bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital aphakia in Peters' anomaly syndrome
Authors: Trabucchi G. , Piantanida A. , Bandello F. , Freschi M. , Nucci P. , Brancato R.
Published: May 2009

The authors report a case of congenital bilateral corneal opacities in which one of the eyes was enucleated because of malignant glaucoma and corneal perforation. Corneal defects and iridocorneal adhesion were found, but aphakia was the major pathologic ocular finding. The clinical picture and pathology study indicated this case as a Peters' anomaly presenting congenital aphakia.
Peripheral colour contrast thresholds in ocular hypertension and glaucoma
Authors: Friström Björn
Published: May 2009

Purpose: To evaluate a new test for peripheral colour contrast sensitivity as a tool for early diagnosis of glaucoma.

Patients and Methods: Peripheral colour contrast sensitivity was measured by a computer and colour monitor system developed by Arden and co‐workers. The monitor displays an annulus subtending 25° at the retina. During the test, 45° of the annulus is removed in one of four quadrants. The patient is asked to identify this quadrant, first at suprathreshold levels and then as the colour contrast between the annulus and the background is varied in order to establish the threshold for identification. The tested colours were varied along the protan, deutan and tritan colour confusion axes, respectively. Thirty‐three normal subjects, 22 glaucoma patients and 69 ocular hypertensive patients were examined. The ocular hypertensive patients were divided into a low risk group, a medium risk group and a high risk group.

Results: The colour contrast thresholds for the glaucoma group and the high risk ocular hypertensive group were significantly (p<0.001) higher for all three colour axes compared with the normal group. There were also significant (p < 0.05‐0.001) differences for all axes between the glaucoma group on the one hand and the ocular hypertensive low risk group on the other hand. There were, however, overlaps in colour contrast thresholds between all groups.

Conclusion: Although there is a large and statistically significant difference in average colour contrast thresholds between normals and glaucoma patients, it was difficult to find an appropriate cut‐off point to separate the two groups. Further studies must clarify the influence of early stages of common diseases such as cataract, diabetes and age‐related maculopathy on colour contrast sensitivity.
Antibodies against a furosemide binding protein from Ehrlich ascites tumour cells inhibit Na+, K+, Cl− co‐transport in frog retinal pigment epithelium
Authors: la Cour M. , Bækgaard A. , Zeuthen T.
Published: May 2009

Purpose: To investigate whether antibodies against a 100 kDa protein purified by furosemide affinity chromatography from Ehrlich ascites tumour cells could inhibit Na+, K+, Cl− co‐transport in the isolated frog retinal pigment epithelium.

Methods: The rate of Na+, K+, Cl− co‐transport across the retinal membrane in the isolated frog RPE preparation was measured as the rate of decrease in the intracellular Cl− activity observed after administration of furosemide in the apical bath. The intracellular Cl− activity was measured with double barrelled Cl− sensitive microelectrodes.

Results: Incubation of frog retinal pigment epithelium for 30 min with antibodies reduced the rate of Na+, K+, Cl− co‐transport by 43%, while leaving all other measured electrophysiological parameters intact.

Conclusion: The antibodies inhibit Na+, K+, Cl− co‐transport in the frog retinal pigment epithelium. This could be due to binding of the antibodies to the co‐transporter itself or to a regulatory protein.
Transvitreal retino‐choroidal biopsy of suspected malignant lesions of the choroid
Authors: Jensen O. A. , Prause J. U. , Scherfig E.
Published: May 2009

The cases of transvitreal retino‐choroidal (TVRC) biopsy from 1987 to 1994 were assembled in order to examine the efficiency, complications and risks to patients. Of 92 biopsies 91 had sufficient material for diagnosis. Eighty (87%) contained malignant tissue, whereas 10 cases were negative and two unsuccessful. Tumours of appropriate size were treated by brachytherapy. Twenty‐three large tumours were enucleated primarily. Eight irradiated eyes had to be removed. In 31 cases, therefore, it was possible to examine the whole tumour for changes caused by the biopsy and to compare the typing of the biopsy with that of the whole tumour. In the irradiated eyes histologically viable tumour cells remained mostly in the inner part of the tumour. Scleral necrosis was not found. The technique used appears to be safe. Histological verification is highly recommended before any conservative therapy, inter alia to obtain true statistics of therapeutic results.
Effects on intraocular pressure and aqueous flow of various dose regimens of latanoprost in human eyes
Authors: Lindén Christina , Alm Albert
Published: May 2009

Purpose: To examine if different dose regimens of latanoprost cause a difference in daytime intraocular pressure (IOP) in normal eyes and if such changes could be attributed to an increase in aqueous flow.

Methods: In a randomised, open, cross‐over study latanoprost 50 μ/ml was instilled in one eye of 18 volunteers. Three dose regimens (one/three drops once daily or one drop twice daily) were evaluated. IOP was measured at the end of each 14‐day treatment period. Aqueous flow and endothelial permeability were assessed by fluorophotometry.

Results: All dose regimens reduced IOP significantly (p<0.001). Once daily applications reduced IOP more than twice daily (p<0.01). No statistically significant difference in aqueous flow was detected between different treatments. One drop daily increased aqueous flow compared with control eyes (p<0.05). A similar, but not statistically significant tendency was present with the other regimens. Corneal endothelial permeability was not affected.

Conclusion: Once daily applications of latanoprost reduce IOP more effectively than twice daily in normal subjects. This cannot be explained by an increase in aqueous flow.
Eye size in healthy Swedish children and in children with fetal alcohol syndrome
Authors: Hellström Ann , Svensson Elisabeth , Strömland Kerstin
Published: May 2009

Purpose: This study set out to collect reference data for normal ocular growth and to study the teratological effects of alcohol on eye development.

Methods: Eye size was studied in 92 healthy Swedish children (age 1 month to 16 years) as reference and in 13 children (age 1.4 months to 17 years) with fetal alcohol syndrome (FAS) using ultrasonographic axial length measurements. Another three children with FAS were evaluated by clinical examination only.

Results: The control group demonstrated a marked increase in total axial length during the first 2 years of life. Girls with FAS had a shorter total axial length (p = 0.045) than their controls. Both boys and girls with FAS demonstrated a relatively smaller vitreous body than the controls, p = 0.015 and 0.068, respectively. Three children with FAS had severe structural anomalies.

Conclusion: The observations support previous studies indicating that alcohol has an adverse effect on growth and configuration of the eye.
Cataract surgery and pupil size in patients with diabetes mellitus
Authors: Zaczek Anna , Zetterström Charlotta
Published: May 2009

Purpose: Constriction of the pupil during phacoemulsification and intraocular lens (IOL) implantation in patients with diabetes mellitus was studied. Methods: Before surgery a combination of 0.75% cyclopentolate and 2.5% phenylephrine was applied topically to the eyes of 32 patients with diabetes mellitus and 25 age‐matched controls. Epinephrine was mixed with buffered saline solution and used during the surgery. The surgical procedure included capsulor‐hexis, phacoemulsification in the posterior chamber and implantation into the capsular bag of a heparine surface‐modified poly (methyl metacrylate) IOL with an optic diameter of 5.0 mm. The durations of phacoemulsification and the whole surgical procedure were recorded. Measurements of the horizontal pupillary diameter were taken before surgery, after phacoemulsification and at the end of the surgery.

Results: There was no significant difference in pupil size between controls and the diabetic group before the operation. Surgically induced miosis after phacoemulsification and at the end of operation were significantly more pronounced in the diabetic group than in controls (p<0.05) (p<0.05). Phacoemulsification and the entire surgical procedure took significantly longer time when performed in the diabetic eyes (p<0.05) (p<0.05).

Conclusion: We conclude from these data that constriction of the pupil during cataract surgery is more pronounced in diabetic eyes as compared to controls.
The effect of heparin‐coated intraocular lenses on intraocular pressure following combined trabeculectomy and cataract surgery
Authors: Hugkulstone C. E. , Sadiq S. A. , Rubasingham A. S.
Published: May 2009

Purpose: To review the effects on intraocular pressure control of the use of standard and heparin‐coated intraocular lenses (IOLs) following combined cataract and glaucoma surgery after a minimum period of 2 years.

Methods: Case note review of all patients with glaucoma who required cataract extraction combined with trabeculectomy and who were randomized to either of the two IOL types. The number of ocular hypotensive medications and the intraocular pressures were recorded pre‐operatively and at 3,6,18 and 24 months following surgery.

Results: The two groups (9 receiving standard IOLs and 10 heparin‐coated IOLs) were comparable for age, sex and follow‐up, as were the pre‐operative intraocular pressures and number of treatments. Post‐operatively, all patients achieved an intraocular pressure < 21 mmHg at the final visit, with only one patient in each group requiring topical medication, but the standard lens group had a higher intraocular pressure at 2 years (p<0.05). The magnitude of the fall from the pre‐operative values was greater in the heparin‐coated lens group at 2 years after surgery (p<0.02). The presence of a visible drainage bleb occurred equally frequently in the two groups.

Conclusions: Use of a heparin‐coated IOL does not adversely affect the intraocular pressure control following combined cataract and drainage surgery. The greater fall in intraocular pressure at 2 years in those receiving a heparin‐coated IOL may have occurred by chance.
The effect of posterior vitreous detachment on the prognosis of branch retinal vein occlusion
Authors: Avunduk Avni Murat , Çetinkaya Kubilay , Kapicioǧlu Zerrin , Kaya Can
Published: May 2009

Purpose: Two important complications causing visual loss in retinal branch vein occlusions are vitreous hemorrhage due to retinal neovascularization and persistent macular edema. The aim of this study was to identify the effect of the total posterior vitreous detachment on the disease prognosis.

Methods: Fifty‐three patients with temporal branch vein obstruction were followed for eighteen months on average. The vitreous conditions of all patients were established, and the effect on persistent macular edema and retinal neovascularization development was statistically investigated.

Results: This prospective study shows that total posterior vitreous detachment has a clear preventive effect on both complications.

Conclusion: Careful vitreous examinations of all patients with branch retinal vein occlusion give us important information about the prognosis and patient management.
A leiomyoma of the iris documented by immunohistochemistry and electron microscopy
Authors: Eide Nils , Farstad Inger Nina , Røger Magnus
Published: May 2009

Purpose: To report an iris leiomyoma documented in accordance with today's stricter diagnostic criteria.

Methods: Light microscopy, immunohistochemistry and electron microscopy were performed on the 3 mm ball‐like, greyish‐white vascularized tumour of the iris, close to the sphincter pupillae.

Results: Light microscopy of the extirpated neoplasm showed the characteristic appearance of a leiomyoma with densely packed spindle‐shaped cells, with oval nuclei and granular cytoplasm. On electron microscopic examination the tumour exhibited the characteristic features of a smooth muscle neoplasm. The immunohistochemistry was consistent with a myogenic tumour because the tumour cells were positive for smooth muscle actin and desmin, but negative for S‐100 and melanin.

Conclusion: The case illustrated the necessity of performing ancillary procedures such as electron microscopy and immunohistochemistry to substantiate a correct, although rare diagnosis.
Histopathological and ultrasound biomicroscopy findings in a case of irreversible mydriasis after keratoplasty in keratoconus
Authors: Gonzalez Francisco , Suarez‐Peñaranda Jose M. , Diez‐Feijoo Elio , Pazos Belen , Sanchez‐Salorio Manuel
Published: May 2009

This report describes the histopathological and ultrasound bio‐microscopy findings of a 35–year‐old woman with keratoconus who developed an irreversible mydriasis after keratoplasty.
Nonsurgical and surgical methods of sclera reinforcement in progressive myopia
Authors: Avetisov E. S. , Tarutta E. P. , Iomdina E. N. , Vinetskaya M. I. , Andreyeva L. D.
Published: May 2009

Purpose: As shown by the clinical picture of progressive myopia, derangements in biomechanical properties of sclera may be more or less manifested. The study aims at the development of a discriminating approach to their correction.

Methods: Patients with the condition were given a sclera strengthening injection, in which a dose of liquid polymeric composition is injected under the Tenon's capsule on the scleral surface. After polymerization, the composition forms over the scleral surface a layer of elastic foamed gel.

Results: Complex experiments on 146 rabbit eyes showed that the injected material promotes collagen formation. Gradually dissolving, the gel stimulates the growth of connective tissue on the surface of the sclera, whose stress‐strain parameters improve. A thorough clinical study of 240 eyes of patients aged 8–25 years with progressive 6–10 D myopia showed that the refraction remained stable in 79.6% eyes 1 year after the sclera strengthening injection and in 52.9% cases 4–9 years after the sclera strengthening injection. At the same time, fellow intact eyes have shown, respectively, 40.3% and 13.3% of myopia stabilization, and 212 untreated eyes of the control group 26.0% and 11.1%, respectively. 612 children and adolescents with high myopia and a yearly progression of over 1.0 D were subjected to a scleroplastic operation. It was found that the myopia remained stable in 95.7% cases 1 year after the operation, and in 71.9%, 7 years after the operation. If myopia progression continued after a sclera strengthening injection or scleroplasty, a second procedure was performed. Second interventions were effected on 118 eyes of 102 patients, including 42 eyes where a sclera strengthening injection followed a sclera strengthening injection, 27 eyes where scleroplasty followed a sclera strengthening injection, 31 eyes where a sclera strengthening injection followed scleroplasty, and 18 eyes on which a second scleroplasty was performed. Second interventions provide a double decrease of myopia progression rate and, in 63% of patients, stop the progression altogether.

Conclusion: It can be concluded that nonsurgical and surgical techniques of correcting the biomechanical properties of sclera for the treatment of progressive myopia as well as discriminative methods of determining the indications to these procedures have proven to be effective.
Confocal microscopy using oblique sections for measurement of corneal epithelial thickness in conscious humans
Authors: Prydal J. I. , Muir M. G. Kerr , Dilly P. N. , Corbett M. C. , Verma S. , Marshall J.
Published: May 2009

Purpose: Thickness measurements by confocal microscopy in conscious human subjects may be liable to error as a result of instability of the eye or instrument. Our aim was to evaluate a technique which was expected to be less sensitive to such problems.

Method: Thickness of corneal epithelium was determined from oblique confocal sections through cornea. A contact lens of known thickness worn by subjects was used to calibrate images.

Results: There were two layers in images which could have corresponded to the stromal/epithelial interface. The mean result in each subject ranged from 38 to 53 μm using the more superficial layer and 46 to 60 μm using the deeper one. The smaller values gave the distance between the epithelial surface and the subepithelial nerve plexus and thus seemed to correspond to epithelial thickness.

Conclusions: Measurements of epithelial thickness by our new method are comparable with results of earlier studies.
Comparison of objective methods for quantifying the refractive effect of photo‐astigmatic refractive keratectomy using the MEL‐60 excimer laser
Authors: Olsen Hanne , Hjortdal Jesper Ø. , Ehlers Niels
Published: May 2009

Purpose: To investigate the accuracy and precision of automated keratometry, automated refractometry, and computerized corneal topography in estimating the subjective refractive outcome of photo‐astigmatic refractive keratectomy six months postoperatively.

Methods: Photo‐astigmatic refractive keratectomy (Aesculap‐Meditec, MEL‐60 Excimer Laser) was performed on 26 eyes with a preoperative myopia ranging from − 4.0 to 7.6 dioptres, and a naturally occurring astigmatism from 0.75 to 5.0 dioptres, Six months postoperatively refractive outcome was evaluated by automated keratometry, automated refractometry (Nikon NRK‐8000), computerized topography (TMS‐1), and subjective refraction. Estimate errors were computed as the difference between the change in subjective refraction and the change in automated keratometry, automated refractometry, and surface topography, respectively. Astigmatic changes were evaluated by the second harmonic component in the Fourier series analysis.

Results: Subjective spherical as well as cylindrical values were reduced significantly six months postoperatively. The estimate error (mean ± one standard deviation) for automated keratometry was −1.26 ± 0.72 dioptres for the spherical equivalent and −1.36 ± 1.02 dioptres for the cylinder; for automated refractometry it was −0.78 ± 0.91 dioptres for the spherical equivalent and − 0.66 ± 0.92 dioptres for the cylinder. The best estimates of subjective changes were obtained when the average of ring 2 and 3 of the topographic data was used: − 0.15 ± 0.82 dioptres for the spherical equivalent and − 0.78 ± 0.80 dioptres for the cylinder.

Conclusions: The computerized topographer with the Fourier analysis was superior to automated keratometry and automated refractometry in estimating the subjective spherical refractive outcome and comparable to automated refractometry in estimating the subjective cylinder refractive outcome after photo‐astigmatic refractive keratectomy.
Long‐term supplementation with alpha‐tocopherol and beta‐carotene and age‐related cataract
Authors: Teikari J. M. , Virtamo J. , Rautalahti M. , Palmgren J. , Liesto K. , Heinonen O. P.
Published: May 2009

Purpose: To study if long‐term supplementation with alpha‐tocopherol or beta‐carotene is associated with cataract prevalence and severity.

Methods: An end‐of‐trial random sample of 1828 participants from the randomized, double‐blind, placebo‐controlled clinical trial the alpha‐tocopherol, beta‐carotene cancer prevention study. The alpha‐tocopherol, beta‐carotene cancer prevention study was originally designed to examine whether supplementation with alpha‐tocopherol or beta‐carotene would reduce the incidence of lung cancer in male smokers. The participants for this study lived in Helsinki City or Uusimaa province and were at entry to the alpha‐tocopherol, beta‐carotene cancer prevention study 50 to 69 years old and smoked at least 5 cigarettes per day. They received alpha‐tocopherol 50 mg/day, beta‐carotene 20 mg/day, a combination of the two, or placebo supplements for 5 to 8 years (median 6.6 years). Outcome measures were: cortical, nuclear, and posterior subcapsular cataract, differentiated and quantified with lens opacity classification system (LOCS II). Lens opacity meter provided a continuous measure of cataract density.

Results: Supplementation with alpha‐tocopherol or beta‐carotene was not associated with the end‐of‐trial prevalence of nuclear (odds ratio 1.1 and 1.2, respectively), cortical (odds ratio 1.0 and 1.3, respectively), or posterior subcapsular cataract (odds ratio 1.1 and 1.0, respectively) when adjusted for possible confounders in logistic model. Neither did the median lens opacity meter values differ between the supplementation groups, indicating no effect of alpha‐tocopherol or beta‐carotene on cataract severity.

Conclusion: Supplementation with alpha‐tocopherol or beta‐carotene for 5 to 8 years does not influence the cataract prevalence among middle‐aged, smoking men.
Indocyanine green videoangiography of angioid streaks
Authors: Atmaca Leyla S. , Batioǧlu Figen , Atmaca Pelin
Published: May 2009

Purpose: This study was performed to define the indocyanine green angiographic features of angioid streaks and associated posterior pole lesions and to compare them with fluorescein angiography.

Methods: Digital fluorescein and indocyanine green videoangiography was performed on 16 eyes of 8 patients with angioid streaks.

Results: Streaks were hyperfluorescent in 15, hypo‐ and hyperfluorescent in 1 of the 16 eyes with fluorescein angiography. Indocyanine green angiography showed hyperfluorescent streaks in 10 and hypofluorescent streaks in 6 eyes. Of the hyperfluorescent streaks, 6 had a hypofluorescent line between fluorescent edges and 4 were made up of numerous hyperfluorescent spots. Peau d'orange appearance was more evident in indocyanine green angiography as dark, round spots throughout the posterior pole. Fluorescein angiography confirmed the presence of well‐defined choroidal neovascularization in 5 eyes. In one eye, occult choroidal neovascularization which was not evident on fluorescein angiography, became well‐demarcated on indocyanine green angiography.

Conclusion: Indocyanine green angiographic features of angioid streaks are different from fluorescein angiography. Angioid streaks and peau d'orange are more evident with indocyanine green angiography.
Induced astigmatism after 4 and 6 mm scleral tunnel incision
Authors: Dam‐Johansen Mikael , Olsen Thomas
Published: May 2009

Purpose: To study the surgically induced astigmatism after phacoemulsification through either a 4 or a 6 mm scleral tunnel incision by using multiple analyses of astigmatism.

Methods: 197 eyes from 186 patients scheduled for phacoemulsification between October 1992 and March 1994 were randomly assigned two different‐sized incisions with follow‐ups at 1 day, 1 week, 2 weeks, 1 month and 4 months after surgery. The surgically induced astigmatism was evaluated using at each follow‐up: 1) The subtraction method, 2) vector analysis, 3) vector decomposition, 4) Cravy's vertical vector, 5) Naeser's polar values, and 6) the algebraic method.

Results: By subtraction, without regard to axis, the induced astigmatism 4 months after surgery was + 0.04 D and + 0.18 D in the 4 mm and the 6 mm incision group, respectively. By vector analysis, the numerical value of the induced cylinder was stable one month after surgery at 0.61 D and 0.77 D in the 4 mm and in the 6 mm group, respectively. However, cylinder orientation was not found stable until 4 months after surgery, where 94% and 96% of the surgically induced astigmatism (vector decomposition) was against‐the‐wound in the two groups, respectively. By Cravy's method, the mean induced astigmatism changed from − 0.08 D to − 0.32 D and from − 0.42 D to − 0.60 D between 1 and 4 months in the 4 mm and the 6 mm group, respectively. Similar values were found with Naeser's method and with the algebraic method.

Conclusion: We conclude the mean cylinder of the surgically induced astigmatism (vector analysis) to be stable 1 month after phacoemulsification with both the 4 mm and 6 mm scleral tunnel incision. However, the direction of the induced axis (vector decomposition) was still drifting between 1 and 4 months in both groups. These astigmatic changes were adequately described using vector analysis and vector decomposition.
Video fluorescein angiography of the anterior eye segment in severe eye burns
Authors: Kuckelkorn Ralf , Remky Andreas , Wolf Sebastian , Reim Martin , Redbrake Claudia
Published: May 2009

Purpose: Severe eye burns often result in extensive necrosis of the conjunctiva and episcleral tissue. Video fluorescein angiography was performed to reveal the perfusion of the anterior eye segment after severe eye burns.

Methods: A scanning laser ophthalmoscope was used for anterior segment fluorescein angiography in 12 patients (14 eyes) with severe burns grade III‐IV and in 7 healthy volunteers.

Results: Necrotic tissues occurred as non perfused areas and remained dark throughout the whole angiogram. In general, the borders from healthy to necrotic conjunctival tissue were sharply demarcated. Thus, the extent of scleral and lim‐bal ischemia could be determined exactly. Injured vessels showed hyperfluores‐cence with late leakage. Damage of the subconjunctival tissue appeared as a deep weak fluorescence in the early angiography and exhibited patchy leakage in the late angiogram.

Conclusions: Anterior segment angiography provides a basis for deciding the extent of surgical debridement of necrotic tissue in the acute phase of the burn. The determination of the extent of limbal and scleral ischemia may give useful information for early plastic‐reconstructive procedures.
Visual impairment in Swedish children
Authors: Blohmé Jonas , Tornqvist Kristina
Published: May 2009

Purpose: To gain an overview of the spectrum of diagnoses among Swedish visually impaired children.

Methods: An epidemiological study of all known visually impaired children was made by review of medical records.

Results and conclusion: In all we found 2373 children, 0–19 years of age, with an age‐specific prevalence of 10.9/10 000. The two largest diagnostic groups included neuro‐ophthalmological and retinal diseases. The most frequent disorders were cerebral visual impairment, non‐hereditary optic atrophy, retinal dystrophy (when regarded as a general entity), congenital hypoplasia of the optic nerve and congenital cataract. Nystagmus secondary to brain disorder, albinism, congenital nystagmus, retinopathy of prematurity and high myopia were also found in a considerable number of patients. The leading diagnoses in children with WHO‐defined childhood blindness were non‐hereditary optic atrophy, cerebral visual impairment and retinopathy of prematurity. A large proportion of the children, especially in the groups with neuro‐ophthalmological disorders and malformations of the posterior segment had additional impairments, emphasizing the importance of a multi‐disciplinary approach when assessing multi‐handicapped children.
An outcome study of cataract surgery based on a national register
Authors: Steneviy Ulf , Lundström Mats , Thorburn William
Published: May 2009

Purpose: To test the viability of performing a national cataract outcome study with a national cataract register as a reference base.

Methods: Seven Swedish eye clinics participated. All patients operated during the month of January 1994 were included. The total number of patients was 605.

Results: This outcome study is based on few, but well defined parameters. On the basis of these measurements quality indicators are suggested that makes comparison between surgeons/clinics possible.

Conclusion: Outcome studies are different from controlled clinical trials. They are less time consuming and designed to describe the outcome of surgery in daily practise. An outcome study of cataract surgery does not replace the careful monitoring of each patient at the clinical level, which is necessary for the development of new surgical technics and medical treatments. However, an outcome study can provide an overall quality description of cataract surgery in the daily practise of any given surgical unit.
Evaluation of glaucoma patients referred to a university clinic during one year
Authors: Vuori Marja‐Liisa , Nikoskelainen Eeva
Published: May 2009

Purpose: In the spring of 1994, the post‐referral waiting time for glaucoma patients at our institution was approximately 7 months. In an attempt to evaluate and possibly reduce this waiting time we compared the referral criteria to the actual treatment requirements of 472 patients admitted for glaucoma in 1995.

Results: 175 patients were referred as glaucoma suspects, 134 as chronic simple glaucoma, and 123 as capsular glaucoma. In addition, 40 patients were referred as other types of glaucoma. Elevated IOP was the main criterion for referral in 133 (76%) of glaucoma suspects. The diagnosis of glaucoma could not, however, be confirmed in 54 (31%) glaucoma suspects. 93 (69%) patients with simple open angle glaucoma and 103 (84%) patients with capsular glaucoma were also referred because of IOP ≥ 22 mmHg. Maximally tolerated medication was not used by 44% of open angle glaucoma patients at time of referral.

Conclusion: The clinical follow‐up of glaucoma patients and glaucoma suspects should primarily take place at an ophthalmologist's office and the new effective glaucoma drugs and laser treatments should also be more actively in use. The cooperation between the referring ophthalmologists and the university clinic should be improved. Hospitalisation turned out to be unnecessary because, with a few exceptions, all procedures could have been performed on an out‐patient basis, which is a general practice in most glaucoma clinics today. The university clinic should focus only on those patients who need special evaluation or surgical treatment.
Nd:YAG laser removal of pupillary membranes developed after ECCE with PC‐IOL implantation
Authors: Kozobolis Vassilios P. , Pallikaris Ioannis G. , Tsambarlakis Ioannis G. , Vlachonikolis Ioannis G.
Published: May 2009

Purpose: To define the frequency of development of pupillary membranes after ECCE with PC‐IOL implantation, and to remove the pupillary membranes using the Nd:YAG laser.

Methods: From 400 patients who had undergone ECCE and were free from local or systemic illness affecting the blood‐ocular barrier, 20 eyes developed pupillary membranes Nd:YAG laser was used to remove these pupillary membranes.

Results: The frequency of pupillary membranes was found to be 5% (9.8% in pex eyes and 3.3% to the non‐pex eyes). Visual acuity improved in 17 eyes by 2 to 5 Snellen lines. No serious complications were observed, endothelium inclusive.

Conclusion: Pseudoexfoliation might play a significant role in the development of postoperative pupillary membranes which could be successfully treated with the use of Nd:YAG laser. The safety of the procedure has to be evaluated in relation to the corneal endothelium damage in long‐term.
The etiology of uveitis: The role of infections with special reference to Lyme borreliosis
Authors: Mikkilä Helena , Seppälä Ilkka , Leirisalo‐Repo Marjatta , Immonen Ilkka , Karma Anni
Published: May 2009

Purpose: To assess the distribution of different uveitis entities and to evaluate their associations with infections, especially Lyme borreliosis.

Methods: During a one‐year period 160 consecutive uveitis patients were evaluated in a university clinic. Selected tests were performed depending on the medical history of the patient and the clinical picture of the ocular inflammation.

Results: Uveitis was classified into selected entities for 74.4% of the patients. A direct infection was suggested to be linked with uveitis in 23 patients (14.4%). Lyme borreliosis, toxoplasmosis, and herpetic infections were the most frequently seen, in seven patients (4.3%) each. All patients with Lyme uveitis had manifestations of the posterior segment of the eye, such as vitritis, retinal vasculitis, neuro‐retinitis, chorioretinitis, or optic neuropathy.

Conclusion: Infections are an important cause of uveitis in a university clinic. Lyme borreliosis is a newly recognised uveitis entity which should be kept in mind in the differential diagnosis of intermediate or posterior uveitis in areas endemic for Lyme borreliosis.
Epidemiology of pseudoexfoliation in the island of Crete (Greece)
Authors: Kozobolis Vassilios P. , Papatzanaki Maria , Vlachonikolis Ioannis G. , Pallikaris Ioannis G. , Tsambarlakis Ioannis G.
Published: May 2009

Purpose: To evaluate the pseudoexfoliation (PEX) prevalence in the island of Crete (Greece).

Method: Organized visits to various villages, to examine a predetermined number of people born and living in these villages, in collaboration with the local birth register offices.

Results: PEX prevalence in Crete, in people aged 40 years and more, was found to be 16.1% (men: 21.3%, women: 12.6% ‐ Prefecture of: Heraklion 11.5%, Chania 13.4%, Lasithi 16.9%, Rethymnon 27%). 28.8% of PEX‐patients presented IOP >21 mmHg. In unilateral PEX‐patients, mean IOP of PEX‐eyes was found to be 17.82 mmHg versus 15.6 mmHg in fellow eyes.

Conclusion: PEX prevalence was higher in men than in women and increases with age, as does bilaterality. A correlation between increased PEX prevalence and high altitude may exist. PEX is a risk factor for the development of IOP disturbances which seem to appear earlier in women.
Acute glaucoma and acute corneal oedema in association with tularemia
Authors: Pärssinen Olavi , Rummukainen Maija
Published: May 2009

Purpose: To describe the clinical course of oculoglandular tularemia with acute glaucoma and corneal oedema.

Methods: Clinical course, results of laboratory assays and treatment of oculoglandular tularemia in a 58‐year‐old woman.

Results: The patient had acute glaucoma and corneal oedema in connection with acute tularemia. At the onset of the disease she had a fever (39°C), pains in her muscles and in her right eye. The intraocular pressure, which was 68 mmHg at the beginning was lowered with intravenous and per oral acetatcolamide together with timolol and pilocarpine eyedrops, and because of a narrow anterior chamber, with subsequent laser iridotomies. The tularemia was treated with ciprofloxacin 500 mg twice daily for ten days. Vision was finger counting at the beginning of the disease. The corneal oedema gradually subsided and vision normalized during the two‐month follow‐up.

Conclusion: Oculoglandular tularemia was connected with acute glaucoma and corneal oedema.
Effects of dorzolamide hydrochloride 2% on the retinal circulation
Authors: Grunwald Juan E. , Mathur Sameer , DuPont Joan
Published: May 2009

Purpose: To study the effect of a single dose of topical dorzolamide hydrochloride 2%, a carbonic anhydrase inhibitor, on the retinal circulation of normal subjects.

Methods: Measurements of the effect of dorzolamide hydrochloride were performed in 20 normal subjects using bidirectional laser Doppler velocimetry and monochromatic fundus photography. In a double‐masked randomized design, one eye received one drop of dorzolamide hydrochloride 2% and the other eye one drop of placebo. Vessel diameter, maximum erythrocyte velocity and volumetric blood flow rate were measured in a main temporal vein of each eye before the drops, and then, 2h later.

Results: Following treatment, intraocular pressure decreased by 12% in the dorzolamide‐treated eye (p = 0.0004, paired Student's t‐test) and by 4% in the placebo‐treated eye, p = 0.04). No significant changes in venous diameter, maximum erythrocyte velocity, and volumetric blood flow rate were observed in the dorzolamide‐treated eyes (0.6%, 2.6% and 1.4%, respectively) or the placebo‐treated eyes (1%, 3.7% and 1.6%, respectively).

Conclusions: A single drop of dorzolamide hydrochloride does not cause any significant change in any of the hemodynamic parameters measured. With the variability of our measurements, we have about 89% power to detect average 10% change in volumetric blood flow rate if significance testing is performed at p = 0.05 level.
Intraocular lens thickness and ocular growth in newborn rabbits
Authors: Kugelberg Ulla , Zetterström Charlotta , Lundgren Björn , Syrén‐Nordqvist Sinikka
Published: May 2009

Purpose: To examine ocular growth in newborn rabbits with a thick or a thin silicone intraocular lens implanted.

Methods: Bilateral lensectomy was performed in twelve 23‐day‐old rabbits. All eyes were implanted with a silicone intraocular lens (IOL) with polypropylene haptics (Allergan Medical Optics SI 26 NB). In each rabbit, one eye was selected at random and a + 12 diopter IOL with a centre thickness of 1.10 mm was implanted in the capsular bag. In the other eye a + 24 diopter IOL with a centre thickness of 1.83 mm was implanted. Axial length, corneal diameter, corneal thickness and intraocular pressure were measured in all eyes preoperatively, and then 1, 2 and 3 months after surgery. The wet mass of the after‐cataract was measured 3 months after surgery.

Results: Both the axial length and the corneal diameter were significantly increased in eyes implanted with the thicker silicone IOL. No significant difference in corneal thickness or intraocular pressure was found between the eyes. No correlation was found between the IOL‐thickness and the wet mass of the after‐cataract.

Conclusion: The results suggest that in the young rabbit eye the thickness of an implanted IOL influences eye growth.
CHARGE association with congenital glaucoma due to maldevelopment of the anterior chamber angle
Authors: Katai Naomichi , Urakawa Yoshio , Sato Yukio , Miyanaga Kazuto , Segawa Katsuzo , Yoshimura Nagahisa
Published: May 2009

Purpose: We examined the clinicopathologic features of a male infant with the CHARGE association and bilateral congenital glaucoma.

Methods: Trabeculectomy specimens were obtained from the anterior chamber angle and examined by light and electron microscopy.

Results: Histopathologic examination of the trabeculectomy specimens showed immature development of the trabecular meshwork that was covered by the ciliary muscles. There were few intertrabecular spaces because the meshwork was almost completely filled with cells and extracellular substances. Deposition of a granular and/or homogeneous substance was observed in the subendothelial area of Schlemm's canal.

Conclusions: Our patient exhibited features typical of the CHARGE association, but also had congenital glaucoma. We hypothesize that these clinical findings are all mediated by a neurocristopathic mechanism. Our findings suggest that the CHARGE association may predispose to anterior chamber angle maldevelopment, which can lead to congenital glaucoma.
Endocannabinoids render exploratory behaviour largely independent of the test aversiveness: role of glutamatergic transmission
Authors: Jacob W. , Yassouridis A. , Marsicano G. , Monory K. , Lutz B. , Wotjak C. T.
Published: May 2009

To investigate the impact of averseness, controllability and familiarity of a test situation on the involvement of the endocannabinoid system in the regulation of exploratory behaviour, we tested conventional and conditional cannabinoid receptor type 1 (CB1)‐deficient mice in behavioural paradigms with different emotional load, which depended on the strength of illumination and the ability of the animals to avoid the light stimulus. Complete CB1 null‐mutant mice (Total‐CB1‐KO) showed an anxiogenic‐like phenotype under circumstances where they were able to avoid the bright light such as the elevated plus‐maze and the light/dark avoidance task. Conditional mutant mice lacking CB1 expression specifically in cortical glutamatergic neurons (Glu‐CB1‐KO), in contrast, failed to show a similar phenotype under the same experimental conditions. However, both mutant lines showed increased avoidance of open arm exploration during a second exposure to the elevated plus‐maze. If tested in situations where the fear eliciting light could not be avoided, Total‐CB1‐KO mice showed increased thigmotaxis in an open field, decreased social investigation and decreased novel object exploration under aversive light conditions, but not under non‐aversive low light. This time, Glu‐CB1‐KO also showed decreased exploratory behaviour towards objects and conspecific juveniles and increased thigmotaxis in the open field. Taking into consideration that the behavioural performance of wild‐type mice was only marginally affected by changes in light intensities, these data indicate that the endocannabinoid system renders exploratory behaviour largely independent of the test averseness. This process differentially involves endocannabinoid‐controlled glutamatergic transmission, depending on the controllability of the test situation.
Podoconiosis – non‐filarial geochemical elephantiasis – a neglected tropical disease?
Authors: Nenoff Pietro , Simon Jan Christoph , Muylowa Grace K. , Davey Gail
Published: May 2009

Podoconiosis or mossy foot is a form of non‐filarial lymphedema. This geo‐chemical elephantiasis is a disabling condition caused by the passage of microparticles of silica and aluminum silicates through the skin of people walking barefoot in areas with a high content of soil of volcanic origin. Podoconiosis is widespread in tropical Africa, Central America and North India, yet it remains a neglected and under‐researched condition. The disabling effects of podoco‐niosis cause great hardship to patients. It adversely affects the economic (reduced productivity and absenteeism), social (marriage, education, etc.) and psychological (social stigma) well‐being of those affected. Podoconiosis can be prevented; the main primary preventive measure is protective footwear. Secondary measures include a strict hygiene regimen and compression therapy, which can reverse initial lesions. Tertiary approaches include surgical management, such as shaving operations to reduce hyperplastic and verru‐cous elephantiasis.
STUDENT RIGHTS, CLARENCE THOMAS, AND THE REVOLUTIONARY VISION OF EDUCATION
Authors: Warnick Bryan R. , Rowe Bradley , Kim Sang Hyun
Published: May 2009

Abstract In his concurring opinion to the 2007 U.S. Supreme Court decision, Morse v. Frederick, Justice Clarence Thomas argues that the Tinker decision, which granted students constitutional rights in public schools, should be overturned on originalist grounds. In this essay, Bryan Warnick, Bradley Rowe, and Sang Hyun Kim make the case that Thomas’s originalist analysis is inconclusive. Instead of looking at court decisions relating to public education starting in the middle of the nineteenth century to establish original meaning, as Thomas does, they argue that a better strategy involves an analysis of educational ideas circulating closer to the time of constitutional ratification. Using this strategy, the authors show that many prominent educational writers (a) believed that it was important for students to learn to act independently and to value their constitutional rights, and (b) believed that students learn best by imitating civic examples. These two ideas work together in early American educational thought to imply that schools should exemplify the sort of respect for self‐governance and individual rights that is present in the larger constitutional order. Thus, Warnick, Rowe, and Kim argue that there are originalist reasons for supporting student rights that Thomas ignores. In the end, this analysis not only highlights the limitations of originalist interpretative strategies, it also reminds us, more broadly, of a way to reconcile liberty and order in civic education.
MAD ABOUT IDEALS? EDUCATING CHILDREN TO BECOME REASONABLY PASSIONATE
Authors: Sieckelinck Stijn M.A. , De Ruyter Doret J.
Published: May 2009

Abstract The current public concern about radicalization and extremism challenges philosophers and particularly philosophers of education to explore questions such as “Why do adolescents with strong ideas transgress?” and “What can we do about it?” The first question can be addressed by examining the role of their passionate commitment to their ideals as well as how this passion manifests in their pursuit of these ideals. The second question refers to the role of education in orienting and directing young people’s passionate attachment to and pursuit of ideals. In this essay, Stijn M.A. Sieckelinck and Doret J. de Ruyter argue that educating children to become reasonably passionate about ideals is a justifiable, and in fact an important, educational aim. This educational aim rests upon the notion that people take a rational, moral, and prudent stance toward their ideals and that they pursue their ideals in a way limited (yet also enabled) by rational, moral, and prudent considerations. While extremism is not likely to be defeated by educational efforts only, democratic citizenship demands urgent educational attention to young people’s passion for ideals.
Ca2+‐induced linker transformation leads to a compact and rigid collagen‐binding domain of Clostridium histolyticum collagenase
Authors: Philominathan Sagaya T. L. , Matsushita Osamu , Gensure Robert , Sakon Joshua
Published: May 2009

Clostridium histolyticum collagenase is responsible for extensive tissue destruction in gas gangrene, and its activity is enhanced by calcium ions. The collagen‐binding domain is the minimal segment of the enzyme required for binding to insoluble collagen fibrils and for subsequent collagenolysis. The collagen‐binding domain is joined to another binding module by a conserved 14‐amino‐acid linker. The linker undergoes secondary structural transformation from an α‐helix to a β‐strand and forms a nonprolyl cis‐peptide in the presence of calcium ions. In this study, various biophysical methods were utilized to better understand the structure and functional role of the novel calcium‐activated linker. Two Ca2+ ions bind cooperatively with macroscopic association constants of K1 = 5.01 × 105 m−1 and K2 = 2.28 × 105 m−1. The chelation of the second calcium ion is enthalpically unfavorable, which could be a result of isomerization of the nonprolyl cis‐peptide. The holo protein is more stable than the apo protein against thermal denaturation (ΔTm ∼ 20 °C) and chemical denaturation (ΔΔGH2O ∼ 3 kcal·mol−1 for urea or guanidine HCl denaturation and Δ20% v/v in 2,2,2‐trifluoroethanol). The compact holo collagen‐binding domain is more resistant to proteolytic digestion than the apo collagen‐binding domain. The orientation of the linker appears to play a crucial role in the stability and dynamics of the collagen‐binding domain.
Post‐translational modifications of the linker histone variants and their association with cell mechanisms
Authors: Wood Christopher , Snijders Ambrosius , Williamson James , Reynolds Colin , Baldwin John , Dickman Mark
Published: May 2009

In recent years, a considerable amount of research has been focused on establishing the epigenetic mechanisms associated with DNA and the core histones. This effort is driven by the fact that epigenetics is intimately involved with genomics in a whole range of molecular processes. However, there is now a consensus that the epigenetics of the linker histones are just as important. The result of that consensus is that the post‐translational modifications (PTMs) for most of the linker histone variants in human and mouse have now been established by a number of experimental techniques, foremost of which is mass spectrometry (MS). MS was also used by our group to establish the PTMs of the linker histone variants in chicken erythrocytes. Although it is now known which types of PTM occur at particular locations on the linker histone variants, there is still a large gap in the knowledge of how this data relates to function. The focus of this review is an analysis of the PTM data for the linker histones from several species, but with an emphasis on human, mouse, and chicken. Our analysis reveals that certain PTMs can be clearly correlated with specific functions of the linker histones in particular cell types, and that unique PTM patterns exist for different cell types.