bluuebunny/crossref_metadata_2025 huggingface dataset:
Difference of ocular injury by millimeter wave exposure with different frequency
Authors: KOJIMA M , YAMASHIRO Y , SASAKI H , SASAKI K
Published: October 2007

Purpose: The validity of the safety standard (10‐300 GHz 10 W/m2 in public, ICNIRP) of a wide‐ranging quasi‐ and millimeter‐ wave was examined from ocular temperature changes during exposure and ocular injury after exposure.

Methods: Pigmented rabbits were exposed unilaterally to 18, 22, 26.5, 35, 40 GHz quasi‐ and millimeter‐wave with a lens antenna for 3 minutes. The focused beam was exposed to the center of the rabbit cornea. Ocular temperature changes (cornea, lens, vitreous, retrobulbar) during a 3 min. exposure were measured with a Fluoroptic thermometer and corneal surface temperature was measured with a thermography camera. For evaluating ocular injury, a rabbit was exposed to one frequency (18, 22, 26.5, 35, 40, 60 GHz) with 800, 1500, 3000 mW/cm2 for 6 min. Ocular changes were evaluated by slit lamp and ocular inflammation was measured by laser flare meter immediately after and 1 day after exposure. Enucleated lens was observed with lens epithelial cell flat mounting.

Results: Cornea and lens temperature rise were detected by exposure with all examined frequencies. The highest ocular and corneal surface temperature was 40 GHz, followed by 35, 22 and 18 (almost the same), and the lowest was 26.5 GHz. Ocular injury by 800 mW/cm2 for 6 min. exposure was seen only with 40 GHz. Miosis and iris vasodilation were seen immediately after exposure, and corneal epithelial defect at the center of the cornea and corneal opacity were seen one day after exposure. 40 GHz 3000 mW/cm2 for 6 min. exposure developed cornea and lens opacity. But the same dose of 60 GHz exposure showed only corneal opacity.

Conclusions: It was suggested that thermal and biological reactions differed according to frequency.
Acute effects of the sigma‐2 receptor agonist siramesine on lens epithelial cells
Authors: KARLSSON JO , JONHEDE S , PETERSEN A , ZETTERBERG M
Published: October 2007

Purpose: Experiments were carried out to study the effects of siramesine on markers for apoptosis, oxidative damage and mitochondrial function in primary cultures of human lens epithelial cells (HLEC).

Methods: HLEC were incubated with 25 μM siramesine for 1, 2, 3, 4, 6 and 8 hours. Caspase‐3 was assayed in cell extracts with DEVD‐AMC. Mitochondrial depolarization was assayed with JC‐1. Peroxide production was studied with DCF‐DA and superoxide levels with hydroethidium. Glutathione levels were assayed with monochlorobimane.

Results: Siramesine induced a significant increase of caspase‐3 activity after 6h exposure to 25 μM siramesine. Nuclear morphology examined with Hoechst 33342 showed signs of apoptosis after the same time intervals. A significant increase in the production of peroxide and superoxide were found up to 4 ‐8 hours after administration of siramesine.

Conclusions: Siramesine, a piperidine analogue, was developed for the treatment of psychiatric disorders and is considered to be relatively nontoxic. This study, and others, indicate effects on cell growth, apoptosis and production of ROS. The sigma‐2 receptor may be a regulator of HLEC growth and apoptosis.
Menstrual cycle influences ocular surface parameters in normal and dry eye patients
Authors: VERSURA P , PROFAZIO V , COSLOVI C , CAMPOS EC
Published: October 2007

Purpose: We analyzed the changes of ocular surface parameters and symptoms in healthy and dry eye women over the menstrual cycle. To our knowledge, incomplete reports appear in the literature on this issue in healthy women still in the fertile period, and none on dry eye women of the same age. This to comparatively evaluate what then happens in peri‐ and post‐menopause.

Methods: 29 females in the fertile age and a regular 26‐29 days menstrual cycle were included in the study. 14 subjects with and 15 without dry eye symptoms. Symptoms were scored by the validate questionnaire OSDI. Degree of dryness was evaluated with the Schirmer test I, Jones test, BUT, Ferning test, Tear Function Index (TFI) and conjunctival imprint cytology. Degree of inflammation was evaluated with conjunctival brush cytology and dosage of exudated serum albumin in tears. Hormonal cytology procedures were applied to exfoliated cells in tears. Patients were analysed during menstruation, in the follicular and in luteal phases over two consecutive cycles and results were statistically evaluated

Results: TFI, tear stability, surface dryness and inflammation were significantly related to the hormonal fluctuations in menstrual cycle, in particular to the estrogen peak occurring during the follicular phase, especially in dry eye patients. Subjective symptoms appeared to increase in the luteal phase, suggesting the presence of a pre‐menstrual syndrome

Conclusions: The ocular surface is confirmed to be dependent from hormonal variations; clinicians would take into account these cyclic variations during the examinations of subjects still in the fertile age, with dryness symptoms
Corneal graft endothelial viability assessment using the triple labeling Hoechst/Ethidium homodimer/Calcein‐AM: technical improvements usind 3D microscopy
Authors: THURET G , PIPPARELLI A , DUBAND S , PISELLI S , MURAINE M , PEOC'H M , ACQUART S , ZHAO M , PRADES JM , GAIN PG
Published: October 2007

Purpose: A reliable viability test for corneal endothelium is necessary for the assessment of new processes likely to affect it (storage media, lamellar cutting methods...). Aim: to improve the classical calcein‐AM (C)/Ethidium homodimer (E) double staining (live/dead assay) by adding Hoechst and by using a 3D microscope and image analysis that allow a quantitative assessment on the whole endothelium. As an example of application, the assessment of the actual endothelial viability immediately before graft is given.

Methods: The endothelial side was incubated 45 min at 31°C with 200 μL of C (2μM), E (5μM), H (10μM). After flat mount, images of the whole endothelial area (81mm²) were taken using a microscope equipped with a motorized stage (IX81, Olympus) and a x4 objective. Z stacks were taken and an extended focal imaging algorithm allowed taking account of corneal folds. Endothelial cell density (ECD) and mortality were determined by automatic counting of H+ and E+ nuclei. Area of C+ cells was measured.

Results: This upgraded staining on the whole endothelium allowed the exhaustive assessment of ECD, cell mortality and metabolic activity. On corneas immediately before graft, it highlighted a dramatic lower number of viable cells than expected with the routine assessment of ECD only, done 48H before graft in the eye bank.

Conclusions: The triple HEC staining takes account of the heterogeneous pattern of lesions within the whole endothelial layer and is therefore far less biased than assessment done on small cell samples. Its use improves the assessment of all new processes likely to affect the endothelium ex vivo.
Improving glaucoma diagnosis by the combination of structural and functional measurements
Authors: SKORKOVSKA SS , MICHALEK JM
Published: October 2007

Purpose: To determine, whether an appropriate combination of the structural and functional examination methods can improve the diagnosis and follow‐up of glaucoma.

Methods: One randomly selected eye of patients with primary open angle glaucoma (POAG) with none or early glaucomatous visual field loss and age‐matched healthy persons were included in the prospective longitudinal study. Structural evaluation was conducted using Heidelberg Retina Tomograph (HRT) and retinal nerve fiber layer (RNFL) loss scoring according to Airaksinen method. Functional evaluation were reviewed by means of standard white‐on white (W/W) perimetry and blue‐on yellow (B/Y)perimetry. Linear discriminant analysis were applied to assess the diagnostic value of different data. The accuracy of discrimination was described and visualized by the Receiver Operating Characteristics Curves (ROC).

Results: There were statistically significant differences between healthy and glaucomatous group in the scoring of RNFL loss, HRT parameters (CA,CD,RD,RV,CSM) and W/W perimetry. Parameters with the highest diagnostic ability obtained by ROC curves were scoring of RNFL loss.

Conclusions: There were statistically significant differences between healthy and glaucomatous group in the scoring of RNFL loss, HRT parameters (CA,CD,RD,RV,CSM) and W/W perimetry. Parameters with the highest diagnostic ability obtained by ROC curves were scoring of RNFL loss.

Supported by IGA NR‐8371
Harry Moss Traquair (1875‐1954) – Scottish ophthalmologist and perimetrist
Authors: GRZYBOWSKI A
Published: October 2007

Purpose: The aim of the study was to

1 analyze the medical achievements of Harry Moss Traquair and

2.collect all available informations concerning his family and privat life for a future biography.

Methods: Typical for the study in the field of the history of science.

Results: Harry Moss Traquair (1875‐1954) was a Scottish ophthalmologist, who devoted most of his professional life to made important contributions to our understanding of visual field studies. His fundamental work An Introduction to clinical perimetry was for years the primary reference work for perimetry. Traquair carried out many carefully designed experiments concerning different aspects of visual field testing, including working distance, test‐objects, movement of test‐objects, illumination, and background. He also contributed detailed recommendations and standards for clinical perimetry in ophthalmology and neurology. He introduced, as well, definitions for some scotomata, which were used for years in the ophthalmic literature. The junction scotoma, often named the Traquair scotoma or the Traquair junction scotoma, is this term used to describe a unilateral temporal visual field defect and is named for the pathology of the ipsilateral optic nerve where it joins the chiasm. Traquair also devoted much work to phenomena which are not considered important any longer, such as baring of the blind spot in glaucoma and visual field defects in tobacco toxic amblyopia. He was an accomplished eye surgeon and had a special interest in dacryocystorhinostomy.

Conclusions: Traquair was a strong advocate of the benefits of visual field testing in ophthalmology and neurology. But most of all, we will remember him as the scholar who taught that “perimetry is not done by the perimeter but by the perimetrist.“
Genotype–phenotype correlation in AMD: The influence of complement factor H polymorphism
Authors: MANTEL I , DROZ I , AMBRESIN A , SCHORDERET D , MUNIER F
Published: October 2007

Purpose: Complement factor H (CFH) Y402H SNP rs1063170 shows strong association with AMD.

Phenotypical concordance of AMD is known from sibling and twin studies. Studies about genotype‐phenotype associations showed inconsistent results. This study investigates the association of CFH Y402H SNP with AMD in a Swiss population, and the genotype‐phenotype association, particularly in early stages of AMD.

Methods: A total of 473 AMD patients and 69 control individuals were enrolled. Colour fundus photographs were graded according to the International Classification and Grading System for AMD. The SNP rs1063170 was evaluated for each patient. Statistical analysis was restricted to individuals with complete clinical data (420 AMD cases and 50 controls).

Results: An OR of 3.0 was found for the presence of at least one risk C‐allele, and OR 9.3 for the homozygous genotype. Individuals over the mean age of 76y and homozygous for the risk‐allele C showed more frequently late forms of AMD. No phenotypic association was found for drusen size, drusen covered surface, drusen localisation nasal to the disc, and pigmentary changes. A trend for central drusen location was found in patients homozygous for the risk allele C [p=0.051]. Peripheral drusen were significantly more frequent in individuals with the risk allele C, particularly if homozygous [p=0.027].

Conclusions: This study confirms the risk association of the CFH Y402H polymorphism with AMD for the Swiss population. A genotype‐phenotype association could be found for early forms of AMD, however only for some drusen features. Additional genetic factors are likely to influence the drusen phenotype. Further careful research is needed to better understand the genetic influence on AMD phenotypes.
Microbiological culture and universal PCR yield after intravitreal injection of antibiotics in acute endophthalmitis following cataract surgery
Authors: VINH V , PALOMBI K , CREUZOT‐GARCHER C , BRON AM , CORNUT PL , THURET G , ROMANET JP , BENITO Y , VANDENESCH F , CHIQUET C
Published: October 2007

Purpose: To isolate bacteria after intravitreal antibiotic injection in acute endophthalmitis after cataract surgery, using cultures and eubacterial PCR.

Methods: We prospectively enrolled in a multicenter study 100 eyes of 100 patients (2004‐2005) presenting an acute endophthalmitis following cataract surgery. Aqueous humor samples were collected before and after one intravitreal antibiotic injection (vancomycin and ceftazidim) for 53 patients while 19 patients underwent a vitreous tap before and after intravitreal antibiotic injections. Microbiological identification was performed using BHI (Brain Heart Infusion) medium and eubacterial PCR.

Results: In aqueous humor, microbiological cultures associated with eubacterial PCR identified a bacterium in 26.4% of cases after intravitreal antibiotherapy. Positive cultures before treatment became negative after antibiotic treatment in 33% whereas initial positive PCR before became negative after antibiotic treatment in 35%. However PCR allowed the recognition of previously unidentified bacteria after antibiotic injections in 8% of patients.

In vitreous samples, a bacterium was identified in 70% of cases before and in 81.2% after intravitreal injection. After antibiotic injection, initially positive cultures and PCR became negative in 90% and 7% of cases, respectively.

Conclusions: A single intravitreal antibiotic injection is not sufficient to eradicate the pathogens responsible for acute post operative endophthalmitis. Eubacterial PCR is useful for the microbiological identification in vitreous samples after intravitreal injections of antibiotics.
Placental growth factor (PlGF) inhibition reduces choroidal neovascularization in a mouse model for age‐related macular degeneration
Authors: VAN DE VEIRE S , MOONS G , VINORES SA , CARMELIET P , STALMANS I
Published: October 2007

Purpose: To evaluate whether and through which mechanism PlGF blockage can inhibit choroidal neovascularization (CNV) in a mouse model of age‐related macular degeneration (ARMD).

Methods: CNV was induced in mice by placing 3 Argon laser burns on the choroid. In a first experiment we compared CNV formation between PlGF knock‐out and wild type mice. Secondly, 144 wild‐type mice were injected every 2 days with 5, 10, 20 or 40 mg/kg of either an anti‐PlGF‐antibody, an anti‐VEGF receptor‐2 (VEGFR2) antibody or an irrelevant control antibody. The CNV lesions were evaluated on histological cross‐sections. The amount of endothelial cells, pericytes and inflammatory cells in the lesions were morphometrically analyzed after immunostaining for CD31, smooth muscle alpha‐actin and F4/80 respectively.

Results: CNV formation was significantly reduced in the PlGF knockout mice. The dose‐response experiment showed that the 20 mg/kg dose of anti‐PlGF significantly reduced the number of vessels in the lesions as compared to control antibody (p= 0.045), although less than a comparable dose of anti‐VEGFR2 (p=0.027). Moreover, smooth muscle cell coverage was significantly increased in the anti‐PlGF treated (p=0.04) and reduced in the anti‐VEGFR2 treated mice (p=0.03) as compared to control mice. Finally, a significant reduction in number of inflammatory cells was observed in the lesions treated with anti‐PlGF (p=0.017) but not in the anti‐VEGFR2 treated mice (p=0.33).

Conclusions: Anti‐PlGF treatment inhibits CNV formation in a mouse model for ARMD. Both anti‐PlGF and anti‐VEGFR2 impair capillary growth, but in contrary to VEGFR2 blockage, anti‐PlGF also reduces inflammation and promotes vessel maturation.
Relationship between visual acuity, visual evoked patterned potentials done at different spatial frequencies and fundus findings in more than 100 Cerebral Visual Impairment affected subjects
Authors: RUBERTO G , BERTONE C , ANTONINI M , SIGNORINI S , ANGELI R , LUPARIA A , FAZZI E , PEZZOTTA S , TINELLI C , BIANCHI PE
Published: October 2007

Purpose: To analyze relationship between visual acuity (VA), visual evoked patterned potentials (VEP) and fundus state of the optic disk in children diagnosed by MR as cerebral visual impaired (CVI).

Methods: Full clinical examinations, including Teller Acuity Cards (TAC) and/or optotype for decimal visual acuity, VEP and fundus optic disk findings , were done in 107 CVI affected infants (mean age 7,9±6). TAC were administered at spatial frequencies ranging from 0.23 to 38 cycles/degrees, at a distance varying from 84 to 55 cm. VEPs were recorded at Oz, O1, O2, referenced to Fz. Five black and white checks sizes, 300’,120’,60’,30’,15’, were presented. At least two spatial frequencies were performed depending upon the visual function. Statistical analysis: means and standard deviations were presented, correlation between VA and VEP, and association between optic disk features and VA were made.

Results: Mean VA in decimal, was 3.55, ranging from 1.5 (p 25)to 4.8 (p 75). Percent success in TAC responses was 75. Mean VEP latencies in Oz varied from 112 ( 15’) to 105,9 ( 300’). Mean amplitudes varied from 18,8 ( 15’) to 22,3 (300’). VEP percent success was 77.6. A negative correlation coefficient ( r ) was found between VA and larger checks . A weak association was found between VA, VEP and optic disk features.

Conclusions: Behavioural and objective tests correlate at different levels with fundus findings in CVI affected children, and are both useful in their follow‐up.
Unusual recurrent orbital tumour
Authors: IRION LD , BONSHEK RE , ATAULLAH S , LEATHERBARROW B , MCKEAG D , FERNANDO B
Published: October 2007

Purpose: We present a case of an unusual CD34+ recurrent orbital tumour.

Methods: A 62‐year‐old male presented with progressive left proptosis and preserved visual acuity. CT scans showed a circumscribed mass at the inferomedial orbit. After incisional biopsy, the patient preferred conservative treatment and the lesion was debulked. Further debulking was necessary in other two occasions. With radiological signs of bone invasion, left orbital exenteration was agreed in the fourth relapse.

Results: The lid skin sparing exenteration revealed a tumour mass (45 x 29 x 27 mm) in the inferomedial orbit. There was no evidence of invasion of either the globe or the optic nerve. In all occasions, the tumour consisted of spindle cells alternating vague storiform areas with patternless areas. The tumour was very cellular, showed low mitotic count and no necrosis or ulceration. There was focal invasion of fibrous tissue, extra‐ocular muscle, fat and bony fragments. The tumour was diffusely and consistently positive for CD34, S100 and vimentin. EMA and CD99 were focally positive. Several other markers were negative. This slow growing lesion with low grade histological appearance and EM suggestive of Schwannian processes was diagnosed as a CD34 positive Schwannoma on the first debulking. In the next two recurrences, experts agreed with a diagnosis of a DFSP based on the diffuse positivity for CD34. In the exenteration specimen, due to the exceptional location of the presumable DFSP, this diagnosis was disputed and after EM and further reviews the case was concluded as variant of low grade MPNST.

Conclusions: The consistent positivity for CD34 in our case has lead to diagnostic disagreement. Only after the fourth recurrence the final diagnosis of a CD34 positive low grade PNST could be made.
Meningeal carcinomatosis ‐ a hidden cause of bilateral visual loss
Authors: HENC‐PETRINOVIC LJ , JURIC A , VUKAS D , PETRINOVIC‐DORESIC J
Published: October 2007

Purpose: To present an unusual case of meningeal spreading of breast carcinoma causing bilateral blindness.

Methods: Diagnostic methods: cranial CT and MR, ophthalmic echography, perimetry, visual evoked potentials, and liquor analysis.

Results: The 50‐years old woman experienced gradual visual loss of her left, better eye while her right eye was amblyopic. Two and a half year ago her left breast was removed due to carcinoma with consecutive irradiation and chemotherapy. Bilateral optic disc oedema hyperemic on the right eye and pale on the left eye was found with reduced visual acuity and constricted visual field on both eyes. Cranial CT and conventional MR were negative. Visual evoked responses of the right eye showed reduced amplitude of P100 wave with normal latency while it was prolonged on the left eye. Echography confirmed optic nerve oedema. First presumption was anterior ischemic opticoneuropathy, but corticosteroid therapy was unsuccessful. Further deterioration and severe headaches were the indication for cerebrospinal liquor analysis. Carcinomatous cells were found and the diagnosis of meningeal carcinomatosis proven. Chemotherapy was suggested (BCNV+Platimit) in five cycles followed by Xeloda in 17 cycles. Two and a half year after the initiation of chemotherapy it was ceased and the patient died a month later.

Conclusions: Imaging methods alone were not sufficient to reveal the unusual way of spreading of the breast carcinoma, being the cause of bilateral blindness. It could be presumed that early chemotherapy and irradiation suppressed the carcinomatous proliferation to the other sites, but not intracranially. Survival of our patient for three years after positive liquor finding is exceptional.
Amniotic membrane preservation in RPMI‐1640 medium – 5 years experience
Authors: ASOKLIS R , BUTKIENE L , JUODKAITE G , MAKSELIS A , MONTVILAITE D
Published: October 2007

Purpose: Present amniotic membrane preservation method using RPMI‐1640 medium and brief analysis of performed surgeries.

Methods: Amniotic memmbrane preservation and transplantation surgeries in Vilnius University Hospital Center of eye Diseases was started at the end of 2001. Till the June 2007 amniotic membrane was prepared from 5 placentas obtained during the caesarean delivery. The essence of the preparation of the amniotic membrane was as described by H.Dua and other authors. However, because of the supply disturbances in our hospital instead of the traditional mediums we used RPMI‐1640 medium. Before the cuting amniotic membrane to a small pieces we put the whole membrane in RPMI‐1640 medium with high concentration of antibiotics and antifungals and stored in +5ºC temperature for 24 hours. After that amniotic membrane we put on paper cut to small peaces and stored in RPMI‐1640 medium and glicerol in ‐ 80°C.

Results: Before the surgery amniotic membrane was warmed in room temperature. No damage of the structure was observed. Hystopathological slides of membrane samples were performed. Preservation medium specimens for microbiological investigation were taken. From all 5 placentas series no growth was observed. Amniotic membrane was used during 179 ocular surface surgeries.

Conclusions: 1. RPMI‐1640 medium can be successfully used for amniotic membrane preservation. 2. Before final frosting in ‐ 80°C, 24 hours in high concentration of antibiotics and antifungals can guaranty high impregnation of amniotic membrane with antimicrobial medication. 3. After preservation in RPMI‐ 1640 medium amniotic membrane retains it appearance, clarity and physical durability.
Why is geographic atrophy more common in Iceland than in other white populations.
Authors: JONASSON F
Published: October 2007

Purpose: Studies have shown geographic atrophy to be more common in Iceland than elsewhere. Several possible causes for this are explored.

Methods: We use fundus photographs and standardized grading and classification of age‐related maculopathy and age‐related macular degeneration to establish prevalence and 5‐year incidence. We use a questionnaire regarding lifestyle and diet. We genotyped 581 Icelandic patients with advanced AMD (278 neovascular AMD, 203 GA & 100 with mixed neovascular AMD/GA). We examined CFH and closely related genes CFHR1‐4 and HTRA1.

Results: Reykjavik Eye Study includes 1045 participants born 1890 – 1946. Those better nourished than the average seemed to have a protective effect against late AMD. Iris colour was not associated with AMD. Smoking may confer similarly increased risk for GA and wet AMD. CFH confers similar risk for drusen, GA and wet AMD. Changes in the promoter region of HtrA serine peptidase1 (HTRA1) confer slightly higher risk to wet AMD than GA though this difference is not statistically significant.

Conclusions: Smoking lead to increased risk of prevalent AMD and to increased 5‐year mortality. Genetic risk for wet AMD and GA appeared similar suggesting that at least in part they share the same genetic pathway. The generation under consideration consumed hardly ever vegetables containing lutein and zeaxanthin, did however have a very high intake of Omega‐3 from fish and fish‐oil the latter with high doses of Vitamin A added. High Vitamin A itake over a lifespan may have increased the lipofuscine content in the retinal pigment epithelium and lack of lutein and zeaxanthin intake over the same lifespan may have lead to serious deficit and both may have increased the risk of geographic atrophy in this population.
Morphologic factors associated with progressive glaucomatous optic disc damage in patients with primary open angle glaucoma and low tension glaucoma
Authors: LAEMMER R , HORN FK , JUENEMANN AGM , MARDIN CY
Published: October 2007

Purpose: To investigate the influence of morphologic characteristics on the rate of progression in patients with open angle glaucoma with and without elevated intraocular pressure.

Methods: One hundred eight eyes of 54 patients with low tension glaucoma and 128 eyes of 64 patients with open angle glaucoma were recruited from the Erlangen Glaucoma Registry for this study. All included patients received an annual standardized glaucoma examination. Progressive glaucomatous optic disc atrophy was determined as rate of neuroretinal rim loss by masked comparative analysis of stereographic optic disc slides by two experienced observers independently. Standard parameter from Scanning Laser Tomography (HRT I, Heidelberg Engineering) from baseline examination were compared between stable and progressive patients in both groups.

Results: Neuroretinal rim area and volume was already at baseline significantly lower in the progressive group in patients with open angle glaucoma (1.26 +/‐ 0.38 mm² vs. 1.57 +/‐ 0.48 mm²; p<0.001 and 0.28 +/‐ 0.17 mm³ vs. 0.41 +/‐ 0.23 mm³; p<0.001, Mann‐Whitney‐U test) but not in patients with low tension glaucoma (1.07 +/‐ 0.39 mm² vs. 1.16 +/‐ 0.40 mm²; p=0.404, and 0.19 +/‐ 0.12 mm³ vs. 0.23 +/‐ 0.15 mm³; p=0.180, Mann‐Whitney‐U test) if compared with the non‐progressive group.

Conclusions: Patients with open angle glaucoma with and without elevated intraocular pressure seem to differ concerning morphologic factors for eventual progression. Low neuroretinal rim area or volume as quantified by Scanning Laser Tomography may be a risk factor for further neuroretinal rim loss in patients with open angle glaucoma.
Imaging of iris melanotic lesions and corneal tumors with three different high speed optical coherence tomography instruments
Authors: DE KEIZER RJW , RAZZAQ L
Published: October 2007

Purpose: Should it be possible to detect anterior segment melanocytic lesions with anterior segment OCT’s. When detected was special pachymetry possible to calculate our brachytherapy diagram.

Methods: Three different IAS instruments were used, however at different times. In total 46 patients with light coloured eyes were analysed. The results were compared with already known clinical parameters and with anterior eye segment ultrasound when available.

Results: Sixteen eyes were analysed using one infrared IAS, nine eyes using another infrared IAS and 15 eyes with using a blue light IAS. Iris tumours were detectable in 90% using the infrared methods. With the infrared instruments we found the iris tumour or lesion in a high percentage so they could be analysed. With one of these infrared instruments we could compare the pictures with the ultrasound findings, but the pachymetry was even better than the ultrasound. In the selected group only anterior cilio‐irido melanomas were detected. Corneal and conjunctiva tumorous lesions could be also in some cases detected.

Conclusions: Conclusion: In this pilot study we demonstrated melancytic lesions in light coloured eyes using the infrared anterior segment OCT’s in a high percentage of the cases. Only anterior cilio‐irido tumours were minimal positive. Using these instruments new chamber angle pathology could also be found. Optimal special pachymetry for our brachytherapy calculation diagram was also good possible.
Microstructural changes of longitudinal retinal venous profiles measured by retinal vessel analyzer in systemic hypertension
Authors: KOTLIAR KE , NAGEL E , SEIDOVA SF , LANZL IM
Published: October 2007

Purpose: The Retinal Vessel Analyser (RVA) observes vessels in their dynamic state non‐invasively. We found earlier a significant increase in roughness along longitudinal vessel profiles with increasing age. Whether longitudinal retinal venous profiles in systemic hypertension (SH) are altered is investigated.

Methods: 15 untreated SH‐patients (age 50,9±11,9 years) and 15 age matched healthy volunteers were examined. After baseline assessment a monochromatic (530‐600nm) rectangular flicker of 12.5 Hz was applied for 20 sec. In venous segments (1 mm length) vessel diameters were measured to obtain a longitudinal vessel profile.

Results: Baseline average diameters and caliber range differed significantly in both groups (p<0,03) (median(1quartile; 3quartile)): SH: 164,4(151,8; 168,4)MU/ 33,5(21,6; 35,8)MU; control: 146,4(132,3; 152,1)MU/ 19,9(16,0; 23,6)MU. Average area under power spectra within the frequency band of 0,03‐0,065 Hz differed significantly at dilation (SH: 0,171(0,113; 0,351); control: 0,366(0,328; 0,490)); initial restoration (SH: 0,213(0,134; 0,359); control: 0,382(0,303; 0,514)) and restoration (SH: 0,252(0,128; 0,374); control: 0,425(0,311; 0,496))(p<0,03).

Conclusions: The veins in SH seem pre‐dilated and pe‐stretched. The microstructure of longitudinal venous profiles in healthy volunteers and SH‐patients does not change in different phases of the reaction. In longitudinal venous profiles in SH low frequencies are more expressed and mid frequencies are less pronounced than in the control group. These microstructural changes in vessel profiles in SH‐patients might be an indication for alterations in the vascular endothelium, leading to impaired local perfusion and regulation.
Efflux proteins of outer blood‐retinal barrier
Authors: MANNERMAA E , VELLONEN KS , RYHÄNEN T , KAARNIRANTA K , URTTI A
Published: October 2007

Purpose: Blood‐retinal barrier (BRB) restricts movements of drugs from blood circulation to the retina. Efflux proteins of retinal pigment epithelium (RPE), which forms the outer part of BRB, may have a role in this barrier. The aim of this study was to measure efflux protein (multidrug resistance associated proteins (MRP1‐6) and breast cancer related protein (BCRP)) expression in RPE and to test activity of MRP5 in RPE.

Methods: Expression of efflux proteins was studied by quantitative PCR, western blotting and immunohistochemistry. The activity of MRP5 was assessed by CDCFDA/CDCF efflux test and permeability assay. Probenecid was used as an inhibitor. Materials included cell lines: ARPE‐19, D407, HRPEpiC and tissues: bovine RPE/choroid and human eye specimens.

Results: Expression of MRP1,4 and 5 was found in RPE both in RNA and protein level. In addition MRP2‐3 and BCRP were expressed in D407 cell line. CDCF efflux was inhibited by probenecid in ARPE‐19 cells indicating functional activity of MRP5 in ARPE‐19 cells. The apparent permeability of CDCFDA/CDCF in bovine RPE/choroid tissue was ten times higher from neural retina to choroid compared to opposite direction.

Conclusions: Particularly, we have shown pronounced expression of MRP1, 4 and 5 in RPE. Our results suggest that MRP5 may be active efflux transporter in RPE. MPR5 may function in physiology and also have impact on drug delivery to the posterior eye segment. Our findings may be important in the development of specific drug targeting to RPE and retina and to understand the function of BRB more comprehensively.
Fish analysis of chromosome 3 and 6 on fine needle aspiration biopsy identifies distinct uveal melanoma subgroups
Authors: PARROZZANI R , BONALDI L , RADIN PP , PILOTTO E , MIDENA E
Published: October 2007

Purpose: Some evidence suggests that uveal melanomas develop following one of two ways in a pathogenetic model, one starting with a loss of chromosome 3 and the other with extra copies of 6p (+6p), heaving different prognostic outcome. The aim of this study was to analyze the role of Fluorescence In Situ Hybridization (FISH) applied on Fine Needle Aspiration Biopsy (FNAB) specimen to in‐vivo verify the presence/ absence of this bifurcated pathogenetic and prognostic model.

Methods: Thirty‐five consecutive patients, affected by posterior uveal melanoma (>3,5 mm in thickness), scheduled for Iodine‐125 brachitherapy, underwent intraoperative trans‐scleral FNAB just before plaque implantation. Specimens underwent Fluorescent in Situ Hybridisation (FISH) to detect chromosome 3 and 6 (as +6p and 6q‐) status.

Results: Minimum follow‐up was 12 months (range: 12‐40 months). All cases gave enough material for cytogenetic analysis. +6p and monosomy 3 were mutually exclusive in 29 cases (83%). Three cases (8.5 %) showed no chromosome 3 and 6 abnormalities and three cases (8.5%) showed both monosomy 3 and +6p. Monosomy 3 was not significantly related (p>.05) to tumour dimensions and tumour location (choroid/ciliary body). No major complications or extrascleral extension were documented. Three patients (8,5%) with monosomy 3 developed metastatic disease during the follow up.

Conclusions: In‐vivo detection of cytogenetic prognostic‐related characteristics in posterior uveal melanoma is possible analyzing cytologic specimens obtained by transcleral FNAB before episcleral plaque implantation. FISH analysis for chromosome 3 and 6 status could offer more prognostic information than monosomy 3 alone.
Mathematical analysis of the cone ERG photopic hill: Clinical applications
Authors: LACHAPELLE P , GARON M , JAUFFRET C , RUFIANGE M , HAMILTON R , MCCULLOCH C , KOENEKOOP RK , POLOMENO RC , LITTLE JM
Published: October 2007

Purpose: With brighter stimuli, the photopic ERG b‐wave increases to a maximal value and then decreases to a plateau, a feature known as the Photopic Hill (PH). Recently, a mathematical model combining a Gaussian (GF) and a Logistic Growth (LGF) functions was developed to fit the PH (Hamilton et al., Vision Research, in press). We examined if this equation could help us sort out selected retinopathies.

Methods: We compared PHs (background: 30 cd.m‐2; intensities: ‐0.8 to 2.84 log cd.sec.m‐2) obtained from normals (N=40) and patients (N=20) affected with Congenital Stationary Night Blindness (CSNB), Congenital Postreceptoral Cone Pathway Anomaly (CPCPA) and Retinitis Pigmentosa (RP) with the GL ratio [GL= Gb / (Gb+Vbmax)] were Gb and Vbmax represent the amplitude of the Gaussian and logistic (Vbmax) functions respectively.

Results: The normal GL ratio is 0.60 ± 0.08 (mean ± 1SD) compared to ≈1.0 in CSNB (almost pure GF) and 0.32±0.08 in CPCP [reduced GF (p<.05) and normal LF (p>.05)] patients. Six of the 8 RP patients had a GL ratio above 0.5 (mean GL= 0.70 ± 0.19) and 2 below (0.28 and 0.41). Of interest, while in some retinopathies, a decline in Gb and Vbmax occurred with disease progression (longitudinal and transversal comparisons), it did not always modify the GL ratio.

Conclusions: Human PH can be dissected into two distinct and concomitant phenomena each represented by its own equation. Altghough the retinal origin of the GF and LGF awaits to be confirmed, use of this mathematical approach appears to add valuable information that will further refine the diagnosis of retinal disorders affecting the photopic (cone) pathway. Supported by CIHR and Réseau Vision.
Haptoglobin knockout mice exhibit morphologic changes consistent with iridocorneal dysgenesis and glaucoma
Authors: VAN GINDERDEUREN R , GALICIAS‐ROSAS G , VANDEVEIRE S , OP 'T HOOG B , CEUPPENS J , STALMANS I
Published: October 2007

Purpose: To investigate the ocular phenotype of mice that lack the acute phase protein Haptoglobin (Hpko).

Methods: Hpko mice were clinically evaluated at 16 weeks of age. Mice that showed macroscopic changes of the eyes were sacrificed and their eyes were enucleated, fixed in paraformaldehyde, histological sectioned and stained with hematoxylin and eosin. The diameter of the eye was measured and the histomorphology was evaluated and compared with eyes of normal wild‐type mice.

Results: Clinical observation revealed that between 10 and 20 % of the Hpko mice exhibited gradual opacification of the cornea and shrinkage of the eyes . These mice were investigated. The eyes of Hpko mice were between 10 and 40 % smaller than eyes of normal mice. The eyes of Hpko mice showed rudimentary and more widely spread processi of the ciliary body. Moreover the anterior chamber showed goniosynechia and irido‐corneal adhesions, as well as attenuation of the trabecular meshwork. The neuroretina showed a variable atrophy in ganglion cell layers in all Hpko mice and in the inner nuclear and plexiform layer in 80 %.

Conclusions: Haptoglobin knockout mice have structural abnormalities of the anterior segment and neuroretina comparable to human iridocorneal dysgenesis and developmental glaucoma.
Retinal fixation in Diabetic Macular Edema
Authors: BOTTEGA E , VUJOSEVIC S , PILOTTO E , MIDENA E
Published: October 2007

Purpose: Diabetic macular edema (DME) determines central retinal sensitivity reduction with a functional correlate to increased macular thickness. Data about fixation are controversial. The aim of this study was to determine fixation characteristics in diabetic patients with or without clinically significant macular edema (CSME).

Methods: 120 consecutive diabetic patients (165 eyes) underwent best corrected visual acuity (BCVA) determination (ETDRS charts), and a complete ophthalmologic examination. Diagnosis and classification (focal, diffuse and cystoid) of CSME were made on 30 degrees stereo retinal photographies (field 2 of ETDRS) and fluorescein angiography and OCT. The presence and site of hard exudates was evaluated. Retinal fixation and macular sensitivity were investigated with an advanced, automatic microperimeter (MP1, Nidek Technologies, Italy). Macular thickness and foveal neuroretinal detachment were determined by Optical Coherence Tomography (OCT Stratus, Zeiss Humphrey Instruments, Germany).

Results: Of 141 examined eyes 24 (17.14%) had focal CSME, 37 (26.43%) had diffuse CSME, 51 (36.43%) cystoid CSME, 29 (17.6%). Mean BCVA was 0.6+0.36 logMAR. There was no significant correlation between the type of edema and the site and the stability of fixation (P>0.05). Fixation was eccentric or unstable in case of subfoveal hard exudates (Site P=0.032; Stability P= 0.0113). The presence subfoveal neuroretinal detachment did not significantly influence fixation pattern (P>0.05).

Conclusions: Retinal fixation patterns in DME vary diferently based on clinical characteristics of foveal involvement. Fixation may be often located in areas undergoing laser treatment. The functional impact of focal photocoagulation should be investigated also from the fixation point of view
Dissectional and endoscopical anatomy of the lacrimal duct
Authors: JAVDANI Z , DENEFFE G , VERBINNEN J
Published: October 2007

Purpose: A better knowledge of the external and internal anatomy of the lacrimal duct is

essential for any intervention. The induced prussure of the medial canthal ligament into the lacrimal sac might be considered as one of the reasons of epiphora.

Methods: In this study, cadaver disection, trans‐canalicular and endonasol endoscopy are used to provide a better intuition of anatomy.

Results: Concerning the medial canthal ligament, cadaver study of the lacrimal duct reveals that there are two portions: the posterior portion and anterior one which passes over the lacrimal sac and inserts on the lacrimal bone. The medial portion of the medial canthal ligament is connected by the medial part of the tarsus superior and inferior. There are fascial connections between the anterior part of the ligament and the lacrimal sac and between the anterior part of this ligament to the orbicular superior and inferior muscels.

The lacrimal duct starts from the Punctum superius and inferius and terminates in the nose. The inferior opening of the duct comes in the nose on the level of the inferior turbinate.

Collaps of the canaliculi or the lacrimal sac is investigated by trans‐canalicular endoscopy. It is observed that the pressure induced by medial canthal ligament into the lacrimal sac is the main reason of collps of the canaliculi or the lacrimal sac.

Conclusions: Trans‐canalicular and endonasal endoscopy which are complementary to disectional anatomy, provid a better insight of the naso‐lacrimal duct anatomy and physiology. This knowledge is mandatory for any naso‐lacrimal duct interventions. Epiphora with exclusion of the other ethiology (allergy, foreign body) than obstruction, can be caused by collaps of the lacrimal sac due to pressure of the medial canthal ligament.
Cytokeratin 8 and 18 expression in human corneal endothelium
Authors: JIRSOVA K , MERJAVA S , NEUWIRTH A
Published: October 2007

Purpose: To determine if cytokeratins (CK) 8 and 18 are expressed in healthy corneal endothelium.

Methods: Five healthy human corneal discs not suitable for transplantation were used. The mean age of the corneal donors was 70 years (range: 51‐83 years). The corneal buttons were dissected into two parts. One half was used for impression cytology of the endothelium followed by semi‐quantitative RT PCR and immunohistochemical detection of CKs. The second half was frozen and cryosections were prepared. Impression specimens as well as cryosections were fixed and indirect immunofluorescent staining was performed using antibodies against CK8, CK18 (Chemicon) and CK8/18 (Dako). The percentage of positive cells and the intensity of the staining were assessed using fluorescent microscopy. A minimum of two hundred cells were counted per specimen.

Results: All impression specimens displayed cells with the hexagonal morphology typical of the corneal endothelium. The mean number of positive cells was 57% for CK8, 8% for CK18 and 42% for CK8/18. The mean number of positive cells in cryosections was 47, 4, and 38% for CK8, CK18 and CK8/18, respectively. Furthermore, expression of the CK8 and CK18 genes was present in all corneas.

Conclusions: We detected both CK8 and CK18 in the endothelium of all specimens at both protein and mRNA levels. These results unambiguously demonstrate that cells of the corneal endothelium express the CK pair 8/18 and share some features with simple epithelia.
Long‐term stability of LASEK performed to correct myopia in thin corneas.
Authors: TEUS MA , DE BENITO‐LLOPIS L , ALVAREZ M , TORRES J , GIL‐CIGANDA N
Published: October 2007

Purpose: To study the stability of the refraction 15 months after myopic laser‐assisted subepithelial keratectomy (LASEK) performed in thin corneas.

Methods: We performed a retrospective study of 92 consecutive eyes that had undergone LASEK to correct their myopia and that had a preoperative corneal thickness <500 μm. Intraoperative mitomycin‐C (MMC) was applied when the ablation depth was ≥50μm. We compared the residual spherical refraction between the 3‐month and 15‐month examinations, in order to detect a possible myopic change that would suggest secondary corneal ectasia.

Results: Preoperative corneal thickness was 483.9 ± 14.0 μm (range 435 to 500). Preoperative spherical refraction was ‐3.60±2.40D. Preoperative cylinder was ‐0.90±1.10D. The residual sphere was +0.18±0.50D (range ‐1.25 to +2.00D) 3 months postoperatively and +0.13±0.7 (range ‐1.75 to +2.00D) 15 months after surgery (P>0.05). Uncorrected visual acuity was 0.97±0.2 and 1.03±0.2, respectively (P>0.05). Topography showed no signs of ectasia in any case.

Conclusions: Myopic LASEK performed on thin corneas seems to obtain long‐term stable refractive results, with no sign of ectasia 3 and 15 months postoperatively.
Diabetes related complications – the Moorfields Diabetes Survey
Authors: PETO T , LEUNG I , HARRIS N , XING W , BUNCE C
Published: October 2007

Purpose: The aim of this study was to establish characteristics of patients with diabetes mellitus (DM) attending Moorfields Eye Hospital (MEH) before implementation of the national diabetic retinopathy (DR) screening programme.

Methods: Patients with DM attending MEH Medical Retina Clinics during a 4 week time period were interviewed about DM, its complications and knowledge and expectations on laser treatment.

Results: In 4 weeks, 830 patients with DM were identified, of whom 4.3% were registered partially sighted and 4.7% registered blind. 141 did not attend, 109 could/would not be interviewed and 580 interviews were conducted. Interviewed patients were similar to those not except for previous laser treatment (p=0.016). The median duration of DM was 10 years (0.3‐52 years); 74.3% had Type 2 DM; 64.8% had hypertension. A high proportion of patients had at least one diabetic complication (heart disease 24%; stroke 9.7%; diabetic neuropathy 48.9%; diabetic nephropathy 13.4%); 13.1% did not understand the relationship of DM with DR. In the past 61.5% and 64.1% patients had fluorescein angiography (FFA) and laser treatment; on the day of the interview 5.8% had FFA and 13.4% laser. Despite full consent, 51.6% did not understand how long it took the laser treatment to work or expected it to take effect immediately; 16.6% expected to have only one treatment ever. Only 20.9% were members of Diabetes UK.

Conclusions: Patients currently attending eye clinics have many diabetes related complications. With full implementation of the National Screening Programme for DR this percentage is expected to rise. Careful planning of ophthalmic services needs to be undertaken to accommodate the need for services for patients with multiple diabetes related complications.