bluuebunny/crossref_metadata_2025 huggingface dataset:
Subfoveal choroidal thickness in Caucasians
Authors: STEINMETZ P
Published: August 2012

Purpose Purpose: To examine the normal thickness of the subfoveal choroid and associated factors.

Methods Methods: Patients without any macular or optic nerve disease and attending the clinic for cataract surgery underwent biometry and enhanced depth imaging of the deep retinal and choroidal layers by spectral domain optical coherence tomography (SD‐OCT, Spectralis).

Results Results: The study included 47 patients (24 women) with a mean age of 73.4 ± 7.3 years (range: 57.1 – 87.4 years) and mean axial length of 23.56 ± 0.88 mm (range: 21.65 – 25.47mm). In multivariate analysis, mean choroidal thickness (253 ± 103µm; mean: 241µm; range: 94‐573µm) decreased significantly with longer axial length (non‐standardized correlation coefficient B: ‐0.46; standardized correlation coefficient ß= ‐0.39; P =0.006) and older age (B: ‐4.4; ß= ‐0.31; P=0.03).

Conclusion Conclusions: Mean subfoveal choroidal thickness in elderly Caucasians was 253 ± 103µm. For each mm increase in axial length, and for each increase in year of age, subfoveal choroidal thickness decreased by 46µm and 4.4µm, respectively. These data are almost identical with those measured for Chinese in the Beijing Eye Study (mean thickness: 254±107μm; decrease in choroidal thickness by 45μm and 4.1μm for each mm increase in axial length and each year increase in year of age, resp.)
Automated measurement of retinal vascular caliber and arteriovenous ratio in type 2 diabetic patients without retinopathy
Authors: LEE DW , BAE JH , JANG HJ , KIM JM , CHOI CY
Published: August 2012

Purpose To determine the retinal vascular caliber and arteriovenous ratio (AVR) in type 2 diabetic patients without retinopathy.

Methods We retrospectively reviewed the medical records of 70 patients diagnosed as type 2 diabetes without retinopathy. Digital fundus photographs of the right eye were selected for measurement. The caliber of all retinal vessels passing through an area 0.5 to 1 disc diameter around the optic disc was measured using automated computer software (Zeiss AV ratio). Seventy seven age‐ and sex‐matched healthy subjects were included in the study as a control.

Results The mean AVR was 0.801 ± 0.068 in the diabetic patients compared to 0.762 ± 0.054 in the control group (P < 0.001). Higher AVR was significantly associated with increasing blood HbA1c levels (r2 = 0.106, P = 0.006). However, there was no significant correlation between AVR and body mass index (P = 0.478).

Conclusion The rise in AVR seems to be an early feature of retinal vascular caliber in type 2 diabetes and correlates with an elevated blood HbA1c level.
Cataract surgery and the dexamethasone drug delivery system for the treatment of retinal venous occlusion
Authors: EGEA ESTOPINAN C , FERNANDEZ‐PEREZ S , HERRERO R , GARCIA‐MARTIN E , DE LA MATA G , SATUE M , BAMBO MP , ARA M , FERNANDEZ‐LARRIPA S , FERRERAS A , ABECIA E
Published: August 2012

Purpose To report our case report with sustained‐release dexamethasone 0.7 mg intravitreal implant (Ozurdex®; Allergan, Inc., Irvine, CA) in retinal vein occlusion with macular edema

Methods A 81‐years old male patient with recent retinal vein occlusion with macular edema treated with sustained‐release dexamethasone 0.7 mg intravitreal implant and cataract surgery was performed. On initial examination, the right best‐corrected visual acuity (BCVA) was 0,1. Right fundoscopy revealed retinal hemorrhage in the superior quadrant of the retina. The fluorescein retinal angiography showed a delay of filling time and spectral domain optical coherence tomography (Spectralis SD‐OCT; Heidelberg Engineering, Heidelberg, Germany) showed macular edema 485 μm

Results The patient was treated with two dexamethasone 0.7 mg intravitreal implant and cataract surgery in one year. During the first six months after implant the right BCVA was 0,4 and OCT: 294 μm. At six months the macular edema increased 335 μm and we treated with the second implant, the macular edema improved 280μm but not the BCVA and we realized cataract surgery and BCVA was improved to 0.5.

Conclusion The dexamethasone drug delivery system is one of the most recent additions to the armamentarium against macular edema, and is intriguing for its potency, dose consistency, potential for extended duration of action, and favorable safety profile but can accelerate cataract surgery.In patients with macular edema in retinal vein occlusion, sustained‐release dexamethasone 0.7 mg intravitreal implant may be an effective treatment option to control macular edema
Effects of arteriolar constriction on retinal gene expression and müller cells in an experimental retinal vein occlusion
Authors: KOEFERL P , BRINGMANN A , WIEDEMANN P , REHAK M
Published: August 2012

Purpose To investigate the effect of the laser‐induced arteriolar constriction (AC) on branch retinal vein occlusion (BRVO) induced Müller cell responses and alterations in gene expression of factors implicated in the development of edema.

Methods In Brown‐Norway rats the BRVO was induced by laser photocoagulation of the veins in one half of the retina. AC of the afferent arterioles was performed 30 minutes later. The expression of Vegfa, Vegfb, Pedf, Kir4.1, Aqp4, Aqp1, Il1ß, and Il6 was determined with RT‐PCR in the retina and retinal pigment epithelium (RPE) after 1, 3 and 7 days. Potassium currents were recorded in Müller cells 3 days after BRVO. Immunostaining against GFAP, Aqp4 and Kir4.1 was performed on day 1 and 3.

Results BRVO resulted in the neuroretinal transient upregulation of Vegfa on day 1. The expression of the Kir4.1, Aqp4, and Aqp1 channels were downregulated, and Il1ß and Il6 strongly upregulated, on day 1 and 3. The retinal distribution of GFAP and Aqp4 proteins remained unaltered, while the Kir4.1 protein displayed redistribution from a polarized to a uniform retinal distribution. Müller cells showed cellular hypertrophy and a decrease in potassium currents. AC accelerated the restoration of downregulated Kir4.1, Aqp4, and Aqp1 in the RPE, of Kir4.1 in the neuroretina and of upregulated Il6 in the neuroretina. AC did not influence the gliotic alterations of Müller cells and the redistribution of Kir4.1 protein.

Conclusion The constriction of the afferent artery in the BRVO region had only marginal effect on the BRVO‐evoked alterations in retinal gene expression.
AMD atrophic areas. Characteristics, evolution study, and its interest. 3 years follow‐up
Authors: GONZALEZ C
Published: August 2012

Purpose To evaluate the characteristics of AMD atrophic areas, their change, evolution and incidence or no of neovascular complication.

Methods 134 eyes of 108 patients, 32 men, 76 women, with AMD Atrophic areas. Atrophic areas were evaluated by autofluorescence imaging Spectralis HRA +OCT (in particular with region finder software), OCT (notably choriocapillary depth), FA, ICG. We evaluate the size, characteristics, topography of the lesions, their growth way. The areas themselves, their edge and rim were considered and evaluated. Each element was studied, compared cut to cut and time to time to itself and to each other data, every 4 months. The impact of AMD and /or Neovascular complication on the evolution of atrophic areas is also valuate.

Results VA impaired in 24% cases, stabilized in 76%. AF imaging and their region finder analyze were the main elements of the atrophic lesions’ study. The surface of the atrophic area grows by 14%, the edge changes in 20%, the rim increases 15% in 30% cases, with ZAC spared in 87%. Atrophy extension preferred nasal side, confluence in 65% when multiple areas. At OCT,thickness of photoreceptor, pigment epithelium layer diminished at area and edge. Choriocapillary depth values, FA and ICG data were mainly significative in the large atrophic areas and less than AF indications. Neovascular complication has few effects on atrophic areas evolution.

Conclusion The study of atrophic process and its progression is a main question in AMD, its follow –up, its evolution, its increase. It also allows the evaluation of Neovascular complication impact. Atrophic areas are of main importance to AMD, either no or neovascular.
The in vitro anti‐inflammatory and anti‐angiogenic potential of a new resveratrol‐based formula (Resvega)
Authors: LANCON A , LIZARD G , LATRUFFE N
Published: August 2012

Purpose Age‐related Macular Degeneration (AMD) is a pathology driven by inflammatory and angiogenic processes. The aim of this work was to study the in vitro anti‐inflammatory and anti‐angiogenic potential of a new resveratrol‐based formula (Resvega, Laboratoires THEA, France) on Human retinal pigment epithelium cell line ARPE‐19 after an inflammation induced by the bacterial lipopolysaccharide (LPS).

Methods Human ARPE‐19 cells were subjected to inflammation by LPS (0128:B12) and co‐treated during 24 hours with Resveratrol (50,30,10 or 1µM) or the Resvega formula (50,30,10 or 1 µM expressed in Resveratrol equivalent). Cell media were collected and the levels of 6 cytokines were measured by the multiplex Cytometric Bead Array Kit (BD Bioscience) : IL‐8, IL‐1 beta, IL‐6, IL‐10, TNF alpha and IL‐12p70. Finally the level of the major angiogenic factor VEGF‐A was measured in these media by ELISA (eBioscience)

Results The results showed that among the 6 cytokines only IL‐6 and IL‐8 were over‐expressed during the inflammation triggered by the LPS treatment. These two pro‐inflammatory cytokines were down‐regulated by Resveratrol and Resvega treatments by at least 50‐60% in all conditions even at the very low concetrations (1 µM). Concerning VEGF‐A levels, Resveratrol and Resvega showed a dose‐dependent inhibition. The maximum inhibition was observed for the highest concentration of Resvega (50 µM resveratrol equivalent)with a decrease by 74%.

Conclusion In conclusion, we demonstrated that Resvega had an anti‐inflammatory and anti‐angiogenic effect in vitro, on the human retinal pigment epithelial cells.
Effects of bevacizumab on newborn rat retinal proteoglycans gene expression and on cell proliferation, death and differentiation, in vitro
Authors: MONTEIRO M , KREMPEL P , PORTES A , MATSUDA M , ALLODI S , SHOLL‐FRANCO A , MARQUEZINI M , PUNTAR T , MENDEZ‐OTERO R , MIGUEL N
Published: August 2012

Purpose VEGF is an important in nervous development, promoting neurogenesis and glial cell growth. Bevacizumab (BVZ), an anti‐VEGF agent, has been extensively used for controlling pathological retinal neovascularization in adult and newborn patients, although its effect on the developing retina remains largely unknown. In this study we investigate BVZ effect on proteoglycans and on cell death, proliferation and differentiation in newborn rat retina.

Methods Retinal explants of sixty 2‐day‐old Lister hooded rats were maintained in culture media with or without BVZ for 2 days. Immunohistochemical staining was assessed against proliferating cell nuclear antigen (PCNA), caspase‐3 and beclin‐1 and vimentin and glial fibrillary acidic protein (GFAP). Gene expressions for PCNA, caspase‐3, beclin‐1, vimentin, GFAP and for proteoglycans were quantified by real‐time reverse‐transcription polymerase chain reaction. Results from treatment and control groups were compared

Results No significant difference in staining intensity of PCNA, caspase‐3, beclin‐1 and GFAP or in the mRNA levels of PCNA, caspase‐3, beclin‐1, vimentin, neurocan and phosphacan was observed. However, a significant increase in vimentin levels, decrease in GFAP and in syndecan‐3 mRNA expression were observed in BVZ‐treated retinas compared to controls.

Conclusion Bevacizumab did not affect cell death or proliferation in early developing rat retina but appeared to interfere with glial cell maturation (by interfering with vimentin and GFAP). It can also alter syndecan‐3 gene expression. Thus, we suggest anti‐VEGF agents be used with caution in developing retinal tissue.
Cytomegalovirus retinitis (CMVR) with and without extra‐ocular CMV (EO‐CMV) Infection – a comparative analysis of outcomes in HIV patients
Authors: GAN N , AGRAWAL R , TEOH S
Published: August 2012

Purpose To compare the characteristics and treatment outcomes of HIV patients with cytomegalovirus retinitis (CMVR), with and without extra‐ocular CMV (EO‐CMV) infection in Singapore.

Methods This is a retrospective cohort study. All HIV patients diagnosed with CMVR at the Singapore Communicable Disease Centre from January 2005 through November 2009 were included.

Results 101 patients (138 eyes) were included. 92% were male, with a mean age of 48.6±10.4 years. Median follow‐up was 8 months (range 0.5‐58). 11% defaulted at a median of 6 months, and overall mortality was 24% at a median of 4 months. There were 68 patients (88 eyes) with only CMVR and 33 patients (50 eyes) with CMVR and EO‐CMV. 36% had multiple sites of EO‐CMV infection. In the EO‐CMV group, 24% developed EO‐CMV after CMVR, of which 6 were diagnosed with EO‐CMV infection within 3 months after initiation of anti‐retroviral therapy. Bilateral CMVR was significantly higher in the EO‐CMV group (52% versus 29%; p=0.03). Patients with EO‐CMV were less likely to develop immune reactivation uveitis (OR 0.8; CI 0.3‐2.4), although mortality was higher (42% versus 15%, p=0.002). Multivariate logistic regression analysis showed that a longer duration of prior anti‐CMV treatment had higher odds (OR 1.127, p=0.037) of CMVR recurrence, but no significant difference between both groups (OR 0.886, p=0.866).

Conclusion EO‐CMV infection was significantly associated with increased mortality, bilateral CMVR disease and can manifest as CMV‐associated immune reconstitution inflammatory syndrome. Our results also suggest that CMVR recurrence is multi‐factorial and cessation of anti‐CMV therapy should be tailored to an individualized risk factor profile.
Macular involvement in non infectious intermediate, posterior and panuveitis
Authors: BOULADI M , CHEBIL A , LARGUECHE L , KORT F , BROUR J , TURKI F , MGHAIETH F , EL MATRI L
Published: August 2012

Purpose To study macular involvement in non infectious intermediate, posterior and panuveitis.

Methods The data of 201 eyes in 118 patients with diagnosed non infectious intermediate, posterior or panuveitis examined between January 2007 and June 2012 were retrospectively reviewed. All patients underwent complete ophthalmic examination with fluorescein angiography and optical coherence tomography (OCT) to assess macular involvement.

Results Uveitis was due to behcet’s disease in 62 eyes(30.8%), sarcoidosis in 22 eyes (10.9%), VKH in 24 eyes (11.9%), sympathetic ophthalmia in 1 eye (0.5%), birdshot chorioretinopathy in 2 eyes (1%), and multiple sclerosis in 2 eyes (1%). At initial examination, 54 eyes (27.2%) demonstrated macular involvement which consisted in macular edema (ME) in 32 eyes (15.9%), serous retinal detachment in 29 eyes(14.4%), epiretinal membrane (ERM) in 8 eyes (3.9%), macular atrophy in 2 eyes (1%), vitreo‐retinal traction in 1 eye (0.5%), macular hole in 1 eye (0.5%) , and active macular chorioretinitis in 1 eye (0.5%). During follow up, 16 eyes (8%) developed macular complications including ME in 6 eyes(3%), ERM in 5 eyes (2.5%), and macular atrophy in 5 eyes (2.5%).

Conclusion Macular involvement,especially macular edema, is common in non infectious intermediate, posterior and panuveitis. It may lead to irreversible visual impairment. Thus, recognition of macular morphological characteristics by performing both OCT and fluorescein angiography in uveitic disease may facilitate earlier diagnosis and the initiation of specific treatment.
Traumatic macular hole revealing a retinitis pigmentosa: a case report
Authors: BAUDOT A , KURUN S , MAALOUF T , ANGIOI K
Published: August 2012

Purpose To report a case of traumatic macular hole revealing a retinitis pigmentosa.

Methods A 33‐year old man without past medical history complained of visual loss after direct trauma of his left eye. Visual acuity was 20/50 RE and 20/400 LE. Anterior chamber examination was normal and fundus examination revealed a large macular hole associated with optic atrophy in his left eye. Right eye funduscopy showed a cystoid macular edema and optic nerve palor (RE). Many pigment deposits were present in retinal mid‐periphery of both eyes. Optical coherence tomography showed cystoid macular edema (517 microns) RE and a large macular hole (3100 microns) LE. Typical visual field defects and extinguished electroretinogram responses confirmed the diagnosis of retinitis pigmentosa.

Results Macular diseases are well‐known complications of retinitis pigmentosa, especially macular edema. Vitreomacular tractions, epiretinal membranes and macular holes are less frequent. These complications may be explained by pigment epithelium disorders that may compromise ionic drainage of the retina. Causes of macular hole in retinitis pigmentosa remain uncertain. In our patient, development of a macular hole may be explained by occurrence of trauma in an eye with pre‐existent macular edema secondary to the unknown retinitis pigmentosa.

Conclusion Despite macular complications of retinitis pigmentosa are relatively common, a traumatic macular hole as a revealing symptom is exceptional.
Age macular degeneration‐Alzheimer disease: relevance and interest of ophthalmologic exam in detection and follow‐up of Alzheimer disease
Authors: GONZALEZ C
Published: August 2012

Purpose To evaluate the impact of AMD on Alzheimer disease and their in‐between visionary correlation.

Methods 285 patients, 95 men, 190 women, with AMD.3 Groups A,B,C: A, 90 patients with first stage AMD (drusen, drusenoid PED, pigment, small atrophic areas);B:80 patients with predominant atrophic areas;C,115 patients with Neovascular AMD. AMD evaluation included ETDRS visual acuity (VA), complete ophthalmic examination, autofluorescence imaging (FAF), optical coherence tomography (OCT) and fluorescein (FA) angiography, and ICG when neovascular complication.AD was diagnosed and valuated by general practice doctors and /or neurologists.

Results 20% patients in group A , 25% in group B, 30% in group C have mild cognitive impairment (MCI). 25% in group B, 35% in group C have early stage AD. 20% in group C have symptomatic AD. AMD ophthalmologic signs are predictive and precursor for AD. Fundus examination and even more (FAF , OCT) are useful and needed to enhance AD screening and follow‐up.

Conclusion The AMD‐AD correlation allows us to improve detection, follow‐up, screening of both AMD and AD pathologies and furthermore progress in etiopathogenic knowledge and therapeutic prospects.
Bilateral macular coloboma in a patient with retinitis pigmentosa like changes
Authors: KABANAROU SA , KOUROUPAKI A , PORTALIOU DM , FERETIS E , XIROU T
Published: August 2012

Purpose To report a case with bilateral macular coloboma and RP (retinitis pigmentosa) like changes.

Methods A 46‐year‐old female presented with macular coloboma in both eyes. There was a history of strabismic amblyopia in her right eye but no other contributory medical or family history.Best corrected Snellen visual acuity (BCVA) was measured and full ophthalmic examination was performed. Visual field testing, optical coherence tomography (OCT) and international‐standard electrophysiological (ISCEV) evaluation, including pattern and full‐field electroretinography (PERG and FFERG), were also performed.

Results BCVA was hand movements in the right eye and 0.5 in her left eye. Fundoscopy revealed an oval sharply‐ demarcated defect at the macula with bare sclera at its base and pigment clumping, mainly in the right eye, resembling macular coloboma. There were also severe retinal vessel attenuation and scattered retinal pigmentary changes, occasionally resembling bone spicule RPE changes, in the retinal periphery in both eyes. Optic discs were pale bilaterally. Visual field testing demonstrated bilateral scotomas. OCT revealed a crater‐like depression at the macula with atrophic neurosensory retina and absence of retinal pigment epithelium (RPE) and choroid, more extensive in her right eye, where scleral excavation was also documented. Pattern ERG as an indication of macular function was extinguished in the right eye and severely affected in her left eye. Full field ERG was extinguished bilaterally for both scotopic and photopic responses.

Conclusion Bilateral macular coloboma associated with RP like changes, an abnormal electroretinography and no relevant family history, may be indicative of a developmental retinal abnormality.
Priminary observations of the effects of ACE inhibitor ramipril in patients with Stargardt's disease
Authors: REKIK R , CHARFEDDINE R
Published: August 2012

Purpose to assess the effect of Ramipril 2% eyedrops on visual function in patients with Stargardt’s disease.

Methods We conducted a prospective, interventional, open label pilot study. 12 eyes of 6 consecutive patients in whom Stargardt’s disease had been diagnosed were treated with Ramipril 2%, one drop three times a day in both eyes. Four follow‐up visits were performed over 3 months. Retinal imaging workup was performed at baseline to confirm diagnosis. During follow up, best corrected visual acuity, fundus examination, static perimetry and electroretinogram were performed to assess safety and efficacy.

Results Treatment was well‐tolerated in all cases. Mean BCVA improved from 40 +/‐ 20 letters to 51 +/‐ 17. Mean sensitivity improved from 20.6 +/‐ 3.2 dB to 22.5 +/‐ 3.7dB.

Conclusion Ramipril demonstrated a good local and systemic safety profile as well as efficiency in terms of BCVA improvement and retinal sensitivity in patients with Stargardt’s disease. These results encourage us to further describe the effects of Ramipril used as a NO‐donating and antioxidative drug in ophthalmology.

Commercial interest
Recurrent retinal detachment secondary to hereditary congenital collagen disease
Authors: BAMBO M , ARA M , EGEA MC , FERNANDEZ‐PEREZ S , HERRERO R , GARCIA‐MARTIN E , DE LA MATA G , SATUE M
Published: August 2012

Purpose Hereditary progressive arthro‐ophthalmopathy, also called Stickler syndrome, is an autosomal dominant genetic disease affecting connective tissue collagen. It is considered the leading cause of inherited retinal detachment in all ages and produces multisystem manifestations such as premature arthritis, micrognathia or eye disorder.

Methods A 31‐year‐old man reports hereditary progressive arthro‐ophthalmopathy. He presented degenerative myopia, congenital cataract and bilateral recurrent retinal detachments during childhood. At birth, he presented craniofacial anomalies, hearing loss and flat feet. When he was 6 years old, he suffered a retinal detachment associated with giant tear, which was treated with 20G pars plana vitrectomy and injection of silicone oil. At 22 years, the right eye presented another retinal detachment that was treated with silicone band placement, cryotherapy and C3F8 gas intravitreal injection. Two months later the retinal detachment recurred in right eye, needing 23 G pars plana vitrectomy and intravitreal silicone oil implantation.

Results The patient presented several ophthalmic complications such as post‐surgical ocular hypertension and retinal tears requiring selective photocoagulation with argon laser in the right eye. Recently, genetic diagnosis was confirmed by COL11A1 gene mutation.

Conclusion Development, prevention and therapeutic management of ophthalmic complications during 26 years follow‐up are presented. The importance of early diagnosis and follow‐up by a vitreoretinal surgeon are also emphasized.
Changes in chronobiological function related to retina degeneration P23H line 1 transgenic rats
Authors: PINILLA I , LAX P , FUENTES L , FERNANDEZ‐SANCHEZ L , ESQUIVA GEMA , PEREZ‐GARCIA D , RAMIRO P , SANCHEZ‐CANO A , SEGURA F , CUENCA N
Published: August 2012

Purpose To evaluate and determinate changes in the circadian rhythms related to retinal degeneration in P23H line 1 rats.

Methods Male rats homozygous for the P23H rhodopsin mutation line 1 and male SD rats were evaluated during a 12 months period. All of them were individually housed and maintained during this time under controlled humidity (60%), temperature (23 ± 1°C) and under a 12‐h light/dark cycle. Locomotor activity (LA) was monitored throughout the experiment by an intraperitoneal transmitter. Electroretinograms (ERG) were used to evaluate retinal function and retinas were evaluated by ICC looking for the degeneration pattern.

Results The LA recordings from wild type and mutant animals showed no differences in the pattern of the mean waveform and the periodogram. However, a progressive decrease in the amplitude of the LA rhythm was observed in P23H rats, when compared to wild‐type animals. The nonparametric analyses of the data showed a gradual decrease in the coupling strength of the LA rhythm to environmental zeitgebers (inter‐daily stability, IS) and an increased rhythm fragmentation (intra‐daily variability, IV) in P23H rats, as compared with wild type animals. The circadian changes are related to the rate of the degeneration. In 6 months P23H line 1 rats, the only remaining photoreceptor were cones, distributed in a disrupted single layer. B‐wave amplitude was declined at this age.

Conclusion Vision loss in P23H line 1 rats produces a progressive fragmentation of their circadian patterns.
Manual rhexis vs femtosecond laser assisted rhexis in cataract surgery
Authors: MOUINGA ABAYI DA , LAAYOUN J , COLAS E , ABRIEU M , LUSSATO M , RIGAL SASTOURNE JC
Published: August 2012

Purpose To evaluate the reproducibility and safety of capsulorhexis femtosecond laser assisted.

Methods Admitted patients for cataract surgery have been received into the “PERCY Military Hospital” refractive surgery unity.We have treated 11 eyes of 11 patients, on the Victus femtosecond laser platform.A control group (11 eyes of 11 patients) has been operated manually in the same center.The rhexis diameter measurement has been realized at one week postoperative,to the angiograph,as iris angiography,using the HRA OCT Spectralis.On the pictures,we measured the vertical diameter and the horizontal diameter.For the rhexis centration,three circles were drawn following the contour of the rhexis, the pupillary border,and the margin of limbus.We measured the position of rhexis center to pupillary center.

Results In the laser assisted group,the mean horizontal rhexis diameter was 5.35 mm +/‐ 0.22,and the mean vertical rhexis diameter was 5.37 mm +/‐ 0.22. In the control group,the mean horizontal and vertical rhexis diameters were respectively 5.3 +/‐ 0.28,and 5.6 +/‐ 0.21.We found that 85% of femtosecond laser assisted rhexis were within 0.35 mm from the programmed diameter. In the control group,only 15% have obtained the same level of accuracy.In the laser group,the three circles have the same center,and then are concentric,tell‐tale of a rhexis good centration,unlike the manual rhexis.The femtosecond laser rhexis was circular,regular and covers the IOL’s periphery including the haptics.

Conclusion The femtosecond laser has multiple benefits for cataract surgery, as the regular and circular capsule, the reduced variability in the effective lens position. The technique is reproducible and very safe.
Long‐term endothelial cell loss after iris‐fixated phakic intraocular lens for high ametropia
Authors: LECUEN N , SANDALI O , BASLI E , AMELINE B , BULLET J , PECHA F , BORDERIE V , LAROCHE L
Published: August 2012

Purpose The aim of the study is to report and to predict long‐term endothelial cell outcomes after iris fixated phakic intraocular lens implantation for the correction of high refractive errors.

Methods Retrospective, non randomized study of patient who underwent surgery between January,2000 and December,2009 in the same department in the Centre Hospitalier National d’Ophtalmologie des Quinze‐Vingts. To predict long‐term endothelial cell density, 2 joint regression models were fitted on ECD to individuals with at least 2 ECD measurement in time. Model‐predicted parameters for endothelial cell density and survival were obtained for each patient and were used in a Kaplan‐Meier method plot for predicted percentage of eyes .

Results This study consisted of 78 phakic eyes including 70 myopic eyes and 8 hyperopic eyes. 73 Verisyse/Artisan and 5 foldable Artiflex were implanted. Three eyes underwent further keratorefractive surgery (Bioptic). Two eyes were lost of follow‐up.The mean follow‐up was 68 months. Recent studies reported an endothelial cell loss 5 years after surgery ranged from ‐9 to ‐14%, but we found a decrease of 25% for 18 eyes. Surgery trauma is partially involved but we also found a higher endothelial cell loss one year after surgery ( range from ‐3.5 to ‐9%).

Conclusion Potential complications such as progressive endothelial cell loss and risk of dislocation are major concerns in operative decision. Close follow‐up with regular monitoring is necessary in patients with phakic intraocular lens.
Moxifloxacin superior to cefuroxime in reducing early‐phase adherence of staphylococcus epidermidis to hydrophobic intraocular lenses
Authors: BENBOUZID F , BAILLIF S , RENAUD F , DENIS P , KODJIKIAN L
Published: August 2012

Purpose To evaluate the bacterial anti‐adhesive effect of cefuroxime and moxifloxacin on the primary‐attachment phase of S.epidermidis to acrylic intraocular lenses IOLs

Methods 40 single‐piece SA30AT IOLs were used throughout the study. IOLs were divided into 5 groups. 2 groups were soaked in antibiotic solution,(moxifloxacin 0.5mg/0.1ml or cefuroxime 1mg/0.1ml),15 min before incubation in a S.epidermidis suspension 108 CFU/ml,t1.2 groups were incubated in the bacterial suspension for 15 min before being added with antibiotics,t2.The last group consisted in a control group. After 1 hour incubation at 37°C, for all groups, IOLs were removed from the test vial and rinsed before being sonicated and vortexed to remove the adhering bacteria. The resultant suspension was diluted and spread over a nutritive agar plate. Colonies were counted after 24‐hour incubation. Comparison among groups was performed using the Wald parametric statistical test. A p‐value <0.05 was considered statistically significant.

Results Mean numbers of CFU/IOL was Cef‐t1:184.103[SE: 5,24 ; SD: 28,21],Cef‐t2:117.103[SE: 5,74 ; SD: 30,37], Mox‐t1:1,27.103[SE: 0,12 ; SD: 0,61], Mox‐t2:25.103[SE:1,98 ; SD: 9,72] and Ctrl:361.103[SE: 26,9 ; SD: 107,6].There was no significant difference in antibiotic time introduction concerning cefuroxime (p=0.132). Moxifloxacin was more effective when used before incubation (p<0.001). Overall, moxifloxacin was more effective than cefuroxime (p<0,001).

Conclusion Both moxifloxacin and cefuroxime significantly reduced S.epidermidis adherence on IOLs.The anti‐adhesive effect was superior with moxifloxacine. Further studies are needed to confirm results on IOLs made of other biomaterials.
Single IOL surface measurements with UV‐Shack‐Hartmann‐Sensors
Authors: KANNENGIESSER M , GILLNER M , LANGENBUCHER A , JANUNTS E
Published: August 2012

Purpose Measuring single IOL surface topographies remains a difficult task due to reflexes from the second surface. Currently no commercially system is available for this task. The purpose of this study is to discuss the feasibility of a new and customized UV‐SHS (Shack‐Hartmann‐Sensor) method in the field of measuring individual IOL surfaces.

Methods The WaveMaster system (Trioptics, Wedel) represents the SHS technique. It is customized to work in the UV range of light spectrum and eliminates the possibility of back surface reflections. Repeatability and reproducibility measurements are performed before measuring spherical and freeform IOLs of different radii of curvature (ROC) between 6 mm and 20 mm. For validation of the measurement system 2 criteria are applied: The correct measurement of a sample’s ROC and the RMS of the residual (the topography after subtracting the best‐fitted‐sphere).

Results The repeatability and reproducibility measurements provide acceptable figures; a measurement of a sample’s ROC takes about 5 seconds and delivers accurate results. The maximum deviation from the theoretical design ROC is about 100 µm while many results show a deviation of some µm. The results for spherical IOLs prove that the device can be applied over the whole range of ROCs. The residuals show an RMS deviation of some µm for spherical surfaces and correspondingly higher values for freeform surfaces.

Conclusion The UV‐WaveMaster system is an appropriate device for measuring individual IOL surfaces for a wide range of ROCs making it applicable for quality control for freeform IOL surfaces. The acquisition of the sample’s topography and ROC with its residual is fast and. Future application of the device will show its advantages and limitations in detail.
Extraction of lens geometry in an optomechanical eye model during accommodation using automatic image processing
Authors: GILLNER M , EPPIG T , KANNENGIESSER M , LANGENBUCHER A
Published: August 2012

Purpose To extract curvature, lens thickness and optical performance of accommodative intraocular lenses (AIOL) in an optomechanical eye model.

Methods Freshly enucleated porcine eyes with an implanted AIOL and removed cornea were placed in a cuvette with BSS (35°C) simulating physiological conditions. The ciliary body was expanded radially symmetric to stretch or release the zonula fibers effectuating pseudophakic accommodation. Dynamic accommodation and imaging quality was measured with a Shack‐Hartmann‐Sensor (SHS). Shape and relative lens position during accommodation was measured with an optical coherence tomograph (OCT). The 3D OCT image was processed with denoising and edge detection extracting the AIOL surface. Remaining haptic data were eliminated. Images were corrected by inverse ray‐tracing for compensation of the OCT’s beam divergence and refractive effects of optical surfaces. Finally the AIOL geometry was derived by a spherical fit and the center thickness was determined.

Results The algorithm allows to extract edge data from noisy OCT images and up‐to‐scale geometrical data. Curvature was derived from a fit of the edge points and relative lens position, lens thickness as well as optical power for the optomechanical eye model were measured at different states of accommodation. Optics with a diameter up to 6 mm could be measured with a lateral/depth resolution of 20/5 µm. The results yield complimentary data to the image quality measured with the SHS.

Conclusion The algorithms are elementary tools for the setup of the optomechanical eye model for AIOL. It is now possible to evaluate different AIOL in an experimental setup as a base for development of next generation AIOL.
Pirfenidone inhibits the induction of COX‐2 stimulated by IL‐1β at a step of NF‐κB DNA binding in orbital fibroblast
Authors: KOOK K , PARK S , CHOI A
Published: August 2012

Purpose The aim of this study was to determine the effect of pirfenidone on interleukin‐1β(IL‐1β)‐induced cyclooxygenase 2(COX‐2) increase in orbital fibroblasts from patients with thyroid‐associated ophthalmopathy(TAO).

Methods Orbital fat tissues were obtained during decompression surgery of patients with TAO and orbital fibroblasts were primarily cultured. After treatment of cells with IL‐1β in the presence and absence of pirfenidone, COX‐2 induction and its signal including NF‐κB were analyzed. The effect of pirfenidone on the IL‐1β‐induced prostaglandin E2(PGE2) production in orbital fibroblast was also evaluated.

Results Pirfenidone attenuated the IL‐1β‐induced COX‐2 mRNA and protein increase. In electrophoric mobility shift assay, pirfenidone showed the inhibitory effect on NF‐κB DNA binding. However, pirfenidone showed no effect on the degradation and phosphorylation of IκB, and could not prevent nuclear translocation of p50/p65. Finally, the production of PGE2 was nicely inhibited by pirfenidone.

Conclusion The results of this study indicate that pirfenidone effectively attenuates IL‐1β‐induced COX‐2 gene expression at a step of NF‐κB DNA binding, which suggests that pirfenidone could be considered as a candidate for treatment of thyroid‐associated ophthalmopathy.
Ocular symptoms are not predictive of ocular inflammation in inflammatory bowel disease. A large cross‐sectional survey
Authors: CLOCHé V , BIGARD MA , PEYRIN‐BIROULET L , ANGIOI K
Published: August 2012

Purpose The aims of this study were to assess the predictive value of ocular symptoms for predicting ocular inflammation and the impact of medications on ophthalmologic manifestations in a large prospective cohort of IBD patients.

Methods All consecutive IBD patients seen in the Department of Gastroenterology between April 2009 and July 2011 were interviewed for this cross‐sectional study using a pre‐established questionnaire. If the patient had at least one ocular symptom, he systematically underwent an ophthalmologic examination.

Results Three hundred and six patients were enrolled in this cross‐sectional study: 169 were women (55.2%), 228 had Crohn’s disease (74.5%), 77 ulcerative colitis (25.2%) and 1 microscopic colitis (0.3%). Ninety‐eight patients (32%) reported at least one ocular symptom: ocular irritation (56.8%), red eye (40.5%), blurred vision (37.8%), ocular pain (31.1%), progressive visual loss (34.4%), myodesopsia (23.3%), eyelid secretion (12.2%), dry eye (9.5%), watering (6.8%), diplopia (5.4%), metamorphopsia (4%), and sudden visual loss (4%). Following ophthalmologic examination (n=79), 41.9% patients had evidence of dry eye (n=31), 14.9% blepharitis (n=11) and 1.4% scleritis (n=1). No uveitis was reported. Methotrexate was associated with dry eye (p=0.03).

Conclusion Ocular symptoms are frequent in IBD patients, but are nonspecific and rarely associated with ocular inflammation. Systematic ocular symptoms assessment is of poor value for diagnosing ocular inflammation in clinical practice in IBD patients.
Choroidal thickness measurements in children using Spectral‐Domain OCT
Authors: PEREZ GARCIA D , PINILLA I , IBANEZ ALPERTE J , PEIRO C , ASCASO F , REMON GARIJO L , CRISTOBAL JA
Published: August 2012

Purpose The aim of this study was to assess changes in choroidal development in normal children with no refractive error.

Methods Forty children age from 3 to 14 ages with refractive error from 0‐1.5 aspheric equivalent and absence of ocular pathology, were evaluated to assess changes in choroidal thickness during development. Seven measurements were taken in a good quality vertical scan: the first was through the fovea and the others in 400 microns steps to nasal and temporal sides (3 each side). Measurements were taken using the manual caliper provided by the software of the device, a Spectralis OCT (Heidelberg, Germany). All measurements were performed by 2 independent observers.

Results Reliable measurements of choroidal thickness were obtainable in 96 % of eyes examined. Mean (SD) choroidal subfoveal thickness was 287.17±70.85 for children aged 3‐6, 297.14±66.95 for children 7‐10 and 314.70±72.07 for subjects aged 11‐14 years. Measurements were lower at the nasal edge 256.05±73.29 compared to 283.50±70.93 at temporal one. There was no difference between sex.

Conclusion Choroidal development during childhood can be assessed by Spectral OCT using manual caliper. Mean choroidal thickness increases with age in childhood and temporal thickness is higher than the nasal one .
Long‐term nanostructural effects of high radiofrequency treatment on the rabbit skin tissues
Authors: JAE HO S
Published: August 2012

Purpose The purpose of this study was to investigate the long‐term effects of high radiofrequency (HRF) tissue‐tightening treatment in in vivo rabbit dermal collagen fibrils.

Methods These effects would be measured at different energy and at varying pass procedures on the nanostructural response level using histology and AFM analysis. Each rabbit was into one of seven experimental groups, which included the following: control group, and six HRF group according to three HRF energy (10 W, 20 W and 30 W) and two HRF pass procedures. The progressive changes in the diameter and D‐periodicity of rabbit dermal collagen fibrils were investigated in detail over one month post‐treatment period.

Results Normal dermal tissues show an irregular collagen network structure, whereas those treated with the HRF tissue‐tightening device showed more prominent inflammatory responses with inflammatory cell ingrowth compared to the control as well as a well‐aligned collagen network structure at the nanostructural level. This effect showed more prominent with the passage of day after treatment. Although an increase in the diameter and D‐periodicity of dermal collagen fibrils was identified immediately after the HRF treatment, a decrease in the morphology of dermal collagen fibrils continued until the proliferative period. The dimensions of collagen fibrils returned to level of the control group at the postoperative 7 days.

Conclusion A multiple pass treatment at low energy rather than a single pass treatment at high energy showed the changes in the collagen fibrils at the nanostructural level.
Ocular surface effects of antiglaucoma combination therapies in a rat model of corneal scraping
Authors: DAULL P , GARRIGUE JS , FERAILLE L , BAUDOUIN C , ELENA P
Published: August 2012

Purpose Severity of ocular surface damages in glaucoma patients was shown to be correlated to the number of instilled benzalkonium chloride (BAK) preserved (P) antiglaucoma eye drops. While preservative‐free (PF) eye drops reduce iatrogenic toxicity they do not restore the ocular surface. The effects of PF‐cationic emulsion of latanoprost (Catioprost®) and BAK‐free travoprost combined with P‐ or PF‐timolol formulations were compared to BAK‐preserved prostaglandin (PG)/timolol‐fixed combinations (FC) in an established rat model of ocular surface injury.

Methods Seven PG/timolol combinations were assessed in a rat model of corneal scraping. The upper part of the corneal epithelium was scraped mechanically prior to a 5‐day treatment followed by clinical (in vivo confocal microscopy (IVCM), fluorescein staining) and histological evaluations. Conjunctival function was assessed by goblet cell count and MUC5AC immunostaining.

Results Catioprost®/timolol combinations did not induce toxicity as evidenced by IVCM scoring, both reducing inflammatory cell infiltration greater than BAK‐free travoprost/P‐timolol combination. In contrast, BAK‐preserved PG/timolol‐FC presented elevated IVCM scores. MUC5AC staining and goblet cell count demonstrated that BAK‐free Catioprost®/PF‐timolol is the best tolerated combination.

Conclusion BAK‐free Catioprost®/P‐timolol is very well tolerated, in contrast to BAK‐preserved PG/timolol‐FC. The findings suggest that Catioprost® associated with PF‐ or P‐timolol have the potential to benefit glaucoma patients with ocular surface disease.

Commercial interest
Granulomatous conjunctivitis associated with chronic blepharitis in children
Authors: BAïZ H , MAURAGE CA , LAUMONIER E , ROULAND JF , LABALETTE P
Published: August 2012

Purpose To outline the clinical and pathological characteristics of granulomatous conjunctivitis associated with primary chronic blepharitis in children

Methods 23 children presenting ocular rosacea with suspected conjunctival granulomas were examined prospectively. Conjunctival biopsies were performed in 20 patients; for each sample we associated histological study with an immunohistochemistry analysis (CD3, CD4, CD8, CD1a, CD11c, CD68, CD123).

Results Conjunctival inflammation was micronodular, associated with follicles in 4 cases. Conjunctival granulomas appeared as whitish or subtle yellowish nodules. Corneal complications were common (87%), as phlyctenular lesions (43.5%) and neovascularization (69.5%). Epithelioid granulomas associated with giant cells infiltrated the conjunctival matrix of most patients (80%), inflammatory infiltrate only was found for 4 patients. The granulomatous specimens showed peri‐ and intra‐granulomas infiltration by inflammatory T‐cells (CD3), with more CD4 cells than CD8 cells, monocytic‐derived cells (CD11c) including macrophages (CD68+ CD1a), and less frequently plasmacytoid dendritic cells (CD123). Treatment included topical steroids, lubricants and eyelids care (100%), topical ciclosporine (13%), systemic antibiotics (35%).

Conclusion Granulomatous conjunctivitis is a complication of ocular rosacea in children. The immunopathology of the conjunctiva identified the main cellular actors involved in the granulomatous process. Our results provide a new look on this pathology.
Nicorandil: a new case of corneal ulceration
Authors: TRECHOT F , BAZARD MC , BATTA B , ANGIOI K
Published: August 2012

Purpose To describe a case of corneal ulceration induced by nicorandil.

Methods A 78‐year old woman presented a persistant corneal ulceration (RE), resistant to local treatment. She complained of pain and photophobia and visual acuity was 20/125. Slit‐lamp examination revealed epithelial erosion, stroma thinning and folds of Descemet’s membrane. Anterior chamber and fundus examination were normal. Neither mechanical nor infectious local causes explained the lesions. The trigger was most likely a cataract surgery, two months earlier. In her past medical history she reported angor treated by nicorandil for 2 years, treatment that has been suspected to impede corneal healing. With the appointment of her cardiologist we decided to stop nicorandil and observed complete resolution of the symptoms and ulceration after a few weeks.

Results Pathogenesis of nicorandil‐induced ulcerations is not yet elucidated. Recently it has been hypothesized that during prolonged high‐dose treatment with nicorandil, or after increased dosage, nicotinic acid (a metabolite) may accumulate outside the endogenous pool of nicotinamide adenine dinucleotide/phosphate and become abnormally distributed. In case of a rather recent or sustained trauma (surgery in our case), nicotinic acid, thanks to nicotinamide, a potassium channel openers with vasodilatator effects, may ulcerate the epithelial proliferation of the edge of the raw area, ultimately flooding the whole scar. The sequence of events of this case strongly suggests a nicorandil‐induced ocular side effect.

Conclusion Attention should be paid to the possible ocular iatrogenic role of nicorandil in cases of unexplained corneal ulceration.
Wetability and deposits accumulation on anterior surface of blue light‐filtering contact lens
Authors: CHAMORRO E , BONNIN‐ARIAS C , RAMIREZ‐MERCADO G , URBANO‐RODRIGUEZ R , RIOS‐SANTOS R , SANCHEZ‐RAMOS C
Published: August 2012

Purpose To evaluate wetability and deposits accumulation on anterior surface of blue light‐filtering contact lens after a cleaning process with Multi‐purpose Solution Cleaning, Hydrogen Peroxide solution and Lubricant Drops.

Methods A self‐controlled trial was carried out in 41 contact lens users who were wearing blue light‐filtering contact lens (Profilcon A 52%WC) for 30 minutes per test. Wetability and deposits accumulation on anterior surface were evaluated according to the International Organization for Standardization ISO11980 guidelines. Four conditions were set: a)usual contact lens, b)blue light‐filtering contact lens after cleaning process with Multi‐purpose Solution Cleaning, c)after Hydrogen Peroxide solution disinfection and d) after Lubricant Drops instillation.

Results Statistically significant differences were not observed within the parameters evaluated among the different cleaning solutions proposed. For a,b,c and d conditions, the percentage of lens that showed very insignificant deposits accumulation(visible after drying tear film) were 25%,34%,20% and 27%, respectively and the percentage of lens that showed not significant deposits (deposits easily eliminated) were 3%,2%,7% and 8%, respectively. Regarding wetability, minor wetability problems were showed and these ones were solved by the blinking in 18%, 29%, 18% and 18% of the cases, respectively, whereas the areas that remained dry on the contact lenses were 4%,0%,5% and 2% of the cases.

Conclusion The wetability and deposits accumulation on anterior surface of blue light‐filtering contact lenses is similar for the different cleaning treatment and equivalent to the non blue light‐filtering contact lens.