bluuebunny/crossref_metadata_2025 huggingface dataset:
The role for stimulus timing in local retinal responses: global propagation of retinal inhibition, in space and time
Authors: CASTELO‐BRANCO M , MAIA‐LOPES S , REIS AA , MATEUS C , SEBASTIAO AR , STASCHE M , FINGER J , NUNES S
Published: September 2008

Purpose Stimulus timing strongly influences visual responsiveness, a dramatic example being the exquisite neural sensitivity to certain spatiotemporal patterns in photosensitive epilepsy. Local inhibition is a widely recognized property of mammalian retinal function. One signature of such adaptive inhibition is the reduced local response to a second flash. Here we studied global propagation of retinal inhibition, in space and time, as a function of temporal stimulus properties.

Methods We have used a scanning laser ophthalmoscope based system interfaced with multifocal electroretinography to extract local retinal responses by means of standard reverse correlation techniques across 19 independent locations in 11 subjects.

Results Specific manipulations of previous stimulus history and timing revealed invariable shifts of the balance between excitation and inhibition. Local responses were significantly inhibited, by the presentation of flashes within a preferred temporal window at other locations, depending of local flash modulation rate. Asymmetries were observed for P1, but not for the N1 component contribution, showing a retinal origin beyond the photoreceptor level.

Conclusion These findings confirm that responses to even apparently homogeneous patterns may systematically shift depending on stimulus timing and that human retinal networks can globally adapt with exquisite temporal sensitivity, with local responses influencing far responses in space and time even when local stimulation patterns are independent.
What limits chromatic sensitivity in normal and colour deficient observers?
Authors: BARBUR JL , RODRIGUEZ‐CARMONA M , HARLOW JA
Published: September 2008

Purpose Variability in chromatic sensitivity was assessed in normal trichromats (n=133) and in subjects with deutan (n= 106) and protan (n=48) deficiency. The purpose of this study was to quantify variability within normal colour vision and to determine how this impacts the assessment of minimum colour vision requirements within occupational environments.

Methods Rayleigh matches were modelled with the aim of explaining the locations of match midpoints and ranges. Model parameters included the wavelength of peak sensitivity of cone photopigments, the photopigment optical density and the noise amplitude in the red/green colour channel. In order to avoid the suprathreshold, perceptual effects of extreme L:M cone ratios on colour vision, selective postreceptoral amplification of cone signals is needed. The noise is also amplified and this causes corresponding changes in red/green threshold sensitivity.

Results We measured midpoint and matching range in anomaloscope matches and red/green and yellow/blue thresholds under conditions that isolate the use of colour signals. A subset of subjects with deutan deficiency that exhibited less common Nagel matches were selected for genetic analysis of their cone pigment genes to predict the corresponding peak wavelength separation of their two, long‐wavelength cone pigments.

Conclusion The model predicts accurately the midpoint and the range for the spectral differences specified by the genes. The model also predicts the “normal” matches made by some subjects that rely on two hybrid genes and therefore exhibit red/green thresholds outside the normal range, typical of mild deuteranomaly. The anomaloscope is therefore not by itself sufficient to classify with certainty the colour deficiency involved.
New approach to establish safe colour vision limits for occupational environments
Authors: RODRIGUEZ‐CARMONA M , O'NEILL‐BIBA M , BARBUR JL
Published: September 2008

Purpose Concern has been expressed that current colour vision (CV) standards in occupational environments tend to screen for normal trichromacy and may not therefore relate directly to actual CV requirements within specific working environments.

Methods The new approach of establishing CV limits for specific occupations involves: ‐ measuring chromatic sensitivity and investigating the variability amongst normal trichromats ‐ accurate assessment of the severity of CV loss ‐ identifying the most important colour‐critical tasks at the work place when no redundancy is involved and discrimination of colour differences is most difficult ‐ simulating the most critical colour‐based tasks identified ‐ correlating the level of chromatic sensitivity and the subject’s performance of these tasks.

Results A large number of normal trichromats and colour deficient observers have been examined on the CAD (Colour Assessment & Diagnosis) test. The test provides an accurate measure of the severity of CV loss (for red‐green and yellow‐blue discrimination) and diagnoses the class of deficiency involved. The findings from this study so far have produced minimum CV requirements in two specific occupational environments. These limits specify the level of chromatic sensitivity loss below which colour deficient subjects no longer perform the most demanding colour related tasks with the same accuracy as normal trichromats.

Conclusion The new approach provides evidence‐based guidelines for minimum CV standards that can be implemented through objective testing without having to rely on either arbitrary limits or normal trichromacy. Further, this approach can be extended to other occupational environments where colour is important for carrying out visual tasks.
Variability of pupil behaviour due to different retinal’s illumination levels
Authors: SANCHEZ RAMOS C , DIAZ SERRANO Y , VINAS PENA M , RODRIGO E , BONNIN C , SILLERO QUINTANA M
Published: September 2008

Purpose To get the knowledge about how can pupil size be manipulated, in an artificial way, by using optical filters, with different absorbances, in order to change the level of retinal’s illumination. This knowledge will allow the obtaining of an artificial myosis or mydriasis, with an optimal non‐invasive technology, so that will be applied in several ways.

Methods The transversal study included data from 56 eyes of 28 subjects. To measure the different pupil size was used a digital binocular infrared pupillometer, which simulated 3 different light’s conditions: high mesopic (4lux), low mesopic (0,4lux) and scotopic (0,04lux). The obtained pupil size measurements, without filter, were compared with the results after the insertion of the different optical filters used: 16 filters with different transmittances (from 82% to 5%).

Results Only in high mesopic (4lux) condition, the results showed significant differences between the pupil size measurements without and with different transmittance optical filters. The mean variation was between 10% and 14% depending on the filter which was used.

Conclusion The existence of a physiologically visual system limit for myosis in scotopic condition was confirmed, due to the lower amount of light in retina. Only in high mesopic condition, significant differences were obtained in the pupil size results with filter.
Introduction to straylight as quality measure for ophthalmic procedures
Authors: VAN DEN BERG TJTP
Published: September 2008

Purpose Often patients complain about halos, glare, hazy vision and blinding at night, but while doing regular tests like visual acuity, contrast sensitivity and slit lamp examination little unusual can be found. Most probably, the patient’s complaints are caused by increased large angle light scattering in the eye media which can not be detected by common tests, but straylight degrades the image projected on the retina, thus decreasing the quality of vision. Usually the variable for increasing ocular straylight is the crystalline lens and a cataract may cause a significant increase. Increased ocular straylight may also be caused by refractive surgery and pathological changes.

Methods A forced choice psychophysical assessment technique was developed ("Compensation Comparison"), which resulted in a commercial product (C‐Quant from Oculus). The task of the patient is to make 25 short observations, comparing flicker strength in two half fields, and indicate with push buttons wich half field flickers most strongly. The straylight value is obtained including a reliability estimate. Added value in comparison to visual acuity was assessed in 2400 subjects in the European GLARE study.

Results Straylight gives the part of the point‐spread‐function outside 1 degree. In contrast, visual acuity and contrast sensitivity relate to the psf within 0.3 degrees. Consequently, straylight assesses a part of the visual spectrum that is missed with the classical visual function measures. Patient studies have been performed on normal aging, cataract and cataract surgery, refractive surgery, YAG capsulotomy, etc. In all those studies straylight was often much increased, corresponding to complaints, while visual acuity was good.

Conclusion Straylight is important to assess quality of vision.

Commercial interest
In‐vitro characterisation of corneal scatter in rabbit corneas following PRK
Authors: GINIS H , DE BROUWERE D , PENTARI I , PALLIKARIS I
Published: September 2008

Purpose The present work pertains to the measurement of light scatter in rabbit corneas after Excimer laser treatment, to the microscopic characterisation of the corneal irregularities and to the development of a mathematical model of light propagation through the post‐laser treatment cornea, based on the statistical properties of the scattering structures.

Methods Fourteen rabbits underwent photorefractive keratectomy (‐6D). Nine to twelve weeks postoperatively, after confocal imaging, animals were sacrificed and the corneas were excised. The intensity and angular distribution of scatter was measured by enclosing the excised rabbit corneas between two glass elements to form a triplet lens. This lens was used with a CCD camera to record images projected on a computer screen. Scatter intensity and distribution was calculated by measuring the intensity in small dark disk concentric with a series of bright disks. After the scatter measurement, the corneas were examined histologically. The structures observed using the confocal microscope ‐corresponding to refractive index (and therefore optical path difference) variation were fitted with a fractal surface band‐pass filtered in the Fourier domain.

Results Scattered light is characterised by a narrow forward distribution. Scatter is dominated by the subepithelial structures having sizes of the order of 50‐150 microns. The modelling of scatter by means of a spatially filtered fractal surface corresponding to OPD results to predictions in accordance to the experimental data.

Conclusion Forward scatter following PRK can be attributed mainly to the subepithelial irregular layer. The angular distribution of scatter is in accordance to the size of structures observed microscopically in this layer.
Glare test as indicator for cataract surgery
Authors: TASSIGNON MJ , ROZEMA JJ
Published: September 2008

Purpose The concept of glare, as determined by the Oculus C‐Quant device, can be useful in clinical practice as additional parameter to guide the surgeon in its decision for cataract surgery. Before to decide upon pathological conditions of glare, benchmarks of what is considered normal should be available.

Methods The C‐Quant device was calibrated in the Department of Ophthalmology of the Antwerp University Hospital in order to achieve benchmarks of what is “physiological” glare.

Results Based on the results of the Gullstrand Benchmark study, glare in our “normal” population was found slightly higher than in other settings. Glare was also measured prior to each cataract operation as well as after cataract surgery.

Conclusion Two conclusions can be drawn: it might be important to calibrate each individual machine before testing pathology, and glare is generally increased prior to cataract surgery and decreased after successful cataract surgery.
Risk factors for progression in glaucoma. The Groningen Longitudinal Glaucoma Study
Authors: JANSONIUS NM , WESSELINK C , HEEG GP
Published: September 2008

Purpose To investigate risk factors associated with visual field progression in glaucoma.

Methods 221 patients with a reproducible glaucomatous visual field defect at baseline were followed prospectively with perimetry (HFA 30‐2). Three criteria for progression were used: the EMGT algorithm (GPA), a non‐parametric algorithm applied to mean deviation (MD; NPA) and MD slope. For progression according to GPA, the last field had to be labelled as possible or likely progression. For progression according to NPA, the last two or more consecutive fields had to have an MD value worse than the worse baseline MD value. Risk factor analyses were performed using Cox proportional hazard models (dependent variables: classification by GPA and NPA) and multiple linear regression (dependent variable: MD slope).

Results Mean follow‐up was 5.4 years; on average 7.2 reliable fields were available. Mean MD at baseline and MD slope during follow‐up were ‐9.9 dB and ‐0.26 dB/yr for OD and ‐9.0 dB and ‐0.21 dB/yr for OS. Of 167 eligible right eyes, 45 showed progression with GPA and 69 with NPA. For OS, these numbers were 36 and 67 of 167. Mean IOP during follow‐up (per mmHg increase; GPA: HR 1.13, P=0.014; NPA: HR 1.10, P=0.016; MD slope: ‐0.042 dB/yr/mmHg, P=0.002) and disease stage (early versus moderate/severe glaucoma with MD = ‐6 dB as cut‐off point; GPA: HR 1.88, P=0.034; NPA: HR 2.05, P=0,001; MD slope: ‐0.20 dB/yr, P=0.010) were found to be significant risk factors. Less convincing associations were found for family history of glaucoma and age. Highest IOP ever measured, myopia, sex and cardiovascular disease were not associated with progression.

Conclusion Higher mean IOP during follow‐up and worse disease stage at baseline were associated with progression.
Higher‐order wavefront aberrations and accommodative response variations with phenylephrine 5%
Authors: GICQUEL JJ , NGUYEN–KHOA JL , HARMS F , LOPEZ GIL N , LEGRAS R , DIGHIERO PL , LEBUISSON DA , LE GARGASSON JF
Published: September 2008

Purpose To study the effects of phenylephrine 5% topical administration on accommodative response and optical aberrations variation.

Methods The research followed the tenets of the Declaration of Helsinki . 28 eyes from 14 volunteers with spherical equivalent defocus error between –2D and +1D, no eye disease history and between 20 to 25 years of age, underwent wavefront measurements with a Shack–Hartmann wavefront aberrometer which included a movable accommodative target. Wavefront data was acquired while applying 6 different increasing accommodative stimuli, from 0 D to 5 D by steps of 1 D, before and after pupil dilation with Phenylephrine 5%.

Results The dilation using Phenylephrine 5% was found to larger lag errors in the accommodative response of about half of the subjects. The total RMS amount of aberrations above defocus remained stable during accommodation with and without dilation. Spherical aberration was positive in average in the non accommodated eye and changed toward negative values with increasing accommodation (p<0.05). Cylinder axis came closer to 90° as accommodation increased (p<0.05). Although vertical coma did not significantly vary with accommodation, horizontal coma increased significantly with accommodation (p<0.05). These changes in aberrations with increasing accommodation were similar on average in both pupil conditions.

Conclusion Phenylephrine 5% modifies the accommodative focus response of a significant proportion of young adult eyes. Wavefront aberrations above defocus undergo similar variations in both natural and dilated pupil conditions. However the total RMS error of aberrations above defocus remains relatively constant when the eye accommodates.
Accommodative function in school ‐age children with poor reading skills
Authors: PALOMO‐ALVAREZ C , PUELL MC
Published: September 2008

Purpose Prior findings suggest correlation between reading problems and accommodative function, but few studies have assessed accommodation in children with poor reading skills. Our aim was to characterize monocular accommodative amplitude, relative accommodation and binocular accommodative facility in a population of healthy, non‐dyslexic primary school children with reading difficulties.

Methods We conducted a cross‐sectional study on 87 poor readers and 32 control children (all 8‐13 years of age) in grades three to six recruited from eleven elementary schools in Madrid, Spain. In each subject with best spectacle correction, negative relative accommodation and positive relative accommodation were measured using a phoropter, monocular accommodative amplitude was determined using the minus lenses method, and binocular accommodative facility was measured using the Bernell Acuity Suppression Slide (VO/9) and a ± 2.00 D accommodative demand during 1 minute.

Results Monocular accommodative amplitude was significantly lower (p < 0.001) in the group of poor readers (right eye 9.1 D ± 2.3, left eye 9.0 D ± 2.3) than in the control group (right eye 10.5 D ± 1.7, left eye 10.5 D ± 1.7). Binocular accommodative facility values were significantly lower (p<0.05) in the poor readers (4.9 cpm ± 3.1) than controls (6.3 cpm ± 2.9). Negative and positive relative accommodation values were similar in both groups of children.

Conclusion This study provides data on the accommodative capacity of a population of children with reading difficulties. Our findings suggest a reduced monocular accommodative amplitude and binocular accommodative facility such that this function should be assessed by an optometric clinician in children whose reading level is below average.
Effect of litter size and birth weight on naturally occurring myopia in the Labrador retriever
Authors: PHILLIPS JR , BLACK J , BROWNING SR , COLLINS AV
Published: September 2008

Purpose To evaluate early environmental influences (e.g. litter size, birth weight, birth season) on adult refractive error in dogs. A previous familial aggregation analysis has shown that the distribution of refractive error in a large family of pedigree Labrador Retrievers has a significant genetic component, but that litter size and other residual/environmental factors also have significant effects.

Methods Refractive error was measured by cycloplegic retinoscopy in both eyes of 166 dogs, 1‐8 years of age and free of ocular pathology, from a large family of pedigree Labrador Retrievers. All dogs originated from the same breeding colony. The early records of these dogs included information on birth weight, maternal litter cohort, litter size and neonatal weight gain, measured daily for the first 6 weeks. These factors were analyzed to investigate their effect on adult refractive error.

Results The average adult spherical equivalent refraction (SER) was ‐0.44D (‐5.38D to +1.65D, n = 166): 35% were myopic (SER ≤ ‐0.50D), 58% emmetropic (SER = ‐0.49 to +0.99) and 7% hyperopic (SER ≥ +1.00D). Mean birth weight was 421±57g. Higher birth weight was weakly (R=0.3) correlated with more hyperopic adult refractions. Relative to large litters (≥ 7), dogs from small litters (< 7) gained more weight within the first 6 weeks of life and were on average 0.43D more myopic.

Conclusion The dog provides a unique model for studying a wide range of environmental influences on the development of naturally occurring, high prevalence, low degree myopia.
The acutely isolated human anterior lens capsule as a tool to study the physiology of human lens epithelial cells
Authors: ANDJELIC S , ROBIC T , PEROVSEK D , ZUPANCIC G , HAWLINA M
Published: September 2008

Purpose The defects in functional characteristics of lens capsule epithelial cells, can lead to the formation of the cataract, especially as cortical cataract. In the germinative zone of the lens the same progenitor cells, which also form the epithelil cells, differentiate also into the fiber cells, which make up the inside of the lens and through their activity also keep the lens clear. When their function is impaired the nuclear cataract ensues. We set out to make a preparation of the human anterior capsule from cataract surgery, which would allow functional studies of the physiology of capsule epithelial cells from patients with different types of cataract, using cell physiological methods.

Methods We used the entire anterior capsules, with the cells still attached. Cell contacts were preserved and allowed the communication between the cells. In addition all the contacts to the basement membrane were largely preserved although some parts of the capsule were denuded of the epithelium – possibly due to manipulation during the surgery itself, or to epithelial cell apoptosis. The remaining cells were viable and the capsules usable for experimentation for at least a day when kept in a tissue culture incubator. For experimentation using an inverted microscope, the capsules were weighed down with a harp as the one used for electrophysiological experiments. In a series of pilot experiments the lens epithelial cells were loaded with fura‐2.

Results They exhibited normal [Ca2+]i responses to agonist application such as Ach.

Conclusion We conclude that this preparation represents a useful tool to study many aspects of the lens epithelial cell physiology.
Anterior chamber morphometric estimation in patients they who underwent CTR implantation using Anterior Segment OCT and ultrasound biomicroscopy
Authors: MILKA M , WYLEGALA E , JANISZEWSKA D , NOWINSKA A , MANKOWSKI W
Published: September 2008

Purpose To estimate anterior chamber morphometric parameters (depth and volume) in case of patients they who underwent cataract surgery with posterior intraocular lens and capsular tension ring (CTR) implantation, using Anterior Segment OCT (OCT Visante) and ultrasound biomicroscopy (UBM).

Methods Studied group consisted of 23 persons 12 women and 11 men, aged from 79 to 52 years old (mean 63.9 years). BCVA ranged from 0.2 to 1.0 (mean 0.6). Anterior chamber depth and width were measured at first using Anterior Segment OCT (OCT Visante) than with the use of ultrasound biomicroscopy (UBM ). Anterior chamber volume was calculated.

Results Anterior chamber depth measured using Visante OCT ranged from 4.34mm to 4.79mm ( mean 4.61 ± 0.17) and in case of UBM ranged from 4.17mm to 4.92mm ( mean 4.57 ±0.28). Anterior chamber volume measured using Visante OCT ranged from 230,42µl to 339,91µl ( mean 278,2 ± 31,32) and in case of UBM ranged from 212,75µl to 330,51µl ( mean 269,23 ±36,77).

Conclusion Anterior Segment OCT is more precise in anterior chamber estimation also allows to enlarge measured area. As a non contact device is easier and faster to performe, however picture’s width in case of ultrasound biomicroscopy is larger.
Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency and senile cataract in a sardinian population, Italy
Authors: PES A , SOLINAS G , PINNA A
Published: September 2008

Purpose There is still no general agreement on the role of G6PD deficiency in the pathogenesis of cataract. Although G6PD deficiency has been correlated with cataract in some studies, other reports have showed no correlation. The purpose of this study was to determine the prevalence of G6PD deficiency in male patients of Sardinian origin with senile cataract and to compare it with the prevalence rate of G6PD deficiency in the general population of the same area.

Methods Erythrocyte G6PD activity was determined using a quantitative assay in 1628 male patients with cataract. The control group consisted of 1646 apparently healthy male patients from the same area described in a former study. Student’s t test was used to determine differences between groups.

Results G6PD deficiency was found in 134 (8.2%) patients with cataract and in 120 (7%) control subjects. Differences between cases and controls were not statistically significant (P=0.78).

Conclusion The results of this large study suggest that male patients with G6PD deficiency in the Sardinian population do not have a higher risk of developing presenile cataract.
Protein quality control and ubiquitin proteasome system: implications on cataract
Authors: MARQUES C , SHANG F , PEREIRA P
Published: September 2008

Purpose Accumulation of damaged or abnormal proteins is cytotoxic and is causally related to various age‐related diseases, including cataract. The objective of this study is to investigate the effect of 19S regulatory complexes on the fate of damaged proteins.

Methods The denaturation of firefly luciferase (a model protein) was performed at 43°C during 10 min in the presence of Hsp90 and denaturation of luciferase was monitored by the loss of its enzymatic activity. Luciferase activity in the cells was determined to monitor the refolding of denatured luciferase at 30°C in the presence or absence of ubiquitination system.

Results The data showed that heat‐denatured luciferase was preferentially ubiquitinated and degraded by the UPP as compared with the native form. Inhibition of the ubiquitination or proteolysis enhanced renaturation. The 19S regulatory complex enhances renaturation of denatured substrate in the presence of ubiquitinating activity. The data also suggested that recognition of a poliubiquitinated substrate requires that polyubiquitin chain interact with specific domains of the 19S cap of the proteasome and this interaction play an important role on the fate of denatured proteins. Additionally, the data shown that are critical lysines in the ubiquitin moiety are required for an efficient and productive interaction with proteasome.

Conclusion Failure in the protein quality control system is likely to have important implication in loss of lens transparency and cataract formation.
Effect of glutathione with sea tangle extract on prevention of selenite‐induced cataract formation in rat eyes
Authors: KIM K , OH JH
Published: September 2008

Purpose To evaluate antioxidative and preventive effects of sea tangle extract on selenite‐induced cataract formation.

Methods Eighty SD rat pups were randomized into 8 groups. Group 1, not injected any reagent (normal); In group 2‐8, selenite(15μmol/Kg, s.c.) was injected on day 11. In group 2 (control) and group 3, normal saline (i.p.) and ascorbic acid (i.p.) was injected on days 3–31; In group 4‐8, sea tangle extract (i.p.) was injected on days 3–31 with concentration of 12.5, 25, 50, 100, 200mg/Kg, respectively. Development of cataract was assessed and photographed weekly under slit lamp photo. After 31st day, rat lenses were analyzed for antioxidant enzymes, glutathione peroxidase (GPx), superoxide dismutase and malondialdehyde. Furthermore, amino acid analysis of sea tangle extract was performed.

Results Significant differences (p < 0.05) were seen in cataract development by the 8 groups. No rats developed cataract in group 1; Dense nuclear cataract was developed 8 of 10 and 4 of 10 rats in each group 2 and 3; Group 4‐8 developed nuclear cataract with proportion of 6/10, 3/10, 2/10, 1/10 and 6/10 rats. In sea tangle injected group (group 4‐8), levels of GPx were higher than those in ascorbic acid and control group. Especially, group 7, injected with 100mg/kg of sea tangle extract showed significantly high level of enzyme. Results of amino acid analysis showed sea tangle includes glutamate‐glycine‐cysteine, major constituents of glutathione(GSH).

Conclusion The glutamate‐glycine‐cysteine in sea tangle is supposed to increase the level of lens GSH and this may contribute to lowering cataract development. This study strongly supports the activity of sea tangle as an endogenous antioxidant and anticataract agent.
Modifications in conjunctival and limbar epithelium after micro‐incision cataract surgery (MICS). Impression cytology study
Authors: ALIO SANZ JL , RODRIGUEZ AE , WALEWSKA A , FERRER C , RODRIGUEZ‐PRATS JL , BATAILLE L
Published: September 2008

Purpose To know if the exposition of the conjunctiva during the micro‐incision cataract surgery (MICS) and the energy released during the phacoemulsification produce alterations in the goblet cell population and nucleus / cito plasm relation in the different areas of the conjunctiva of these patients.

Methods 32 patients scheduled for MICS surgery were included in this study. The cataract grade, phacoemulsification power, phacoemulsification time and time of the exposition of the conjunctiva were registered during the surgery. Goblet cell count, epithelial cell morphology and inflammatory cells were studied by conjunctival impression cytology before and after the surgery, at one and three months. The conjunctival samples were obtained from the nasal area, temporal area, and the phacoemulsification incision area.

Results Mean age of the patients was 67‐years old. Mean phacoemulsification power was 6 %, and the “phaco” time was 30 seconds. Mean time of the exposition of the conjunctiva was 9 minutes and 30 seconds. Analysis by impression cytology of the ocular surface showed a goblet cell population pre‐operative of 408/mm2 in the nasal area, 317/mm2 in the temporal area, and 343/mm2 in phacoemulsification incision area. Goblet cell count in the three different places decreased significantly after MICS surgery: p=0.038, p=0.018, and p=0,001 respectively.

Conclusion Impression cytology showed a significant reduction in the goblet cell populations after MICS in the three studied areas of the conjunctiva.
Ophthalmologic surgeries in the one‐day surgery unit. A descriptive study evaluating 13 years of activity
Authors: PEREZ GARCIA D , IBANEZ ALPERTE J , JIMENEZ A , VALYI S , MATEO OROBIA AJ , PEIRO C , ROJO M , CRISTOBAL JA
Published: September 2008

Purpose A descriptive, retrospective study about the surgical activity at the One‐day surgery Unit (ODSU) of the Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, during the years 1995 to 2007.

Methods To review the surgical activity of the ODSU, the following variables were analyzed: sex, age, diagnosis, risk of anaesthesia and applied anaesthesia, surgical technique, intra‐ and postoperative complications, medication, morbidity, criteria of discharge from hospital, waiting list time as well as the grade of information given to the patient, comfort, sanitary attention, and grade of satisfaction. These data were obtained from a personal questionnaire and a phone call and were statistically analyzed by the StatView program.

Results During the period of 1995 to 2007 13.585 surgical interventions were realized at the ODSU, among those 4.734 ophthalmologic surgeries (34, 8%). The average age of the patients was 56, 53 years. The 56 % were males. In the 22, 9% of the cases the employed anaesthesia was retrobulbar. The surgical techniques were: phacoemulsification and IOL 3550 (26, 1%), extracapsular cataract extraction 256 (1, 8%). In the 95% of the cases the patients were discharged from hospital, the remaining 5% is composed of non intervention, ocular hypertension, infection, retrobulbar haematoma and fever. The grade of general satisfaction was qualified as high (85%), with the acceptance to return to the ODSU in the 76% of the cases

Conclusion The ODSU offers a safe, fast and comfortable alternative to classic hospitalisation.
Morphologic changes in haptoglobin knockout mice, typical for anterior segment dysgenesis, may be linked to diminished expression of C‐Maf
Authors: VAN GINDERDEUREN R , GALCIAS‐ROSAS G , CEUPPENS J , STALMANS I
Published: September 2008

Purpose To study the ocular phenotype of mice that lack Haptoglobin (Hpko) and investigate whether these changes correlate with the expression of C‐maf. C‐maf is known to be expressed in embryonic life and to be involved in the development of the lens and anterior segment

Methods Hpko mice and wild type(WT)littermates were histological investigated at embryonic day(E)12,15 and 18 and postnatal day(P)1,4 and 21. The expression of C‐maf was studied at mRNA level by rt‐PCR. C‐maf expression in eyes was compared in adult mice between clinically blind versus not‐blind Hpko and WT mice and in embryos at E12,between offspring from clinical blind versus not‐blind Hpko mothers

Results Eyes of Hpko mice were histological normal at E12 compared with WT mice. At P1 eyes of Hpko mice were significantly smaller (mean 29%); in 55% of mice the lens was not yet separated form the cornea. At P21 12% of the eyes from Hpko mice still showed contact between lens and cornea; anterior senychiae were present in 42% of the eyes,whereas these structural abnormalities were never observed in WT eyes. The ocular C‐maf mRNA expression at E12 was significantly lower in Hpko embryos as compared to WT embryos (P<0.05). C‐maf expression levels in eyes of Hpko non‐blind mothers were intermediate

Conclusion Haptoglobin knockout mice exhibit developmental disorders that are similar to those observed in developmental glaucoma. There is a delay in development of the anterior segment structures, which start during late embryonic life and continue after birth. C‐maf expression is diminished at E12 and this may be linked to the aberrant anterior chamber development
A novel OPA1 mutation in a patient with severe, acute and late‐onset Autosomal Dominant Optic Atrophy
Authors: NOCHEZ Y , ARSENE S , LE LEZ ML , AMATI‐BONNEAU P , REYNIER P , CARDON A , PISELLA PJ
Published: September 2008

Purpose We report the first case of acute and late‐onset Autosomal Dominant Optic Atrophy with a novel mutation. Autosomal Dominant Optic Atrophy (ADOA) is an inherited primary optic neuropathy that leads to reduced visual acuity. ADOA has often been associated with mutations in OPA1 gene. OPA1 encodes a large dynamin‐related GTPase, involved in mitochondrial structure, mitochondrial DNA maintenance and apoptosis regulation.

Methods We conducted direct DNA sequencing of the entire coding sequence and the exon/intron junctions of OPA1 gene.

Results A 62‐year‐old woman noticed blurred vision with a central scotoma. Visual loss was sudden, painless and severe in her right eye. Papillary edema was noted. Left visual loss occurred one year after initial presentation. The ophthalmoscopic feature of our patient was diffuse optic disc atrophy. MRI examination confirmed the diagnosis of isolated bilateral optic neuropathy. We did not found any neurological, metabolic, toxic, or ophtalmic causes. One novel heterozygous missense mutation in exon 27 was characterized. This mutation has not been previously reported, was absent in 400 control chromosomes and affected highly conserved amino acids.

Conclusion The age of onset, like ADOA penetrance must be accepted to be more variable than initially thought, including late‐onset cases. The presence of an OPA1 mutation reveales that this sporadic late‐onset and acute case of optic neuropathy is related to ADOA. This result shows that the mutation screening of OPA1 gene could be justified in every case of optic nerve atrophy with no clear cause.
Ophthalmological findings in childhood onset myotonic dystrophy type 1
Authors: ARING E , EKSTRÖM AB , TULINIUS MAR , SJÖSTROM A
Published: September 2008

Purpose Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystemic disorder, characterised by increasing severity and anticipation (progressive expansion of the repeat size and earlier onset in successive generations). It is caused by an expanded cytosine‐thymine‐guanine (CTG) triple repeat expansions in the myotonic protein kinase gene located on chromosome 19. Muscle wasting, myotonia and cataract are features of classical DM1, while congenital and childhood DM1 are also present with CNS involvement and cognitive impairments. The aims of the current study were to describe ophthalmological findings in individuals with childhood onset DM1, to correlate the ophthalmological findings with the size of the CTG expansions, inheritance and the age of onset and presenting clinical symptoms.

Methods Sixty‐ two children and adolescents were eligible for the study and 49 accepted to participate. All had clinical symptoms <10 years of age and were diagnosed with >40 CTG repeats <18 years of age. According to the age of onset and presenting clinical symptoms, the subjects were divided into three subgroups: I/ severe congenital II/ mild congenital and III/ childhood DM1.

Results High hyperopia, heterotropia, subnormal VA, motility abnormalities and nystagmus were common features of congenital onset DM1. No cataract was found and ptosis was rare while pseudoptosis and motility disorders occurred frequently among individuals with high number of CTG repeats.

Conclusion Ophthalmological pathology was common and individuals with severe congenital DM1 were present with the highest frequency. Number of CTG repeats affected the motility and pseudoptosis while inheritance had no influence on ophthalmological abnormalities.
Genetic analysis of families with autosomal recessive retinal dystrophies
Authors: KANNABIRAN C , SINGH H , JALALI S
Published: September 2008

Purpose To screen candidate gene loci in families with autosomal recessive RP

Methods We used an approach of screening for homozygosity at candidate gene loci in affected individuals. 34 families with autosomal recessive RP (ARRP) or related phenotypes were included in the study of which 25 families were consanguineous, and all families had 2‐4 affected offspring. Patients and family members were clinically evaluated and blood samples were collected for DNA extraction after obtaining consent. Microsatellite markers flanking 23 known candidate genes for retinal dystrophy were genotyped in available members of all families. Microstallite markers selected were located in a 5.0 cM interval of the candidate gene. Families in which homozygosity was present and specific for all affected members at a candidate gene locus were further screened for mutations in the relevant gene. Coding regions of the genes were amplified using exon‐specific primers and subjected to direct sequencing.

Results Screening of 23 gene loci revealed homozygosity shared by affected individuals in 10 out of 34 families. Homozygosity was detected at 2‐6 informative markers at each locus. The candidate gene loci are: ABCA4 (1p22.1), RPE65 (1p31), CRB1 (1q31), CNGA1 (4p12), PDE6B (4p16.3), TULP1 (6p21.3), RP1 (8q12.1), RGR (10q23), NRL (14q11) and RLBP1 (15q26). Putative pathogenic sequence changes were found in the probands upon screening the TULP1, ABCA4 and RPE65 genes. Screening of other candidate genes is in progress.

Conclusion This approach enabled a rapid preliminary screen of known loci in recessive RP and may be suitable for identifying the disease locus in small consanguineous families.
Ocular phenotype of CORD5, an autosomal dominant cone‐rod dystrophy associated with a Q626H mutation in the PITPNM3
Authors: REINIS A , GOLOVLEVA I , KÖHN L , SANDGREN O
Published: September 2008

Purpose The aim of the study was to describe the phenotype of CORD5, an autosomal dominant retinal dystrophy with a mutation Q626H in the PITPNM3/Nir1 gene encoding the PITPNM3 protein.

Methods The study included 33 individuals from two different families, all heterozygous for a Q626H mutation in the PITPNM3/Nir1 gene. Ophthalmological examination including kinetic perimetry, and in selected cases adaptometry, colour vision tests, OCT and electrophysiological studies were performed. In some case the data was obtained from medical records.

Results A majority of patients presented symptoms with subnormal visual acuity and light sensitivity from childhood. Signs of macular degeneration were observed early as well. There was a progressive decrease of visual acuity leading to legal blindness in early adulthood in some cases. Electrophysiological testing showed a progressive loss of photoreceptor function restricted to the cones. There seems to be a difference regarding severity of clinical manifestations between the families.

Conclusion Our observations and electrophysiological findings indicate a phenotype in CORD5 with loss of photoreceptor function restricted to the cones. An intra‐familial and inter‐familial difference regarding severity of clinical picture was noted.
Spectrum of TGFBI gene mutations among Polish patients with corneal dystrophies
Authors: OLDAK M , SZAFLIK JP , MAKSYM RB , KOIODZIEJSKA U , POLLAK A , PIOSKI R , SZAFLIK JP
Published: September 2008

Purpose To report the clinical and molecular findings in Polish patients with stromal corneal dystrophies caused by TGFBI gene mutations.

Methods Patients with clinically diagnosed granular (n=14; 9 unrelated families) and lattice (n=2; 2 unrelated families) corneal dystrophies participated in the study. Corneal phenotypes were assessed by slit lamp and confocal microscopy in vivo. Genomic DNA was obtained from blood samples and exons 4, 12‐14, known to contain mutation hot spots, were PCR amplified and sequenced on both strands.

Results Molecular genetic testing revealed a heterozygous R555W (exon 12) mutation in eight (5 families) patients diagnosed with granular Groenouw type I corneal dystrophy. In one patient a heterozygous R124H mutation (Avellino corneal dystrophy, GCD type II) was found. In three families with “atypical granular” dystrophy affecting mainly the anterior stroma no mutation was detected in the analyzed regions. Heterozygous T538R (exon 12) and H626R (exon 14) mutations were identified, respectively, in two patients diagnosed with lattice corneal dystrophy.

Conclusion Our results show that TGFBI gene mutations located in exons 4, 12 and 14 are frequently (8/11, 72%) found in Polish patients with corneal dystrophies of granular and lattice type. This indicates that a relatively straightforward molecular analysis can be a practical use in diagnosis of these conditions and associated genetic counseling.
Ophthalmic skills – Confidence and knowledge of recently graduated doctors
Authors: YEUNG AM , YEUNG JM , ASHRAF N , YEUNG TM
Published: September 2008

Purpose Undergraduate medical education in ophthalmology is not standardized in the UK. The purpose of the study was to determine Foundation Year 1 Doctors (FY1) confidence in their own ophthalmic clinical knowledge and skills.

Methods Questionnaires were distributed to FY1 at a University Hospital in the United Kingdom. A total of 15 questions were asked and topics ranged from self‐confidence in ophthalmic skills to ones regarding management of common ophthalmic conditions that present to an Accident and Emergency department.

Results A total of 20 doctors completed the form. More FY1 felt more confident measuring visual fields (80%) than visual acuity (70%). Only one (5%) was confident in measuring pupillary reflexes. 85% felt that they were not confident in using an ophthalmoscope or needed practise. Even though most were confident in measuring visual fields and 90% could identify a homonymous hemianopia, only 15% could identify a valid cause. Safe management questions were answered poorly with less than 50% correct responses in most questions. 70% indicated an interest in more teaching on practical skills and clinical scenarios in ophthalmology.

Conclusion There is a lack of confidence amongst FY1 in clinical skills and in particular with the use of the ophthalmoscope. The majority of FY1 questioned wanted more ophthalmology tuition.
The ocular findings among young males: a 12‐year prevalence study of the military service in Poland
Authors: NOWAK MS , JUROWSKI P , GOS R , SMIGIELSKI J
Published: September 2008

Purpose To determine the prevalence of ocular diseases among young males and to assess the main ocular causes reflecting discharge from military service in Poland.

Methods A retrospective review of the medical records, of the 105017 men preliminary examined to military service during the period 1993‐2004. All of them were of European Caucasian origin. Sample size for the study was calculated with 99% confidence, within an error bound of 5%. Data regarding the vision status was assessed in 1938 eyes of 969 subjects. Based on the age of subjects they were divided into two groups; group I aged 18‐24 and group II aged 25‐34.

Results Presenting visual impairment (VA <20/40) followed by color vision defects was the commonest ocular disorder and accounted for 13.21%. There were statistically significant differences of uncorrected visual acuity as well as of rates of particular refractive errors, in between age groups (p<0.05). Orthoptic problems, including various types of strabismus, were recorded in 3.61% subjects. Totally, 302(31.17%) males failed their medical examination and were temporally or permanently discharged from duty. Of them 52 (17.22%) subjects were discharged due to various ocular disorders. High refractive errors followed by chronic and recurrent diseases of posterior eye segment were the commonest ocular causes and accounted for 38.46%.

Conclusion Prevalence of ocular disorders among young males in unselected military population was closer to the results obtained in other population‐based studies comprising both males and females in the same age group. High refractive errors followed by chronic and recurrent diseases of posterior eye segment are important causes of medical discharges from military service.
Reliability and diagnostic significance of frequency doubling visual field testing
Authors: SAEDON H , HAMADA S , TAHHAN M
Published: September 2008

Purpose The aims of this study were to compare results of Frequency Doubling Perimetry (FDP) with the gold standard of Humphrey Visual Field Testing (HVF). To determine the reliability and repeatability of FDP, and whether referrals had diagnostic significance.

Methods Notes collected of patients referred from the community because of abnormal visual fields, tested by FDP. Information gathered on proforma included reason for referral, place of referral, number of defects in both eyes, whether they were repeatable, consistent with HVF, reliability, follow‐up and diagnosis.

Results 49 case notes were collected and reviewed, 98 eyes included. 31 females (63%), 18 males (37%). Mean age 59.5. All patients were referred because of VF defect. In 21 patients (43%), this was the only reason for referral. FDP showed poor consistency with HVF. This may be because it detects field loss earlier in the disease process. However, there was a lack of repeatability in FDP testing. In 29% of referrals, tests were not repeated, even though each test takes less than 90 seconds. FDP showed high reliability, possibly because it is a shorter test, simpler to perform and requiring less concentration Most patients were discharged at first or second appointment. Patients were seen an average of 2.6 times. The number diagnosed with glaucoma are very low (3), and the number labelled ‘glaucoma suspects’ higher (6). These patients are unlikely to have been detected without this technology.

Conclusion In our study, FDP showed poor correlation with HVF. The lack of repeatability between field defects in FDP casts doubts on its validity of screening for glaucoma.Most patients were not diagnosed with glaucoma, ocular hypertension or glaucoma suspects following assessment.