bluuebunny/crossref_metadata_2025 huggingface dataset:
Interrelationship Between Plasma Membrane Integrity, Mitochondrial Membrane Potential and DNA Fragmentation in Cryopreserved Bovine Spermatozoa
Authors: Bollwein H , Fuchs I , Koess C
Published: November 2007

Contents

The objective of this flow cytometric study was to examine plasma membrane integrity, mitochondrial membrane potential (MMP) and the degree of DNA fragmentation of cryopreserved bovine sperm immediately (0 h) and 3 h after thawing and to compare the results with each other and with the fertility of bulls. Cryopreserved spermatozoa from 4 consecutive ejaculates of 20 bulls were examined. Percentages of plasma membrane intact sperm (PMI) and sperm showing a high MMP (HMMP), respectively, were determined by the SYBR14/PI‐ and the JC‐1 assays. DNA fragmentation was analysed by the standard deviation of the DNA fragmentation index (SD‐DFI) and the percentage of sperm with a high degree of DNA fragmentation (%DFI) by using SCSATM. The mean non‐return rate on day 56 (NRR 56) ranged from 63.7% to 78.0% (mean ± SD: 71.8% ± 3.7%). Mean values for PMI and HMMP decreased from 37.4% ± 6.8% to 31.2% ± 6.1% and from 38.8% ± 7.1% to 23.8% ± 7.7% respectively. SD‐DFI increased from 56.9% ± 8.0% to 69.0% ± 12.9% and %DFI from 6.4% ± 2.5% to 12.4% ± 5.8%. The correlation between PMI 0 h and HMMP 0 h (r = 0.95; p < 0.0001) was higher (p < 0.05) than that between PMI 3 h and HMMP 3 h (r = 0.88; p < 0.0001). %DFI 0 h was neither related to PMI 0 h nor to HMMP 0 h (p > 0.05), nor was there a correlation (p > 0.05) between DFI 3 h and PMI 3 h; but %DFI 3 h and HMMP 3 h were significantly correlated (r = −0.31; p < 0.05). SD‐DFI and %DFI 3 h were the only parameters related to NRR 56 (r = −0.58; p < 0.05). In conclusion, plasma membranes and mitochondria are similarly affected by the freezing and thawing process, but not during the incubation period after thawing.
Extensive loss of arterial medial smooth muscle cells and mural extracellular matrix in cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL)
Authors: Oide Takashi , Nakayama Hiroshi , Yanagawa Sohei , Ito Nobuo , Ikeda Shu‐ichi , Arima Kunimasa
Published: November 2007

Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a distinctive clinicopathologic entity characterized by young adult‐onset non‐hypertensive vasculopathic encephalopathy accompanied by alopecia and disco‐vertebral degeneration. CARASIL arteriopathy is histopathologically characterized by intense arteriosclerosis without the deposition of granular osmiophilic materials. Until now, the obliterative arteriosclerosis is the presumptive cause of subcortical ischemia in CARASIL; however, a detailed vascular pathology leading to diffuse leukoencephalopathy remains unclear. In this study, we examined two autopsied CARASIL brains in comparison with an autopsy case of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Intensity of arterial sclerotic changes of CARASIL was evaluated by sclerotic index analysis. Immunohistochemical investigations were performed using a battery of primary antibodies, which recognized vascular cellular and extracellular components. As a result, sclerotic changes were disclosed to be mild and infrequent in CARASIL, in contrast to CADASIL that showed severe obliterative arterial changes. In CARASIL, conversely, most of the arteries were centrifugally enlarged and some were collapsed. We further revealed that arterial medial smooth muscle cells (SMCs) in patients with CARASIL were extensively lost, even in arteries without sclerotic changes. Arterial adventitia in CARASIL was conspicuously thin and immunoreactivities for type I, III, and VI collagens and fibronectin were appreciably weak in this region, indicating a reduction in the mural extracellular matrix (ECM). Because of the medial and adventitial degeneration, CARASIL brains likely receive marked fluctuations in blood flow because of deviations in the structural and functional basis of autoregulation mechanisms. We thus consider that diffuse leukoencephalopathy in CARASIL may be caused by arterial medial SMC loss with mural ECM reduction. We speculate that the abnormalities in the ECM are causatively related to the SMC degeneration, since the ECM is a crucial signal determining the biophysiological properties of arterial SMCs.
Climatic determinants of the northern range limit of Fagus crenata forests in Japan
Authors: YAGIHASHI TSUTOMU , MATSUI TETSUYA , NAKAYA TOMOKI , TANAKA NOBUYUKI , TAODA HIROSI
Published: November 2007

We sought to identify the factors that determine the current northern range limit of Fagus crenata (Fagaceae) forests in Japan. Four climatic factors (warmth index, minimum temperature of the coldest month, summer precipitation and winter precipitation) can potentially explain the distribution. Five classification tree models were developed: one based on all four factors, the others based on the four permutations of three of the four climatic factors (i.e. each excluded one of the four factors). The performance and the distributions of F. crenata forests predicted by these models were then compared, with particular reference to the distributions in Hokkaido. The distribution predicted by the model developed without summer precipitation extended continuously northwards along the Sea of Japan coast beyond the current northern range limits, but the distributions predicted by the other three models showed gaps around the current limit. When the warmth index, minimum temperature of the coldest month or winter precipitation were excluded the contribution to the resulting models of the other three variables increased, thereby compensating for the exclusion. However, the exclusion of summer precipitation was not compensated by increases in the contributions of the other variables in the model developed without this factor. These results suggest that summer precipitation is the most influential factor explaining the absence of F. crenata forests in the areas immediately to the north‐east of the current northern range limit.
Diagnostic Problems with Pigmemted Lesion at the Macular
Authors: Kurdian B.
Published: November 2007

Summary

A pigmented lesion at the macular area often presents a diagnostic challenge to the ophthalmologist. The main issue to be decided is whether the lesion is malignant or not, since obviously the treatment is dependent upon this.
Ocular Injuries from Martial Arts
Authors: Lim K. H.
Published: November 2007

Summary

Cases of ocular injuries from martial arts are reported, emphasizing the potential dangers of this sport which is fast gaining popularity in the Asian, as well as Western, countries. Legislation in Singapore to regulate its practice is discussed.
Preretinal Macular Fibrosis: A Review Stressing Its Association with Massive Preretinal Retraction
Authors: McGuinness R. , Mitchell P. , Banks C. N.
Published: November 2007

Summary

Preretinal macular fibrosis is a common condition in its early form manifesting as a glistening reflex on the surface of the retina leading to retinal folds and tortuosity of the retinal blood vessels. A more extensive late form exists which may lead to spontaneous massive preretinal retraction.
Trends in Penetrating Eye Injuries
Authors: West R. H.
Published: November 2007

Summary

Analysis of penetrating eye injuries resulting from motor car accidents admitted to the Alfred Hospital from 1969 to 1975 shows a continuous change of incidence and pattern of injury. These changes are related to various factors including particularly compulsory safety‐belt wearing legislation.
INVESTIGATION OF RETINITIS PIGMENTOSA
Authors: BIRD A. C.
Published: November 2007

Retinitis pigmentosa is a solitary manifestation o1 separate genetically determined disorders in which there is progressive loss of vision and the appearance of characteristic fundus abnormalities. It is likely that each disease contained within this family of disorders has a different aetiology, a consideration which is important to the clinician, the researcher and the therapist. To the clinician it is essential to be able to identify the inheritance of the disorder in order to give educated genetic advice. It is the responsibility of the clinician to sub‐divide retinitis pigmentosa into purer samples of disease since without such a sub‐division research is unlikely to be fruitful. It is unreasonable to expect a biochemist to define systemic biochemical abnormalities if blood is analysed from a series of patients, each of which has a different disorder. If the cause of retinal degeneration in an animal homologue of human retinitis pigmentosa is identified the question is then raised as to whether the abnormality is relevant to human disease and, if so, to which one. Moreover, if a metabolic abnormality is identified in one disease it will not necessarily be found in others and similarly, if therapy is effective in one form of the disease it may not be effective for all patients.

A sub‐division of retinitis pigmentosa may be made on the basis of inheritance of the disorder, on the basis of morphologic changes in the fundus, and on the qualitative functional changes identified. Such observations may also give some clues as to the pathogenesis of the different forms of RP or at least indicate in which cell system the primary disorders lie and will also show in what way the defect interferes with cell function.

In this paper it is hoped to show that studies undertaken by the various disciplines within ophthalmology have now made limited achievements towards the goals of subdividing retinitis pigmentosa (RP) into purer samples of disease and typifying the functional and morphological attributes of the constituent disorders.
INTRAOCULAR LENSES
Authors: McGuinness R.
Published: November 2007

A review is given of the history and future of intraocular lens implantation and a broad outline of indications and contra‐indications for implantation.
OCULAR LEUKAEMIA IN ACUTE LYMPHOBLASTIC LEUKAEMIA OF CHILDHOOD
Authors: BREMNER M. H. , WRIGHT J.
Published: November 2007

Abstract

Modern cytotoxic drugs increase the survival rate of children with Acute Lymphoblastic Leukaemia (ALL): But the eye is a pharmacological sanctuary and after clinical “cure” of the haematological disease the child may be blinded by leukaemic ocular infiltration.

Should this prophylactic irradiation of the posterior segment of the eye and optic nerve be repeated on diagnosis of CNS leukaemia and at specified intervals thereafter with recurrence of CNS leukaemia?

This is the history of a child who had had no recurrence of haematological leukaemia for four and a half years but following remission developed central nervous system (CNS) leukaemia followed by leukaemic iridocyclitis in the right eye after 20 months and in the left eye after three years three months from the initial diagnosis of ALL

Prophylactic cranial irradiation is performed on initial haematological diagnosis of ALL This includes prophylactic irradiation of the posterior segment of the eye and optic nerve.
IMMUNOLOGY OF OCULAR TOXOPLASMOSIS
Authors: Wakefield Denis , Penny Ronald
Published: November 2007

Abstract

Toxoplasma gondii, due to its ability to escape and modify the normal immune response, is able to survive within the retina indefinitely with the production of an occasional acute inflammatory response. The cellular immune system is mainly responsible for limiting infection. Diagnosis is based on clinical features coupled with measurements of antibody response (systemic and ocular) and cell mediated immunity. The treatment of toxoplasma chorioretinitis when indicated should be specific and immunosuppressive agents should only be used in conjunction with antibiotics to avoid dissemination of the organism.
HERPETIC EYE DISEASE
Authors: FRACO DOUGLAS J. COSTER , MD RICHARD D. GRUTZMACHER
Published: November 2007

Herpetic keratitis is a common condition which can produce severe complications. The pattern of disease created by the virus depends on an interaction of virus and host mediated mechanisms. The changes in the epithelium are a consequence of the cytopathic effect of the virus and are related directly to virus replication. Changes produced in the stroma are due to inflammatory mechanisms initiated by the presence of virus antigens. The treatment of epithelial disease is aimed at reducing virus replication. The treatment of stromal disease is directed towards suppressing inflammation without increasing virus replication. Various anti‐viral agents are available and each has a different mechanism of action and properties which make each anti‐viral agent more suitable in particular situations. Many clinical trials have been conducted which indicate the place of anti‐viral agents. The management of stromal disease is more complicated and less information is available from clinical trials to indicate the best possible method of treatment.
THE SIGNIFICANCE OF OCULAR MORBIDITY IN VERY‐LOW‐BIRTHWEIGHT INFANTS TO THE AUSTRALIAN HEALTH SERVICE
Authors: FRACO C. G. KEITH , MD W. H. KITCHEN
Published: November 2007

The survival rate of very‐low‐birthweight (VLBW) infants has greatly increased due to the introduction of intensive‐care methods to neonatal nurseries. It was feared that this would also cause an increase in the amount of ocular morbidity associated with prematurity. In order to estimate this, 111 very‐low‐birthweight infants (birthweights ≤ 1500 g) were reviewed at two years of age. They comprised 63% of the total number of long‐term surviving babies born at, or transferred in the neonatal period to, the Royal Women's Hospital, Melbourne, in 1977 and 1978. In 33% a significant ocular problem was detected; 19% had strabismus. 17% had a significant refractive error, 10% had cicatricial retrolental fibroplasia (RLF), and 2.7% were blind, due to optic atrophy associated with cerebral palsy. Other studies have shown that 7% of VLBW infants develop severe (Stage III) RLF, and 18% of these (1.26% of VLBW infants) will be socially or totally blind.

In order to estimate the significance of VLBW infants to the ophthalmic health services, and to the organisations for the care of the visually handicapped, these figures can be extrapolated. Based on 1980 figures, it would be expected that approximately 1105 VLBW infants would survive annually, and nine would become blind from RLF, while 110 would have been affected by RLF. Thirty‐three children would be blind from optic atrophy associated with cerebral palsy, 210 would have strabismus, and at least 187 would have a significant refractive error. VLBW infants will contribute significantly to the number of children requiring ocular care, and because of the high incidence of ocular abnormalities, it is recommended that routine screening of all VLBW infants be carried out at one year and two years of age.
VISUAL DISPLAY UNITS
Authors: FRACO MARK R. HARRISON
Published: November 2007

The suggestion that cataracts or other organic damage can result from exposure to radiation from visual display units (VDUs) is not supported by the best currently available epidemiological and experimental evidence.

Eyestrain is common among VDU operators but is usually due to factors in the office environment, rather than defects in vision. Visual screening fests for operators should be simple, and tests for extraocular muscle balance and colour vision are not recommended.
MANAGEMENT OF PERSISTENT HYPERPLASTIC PRIMARY VITREOUS
Authors: WALTER J. STARK MD  , WARREN FAGADAU MD  , PEGGY S. LINDSEY MD  , HUGH R. TAYLOR FRACO, MD  , RONALD G. MICHELS MD
Published: November 2007

Instruments designed for pars plana vitrectomy can be used to manage selected complicated congenital cataracts such as those with persistent hyperplastic primary vitreous (PHPV). We have applied closed‐eye vitrectomy techniques through a limbal approach in seven eyes with PHPV. A clear pupillary space was achieved in all cases and two of the seven eyes achieved useful vision. The management of children with complicated congenital cataracts such as those with PHPV is discussed.
EPIKERATOPHAKIA: EXISTING LIMITATIONS AND FUTURE MODIFICATIONS
Authors: WERBLIN THEODORE P. , J. ELLIOTT BLAYDES MD
Published: November 2007

The predictability of optical correction has been a problem for all forms of refractive corneal surgery. In epikeratophakia, changes in graft dimensions and surgical technique improved accuracy, but several problems still exist in cryolathing preserved corneal tissue. Preserved corneal tissue is quite oedematous and when frozen on the cryolathe, assumes an irregular shape. A mechanical technique to dehydrate tissue was developed which yields corneal tissue which behaves in a predictable fashion. The use of donor corneal tissue in refractive surgery has certain inherent limitations. There is no way of measuring the power of the lathed corneal lens prior to surgery; the power is a function of the shape the lens will take in vivo. The ability to supply large numbers of donor corneal buttons may be an impractical task should this type of surgery become widely used. The use of alloplastic lenses should overcome most of these difficulties.
AN OUTLINE OF ONE HUNDRED YEARS‘ HISTORY AT ST VINCENT'S HOSPITAL, SYDNEY, 1872–1972
Authors: FRACO JOHN ANTILL POCKLEY
Published: November 2007

H. D. McLaurin, the first ophthalmic surgeon to St Vincent's Hospital, Sydney, was appointed in 1872 and in 1874 he also became physician to the Hospital. The clinic passed to a line of talented, well trained, dedicated but highly individualistic ophthalmologists, but with its division into two and later four, a large ophthalmological department evolved with competitive individualism giving way to cooperative team work. The golden years were probably ten years before and after World War II. Ophthalmology advanced with increasing medical science and technological development, while control slipped from the Sisters of Charity and an Honorary Medical Staff to a salaried service and a ponderous secular bureaucracy. An amazing level of therapeutic and surgical efficiency was reached, but a t a cost of reduced spiritual and human values.
DRAINING PUS FROM THE CORNEA
Authors: FRACO R. L. COOPER , FRACO I. J. CONSTABLE
Published: November 2007

Thirteen patients with varying grades of suppurative keratitis were studied with regard to their response to keratoplasty. In all patients there was a rapid improvement in symptoms and signs. In eight of the 13 there was restoration at least of previous function: one patient lost all vision due to secondary closed‐angle glaucoma, because he refused further surgery. Corneal graft opacification occurred in three eyes; one other became partially opaque; whilst in a fourth, the lamellar graft remained clear while the original autograft failed. At last follow‐up, all eyes were normotensive and free of symptoms. Keratoplasty should assume an important part of the management of suppurative keratitis, from both theoretical and practical considerations.
DYSPLASTIC OPTIC DISCS IN ASSOCIATION WITH TRANSSPHENOIDAL ENCEPHALOCELE AND HYPOPITUITARY DWARFISM: A CASE REPORT
Authors: TUFT S. J. , CLEMETT R. S.
Published: November 2007

A patient with a basal encephalocele, dysplastic optic discs and hypopituitary dwarfism is described. The importance of identifying associated structural defects and endocrine dysfunction in patients with dysplastic optic discs is emphasised.
TRANSPLANTATION ANTIGENS AND KERATOPLASTY
Authors: STARK WALTER J. , TAYLOR HUGH R. , DATILES MANUEL , YOUNG ELAINE , KLEIN PAMELA
Published: November 2007

Allograft rejection is one of the leading causes of corneal graft failure in man when the cornea is heavily vascularised. This paper reports the feasibility and possible benefits of using histocompatibility (HLA) antigen crossmatch testing and HLA‐D locus antigen matching for corneal donor selection. Double‐masked clinical trials designed to determine the value of these procedures for keratoplasty are discussed.
AN ULTRASTRUCTURAL STUDY OF THE ROLE OF LEUCOCYTES AND FIBROBLASTS IN THE BREAKDOWN OF BRUCH'S MEMBRANE
Authors: MPhil PHILIP PENFOLD , BSppSc MURRAY KILLINGSWORTH , FRACO SHIRLEY SARKS
Published: November 2007

Ultrastructural examination was performed on 30 eyes selected on the basis of a light microscopic classification as representing all stages of macular degeneration. The eyes belonged to 29 patients aged 40 to 91 years at death and all patients with the exception of the 40‐year‐old had been examined during life.

The results indicate that monocytes, lymphocytes, fibroblasts and mast cells may play a role in the formation of breaks in Bruch's membrane at early and late stages of macular degeneration. The implications of these observations are discussed in the context of their possible role in choroidal neovascularization.
VITREOUS CYTOLOGY IN PRIMARY CEREBRORETINAL MALIGNANT LYMPHOMA
Authors: FRCPA JOHN M. WEINER , FRACO ROBERT J. RAMSAY , BS NEERAJ ANAND MB , FRACO JAMES D. CAIRNS
Published: November 2007

We report the case of a 72‐year‐old woman who presented with vitreous opacities of unknown cause. A pars plana vitrectomy yielded material in which there were atypical lymphoid cells consistent with malignant lymphoma. Five months after the vitrectomy, the patient re‐presented with cerebral lymphoma. Our report emphasizes the value of cytological examination of the vitreous in selected cases. We also review the features of malignant lymphoma of the retina and stress the cerebroretinal axis of involvement in this disease.
A CASE OF JUNCTIONAL EPIDERMOLYSIS BULLOSA (HERLITZ‐PEARSON) WITH CORNEAL BULLAE
Authors: MB MICHAEL E. HAMMERTON , TURNER THOMAS W. , PYNE REMINGTON J.
Published: November 2007

A proven case of junctional epidermolysis bullosa is presented in which there have been recurrent right and left corneal lesions. The corneal changes arose either spontaneously or after minor trauma. We have no histological findings of the cornea at present, but the clinical features are similar to those reported in epidermolysis bullosa dystrophica‐recessive. We believe that this is the first detailed case report of corneal involvement in proven junctional epidermolysis bullosa. The literature is reviewed.
THE FDA REPORT ON INTRAOCULAR LENSES*
Authors: MD WALTER J. STARK , MD DAVID M. WORTHEN , MD JACK T. HOLLADAY , MD PATRICIA E. BATH , PhD MARY E. JACOBS , PhD GEORGE C. MURRAY , McGHEE ELEANOR T. , PhD MAX W. TALBOTT , OD MELVIN D. SHIPP , MD NANCY E. THOMAS , BARNES ROGER W. , PhD DANIEL W. C. BROWN , MD JORGE N. BUXTON , MD ROBERT D. REINECKE , PhD CHANG‐SHENG LAO , FISHER SCARLETT
Published: November 2007

Clinical studies of intraocular lenses (IOLs) as investigational devices have been regulated in the United States by the Food and Drug Administration (FDA) since 9 February 1978. As of August 1982. data have been collected on more than one million IOLs implanted. During the last 12 months of the study, 409 000 IOLs were implanted. Visual acuity of 20/40 or better at one year after surgery was present in 85% of over 45 000 cases reviewed. Increasing patient age, surgical problems, postoperative complications, and adverse reactions were factors that reduced the visual acuity. The current trend in the USA is for implantation of posterior chamber and anterior chamber IOLs.
THE NATIONAL REGISTRY OF DRUG‐INDUCED OCULAR SIDE EFFECTS
Authors: MD F.T. FRAUNFELDER , BS S. M. MEYER
Published: November 2007

The National Registry of Drug‐induced Ocular Side Effects is an international information centre for ocular toxicology. The Registry collects case reports of drug‐induced ocular side effects from physicians and other national registries, and surveys the world literature for drug‐related ocular events. Possible adverse drug associations can be identified in this system, and cause‐and‐effect relationships may on occasion be proven. Functions of this Registry include increasing ophthalmic awareness of human ocular toxicology, and promoting continuation of contributions to decrease the delay between recognition of a possible adverse drug reaction and the actual reporting of it in the literature.
OCULAR CHANGES IN PATIENTS INFECTED WITH THE FILARIAL NEMATODE ONCHOCERCA VOLVULUS IN SOUTHWESTERN SUDAN
Authors: JUSTIN O'DAY , BSC CHARLES D. MACKENZIE , BVSC JEFFREY F. WILLIAMS
Published: November 2007

Ophthalmological examination of 417 patients with onchocerciasis in southwestern Sudan, a woodland savannah region, showed that ocular disease is a major health problem in these patients. Visual acuity was severely impaired in approximately 6% of patients and was reduced to finger counting in some individuals as young as 16 years. Pathological changes seen in the cornea ranged from punctate opacification to more severe sclerosing keratitis; the punctate lesions were more common in juveniles than adults. These punctate lesions were often associated with degenerating microfilariae, and a hypothetical sequence of their development is presented. Posterior segment lesions varied from mild focal retinal pigment changes, visible as dots, to widespread chorioretinal atrophy. Optic atrophy and vascular sheathing were also seen and were found exclusively in adults. These ocular changes are consistent with the findings of workers in other endemic areas who attributed them to onchocerciasis. Additional changes seen in this study included dispersal of pigment in the anterior chamber, iritis with seclusion of the pupil, and cataracts.

These findings are discussed in the light of current knowledge of the pathogenesis of the disease and the need for further research into its immunopathology.
LESSONS FROM PROBLEMS OF FUNGAL KERATITIS
Authors: FRCS C. PETER RING
Published: November 2007

A case history is reported of a contact lens wearer who presented with a keratitis from which Candida albicans was grown. This perforated, but appeared to heal and the patient was discharged only to be readmitted a few weeks later with what was shown to be a fungal endophthalmitis. Although the infection resolved problems of management and mismanagement are reviewed.
CAUSES AND EFFECTS OF EYE INJURIES IN CHILDREN
Authors: FRACO PHYLLIS M. WADDY
Published: November 2007

A retrospective analysis was carried out of 563 records of children up to 13 years of age (413 [73.4%] boys, 150 [26.6%] girls) who were admitted to the Royal Alexandra Hospital for Children and Sydney Eye Hospital between July 1969 and June 1979 with trauma to the globe. Associated injuries to lids and adnexae were not included.

The right eye was injured twice as often as the left. Girls exhibited a tower rate of injury and less severe trauma with no age peak, whereas boys in the 12‐year group were markedly at risk.

Implicated were 81 agents classified into 14 groups, with kitchen items accounting for 54% of trauma. Two hundred and seventy‐seven (49.2%) were contusion injuries, 259 (46%) were perforating injuries. Because of the difference in causative agents, penetrating injuries tended to occur in younger children and contusion injuries in the older age group.

In this series 40 (7%) eyes were enucleated. There were no cases of endophthalmitis or sympathetic ophthalmia.
THE TWIN CYLINDER: A REFRACTING AID
Authors: PETTINGER DOOGLAS F.
Published: November 2007

A simple refracting aid is described which differs from the Jackson Cross‐Cylinder in utilizing plain cylinders in a convenient, quickly manipulated form to assist in determining whether astigmatism is present and, in known astigmatism, in deciding whether the power should be increased or decreased by a cylinder alone or with a compensating sphere. It can be used in conjunction with the cross‐cylinder to obtain the final adjustment or it can be used independently, its design with the lenses arranged on opposite sides of a stalk permits rapid change in variations presented to the patient and reduces to‐and‐fro movements of lenses from trial case to trial frame. Key words: refraction, astigmatism, cylinder determination.
UNTREATED HANSEN'S DISEASE OF THE EYE: A CLINICOPATHOLOGICAL REPORT
Authors: ROBERTSON IAN , WEINER JOHN M. , FINKELSTEIN ERNEST
Published: November 2007

A Maltese immigrant presented with intermittent bilateral anterior uveitis for which no cause could be found. The inflammation did not respond to topical treatment and ultimately the left eye developed a hypopyon and was enucleated. Histological examination revealed granulomatous inflammation and large numbers of Mycobacterium leprae throughout the anterior segment. Occasional foci of inflammation containing Mycobacterium leprae were found in the vitreous extending to the retina at the posterior pole. These findings in the posterior segment have rarely been reported. Eye infection in Hansen's disease is frequent and delays in diagnosis are common.
CHOROIDAL OSTEOMAS
Authors: ALEXANDER T. A. , HUNYOR A. B. L.
Published: November 2007

Two patients with choroidal osteoma, one with bilateral involvement, diagnosed by fluorescein angiography, ultrasonography and CT scanning are presented. The clinical presentation, differential diagnosis and significance are discussed.
DEVELOPMENT AND PROGRESSION OF DIABETIC EYE DISEASE IN NEWCASTLE (1977–1984): RATES AND RISK FAC
Authors: MITCHELL PAUL
Published: November 2007

A prevalence study of diabetic eye disease was conducted in Newcastle during 1977–1978. Ophthalmoscopic retinopathy was found in 49% of 1210 clinic diabetics, while vision‐threatening retinopathy (VTR) (proliferative signs or maculopathy) occurred in 13%. Maculopathy was the commonest cause of visual loss, occurring frequently in subjects with non‐insulin‐dependent diabetes.

This group has now been followed for up to seven years (including 70% at four years); incidence rates for the development of retinopathy and for progression to a vision‐threatenig stage can now be estimated. The study found that diabetics with no retinopathy developed this at a rate of 8% per year, while only 0.4% per year progressed to VTR. However, once any retinopathy was present, progression to VTR occurred in 6% per year (2% proliferative and 4% maculopathy); and if any retinal signs indicating the presence of capillary closure were noted the rate was 13% per year.

These rates are for the group overall: however, certain parameters were found to influence the progression in individual patients. Included were the age at onset and the duration of diabetes, the presence of poor control (particularly in older diabetics on oral agents) or associated nephropathy. An analysis of these data and their implications for routine eye screening of diabetics is presented.
CONGENITAL ECTROPION UVEAE AND GLAUCOMA
Authors: HERTZBERG R.
Published: November 2007

Congenital ectropion uveae is a rare condition which may be present in one or both eyes. If the patient is followed glaucoma will always be found to be present. Associated features which have been described are ptosis, Rieger's anomaly, Prader Willi syndrome, facial hemiatrophy and neurofibromatosis. This paper describes a patient followed for 18 years who had bilateral congenital ectropion uveae, bilateral ptosis, asthma and late onset of a dental defect.
THE CONCURRENT APPLICATION OF OPHTHALMIC DROPS
Authors: GEYER O. , GODEL V. , LAZAR M.
Published: November 2007

The significance of the time interval between topical instillation of two different ocular preparations in 63 normal subjects was investigated. The experimental model selected was pupillary dilatation by mydriatic agents. The results indicated that two drugs applied at the “same time” had an equal effect to drugs applied 10 minutes apart. The implications of the study to clinical practice are discussed.
INFLUENCE OF NEURAL RETINA ON LENS FIBRE DIFFERENTIATION IN RATS
Authors: McAVOY J. W. , WALTON J. , CAMPBELL M. T.
Published: November 2007

Lens epithelial explants grown in retina‐conditioned medium (RCM) undergo structural and molecular changes characteristic of fibre differentiation in the intact lens. We suggest that\n vivo neural retina releases a fibre differentiation factor (FDF) that interacts with equatorial lens epithelial cells and stimulates them to undergo fibre cell differentiation. According to this model, interaction with neural retina is essential for normal lens formation in embryos and for normal lens growth throughout life. Preliminary work on purification of the factor indicates that FDF activity is associated with a high molecular weight complex of 500 kd. The active component of this complex appears to be an 80 kd molecule.
RETINAL DEVELOPMENT IN HUMANS: THE ROLES OF DIFFERENTIAL GROWTH RATES, CELL MIGRATION AND NATURALLY OCCURRING CELL DEATH
Authors: PROVIS JAN M. , DRIEL DIANA VAN
Published: November 2007

The distribution of ganglion cells throughout the retinal ganglion cell layer is non‐uniform in adult mammals. This paper reviews some of our data describing the development of retinal ganglion cell topography in the human fetus. Results indicate that early in the fetal period the distribution of ce/fe in the ganglion cell layer is almost uniform, but by the end of gestation there is a gradient in cell density of about 10:1 (centrahperipheral). Peripheral retina grows more rapidly than the central retina prior to about 23 weeks gestation, but this differential growth rate apparently has little effect on the development of a centre‐peripheral density gradient. The gradient appears between about 18 and 30 weeks gestation, and during this period there appears to be a greater rate of cell death in the ganglion cell layer of the peripheral retina. Cell density at the developing fovea is less than the perifoveal cell density at all ages, suggesting that ganglion cells migrate from fovea/ into perifoveal regions throughout the fetal period.
RECONSTRUCTION OF THE CONTRACTED OCULAR SOCKET
Authors: PUTTERMAN ALLEN M.
Published: November 2007

Totally contracted ocular sockets are difficult to reconstruct and many patients resort to wearing a black patch. One reason for surgical failure is that many popular techniques attach a mucous membrane or a skin‐lined vertical stent to the superior or inferior orbital rim. This produces a vertical space that commonly shrinks and becomes too small to retain an artificial eye.

The normal anatomy of the ocular cul‐de‐sac is C‐shaped rather than vertical. It passes under the orbital roof superiorly and over the floor interiorly. A technique has been devised in which the mid‐aspect of a custom‐made C‐shaped mucous membrane‐lined conformer is secured to the superior and inferior orbital rims. This attachment forces the posterior periphery of the conformer deep into the socket to form a space that simulates the normal anatomy of the ocular cul‐de‐sac.

The described technique has been successful in producing a spacious cul‐de‐sac in 36 patents with total socket contractures. A modification of the technique has been successful in treating 12 patients with partial contractures. All patients have easily retained an artificial eye after operation.
Müllers MUSCLE‐CONJUNCTIVAL RESECTION PTOSIS PROCEDURE
Authors: PUTTERMAN ALLEN M.
Published: November 2007

The Müllers muscle‐conjunctival resection procedure is a relatively simple means of relieving upper eyelid ptosis. Candidates for the operation are chosen by placing several drops of 10% phenylephrine hydrochloride into the upper ocular fornix. If the upper lid elevates close to a norma! level after five minutes, the patient is selected for the operation. A specially designed clamp is applied to 6.5 to 9.5 mm of conjunctiva and müllers muscle above the superior tarsal border. A suture is run distal to the clamp, connecting conjunctiva and müllers muscle to the superior tarsal border, and then the tissues held in the clamp are resected.

The müllers muscle‐conjunctival resection has advantages over the Fasanella procedure, because tarsus is preserved, and over the levator aponeurosis advancement and tuck procedures, because the results are much more predictable.
INVOLUTIONAL PTOSIS: RECOGNITION AND MANAGEMENT
Authors: MARTIN PETER A. , ROGERS PETER A.
Published: November 2007

Involutional ptosis is a ptosis of varying degree. There is good levator function with a high lid fold and increased lid excursion on downgaze. There may be increased translucency of the upper lid. We reviewed all adult ptosis cases over the past three years at Sydney Eye Hospital and found 20 cases to have aponeurotic defects such as a dehiscence or disinsertion. Ninety percent of our cases had a positive 10% phenylephrine test.

We recommend that all operations be done under local anaesthesia without adrenaline, overcorrecting by 1–2 mm at the time of surgery.
HYDATID CYST: AN UNUSUAL CAUSE OF DIPLOPIA
Authors: CROMPTON JOHN L. , IYER PREMA V. , MERRY DAVID J. , TOMICH JOHN , PERRETT LANCE V.
Published: November 2007

A 59‐year‐old man presented with double vision due to vertical displacement of one eye by an infraorbital mass that indented the globe. Some 10 years previously he had had a Caldwell‐Luc antrostomy for chronic sinusitis. Following investigation, the antrostomy was revised and an orbital cyst with a histological appearance suggestive of a mucocele was excised via an anterior inferior orbitotomy. The orbital mass recurred with identical symptoms some 18 months later with a second mass confluent with the first, presenting subcutaneously through his zygoma. A further radical antrostomy was performed enabling a diagnosis of a hydatid cyst of the antrum to be made. The unusual features of tfi/s rare cause of diplopia are discussed and illustrated. The literature on orbital hydatid cysts is reviewed and recommendations made as regards adequate surgical exposure and not irrigating orbital cysts with noxious agents.
SURGICAL TREATMENT OF OPEN‐ANGLE GLAUCOMA
Authors: MISHIMA SAIICHI , KITAZAWA YOSHIAKI , SHIRATO SHIROAKI
Published: November 2007

The influence of intraocular pressure (IOP) on the visual field of glaucoma patients is discussed; the criterion level for postoperative IOP control was set at 20 mmHg. When the IOP exceeded this level for two consecutive months, the IOP control was judged to be a failure, and the surgical results were analysed by a life‐table method.

Argon laser trabeculoplasty (AL T) with 50 shots over 180° of the angle was used routinely, because of fewer complications than with 360° ALT. A second session sometimes improved the final success rate, which was about 57% in primary open‐angle glaucoma and 94% in capsular glaucoma after a follow‐up period of two years and two months. All patients (120 eyes) required drugs, but their use could be reduced in about 35%. The IOP distribution in successful cases showed a peak at 16 to 17 mmHg, and the IOP was 15 mmHg or less in 21%.

In trabeculectomy, pretreatment with topical indomethacin and steroid drip infusion was advocated, and concentrated sodium hyaluronate was used during surgery. These procedures reduced the incidence of shallow anterior chamber and associated choroidal detachment. The final success rate was about 60% after five years of follow‐up. The IOP distribution after more than two years peaked at 13 to 15 mmHg, and the IOP was 15 mmHg or less in 53%.
TWO YEARS‘ EXPERIENCE WITH LASER TRABECULOPLASTY
Authors: HIGGINS RALPH A.
Published: November 2007

A series of 115 argon laser trabeculoplasties on 109 eyes in 84 patients over a two‐year period is reviewed. Control of glaucoma was achieved in 85%. There was correlation of a greater fall in intraocular pressure with initial height of intraocular pressure and degree of pigmentation of the angle. Gonioplasty proved an effective means of treating cases with a narrowed angle to gain access to the trabecular meshwork.
SPONTANEOUS BILATERAL MALIGNANT GLAUCOMA
Authors: MANKU M. S.
Published: November 2007

A case of spontaneous bilateral malignant glaucoma is described. There was no history of antecedent eye disease of any kind and the patient had not been on any ocular therapy. The condition resolved completely with conservative treatment.
VISUAL DEPRIVATION IN INFANCY AND CHILDHOOD: CLINICAL ASPECTS
Authors: BILLSON F. A. , FITZGERALD B. A. , PROVIS J. M.
Published: November 2007

The effects of visual deprivation in 75 patients (14 children and one adult) were studied. The age of onset of deprivation and the significance of final visual outcome are discussed. Results indicate that a critically sensitive period in visual development occurs between approximately four months and three years of age, A period of plasticity, when the effects of deprivation are more responsive to therapy, follows. Age of onset of deprivation was found to be most important, but in addition loss of accommodation in association with deprivation may be a significant factor in the development of amblyopia.
THE VISUAL OUTCOME IN CASES OF NEOVASCULAR GLAUCOMA
Authors: MOLTENO A. C. B. , HADDAD P. J.
Published: November 2007

The visual outcome of cases of neovascular glaucoma treated by draining implants has improved from 12% to 32% of eyes achieving a vision of 6/60 or better. The main factor responsible for this improvement has been the recognition that, in neovascular glaucoma, the retinal blood vessels are not capable of autoregulation of calibre in response to changes in intraocular pressure and ophthalmic artery perfusion pressure. The consequences of this situation are discussed and the importance of early treatment of neovascular glaucoma by a combination of photocoagulation, insertion of a draining implant and medical measures to improve the circulation where possible is emphasized.
LASER TRABECULOPLASTY AND ITS EFFECT ON TONOGRAPHY, CENTRAL VISUAL FIELDS, AND ANTERIOR CHAMBER DEPTH. A PRELIMINARY STUDY
Authors: BOOTH FRANCES M. , FRANCIS IAN C. , KAPPAGODA MEDDUMA B.
Published: November 2007

A preliminary study of ten patients with glaucoma, each of whom has undergone laser trabeculoplasty to one or both eyes, is presented. Tonography‐on‐treatment was performed on each patient approximately four weeks prior to laser, and repeated approximately ten weeks afterwards. Central fields and anterior chamber depth measurements before and after laser trabeculoplasty are also presented.

Intraocular pressures fell by a mean of 12.34 mm (SD±8.5, range 3–23) in all 12 lasered eyes. Central fields improved in ten eyes, and the anterior chamber of treated eyes became shallower by an average of 0.27 mm, compared with untreated eyes (p<0.05). Po/C values improved in 11 treated eyes. Very little attempt was made to alter medical treatment during the period outlined above.
AN EVALUATION OF SIGNS IN OCULAR MYASTHENIA GRAVIS AND CORRELATION WITH ACETYLCHOLINE RECEPTOR ANTIBODIES
Authors: FRANCIS IAN C. , NICHOLSON GARTH A. , KAPPAGODA MEDDUMA B.
Published: November 2007

Fifteen patients with ocular myasthenia gravis were examined in detail for 21 different signs, and tested for acetylcholine receptor antibodies. The major signs of ocular myasthenia gravis included ptosis, disorders of ocular rotations, weakness of eyelid closure, “pseudosupranuclear” signs and the lid twitch sign. Acetylcholine receptor antibodies were found in eight of the 15 patients. One hundred and four normal, non‐myasthenic patients were also examined for the lid twitch response, and the relationship between the lid twitch of ocular myasthenia gravis and that found in normal subjects is discussed.
ALTERNATIVES TO ENUCLEATION IN THE MANAGEMENT OF CHOROIDAL MELANOMA
Authors: FOULDS WALLACE S. , DAMATO BERTIL E.
Published: November 2007

Over the past 15 years 140 patients with choroidal melanoma have been treated by local surgical resection of the tumour. The method appears worth considering for tumours up to 15 mm in diameter not involving more than one‐third of the ciliary body. Sixty percent of patients retained useful vision and 25% good vision. Eighty‐two percent retained a cosmetically satisfactory eye. The total tumour‐related mortality in this group of patients was 9%. almost all of the 12 patients dying having had tumours larger than would now be recommended for local resection. The five‐year survival rate among patients undergoing local resection was 84%.

Low‐energy long‐exposure laser has been used to treat a small number of choroidal tumours, The technique appears useful for tumours up to 10 mm in diameter and not more than 3 mm in thickness. Ruthenium plaque therapy has also been used in some cases and appears a suitable method of treatment for tumours up to 10 mm in diameter and not more than 6 mm in thickness.

The options for conservative management of choroidal tumours are greater with small tumours than with large ones except in only eyes, tumours of over 15 mm in diameter are best treated with enucleation.

The long‐term survival after all forms of conservative management has not yet been established. At present the use of controversial techniques such as local resection should be restricted to a few centres so that adequate statistical evaluation of the method may be made.
SURFBOARD‐RELATED OCULAR INJURIES
Authors: LAWLESS MICHAEL , PORTER WILLIAM , POUNTNEY RICHARD , SIMPSON MAX
Published: November 2007

Three cases of ocular trauma caused by surfboards are reported. The severe nature of the injuries is discussed and the prevalence of this type of injury is reviewed.
OCULAR LEPROSY: A CASE REPORT AND DISCUSSION OF THE PATHOLOGY
Authors: HOUSE PHILIP H.
Published: November 2007

Although leprosy IS considered rare in Australia outside the Northern Aboriginal population, its presence within Indian and Southeast Asian migrant groups must be considered A case of ocular leprosy is presented in which the definitive diagnosis was delayed because lid changes had been diagnosed as senile ectropion The pathology of ocular leprosy is discussed, together with relevant therapeutic considerations.
CONGENITAL LOWER NASOLACRIMAL DUCT ANOMALY: A CASE REPORT
Authors: LOWE D. , MARTIN F. , BECKENHAM E. , WILLIAMS B.
Published: November 2007

A congenital anomaly of the nasolacrimal system not previously described is reported. The apposition of the distal end of the nasolacrimal duct was not with the nasal cavity as normally occurs prior to birth but to the external skin. As a result the child presented with difficulty with tear drainage and consequent infection —“neonatal conjunctivitis” followed by a facial abscess at the left lower border of the nose.

Recent embryological studies1,2 suggest that this anomaly is due to failure of complete separation and migration of the epithelial rod most distal from the surface ectoderm to the inferior meatus of the nasal cavity. This distal remnant of the nasolacrimal duct thus remains juxtaposed to the surface ectoderm of the face on the lateral aspect of the alar nares.

The modern concept of the embryological development of the nasolacrimal system is reviewed.
CONGENITAL CATARACT SURGERY: A RETINAL SURGEON'S VIEWPOINT
Authors: McLEOD DAVID
Published: November 2007

Rhegmatogenous retinal detachments presenting many years after surgery for congenital cataracts frequently present formidable problems in management. de techniques and results of treatment are being presented and the implications for modern‐day congenital cataract surgery are discussed.
INVOLUTIONAL PTOSIS
Authors: COLLIN J. R. O.
Published: November 2007

Involutional ptosis was corrected by either an anterior or posterior approach in 105 eyelids The posterior approach was preferred unless there was a specific indication for the anterior approach which included excess skin and bulky eyelids At operation approximately 10% of cases were found to have fatty degenerative changes in the anterior part of the levator muscle These changes were associated with a relatively normal skin crease, bulky eyelids, lateral displacement of the tarsus, and a more marked ptosis in the medial part of the lid A second procedure was required in 14 eyelids to achieve eyelid heights which remained within approximately 1 mm of each other for the follow up period, which extended to eight years.