bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic distribution according to the clinical guide of practices of the Finnish Society of Ophthalmology represented by HRT and OCT
Authors: ALIAS EG , LARROSA JM , POLO V , BORQUE E , HONRUBIA FM
Published: September 2008

Purpose To know the diagnostic coincidence of the level of excellent quality of the "Guide of Clinical Practices of the managing of the glaucomatous patient” of the Finnish Society of Ophthalmology, of the confocal scanning laser HRT and of the optical coherence tomography Stratus OCT 3000.

Methods There were included 312 consecutive patients sent by suspicion to suffer glaucoma (pressure intraocular > 21 mmHg, suspicious optic nerve head morphology and standard automated perimetry). There was realized a clinical complete study including optic disk stereophotography and of retinal nerve fiber layer, and, an analysis by means of HRT and OCT. Your distribution was valued depending on the above mentioned diagnostic clinical level and your coincidence by HRT and OCT.

Results To being classified by the above mentioned diagnostic clinical level finds a major number of normal and glaucomatous cases (175 and 113), with minor number of suspicious subjects, in comparison to the cases catalogued by the HRT and OCT, (166, 87 and 59 respectively).

Conclusion In spite of obtaining a high coincidence, certain disparity exists; in such a way that the employment of analyzers allows to obtain quantitative parameters that detect the presence of structural damage; but they must not be valued of isolated form, needing a valuation it combines of all of them to increase your diagnostic efficiency close to the clinical evaluation. Key words: clinical guide, glaucoma, HRT, OCT.
Realationship optical coherence tomography and short‐wavelength automated perimetry in glaucoma patients
Authors: FERRERAS A , FOGAGNOLO P , PAJARIN AB , PINILLA I , BORQUE E , GARCIA‐MARTIN E
Published: September 2008

Purpose To correlate the main indices of short‐wavelength automated perimetry (SWAP) with the peripapillary retinal nerve fiber layer (RNFL) thickness measured with optical coherence tomography (OCT) in glaucoma patients.

Methods 66 eyes of 66 glaucoma patients were prospective and consecutively selected. All of them had intraocular pressure >21 mmHg, and reproducible glaucomatous visual field loss in standard automated perimetry. SWAP test were performed with a Humphrey perimeter and the 24‐2 full threshold algorithm. Pearson correlations were calculated between SWAP indices (mean deviation and pattern standard deviation) and OCT parameters.

Results Mild significant (p<0.05) correlations were observed between SWAP indices and some OCT parameters. The strongest correlations were found between the RNFL thickness in the vertical axis (superior and inferior pole thickness) and mean deviation of SWAP. Pattern standard deviation did not correlate with any OCT parameter. Average thickness and superior quadrant thickness had the strongest correlations with mean deviation of SWAP (both 0.36).

Conclusion RNFL thickness measured with OCT showed mild correlations with SWAP indices in glaucoma subjects.
Correlation of GDx VCC with standard automated perimetry in glaucoma diagnosis
Authors: BORQUE E , FERRERAS A , ALIAS E , PUEYO V , LARROSA JM , POLO V
Published: September 2008

Purpose To evaluate the correlation between GDx VCC parameters with global indexes of standard automated perimetry (SAP).

Methods 417 eyes of 417 patients were included. They were divided into 60 normal, 218 ocular hypertensive, 68 preperimetric glaucoma, and 71 glaucoma. Correlation between GDx VCC parameters and global indexes of SAP (MD and PSD) was calculated in all groups.

Results There was no significant correlation between GDx VCC and SAP between GDx and SAP in normal patients. Significant correlations were found for some parameters of GDx VCC and MD, being low for ocular hypertensive eyes and preperimetric glaucoma, and moderate‐low for the glaucoma group. We only found significant correlations for a few parameters of GDx VCC and PSD in the glaucoma group, being the correlation coefficients low.

Conclusion GDx VCC shows weak‐moderate correlations with SAP. The correlations were higher for MD than PSD.
Myopic macular degeneration: classification and treatment
Authors: WARD B
Published: September 2008

Purpose There is no accepted method for the control of progressive high axial myopia, the phenotype of Degenerative Myopia. Myopic Macular Degeneration was studied and classified by clinical presentation, structural features and responses to certain natural and therapeutic changes.

Methods Two hundred eyes, with 9.0 D to 24.O D of axial myopia, were evaluated in terms of their clinical presentations, axial length and Optical Coherence Tomography images. The changes occurring with vitreous detachment, macular buckling, vitrectomy and the treatment of exudative complications were also evaluated.

Results Vision loss progressed with the length of the eye, the shape of the posterior pole and the age of the patient. The macular degeneration was classifiable into: Atrophic, Exudative, Cicatricial and Neural‐disruptive stages. Macular buckling stabilized axial length and corrected some features of macular traction. Vitrectomy and membrane peeling relieved other aspects of macular traction, but gave no restraint to axial myopia progression. Photo‐dynamic‐therapy and intra‐vitreous anti‐VEGF injections controlled exudative macular complications.

Conclusion The stages of Myopic Macular Degeneration were: Atrophic, Exudative, Cicatricial and Neural‐disruptive. Progression was related to time, axial length, posterior pole anatomy and vitreous detachment. Macular buckling limited axial myopia progress and modified schisis and other neural‐disruptive features. It remains to be shown that such surgery can prevent myopic macular degeneration and preserve macular function. Additional vitreous surgery may be required for macular holes, detachments and pre‐retinal fibrosis. Exudative changes were found to respond to treatments for the comparable stage of age‐related macular degeneration.
Time spent outdoors can prevent the development of myopia
Authors: ROSE KA
Published: September 2008

Purpose To examine the relationship between the development of myopic refractive error and near‐work and time spent outdoors.

Methods The Sydney Myopia Study is a school‐based study using a random cluster design stratified by socio‐economic status. Over 4,000 Australian school‐aged children from two age groups had a comprehensive eye examination including cycloplegic autorefraction. Parents and students completed questionnaires on relevant lifestyle factors. Myopia was defined as spherical equivalent ≤‐0.5D in at least one eye. 1,765 children with a mean age of 6.7 years (75.3% response rate) and 2367 with a mean age of 12.7 years (75.3% response rate).

Results There were no consistent associations between refraction and measures of activity in the 6 year‐old sample, where the myopia prevalence was 1.3%. It was significantly higher in the 12 year old sample at 12.7%. In this age sample, higher levels of outdoor activity (sport and leisure activities) were associated with more hyperopic refractions and lower myopia prevalence. Students who combined low levels of near‐work with high levels of outdoor activity had the most hyperopic mean refraction (+0.56D; CI 0.38‐0.75), while those who performed high levels of near‐work but had low levels of outdoor activity, had the least hyperopic mean refraction (+0.27D; 95% confidence interval, CI, 0.02‐0.52). The lowest odds ratios for myopia, after adjusting for near‐work, parental myopia and ethnicity, were found in groups performing the highest levels of outdoor activity. There were no associations between indoor sport and myopia.

Conclusion Increasing time spent outdoors was associated a lower prevalence of myopia in the 12 year‐old sample. This may form the basis of a public health approach to the prevention of myopia.
Atropine and plus lenses in the control of myopia ‐ results from clinical trials
Authors: CHUA WH
Published: September 2008

Purpose A safe and effective treatment that can control or slow the progression of myopia, which typically occurs during childhood, would be a significant advance in the management of myopia. The findings of recent clinical trials evaluating the use of antimuscarinic agents atropine and pirenzepine as well as optical modalities such as progressive addition lenses for controlling the progression of myopia in children are reported.

Methods Randomized controlled trials with comparisons of the effectiveness of interventions such as atropine, pirenzepine and progressive addition lenses to decrease myopia progression in myopic children were reviewed.

Results Topical atropine was well tolerated and effective in slowing the progression of low and moderate myopia and ocular axial elongation in children. Pirenzepine gel was also effective and relatively safe in slowing myopia progression during a 1‐year treatment period. Progressive addition lenses did not, or at best marginally slowed the increase of myopia and axial elongation.

Conclusion Trials of progressive addition lenses on myopia progression have yielded disappointing results. To date, only pharmacological intervention with atropine and pirenzepine appear to have some consistent effect on reducing the progression of myopia. However, the long‐term safety and efficacy profiles of these drugs are not known. As such, well‐designed clinical trials with longer duration of treatment and follow‐up are required.
Pseudoexfoliation in the Reykjavik Eye Study: 5‐year incidence and changes in related ophthalmological variables
Authors: ARNARSSON A , DAMJI K , JONASSON F
Published: September 2008

Purpose The objective of this study was to examine the 5‐year incidence of definite and possible pseudoexfoliations (PEX) in a randomized sample, and changes in related ophthalmological variables.

Methods The Reykjavik Eye Study is a randomized population‐based study of 1045 persons 50 years and older. It included keratorefractometry, air puff tonometry, Scheimpflug photography of the anterior segment, fundus photograph, and slit‐lamp examination. 88% of survivors participated in the 5‐year follow‐up study.

Results Incidence PEX was found in 3.5% of all right eyes. Females have a twofold risk of 5‐year incidence compared with males (p=0.05). Increasing age was also linked to the incidence of PEX by an average of 5% between the 10‐year age‐groups (p=0.022). 68%, of those right eyes that did not have PEX at baseline remained the same 5 years later, whereas 11% were deemed to have progressed to possible PEX and 2% had progressed to definite PEX. 47% of the right eyes diagnosed with possible PEX at baseline, were not found to have signs of PEX after 5 years. 21% continued to be diagnosed as possible PEX and 5% progressed to definite PEX. Five year incidence cases of PEX showed a significant increase in IOP (p=0.007). Cup/disc ratio increases for all participants, significantly more for those that already had PEX at baseline.

Conclusion The diagnosis of definite PEX holds well over five years, but not possible PEX. The incidence of PEX increases with age, and is more common in females. The results indicate that the increase in IOP that usually accompanies PEX develops in the same period as the PEX changes become visible. The increase in cup/disc ratio seem to accelerate after the PEX changes have established and not before.
Histological analysis of sensory receptors in human extraocular muscles
Authors: BRUENECH JR , KJELLEVOLD HAUGEN IB
Published: September 2008

Purpose Recent publications have promoted the view that tendon receptors at the distal insertion of extraocular muscles (EOMs) provide more adequate proprioception than the muscle spindles, yet some uncertainty remains. The purpose of this study was therefore to analyse the morphological features of the muscle spindles and their potential proprioceptive capacity.

Methods Samples of human EOMs were selected from stock and all sections containing muscle spindles were selected for further analysis. The age of the subjects ranged from 6 months to 90 years and both sexes were included. No previous history of binocular anomalies or neuromuscular disease had been recorded. An image analysis system (Imaris Imageaccess) was attached to a light microscope (Nikon Optiphot) in order to obtain a more detailed analysis.

Results Digital three dimensional reconstructions of the most prominent morphological features were obtained from serial sections of 35 spindles. These features included narrow periaxial spaces, fragmented intrafusal fibres and other peculiar features which could potentially interfere with the functional principals upon which this type of mechanoreceptor is based. The digital reconstruction provided additional information about variations in spindle shape which most likely would have been missed by conventional light microscopic observations.

Conclusion The proprioceptive capacity of the muscle spindles in human extraocular muscles has previously been questioned based on the presence of several peculiar morphological features. The current study confirmed these observations and has added credence to the notion that the muscle spindle in human EOMs in not the main source of proprioception. A similar study of the tendon receptors is now in progress.
Crosstalk between Hsp70 molecular chaperone, lysosomes and proteasomes in autophagy‐mediated proteolysis in human retinal pigment epithelial cells
Authors: KAARNIRANTA K
Published: September 2008

Purpose The pathogenesis of age‐related macular degeneration involves chronic oxidative stress, impaired degradation of membranous discs shed from photoreceptor outer segments and accumulation of lysosomal lipofuscin in retinal pigment epithelial (RPE) cells. It has been estimated that a major part of cellular proteolysis occurs in proteasomes, however the importance of proteasomes and the other proteolytic pathways including autophagy in RPE cells are poorly understood. In the present study the role of Hsp70 molecular chaperones, proteasomal and lysosomal proteolytic pathways were evaluated in human RPE cells (ARPE‐19).

Methods The Hsp70 and ubiquitin protein levels and localization were analyzed by western blotting and immunofluorescense. Confocal and transmission electron microscopy were used to detect cellular organelles and to evaluate morphological changes.

Results The proteasome inhibition evoked the accumulation of perinuclear lysosomal vesicles/residual bodies positive for ubiquitin and the lysosomal membrane protein LAMP‐2, and a robust accumulation of Hsp70 protein and ubiquitin‐protein conjugates. We found that the accumulation of lysosomal/residual bodies was reversible, a cessation of proteasome inhibition led to clearance of the deposits via a mechanism that probably includes autophagy.

Conclusion We show novel connection of Hsp70 molecular chaperones, proteasomes and autophagy in regulation of protein turnover in human retinal pigment epithelial cells that may thus open new insights to understand degenerative processes in retina cell pathology.
Binocular vision disturbances and eye movement restrictions in patients with thyroid associated ophthalmopathy(TAO)
Authors: KLYSIK AB , KOMOROWSKI J , GOS R
Published: September 2008

Purpose To investigate the incidence and associations of various types of double vision and limitations of gaze among patients presenting with ocular complaints related to thyroid associated ophthalmopathy.

Methods We included 325 patients (268 female and 57 male) aged 42 to 78 (mean 51.1 +/‐5.2) referred with ocular symptoms and the diagnosis of TAO. 156 sex and age matched, healthy volunteers served as a control group. Eye movements restrictions were investigated and recorded in the four point scale. The degree of exophthalmos was recorded, as well as the degree of horizontal and vertical disparation.

Results 59.8% of patients reported significant double vision. 96% of patients complaining of double vision trported that it is intermittent,(29% in primary gaze position and 67% in other than primary). The most common limitation of eye movement was elevation(49%). There is a significant correlation between clinically significant double vision and vertical disparation (P=0.30) as well as asymmetrical exophthalmos (p=0.34). There is no correlation between the amount of exophthalmos and double vision.

Conclusion Diplopia is an extremely common presenting sign of TAO. Most patients are troubled by diplopia in different than primary gaze direction. Asymmetrical exophthalmos, and asymmetrical vertical eye muscle involvement are the most significant factors associated with symptomatic diplopia.
Corneal cross‐linking for keratoconus
Authors: MENCUCCI R , PALADINI I
Published: September 2008

Purpose to point out the efficacy and safety of collagen cross linking of the cornea as a parasurgical treatment of keratoconus

Methods corneal cross linking has been performed on 50 patients from 17 to 35 years old with topographical and clinical evolutive keratoconus

Results Cross linking treatment has been proven to strengthen the weak corneal structure by increasing collagen cross links, wich are the natural anchors within the cornea.These anchors prevent the cornea from bulging out and becoming steep and irregular.Several aspects of the procedure will be considered including ultrastructural and histological behaviour of the corneal collagen after this photodynamic procedure.

Conclusion The procedure seems to be safe and effective in increasing stiffness of the cornea.More studies are needed to clarify the intrinsic mechanisms of the procedure
New insights in amniotic membrane transplantation
Authors: GICQUEL JJ
Published: September 2008

The amniotic membrane (AM) has been used for almost a century in reconstructive surgery of various parts of the human body, including bladder, and vagina. More recently, it has found application for treating ocular burns and ocular surface disorders, including conjunctivital and corneal defects. One placenta can provide material sufficient for more than 20 surgeries. Limbal epithelial cells are also cultured and expanded on denuded AM. Until now there have been very few studies on the proteins present in AM and responsible for its anti‐inflammatory, anti‐scarring and anti‐angiogenic properties. A better knowledge of the biochemical composition and function of the AM will help develop standardised AM, both for culture and surgery as well as later on synthetic membranes. Thru a review of published studies and of the research performed at the Division of Ophthalmology and Visual Sciences we will focus on the necesity of using standardized membranes for both limbal epithelial cells culture and surgery.
Deep anterior lamellar keratoplasty
Authors: FONTANA L
Published: September 2008

Despite the long term risk of endothelial rejection, full‐thickness corneal transplantation is still considered the gold standard surgery for replacing a diseased cornea. Deep anterior lamellar keratoplasty (DALK) is not a new procedure, but in the past, its use has been of limited popularity owing to the challenging, lengthy and tedious surgery involved. With the advent of newer surgical techniques and instruments for performing lamellar corneal surgery, DALK has gained in popularity. This presentation discusses the techniques for performing the procedure as well as the clinical outcomes, especially focusing on Big bubble DALK. Results will be compared with the outcomes of penetrating keratoplasty (PK). Results suggest that DALK is the logical choice in the surgical management of corneal stromal disease, in presence of a functional endothelium.
Options in endothelial transplantation
Authors: POCOBELLI A , AMATO D , DONATI R , AMICI C , COLABELLI GISOLDI RAM
Published: September 2008

Purpose To reduce DSAEK surgery time using pre‐cut tissues.In addition real time valuation of specific parameters like cell density,endothelial mortality rate and finally thickeness of the posterior corneal lamella.

Methods Corneo scleral discs were fixed in an artificial anterior chamber AC and Moria One microkeratome (Moria S.A., Antony, France) with a 350‐micron Carriazo‐Barraquer‐type head was used to the prepare the lamellar corneal tissues.The artificial AC was cushioned with EUSOL‐C (AL.CHI.MI.A.S.r.l,Ponte S.Nicolò,Italy).The sectioned tissues were stored at 4°C;post‐cut and 24 hours pachymetry was repeated.Before the cutting,post‐cut,at 4 and 24 hours cell viability and the same time cell morphology was measured with an inverted microscope.Cell density was measured at beginning and at the end of time course.Following this preliminary study,40 tissues were assigned for transplantation.

Results Endothelial cell mortality was observed,which was characterized by trypan blue‐positive cells diffused in the whole endothelial surface and corneal folds.The pattern of damage was typically due to mechanical factors associated to the passage of the microkeratome head.Cell morphology was well preserved at the end of the storage period at 4°C in EUSOL‐C. We find a regular endothelial mosaic and absence of significant pleomorphism and polymegathism. An increase (approx.20%) in corneal thickness was observed at the end of time course. Finally no cases of graft dislocation or primary graft failure were observed.

Conclusion The results have demonstrated the reproducibility of the procedure.In this way is possible to provide tissues ready to use,within 24h, and at the same time to certify tissue quality to prevent the primary graft failure and graft dislocation.
Functional activity of the retina before and after IOP normalization in glaucoma
Authors: KAZARYAN AA , SHAMSHINOVA AM
Published: September 2008

Purpose To study dynamics of bioelectrical activity of the retina before and after normalization of intraocular pressure (IOP) in primary open angle glaucoma (POAG).

Methods 20 normal subjects and 68 patients with different stages of glaucoma (early–I, advanced – II, late – III) and high level of IOP were included in our study. IOP ranged from 27 to 36 mmHg. All patients underwent complete eye examination, HRT II imaging, ERG including full‐field, flicker, pattern ERG (PERG), oscillatory potentials (OP), long‐duration flash ERG, chromatic macular ERG to red, green and blue stimuli (MBN, Russia).

Results Different decrease of ERG amplitudes were detected depending on the stage of POAG. Subnormal flicker, as well as subnormal macular ERG to red and green stimuli, diminished or unrecordable off‐response were observed in all stages of POAG with increased IOP. A pathological configuration and decreased amplitudes of OPs, prolonged N95‐component of PERG and subnormal full‐field ERG was revealed in advanced and late stages of glaucoma. After reduction of IOP significant increase of amplitude values and shortening of implicit time (IT) were observed in early and advanced stages of POAG (p≤0,05), whereas those in late stage of POAG showed slight positive dynamics.

Conclusion ERG symptoms in POAG have high value for assessment the functional state of the retina and optic nerve, determination of degree of IOP normalization and must be used in treatment control.
UVR exposure of the lens in the mammalian eye, species difference
Authors: DILLON J , MERRIAM J , GAILLARD ER
Published: September 2008

Purpose To determine the absorption properties of the anterior segment of the mammalian eyes and relate those changes to aging mechanisms of the anterior segment and to possible consequences of cataract formation.

Methods A simple method has been developed to determine the optical properties of the anterior segment of the intact eye. This consists of a probe which is inserted into the posterior sclera and detects light passing through the anterior segment. The probe is connected to a CCD spectrophotometer via a fiber optic bundle. Digitized data is collected and analyzed by a laptop computer.

Results The absorption and transmission characteristics of mammallain anterior segments vary markedly with species and age. This has implications for photochemical and other light studies in both the lens and retina. The anterior segment of nocturnal animals, such as the rodent, transmit light down to 300 nm, but as they age this increases to 310‐320 nm. Diurnal mammals, such as the rabbit, guinea pig and cow contain large amounts of NAD(P)H, which absorbs all of the UV‐B and most of the UV‐A. The yellowing of the primate lens results in a progressive decrease in the amount of blue light reaching the retina. The young lens absorbs primarily UV‐A, whereas with age, there are increases in absorptions at 320 nm and out to wavelengths as long as 550 nm. The position of cortical cataract may be due to the optical characteristics of anterior segment.

Conclusion The optical characteristics of the lenses of various animal models have markedly different UVR absorption properties. These qualities are critical to consider when using animal models to study aging mechanisms and cataract formation in the lens.
Corneal central and temporal thickness in rabbits
Authors: MORAES SILVA MRB , ANDREGHETTI E , DOMINGUES MA , SEGUNDO PR
Published: September 2008

Purpose Rabbits are largely used in experimental eye research, including investigations related to glaucoma. Thus, it is important to know some clinical parameters of this animal, such as corneal thickness.

Methods Thirty eyes of 15 albinal Norfolk rabbits were evaluated, under anesthesia. Central and temporal corneal thickness were measured by ultrasonic pachimetry.

Results For the right eyes the mean values of central and temporal corneal thickness were 393.40 micra (sd=18.25) and 389.07 micra (sd=22.36), respectively. For left eyes the mean values were ‐ central corneal thickness: 398.73 (sd=23.75) and temporal corneal thickness: 382.53 (sd=26.03).

Conclusion It is necessary to consider the corneal central thickness in the evaluation of ocular pressure values in rabbits.
Pathology of conjunctival melanocytic neoplasms
Authors: COUPLAND SE , DAMATO B
Published: September 2008

Purpose To describe the classification, grading and staging of conjunctival melanocytic proliferation.

Methods We have audited our experience with conjunctival melanomas, using a novel mapping system and have found shortcomings in the current Tumour Node Metastasis (TNM) staging system. We have also reviewed our cases of intra‐epithelial melanocytic neoplasia and confirmed other authors’ impressions that conjunctival ‘primary acquired melanosis with atypia’ is histologically similar to cutaneous in situ melanoma. To improve objectivity in the reporting of conjunctival intra‐epithelial melanocytic neoplasia, we propose a scoring system based on pattern of melanocytic infiltration, density of melanocytes & degree of cellular atypia.

Results The term ‘conjunctival melanosis’ should be used only to describe the slit‐lamp appearance of hyperpigmentation. Histologically, this abnormality should be categorized as ‘hypermelanosis’ or ‘melanocytosis’. Hypermelanosis can either be primary or secondary to ocular or systemic disease. Benign melanocytosis comprises conjunctival melanocytic hyperplasia and naevi. Malignant melanocytosis is essentially melanoma, which is primary (in situ or invasive) or secondary (i.e., spreading to conjunctiva from adjacent tissues) or rarely metastatic. We suggest that the TNM staging system for conjunctival melanoma should be revised to: (1) include a Tis stage; (2) take account of superficial extent, invasion of adjacent tissues and caruncular involvement, in stages TI to TIII; and (3) to sub‐categorize TIV disease so that there is better correlation with likely mortality.

Conclusion We have revised the classification of conjunctival melanocytic proliferations & improved the grading and staging of melanoma. These developments should be useful in treatment & research.
Physiological short‐term variability of ocular pulse amplitude (OPA) measured by dynamic contour tonometer (DCT) in healthy subjects
Authors: POURJAVAN S , DETRY‐MOREL M , MUSTAKA L
Published: September 2008

Purpose The Pascal® dynamic tonometer is a new non‐applanation contact tonometer designed to be largely independent of the structural properties of the cornea. It measures the systolic and diastolic IOP and their difference to determine OPA. By recording the pulsatile component of ocular blood flow (heart pulse as a function of time) the OPA could provide an indirect measurement of the choroidal perfusion. It has been suggested that OPA could be an indirect risk factor for glaucoma progression. We aimed to assess the short‐time variability of OPA in healthy persons

Methods The left eyes of 30 healthy subjects were included in this prospective study. The IOP was measured twice by Goldmann applanation tonometers (GAT) followed by 3 consecutive measurements by DCT 10 min later. Pachymetry, arterial blood pressure and pulse rate were measured after IOP measurements. These measurements were repeated with an interval of fifteen days at the same hour of the first measurements. The mean value of each parameter was taken into account for the statistical analysis. Student Test was used to assess the difference and the Pearson correlation was used to assess the correlation between the various parameters

Results The mean age was 41 ± 12 years. The mean IOP at the first visit was 13.6 ± 2.9 mmHg by GAT and 14.3 ± 2.2 mmHg by DCT. The mean OPA was 2.4 ± 0.9 mmHg (0.8 to 4.3 mmHg) at the first visit. The mean IOP at the second visit was 13.4 ± 3.2 by GAT and 15.0 ± 2.5 mmHg by DCT. The mean OPA was 2.6 ± 1.0 (0.9 to 5.8) mmHg at the second visit.

Conclusion There was no significant difference in both OPA measurements. This parameter remains stable in a short‐time interval in healthy subjects.
Vitrectomy cryo gas for the treatment of pseudophakic retinal detachment
Authors: POURNARAS CJ , MENDRINOS E
Published: September 2008

Purpose The management of pseudophakic rhegmatogenous retinal detachment (PsRD) has represented a challenge for vitreoretinal surgeons for many years. Different surgical techniques have been used to manage PsRD including pneumatic retinopexy, scleral buckling (SB) and primary pars plana vitrectomy (PPV) with or without SB. Recent advances in the vitrectomy technique and instrumentation have contributed to the expanding role of PPV as a first‐line surgical treatment in cases of PsRD.

Methods A potential advantage of PPV is removal of posterior capsular and vitreous opacities for better visualisation of the peripheral retina and the use of wide‐angle viewing systems and microscopic inspection of the fundus periphery with internal illumination and scleral identation during PPV. This allows for an accurate diagnosis of retinal breaks, their prompt treatment and thus high initial anatomical success.

Results A meta‐analysis of published studies suggested that PPV with or without SB is more likely to achieve favorable anatomical and visual outcomes than conventional scleral buckling alone in uncomplicated PsRD. Recently published prospective or randomized clinical trials also found that primary PPV alone is at least as effective as scleral buckling for the treatment of PsRD. The Scleral Buckling versus Primary Vitrectomy in Rhematogenous Retinal Detachment study, found no difference in visual acuity between PPV and SB alone in pseudophakic eyes, but anatomic outcomes were better in the PPV group.

Conclusion Primary vitrectomy without scleral buckling provides a high anatomic success rate in eyes with PsRD and is associated with few complications.
Combined surgery (phacovitrectomy)
Authors: BERROD JP , HUBERT I
Published: September 2008

Purpose To review the results and complications of combined phacoemulsification and vitrectomy in phakic patients.

Methods Retrospective review of 412 consecutive phakic patients who underwent phacoemulsification and vitrectomy for primary rhegmatogenous retinal detachment (RRD) (71), stages 2 to 4 full thickness macular holes (FTMH) (86), idiopathic epiretinal membrane (ERM) (237), diabetic macular edema (DME) (18) .

Results Lens opacity was absent or mild in 85% of patients. Reattachment rates for primary RRD after one procedure were 86% and final reattachment rates were 95% . Macular hole closure rate was 95% for holes under 500 microns. There was significant improvement in the median logMAR visual acuity from 1.6 preoperatively to 0.48 postoperatively for the retinal detachment patients ,from 0,59 preoperatively to 0,28 for the idiopathic epiretinal membrane , from 0,93preoperatively to 0,4 in full thickness macular holes and from 0,96 to 0,60postoperatively in diabetic macular edema. Postoperative complications included fibrinous uveitis (2%), IOL/iris capture secondary to gas overfill (1.1%), and posterior capsule opacification (8%).

Conclusion Combined phacoemulsification and vitrectomy is a safe and desirable option in the management of phakic patients with vitreoretinal pathologies that warrant vitreous surgery, even in the absence of significant lens opacity.
An opto‐mechanical device for the measurement of ocular rigidity and intraocular pressure
Authors: GINIS H , DE BROUWERE D , PANAGIOTOGLOU TH , TSILIMBARIS MK , PALLIKARIS I
Published: September 2008

Purpose The purpose of the present study is to demonstrate pilot measurements of ocular rigidity and intraocular pressure (IOP) with a minimally invasive opto‐mechanical device.

Methods The device consists of a glass lens that is used to contact and deform the corneal surface, while the force required for this deformation is measured by means of a load cell. An infrared LED is used to illuminate the area of deformation. The area of deformation is measured by sensing the reflected light by means of a quadrant photodiode. All signals are simultaneously recorded for post‐processing. A nomogram (look‐up table) developed using enucleated rabbit eyes is used to convert force‐area data to IOP. Twenty right eyes of twenty healthy young subjects were enrolled in the initial evaluation of the instrument’s measurement. In addition, intraocular pressure provided by the instrument was compared to GAT.

Results Twenty young ocular‐disease‐free persons (6 men and 14 women) with a mean age of 30 + 6,2 (mean + standard deviation(SD)) performed a measurement of ocular rigidity and IOP with the above‐mentioned instrument. The average ocular rigidity was 0.562 + 0,254 mmHg/ uL (mean + SD) which in Friedenwald’s notation corresponds to 0,0157 + 0,0071. The average IOP estimated was 21 + 9.3 mmHg (mean + SD). Average IOP using GAT was 18,5 + 3,8 mmHg.

Conclusion The calculated values of ocular rigidity are comparable to values reported in the literature. Measurement of rigidity in a simple and non‐invasive manner may improve our understanding significance of this parameter in health and disease.
Can amblyopia treatment be optimised?
Authors: PRADEEP A , AWAN M , GOTTLOB I
Published: September 2008

Purpose To investigate the efficacy of an educational program in improving the compliance with patching treatment.

Methods A randomised control trial was conducted with 29 amblyopes receiving no educational program and 31 receiving educational program.The compliance was measured using occlusion dose monitors for the entire patching period of 12 weeks.Our secondary aim was to look at the dose effect response for longer effective hours of patch wear.

Results We found that patients who received the educational program complied more and dropped out less ( p=0.02).We also found a significant dose effect relationship in strabismic and mixed group with a greater improvement in visual acuity with longer hours of patching ;greater than 6 hours (p= 0.0001).We did not find any significant relationship in anisometropes.

Conclusion An educational program would reduce poorly compliant patients and drop outs in amblyopia treatment.
The basics of wavefront aberrometry
Authors: LANGMAN ME , GICQUEL JJ
Published: September 2008

Wavefront technology has been first used by astronomers for years in order to reduce higher order aberrations induced by the earth’s atmosphere, it has been introduced into clinical eye care recently.
 Ophthalmological practice involves performing a full subjective refraction. The sphere, cylinder and axis of astigmatism are measured. We are only correcting two components of a whole host of refractive components of the optics of an eye. These two components (sphere and cylinder) constitute by far the majority of the optical aberration of an eye.
 Even a basic exam yields important information about optical quality. However, all ophthalmologists have been faced with patients reporting visual acuity (or contrast sensitivity, glare, etc.) at levels much lower than would be expected from an eye exam.
 Wavefront aberrometry measures aberrations over the entire eye taking into account not only spherocylindrical refractive error, but also spherical aberration, trefoil, coma, secondary astigmatism as well as other “higher order” aberrations described by Zernike polynomials. Higher order aberrations are thought to contribute to more than 20% of the total number of aberrations in a normal eye an increase with pupil size. In the majority of normal patients, these high order aberrations play a minor role, however, in cases of refractive surgery, keratoconus and orthokeratology, they can induce a number of visual disturbances.
 We will define higher‐order aberrations and show how to measure them, giving you a basic working knowledge of wavefront sensing (also known as aberrometry).
 We will show how wavefront sensors work, what are Zernike polynomials, what they tell us and we will show present and future clinical applications of wavefront aberrometry.
Custom wavefront optimization of intraocular lens asphericity
Authors: GICQUEL JJ , COHEN G , CHATEAU N , LEYNAUD P , DONATE D
Published: September 2008

Purpose To investigate the optimal amount of ocular spherical aberration (SA) in an intraocular lens (IOL) to maximize optical quality.

Methods In 54 eyes of 27 patients, implantation of aspheric IOLs was simulated with different amounts of SA to produce residual ocular SA from ‐0.30 microm to +0.30 microm. Corneal wavefront aberrations up to 6th order were computed from corneal topographic elevation data. HOAs were measured with the Imagine Eyes IRX3 wavefront aberrometer. The PSF was calculated for the residual ocular higher‐order aberrations (up to the 6th order)with fully corrected 2nd‐order aberrations. 14 patients were implanted with the Tecnis (AMO)IOL and 13 with the SN60WF (Alcon France).

Results The amount of optimal SA could be predicted based on other HOAs of the cornea. The amount of ocular SA varied among subjects and could be predicted based on corneal HOAs.

Conclusion Selection of an aspheric IOL should be performed according to corneal HOAs.
Retinal images using adaptive optics
Authors: LE GARGASSON JF , GLANC M , ROUSSET G , PAQUES M , SAHEL JA
Published: September 2008

Purpose To image cells of the retina using adaptive optics.

Methods Imaging the human retina in vivo is affected by the eye's natural aberrations, which limit the resolution of retinal images. Measuring these aberrations, including the high order ones, is possible using wavefront sensing techniques.

Results A review of the rapid progress in this field is given. Once the aberrations are known, adaptive optics methods, developed for astronomical observing in the past 15 years, can be applied in order either to improve retinal imaging or to give hyper‐vision to the subject. Progress in this domain is reviewed, and some original results are reported with a new instrument.

Conclusion Applications are discussed, including a possible three‐dimensional, high‐resolution method to image the human retina in vivo.
Optical aberration measurements in dog and cat eyes: interest & limit
Authors: ROSOLEN SG
Published: September 2008

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

Methods Two dogs and one cat were sedated (Medetomidine, 0.1 mg/kg) and their right eye (RE) pupils were artificially dilated (tropicamide). Wavefront aberrations were measured using an irx3 aberrometer (Imagine Eyes, Orsay, France). Prior to each measurement, the eye was aligned with the instrument optical axis by centering both the eye pupil and Purkinje images. The Hartmann‐Shack spot images were produced by an array of 1024 microlenses that defined a 7.2x7.2 mm square area in the pupil plane. In preliminary tests, spot image histograms were optimized by adjusting the sensor acquisition time. Wavefront aberrations were then repeatedly measured 10 times in each animal’s RE. Spherical defocus, astigmatism and Zernike coefficients up to the 8th order were finally analyzed.

Results The optimal acquisition time was 10 ms for all animals, instead of 33 ms when measuring human eyes. Refractive errors could be analyzed in a 6 mm pupil diameter in all cases. The dilated pupil often exceed the sensor area. The average 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. Standard deviation in sphere and cylinder was 1.0D in the cat and less than 0.5D in both dogs. Standard deviation in the higher‐order RMS was 0.8 µm in the cat and less than 0.5 µm in both dogs. The observation of individual data revealed that a significant part of this variability was due to blink‐related changes in aberrations.

Conclusion Ocular optical aberrations can be easily measured in 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 to date measured in healthy human eyes. Measurement reproducibility was notably affected by tear layer effects. This variability could probably be reduced using a larger sensor area, specific head contention device and artificial tears. This new diagnostic technique is easily feasible without any use of anaesthesia and provides less variability and more detailed information than skiascopy. Wavefront aberrometry could be useful in both research and clinical applications.
Effects of higher‐order wavefront aberrations on the eye's depth of focus
Authors: CHATEAU N , MAIA ROCHA K , VABRE L , RAMOS ESTEBAN J , KRUEGER RR
Published: September 2008

Purpose To evaluate the impact of higher order aberrations (HOA), defined by individual Zernike polynomial coefficients, on the eye's depth of focus using an adaptive optics (AO) system.

Methods A crx1 AO visual simulator (Imagine Eyes, France) was used to introduce different amounts of individual 3rd and 4th order HOA in 10 healthy eyes. These HOA included coma (Z(3,‐1)) and trefoil (Z(3,‐3)) at magnitudes of +/‐0.3 µm, and spherical aberration (SA) (Z(4,0)) at magnitudes of +/‐0.3,+/‐0.6 and +/‐0.9 µm through a fixed 6‐mm pupil diameter. A through‐focus response (TFR) curve was assessed by recording the percentage of optotype letters of fixed 20/50 size that the subject could identify while these letters were presented at various target distances. Testing was performed under cycloplegia. For each applied HOA, the subject's depth of focus (DoF) and center of focus (CoF) were computed as, respectively, the half‐maximum width and the midpoint of the TFR curve.

Results The introduction of SA resulted in linearly shifting the CoF by 1.3 D for each 0.5 µm of wavefront. The shift was hyperopic with positive SA, myopic with negative SA. The simulation of either positive or negative SA also had the effect of enhancing the DoF, up to a maximum increase of 2 D with 0.6 µm of SA. The enhancement became smaller when the SA was further increased. Trefoil and coma appeared to neither shift the CoF nor significantly modify the DoF.

Conclusion AO technology allowed us to selectively test the visual impact of several HOA on the DoF. The introduction of SA significantly shifted and expanded the subjects’ overall DoF. This technique could help in designing optimal corrections for presbyopia and allowing patients to preview refractive surgery outcomes.

Commercial interest
Neuroophthalmological findings of sarcoidosis and Vogt‐Koyanagi‐Harada syndrome
Authors: AKOVA Y
Published: September 2008

Besides common ocular manifestations neurologic involvement including optic nerve disease, cranial nerve palsies and disorders of the hypothalamus and pituitary gland was also identified in 12% of patients with sarcoidosis. Facial nerve palsy is the most common but usually self‐limited neurological manifestation. Optic nerve involvement is the most common neuroophthalmic manifestation. Papilledema, compressive, ischemic, or neuritic optic neuropathy due to granulamatous infiltration of any part of the optic nerve may be seen. Lacrimal gland involvement is also common and is usually asymptomatic. Extensive granulomas may lead to diplopia. Orbital symptoms may mimic other inflammatory syndromes. Like sarcoidosis Vogt‐Koyanagi Harada is a disorder characterized with bilateral, granulomatous panuveitis associated with central nervous system and auditory manifestations. At prodromal stage lumbar puncture reveals a pleocystosis, ultrasonography shows diffuse thickening of the choroid tissue. At this stage patients typically report severe headaches, nausea, meningismus, dysacusia, tinnitus, and may even have fever, orbital pain and photophobia. Prodromal phase usually lasts for several days, which may persist for several weeks. It is followed by acute uveitic phase, characterized by bilateral choroiditis, vitritis and papillitis. After that chronic phase is seen with vitiligo, poliosis and resolution of exudative retinal detachments. Neuroophthalmological manifestations may help in diagnosis of rare disorders like Sarcoidosis and VKH syndrome.
Multiple sclerosis & Behçet disease
Authors: TUGAL‐TUTKUN I
Published: September 2008

Purpose To discuss uveitis associated with multiple sclerosis and Behcet disease

Methods Literature review

Results Uveitis is an uncommon manifestation of MS occurring in around 1% of patients. MS uveitis is more common in females between 20‐40 years of age. Intermediate uveitis and retinal periphlebitis are the most common forms of intraocular inflammation associated with MS. Isolated anterior uveitis, more commonly granulomatous, is also seen. The onset of uveitis may precede the diagnosis of MS by several years. The presence of retinal periphlebitis shows a strong correlation with progressive neurological dysfunction.Uveitis is a common manifestation of Behcet disease occurring in around 70% of patients whereas neurological involvement develops in around 5%. Both uveitis and neurological involvement are more common in males, and the typical age of onset is in the 3rd or 4th decade of life. There are mainly two types of neurological involvement. Around 70% of patients have parenchymal involvement which is characterized by an aseptic meningoencephalitis involving the brainstem structures. Around 30% of patients with neurological involvement have dural sinus thrombosis. The most common form of ocular involvement in Behcet disease is nongranulomatous panuveitis and retinal vasculitis with a relapsing and remitting course.

Conclusion While uveitis is uncommon in multiple sclerosis, it is one of the most frequent manifestations of Behcet disease. Clinical findings and course of the disease help in the differential diagnosis.