bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Mitomycin C in the treatment of conjunctival and corneal squamous cell carcinoma. a case report
Authors: CELLINI M , LEONETTI P , STROBBE E , CAMPOS EC
Published: October 2007

Purpose: Corneal conjunctival squamous carcinoma is a rare form of slowly progressive carcinoma of low malignant potential. Mitomycin C (MMC) is a chemiotherapic antibiotic isolated from Streptomyces Caespitosus and medical literature reports efficacy of MMC in the treatment of squamous cell carcinoma. We present a case of conjunctival and corneal squamous cell carcinoma which was treated with both surgical excision and topical use of MMC 0.02%.

Methods: A 78‐year old man with a red‐grey vascularized elevated epithelial lesion that started at the conjunctiva and extended past the corneoscleral limbus on to the cornea for about 1.5 mm.

The patient was given surgical exeresis of the conjunctival neoformation and the histological exam highlighted a corneal conjunctival squamous cell carcinoma. after three monthes a recurrence of the neoformation was displayed and we therefore decided to start topical MMC 0.02% eye drops treatment four times daily for 7 days. Four cycles of treatment were done with a one‐week interval during which only sodium hyaluronate 0.4% lubricant eye drops were administered.

Results: During the period of treatment with the MMC 0.02% eye drops, the patient did not display any adverse systemic or ocular reactions. At the end of the treatment we found a complete regression of the disease. Twelve months after treatment he was without conjunctival and corneal epithelial dysplasia.

Conclusions: This case highlights the efficacy of MMC 0.02% eye drops in the treatment of conjunctival and corneal squamous cell carcinoma that can avoid the topical use with sponge of MMC at higher concentration that it would present a not predictable long term effects on the conjunctival fornix and on lachrymal secretion.
Correction of congenital ptosis using Ptose‐up
Authors: ALTAN‐YAYCIOGLU R , AKOVA YA
Published: October 2007

Purpose: To determine the functional and cosmetic results of Ptose‐up ptosis sling material for the correction of congenital ptosis.

Methods: In this prospective study, 13 frontalis sling suspension surgeries were performed by the same surgeon in 12 consecutive children with congenital ptosis. The sling material was sutured to the tarsus through an eyelid crease incision. The eyelid contour, complications during and following surgery were recorded.

Results: The ages of the cases ranged from 1 to 21 years (mean 7.5 ± 6.9 years). The patients were followed‐up for at least 6 months (mean 16.7 ± 8.4 months). All ptotic eyelids were corrected with acceptable final lid position. Exposure keratitis, wound infection, eyelid contour abnormality or overcorrection was not observed in any patient. One case had trauma to the periorbital area one month following surgery which resulted in recurrent ptosis and required re‐operation. Another patient with recurrent ptosis at presentation had persistent eyelash ptosis following surgery which required an additional surgery. Good to excellent final postoperative height was achieved in 8 patients (9 eyelids), and 2 cases with mental retardation could achieve good height with conscious active brow elevation.

Conclusions: Ptose‐up sling material is a biocompatible, biointegrable, inert material, which results in cosmetically and functionally satisfactory results following surgery of congenital ptosis. Following surgery, patients learn to use their frontalis muscle to achieve satisfactory eyelid height. This can also be achieved in patients with mental retardation if taught to exert conscious effort to activate the frontalis muscle.
Which color vision test should be used in progressive cone dystrophy?
Authors: THIADENS AAHJ , VAN LITH‐VERHOEVEN JJC , BERNAERTS MGJ , KLAVER CCW
Published: October 2007

Purpose: The early manifestation of progressive cone dystrophy (COD) can remain unrecognized due to the relatively normal macular appearance. Color vision testing can be very useful as a first diagnostic step. The many available color vision tests have different benefits and shortcomings. We aimed to identify which test would be preferred to use in a clinical setting as a first step towards diagnosis of COD.

Methods: We compared patients (n=18) derived from the ophthalmogenetic unit of Erasmus Medical Center and University Medical Center Nijmegen, with various levels of cone dysfunction. Golden Standard for diagnosis of COD was a diminished photopic ERG and a relative central scotoma on Goldmann perimetry. Controls (n=33) were patients from these clinics with other diagnoses or healthy companions of COD patients. We estimated sensitivity and specificity of the Ishihara test, Lanthony Desaturated and Saturated Panel D15 test, the Hardy‐Rand‐Rittler (HRR) pseudo‐isochromatic plates, and the Nagel anomaloscope. We analyzed sensitivity, specificity and the predictive value with receiver operating characteristic curve (ROC).

Results: The HRR test had the highest sensitivity and specificity for protan and deutan axes. HRR and Ishihara had the highest predictive value. Lanthony Panel D15 test did not have an additional predictive value for severe color vision defects. The Nagel anomaloscope was not reliable due to low specificity. Its results showed high variations among both healthy and afflicted individuals.

Conclusions: The HRR test was the most useful for COD. This test had the highest sensitivity in detecting early dysfunction of all three cone types, and it adequately quantifies the level of cone dysfunction in the course of the disease.
Age dependence of cataract induced by ultraviolet radiation‐B in mice
Authors: ZHANG Y , WANG J , DONG X , MEYER L , MODY V , LÖFGREN S , GALICHANIN K , SÖDERBERG PG
Published: October 2007

Purpose: To investigate for the C57BL/6 mouse if there is an age dependence of the dose‐response function for in vivo UVR‐300 nm induced forward light scattering in the lens.

Methods: Each of four age groups of 25 mice aged 3, 6, 12, or 24 weeks were randomly distributed on five age group specific UVR‐B dose levels. The dose levels selected for each age group were derived from the expected maximum tolerable dose (MTD). Expected MTDs were set to 1.9, 3.2, 4.8, and 6.0 kJ/m^2 for the 3, 12, and 24 weeks mice, respectively, based on published data for the albino Sprague Dawley rat. Each animal was unilaterally exposed to UVR‐B to the pre‐determined dose, delivered during 15 minutes. All mice were sacrificed two days after exposure and both lenses were extracted for; macroscopic imaging in incident illumination against a grid and in dark‐field illumination, and measurement of intensity of forward light scattering. The difference of intensity of forward light scattering between the exposed and the contralateral not exposed lens was fitted against dose received using regression based on a second order polynomial model.

Results: Two days after exposure, subcapsular opacities were observed in the exposed lenses from all dose groups except at 0 kJ/m^2. In all age groups, the difference of intensity of forward light scattering increased with increasing UVR‐B dose. The increase was age dependent.

Conclusions: In the pigmented C57BL/6 mouse, an increasing in vivo dose of UVR‐300 nm induces an increasing intensity of forward light scattering that is age dependent in the age interval 3‐24 weeks. This finding should be considered in future design of experiments on UVR‐effects to the mouse lens.
Characterization of a rat model of glaucoma induced by laser
Authors: BRON AM , SCHNEBELEN C , SALINAS‐NAVARRO M , ACAR N , PASQUIS B , CREUZOT‐GARCHER C , VIDAL‐SANZ M , BRETILLON L
Published: October 2007

Purpose: To characterize a rat model on which glaucoma was induced by laser photocoagulation of episcleral veins, trabeculum and limbal veins. The characterization of the model was based on the evaluation of the intraocular pressure (IOP), the retinal function and the number of functional retinal ganglion cells (RGCs).

Methods: Male Sprague Dawley rats were used at 6 weeks of age. Three of the episcleral veins, the trabeculum and the limbal veins were photocoagulated with a laser (532nm) in one eye. IOP (using a Tonolab®) and electroretinogram (ERG) were recorded every 2 weeks during 11 weeks. Three months after photocoagulation, RGCs were retrogradely labelled with a 5% Fluorogold solution applied to both superior colliculi. Seven days after labelling, retinas were flatmounted and were examined under a confocal fluorescence microscope equipped with a motorized stage. Functional RGCs were counted using an image analysis software (Image Pro Plus®).

Results: Treated eyes displayed a significant increase in IOP as soon as the first week after the procedure (32 mmHg versus 18 mm Hg in control eyes) and lasting for 7 weeks. The retinal function of treated eyes was altered since the ERG b‐wave amplitude was significantly decreased when compared to control eyes (50% after 11 weeks). No differences were observed in the b‐wave latencies. A reduction of 50% of the number of RGCs was observed in treated eyes when compared to control eyes

Conclusions: These results show that in the rat, eyes treated by laser photocoagulation are a valuable model of glaucoma since they display typical characteristics, namely elevated IOP, followed by an alteration of the inner retinal function and retinal ganglion cell death.
Evaluation of the performance of multifocal intraocular lenses image quality: analysis of the standard methods
Authors: MENEZO ROZALEN JL , ARTIGAS JM , FELIPE A , PERIS‐MARTINEZ C
Published: October 2007

Purpose: To analyze the standard methods used to describe intraocular lenses (IOL) and to suggest some improvements to make them applicable for multifocal IOLs.

Methods: The EN‐ISO standards and the standards of the American National Standards Institute (ANSI) for the evaluation of the performance of IOLs are tested for multifocal IOLs. The MTF of the one refractive multifocal IOL and two hybrid refractive‐diffractive multifocal IOLs is measured for both distance focus and near focus and using different pupil sizes.

Results: The average modulation (AM) from 0 to 100 c/mm of multifocal IOLs (for the distance focus) is about 40‐50% lower than the AM of monofocal IOLs, for all pupil sizes studied. This fact suggests that the EN ISO standards must be revised in some points to be adapted for multifocal IOLs. Moreover, the near focus of the refractive IOL only appears beyond 3.5 mm of pupil size; in consequence this type of multifocal IOL could not be described only with a 3 mm pupil as stated in ISO standard.

The width at half height of the point spread function (PSF) or the cut‐off frequency value of the MTF, are not useful for multifocal IOLs. Multifocal IOLs can have a narrow PSF at half height but be very wide at the bottom, occuring this even in some so‐called apodized IOLs. The cut‐off frequency value is also useful in monofocal lenses as quality factor to compare MTFs of different lenses or pupil sizes because an approximately uniform slope for the MTF is suppose.

Conclusions: EN‐ISO and ANSI, demand the modulation of only one pupil and one frequency: 3 mm and 100 c/mm. We recommend to measure at least with 2 different pupils and to give the AM value for both distance and near focus.
The retinal vessel response to flicker light in patients with central retinal vein occlusion
Authors: REHAK M , REHAK J , LANGOVA K , WIEDEMANN P
Published: October 2007

Purpose: The study examined the retinal vessel diameter (A/V Ratio) and the response to flicker light in patients with central retinal vein occlusion and in patients with arterial hypertension.

Methods: The prospective study included 30 patients. In the group I. were 12 patients with central retinal vein occlusion (CRVO), in group II. 10 patients with hypertension and in group III. 8 healthy volunteers. A/V ratio (static analysis) and the diameter response of an arterial and venous vessel segment to flicker light (dynamic analysis) were measured with a Retinal Vessel Analyzer. Each dynamic examination consisted of a 50 s baseline measurement and three periods of 20‐s flicker light provocation followed by 80 s observation. The mean of three flicker cycles was calculated as dynamic vessel response.

Results: Statistically significant differences of A/V ratio were observed in the static vessel analysis between groups I.‐III. (A/V ratio: 0.71±0.07; 0.76±0.06 and 0.82±0.02 respectively). The dynamic analysis showed statistically significant differences in arterial dilatation and constriction between all investigated groups as well. The venous flicker response showed significant differences between healthy controls (group III.) and group I. and II. No significant differences in venous response were measured between group I. and II.

Conclusions: The results show significant differences in A/V ratio and arterial response to flicker stimulation in patients with CRVO. We suppose that the degree of retinal vessels endothelial dysfunction is one of the leading factors in the ethiopathology of central retinal vein occlusion.
Frozen fortified antibiotic in ophthalmic solutions stability during 2 months
Authors: MOURIAUX F , FINES‐GUYON M , CHEREL A , PERDRIEL A , ALBESSARD A , DEBRUYNE D , CHEDRU‐LEGROS V
Published: October 2007

Purpose: Fortified antibiotic ophthalmic solutions are regularly administered as an immediate treatment for bacterial keratitis. The fortified antibiotics were used to be self‐prepared by nurses. To solve this problem, pharmacy staff studied the stability of three 5% solutions of vancomycin, amikacin and ceftazidim, prepared in aseptic conditions from parenteral antibiotic solutions.

Methods: Solutions were frozen at ‐20°C. Portions of each solution were examined before storage and over a 75‐days period. Ceftazidim and amikacin were dilute in 0,9% sodium chloride and vancomycin in 5% dextrose. Over a 75 days period, physical, pharmacological (absorbance spectra) properties and sterility of each stock solution were studied.

Results: The pH of amikacin (6,51), ceftazidim (6,47) and vancomycin (3,77) remained stable during the 75 days period. Osmolarities also remained stable (367, 488 and 351 mOsm/L). There were no significant differences in the concentration, osmolarity and pH of the three antibiotic solutions before storage and after 75 days of freezing. Over a 75 days period, stability of amikacin, ceftazidim and vancomycin remained constant; no contamination was detected before storage and after 75 days.

Conclusions: Topical fortified antibiotic solutions can be stored 75 days at ‐20°C (15 days quarantine). After, these eye‐drops should be stored at 4°C and should be discarded after 3 days.
Functional characterisation of rats visual system following ocular ischemia by evoked potentials and retrograde transportation of retinal ganglion cells
Authors: JEHLE T , WINGERT K , DIMITRIU C , MESCHEDE W , LASSECK J , BACH M , LAGREZE W
Published: October 2007

Purpose: The development of therapeutic strategies to protect cells following ischemia needs objective criteria for quantification of rats’ visual function. The present study demonstrate the impact of ocular ischemia on luminance and frequency modulated contrast vision and compare these with the function of the retinal cells and retrograde transportation of retinal ganglion cell staining.

Methods: Ischemia was induced in adult Brown‐Norway rats by elevating the intraocular pressure to 120 mmHg for 30, 45, 60 and 90 min. The entire visual system was evaluated by visual evoked potentials (VEPs) modulated in luminance and frequency. The retinal function was analysed by scotopic and photopic electroretinogram (ERG). Vitality of RGC was investigated by stereotactic injection of FluoroGold into the superior colliculus for estimation of retrograde transport capacities four days after ischemia.

Results: VEPs decreased depending on duration of ischemic episodes. The sensibility to ischemia was pronounced in higher frequencies. For ERG recordings, ischemia reduced oscillatory potentials and photopic flicker responses more intense than scotopic a‐ and b‐waves. RGC decreased from 2307±38 up to 36±58 (cells/mm2±SEM) and were significantly correlated with all electrophysiological parameters. The ischemic duration with 50% inhibition of responses was estimated for VEP between 36 to 58 min, for ERG between 36 to 41 min and was 51 min for RGC.

Conclusions: Evoked potentials were sensitive indices for rat visual function after ocular ischemia. Understanding of these functional deficits may help to investigate neuroprotective strategies.
Retinal vein occlusion signals a significant risk of mortality in the Beijing eye study
Authors: LIBONDI T , XING L , LIU W , WANG Y , YANG H , JONAS JB
Published: October 2007

Purpose: The purpose of the present population‐based investigation to assess whether retinal vein occlusion (RVO) may be associated with an increased mortality in the years following the event.

Methods: The present investigation consisted of 8609 eyes (97.0%) of 4335 (97.7%) subjects for whom readable fundus photographs were available. For our study recent central retinal vein occlusion (CRVO) was characterized by the presence of retinal edema, optic disc hyperemia or edema, scattered superficial or deep hemorrhages, and venous dilatation. Old retinal vein occlusions were characterized by occluded and sheathed retinal veins.

Results: Out of the 4335 subjects, 3194 (73.7%) subjects returned for follow‐up examination while 134 (3.1%) subjects were dead and 1005 (23.2%) subjects did not agree to be re‐examined or had moved away. In binary logistic regression analysis, mortality was significantly associated with age (P<0.001;95%CI:1.08,1.12) and RVO (P=0.047;95%CI:1.01,6.27). Including subjects with an age <70 years or <65 years, respectively, the association between RVO and mortality became further more significant (P=0.007; 95%CI:1.46,10.54; and P<0.001;95%CI:3.10,24.95, respectively).

Conclusions: The results suggest that retinal vein occlusion, particularly in relatively young persons, may signal a significant risk of mortality. It confirms a recent combined evaluation of the Blue Mountain Study and the Beaver Dam Study in which, as in the present study on Chinese, patients with a retinal vein occlusion, particularly if the persons were younger than 69 years, had a significantly increased of mortality.
Intravitreal treatment with Erythropoietin (EPO) preserves visual function following ocular ischemia in rats
Authors: DERSCH R , JEHLE T , MESCHEDE W , DIMITRIU C , BACH M , LAGREZE W
Published: October 2007

Purpose: Erythropoetin (EPO) is a promising neuroprotective drug. It is known that EPO reduces apoptosis of retinal ganglion cells following axotomy or glaucoma in rats. Until now, functional aspects of this neuroprotective effect have not been addressed. We investigated effects of

EPO on retinal and optic nerve function and on the survival of retinal ganglion cells following ocular ischemia.

Methods: Ocular ischemia was induced by increase of the IOP to 120mmHg for 55 min in Brown‐Norway rats. Animals were treated intravitreally with 4U/eye (n=12) during the time of ischemia, controls (n=16) recieved BSS instead. Visual pathway was investigated by VEP 4 days after ischemia. Potentials were evoked by frequency and luminance modulated flicker stimuli and recorded in awake freely‐moving rats. Retinal function was evaluated by ERG 7 days after ischemia. Retinal ganglion cells were labelled retrogradelly 4 days after ischemia and were quantified 6 days later in retinal flatmounts.

Results: Both frequency and luminance modulated evoked potentials increased due to the application of EPO from 6±2% (mean in percent of the non‐ischemic eye ± standard error) in control to 46±8% in treated animals and from 26±5% to 69±6% respectively. EPO increased responses of ischemic eyes from 31±6μV to 96±8μV (a‐wave) and from 34±6μV to 110±15μV (b‐wave). Morphologically, the intravitreal administration of EPO increased the number of surviving ganglion cells from 32±4% to 92±11%.

Conclusions: We found a sizable functional benefit of intravitreal injection of EPO following interruption of ocular blood supply. This suggests that administration of EPO is a viable therapeutic option in ischemic retinal diseases.
Screening for diabetic retinopathy in a rural population with an itinerant non‐mydriatic camera
Authors: GARCHER CREUZOT C , BEYNAT J , ARNAVIELLE S , CHARLES A , ASTRUC K , BRON AM
Published: October 2007

Purpose: The aim of this study was to evaluate the yield of diabetic retinopathy (DR) screening in a rural population with an itinerant non‐mydriatic camera.

Methods: 1974 diabetics were screened between 2005 and 2006: 676 the first year and 1298 the second. The 72 lowest medicalised areas of Burgundy were visited. An orthoptist performed fundus photographies with a Topcon’s TRC‐NW200 non‐mydriatic camera (4 fields: posterior pole, nasal, temporal and upper). The photographies analysis was performed in the department of Ophthalmology, according to the International Clinical Diabetic Disease Severity Scale. The private ophthalmologists agreed to receive the positive or doubtful patients within one month.

Results: On the 1974 screened patients, 103 presented a DR (5.2%), including 70 mild non‐proliferative DR (68%), 21 moderate non‐proliferative DR (20.4 %), and 12 severe non‐proliferative DR (11.6%). The rate of non interpretable photographies was 27.6%.

The average age of the patients with a DR was 67.5 (27 to 94). The average onset of the diabetes was 16.5 years. Insulinic treatment was founded in 48 patients (46.6%) and 35 were aware of there HbA(1c) (34%) with an average of 7.8%. Lastly, 19 have had an ophthalmologic visit within one year before screening (18.4%), 38 between 1 and 2 years (36.9%), 28 more than 2 years (27.2%) and 10 more than 5 years (9.7%); 7 had never seen an ophthalmologist (6.8%).

Conclusions: This screening improves the quality of the ocular follow‐up of the diabetics in rural area. The increase of the number of patients per meeting as well as a better recruitment would improve the medical and economic performances of the future campaigns.
Methylprednisolone (MP) failed to protect retinal ganglion cells and visual function following ocular ischemia in rats
Authors: DIMITRIU C , JEHLE T , MESCHEDE W , LASSECK J , BACH M , LAGREZE W
Published: October 2007

Purpose: Methylprednisolone (MP) is commonly used to treat traumatic optic neuropathy and optic neuritis. It was neuroprotective in animal models of optic nerve crush, but showed negative effects after experimental autoimmune encephalitis. The present study investigated effects of MP on retinal ganglion cell (RGC) survival and on retinal and optic nerve function following ocular ischemia.

Methods: Ocular ischemia was induced by increase in intraocular pressure to 120 mmHg for 55 min in adult Brown‐Norway rats. Animals were treated either with NaCl, 0.5 mg/kg MP or 15 mg/kg MP intraperitoneally direct after and every 12 hours for 3 days. RGCs were labelled retrogradelly 4 days after ischemia and were quantificated 6 days later. Retinal function was accessed by scotopic and photopic electroretinogram (ERG) 7 days after ischemia. The investigation of the visual pathways by frequency and luminance modulated visual evoked potentials (VEP) was performed in awake freely moving animals on day four and ten after ischemia.

Results: Ocular ischemia lead to a decrease of labelled RGC to 47±3% when obtained NaCl (mean±SEM), 46±3% with 0.5 mg/kg MP and 43±6% with 15 mg/kg MP. ERG did neither differ significantly for scotopic a‐wave, b‐wave and oscillatory potentials nor for photopic 18 Hz flicker stimulation. Four days after ischemia the VEPs of rats receiving MP (0.5 and 15 mg/kg) were significantly higher compared to control. Ten days after ischemia potentials in both steroid groups decreased to control level.

Conclusions: In our experiments treatment with MP did neither improve RGC survival nor retinal function. The delayed decrease of VEP indicated only a temporal benefit due to steroids.
Comparison of DCT, GAT and ORA values in patients with glaucoma
Authors: BREDOW L , LAUTEBACH S , HERDENER S , REINHARD T , PACHE M
Published: October 2007

Purpose: The Ocular Response Analyser (ORA) is a novel device for the measurement of intraocular pressure (IOP), corneal hysteresis (CH) and the corneal resistance factor (CRF). We compared the ORA with Dynamic Contour Tonometry (DCT) and Goldmann Applanation Tonometry (GAT).

Methods: We examined 63 eyes of 63 glaucoma patients (primary open angle glaucoma (POAG) n=26, normal tension glaucoma (NTG) n=10, ocular hypertension (OHT) n=15, pseudoexfoliation glaucoma (PEXG) n=12). After assessment of corneal thickness (CCT) by Orbscan, IOP was measured in a randomized order with the ORA, DCT and GAT. For each device mean IOP and for the ORA mean IOP, CH and CRF were calculated and assessed for potential dependency on CCT.

Results: Mean IOP in mmHg was 20.6 (±6.1 SD) for the ORA, 18.2 (±4.2 SD) for DCT and 16.5 (±4.4 SD) for GAT. Bland‐Altman‐Analysis showed a good agreement between DCT and GAT, while the ORA showed a tendency to higher values in patients with higher IOP. None of the devices showed a dependency on CCT (GAT: r²=0.12, DCT: r²=0.07, ORA: r²=0.08). There was no correlation between CH and CCT (r²=0.01), but a weak correlation between CRF and CCT (r²=0.2). Patients with NTG had a significantly (p=0.005) thinner CCT (506±55μm) than patients with POAG (567±53μm). As could be expected, OHT‐patients showed higher CCT values (592±41μm). CRF was significantly higher in the OHT (11.6±2.2) than in the POAG group (9.6±2.0) (p=0.006). For CH, we observed no difference between groups.

Conclusions: The ORA showed a good agreement with DCT and GAT for “normal” IOP, but we observed higher results compared to the other methods for high IOP‐values. We observed no correlation between CCT and IOP, but a weak positive correlation between CRF and CCT.
Corneoscleral transplantation for extensive infection of the cornea
Authors: FRESINA M , CELLINI M , LEONETTI P , BENDO E , CAMPOS EC
Published: October 2007

Purpose: Corneoscleral grafts have been used in the past for anterior segment reconstruction after extensive infection of the cornea. The aim of this study is to present the results of a series of ten consecutive anterior segment reconstruction using corneaoscleral grafts.

Methods: We studied ten patients with widespread corneal infection and coagulative necrosis of the cornea. Common features of the surgical technique included a total limbal peritomy in an endeavor to save possible limbal stem cells. To mark the scleral surface and partially trephine this tissue we used trephines of 14‐15 mm. After a careful haemostasis we entered the anterior chamber with a diamond knife. The entire cornea was removed and the donor corneoscleral graft was sutured into place onto the scleral ledge using interrupted 8.0 silk or 9.0 nylon sutures. The anterior chamber was filled with viscoelastic material and the conjunctiva was then closet to cover the peripheral part of the graft. Postoperative steroid therapy was methylprednisolone (1gr/kg of body weight) and betametasone 1% eye drops every two hours for 4 weeks and then every four‐hour for long term.

Results: After a mean time of 15 months after corneoscleral grafts four patients maintain a clear graft. Six patients could be defined as having typical rejection episodes with the corneas becoming opaque

Conclusions: The technique of corneaoscleral transplantation can salvage otherwise end stage eye disease, but the results are poor with respect to maintenance of vision. These patients need careful follow up because of potential complications especially graft rejection and recurrence of disease.
Safety limits estimation for ultraviolet radiation induced cataract in different age groups
Authors: DONG X
Published: October 2007

Purpose: To investigate the effect of age on ultraviolet radiation induced cataract and establish the safety limits for different ages (rats and mice).

Methods: A total of 80 female Sprague‐Dawley rats were included in four age‐groups: 3, 6, 10 and 18 weeks, and of 100 female C53 mice were included in four age‐groups: 3, 6, 12 and 24 weeks. Each age group was divided into 5 subgroups with different UVR exposure doses. The animal were unilaterally exposed to ultraviolet radiation (lmax=300 nm, l0.5= 10 nm ). The incident dose on the cornea was 0 ~ 8 kJ/m2. The animal were sacrificed and both lenses were extracted one week after exposure, the intensity of forward light scattering were measured and photographs were taken. The safety limit for ultraviolet radiation induced cataract for different age groups was estimated by the maximum tolerable dose, which based on the dose‐response function of different age groups.

Results: Maximum tolerable dose for 3, 6, 10 and 18 weeks old rats was estimated to 1.4, 2.0, 3.8 and 4.6 kJ/m2 respectively, for mice of 3, 6, 12 and 24 weeks was 2.0, 3.2, 4.1 and 5.2 kJ/m2 respectively.

Conclusions: Young animals were more sensitive to UVR than old ones, the age‐dependent trend hold the same for rats and mice. Age should be considered when estimating the risk for UVR induced cataract.
Correlation between ocular response analyzer (ora) and dynamic contour tonometer (pdct) parameters in normal subjects and in glaucoma patients
Authors: EHONGO A , DE MAERTELAER V , COLLIGNON N , POURJAVAN S
Published: October 2007

Purpose: The ORA measures corneal biomechanical properties: CH and CRF. The PDCT measures OPA, the systolo‐diastolic variation of IOP. Both ORA and OPA values are lower in glaucoma than normal patients. Our purpose is to assess if there is a correlation between ORA and OPA values, and to compare these values between normal and glaucoma patients.

Methods: 40 adult healthy volunteers (group1: G1) and 42 glaucoma patients (group2: G2) underwent prospectively consecutive 4 ORA, 3 OPA and 2 GAT measurements. Patients with previous refractive or intra‐ocular surgery, contact lenses were excluded for both groups. Also, patients with ocular eye disease, topical or general medications were excluded for G1.

For each device, the mean of the measurements for one randomised eye in G1 and for the more affected eye in G2 was used for statistical analysis. Pearson correlations were used. Comparisons of the two groups mean values were made with a two‐tailed Student’s t test.

Results: 82 eyes of 82 patients. The mean age for G1 and G2 was respectively: 43.6±14.6 and 65,1±13,6 years. The mean IOP was higher in G2 ( p <0.001) for the 3 devices, with no difference in CCT. CH ( p <0.001) and CRF ( p= 0,028) values were lower in G2. OPA was higher in G2 ( p =0,014). The OPA/CH and OPA/CRF Pearson correlations were respectively: r=0,079, p =0,627 and r=0,258, p =0,108 for G1, and r=‐0,116 p =0,463 and r=0,180 p =0,253 for G2.

Conclusions: We did not find any statistical significant correlation between corneal biomechanical properties and the OPA values either in normal or in glaucoma group. We found lower corneal biomechanical properties in glaucoma than in normal group.
Fixation stability during the Rarebit Fovea Test
Authors: NILSSON M , GRANATH H , WAHLBERG M , WANGER P , BRAUTASET R
Published: October 2007

Purpose: To evaluate the fixation stability in normal subjects during the Rarebit Fovea Test (RFT). The RFT is a computerized test designed to evaluate the integrity of the central retinal detector matrix.

Methods: 11 healthy subjects with visual acuity ≥ 1.0, were examined, using the standard RFT setup, i.e. stimulus presentation on a 17 inch computer screen at a viewing distance of 2 m. The test principle is to briefly present one or two very small (< 0.5’) and bright dots in the central 4x3º visual field. The subject responds by clicking the computer mouse once or twice. The test time is approximately 90 sec and audio‐stimulation is given each time the fixation target is rotated in order to enhance central fixation. Fixation stability was measured during the RFT test using the PowerRefractor™ (Purkinje image eye‐tracking).

One eye in each subject was tested. All measurement data were analyzed using SPSS and Matlab.

Results: All subjects had normal RFT test results, i.e. close to 100% of the presented dots were perceived. 97% of the testing time fixation was maintained within 1.38° and 100% of the time within 2.76°.

Conclusions: Normal subjects appear to maintain stable fixation during the RFT. Further studies of patients with minor macular changes are underway.
Prevalence of exfoliation syndrome in Pella‐Greece
Authors: TSIRONI S , BENOS A , ZAFIRIADIS A , MICHAEL R , TSAOUSIS G , MIKROPOULOS D , KONSTAS AGP
Published: October 2007

Purpose: To determine the prevalence of exfoliation syndrome (XFS) in the area of Pella, Greece.

Methods: We studied a cluster, stratified sample of 700 individuals >45 years old (350 women and 350 men), representative of the population of Pella County. A comprehensive protocol recorded exfoliation findings before and after pupillary dilatation, as well as signs commensurate with possible XFS. The intraocular pressure (IOP) was recorded in all cases.

Results: Typical XFS was detected in 10% of the examined persons. The percentage of clinically evident XFS rose from 0% in the 45‐54 age group, to 2% for the 55‐64 age group, 21.3% for the 66‐74 age group and 34% for the >75 group of patients. There was no significant difference between the two sexes concerning the prevalence of XFS. Mean IOP was higher (20.04 mmHg) for the individuals with XFS versus those without (15.37 mmHg). Twelve patients with XFS (17.14%) had previously undiagnosed exfoliative glaucoma (XFG). Among the 70 persons with XFS, 60 (94.2%) had lens opacities, while 224 (35.5%) among the 630 persons without XFS had cataract.

Conclusions: The prevalence of XFS in the area of Pella was determined to be 10% for individuals older than 45. There is strong correlation between XFS, glaucoma and cataract.
Neuropeptide y protects retina neural cells from ecstasy‐induced neurotoxicity
Authors: AMBROSIO AF , ALVARO AR , MARTINS J , FERNANDES E , BASTOS ML , CARVALHO F , CAVADAS C
Published: October 2007

Purpose: The recreational drug 3,4‐methylenedioxymethamphetamine (MDMA; ecstasy) causes neurotoxicity in the brain. Ecstasy consumers may experience visual effects, and significant levels of MDMA were detected in the human vitreous after lethal doses. It is also known that Neuropeptide Y (NPY) can be a neuroprotective agent. In this study, we investigated the putative neurotoxic effect of MDMA in retina neural cells, and the potential neuroprotective effect of NPY.

Methods: Rat retina neural cell cultures were prepared from newborn Wistar rats. The cells were exposed to MDMA (100‐1600 μM) for 24 or 48 h, at 37 ºC or 40 ºC. Cell viability was evaluated by MTT assay and propidium iodide staining. Retinal cells were identified by immunocytochemistry.

Results: MDMA decreased retinal cells viability in a concentration‐, time‐ and temperature‐dependent manner. The toxic effect of MDMA non‐selectively affected different retinal cells (neurons and glial cells) and was dependent on caspase activation. In addition, the toxic effect was significantly reduced by ketanserin, a 5‐HT2A antagonist, and by NPY, but the protective effect of NPY was more pronounced.

Conclusions: These results show that MDMA is neurotoxic to retina neural cells, and the toxic effect can be exacerbated by hyperthermia. The toxicity of MDMA is partially mediated by the activation of the 5‐HT2A receptor. Also, NPY is a potent neuroprotective agent against MDMA‐induced retina cell degeneration. These findings extend previous findings about the dangers of MDMA consumption. Further studies and a closer follow‐up on the visual status of human consumers are evidently necessary. Support: FCT (SFRH/BD/12900/2003) and Fac. Medicine, Univ. Coimbra (GAI 01/07), Portugal
Superoxide dismutase, glutathione reductase and glutathione peroxidase activities in the whole blood of exfoliation syndrome and exfoliation glaucoma patients
Authors: BLOMSTER HT , NURMI A , PUUSTJÄRVI T , KAIKKONEN J , KONTKANEN M , HILTUNEN R , TERÄSVIRTA M , SALONEN JT , VILPPO T
Published: October 2007

Purpose: Oxidative stress is implicated in the pathogenesis of both exfoliation syndrome (XFS) and exfoliative glaucoma (XFG). We aimed to study the whole blood levels of endogenous antioxidative enzymes, superoxide dismutase (SOD, glutathione reductase (GR) and glutathione peroxidase (GPX) in XFS and XFG patients.

Methods: Deep frozen whole blood samples at ‐71 Celcius collected from 35 XFS patients including 11 XFG patients and 35 age‐ and gender matched controls, all of them operated on cataract, were analyzed for SOD, GR and GPX activity by using a commercial kit (Ransod, Randox). For statistical analyses, Wilcoxon Signed Rank Test was used.

Results: The whole blood enzyme activities in the SOD, GR and GPX in XFS/XFG groups were 119,6+‐19,1 U/ml, 498,4+‐105,6 U/L and 7281,5+‐1341,4 U/L, and in controls, 121,4+‐22,5 U/ml, 536,8+‐126,2 U/L and 7689,8+‐1843,9 U/L, respectively. In the statistical evaluation, the respective P‐values were 0,467, 0,169 and 0,263. In the subgroup of XFGs, apart from the XFS/XFG group, there were no statistical differences in the whole blood enzyme activities of SOD (p=0,594), GR (p=0,522) or GPX (p=0,957).

Conclusions: The current study showed no significant differences in the whole blood enzyme activities in SOD, GR or GPX in XFS/XFG patients as compared to control group. This may implicate a proper function of these endogenous antioxidative enzymes dispite of increased oxidative stress known to be involved in XFS and XFG.
NGF topical administration in dogs affected by spontaneous keratoconjunctivitis sicca
Authors: DODI PL , ZANOTTI C , COSTA N , ALOE L
Published: October 2007

Purpose: To study the effect of Nerve Growth Factor (NGF) on spontaneous keratoconjunctivitis sicca (KCS) in dogs and to evaluate the potential therapeutic action of this molecule.

Methods: The present study has been conducted on a sample of randomized dogs affected by spontaneous KCS. It consists of 6 cases (12 eyes), various ages (from 2 to 10 years old), different sexes (4 males‐ 2 females). All dogs showed: different stages of muco purulent filaments and redness; they were negative to fluorescein; Schirmer tear test I (STT I) on right eye was 5,8 ± 2,0 mm/1 min on left one was 6,0 ± 1,4 mm/1 min; cytology showed many inflammatory cells. The dogs were topically treated with purified murine NGF diluted in paraffin oil (value: 50 microgram/ml) for 4 weeks (2 drops every 12 hours).

Results: The result of these studies showed a significant improvement as evaluated by STT I. Thus, the right eye was 13,1 ± 2,4 mm/1 min (p < 0,05), left eye was 14,0 ± 2,4 mm/1 min (p < 0,05). Moreover, dogs treated with NGF displayed decreased purulent corneal secretion and redness and improvement of corneal transparency. Cytology analysis indicated a significant reduction in the number of corneal inflammatory cells.

Conclusions: This report demonstrated that NGF is involved in the regulation of tears production, most probably by acting on tear‐producing cells. NGF caused also a marked anti‐inflammatory action of the dog’s cornea. This result confirmed and extended previous evidences on human dry eye and previous findings suggesting a potential therapeutic utility of NGF in spontaneous KCS affecting dogs. Neverthless, further clinical studies are necessary to assess the consistency of this clinic approach.
The influence of pupil size, accommodation and higher order aberrations on the retinal image of a Rarebit Fovea Test‐stimulus
Authors: WAHLBERG M , BRAUTASET R , UNSBO P , LINDSKOOG PETTERSSON A , NILSSON M
Published: October 2007

Purpose: To study the influence of pupil size, accommodation and higher order aberrations on the retinal image of the small test stimulus (<0.5´) used in the Rarebit Fovea Test (RFT).

Methods: Eleven subjects aged between 22‐36 years participated. All subjects had a corrected visual acuity of 6/6 or better and a refractive error within ± 6 diopters. A PowerRefractorTM measured pupil size and accommodation continuously in all subjects during performance of the RFT. Aberrations were measured with a Zywave aberrometer and Matlab software was used for analysis.

Results: Mean variation in accommodation was 0.4D (range 0.22‐0.61D) and mean pupil size was 6.1 mm (range 5.0‐7.8 mm). The aberrations induced a smearing of the retinal image to ~3.5x the stimulus size. When the variation in accommodation was added the total smearing of the retinal image increased to ~4x the stimulus size.

Conclusions: The minimum retinal image size of a RFT stimulus is given by aberration and defocus rather than the actual size of the object (stimulus).
A new universal rat restrainer for in vivo exposure to UVR without anesthesia
Authors: GALICHANIN K , HUANG S , WANG J , ZHANG Y , MODY V , LÖFGREN S , SÖDERBERG PG
Published: October 2007

Purpose: Immobilization of rats is required in many psychological and physiological experiments with rats. The aim was to invent a universal device allowing for adaptation of rats of wide age range and to maximize convenience for in vivo exposure to ultraviolet radiation under un‐anesthetized conditions.

Methods: Eighty six‐week‐old Sprague‐Dawley albino female rats were progressively familiarized daily with the restraining device seven days prior to exposure in order to acquire conditioned reflex of place and reduce stress of the awake rodents. In this training period, the animals were handled in the rat restrainer for 5 to 15 minutes during the first day and restrained for 5, 10 and 15 minutes during the second, third and fourth days, respectively. After initial habituation ten minutes preceding the exposure, the animal was fixed in the rat restrainer. Each animal was unilaterally exposed to 8 kJ/m2 UVR‐300nm for 15 minutes without narcosis. After exposure the animal was unfixed and then replaced into the cage.

Results: All rats were acclimatized to the limited activities in the rat restrainer during exposure time. The device prevents both intensive head movement and body rotation, making the device effective for in vivo exposure to UVR without anesthesia.

Conclusions: The currently designed rat restrainer reduces mobility of rats without need of sedatives, enabling our device to be useful in future projects involving chronic repeated in vivo exposure of the eye to ultraviolet radiation.
Foveal function in children treated for amblyopia
Authors: AGERVI PH , NILSSON M , MARTIN L
Published: October 2007

Purpose: To evaluate foveal function in children treated for amblyopia using best‐corrected visual acuity (BCVA) and the Rarebit Fovea Test (RFT).

Methods: Nineteen children, aged 7‐9 years, previously treated for monocular amblyopia were examined with BCVA and RFT. Twenty‐three healthy, age‐ and gender matched children served as controls. BCVA was measured with a line letter chart. The foveal function was measured with the computerized RFT, designed to detect minor defects in the retino‐cortical detector matrix. In all amblyopic eyes, the non‐amblyopic eye was tested first.

Results: The median decimal BCVA was significantly lower in the amblyopic eyes (0.8, range 0.2‐1.0) compared to the non‐amblyopic eyes (1.0, range 0.8‐1.3, p = 0.0005) and to both eyes in the control group (1.0, range 1.0‐1.3, p<0.0001 and p<0.0001, respectively).

The RFT results were significantly (p=0.0012) lower in the amblyopic eyes (second tested) compared to the second, but not the first, tested eyes in the control group. In this group the second tested eye showed better RFT results compared to the first tested eye, but the difference was not statistically significant. A weak (r2=0.25) but significant (p=0.028) correlation was found between BCVA and RFT results in the amblyopic eyes only.

Conclusions: The study demonstrated a difference in foveal function, measured with RFT, in amblyopic eyes, when tested after the non‐amblyopic eye, compared to the second tested eye in age‐matched controls. This finding may be interpreted as a sign of reduced function in the amblyopic eye or as lack of training effect in amblyopic subjects.
Aberration controll with contact lenses
Authors: LINDSKOOG PETTERSSON A , LUNDSTROM L , UNSBO P , JARKÖ C , ALVIN A , BRAUTASET R
Published: October 2007

Purpose: To investigate and compare the reduction in ocular aberrations with standard hydrogel contact lenses (i.e., lenses not designed to control aberrations) and with aberration controlled hydrogel and silicon‐hydrogel contact lenses.

Methods: The aberrations with and without contact lenses were measured in 42 subjects between 20 and 37 years of age using a Zywave wave front sensor (B&L). 22 subjects were fitted a standard contact lens and an aberration controlled hydrogel lens. The remaining 20 subjects were fitted aberration controlled silicon‐hydrogel lenses

Results: With the standard lens the aberrations were controlled (i.e., close to zero) with a 4.0 mm pupil. Whereas, with both the aberration control lenses the residual spherical aberrations became negative. The reduction in aberrations differed significantly (p<0.05) between all lenses.

Conclusions: Since aberration controlled contact lenses in many subjects overcorrect the spherical aberrations when the pupil size is normal (~4.0 mm) we suggest measuring wave front aberrations in each patient both with and without contact lenses in order to achieve the desired effect.
Keratocyte repopulation in UVB‐exposed thioltransferase knockout mice
Authors: PODSKOCHY A , ZHANG Y , HO YS , LÖFGREN S
Published: October 2007

Purpose: Thioltransferase is involved in cell protein homeostasis and DNA synthesis. It inhibits apoptosis and stimulates cell proliferation. Keratocyte repopulation after ultraviolet B (UVB) damage was studied in corneas of thioltransferase (‐/‐) mice.

Methods: Six wild type mice and six thioltransferase (‐/‐) mice corneas were exposed at 300 nm UV‐radiation at a dose producing damage in the corneal stroma (8 kJ/m2). Animals were killed 3 and 7 days after exposure. Corneas were processed for light microscopy.

Results: All corneas of wild type mice and thioltransferase (‐/‐) mice showed extensive damage 3 days after UVB exposure. Keratocytes disappeared throughout the entire thickness of the UVB‐damaged central stroma. Corneal thickness was nearly doubled compared with non‐treated control corneas. However, 7 days after UVB exposure corneas of wild type mice were almost completely repopulated by keratocytes, only superficial ¼ of the stroma was still free of keratocytes. Corneal thickness was almost normal. Corneal stroma in the thioltransferase (‐/‐) mice 7 days after UV exposure was still not repopulated by keratocytes and the corneas were still very thick.

Conclusions: The keratocyte repopulation in thioltransferase (‐/‐) mice is delayed. Thioltransferase seems to play an important role in the corneal wound healing and keratocyte repopulation after UVB induced damage.