bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanical properties in healthy subjects with and without refractive errors. A comparative study
Authors: DEL BUEY MA , CRISTOBAL BESCOS JA , LAVILLA L , ASCASO FJ , MATEO OROBIA A , JIMENEZ B , RUIZ DE GOPEGUI E , PALOMINO C
Published: November 2010

Purpose To determine in vivo corneal biomechanical properties in patients without refractive errors and patients with moderate‐high myopic and hyperopic spherical refractive errors.

Methods A comparative study was carried out to measure Corneal Hysteresis (CH, mmHg) and Corneal Resistance Factor (CRF, mmHg) of 384 eyes of 201 patients classified in four groups. Moderate myopia (< 6 D, n=203), high myopia (> 6 D, n=43), moderate‐high hyperopia (> 2 D, n=62), and emetropic group (n=76). Corneal compensated intraocular pressure (IOPcc),and Goldman correlated intraocular pressure (IOPg) were also studied. Central corneal thickness (CCT, microns) was measured by ultrasonic pachymetry. Patients with ocular pathology or astigmatism greater than the spherical refractive error were not considered. A multiple‐comparison analysis was made to establish differences among the groups.

Results Mean values were: CH= 10.59±1.52, CRF= 10.52±1.69 and CCT= 556.3 for the moderate myopia group, CH=10.04 ±1.55, CRF=10.23 ±1.82 and CCT=543.75 for the high myopia group, CH=11.16 ±1.88, CRF=10.69 ±2.07 and CCT=555.43 for the hyperopia group, CH=10.66 ±1.30 , CRF=10.48±1.14 and CCT=558.10 for the control group. Although these results of the biomechanical parameters showed higher values corresponding to the hyperopia group and lower to the myopia group, these differences were not statistically significant.

Conclusion CH and CRF are greater in hyperopic patients in comparison with myopic and emetropic eyes. We do not find statistical significant differences between moderate myopia and high myopia. There are significant differences in CH between the high myopia and the hyperopia groups.
Refractive amblyopia and life quality
Authors: BOGDANICI CM , GAVRIL MM , BOGDANICI T
Published: November 2010

Purpose To assess the quality of life in amblyopic children with refractive errors.

Methods Prospective observational transversal study for 44 ambulatory pacients (88 eyes). Clinical parameters checked: visual acuity, binocular vision, (auto)‐refractometry, ophthalmoscopy, orthoptic exams. We used 46 questionnaires in 9 chapters.

Results Age of study was: 8,19 ± 2,92 years (limits 4 ‐16 years) and age of first ophthalmological diagnosis was: 3,90 ± 2,15 years. Amblyopia moderate and severe was present in 47,72% for right eye and in 43,18% in left eye. Visual acuity (right eye) non‐corrected was 0,45 ± 0,31 and corrected was 0,63 ± 0,31, (p<0,0001). Visual acuity (left eye) non‐corrected was 0,49±0,33 and corrected 0,69±0,32, (p<0,0001). It wasn’t any difference between right and left eye. Questionnaires focused on child health, visual acuity, binocular vision, refraction, time for occlusion, penalization, child emotions / activity , family and society integration.

Conclusion The sooner the amblyopia is diagnosed and treated, the better the results are regardless to the amblyopia type. Quality life questionnaires detect life or scholar problems of children with amblyopia and educate parents.
Accommodation response when changing spherical and chromatic aberration
Authors: WAHLBERG M , LINDSKOOG PETTERSSON A , BRAUTASET RL
Published: November 2010

Purpose The aim of this study was to evaluate accommodation response by changing two of the main directional cues for accommodation. This was done under mono‐ and polychromatic light while varying the amount of spherical aberration.

Methods In this study twenty subjects with a mean age 25.0 ±2,37 SD participated. Spherical aberration was measured in the uncorrected eye and accommodation was measured with a PowerRefractor with trial frame correction and with a spherical aberration controlled contact lens (‐0.15μm). Accommodation stimuli of ‐2.0 D was used. The measurements were done in white and monochromatic light (580‐585 nm).

Results The analysis showed no significant influence of either the tested amounts of spherical aberrations or having monochromatic light on response time, velocity or lag of accommodation.

Conclusion The small change of spherical aberration did not affect accommodation response neither did change in chromatic aberration.
Evaluation of pupillary redilation after colored light stimulation in patients with outer retinal photoreceptor disease
Authors: LEON L , CRIPPA S , KAWASAKI A
Published: November 2010

Purpose Stimulation with selective wavelength light has been used to preferentially activate the different types of retinal photoreceptors in humans and thus evoke a differential pupil response to red and blue light. Patients who have outer retinal photoreceptor disease with preserved inner retinal function show a loss of pupil contraction to bright red light and dim blue light. It is hypothesized that the greater inner retinal contribution to the pupil signal in these patients is also reflected in the pupillary re‐dilation after colored light stimulation.

Methods Fourteen patients with retinitis pigmentosa were tested using a previously described stimulus paradigm using a long wavelength (red) or short wavelength (blue) light given as a continuous Ganzfeld stimulus with 3 stepwise increases in intensity over a 2 log‐unit range. The pupillary movement before, during and after the light stimulus was recorded in real‐time with an infrared illuminated video camera. Pupillary re‐dilation was measured using 2 parameters: acceleration during the initial 10 seconds after light termination and time‐to‐recover to 90% of baseline pupil size.

Results The pattern of pupillary re‐dilation was varied. Some patients showed a prompt return to baseline size following either light stimulation with red or blue light, similar to that seen with normal subjects. Others showed a delayed pupillary re‐dilation either after red and blue light stimulation or after blue light stimulation only.

Conclusion Analysis of the differential pupil response and the pattern of subsequent pupillary re‐dilation may be a novel method for identifying patients who have outer retinal photoreceptor dysfunction.
The genetics of corneal dystrophies
Authors: BLACK GCM
Published: November 2010

Purpose To provide an overview of progress in understanding of the genetics of corneal dystrophies.

Methods A systematic review, including case presentations, to illustrate insights into genes underlying inherited corneal dystrophies:

Results Recent advances have extended our undestanding of the causation of a range of classical inherited corneal dystrophies. This includes the identifcation of genes underlying superficial (e.g Meesmann, KRT3/KRT12), stromal (BIGH3/TGFB1) and endothelial (SLC4A11, COL8A2) dysrophies. Understanding of less well‐recognised phenotypes (e.g brittle cornea syndrome) has also shed light on the regulation of corneal homeostasis including the control of corneal thickness.

Conclusion Identification of the genes underlying corneal inherited disease improves diagnosis of corneal dysrophies, sheds light on disease mechanisms and has potential to improve patient management. In the futuire this will lead to new therapeutic modalities for an important group of conditions associated with significant visual loss.
The new IC3D nomenclature of corneal dystrophies
Authors: WEISS J
Published: November 2010

Purpose Advances in genotyping have challenged the significance of the entities called the corneal dystrophies. Although the term corneal dystrophy typically refers to a group of inherited corneal disease that are bilateral, symmetric, slowly progressive and without relation to sytemic disease or environmental factors; exceptions to each part of the definition exist. Mutations in different genes can result in one phenotype and mutations in one gene can result in different allelic dystrophy phenotypes. The phenotypic classification system has become archaic. The International Committee on the Classification of Corneal Dystrophies (ICD3) was created in 2005 to revise the corneal dystrophy nomenclature.

Methods A critical evaluation of the literature to remove inaccurate information and distil the facts was performed by an international panel of world experts including geneticists, pathologist and ophthalmologists. A template was created for each dystrophy which summarized the genetic, clinical and pathologic information with accompanying clinical photographs. Each dystrophy was reviewed to determine if there was an identified gene, gene locus and whether it was clinically well defined.

Results The dystrophies were organized anatomically and each dystrophy was assigned a category from 1 to 4 indicating the level of evidence supporting the existence of a given dystrophy. Category 1‐ A well defined dystrophy with known gene locus and gene Category 2‐ A well defined dystrophy with known gene locus, unknown gene Category 3‐ A well defined dystrophy with unknown gene locus and gene Category 4‐ A poorly defined dystrophy with unknown gene locus and gene

Conclusion The IC3D nomenclature system is available online at www.corneasociety.org in English and Spanish. A German translation has just been completed.
Corneal dystrophies: the paediatric corneal specialist view
Authors: NISCHAL KK
Published: November 2010

Purpose To describe the range of corneal dystrophies presenting to a tertiary refferral paediatric ophthalmology centre and the treatment approach to these various dystrophies

Methods Retrospective review of case notes between Jan 1999 and March 2010

Results The range of corneal dystrophies presenting varied from Meesmans, Map‐Dot , Reis‐Buckler, Posterior polymorphous corneal dystrophy, congenital hereditary endothelial dystrophy, Granular and Lattice ‐Granular and the newly described x linked endothelial corneal dystrophy. The youngest child to present with symptoms was 14 months old. Management approach depended on the ultimate goal of allowing normal visual developemnt until the age of 8 years. Amblyopia plays a great role in the eventual visual outcome in children with corneal transplant surgery also riddled with difficulties in young children.

Conclusion The classical descriptions of corneal dystrophies are not how they present in children . Certain symptoms and signs may tip the clinician off to the possibility of a corneal dystrophy. Visual rehabilitation in children is time limited and must be the priority for the treating physician.
New modalities for the treatment of corneal dystrophies
Authors: CLAERHOUT I
Published: November 2010

Purpose To give an overview of current treatment modalities of corneal dystrophies.

Results New transplant techniques have changed the way that corneal dystrophies are being treated in the last few years. Phototherapeutic keratectomy is still a very valuable tool for superficial dystrophies. Depending on the layers involved the laser will be set to a depth of 5 to 100µm. DALK is now the preferred method of treatment of most stromal dystrophies, although macular dystrophy is an exception to this rule since there is evidence of endothelial involvement in this dystrophy. Endothelial dystrophies are now almost exclusively being treated by different types of endothelial grafts (DSAEK or DMEK).

Conclusion Current treatment of corneal dystrophies has evolved from one size fits all to a more customised treatment schedule, still dependent on the layers involved in the disease.
Descriptive study of topographic patterns in clinically diagnosed keratoconus
Authors: JIMENEZ DEL RIO B , PEREZ GARCIA D , CASAS P , CRUZ N , RAMIRO MILLAN P , DEL BUEY MA , CRISTOBAL BESCOS JA
Published: November 2010

Purpose This study was undertaken with the objective of responding to some questions: how are our patients´s keratoconus? and could we establish unified topographic patterns to describe them?

Methods Descriptive analysis of different parameters evaluated by Orbscan corneal topography system (BFS, RCA/RCP, anterior and posterior elevation, Simk, mean pwr, thinnest) and biomechanical indices measured with Ocular Response Analyzer (CRF and CH) as well as topographic patterns that can be found in the clinical keratoconus diagnosed between 2006 and 2009 in ophthalmology service at Hospital Clinico "Lozano Blesa" in Zaragoza.

Results We have studied 40 eyes of 24 patients diagnosed with keratoconus.Subclinical keratoconus and those who had received treatment,either rigid contact lenses or implanted intracorneal ring segments were previously excluded. The average age of patients was 33.7+/‐11.1 years. Quantitative topographic descriptors were: BFS = 55.99+/‐3.35 D; RCA/RCP = 1.25+/‐0.04, anterior surface elevation = 48.08+/‐26.66 µ; back surface elevation = 107.18+/‐43.11 µ; simk = ‐5.4+/‐2.6 D, mean pwr = 48.5+/‐3.7 D; thinnest = 423+/‐67 µ; biomechanical values: CRF = 6.9+/‐1.7 and CH = 7.8+/‐1.4. Four topographic patterns are also described depending on the situation of the apex of the cone: 30% central, 35% lower, 30% inferior temporal, 5% inferior nasal.

Conclusion There is great morphological variation in keratoconus, it is therefore important to unify criteria for classification. The apex location criteria allows us to make a simple classification of keratoconus and is useful for planning intracorneal ring segments implantation.
Response of p53, capsase 3 and gadd45 genes in the rat lens to in vivo exposure to UV‐B radiation
Authors: GALICHANIN K , SVEDLUND J , LöFGREN S , SÖDERBERG PG
Published: November 2010

Purpose To study the transcriptional induction of p53, caspase 3 and gadd45 genes in the rat lens by in vivo exposure to double threshold UVR‐B around 300 nm.

Methods Forty 6‐week‐old female albino Sprague‐Dawley rats were exposed to double threshold dose (8 kJ/m2) UVR (λmax = 300 nm) unilaterally for 15 minutes. The animals were sacrificed at 1, 5, 24 and 120 h following the exposure to UVR‐B. p53, caspase 3 and gadd45 mRNA expression of the lenses was analysed by quantitative RT‐PCR. Data were analysed using one‐way ANOVA.

Results p53 is downregulated in exposed lenses in 1 h and 5 h groups and upregulated in 24 h and 120 h groups. Caspase 3 is downregulated in exposed lenses in 1, 5 and 24 h groups and upregulated in 120 h group. No difference in gadd45 mRNA expression between exposed and nonexposed lenses was found in all time intervals.

Conclusion p53 mRNA increased expression precedes caspase 3 mRNA increased expression in the rat lens after in vivo UVR‐B exposure. UVR‐B exposure did not induce transcription of DNA damage repair gene gadd45 in the lens up to 120 h.
Evaluation of the higher order wavefront aberrations and the quality of vision after correction of aphakia by a retropupillary implantation of the Verisyze® iris‐claw intraocular lens
Authors: GICQUEL JJ , NOCHEZ Y , PISELLA PJ , DIGHIERO PL
Published: November 2010

Purpose To investigate the influence of the secondary implantation site of the Verisyse® iris‐claw intraocular lens (IOL) on high order aberrations (HOAs) using wavefront analysis in aphakic patients.

Methods Twenty five aphakic patients (25 eyes) who had been left aphakic after complicated phacoemulsification, leaving no capsular support, but good iris support and clear unwounded cornea implantated with the aphakic Verisyse®(AMO) IOL either implanted retropupilarely or over the iris. Wavefront aberrations and contrast sensitivity were measured using the Imagine Eyes IRX3 SH aberrometer.

Results Twelve patients were implanted in the anterior chamber versus thirteen, who had the IOL clipped behind the iris. Surgery was uneventful in all patients. No postoperative complication was observed in the two groups. Best corrected visual acuity was significantly higher and HOAs were significantly lower in the retropupilarely implanted group. Simulated contrast sensitivity results calculated from Point Spread Function measurements were significantly better in the retropupilarly implanted group. There was no significant difference regarding HOAs and vision quality between the retropupillary implanted group and the panel of control âtients implanted with standard monofocal IOL in the capsular bag.

Conclusion In addition to being atraumatic, the Verisyse® IOL implanted behind the iris may restore vision in the absence of capsular support in a more physiological way than when fixated over the iris. The overall quality of vision is better when the Verisyse® is implanted behind the iris and comparable to values obtained with standard monofocal IOLs.
Single scleral suture for subluxated capsular bag in pseudophakic eyes
Authors: FRUSCHELLI M , MENICACCI F , BAGAGLIA SA , MENICACCI C , SPARANO MC , MOTOLESE I , FREZZOTTI P , MOTOLESE E
Published: November 2010

Purpose In‐the‐bag posterior chamber intraocular lens (PC‐IOL) dislocation is an unusual late complication of cataract surgery that can be managed either by exchange with a scleral fixated intraocular lens or by PC‐IOL repositioning with scleral fixation. In the presence of mild subluxation, in older patients, we prefer to suture the fibrotic capsular bag to the sclera without opening the anterior chamber.

Methods 5 patients (mean age 80 y.o.) who had uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL) into the continuous capsulorhexis several years before (4‐12 years), suffered from PC‐IOL subluxation secondary to dehiscence of the zonules supporting the capsular bag. All capsular bags were fibrotic and previously received yag capsulotomy for PCO. Using two self sealing side ports the capsular bag was successfully sutured to the sclera at 12' by introducing a double‐armed polypropylene suture through a scleral flap.

Results The final postoperative visual acuity was 20/30 or better with no complications during the surgical procedure. Patients discomfort was minimum and no endothelial cell loss was reported.

Conclusion Scleral fixation by single suture can be a useful and low‐complication rate procedure for late in‐the‐bag PC‐IOL subluxation in older patients. Use of This procedure in selected cases, can avoid whole capsular bag extraction and replacement with scleral fixated sulcus IOL, with minimal stress for the ocular structures.
The effects of high altitude on central corneal thickness
Authors: BASMAK H
Published: November 2010

Purpose A large number of people are exposed to long‐term hypobaric hypoxic conditions via mountaineering, skiing and trekking. Other people such as aviators and high‐altitude parachutists are exposed to short‐term hypobaric hypoxic conditions. It is known that hypobaric conditions alter physiological and morphological status of the eye including the central corneal thickness (CCT). Our aim is to review the results of the influences of high altitude on CCT. We will also add our experience on the influences of short‐term hypobaric hypoxia on CCT.

Methods Reports covering this topic will be discussed. The possible mechanisms for the alterations in CCT will be included. Hypobaric hypoxic conditions simulate high altitudinal environments, which was the basis of our study covering 70 eyes of 35 healthy men exposed to hypobaric hypoxic condition. We measured the CCT via ultrasound pachmetry at local ground (792 m above sea level) and then during short‐term hypobaric hypoxic exposure (equivalent 9144 m above).

Results CCT has been found to be increased at high altitudes. We also found that hypobaric hypoxic condition increased the CCT significantly. The mechanism of increased CCT is not clear, although the alterations in corneal endothelial cells function seem to be the main explanation. Systemic delivery of oxygen to the anterior chamber can possibly be an important contributing factor based on a recent study.

Conclusion CCT has been reported to be increased at high altitude. The possible underlying mechanisms are altered endothelial function and metabolic activity.
VEGF in uveal melanoma
Authors: BECHRAKIS NE
Published: November 2010

Abstract not provided
VEGF in aqueous humor of eyes with uveal melanoma
Authors: CAUJOLLE JP , FRETON A , GREPIN R , CHAMOREY E , PAGES G , GASTAUD P
Published: November 2010

Purpose To analyze in uveal melanomas (UM) the expression of angiogenic factors in pre‐ and post‐treatment neovascular glaucomas (NVG). To study Vascular Endothelial Growth Factor (VEGF‐A; VEGFxxxb) and interleukin 8 (IL‐8) levels in the aqueous humor of eyes with UM prior to treatment.

Methods The cytokines rates in UM have been studied by performing anterior chamber tap. In a few cases, we also analyzed these rates both in vitreous (V) and aqueous (A) humors to compare their concentrations. In addition, some control measurements were made. The concentrations were determined using dedicated enzyme‐linked immunosorbent assay kits (ELISA) with a threshold of 5pg/ml.

Results We have found no VEGF‐A in A humor of control patients. Regarding our samples, virtually no VEGFxxxb isoforms were detected in V and A humors. Moreover, production of cytokine IL‐8 was found in a few tumors producing or not VEGF. In the first series on patients with NVG, we have collected 11 samples of A humor and 5 of V humor. The VEGF‐A concentrations between A and V humor were nearly equivalent. Concerning A humor samples, VEGF‐A levels were ranged from 70.1 to 5680 pg/ml. The second series was obtained with A humor samples from 31 UM eyes prior to treatment. VEGF‐A levels were ranged from undetectable to 1532 pg/ml. The correlation between VEGF‐A levels and the different tumor features was studied. In both series, the highest rates of VEGF‐A were found in A humor of NVG UM eyes.

Conclusion VEGF‐A and IL‐8 can be produced in the context of UM. However, their expression is not systematic. Our results suggest that VEGF determination should be determined prior to anti‐VEGF therapy in order to prevent post‐protontherapy complications or to improve protontherapy efficiency.
Cytokines in enucleated eyes
Authors: JAGER MJ , LY LV , VAN BEELEN E , BRONKHORST IHG , VERSLUIS M , TAYLOR AW , LUYTEN GPM
Published: November 2010

Purpose One of the prognostically bad parameters in uveal melanoma is the presence of an inflammatory phenotype, characterized by an increased expression of HLA antigens and an immunologic infiltrate. We wondered whether the presence of specific chemokines and cytokines in the aqueous humor (AqH) from uveal melanoma‐containing eyes is associated with this inflammatory phenotype, with the presence of macrophages, and/or with survival.

Methods Directly following enucleation, AqH was obtained from 37 eyes containing uveal melanoma. Samples were stored at ‐80 °C till use. Using a multiplex bead array, 15 different cytokines were measured. Determination of intratumoral macrophages was performed by immunohistochemistry and immunofluorescence. The presence of specific cytokines was compared to histopathological, genetic and clinical tumor characteristics, as well as patient survival.

Results Several cytokines showed a significantly higher expression in the AqH from uveal melanoma‐containing eyes compared to the AqH from eyes undergoing cataract surgery. Only MCP‐3 was associated with the presence of macrophages and the tumor promoting M2‐type macrophage in uveal melanoma patients. Hardly any correlations were found between cytokine levels and known prognostic factors for uveal melanoma. Also, cytokine levels were not of predictive value for survival.

Conclusion Although increased levels of inflammation‐related cytokines are present in the AqH of uveal melanoma‐containing eyes, hardly any associations with the presence of macrophages and their subtypes, with clinical and histopathological parameters, and prognosis were found.
Imaging of choroidal vessels
Authors: ZOGRAFOS L
Published: November 2010

Abstract not provided
Increased gene expression of the apoptosis‐related molecule Fas and the inducible nitric oxide synthase (iNOS) after excimer laser ablation in rat corneas
Authors: PRADA J , NGO‐TU T , ZELMER A , WELLMANN S
Published: November 2010

Purpose The aim of this study was to analyse the gene expression of the apoptosis‐related molecule Fas in relation to the production and accumulation of nitric oxides 1, 12 and 24h after excimer laser keratectomy in rat corneas.

Methods Wistar rats with excimer corneal ablations (Chiron laser, 66‐68 µm/pulse, 1606 pulses, diameter 4‐7.6 mm, and depth in cornea 50µm) were killed 1, 12 and 24h after treatment. Fas mRNA in situ hybridizations were performed in the analysed corneas by using a rat‐Fas specific gene probe. The generation and further accumulation of reactive nitrogen intermediates (RNI) due to the activity of the inducible nitric oxide synthase (iNOS) in corneal cells were further evaluated by systematic mRNA in situ hybridizations with a specific gene probe for iNOS.

Results One hour after treament, the Fas gene expression was higher than in untreated controls, but clearly lower than 12h after treatment. Whereas 24h after treatment, the expression remained higher than in the controls, slight decreases were observed when compared to the corresponding levels 12h after treatment. A similar expression pattern was observed for the accumulation of RNI in plasma. This effect was further confirmed in corneal cells by the detection of similar iNOS hybridization patterns in the corresponding corneas.

Conclusion After excimer laser keratectomy, the Fas gene expression was increased, especially 12h after treatment. These increases were found to be related to the accumulation of RNI in plasma and to the expression of iNOS in corneal cells. The expression of all these three considered markers together may play a relevant role in wound healing after laser treatment.
Confocal microscopy after implantation of intrastromal corneal ring segments
Authors: GAUJOUX T , GAVRILOV JC , TOUZEAU O , LAROCHE L , BORDERIE VM
Published: November 2010

Purpose To evaluate with in vivo confocal microscopy (IVCM) the corneal microstructure changes due to Intrastromal Corneal Ring Segments (ICRS; KERARING Mediphacos Inc., Belo Horizonte, Brazil) implantation.

Methods Nine eyes of keratoconic patients were prospectively examined with the HRT 3 confocal microscope with the Rostock cornea module before and 1 month after ICRS implantation. Epithelial basal cell density, endothelial cell density and keratocyte density in the anterior, mid and posterior stroma were measured in the center of the cornea and around ICRS (approximately 3.5 mm off the center of the cornea).

Results In the central cornea, we found normal morphologic features at all layers. In peripheral section (near the ICRS) epithelial basal cell density and endothelial cell density were unchanged. However, around the ICRS, keratocyte density increased in the mid stroma (6% increase) and in the posterior stroma (9% increase)(P<.05) but no increase was noticed in the anterior stroma (P=.13). This increase may be due to the best visualisation of activated keratocytes. Hyper‐reflective keratocyte nuclei are thought to indicate the presence of fibroblastic cells. Increased haze adjacent to the ICRS is found to be due to fibroblastic accumulation and irregular collagen fibres.

Conclusion Whereas the central corneal zone appears unchanged, the corneal stroma adjacent to the ICRS displays a slight, but distinct, activation of wound healing. IVCM offers a potential insight into the pathophysiology of the microstructural changes in keratoconus after ICRS implantation.
Evaluation of tear secretion and tear film stability in breast cancer patients under chemotherapy
Authors: KARAMITSOS A , KOKKAS V , KOTOULA‐PAPAGIANNAKI M , ANTHOPOULOS M , STERGIOU E , KARAMPATAKIS V
Published: November 2010

Purpose To evaluate tear secretion and tear film stability of women with early stage breast cancer in relation to the disease and the chemotherapy

Methods 50 consecutive early stage breast cancer patients, mean age 58.86±12.28, were recruited for this study. All patients underwent mastectomy and adjuvant treatment with the FEC regimen (5‐FU 600 mg/m2, Epirubicin 60‐90 mg/m2, Cyclophosphamide 600 mg/m2). The patients were taking the regimen every 21 days, for 6 cycles. All patients were free of symptoms and disease affecting tear secretion and tear film stability. Schirmer test (without anesthetic) and tears Break up Time test (BUT) were performed before the initiation of the chemotherapy and immediately after the end of the 3rd therapeutic cycle. Both left and right eyes of the patients (100 eyes in total) were included for analysis. Abnormal (impaired secretion) Schirmer test values were considered those of ≤10mm in 5 minutes and for BUT (impaired tear film stability) the values of ≤10 sec.

Results Before the initiation of chemotherapy, the mean score of Schirmer test was 14.96±6.29 mm and for BUT was 12.94±4.54 sec. After the third chemotherapeutic cycle the mean score for Schirmer test was 17.59±7.27 mm and the BUT was 11.06±4.54 sec. Before the initiation of the chemotherapy, abnormal Schirmer test had 14% of the patients and abnormal BUT test 19%. After the third therapeutic cycle, abnormal Schirmer test values had the 13% and abnormal BUT values the 31% of the sample.

Conclusion After 3 cycles of chemotherapy with the FEC regimen, mainly the BUT values tend to diminish. More patients (31%) have reduced BUT values after the chemotherapy.
Measurement of straylight
Authors: GINIS HS
Published: November 2010

Purpose Straylight in the human eye is associated with low light intensities scattered at angles large compared to the part of the Point Spread Function that is governed by refractive error and aberrations. It is the purpose of this talk to summarise existing methods for the measurement of straylight in the human eye and to discuss new developments.

Methods Among psychophysical techniques are the most well‐established and studied methods. Optical techniques to date are limited by signal to noise as well as dynamic range considerations.

Results Improvements in optical techniques involve the creation of the appropriate imaging conditions where scattered light intensity can be calculated based on the effects of scatter on the acquired image.

Conclusion Psychophysical methods, that have been particularly successful, require specially designed optical schemes (for the presentation of the stimulus), a specific task and a suitable data analysis method. Optical techniques may benefit from refinements in these directions also.
Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy
Authors: MICHAEL R , MONTENEGRO G , GRABNER G , BARRAQUER RI
Published: November 2010

Purpose To study the correlation between posterior capsule opacification (PCO) and intraocular straylight and visual acuity.

Methods We measured visual acuity (VA) (logMAR) and intraocular straylight (C‐Quant straylight parameter log[s]) under photopic conditions before and 2 weeks after YAG capsulotomy in 41 patients (53 eyes) from the Centro de Oftalmología Barraquer in Barcelona and the University Eye Clinic, Paracelsus Medical University in Salzburg. Photopic pupil diameter was also measured. To document the level of opacification, pupils were dilated, and photographs were taken with a slit lamp, using retroillumination and the reflected light of a wide slit beam at an angle of 45º. PCO was subjectively graded on a scale of 0 to 10 and using the POCOman system. A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy.

Results Straylight correlated well with retroillumination and reflected‐light PCO scores, whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values varied widely after capsulotomy. Multiple regression analysis showed that older age, large ocular axial length, hydrophobic acrylic intraocular lenses (IOLs), and small capsulotomies are factors that increased intraocular straylight.

Conclusion Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity scoring methods. When performing a posterior capsulotomy, factors such as age, IOL material, axial length, and capsulotomy size must be taken into consideration, as they influence intraocular straylight.
New insights in ocular surface diagnosis: in vivo confocal microscopy clinical‐pathological correlations
Authors: DUA H
Published: November 2010

Abstract not provided
Corneal diagnostic imaging in the eye banking: how to improve tissue quality?
Authors: POCOBELLI A
Published: November 2010

Abstract not provided
Epidemiology of, and associated risk factors for, MGD
Authors: KNOP N
Published: November 2010

Abstract not provided
Serpiginous choroiditis (SC): patterns of progression and role of tuberculous infection
Authors: DELUIGI G , PAPADIA M , CIMINO L , CAPPUCCINI L , ALDIGERI R , BOUCHENAKI N , HERBORT CP
Published: November 2010

Purpose To relate patterns of progression and role of tuberculosis (TB) infection in serpiginous choroiditis (SC) by reviewing a series of cases of SC seen at Centre for Ophthalmic Specialized Care (COS), Lausanne, Switzerland and at the Ophthalmology Department of Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.

Methods Retrospective review of clinical data, visual field (VF), fluorescein angiographic (FA), indocyanine green angiographic (ICGA) and optical coherence tomography (OCT) features and TB infectious status in cases of SC.

Results In the time span of 9 years 16 SC cases were seen in the two centres. Interferon gamma release assays (IGRA) revealed positivity for latent tubercular infection in 11 out of 16 patients. Patterns of evolution under immunosuppressive therapy differed between the TB positive and TB negative cases

Conclusion Even in non endemic areas TB infection, as a cause of SC has to be excluded. Typical behaviour of TB related SC is relentless progression despite immunosuppressive therapy.
The role of serology in active ocular toxoplasmosis
Authors: PAPADIA M , ALDIGERI R , HERBORT CP
Published: November 2010

Purpose Toxoplasmic serology in suspected toxoplasmic retinochoroiditis is mostly regarded as unnecessary. Our purpose was to examine toxoplasmic serology in relation with episodes of acute retinochoroiditis and evaluate its utility in appraisal of the patient.

Methods Data of patients with active retinochoroiditis were retrospectively analyzed and compared to a group of uveitis cases in which toxoplasmosis as a diagnosis could be ruled out based on clinical appearance and to a group of patients with a quiescent toxoplasmic retinal scar. The mean values of enzymatic immunoassay (EIA) titers for toxoplasmic antibodies were compared in the three groups. Furthermore the proportion of cases under and above a predefined serology value fixed at four times the cut‐off value was compared in all groups.

Results Between 1995 and 2009 97 out of 1276 (7.6%) new uveitis cases seen at Centre for Ophthalmic Specialized Care (COS), Lausanne, Switzerland were diagnosed as toxoplasmic retinochoroiditis. The mean EIA values were 147.75 ± 259.4 IU for patients with active disease, 18.93 ± 23.09 IU for inactive toxoplasmosis cases and 18.35 ± 20.82 IU for controls (p<0.015). The proportion of cases under the designated limit value were respectively 2/51 (4%) in the retinitis group, 14/27 (52%) in the control group and 7/7 (100%) in the group with inactive toxoplasmic disease (p<0.001).

Conclusion Toxoplasmosis serology, in contrast to what is usually said, is useful to confirm active toxoplasmic retinochoroiditis; it is easy, cheap and backs‐up clinical diagnosis in up to 96% of cases. Serology is however absolutely essential in establishing the diagnosis in atypical cases where it should be performed.
Angiographic patterns in ocular syphilis
Authors: BALASKAS K , SERGENTANIS T , GIULIERI S , GUEX‐CROSIER Y
Published: November 2010

Purpose To describe angiographic patterns encountered in the context of ocular syphilis and to offer statistical associations between specific angiographic manifestations and severity of disease presentation as well as disease evolution after treatment.

Methods We retrospectively reviewed the Fluorescein and ICG angiograms of 23 patients with ocular syphilis presented to the Uveitis clinic of the Jules‐Gonin Eye Hospital. FA and ICGA were performed following a standard protocol for posterior uveitis. Patterns of fluorescence were noted and subsequently statistical associations between each angiographic pattern and any demographic, clinical or laboratory parameter at baseline and after treatment were sought.

Results Vasculitis in fluroangiography exhibited a statistically significant association with vitritis (p=0.020) and a borderline association with macular oedema (p=0.086). Disc hyperfluorescence in fluroangiography was significantly associated with seropositivity for HIV infection (p=0.012). The presence of any Dark Dots in ICGA significantly correlated with anterior uveitis (p=0.013) and marginally with vitritis (p=0.034) and relapse of inflammation after proper antibiotic treatment (p=0.066). An important association between the presence of Hot Spots on ICGA and longer duration of symptoms prior to initial visit was also identified (p=0.007).

Conclusion Out of the several associations identified implicating specific angiographic features, we underline the possible predictive value of the presence of any Dark Dots in ICGA for future relapse of inflammation after treatment and the role of Hot Spots in ICGA as markers of long‐standing disease.
Intravitreal dexamethasone implant (Ozurdex®) in patients with chronic uveitis
Authors: THURAU SR , GRüTERICH M , REZNICEK L , KAMPIK A
Published: November 2010

Purpose To evaluate the safety and efficacy of dexamethasone intravitreal implant (Ozurdex®) in eyes with chronic uveitis with or without cystoid macular edema.

Methods A consecutive series of 20 eyes from 18 patients, mean age 49 +/‐21 years, with chronic uveitis (>3 years), 13 eyes with and 7 eyes without cystoid macular edema (CME), was included. Visual acuity, foveal retinal thickness, a full ophthalmological examination and immunosuppressive medication were obtained before injection and over the course (54 days +/‐41 days) after injection.

Results In all eyes dexamethasone intravitreal implant (Ozurdex®) could be implanted successfully. Mean visual acuity (LogMAR) increased from 0.82 to 0.65 after an average of 35 days. CME disappeard in 8 of 13 eyes after 35 days (median) and was reduced in 5 eyes. Immunosuppressive medication could be reduced in 9 of 11 patients, 2 patients continued their medication because of their second uveitic eyes. The main intraoperative complications were one subconjuctival substance‐release before scleral penetration, a postoperative increase of intraocular pressure in 5 of 20 eyes, which could be controlled with topical therapy, one retinal detachment and one dislocation of the device into the anterior chamber in an aphacic and vitrecomized eye. First loss of efficacy was observed 3‐4 months after injection.

Conclusion Dexamethasone intravitreal implant (Ozurdex®) can improve visual acuity and reduce CME and concomitant immunosuppressive medication in patients with chronic uveitis. The observed efficacy lasts for at least 3 months, we suggest a contraindication for aphacic eyes.
New spectrum of Herpes virus‐associated anterior uveitis in immunocompetent patients: a PCR‐based study
Authors: FEL A , ROSENBERG F , BOJANOVA M , TOUITOU V , AKNIN C , CASSOUX N , LEHOANG P , BODAGHI B
Published: November 2010

Purpose To study clinical characteristics and long term follow up of patients with positive viral PCR in the aqueous humor. Clinical specificities of patients with HSV, VZV ans CMV infection are reviewed.

Methods 34 patients (19 M/15F) were included in this retrospective study.We counted the repartition of each virus among the positive viral PCR in the aqueous humor realised for anterior uveitis. We also noticed clinical features for each virus :sex, age, laterality, iris atrophy, synechiae, hypertonia, type and localisation of keratic precipitates, glaucoma.

Results Mean age at diagnosis was 49.5 (range 19‐73) years for CMV, 64 (range 21‐69) years for VZV, 53 (range 32‐72) years for HSV. Sex ratio (M:F) was 10/9 for CMV, 4/2 for VZV and 5/3 for HSV positive patients. Viral anterior uveitis was CMV‐related in 58% of cases, VZV‐related in 15% of cases, and HSV‐related in 27% of patients. Uveitis was unilateral in 100% of HSV and VZV patients and in 84% of CMV patients. Iris atrophy, when present, was diffuse in 100% of CMV positive patients and sectoral in 50% HSV and 20% of VZV patients. No patient with CMV infection had synechiae, but 56% of patients had synechiae in the HSV group. Glaucoma complicated uveitis in 79% of CMV cases, 60% of VZV cases, and 56% of HSV cases. None of the patients with positive PCR had the clinical presentation of Fuchs heterochromic cyclitis.

Conclusion CMV‐related anterior uveitis has a large place among viral anterior uveitis. Specific clinical features should lead to high suspicion of this diagnosis, and PCR should be applied to the aqueous humor in order to initiate the appropriate treatment.
Lacrimal gland: non‐neoplastic and neoplastic lesions in Denmark 1974‐2007
Authors: HEEGAARD S , VON HOLSTEIN SL , THERKILDSEN ML , PRAUSE JU
Published: November 2010

Purpose To evaluate patient characteristics and incidence of lacrimal gland lesions in Denmark during the period 1974‐2007.

Methods All biopsied/surgically removed lacrimal gland lesions collected by the Danish pathological departments during the period 1974‐2007 were identified by SNOMED codes. In each case age, gender, symptoms, clinical findings, treatment and follow‐up were registered. All tumours were re‐classified according to latest guidelines from WHO.

Results 229 lacrimal gland lesions from 209 patients were identified during the 34‐year period. In the study period 7 cases/year were registered (1.3 cases/million/year). Non‐neoplastic lesions predominated with a total of 114 (50 %) with the most frequent being inflammation 63 (55%), normal lacrimal gland tissue 28 (25%) and dacryops 23 (20%). Benign tumours comprised a total of 45 (20%) with the most frequent tumour being pleomorphic adenoma 31 (69%). Malignant tumours constituted a total of 70 (31%). 52 (74%) of these were primary tumours, 9 (13%) were secondary invading tumours, 8 (11%) were local recurrences and 1 (1%) was a distant metastasis. Primary malignant tumours comprised malignant lymphoma 25 (48%) and malignant epithelial tumours 27 (52%). The most frequent malignant tumour was adenoid cystic carcinoma comprising 14 (27%) of the primary malignant tumours.

Conclusion Lacrimal gland lesions are rare and primarily benign. Treatment of malignant lacrimal gland tumours should be considered a specialist treatment.
Epithelial tumours of the lacrimal gland
Authors: COUPLAND SE
Published: November 2010

Purpose To provide an overview of benign and malignant epithelial neoplasms arising in the lacrimal gland.

Methods In the normal orbit, the lacrimal gland is clinically impalpable and is situated in the lacrimal fossa posterior to the superotemporal orbital rim. The gland is not truly encapsulated and is divided into the deep orbital and the superficial palpebral lobes by the levator aponeurosis. The retrospective study of 265 epithelial tumours of the lac¬rimal gland conducted by the Armed Forces Institute of Pa¬thology (AFIP) improved our understanding of the histologic classification and clinical behavior of epithelial tumours of the lacrimal gland. The historic works of Forrest (1954) and Zimmerman (1962) alleviated confu¬sion by applying to epithelial tumours of the lacrimal gland the histopathologic classification of salivary gland tumours. Epithelial tumours originating from the lacrimal gland should be staged according to the 7th Edition of the Tumor Node Metastasis (TNM) system, which is a modification of the World Health Organization (WHO) classification of salivary gland tumours.

Results The most common benign epithelial tumour of the lacrimal gland is the pleomorphic adenoma. The most common lacrimal gland carcinomas include adenoid cystic carcinoma, “carcinoma ex pleomorphic adenoma”, primary adenocarcinoma & mucoepidermoid carcinoma. The regional lymph nodes include: preauricular, submandibular and cervical lymph nodes. The lung is the most common metastatic site, followed by bone and remote viscera.

Conclusion Subtyping & grading of lacrimal gland epithelial tumours requires the latest WHO/AFIP classifications. Staging of these tumours should follow the 7th TNM system. Collection of datapoints is essential to identify biomarkers, which includes only nuclear N23 and MIB‐1 at present.
Fusion oncogenes in adenoid cystic carcinoma
Authors: VON HOLSTEIN SL , FEHR A , STENMAN G , PRAUSE JU , THERKILDSEN MH , HEEGAARD S
Published: November 2010

Purpose Adenoid cystic carcinomas of the salivary glands have a consistent t(6;9)(q22‐23;p23‐24) translocation. A recent study have shown that this results in fusion of the transcription factor gene MYB and the transcription factor gene NFIB which leads to activation of critical MYB target genes. The purpose of the study was to determine the expression of the MYB‐NFIB fusion in lacrimal gland adenoid cystic carcinomas.

Methods Primary lacrimal gland adenoid cystic carcinomas in Denmark during 1974‐2007 were collected and classified according to the latest WHO classification system. The formalin‐fixed paraffin‐embedded tumours were analyzed using RT‐PCR for detection of MYB‐NFIB fusion transcript. 10 other non‐adenoid cystic carcinomas of the lacrimal gland were also tested for the fusion.

Results A total of 13 patients with a primary adenoid cystic carcinoma were identified in Denmark during the 33‐year period. The median age at diagnosis was 41 years and the gender distribution was equal. Using RT‐PCR the fusion transcript could be detected in five (38%) of the 13 cases. The fusion was the transcript variant MYB exon 14 linked to NFIB exon 8c in all five cases. None of the non‐adenoid cystic carcinoma cases expressed the MYB‐NFIB fusion.

Conclusion The MYB‐NFIB fusion is expressed in adenoid cystic carcinomas of the lacrimal gland. The result of the study supports the suggestion that the MYB‐NFIB fusion is specific for adenoid cystic carcinoma. This is the first study to evaluate the frequency of the MYB‐NFIB fusion in adenoid cystic carcinomas in the lacrimal gland.
Development of a health believe model (HBM) scale for glaucoma
Authors: GOULIA O , ZLATANOS D , GKIKA M , TSEKOYRA A
Published: November 2010

Purpose To create scales to measure Health Belief Model (HBM) concepts using the context of glaucoma screening.

Methods HBM addresses the individual’s perceptions of the threat posed by a health problem (susceptibility, severity), the benefits of avoiding the threat, and factors influencing the decision to act (barriers, cues to action, and self‐efficacy). The scales, based on the HBM, were designed from a review of literature as there is no other study on eye diseases based on the model. The dependent variable chosen for scale development was glaucoma awareness in a population visiting a general eye clinic. Independent variables were constructs related to the HBM. A pilot study of the first preliminary version of the scale was conducted with 10 participants. Results showed that the questions were understandable for these individuals and results of this pilot study were not included in the larger study. The final scale constitutes of four subscales on perceived susceptibility, three on perceived severity, two on received benefits, four on perceived barriers, one on cues to action and one on self efficacy. All subscales used a summated Likert format with five response options (strongly disagree‐strongly agree).

Results Chronbach Alpha analysis was used to compute reliabilities. Scales that were judged valid and reliable were susceptibility (0.73), severity (0,72), benefits (0,79), barriers (0,80), cues to action (0,77) and self efficacy (0,74). Factor analysis provided initial support for construct validity of the scales.

Conclusion The HBM scale of glaucoma was determined to be valid and reliable for use in the Greek population.