characterize for the first time a stimulus for the natriuretic peptide system in human retina and explain previous clinical findings. Thus, the measurement of natriuretic peptides in the vitreous may guide the treatment of the intraocular diseases in which the retina is suffering from hypoxia. Future perspectives: Natriuretic peptides regulate oxygen transport in all tissues?
Cellular senescence is increased in human retinal microaneurysms during aging
Authors: MENDES‐JORGE L , LOPEZ‐LUPPO M , NACHER V , RAMOS D , NAVARRO M , CARRETERO A , RODRIGUEZ‐BAEZA A , RUBERTE J
Published: November 2013

Purpose Different studies indicates that the presence of retinal microaneurysms, dilations of the capillaries which often appear as gross outpouchings of the vessel wall, increases during human aging. However, little is known about the mechanisms that may contribute to the development of these structures. The aim of this study was to examine whether cellular senescence may contribute to the formation of microaneurysms and specifically examine the role of p16INK4a, a cyclin dependent kinase inhibitor, that may act promoting the irreversible cell cycle arrest and senescence.

Methods Human retinas were obtained from 14 old‐donors and 3 middle‐aged donors. p16INK4a expression was analyzed using immunohistochemistry and laser‐confocal microscopy. Furthermore, in the same retinas we assessed senescence‐associated β‐galactosidase (SA‐β‐gal) activity, a widely used biomarker for cellular sencescence.

Results Microaneurysms were present in all the retinas obtained from old donors but were absent in those obtained from midle‐aged donors. p16INK4a expression was strongly increased in all retinal layers of old retinas when compared with middle‐aged retinas. We observed that p16INK4a expression was increased in retinal blood vessels of aged donors, in which we also detected the presence of high levels of SA‐β‐gal activity. Furthermore, p16INK4a expression was strickingly increased in retinal microaneuryms when compared with that observed in their associated capillaries.

Conclusion p16INK4a was overexpressed in the retinal microaneurysms of aging people indicating that cellular senescence could be a crucial mechanism contributing to the formation of retinal microaneuryms during aging.
The fractal properties of the retinal vascular architecture
Authors: VEKRIA P , CUBBIDGE R , HEITMAR R
Published: November 2013

Purpose The human retinal vasculature has been demonstrated to exhibit fractal, or statistically self similar properties. Fractal analysis offers a simple quantitative method to characterise the complexity of the branching vessel network in the retina. Several methods have been proposed to quantify the fractal properties of the retina.

Methods Twenty five healthy volunteers underwent retinal photography, retinal oximetry and ocular biometry. A robust method to evaluate the fractal properties of the retinal vessels is proposed; it consists of manual vessel segmentation and box counting of 50 degree retinal photographs centred on the fovea.

Results Data is presented on the associations between the fractal properties of the retinal vessels and various functional properties of the retina.

Conclusion Fractal properties of the retina could offer a promising tool to assess the risk and prognostic factors that define retinal disease. Outstanding efforts surround the need to adopt a standardised protocol for assessing the fractal properties of the retina, and further demonstrate its association with disease processes.
Assessment of macular retinal thickness and volume in normal eyes and highly myopic eyes with spectral optical coherence tomography
Authors: CHEBIL A , BEN ACHOUR B , KORT F , CHAKER N , EL MATRI L
Published: November 2013

Purpose To compare the macular retinal thickness and macular volume between subjects with high myopia and non‐myopia

Methods A prospective comparative study recruited highly myopic eyes with no posterior abnormalities (spherical equivalence (SE) over ‐6 dioptres (D) or AXL>or=26.5 mm) and subjects with non‐myopia (SE between 1.5D and ‐1.5 D). Macular retinal thickness and volume thickness at the fovea 1.5 mm superiorly, inferiorly, nasally, and temporally were measured with spectral‐domain optical coherence tomography (TOPCON SD 2000).

Results One hundred and twelve myopic eyes and 66 non‐myopic eyes were included. The mean age of the high myopic group and non‐myopia group was 34.28 and 28.5 years old, respectively. The mean refraction was ‐13.98 D in the high myopia group and ‐0.24 D in the non‐myopia group. The high myopia group had significantly greater mean retinal thickness in the foveola 188.8 vs 155.2 microm, P<0.0001), and fovea 1 mm area (205.8 vs 181.4 microm, P=0.0088), than the non‐myopia group. The mean retinal thickness in the inner and outer macular area of the high myopia group was significantly less than in the non‐myopia group. In addition, the high myopia group had significantly smaller macular volume than the non‐myopia group (P<0.0001).

Conclusion The retinal thickness in high myopic eyes is thicker in the foveola and fovea, but thinner in the inner and the outer macular region. The retina of individuals with high myopia had smaller macular volume than those with non‐myopia.
Macula of retina ‐ spherical calotte with its focus. Right image on the retina. Applications: Biophotonics Laser Holographic Theory of Vision. Apparatus for the study of human vision
Authors: MANU MD , PLESU GH
Published: November 2013

Purpose The paper presents the results of theoretical multidisciplinary studies, whose purpose was to study the biophysical mechanism of vision, but taking in account macula’s form as spherical callote and its own focus, the structure and functioning of the human eye as a biphocal laser system (cornea and macula focus) with holographic elements, to establish the holographic biophotonic mechanism of vision according to the Biological Lasers Theory, to verify the hypothesis using the bionic method.

Methods For experimental method we built two optical devices, which to be in line with the latest anatomical data of the eye, al 5:1 and 10:1 scale, according to laser holographic biophotonic model of the human eye: optic monocular apparatus or bionic eye‐ compact model and scaffold type, which are models of bifocal laser system with intermediate holographic system.

Results The results and discussions of studies offer great surprises. The image at macula pole may be directly observed, as a right position, colored, dynamic, much diminished and it may be transmitted from one pole to the other, but has a sense daytime and an inverted sense nighttime, as dreams images. The two optic apparatus confirm the laser holographic biophotonic mechanism of human vision.

Conclusion The conclusions of the theoretical and bionic method studies are that Vision Photographic Theory is moral and technical outdated. The Vision Holographic Biophotonic Theory VHBT is modern and according to the principles of lasers, holography, liquid crystals, the nonlinear optics, electronics, biophotonic and human eye physiology.

Commercial interest
The activity of the “when” pathway during visual motion
Authors: KENGO T , SHU M
Published: November 2013

Purpose Recently, a third pathway, the “when pathway” has been described(Batteli ,2007).The when pathway is project from the Primary Visual Cortex(V1) to the inferior parietal lobe(IPL) through the middle temporal and middle superior temporal(MT+) areas. The activity of the when pathway has not been confirmed experimentally. In this study, the activity of the when pathway was examined during visual motion.

Methods A total of 6 healthy volunteers were studied.Task 1 comprised the visual presentation of one black dot alternating with a frequency of 1 Hz. Task 2 comprised the visual presentation of two black dots alternating with a frequency of 1 Hz. Task 3 comprised the visual presentation of three black dots alternating with a frequency of 1 Hz. Electroencephalography(EEG) data were digitized from 32 electrodes, which were placed according to the extended International 10_20 system. The EEG data at rest and for each task included O2ch between 30_50 ms in the right primary visual cortex area, P8 between 170_190 ms is right MT+ areas, and P4 between 200_220 ms in the right IPL area, and the waveform extracts were performed with power spectrum analyses. The calculated power value in the range of 8_13 Hz (α frequency band) from each waveform was examined in V1, MT+, and IPL and compared between rest in each task.

Results The α bands in V1, MT+, and IPL in each task were significantly lower than those at rest (p<0.05).

Conclusion The crucial function of the when pathway is to keep track of multiple objects that temporally overlap or occur sequentially. In this study, the α bands in each task were significantly lower compared with those at rest. However, significant differences in the α bands were not observed in each task. We suggest that the when pathway is active in response to only one object.
Evaluation of direct and consensual accommodation of fellow eyes using binocular open field auto refracto/keratometer WR‐5100K
Authors: TARUTTA E , TARASOVA N
Published: November 2013

Purpose To develop a method of objective simultaneous evaluation of direct accommodation (DA) and consensual accommodation (CA) of paired eyes.

Methods To assess DA and CA, eyes of 83 patients aged 7‐25 with different refraction errors were examined. Objective accommodation response was measured using Binocular Open Field Auto Refracto/Keratometer WR‐5100K (Grand Seiko Co., Ltd., Japan) under full correction of the existing ametropia achieved by spherical and cylinder lenses in a trial frame. A special device was used to separate the visual fields of the two eyes so that a 33 cm target could only be seen with one eye, while the fellow eye was looking at the open field with no fixation mark. In this way the DA was measured for the fixating eye and the CA for the non‐fixating eye. Then the fixation mark position was switched over and the test was repeated. The difference (Δ=СА – DА) between CA and DА was calculated

Results In all cases of hyperopia and emmetropia, consensual accommodation was equal to direct accommodation (Δ=0.02±0.03 D and 0.06±0.02 D, respectively). In low and moderate myopia, an insignificant difference was noted between СА and DA (respectively 0.16±0.04 D and 0.23±0.03 D). In high and anisometropic myopia, the difference was significant: Δ=0,27±0.04 D and 0.48±0.07 D, respectively (р<0.05).

Conclusion CA and DA did not differ in patients with hyperopia and emmetropia. Mismatch of DA and CA was found in high and anisometropiс myopia. This symptom may have diagnostic and prognostic value for progressive myopia.
The relationship between halo size and intraocular light scatter in normal healthy subjects
Authors: PUELL MC , PEREZ‐CARRASCO MJ , PALOMO‐ALVAREZ C , BARRIO AR
Published: November 2013

Purpose To determine the relationship between the size of a halo in the visual field induced by bright light and the intraocular light scatter in normal healthy eyes.

Methods Measurements were made in the right eyes of 66 healthy subjects (mean age 33 ± 9 years). Using the Vision monitor, optotypes of low luminance (1 cd/m2) were presented at a distance of 2.5 m. The visual angle subtended by the radius of the halo was calculated in minutes of arc (arc min). Retinal straylight was measured with the compensation comparison technique. Best‐corrected distance visual acuity (BCVA) was evaluated with logMAR Bailey‐Lovie letter charts.

Results The mean radius of the halo was 199.3 ± 45.6 arc min, mean retinal straylight was 0.98 ± 0.13 log units and mean BCVA was ‐0.02 ± 0.07 logMAR. There was a significant positive correlation between halo radius and straylight (r = 0.32, p < 0.01) and between halo radius and BCVA (r = 0.36, p < 0.01). However, no significant relationship was found between retinal straylight and BCVA.

Conclusion Higher intraocular light scatter levels were related to larger halo size in healthy human eyes.
VEP evidence of significant differences in motion perception in children
Authors: KUBOVA Z , KUBA M , KREMLACEK J , LANGROVA J , SZANYI J , VIT F , CHUTNA M
Published: November 2013

Purpose In adults the motion‐onset visual evoked potentials (M‐VEPs) represent a useful diagnostic tool in neuro‐opthalmology (Kuba et al.,Vision Res., 2007, 47, 189‐202) since they test quite selectively the magnocellular system/dorsal stream function. Whilst in adults robust M‐VEPs with low variability can be acquired easily, it is difficult to record and evaluate them in children. They not only display very long maturation and age dependent shape development (Langrova et al., Vision Res., 2006, 46, 536‐544) but in some children they are unidentifiable to standard stimuli.

Methods To understand better this problem we tested 30 normal children aged 7 ‐ 12 years. Two types of motion stimuli were used – translation motion (TM) and expansion/contraction motion (EXCOM).

Results Reliable VEPs were detected in 77% of children to TM and in 83% of children to EXCOM. The dominant peak of the VEPs was negative in all TM VEPs and in 80 % of EXCOM VEPs (positive in 20%). In both VEP variants the latency of the negative peak did not shorten significantly in the tested age range and there was large interindividual latency variability (176 ms – 268 ms). High contrast stimuli (non‐optimal “magno” stimulus) shortened the M‐VEPs latencies and enlarged amplitudes in majority of subjects. M‐VEPs to peripheral stimulation (outside central 20°) were in contrast to adults detectable only in 43 % of children.

Conclusion These findings show distinct differences in maturation of motion perception in children, which makes a diagnostic use of M‐VEPs in children quite complicated. Acknowledgement: Supported by the project PRVOUK ‐ P37/07.
Upper hemiretinal occult retinopathy
Authors: KRASTEL H , BEUTELSPACHER S , ROSER O , UDODOV E , SCHLICHTENBREDE F , JONAS J
Published: November 2013

Purpose To emphasize the significance of photopsias and positive scotomas as subjective indicators of occult retinopathy.

Methods The patient’s depiction of his photopsias led to a diagnostic work‐up by white and red static and kinetic perimetry, OCT, and visual electrophysiology.

Results Within the OD lower visual field our patient encountered a rapid loss of color vision. In dark environs, coloured photopsias showed up in this region, in bright environs, a positive black scotoma developped over time. Kinetic perimetry revealed a relative lower hemifield scotoma by white and an absolute one by red targets. On static perimetry, a distinct lower hemifield scotoma improved for white but persisted for red stimuli during 3 years of follow up. Retinal origin of the scotoma was proven by mf ERG. Serology for anti‐retinal antibodies remained negative. Difficult to detect by ophthalmoscopy, an affection of the OS / RPE layer in the corresponding fundus area was proven by SD OCT.

Conclusion Coloured photopsias in dark, a black positive scotoma in bright envorons are salient symptoms of this upper hemifield occult retinopathy. OCT, visual fields and electrodiagnostic findings point towards a variant of AZOOR (acute zonal occult outer retinopathy).
Progression of visual field in patients with primary open‐angle glaucoma (1): Preliminary results
Authors: APTEL F , GIRAUD JM , ARYAL‐CHARLES N , EL CHEHAB H , MAY F , CHIQUET C , ROMANET JP , RENARD JP
Published: November 2013

Purpose To evaluate the visual field rate of progression of patients with treated ocular hypertension (OHT) and primary‐open angle glaucoma (POAG).

Methods From a multicentric database, 441 eyes of 228 patients with treated ocular hypertension or POAG followed up at least 6 years with Humphrey 24.2 Sita‐Standard visual field examination at least twice a year were identified. From initial data, eyes were classified in 5 groups: 104 ocular hypertension, 205 early glaucoma (MD>‐6dB), 45 moderate glaucoma (MD ‐6 to ‐12dB), 41 advanced glaucoma (MD ‐12 to ‐18dB) and 46 severe glaucoma (MD<‐18dB). Rate of progression during the follow‐up period was calculated using the trend analysis of the Guided Progression Analysis software.

Results The mean duration of follow‐up was 8.4 years. We found a significant positive association between initial MD and rate of progression in early, moderate and advanced glaucoma (p<0.04). Rate of progression was ‐0.06 dB/year (‐0.19 %VFI/year) in eyes with ocular hypertension, ‐0.24 dB/year (‐0.75 %VFI/year) in eyes with early glaucoma, ‐0.45 dB/year (‐1.72 %VFI/year) in moderate glaucoma, ‐0.54 dB/year (‐2.44 %VFI/year) in advanced glaucoma, and ‐0.45 dB/year (‐1.97 %VFI/year) in severe glaucoma.

Conclusion In early to advanced stages of glaucoma, the rate of progression worsened as the severity increased, but became smaller in latest stage of the disease.
Comparative analysis of hyperaemia rate between preservative‐free latanoprost and preserved prostaglandin eyedrops. An adjusted indirect comparison meta‐analysis
Authors: ROULAND J , CUCHERAT M
Published: November 2013

Purpose For the evaluation of hyperaemia, differences in measurement process could exist between the trial in terms of definition, procedure, follow‐up, etc. These differences make the comparison of absolute rate or proportion of patients with hyperaemia between the trial inappropriate and potentially confused by these differences. To avoid this problem, meta‐analysis does not pool absolute proportion but odds ratio (or risk ratio). Odds ratios make implicit adjustment for this kind of difference by using the value observed in the control group as reference. The technique of “adjusted indirect comparisons” are based on this principle and were used to assess tolerability of a preservative free latanoprost compared to preserved prostaglandins for the treatment of open‐angle glaucoma (OAG) and ocular hypertension (OH)

Methods The meta‐analysis was performed according to a protocol established before the start of the literature search and data analysis. It was conducted and reported according to the recent PRISMA statement. The main endpoints were intraocular pressure (IOP) and hyperaemia

Results Twenty‐one studies were included. The risk of hyperaemia was statistically significantly lower with preservative‐free latanoprost than with polyquaternium‐1‐travoprost (OR [95%CI]: 0.24 , sofzia‐travoprost (0.37 ), BAK‐bimatoprost 0.03% (0.18 ]), BAK‐bimatoprost 0.01% (0.27 ), BAK‐tafluprost (0.18 ), BAK‐travoprost (0.25 ) and BAK‐latanoprost (0.52 [

Conclusion The risk of hyperaemia was found statistically significantly lower with preservative free latanoprost than with all the preserved prostaglandin analogs comprised in the metaanalysis.

Commercial interest
Comparison of Esnoper® implant placement in non penetrating deep sclerectomy
Authors: IBANEZ J , PéREZ GARCíA D , ASCASO PUYUELO FJ , CRISTóBAL BESCóS JA
Published: November 2013

Purpose To compare the efficacy and safety of the Esnoper® implant in non penetrating deep sclerectomy (NPDS) with the implant placed in two different positions: under the scleral flap (in the scleral lake) versus a portion of the implant introduced in the suprachoroidal space.

Methods Retrospective analysis of 40 eyes of 30 patients who underwent NPDS, being the implant Esnoper® placed under the scleral flap in Group A (22 eyes) and a part of it in suprachoroidal space in Group B (18 eyes).

Results In group A, the IOP decreased from 22,8± 4,2 mmHg to 15,1 ±2,9 mmHg and a group B from 23,4±3,1 mmHg to 13,9 ±3,1 mmHg (p< 0,05). The difference in the postoperative IOP between both groups was stadistically non significant (p>0,05). Anti‐glaucoma medications decreased from 2,81±0,5 to 0,8±0,1 in group A, and from 2,9±0,5 to 0,2± 0,4 in group B, being this difference stadistically significant (p<0,05). Qualified success was found in all patients (100%) in both groups. Complete success (IOP without treatment) was achieved in 14/22 (63,3%) eyes in group A and in 15/18 (83,3%) eyes in group B. The average follow up was 1 year .

Conclusion The IOP‐lowering effect and safety of scleral and suprachoroidal Esnoper® implant seem to be comparable, but fewer anti‐glaucoma medications were required with the implant partially introduced in the suprachoroidal space.
Neovascular glaucomas after central retinal artery occlusions
Authors: DEGOUMOIS A , MIOCQUE S , DENION E
Published: November 2013

Purpose Neoovascular glaucoma after acute central retinal artery occlusion (CRAO) is underestimated. It is a serious complication, that can be prevented.

Methods This retrospective study included all consecutive cases treated in Caen University Hospital (France), between January 2010 and December 2012. We studied the incidence of neovascular glaucoma in this cohort, the delay of onset, and the degree of arterial repermeabilisation on flurescein angiography. Patients with pre‐existing ocular neovascularisation or evidence of ocular ischemic syndrome were excluded. We reviewed the literature about the diagnostic, therapeutic and epidemiological aspects of neovascular glaucoma after CRAO.

Results Among thirty one patients with acute central retinal artery occlusion, five developed neovascular glaucoma (16%). These five patients had poor revascularisation, that was not diagnosed by the fundus examination. The time interval between the occlusive event and the neovascular glaucoma ranges from 7 weeks to 7 months. Patients were all treated with topical antiglaucoma drops. A panretinal photocoagulation (PRP) was done in 4 cases, associated with intravitreal bevacizumab injection in 2 cases, and with a transscleral cyclophotocoagulation with diode laser in one case.

Conclusion Neovascular glaucoma is the height of CRAO. To prevent it, a fluorescein angiography should be performed a few deay after each CRAO to evaluate the repermeabilisation. If it is not good, a PRP should be quickly started, associated with a close follow up.
Hemifield pattern electroretinogram, frequency doubling technology and optical coherence tomography for detection of early glaucomatous optic neuropathy in ocular hypertensive patients
Authors: CELLINI M , FINZI A , STROBBE E , CAMPOS E
Published: November 2013

Purpose To assess which is the most sensitive and specific exam for detecting early glaucomatous damage in ocular hypertensive patients (OH) among hemifield test pattern electroretinogram (PERG HF), frequency doubling technology (FDT) and optical coherence tomography retinal nerve fiber layer (OCT RNFL).

Methods Fifty‐two OH patients (mean age of 56±9.6 yrs) with an intraocular pressure (IOP)>21mmHg and 52 healthy controls (mean age of 54.8±10.4 yrs) with IOP<21mmHg were assessed. All the patients had normal visual acuity, normal optic disc appearance and normal standard achromatic perimetric (SAP) indices. All subjects underwent OCT, FDT and PERG examination. Data were analyzed with Mann‐Whitney test and Receiver Operating Characteristic (ROC) curve analysis.

Results OH patients showed thinner OCT‐RNFL than controls, especially in the superior and inferior quadrant (respectively, 130.16±10.02 vs 135.18±9.27μm; p<0.011 and 120.14±11.0 vs 132.68±8.03μm; p=0.001) and a significantly higher FDT pattern standard deviation (PSD) (3.46±1.48 vs 1.89±0.7dB; p=0.001). As regards PERG examination, the amplitude of the N95 wave of the lower and upper PERG HF showed significant differences (respectively, p=0.037 and p=0.023) between the two groups. ROC curve analysis revealed a sensitivity of 92% and specificity of 86% for FDT PSD (with an area under the ROC curve of 0.942), whereas by using OCT

Conclusion Our study show that FDT and PERG HF are the most sensitive and specific exams for detecting early glaucomatous damages in eyes with OH and can be useful in identifying those patients who may develop glaucoma and who need hypotensive ocular medications.
Structure function relationship: Specific index of ganglion cell complex assessment of 2 spectral domain OCT and standard automated perimetry
Authors: EL CHEHAB H , DELBARRE M , FENOLLAND JR , MARéCHAL M , ZERROUK M , FRANCOZ M , OUANEZAR S , GIRAUD JM , MAÿ F , RENARD JP
Published: November 2013

Purpose To investigate structure function relationship between specifics parameters of structural damage analyzed by OCT RTVue100 (Optovue, Inc.) and CirrusHD‐OCT (Carl Zeiss Meditec) with functional parameters of standard automated perimetry (SAP).

Methods 143 open angle glaucoma and 43 control eyes were included. They underwent a macular grid exam with RTVue100, CirrusHD‐OCT and 24°2 and 10°2 SAP (Humphrey SITA‐standard). Specifics structural parameters analyzed were Global and Focal Loss Volume (GLV and FLV) with RTVue, average and minimum Ganglion Cell and Inner Plexiform Layer (GCIPL) thickness with CirrusHD‐OCT. Functional parameters collected were MD, PSD and VFI for 24°2 SAP and MD and PSD for 10°2 SAP. A Student t‐test was performed to compare parameters and a logistic regression to calculate Pearson coefficient (r) studying correlation between structural and functional parameters.

Results Glaucoma group had a significant functional (in 24°2 and 10°2 SAP) and structural impairment compared to control. Logistic regression analysis found a linear correlation between structural and functional parameters. The highest Pearson coefficient with OCT RTVue was between FLV and PSD in 24°2 SAP (r=0.72) and for CirrusHD‐OCT between minimum GCIPL and PSD in 24°2 SAP (r=0.56).

Conclusion This study objectives a strucutre function relationship between specifics focal structural indices (FLV and GCIPL‐Min) assessed with these 2 SD‐OCT and functional (PSD) parameters damage. It would be interesting to confirm this new approch of SFR with these specific structural parameters.
Choroidal thickness in open‐angle glaucoma
Authors: STEINMETZ P , JONAS JB
Published: November 2013

Purpose To examine choroidal thickness in open‐angle glaucoma in a hospital‐based case series study

Methods Choroidal thickness was measured by enhanced depth imaging of spectral domain optical coherence tomography. The study group included patients with open‐angle glaucoma and the control group consisted of subjects with a normal fundus.

Results The study group included 71 eyes (39 patients) and the control group consisted of 189 patients (228 eyes) with significant difference between both groups in age (P=0.16) and refractive error (P=0.07). Choroidal thickness in the foveal region (P=0.18), at a distance of 1000 µm from the fovea (P=0.39), at a distance of 2000 µm from the fovea (P=0.46), and at a horizontal distance of 2500 µm from the fovea (P=0.53) did not vary significantly between both groups. In multivariable analysis with adjustment for age and refractive error, subfoveal choroidal thickness (P=0.12; regression coefficient B: ‐8.60; 95%CI: ‐19.3, 2.1), choroidal thickness at a horizontal distance of 1000 µm from the fovea (P=0.30; B: ‐4.98 (95%CI: ‐14.3, 4.4)), 2000 µm from the fovea (P=0.20; B: ‐20.9 (95%CI: ‐53.2, 11.3)) and 2500 µm from the fovea (P=0.45; B: ‐2.70 (95%CI: ‐9.67, 4.27)) was not significantly associated with the diagnosis of glaucoma. In binary regression analysis with adjustment for age and refractive error, presence of glaucoma was significantly associated neither with subfoveal choroidal thickness (P=0.12; OR: 0.997 (95%CI: 0.993, 1.001)), nor with choroidal thickness at a horizontal distance of 1000 µm from the fovea (P=0.47; OR: 0.998 (95%CI: 0.993, 1.002)).

Conclusion After adjusting for age and refractive error, open‐angle glaucoma was not significantly associated with a marked thinning or a thickening of the choroid in the foveal and parafoveal region.
Eye problems in deaf children: A case‐control study
Authors: OSTADIMOGHADDAM H , MIRHAJIAN H , SOBHANI RAD D , YEKTA A , HERAVIAN J , KHABAZKHOOB M
Published: November 2013

Purpose To compare the prevalence of refractive errors and amblyopia between deaf and normal children

Methods In this case control study, cases were selected from deaf school children in Mashhad. The control group consisted of children with no hearing problem. The sampling was done utilizing the cluster sampling method. All of the samples underwent refraction, cover test and visual examinations.

Results 254 children in case group and 506 children in control group were assessed. The mean spherical equivalent was 1.7±1.9 D in case group, which was significantly different from the control group (0.2±1.5) (p<0.001). The prevalence of hyperopia was 57.15 and 21.5% in case and control groups, respectively. But myopia was mostly seen in the control group (p=0.007). Mean cylinder was 0.65 ±1.3 D and 0.43±0.62 D in case and control groups, respectively. Logistic regression showed that the chance of Amblyopia was significantly greater in cases.

Conclusion Comparing with children in the same ages, deaf children have much more eye problems; therefore there must be a possible relation between deafness and eye problems. Paying attention to assessing eye health in deaf children, may prevent them from adding eye problems to deaf difficulties.
Profiling miRNAs in a hyperglycemic and hypoinsulinemic Ins2Akita mouse model
Authors: GIOCANTI‐AUREGAN A , AHN L , TSANG SH , SANCHO‐PELLUZ J , KISS S , ROSENBLATT MI , TUSCHL T , PENA JTG , D’AMICO DJ
Published: November 2013

Purpose Diabetic retinopathy (DR) is a leading cause of blindness. Our goal is to identify novel genetic targets involved in DR. microRNAs (miRNAs) are non‐coding RNAs that regulate gene expression. The purpose of this study is to characterize the in vivo perturbations of retinal miRNAs in a hyperglycemic and hypoinsulinemic mouse model. Here, we characterize the vascular and macroscopic anatomic properties of the Ins2Akita mouse and then profiled the miRNA abundance longitudinally, using a cost effective multiplexed next generation sequencing method.

Methods Heterozygous male Ins2Akita with a mutation in the insulin 2 gene, were age matched with C57BL6/J mice. We analyzed: vascular permeability by Evans blue extravasation, performed fundus photography and fluorescein angiography, and surveyed for functional visual impairment by electroretinography (ERG). Then, we measured miRNA abundance in the retina and choroid/retinal pigmented epithelium (RPE) at several time points using multiplexed libraries of Ins2Akita and wild‐type mice at 1 and 3 months of age.

Results Morphological changes and fluorescein angiogram abnormalities were identified in the retinas of Ins2Akita at 1 and 3 months. We observed substantially increased vascular permeability in Ins2Aktia retina at 3 months. Functional changes were observed by ERG at 6 months of age. miRNA profiles were generated for Ins2Akita and control mice (1 and 3 months), which showed substantial down regulation of several miRNAs including miR‐126 and miR‐143 in the choroid/RPE, when compared to control.

Conclusion miRNAs identified offer potential targets for genetic modulation in hyperglycemic induced pathology in the eye