bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced levels of VEGF and reduced levels of VEGFxxxb in the vitreous of patients with retinal vein occlusion
Authors: MICHELS D , RENNEL ES , FELTGEN N , MARTIN G , STAHL A , HANSEN LL , AGOSTINI HT
Published: September 2008

Purpose To investigate the role of VEGF and VEGFxxxb in the pathogenesis of Central Retinal Vein Occlusion (CRVO) and Branch Retinal Vein Occlusion (BRVO).

Methods In a cross sectional study we analyzed the vitreous of patients with CRVO (ischemic and non‐ischemic) and BRVO. A group of patients with vitrectomy not due to CRVO/BRVO served as control. The vitreous of 25 patients with CRVO, of 28 patients with BRVO and of 32 patients with no sign of CRVO/BRVO were analyzed using ELISA for VEGF and VEGFxxxb.

Results The ratio CRVO/controls for VEGF was 5.5, and 2.5 in BRVO/controls. In comparison the VEGFxxxb ratio in CRVO/controls was 0.19, and 0.85 in BRVO/controls.

Conclusion Total VEGF levels in patients with CRVO and BRVO are significantly upregulated compared to controls. The finding of a significantly down‐regulated antiangiogenic VEGFxxxb in patients with CRVO is similar to the altered balance of the splice variants found in vitreous samples of patients with proliferative diabetic retinopathy.
Ametropia in children with regressed retinopathy of prematurity
Authors: BHATT UK , ANWAR S
Published: September 2008

Purpose Main aims of this study were:(1)To identify the pattern of refractive changes in children with different degrees of pre‐threshold retinopathy of prematurity (ROP). and (2)To establish whether long term follow‐up is necessary for these children?

Methods ROP screening notes of all premature babies born between Jan 2001 to Jan 2005(5 years) within a defined geographical area (Leicestershire) of the UK and fulfilling the national ROP screening guidelines were reviewed retrospectively. According to the severity, we graded the pre‐threshold ROP as follows: (1)Grade1‐ Any disease restricted to zone 3 or Stage I or II in zone 2, (2)Grade2‐ Stage II+ or III disease in zone 2, and (3)Grade3 ‐ Stage III+ disease in zone 2 Any zone 1 disease. Eyes of matched eyes were used as controls (same gestational age and weight matched children who were premature but without ROP). Cycloplegic refraction data (minimum follow up period‐ 24 months) on these children were then collected through the clinic notes. The results were compared statistically.

Results Refractive status results (at 24 months age) were available for 116 eyes in 62 children (Electronic search + Case notes review). Eyes were assigned to our predefined grades: Grade1:60 eyes(32), Grade2:34 eyes(18), and Grade3:22 eyes(12). The results of cyclopegic refraction (Mean spherical equivalent, Range) were as follows: Grade1:0.59(‐1.75 to +3), Grade 2: ‐0.04(‐4.5 to +2.25), and Grade 3: ‐1.59 (‐7.5 to +1.75). Statistically, refractive outcome of Grade 2 and 3 ROP children were different from controls.

Conclusion In pre‐threshold ROP, the trend of myopia is directly proportional to the severity of ROP. We recommend that regular follow up is necessary for Grade 2 and 3 ROP babies but no follow up required for babies with Grade 1 disease.
The lot of shaken baby syndrome (SBS) cases: Follow‐up of visual outcome and congnitive function
Authors: PINELLO L , ROSA RIZZOTTO M , MAIMONE P , MAZZAROLLO M , MANEA S , FACCHIN P
Published: September 2008

Purpose To study long‐term outcome of SBS on visual and cognitive functions.

Methods Case series of 10 children (7 M, 3 F) with confirmed SBS has been examined and followed‐up. All chldren underwent a fundus evaluation by indirect ophtalmoscopy and wide‐field digital ophtalmic camera (RetCam II) in the acute phase and until retinal hemorrhage resorption. The assessment was repeated at follow‐up combined with ocular motility evaluation, visual field (BEFIE test), visual acuity by preferential looking tecnique (teller acuity cards), refractometry, cognitive‐behavioural evaluations (Griffiths scales, Child Behaviour Check List), and family stress measurement (Parenting Stress Index).

Results Mean age at acute episode of SBS: 6 months (range 2‐20). Mean age at last follow‐up evaluation: 27.6 months (range 4.5‐41). At last follow‐up evaluation: 1 out of 6 had a decreased visual acuity (cortical visual impairment), 3 out of 6 had mild‐severe visual field deficits, 3 out of 6 has strabismus. None of the cases showed significant refractive errors. Due to age or severity of impairment and delay in global development, in any of the cases we were able to perform a recognition acuity test by symbols or E‐charts. Cognitive and behavioural assessment demonstrated global delay and impaiments in speech/language development and attention problems.

Conclusion SBS is characterized by severe long‐term sequelae both in visual and cognitive function. Several visual impairments are observed, mainly related to cortial injury of visuo‐spatial area. Although follow‐up is difficult due to family history, there is strong indication for global assessment until scholar age where other impairments are demonstrated.
Electrophysiological measurement of macular pigment distribution using annular stimuli: implications for colour vision testing
Authors: ROBSON AG , PARRY NRA
Published: September 2008

Purpose To quantify macular pigment optical density (MPOD) and distribution using steady‐state VEPs and to optimize the koniocellular selectivity of large chromatic gratings.

Methods Blue/Green (B/G) gratings were generated within 1 circular and 3 concentric annular fields (maximum radius 9°). All 4 fields were modulated simultaneously, each at a different temporal frequency. Onset‐offset VEPs were recorded as the luminance ratio between adjacent chromatic components within each field changed from 0.25 to 0.85 in 11 automated steps. Fourier analysis showed that the first harmonic was minimised at each subjects’ isoluminant ratio, as verified using flicker photometry. MPOD was computed at each retinal location relative to the most eccentric annulus. The stimuli were adjusted to compensate for the MP profile, allowing generation of a B/G grating that was isoluminant over the whole of the 18° stimulus area. The optimised B/G field was used to probe koniocellular function using onset‐offset VEPs and psychophysical temporal tuning characteristics.

Results Results: MPOD values computed from VEP estimates of B/G isoluminance correlated with those derived from minimum flicker measurements (r=0.94, p<0.005, slope=0.80). Large B/G gratings comprising of concentric annuli and optimised to compensate for MP, elicted large chromatic‐specific onset VEPs of negative polarity. Temporal tuning characteristics to the same stimuli were low‐pass, in keeping with the low temporal resolution of the koniocellular system.

Conclusion The steady‐state VEP can be used to determine MPOD at different retinal eccentricities. Macular pigment profiles may be used to optimise the koniocellular selectivity of large B/G stimuli.
Acquired colour vision deficiency in subjects with ARMD and Diabetes
Authors: O'NEILL‐BIBA M , RODRIGUEZ‐CARMONA M , RAUSCHER FG , WOLF JE , BARBUR JL
Published: September 2008

Purpose Age Related Macular Degeneration (ARMD) is the leading cause of blindness in the developed world in people over the age of 50. Its prevalence increases with age as does diabetes. Such conditions affect the metabolic stability of the retina, resulting in non‐inflammatory damage to retinal structures, and finally retinopathy. These changes to the visual pathway result in colour vision loss and in general, diminished visual performance. The aim of this study was to quantify accurately using sensitive visual tests the severity of visual loss in subjects with ARMD and diabetes.

Methods We investigated a large number of ARMD and Diabetic subjects with varying degrees of retinopathy and assessed their colour vision, achromatic high contrast acuity and flicker sensitivity under photopic and mesopic viewing conditions.

Results Results show a loss of chromatic sensitivity in both the red‐green and yellow‐blue channels, more pronounced under mesopic viewing condition. It was observed that chromatic loss was not localised to the site of retinopathy but affected peripheral retina also. Flicker sensitivity and contrast acuity loss were also observed in all subjects diagnosed with the above conditions. Preliminary findings show that significant loss of chromatic and flicker sensitivity precedes structural changes in the retina as revealed in conventional fundus imaging.

Conclusion The results so far suggest that loss of chromatic sensitivity is the most sensitive measure for detection of early damage in subjects with eye disease and can be used to detect and to monitor the progress of disease or the outcome of treatment.
Chromatic VEP in colour deficient children
Authors: TEKAVCIC POMPE M , STIRN KRANJC B , BRECELJ J
Published: September 2008

Purpose To compare chromatic VEP response to isoluminant red‐green stimulus in children with congenital red‐green colour deficiency with a control group of 30 children with normal colour vision.

Methods 15 children (7‐18 years) with congenital colour vision deficiency (8 in deutan and 7 in protan axis) and 30 healthy children (7‐19 years) were included in the study. Colour vision was assessed with Ishihara plates, Nagel Anomaloscope, Mollon‐Reffin Minimalist test, Farnsworth‐Munsell D‐15 saturated and desaturated test and Farnsworth‐Munsell hue 100 test. VEP were recorded to isoluminant red‐green stimulus. The stimulus was a 7 deg large circle composed of horizontal sinusoidal gratings, with spatial frequency 2 cycles/deg and 90 % chromatic contrast. VEP were recorded from Oz (mid occipital) position. Children were tested binocularly. Latency and amplitude of positive (P) and negative (N) wave were measured and so was mean amplitude (N‐P wave).

Results N wave was present in 24/30 children with normal colour vision (110 ± 25.1 ms; 9.7 ± 4.8 μV) and only in 1/15 child with colour vision deficiency (93 ms; 3.2 μV). P wave was present in 30/30 children with normal colour vision (138 ± 21.1 ms; 21.1 ± 13.5 μV) and in 13/15 children with colour vision deficiency (131.9 ± 6.1 ms; 19.4 ± 10.7 μV). In healthy children waveform changed from predominantly positive to negative wave with increasing age, whereas in colour deficient children no obvious waveform changes were observed.

Conclusion VEP response to isoluminant chromatic stimulus showed different characteristics in children with congenital colour vision deficiency compared to children with normal colour vision. manca.tekavcic‐pompe@guest.arnes.si
Scattered light and visual acuity after Descemet‐stripping with endothelial keratoplasty
Authors: MCLAREN JW , BOURNE WM , PATEL SV
Published: September 2008

Purpose The lamellar interface and anterior host cornea after posterior lamellar keratoplasty scatter more light than normal corneas. In this study, we examined the relationship between forward‐scattered light, back‐scattered light, and visual function after Descemet‐stripping with endothelial keratoplasty (DSEK).

Methods Nineteen eyes of 17 patients received DSEK with the donor prepared by a microkeratome; all eyes were pseudophakic postoperatively. Eyes were examined before and at 6 months after surgery. Best‐corrected high‐contrast visual acuity (HCVA) was measured by electronic‐ETDRS and low‐contrast visual acuity (LCVA) was measured by using a 10% contrast chart. Intraocular forward light scatter was measured by using a stray‐light meter (Oculus C‐Quant) and back‐scattered light was measured in anterior, middle, and posterior thirds of the cornea by using a custom slit‐lamp scatterometer. Generalized estimating equation models were used for statistical analyses to account for possible correlation between fellow eyes of the same patient.

Results HCVA improved from 0.46 ± 0.26 logMAR (20/58) before DSEK to 0.28 ± 0.15 logMAR (20/38) at 6 months (p<0.001, n=19), and LCVA improved from 0.88 ± 0.26 logMAR (20/152) before DSEK to 0.62 ± 0.19 logMAR (20/83) at 6 months (p<0.001). At 6 months after DSEK, forward light scatter correlated with HCVA (r=0.67, p<0.001) and with LCVA (r=0.75, p=0.006). Back‐scattered light from the anterior, mid, or posterior cornea were not correlated with forward scatter or with HCVA or LCVA (p>0.2).

Conclusion Visual outcomes after DSEK are associated with the forward‐scattered light induced by the host cornea and lamellar interface, although not with the back‐scattered light visible on slit‐lamp examination.
Pseudophakic dysphotopsia ‐ Counting the stars
Authors: ASLAM T , ASPINALL P
Published: September 2008

Purpose To demonstrate the use and potential for two very disparate measures of glare and dysphotopsia

Methods We report the development of a system of measuring pseudophakic dysphotopsia dependent on patient recognition of photographic plates. The photographs are structured such that type and intensity of varied dysphotopsia can be assessed. The photographs have been used in preliminary studies to assess prevalence of dysphotopsia and also to compare the amount in patients with different intraocular lenses. In a parallel study C‐Quant measures of stray light were obtained on 106 patients referred to the cataract clinics. In addition to tests of visual acuity and contrast sensitivity (LogMar and Pelli‐Robson), cataract morphology was assessed using the Oxford cataract grading system. The paper examines associations and differences between the visual and clinical measures and using latent class analysis explores subgroups of different patient profiles
Reliability results of straylight measurements using the C‐Quant
Authors: CERVINO A , MONTES‐MICO R , FERRER‐BLASCO T
Published: September 2008

Purpose Assessment of repeatability and reproducibility of straylight measures with the C‐Quant straylightmeter (Oculus AG, Germany), effect of age on reliability measures and correlation of measures determined with new methods of scatter determination.

Methods Results from different studies will be presented. For repeatability assessment, 20 eyes (age 26.9±2.7 years) were examined with the C‐Quant, taking 10 consecutive readings. 5 subjects were also examined on 5 consecutive days to assess reproducibility. Repeated measures from 84 subjects, age range 19‐86 years, were analysed to assess the effect of patient’s age. Software was developed to quantify scatter from centroid patterns obtained using a clinical aberrometer(WASCA, Zeiss) based on previous work by Donnelly & Applegate, and 3 values were obtained on 10 eyes. 3 measures were also made with the C‐Quant. Preliminary results comparing the C‐Quant and the StarLight hallometer will also be presented.

Results Results failed to show differences between readings taken within the same session (mean SD 0.07, p>0.05) or between sessions (mean SD 0.05, p>0.05). Variability of intrasession measurements was not significant for subjects of different age (p=0.094). After removal of incomplete patterns, good correlation was achieved between psychometric and objective measures despite small sample size (n=6; r= ‐0.831, p=0.040).

Conclusion The C‐Quant straylightmeter is repeatable and reliable for retinal straylight assessment on human eyes. Age does not decrease repeatability eventhough they feel more insecure about their ability to perform the test. Psychometrical determination of straylight showed remarkably high correlation with objective measures of scatter on young healthy subjects.
A screening test for visual disorders based on Rarebit perimetry
Authors: MARTIN LM , WANGER P
Published: September 2008

Purpose To evaluate the clinical usefulness of a newly developed screening program, the VisuBit™ Quick test, based on the Rarebit perimetric technique (Frisén 2002).

Methods Twenty‐one subjects (32 eyes), 6 males and 15 females, median age 47 years (27‐67), were examined using the VisuBit Quick and Full test, both including the Fovea test (4x3°visual field) and the Field test (30x20° visual field). Two subjects had amblyopia in one eye, one of these had normal visual acuity in the other eye and one had a history of central serous retinopathy in one eye, 2 subjects had a history of optic neuritis in both eyes and 2 had glaucoma in both eyes. All other eyes were healthy and had normal visual acuity.

Results The correlation coefficients between number of unperceived stimuli in the Quick and the Full test were 0.95 in the Fovea and in the 0.86 Field test. In the Quick Field test more than 4 unperceived stimuli predicted a subnormal result (MHR < 90%; Martin & Wanger 2004) in the Full Test. In the Fovea Test more than 2 unperceived stimuli predicted a subnormal results (MHR < 97%; Nilsson et al 2007). The positive and negative predictive values for the Quick Fovea test were 0.95 and 0.77, respectively. Corresponding values for the Quick Field test were 0.95 and 0.85.

Conclusion The findings in this pilotstudy indicate that this implementation of the Rarebit perimetric technique may be useful for rapid screening for visual disorders.
Effects of repetitive IOP measurements
Authors: JOHANNESSON G , LINDEN C , BEHNDIG A , EKLUND A , HALLBERG P
Published: September 2008

Purpose The purpose of this study was to evaluate the effect of repetitive applanation tonometry measurements on IOP and aqueous humor volume in the anterior chamber.

Methods This is an ongoing study where four healthy volunteers have participated so far. Consecutive repeated series of six measurements with Goldmann applanation tonometry (GAT) and applanation resonance tonometry (ART) were made alternately on both eyes for one hour. Using an Oculus Pentacam, the anterior chamber of the left eye was photographed before the measurements and then consecutively for 20 min. Finally, one additional measurement was performed with both GAT and ART.

Results In this abstract we present the results from the first four subjects. The results show that there was a significant reduction in IOP on the right eye both with GAT and ART. After one hour of measurements, IOP was reduced by 5.5 mmHg (range 4.3‐7.2 mmHg) for GAT and 3.1 mmHg (range 1.0‐4.1 mmHg) for ART. The decrease in aqueous humour volume after IOP measurements was less than 10 % for all subjects.

Conclusion Although Bechrakis showed as early as 1966 that repetitive measurements result in significant IOP reduction, the mechanism behind this is still matter of debate. Our preliminary results confirm the occurrence of IOP reduction after repetitive measurements, but indicate that it could not be explained by the decrease in volume of the anterior chamber.
HLA class I haplotypes and progression of primary open angle glaucoma
Authors: VERONESE RODRIGUES ML , ZENHA F , CASTALDELLI RMOB , DEGHAIDE NHS , DONADI EA
Published: September 2008

Purpose Patients with primary open‐angle glaucoma (POAG) with HLA class I haplotypes (A9‐B12, A2‐B40, A1‐B8) associated with this disease could have a fast disease progression than patients who wouldn’t present these haplotypes.

Methods Anatomic and functional evaluation of 25 patients (six of them with one of the haplotypes associated with glaucoma) followed, in the Glaucoma Outpatient Clinic of the University Hospital of a Brazilian Medical School, for ten years after the typing of their HLA antigens in order to compare with the previous conditions.

Results There was observed a higher increase in the cup/disc ratio in patients with HLA haplotypes associated with POAG predisposition (P=0.01248, comparing with patients of different ages; and P=0.0047, comparing with patients of the same age group), however it wasn’t observed significant differences, between these and the others patients with glaucoma, in functional damage progression (evaluated by Humphrey perimetry) neither in losses in retinal nerve fibers layer (evaluated by optical coherence tomography).

Conclusion These results show the association of class I HLA haplotypes with faster progression of anatomic alterations of the optic nerve head in patients with glaucoma.
Interactions between trabecular meshwork cells and lens epithelial cells – a possible mechanism in infantile aphakic glaucoma
Authors: INBAL M , SHMOISH M , WALTON DS , LEVENBERG S
Published: September 2008

Purpose Infantile aphakic glaucoma may develop as a postoperative complication of early childhood cataract surgery. Its causes and mechanisms to date are poorly understood. Our goal is to study the mechanisms leading to trabecular meshwork (TM) dysfunction and glaucoma following the cataract removal. We focus on deciphering the interactions between TM cells and lens tissue or conditioned medium by analyzing changes in TM cells co‐cultured with lens epithelial cells (LECs), or cultured in the presence of factors found to be secreted by LECs.

Methods These interactions are studied by analyzing for morphological alternations, and differential gene and protein expression. Factors secreted by LECs are analyzed using cytokines array membranes.

Results TM cells grown in the presence of LECs exhibited structural changes (mainly volume and size enlargement and decreased cell‐cell interactions), as well as altered protein expression (mainly cytoskeletal), and gene expression (such as genes related to cell morphogenesis and inflammatory response). Several cytokines were found to be elevated in the medium of LECs, and of the co‐culture, but not in the medium of TM cells, suggesting their role in the changes observed in TM cells co cultured with LECs; co‐culture of TM cells in the presence of these cytokines will be further performed.

Conclusion Many of these changes were reported in primary open‐angle glaucoma, suggesting the possible role of LECs in the development of aphakic glaucoma.
Circulating ether‐lipids as an early marker of POAG
Authors: ACAR N , BERDEAUX O , JUANEDA P , GREGOIRE S , BIDOT S , CREUZOT CP , BRETILLON L , BRON AM
Published: September 2008

Purpose Neuronal tissues such as the retina contain high amounts of particular phospholipids named “ether‐lipids”. Since abnormal blood levels of ether‐lipids have been associated with several neurological disorders, we wanted to check whether ether‐lipid levels were modified and associated with the severity of POAG.

Methods Blood samples were collected from 41 healthy subjects and 64 POAG patients. Following lipid extraction from erythrocytes, total phospholipids including ether‐lipids were isolated using silica cartridges. The fatty acid profile of phospholipids was determined using capillary column gas chromatography (GC). The individual molecular species of phospholipids and ether‐lipids were quantified by tandem liquid chromatography‐mass spectrometry.

Results The levels of ether‐lipids were significantly decreased in glaucoma patients and especially the choline ether‐lipid sub‐class. The Mean Deviation (MD) value from Humphrey perimetry was negatively correlated to erythrocyte levels of total choline ether‐lipids (r²=0.99). The linear regression model predicted that total choline ether‐lipid levels started to decrease about 20 years prior to clinical symptoms.

Conclusion Although the mechanisms responsible for the reduction of erythrocyte levels of ether‐lipids in POAG patients remains unclear, the known functions of ether‐lipids in the protection against oxidative stress make these results very consistent with the pathogenesis of glaucoma.
Correlation of optic disc morphology and ocular perfusion parameters in patients with primary open angle glaucoma
Authors: SCHMIDL D , RESCH H , RENSCH F , HOMMER A , VASS C , LUKSCH A , GARHOFER G , JONAS JB , SCHMETTERER L
Published: September 2008

Purpose Little information is available about the relationship between glaucomatous visual field defects and reduced blood flow in the optic nerve head. It is still not clear, if impaired circulation is a causative factor in the disease process, or if it is secondary as a result of loss of axons in the optic nerve head. In the present study vascular parameters were correlated against structural damage of the optic nerve head and functional damage.

Methods 103 patients with primary open angle glaucoma, documented visual field defects and optic disc morphology changes were examined. Blood flow parameters were assessed using Laser Doppler Flowmetry, Laser Doppler Velocimetry, and the Retinal Vessel Analyzer. To evaluate the morphology of the optic nerve head, a fundus photograph was taken. For determination of the degree of visual field damage, automated perimetry was performed.

Results The degree of optic nerve head damage was significantly correlated with the intensity of visual field loss. Decrease in retinal vessel diameter was only slightly correlated with the degree of glaucomatous optic neuropathy and visual field defect. Reduced optic nerve head blood flow was, however, strongly correlated with the degree of visual field loss and morphological optic disc damage.

Conclusion The data of the current experiment indicates that blood flow in the optic nerve head is strongly associated with the degree of visual field damage, whereas retinal vessel diameters show only little association with the degree of visual field damage.
Frequency of melanocytic conjunctival lesions in an ocular oncology unit
Authors: SANCHEZ‐MANNARELLI F , PORTERO‐BENITO A , CARRENO‐SALAS E , MUNOZ MF , SAORNIL MA
Published: September 2008

Purpose Pigmented lesions of conjunctiva account for 50% of conjuntival tumors.The purpose of this study was to evaluate the frequency of incidence,clinical characteristics and distribution of these pathologies in a referral oncology unit.

Methods Retrospective observational cases series of patients with diagnosis pigmented conjuntival lesions were studied at the Ocular Oncology Unit of Valladolid Clinical Hospital dated from January 1992 until June 2008.Clinical chart of consecutive cases were reviewed through evaluation of the clinical features. Demographic data (age,sex,background) and clinical features (shape,location,ocular and extraocular extension) have been registered in a data base design in AccessXP and statistical SPSS 15 analysis.

Results 314 cases were diagnosed with conjuntival tumors, 149 (47%) corresponded to melanocytic tumors; mean age was 42 years, and 52% were females. 73.2% were benign tumors, 22.1% precancerous and 4.7% malign. Comparing clinical characteristics of PAM and melanoma we found significant clinical differences (p<00,5) regarding clinical presentation, 100% melanomas presenting as a growing lesion;limbal involvement was 42.9% for melanoma and 62% for PAM;Corneal involvement was 28.5% for melanoma compared to 17.2% of PAM and 2% of Nevus. All nevus were circumscribe lesions,38% of PAM were diffuse/multicentrics and 42,9% de melanomas were multicentricts;Mean age at diagnosis was 38 years for nevus,53.5 for PAM and 61.3 for melanomas.

Conclusion Pigmented lesions were more frequent tumor in our serie.Most of them benign.Clinical characteristics were related with precancerous or malignal lesions were growing onset,multicentric lesion with corneal and limbal involvement and older age.
Results of treatment of conjunctival melanoma in 61 consecutive patients
Authors: POGRZEBIELSKI A , BOGDALI A , NAPORA‐KRAWIEC A , ROMANOWSKA‐DIXON B
Published: September 2008

Purpose Analysis of patients with conjunctival melanoma.

Methods Retrospective analysis of 61 consecutive patients with histopathologic diagnosis of conjunctival melanoma treated between 1991‐2007 at the Department of Ophthalmology and Ocular Oncology of Jagiellonian University in Krakow. There were 30 (49.2%) women and 31 (50.8%) men in mean age of 57.6 years (25‐89).

Results The tumors involved in 29 cases right eye and in 32 cases left eye. 26 (42.6%) melanomas were located in temporal quadrant; 37 (60.6%) tumors involved limbus and 22 (36.1%) bulbar conjunctiva; in 2 (3.3%) patients tumors infiltrated tarsal conjunctiva. 53 tumors (86.9%) were pigmented, 5 (8.2%) ‐ amelanotic and 3 tumors (4.9%) ‐ mixed. In 59 (96.7%) patients the tumors were nodular and in 2 (3.3%) diffuse, superficial. In all cases surgical excision was performed and in 44 (73.13%) cases adjunctive Ru‐106 brachytherapy. In 20 (32.7%) cases recurrence of melanoma necessitating secondary treatment was observed. The mean time to recurrence was 24.65 months (2‐91). In 5 (8%) cases documented metastasis occurred. Among all patients 5 (8%) died because of metastatic disease, 3 because of other reasons. 6 cases were lost to follow‐up because they moved to other countries.

Conclusion Conjunctival melanoma most commonly occurs in form of a melanocytic, nodular tumor localized in corneal limbus and bulbar conjunctiva. Local recurrence of the tumor may be expected despite the surgical excision combined with adjunctive therapies.
Genetic predisposition to uveal melanoma
Authors: DESJARDINS L , LUMBROSO LEROUIC L , LEVY C , STOPPA LYONNET DUE , PLANCHER C , ASSELAIN B , BUECHER B
Published: September 2008

Purpose Uveal melanoma is a rare tumor with exceptional familial or bilateral cases. The possibility of genetic predisposition has been evoked. We have tried to identify patients with history compatible with genetic predisposition of uveal melanoma and to perform genetic testing.

Methods Between 1994 and 2008 we have registered for all our uveal melanoma patients the history of personal and/or familial previous cancer. According to the antecedents, selected patients were seen for genetic counselling and were offered blood test.

Results 1665 patients treated in our institution for uveal melanoma had registered personal and familial history of previous cancer. 152 patients had previous cancer: 35 breast cancers, 9 gynaecological cancers, 21 digestive cancers and 87 other locations. 34 of them had a cancer before the age of 50; 23 patients had a familial history of uveal melanoma; 39 patients had a familial history of cutaneous melanoma; 276 patients had a familial history of breast cancer; 40 patients had a familial history of pancreatic cancer; 822 patients had a familial history of other cancers. 143 patients had a genetic counselling, 81 patients had blood sampling and genetic testing was performed on BRCA1and or BRCA2 for 27 patients and p16‐CDK4 for 18 patients. All the results were negative.

Conclusion Further studies should be performed to determine the genes possibly implied in a predisposition to uveal melanoma.
Surgical treatment of severe choroidal detachment after brachytherapy for choroidal melanoma
Authors: ANGI M , DAMATO BE
Published: September 2008

Purpose Choroidal detachment is a rare but potentially serious complication of plaque radiotherapy of choroidal melanoma. We present a patient who was successfully treated by trans‐scleral drainage over the pars plana using an unconventional technique.

Methods A 69‐year‐old man was referred to our service for an infero‐nasal, collar‐stud melanoma in the left eye. On ultrasonography, the tumour measured 14.1 x 11 mm, with a thickness of 5.8 mm. The patient was treated with a 20 mm ruthenium plaque. Two weeks after the plaque removal, the patient was referred back to our service with a painful eye and ocular hypotension. Ophthalmoscopy showed severe choroidal detachments. The patient was managed expectantly, but the pain became uncontrollable. The supra‐choroidal fluid was drained through a circumferential deep scleral incision over the pars plana and under a lamellar scleral flap hinged posteriorly. A high intraocular pressure was maintained with infusion, using a 6 mm cannula placed in an area between the choroidal detachments. The patient was on warfarin and this was not discontinued before the surgery.

Results Postoperatively, the eye was comfortable, the intraocular pressure returned to normal and the choroidal detachments did not recur.

Conclusion Our technique has several advantages over previously described methods. First, it avoids the risk of retinal tear, because of the pars plana location of the incision. Second, the scleral flap facilitates wound closure, also avoiding the risk of retinal prolapse. Third, it does not require the warfarin therapy to be stopped. We propose this technique as a relatively safe and effective treatment for severe, painful and persistent choroidal detachment after plaque radiotherapy of choroidal melanoma.
A clinical pathway for episcleral brachytherapy
Authors: DE FRUTOS‐BARAJA JM , DE LUIS‐PEREZ FJ , SAORNIL‐ALVAREZ MA , LOPEZ‐LARA‐MARTIN F , GIRALDO‐ARGÜELLO A , ESTEBAN‐CASADO R , CEBALLOS‐GARCIA MA , GARCIA‐ALVAREZ C , ANDRES‐RODRIGUEZ C
Published: September 2008

Purpose To develop the clinical pathway of episcleral brachytherapy as developed in our center.

Methods 1 .‐ Recruitment multidisciplinary team 2 .‐ A critical review of clinical practice guidelines applicable 3 .‐ Combining the expertise of professionals with revisions to guidelines previously outlined and the rest of literature applicable 4 .‐ design of the clinical pathway and indicators for evaluation

Results The clinical pathway designed consists of 3 tables: time from diagnosis until they have all the data for treatment, during treatment and variances on the pathway and the establishment of indicators to assess the degree of compliance with the pathway i. ‐ Number of patients included in the pathway in relation to that should have been included ii .‐ Number of patients with variances from the clinical pathway iii .‐ Total number of variances iv .‐ Survey of patients v. ‐ Survey of professionals

Conclusion The establishment of the delimitation of functions through a clinical pathway has served the research team, who is also the team that develops clinical treatments in our center, to narrow the deadlines for action of each specialty and the order in which they must be made. The research team is inclined to clinical pathways of more immediate usefulness for clinical practice the existence of guides in the scientific literature. An improvement that could be done would be the computerization of the pathway. Acknowledgments: This work has been financed partly by a grant of the Junta de Castilla y León (Order SAN/1829/2007 of November 13, BOCYL of November 15, 2007)
Wavefront aberration measurements in dog and cat eyes using an aberrometer designed for human eyes
Authors: ROSOLEN SG , LAMORY B , CHATEAU N , PICAUD S , SAHEL JA , LE GARGASSON JF
Published: September 2008

Purpose To measure the ocular optical aberrations in dog and cat using a wavefront aberrometer based on Hartmann‐Shack technology.

Methods Data were obtained from eyes of two normal sedated dogs and one normal sedated cat in accordance to the ARVO statement for the use of animals in ophthalmic and Vision research. Wavefront aberrations were measured using an irx3 aberrometer (Imagine Eyes, Orsay, France). Spherical defocus, astigmatism and Zernike coefficients up to the 8th order were analyzed.

Results The optimal acquisition time was 10 ms for all animals. Refractive errors have been analyzed in a 6 mm pupil diameter in all cases. The refractive errors in dog #1, dog #2 and the cat were +2.9D(‐2.0D)111°;‐0.8D(‐0.8D)126° and +3.3D(‐2.1D)98°, respectively while their Root Mean Square (RMS) higher‐order aberrations amounted to 1.9, 1.1, and 2.1 µm RMS respectively. SD in sphere and cylinder was 1.0D in the cat and less than 0.5D in both dogs. SD in the higher‐order RMS was 0.8 µm in the cat and less than 0.5 µm in both dogs.

Conclusion Ocular optical aberrations can be measured in sedated dog and cat using a Hartmann‐Shack aberrometer with reduced image acquisition time. The tested animals had relatively large higher‐order wavefront aberrations when compared with healthy human eyes. Measurement reproducibility was affected by tear layer effects. This variability could be further reduced using a larger sensor area, specific head contention device and artificial tears. The measured range of aberrations could be corrected using available adaptive optics technology in order to image retinal cells in living dogs and cats. Financial interest disclosure: B. Lamory and N. Chateau are employees of Imagine Eyes
Objective measurement of near and distance visions by optokinetic response determination
Authors: HAN ER , YEO WE , LEE JH
Published: September 2008

Purpose To evaluate the efficacy of using optokinetic nystagmus (OKN) suppression and induction method as an objective measurement of visual acuity at near and distance.

Methods Eighty‐three eyes of 83 patients were examined from December 2007 to February 2008. The visual stimuli were presented on a 17‐inch monitor screen located 40cm from subject for measuring visual acuity at near and on a 127‐inch projector screen located 3m for visual acuity at distance. Eye movement were recorded by infrared oculography and analyzed. The correlation between objective visual acuities at near and distance and subjective visual acuities at near and distance were evaluated. And the reproducibility of objective visual acuity measurement was also investigated.

Results Linear regression identified that objective visual acuities measured by using OKN suppression and induction methods were found to be correlated with subjective visual acuities(r2; induction method at near: suppression method at near: induction method at distance: suppression method at distance = 0.641:0.685:0.566:0.724, P<.05). And the objective visual acuity measurement showed high reproducibility(intraclass correlation; induction method at near: suppression method at near: induction method at distance: suppression method at distance = 0.963:0.994:0.945:0.988, P<.05). The suppression method is useful in patient with visual acuities better than 20/120 while the induction method is useful in patient with visual acuities worse than 20/120.

Conclusion The objective near and distance visual acuities measured by presenting optokinetic stimuli on 17‐inch monitor screen located 40cm from subject and on a 127‐inch projector screen located 3m were highly correlated with subjective near and distance visual acuities.
Effect of the interposition of optical filters with different visible light transmittances in mesopic and scotopic condition pupil size
Authors: SANCHEZ RAMOS C , VINAS PENA M , DIAZ SERRANO Y , TORETS C
Published: September 2008

Purpose To determine how can the pupil size, in mesopic and scotopic condition, be affected by the interposition of optical filters. Also, the variability of the effect of these optical filters due to each filter’s different visible light transmittance.

Methods The transversal study included data from 56 eyes of 28 subjects. To measure the different pupil size, in high mesopic, low mesopic and scotopic condition, was used a digital binocular infrared pupillometer. The obtained pupil size’s 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 Some filters, 5 of the 16, with different transmittances, 63%, 17%, 8%, 6% and 5%, caused significant variations in the pupil size in mean mesopic condition. The 2 highest transmittance’s filters, 63% and 17%, between these 5 filters, which produced significant results (p<0.00, high mesopic condition, 4.0lux), were the ones that led a higgest pupil size variation, in the 3 different light conditions.

Conclusion The influence of some optical filters in pupil size variation, was confirmed. This effect on pupil size was significant only in high mesopic condition, and it was independent of each filter’s different visible light transmittance.
A comparison of intermediate and near visual outcomes and reading ability in patients bilaterally implanted with bifocal ZM900, ReSTOR IOLs and with multifocal ReZoom IOLs
Authors: FANNI D , DI LAURO MT , RAVALICO G
Published: September 2008

Purpose To compare intermediate and near distance visual outcome, reading performance, level of satisfaction and quality of vision at intermediate and near distance in patients bilaterally implanted with diffractive (AMO Tecnis ZM900 or Alcon ReSTOR) and refractive (AMO ReZoom) multifocal IOLs (MIOL).

Methods This study enrolled 71 cataract patients, 26 of whom received ZM900 diffractive IOL bilaterally (Group A), 22 of whom received ReSTOR diffractive IOL bilaterally (Group B) and 23 of whom received ReZoom refractive IOL bilaterally (Group C). Best distance‐corrected intermediate and near visual acuity (BCDIVA ‐ BCDNVA), defocus curve, binocular vision, reading speed, contrast sensitivity and Visual Function‐7 (VF‐7) modified questionnaire scores for intermediate and near distance everyday activities were assessed a month after surgery. Inclusion criteria were: age range 50‐80 years, no concomitant ocular diseases and no intraoperative complicances.

Results BCDIVA and BCDNVA were better in group A and B than in group C. Group A achieved better contrast sensitivity than group B and C. Reading speed and VF‐7 questionnaire scores were comparable in all groups.

Conclusion Intermediate and near distance performances were acceptable in all groups but diffractive IOLs proved slight1y better than refractive IOLs at near distance. Particularly, diffractive ZM900 IOL obtained better resu1ts than the other lenses. In our opinion the modified prolate aspherical surface of this lens could explain this phenomenon.
10 years followup in children affected by various eye diseases: sensibility and specificity of VA, fundus and 30 Hz and mixed response electroretinogram done during anaesthesia as predictors of visual outcome
Authors: ANGELI R , PEZZOTTA S , BARILLA D , BERTONE C , ANTONINI M , FAZZI E , GUAGLIANO R , BIANCHI PE , TINELLI C , RUBERTO G
Published: September 2008

Purpose This study aimed to define the relationship between 30 herz and mixed maximal response electroretinogram, recorded under anaesthesia, and the visual outcome in subjects affected by various retinal and/or optic disk affections.

Methods We present a review of 87 among 260 children examined under anaesthesia. All subjects(mean age 3,12)underwent ERG without adaptation, in a mid luminance, at 30 hertz and mixed maximal response. Results were matched with fundus findings and the visual acuities. Multiple statistical analysis comprehending student’s t test for independent samples was used for comparisons between groups. A P value of less than 0.05 was assumed to indicate statistical significance.

Results Diagnosis linking fundus findings and ERG were: 7 Leber dystrophy, 12 ROP, 20 retinal dystrophy, 6 ny, 5 CVI, 2 Joubert syndrome, 1 Retinoblastoma, 5 ON coloboma, 1 Morning glory syndrome, 12 pale papilla, 2 congenital cataract associated with retinal anomalies, 14 not defined. Mean VA was 1,94 in right eye, 2,04 in the left. Significant correlations and “p” values were found between 30 hz amplitude, a and b amplitudes, b latency and visual acuities. ROC curves were statistically significant in latency and ampitudes in a and b waves.

Conclusion Our work indicate a correlation between fundus findings, ERG and visual outcome. When we are unable to perform a correct diagnosis by visit and instrumental methods in awake conditions, a brief anaesthesia allow to obtain results otherwise arduous.
Retinal thickness vs. retinal sensitivity at the central human macula
Authors: BERNARDES R , CUNHA‐VAZ J
Published: September 2008

Purpose To assess the detailed correlation between retinal thickness and retinal visual function in the central 300 µm human macular area.

Methods Twenty‐four eyes with clinically significant macular edema (CSME) (12 eyes with and 12 eyes without central foveal involvement) underwent retinal thickness measurement (RT) and retinal sensitivity, performed by Cirrus HD‐OCT (Carl Zeiss Meditec, Dublin, CA, USA) and MP1 (Microperimetry, Nidek, Japan) systems, respectively. The average retinal thickness in the 300 µm diameter area, centered in the fovea, was computed and correlated with the central MP1 value. RT could also be locally correlated with MP1 values in areas of 30 µm in diameter centered at each stimulus site. Precise correspondence between stimuli and RT locations was ensured by bringing into co‐registering the fundus image references from both modalities.

Results A moderate correlation was found between RT and central MP1 value (R=‐0.578, p=0.003). The correlation decreases when analysing, separately, eyes with or without central foveal involvement (p>0.05 for both groups) being stronger for the CSME eyes with central involvement.

Conclusion Cirrus HD‐OCT high resolution mapping allows to correlate structure and function at detailed level in the central fovea. It became possible to demonstrate the lack of direct correlation RT/MP1 and the reason why an apparent correlation exist when considering all cases of being part of the same group.
Lens cellular culture models obtained after cataract surgery: interest in cytogenetics analysis
Authors: MILLAZO S , COPIN H , JANY B , BREMOND‐GIGNAC D
Published: September 2008

Purpose To model two new techniques of lens cellular culture after cataract surgery, depending of the technique used, in order to study cytogenetics characteristics

Methods Two techniques were provided to obtain lens cells during cataract surgery according to the technique used. Twenty phacoemulsification from patients (range 15 to 83 years‐old) allowed to collect anterior capsules were collected during capsulorhexis before. Capsules were applied in thin layer on slides. Then they have been set in culture. Thirty posterior phacophagia (range 1 month‐old to 8 years‐old) allowed to collect liquids and were then cytocentrifuged. The cells centrifugated were set in culture. A cytogenetic analysis was performed with the lens cells and blood. An informed consent was obtained from the patients.

Results Twelve of the twenty capsules could lead to lens culture. The culture centrifugated cells of eighteen phacophagia could be used to perform a cytogenetic analysis and found a regular karyotype according to the blood results. The lens is specially exposed to UV rays and cytogenetic anomalies could be induced and then identify. Other applications could be applied with these lens cells as study of lens pharmacological effects of drugs.

Conclusion The techniques described are simple to perform and could be used in different applications. The cytogenetic analysis we used is one of those and confirms the interest to compare blood and tissue results.
Application of agar sandwich technique for morphologic studies of anterior lens capsule
Authors: STUNF S , HVALA A , GLOBOCNIK PETROVIC M , HAWLINA M
Published: September 2008

Purpose Preparation of the anterior lens capsule for morphological studies is difficult due to its transparency, small size and delicacy. During preparation the capsule curls upon itself, causing various artefacts in capsule thickness and epithelial cells organization. The samples can also be easily lost. To overcome these problems, the agar sandwich technique was introduced.

Methods The capsules were obtained during routine cataract surgery and immediately fixated in 10% paraformaldehid for 1 to 2 hours. The agar sandwich consisted of 8mm wide agar disc and agar in liquid state, to be poured over the disc. The discs were pre‐prepared and stored in alcohol, while the liquid phase was stored cold in syringe and melted for each case. With the aid of laboratory microscope pre‐fixated capsule was gently straightened on the agar disc, mounted in the agar sandwich and fixated overnight. Fixation was followed by standard procedure for light or electron microscopy samples.

Results Anterior lens capsules from different cataracts were included in the study. Once positioned in the sandwich, the capsule remained in its shape throughout the preparation. The agar sandwich did not interfere with the standard Hematoxilyn‐Eosin staining or cutting. Agar was clearly seen around the capsule on light microscopy samples. The appearance of basement membrane remained unchanged. However, for epithelial cells preservation the pre‐fixation and gentle handling of the sample were crucial.

Conclusion The agar sandwich technique is a not‐complicated technique, which turned out as an effective method in processing of the anterior lens capsule samples. In combination with pre‐fixation no interfering with histological section or interpretation was noted.