bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction of a cDNA library from human retinal pigment epithelial cells challenged with rod outer segments
Authors: Cavaney Dinah M. , Rakoczy Piroska E. , Constable Ian J.
Published: November 2007

Background: To study genes expressed by retinal pigment epithelial (RPE) cells during phagocytosis and digestion of rod outer segments (ROS), a complementary (c)DNA library was produced using an in‐vitro model. The cDNA library can be used to study molecular changes which contribute to the development of diseases due to a failure in outer segment phagocytosis and digestion by RPE cells. Here we demonstrate a way to study genes and their functions using a molecular biological approach and describing the first step involved in this process, the construction of a cDNA library.

Methods and results: Human RPE cells obtained from the eyes of a seven‐year‐old donor were cultured and challenged with bovine ROS. The culture was harvested and total RNA was extracted. Complementary DNA was transcribed from the messenger (m)RNA and was directionally cloned into the LambdaGEM‐4 bacteriophage vector successfully. Some clones were picked and the DNA extracted, to determine the size of the inserts as a measure of the quality of the library.

Conclusions: Molecular biology and cell culture are important tools to be used in eye research, especially in areas where tissue is limiting and animal models are not available. We now have a ROS challenged RPE cDNA library which will be used to identify genes responsible for degrading phagocytosed debris within the retinal pigment epithelium.
Blepharophimosis syndrome: association with colobomatous microphthalmos
Authors: Lee Lawrence R. , Sullivan Timothy J.
Published: November 2007

Objective: To highlight the association of colobomatous microphthalmos with blepharophimosis syndrome.

Result: We present a case of blepharophimosis syndrome associated with bilateral optic disc, retinochoroidal and iris colobomas, and microphthalmos, in a Caucasian boy. Inheritance in this case was autosomal dominant from the maternal side.

Conclusion: Colobomatous microphthalmos is an infrequent ocular abnormality in the blepharophimosis syndrome. Ophthalmologists should be aware of this association.
Haemophilus aphrophilus bleb infection after a mitomycin trabeculectomy
Authors: Macken PL , Boyd SR , Campbell I , Chang D , Rootman DS , Trope GE
Published: November 2007

Background: Haemophilus aphrophilus is a rare cause of ocular infection. It has been reported once as a cause of late‐onset endophthalmitis in a patient with an inadvertent bleb after cataract surgery. We present a case of Haemophilus aphrophilus bleb infection after a mitomycin trabeculectomy.

Methods: A 56‐year‐old woman presented with a bleb infection 10 weeks after a mitomycin C augmented trabeculectomy at a University tertiary referral practice of one of the authors (GET). The causative organism was Haemophilus aphrophilus, identified by the Toronto Public Health Laboratory, Ontario, Canada.

Results: The bleb infection resolved following topical, subconjunctival and intravenous antibiotic therapy. A formal bleb revision was required to repair a persistent bleb leak.

Conclusion: Patients who have had trabeculectomies augmented with mitomycin C may be predisposed to bleb infection with unusual organisms. Prompt diagnosis and treatment is necessary to control the infection. Increased awareness and communication with laboratory personnel may increase the isolation of this fastidious organism.
The bust of Aubrey Bowen, oculist
Authors: Lowe Ronald F.
Published: November 2007

A fine marble bust of Aubrey Bowen may be seen at The Royal Victorian Eye and Ear Hospital. Aubrey Bowen had a distinguished and interesting career which has been previously described in the Australian Journal of Ophthalmology. The bust also has an interesting history.
Penetrating ocular injury following local anaesthesia
Authors: McCombe Mark , Heriot Wilson
Published: November 2007

A series of 13 cases of globe perforation following local ocular anaesthesia are reported. All cases were associated with cataract surgery. Perforation occurred with the retrobulbar approach in nine cases and with the peribulbar approach in two cases. In two cases the approach for local anaesthesia was not recorded. In 12 of the 13 cases, perforating wound was found in the inferotemporal quadrant. All cases were found to have vitreous haemorrhage. All cases had significant posterior segment injury. Vitrectomy was carried out in nine of the 13 cases. At final review the retina was attached in 12 of the 13 cases. A final visual acuity of between 6/9 and 6/12 was achieved in six cases, four cases had acuity of between 6/18 and 6/24 and three cases had visual result of less than 6/60.
Knowledge of glaucoma, and its relationship to self‐care practices, in a population sample
Authors: Livingston PM , Lee SE , Paola C De , Carson CA , Guest CS , Taylor HR
Published: November 2007

Objective:
To determine the level of knowledge of glaucoma in a population‐based sample, and its relationship to self‐care practices.

Design and subjects:
A cluster random sample of the Melbourne population 40 years of age and older was interviewed. One thousand seven hundred and eleven residents living in five randomly selected Melbourne metropolitan suburbs, each consisting of two adjacent census collector districts.

Measures:
Questions were asked concerning respondents' awareness, knowledge and description of the disease. Respondents were also asked the year of their last visit to their eye health care provider.

Results:
Seventy per cent of the sample had heard of glaucoma. However, only 22% provided a description that demonstrated a reasonable understanding of the disease. A lack of awareness and knowledge of glaucoma appeared to be negatively related to self‐care practices.

Conclusion:
Serious deficiencies in the basic knowledge of glaucoma in the community was demonstrated. This has significant public health implications as only a small percentage of the at‐risk population may present themselves for assessment and treatment. Informing the community about glaucoma is an important step in promoting preventative ophthalmic care and reducing visual impairment and blindness.
Incomplete Reiter's syndrome with focal involvement of the posterior segment
Authors: Conway Robert M , Graham Stuart L , Lassere Marissa
Published: November 2007

Purpose:
To describe an unusual variant of Yersinia‐induced, HLA‐B27 associated incomplete Reiter's syndrome with focal involvement of the posterior segment.

Methods:
Review of case records of a patient presenting with incomplete Reiter's syndrome which included a reactive arthritis with keratoconjunctivitis and anterior uveitis.

Results:
The uveitis progressed to involve the posterior segment with a vitritis and two transient white retinal spots. After resolving, a retinal pigment epithelial (RPE) defect persisted at the site of one of the lesions.

Conclusions:
While involvement of the anterior segment of the globe in Reiter's disease is well recognised, a review of the literature reveals that focal posterior involvement is a rare feature in either Reiter's syndrome or the reactive arthritis group.
Angiosarcoma of the eyelid
Authors: Bray Lindsay C , Sullivan Timothy J , Whitehead Kevin
Published: November 2007

Background:
Angiosarcomas are uncommon malignant tumours of vascular endothelium. They frequently affect the face and scalp, but to our knowledge there are only three reports of eyelid involvement.

Methods/results:
We report a case of angiosarcoma arising from the eyelid skin in a 79‐year‐old woman. Treatment was surgical with wide excision and staged reconstruction of the defect. Systemic oncological work‐up for metastatic disease was negative. Adjuvant systemic chemotherapy and radiotherapy were considered but were not felt to be of proven benefit and were not used. The patient died seven months after presentation from a myocardial infarct.

Conclusion:
Angiosarcoma should be considered in the differential diagnosis of unusual or atypical eyelid lesions. Management is wide surgical excision, although adjuvant systemic therapy should be considered in selected cases in consultation with an oncologist.
Inadvertent perforation of the globe during regional anaesthesia
Authors: Polkinghorne Philip J.
Published: November 2007

Purpose:This retrospective study was undertaken to review the clinical signs and management of patients with perforating eye injuries associated with regional anaesthesia for ophthalmic surgery.

Methods:Fifteen consecutive patients presenting with inadvertent perforation of the globe were evaluated. Eleven required vitreoretinal surgery. The indications were retinal detachment (six eyes), vitreous haemorrhage (four) and an epiretinal membrane (one eye).

Results:Those eyes with retinal detachments generally had a poor functional outcome in spite of the retinae being attached in five of the six eyes. The operative findings of those eyes with vitreous haemorrhage but attached retina demonstrated varying retinal tear configurations.

Conclusions:Eyes with perforating injuries following intraorbital anaesthesia are at risk of developing a retinal detachment. In those eyes presenting with dense vitreous but attached retina, consideration of vitrectomy and laser photocoagulation is advised.
A foveal‐sparing pattern of cytomegalovirus retinitis in the acquired immunodeficiency syndrome
Authors: Luckie Alan P. , Ai Everett
Published: November 2007

Purpose:We describe the clinical course of 12 eyes of 10 patients in whom recurrent cytomegalovirus (CMV) retinitis exhibited a foveal‐sparing pattern.

Methods:We retrospectively reviewed the case records and photographic charts of 10 patients (12 eyes) with the acquired immunodeficiency syndrome (AIDS), in whom recurrent CMV retinitis exhibited a foveal‐sparing pattern within 1500 mm of the foveola.

Results:The site of primary retinitis was temporal in 10 eyes of nine patients in whom it was known. The median number of recurrences up to the observation of foveal‐sparing retinitis was two (range one to eight), and five patients had active CMV retinitis despite treatment for at least two continuous months. Once established, the median rate of progression in a non‐foveal vector was 2.3 times faster than toward the fovea, and the median time to reduction in acuity to < 6/30 (or death) was 11 to 14 weeks. Three eyes of three patients retained 6/30 or better acuity up to death. Foveal CMV retinitis ultimately reduced acuity to < 6/30 in five eyes. Six eyes suffered retinal detachment, involving the fovea in five, and being the primary reason for acuity of < 6/30 in four. Four patients suffered dose‐limiting toxicity.

Conclusion:Foveal‐sparing CMV retinitis arises in patients with recurrent CMV retinitis resistant to treatment (‘clinically resistant’), particularly that which has arisen temporally. Despite its foveolar proximity, and ultimate significant loss of function, the pattern of progression allows for preservation of useful foveal vision for longer periods than would have been expected.
Penetrating eye injury from a rigid infant pacifier
Authors: Stubbs Anthony J M. , Aburn Neil S.
Published: November 2007

Background:The use of infant pacifiers (dummies) is common in Australasian communities and has been reported to be associated with various injuries, but to date ocular trauma has not been reported.

Case report:A 14‐month‐old child sustained a penetrating eye injury from the infant pacifier that was in his mouth during a minor fall. Only a lid laceration was detected at the time. One week later he presented with mydriasis, heterochromia and a poor red reflex. Diagnosis of a penetrating eye injury was made by examination under anaesthesia, with B‐scan ultrasonography demonstrating hypotony but no retinal detachment or intraocular foreign body. Funduscopy revealed a small inferior vitreous haemorrhage. Exploration of the globe adjacent to the lid wound showed a 6 mm laceration through the sclera plugged with prolapsed vitreous.

Conclusion:Serious ocular injury may result after a minor fall with some designs of rigid infant pacifiers. Heterochromia and anisocoria noted by the mother heralded more serious ocular injury in this case. The delay in diagnosis of this injury emphasises the importance of ocular examination to exclude eye trauma when injuries occur around the orbit.
The pathogenesis of diabetic retinopathy
Authors: Larkins RG , Dunlop ME , Johnson EIM
Published: November 2007

Diabetic retinopathy remains a major cause of loss of vision. The Diabetes Control and Complications Trial (DCCT) has implicated hyperglycaemia as a probable major direct causative factor in the pathogenesis of diabetic retinopathy. There are several plausible mechanisms by which high glucose concentrations could lead to the functional and later structural changes characterising diabetic retinopathy. These include increased activity of the aldose reductase pathway, increase de novo synthesis of diacylglycerol from glucose, causing protein kinase C activation, increased non‐enzymatic glycation and increased oxidative damage. The demonstration of the potential roles of these pathways and the subsequent effects of growth factors in enhancing angiogenesis provide potential new approaches to the prevention and treatment of diabetic retinopathy.
Transduction in human photoreceptors
Authors: Lamb TD
Published: November 2007

Phototransduction (the process by which light triggers a neural response in retinal rod and cone photoreceptors) is now understood at a molecular level. Indeed, the G‐protein cascade of phototransduction is one of the best understood of all biological signalling pathways. The diffusional interactions of the proteins underlying the cascade are described and are briefly analysed. In response to a single activated rhodopsin (R*), formed as a result of a single photon hit, it can be shown that molecules of the G‐protein will be activated (to G*) at an approximately constant rate. This, in turn, will cause the number of activated molecules of the third protein (the effector protein, E*, a phosphodiesterase) also to rise linearly with time. These kinetics of protein activation lead to an accurate description of the time‐course of the rising phase of the photoreceptor's electrical response, both in single‐cell recordings and also in recordings of the human electroretinogram (ERG). By analysing the a‐wave of the ERG it is possible to determine the ‘amplification’ of transduction within living photoreceptors, and to begin to localise the molecular site of dysfunction is cases of photoreceptor abnormality.
Orbital colour Doppler imaging in carotid‐cavernous sinus fistula
Authors: Aung Tin , Oen F T S. , Fu E RY
Published: November 2007

Background: Colour Doppler imaging (CDI) is a recent advance in ultrasonography that allows for colour‐encoded blood flow data of a vascular structure to be displayed simultaneously on a conventional real‐time gray‐scale B mode image. Real time A and B mode ultrasonography have been used for diagnostic evaluation of ophthalmic disorders since the early 1960s. The haemodynamic characteristics of the ophthalmic circulation have recently been studied by the use of CDI.

Method: We present three cases of carotid‐cavernous sinus fistulas with different presentations. In each case, orbital CDI was used in evaluating the patient's condition.

Results: Orbital CDI was successful in confirming the diagnosis in all three cases. CDI was capable of showing the haemodynamic changes in the orbital vasculature which resulated from carotid‐cavernous sinus fistula.

Conclusion: This non‐invasive technique presents as an excellent alternative to invasive vascular studies such as angiography for the diagnosis and evaluation of carotid‐cavernous sinus fistulas.
Vogt‐Koyanagi‐Harada syndrome in patients of Vietnamese ancestry
Authors: Riddington Leisha , Hall Anthony JH , Tait Brian , Nicholson Ian , Varney Michael
Published: November 2007

Background: Vogt‐Koyanagi‐Harada syndrome (VKH), is an idiopathic, multisystem inflammatory disorder primarily involving the eye. HLA typing has shown a strong association between the HLA‐DR4 antigen and people of Japanese, Han Chinese and Hispanic ancestry with VKH. This study reviewed the clinical features and HLA typing of Vietnamese patients with VKH.

Patients and methods: A retrospective review of four unrelated Vietnamese patients with VKH seen in private practice and hospital clinic. The American Uveitis Society (1978) criteria for VKH diagnosis were satisfied. Standard microcytotoxic assays for Class I antigens and HLA‐DNA typing of Class II DR antigens (DRB1 genotyping) by the PCR‐SSO method were performed.

Results: The clinical features of VKH in Vietnamese were comparable to those seen in other Asian races. HLA‐DR4 was present in three of the four VKH patients. Two of these patients also expressed the allele DRB1*0405.

Discussion: The strong association betlNeen HLA‐DR4 and the DRB1*0405 allele and VKH seen in Japanese people, may well also exist in Vietnamese people. The HLA association suggests an immunogenetic predisposition to VKH.
Disorders of perfusion of the anterior segment of the eye
Authors: Gillies William E. , Brooks Anne MV
Published: November 2007

Background: We have investigated the vascular perfusion of a wide variety of conditions of the anterior segment using fluorescein angiography.

Methods: The conditions were classified and findings reported according to the system set out below. Patients underwent full ocular examination. Fluorescein angiography of the anterior segment was carried out when indicated to investigate iris atrophy and neovascularisation. Specular microscopy of the corneal endothelium was used to detect changes in this tissue.

Results: The hypoperfusion was variable in degree and accompanied by varying degrees of iris hypoplasia and atrophy with neovascularisation. The degree of neovascularisation depended upon its rapidity of development, the pre‐existing state of vascular perfusion and the underlying pathological condition.

Conclusions: Hypoperfusion with resultant ischaemia and neovascularisation is common in conditions of the anterior segment. An understanding of the changes is valuable in treating many conditions affecting the anterior segment. The changes observed may also occur elsewhere in the physical system and may be a significant part of the ageing process, either as scattered, disparate processes or as part of a general disease process.
Allergic reactions to oral, surgical and topical bovine collagen: Anaphylactic risk for surgeons
Authors: Mullins Raymond J. , Richards Carole , Walker Thomas
Published: November 2007

Background: Two cases of allergic (IgE‐mediated) reaction to bovine collagen are described. Both patients developed conjunctival oedema in response to the topical application of highly purified bovine collagen to the eye during opthalmic surgery (corneal shields and catgut suture material). One patient developed periocular angioedema and angioedema of the throat after the ingestion of bovine collagen in the form of gelatin‐containing foods.

Methods: The presence of allergen‐specific IgE was evaluated by skin prick testing with collagen‐derived products, and by topical challenge with a highly purified bovine collagen‐derived corneal shield.

Results: In both patients, application of collagen to the eye reproduced the original subconjunctival oedema. In one patient, skin testing with purified and crude extracts of bovine collagen in the form of a corneal shield, catgut suture material and edible gelatin demonstrated evidence of collagen‐specific IgE.

Conclusions: Clinical reactions to collagen are rare. Neverthless, patients with a history of allergic reactions to bovine collagen‐derived products should be investigated because of the widespread use of collagen‐derived therapeutic devices, the potential for immunological cross‐reactivity with dietary collagen (gelatin) and the potential for anaphylaxis.
The pathogenesis of polychromatic cholesterol crystals in the anterior chamber
Authors: Kennedy Christopher John
Published: November 2007

Purpose: Polychromatic cholesterol crystals of the anterior chamber are an interesting and unusual finding. This paper examines the different pathogenetic mechanisms leading to the formation of these clinically detectable anterior chamber crystals.

Methods: Three aetiologically different cases which exhibited polychromatic crystals in the anterior chamber were reviewed. Aqueous samples were examined by wet field microscopy in all cases and additionally by electron microscopy in one of these. One enucleated globe was available for histopathology.

Results: Typical highly refringent cholesterol crystals were identified in the aqueous of all cases. In the first case, the cholesterol crystals developed following the breakdown of vitreous and anterior chamber haemorrhage. In the second case, the cholesterol appeared to derive from the subretinal fluid of a chronic total retinal detachment in the absence of any intraocular haemorrhage. The cholesterol crystals of the final case resulted from phacolysis and were associated with a marked neutrophil response and the presence of proteinaceous crystals consistent with the crystallins.

Conclusion: Anterior chamber cholesterolosis is a secondary phenomenon that always occurs as a result of an ocular disease process. Although the prognosis is dismal for chronically diseased eyes displaying cholesterol crystals in the anterior chamber, the prognosis for eyes with phacolysis may be excellent.
Suprachoroidal effusion following argon laser trabeculoplasty
Authors: Kennedy Christopher J. , Roden Dermot M. , McAllister Ian L.
Published: November 2007

Purpose: This is first report of suprachoroidal effusion occurring subsequent to argon laser trabeculoplasty (ALT).

Methods: Review of the records of the patient in question.

Results: A 77‐year‐old woman with bilateral pseudophakia and primary open‐angle glaucoma was treated with ALT when her visual fields deteriorated despite topical timolol therapy. Although ALT was initially performed without complication in one eye, treatment of the other eye led to a choroidal detachment. This was associated with temporary reduction in visual acuity, shallowing of the anterior chamber and hypotony.

Conclusion: Suprachoroidal effusion appears to be another complication of ALT. In the reported case, this complication and its effects were temporary and resolved with conservative management.
Keratoprosthesis: preliminary results of an artificial corneal button as a full‐thickness implant in the rabbit model
Authors: Hicks Celia R. , Chirila Traian V. , Dalton Paul D. , Clayton Anthony B. , Vijayasekaran Sarojini , FRACO Geoffrey J Crawford. , Constable Ian J.
Published: November 2007

Purpose: To develop a prototype artificial cornea and evaluate it in the rabbit model.

Methods: Hydrogel core‐and‐skirt keratoprostheses were made and were inserted as full‐thickness implants covered with conjunctival flaps in the right eyes of eight rabbits.

Results: Peroperative complications related to inadequate mechanical strength led to failure in the early postoperative period in three animals, one was euthanased for an unrelated reason and the remaining four have been successful for up to 16 weeks' follow‐up.

Conclusions: Full‐thickness implantation of an artificial cornea; analogous to penetrating keratoplasty, has been achieved in the rabbit model. Histological findings confirm that integration of the prosthesis with host tissue occurs. The main complications encountered in this preliminary series were related to inadequate strength of the sponge skirt of this prototype device. Work in our laboratories is now concentrated upon improving the mechanical qualities of the hydrogel skirt and on the enhancement of biointegration.
Cost effectiveness of cataract surgery: A comparison of conventional extracapsular surgery and phacoemulsification at Flinders Medical Centre
Authors: Asimakis Peter , Coster Douglas J. , Lewis Deborah J.
Published: November 2007

Purpose:To compare the cost of conventional extracapsular cataract surgery and phacoemulsification at Flinders Medical Centre.

Methods:The costs of the two forms of cataract surgery were assessed over a 12‐month period. During this period 410 cataract operations were performed.

Setting:The cataract surgery was carried out in a dedicated day surgery unit in a teaching hospital.

Outcome measure:The direct, indirect and tangible costs were measured.

Results:Conventional extracapsular cataract surgery with posterior chamber lens implant costs $1000.85 and phacoemulsification with lens implantation costs $1231.00.

Conclusions:Although conventional extracapsular surgery generates slightly lower costs than phacoemulsification, the cost difference is small. In generating these figures, some assumptions must be made and the real difference may prove to be less than this.
Evaluation of photoscreener instruments in a childhood population: 1. Otago photoscreener and Dortmans videophotorefractor
Authors: Cooper Carolyn D. , Bowling Francis G. , Hall Julie E. , Colville Deborah J. , Dortmans Renus J. , Munch Jesper , Gole Glen A.
Published: November 2007

Objective:To evaluate two photoscreeners in a childhood population.

Study design:Double‐masked study.

Subjects and method:One hundred and thirteen children aged between 11 and 44 months with either normal vision or known visual disorders were photoscreened without cycloplegia by the Otago and Dortmans (prototype) photoscreeners. Each child had a full ophthalmological examination either on the day of screening or in the preceeding six months. Photoscreen images were reviewed by an independent observer for indicators of amblyopiogenic risk factors, and compared to the full ophthalmological examination to determine sensitivity and specificity for each instrument.

Results:The Otago photoscreener returned a sensitivity of 70% and specificity of 82% for the detection of amblyopiogenic risk factors. The Dortmans photoscreener returned a sensitivity of 70% and specificity of 90%. Both photoscreeners were portable and easily operated. Conclusion: Children can be screened successfully for amblyopiogenic risk factors with these photoscreening systems. Further evaluation is required to determine specificity in a normal population. This would also provide information on the potential usefulness of photoscreeners in a cost effective childhood vision screening program.
Intralenticular metallic foreign body
Authors: Lee Lawrence R. , Briner A Michael
Published: November 2007

Background:Intralenticular metallic foreign bodies may be well tolerated for many years.

Case Report:A 24‐year‐old Caucasian man was referred with an intralenticular metallic foreign body present in the left eye for five days. Following initial treatment with topical steroid and antibiotic, the lens remained clear and visual acuity normal. Two years later the left eye developed an anterior uveitis, with reduced vision. A left phacoemulsification lens extraction with removal of the intralenticular foreign body and insertion of a posterior chamber intraocular lens was performed.

Conclusion:Management of intralenticular metallic foreign bodies may be conservative till intraocular inflammation or cataract develops.
Coexistent orbital and cerebellar venous anornalies in linear sebaceous naevus syndrome
Authors: Seawright Ashley A. , Sullivan Timothy J. , Pelekanos James T. , Masel John
Published: November 2007

Background:Orbital venous anomalies can result in significant morbidity and have been reported in association with other venous anomalies, some with the potential for serious complication.

Methods/results:We present a case of an orbital venous anomaly coexistent with a large cerebellar venous angioma and a linear sebaceous naevus. Clinical features, asSociations, complications and management principles are presented.

Conclusion:Upon clinical recognition of an orbital venous anomaly, brain imaging and appropriate clinical assessment should be considered in light of the possibility of coexistence of potentially life‐threatening lesions.
Congenital orbital teratoma
Authors: Lee GA , Sullivan TJ , Tsikleas GP , Davis NG
Published: November 2007

Background: The occurrence of proptosis at birth unusual and may be associated with a variety of tumours and structural abnormalities. Congenital orbital teratoma a rare cause of congenital proptosis.

Methods: A case report is presented of a female infant with gross right proptosis.

Results: Computed tomography demonstrated a characteristic multicystic structure with no intracranial involvement. Histological examination found tissues derived from all three germ cell layers, consistent with a congenital orbital teratoma. The tumour was successfully removed preserving the globe and vision.

Conclusions: This report is an example of how early surgical intervention may allow preservation of the globe and vision in some patients with congenital orbital teratoma.
Ocular gene therapy: The basic science and current state of research
Authors: da Cruz L , Rakoczy P , Constable I
Published: November 2007

Recent technical advances have led to the demonstration of the molecular basis of many genetic eye diseases. Methods now in use have been able to both suppress and insert genes in vitro and in vivo in ocular cells. The combination of this new knowledge and these techniques offers the potential for a new therapeutic approach to diseases that currently have no treatments. The scientific basis of gene therapy is introduced and then the current state of research is discussed in relation to the eye and ocular tissues.
Visual acuity in an Australian Aboriginal population
Authors: Stocks NP , Hiller JE , Newland H
Published: November 2007

Background: Australia is a developed country, However; Aboriginal Australians have rates of blindness comparable to Third World countries. There have been well‐funded eye health programs for 15 years in Central Australia. This paper examines if there has been an improvement in visual disability of one traditional group of Aboriginal Australians.

Methods: Results from an eye health survey of the Anangu Pitjantjatjara of South Australia in 1990 are presented. These data are compared with results for ‘blindness’ and ‘poor vision’ from a national survey undertaken in 1976. The two surveys were comparable in design, both were cross‐sectional population‐based prevalence surveys. Prevalence rates were adjusted for the size of the source population.

Results: Young rural Aboriginal Australians have good visual acuity. Low vision and blindness (WHO definitions) occur in 19.6% and 10.4% of 60+ year olds, respectively. Women were more likely than men to be blind or have low vision (OR= 1.93; 1.06‐3.58). There was a decline in ‘poor vision’ between surveys (OR=2.86; 1.86‐4.75) but not in ‘blindness’.

Conclusion: Although there has been a reduction in the prevalence of visual disability in rural Aboriginal Australians, improvements in the provision of eye care for the elderly need to occur.
Orbital colour Doppler imaging in chronic ocular ischaemic syndrome
Authors: Lee HM , Fu ERY
Published: November 2007

Background: The clinical syndrome of chronic ocular ischaemia may be difficult to diagnose due to its wide range of non‐specific presentations, and its diagnosis often implies the presence of underlying severe carotid occlusive disease. Colour Doppler imaging (CDI), a recent advance in ultrasonography that allows for colour‐encoded blood flow data of a vascular structure to be displayed simultaneously on a conventional real‐time gray‐scale B mode image, has been used in the assessment of ocular and orbital vasculature.

Method: Four patients with chronic ocular ischaemic syndrome whose diagnoses were aided by CDI are presented.

Results: Orbital CDI was successful in confirming the diagnosis in all four cases. Reversal of blood flow in the ophthalmic arteries was demonstrated. Central retinal vessels were not detected with CDI in all four patients with complete occlusion of the ipsilateral internal carotid artery. One of the four patients had intermittent reversal of ophthalmic arterial flow ipsilateral to the 60% stenosed internal carotid artery.

Conclusion: This non‐invasive technique is an excellent alternative to invasive vascular studies such as angiography for the diagnosis and evaluation of the chronic ocular ischaemic syndrome.
Georg Bartisch: Ophthalmodouleia, der Augendienst, 1583. A treatise on service of the eyes and a review of the chapter on strabismus
Authors: Lowe Ronald F
Published: November 2007

In 1583, Georg Bartisch, oculist and cutter for bladder stones at the court of Duke August 1 of Saxony, published at his own expense a 273 page textbook of ophthalmology. It contained 91 wood cuts and, in the present volume, they are presented in brilliant colour as they were in the original books prepared for presentation. The book was one of the first medical treatises to be published in the German vernacular instead of traditional Latin. It has been translated into English and published in gothic type to simulate the original. Treatment of diseases of the eye by medicines or surgery are reported in great detail. It gives an account of ophthalmology at the time of the early Renaissance when enlightenment was beginning to overtake the darkness of the Middle Ages.
Changes in the interpupillary distance with age and its effect on the near fusion free position
Authors: Chen AH , O'Leary DJ
Published: November 2007

Purpose:

The effect of the rate of the interpupillary distance (IPD) change with age on the near fusion free position was investigated in the present study.

Methods:

Three hundred and fifty‐two children aged from 2 to 16 years of age were tested. Interpupillary distance was estimated with a modified Viktorin's method and the near fusion free position was measured with a modified Maddox Wing.

Results:

The results reveal a significant difference in IPD growth rate between females and males and between children aged below and above 5 years. Most children below 5 years of age were orthophoric, but heterophoria became more common above 5 years of age.

Conclusion:

The present study suggests that the oculomotor control system for convergence can compensate for age changes in IPD.
Interactions between the constitutive host defences of tears and Staphylococcus epidermidis
Authors: Leitch EC , Willcox MDP
Published: November 2007

As part of the normal microbiota of the external eye, Staphylococcus epidermidis has probably developed strategies to overcome tear defences. The interaction of this bacteria with constitutive tear proteins was examined. Isolates of S. epidermidis grown in 10% serum or artificial tear fluid containing lysozyme or lactoferrin were resistant to the action of these proteins. Using ELISA, cell wall binding of C3, vitronectin and lactoferrin differed quantitatively between strains and in closed‐eye compared to open‐eye conditions. No differences were observed between ocular and non‐ocular strains. This suggests that ocular isolates originate from the general host microbiota and S. epidermidis isolates are resistant to individual constitutive tear proteins.
Presence of inflammatory mediators in the tears of contact lens wearers and non‐contact lens wearers
Authors: Tan M , Thakur A , Morris C , Willcox MDP
Published: November 2007

The present studies have demonstrated the levels of N‐methyl histamine in tears from normal physiological states, pathological states and contact lens wear Histamine was significantly increased in closed eye tears compared with both open and reflex tears. Tears from other ocular conditions had low levels of histamine except for environmental hypersensitivity, which contained significantly elevated levels compared to normal tear types. Interestingly tears from asymptomatic contact lens wearers had significant levels of histamine whereas tears from contact lens adverse events had lower levels, possibly reflecting a change in histamine metabolism.
Modulation of cytokine production from an EpiOcular corneal cell culture model in response to Staphylococcus aureus superantigen
Authors: Thakur A , Clegg A , Chauhan A , Willcox MDP
Published: November 2007

The present study investigated the hypothesis that Staphylococcus aureus enterotoxin B (SEE) produces epithelial cell death and releases inflammatory cytokines that produce stromal infiltration during contact lens induced peripheral ulceration. Epithelial cells were incubated with different doses of SEB for various time periods. Culture supernatants were assayed for cytokines IL‐ lo, IL‐6 and chemotactic agents IL‐8 and LTB,. SEE induced the production of IL‐ I p and IL‐8. Epithelial cells exposed for longer periods (48 h) with low concentrations of SEB produced significantly higher levels (N0.02) of IL‐Ip and IL‐8 (P<0.05) compared t o a 24 h exposure. SEB did not induce the production o f IL‐6 and
Fourier transformation of corneal topography data
Authors: Keller P , van Saarloos P
Published: November 2007

Background:

The clinical interpretation of corneal topography power maps has progressed through the development of both qualitative pattern classification systems and a range of quantitative descriptors. Although a number of different indices have been described, they do not all possess obvious clinical utility.

Methods/Results:

Fourier series analysis decomposes any circumferential fluctuations in corneal power into various components that have direct clinical correlates. The zero frequency and two‐cycle components, which represent spherical equivalent and regular astigmatism, respectively, are analogous to keratometric spherical (equivalent) and astigmatic powers. The other Fourier components have no keratometric equivalent but have distinct clinical value. Decentration is a tilt of the cornea with respect to the videokeratoscope axis and irregular astigmatism is the sinusoidal variation in power that cannot be corrected with conventional lenses.

Conclusion:

The present paper demonstrates the application of Fourier series analysis to corneal topography data.
Dopaminergic behaviour in chicken retina and the effect of form deprivation
Authors: Megaw PL , Morgan IG , Boelen MK
Published: November 2007

Purpose:

Dopamine (DA)is cinsidered to be a neurotransmitter involved in light‐adaptive responses in the retina and has been implicated in the control of the eye growth include by form deprivation vitreal DOPAC was shown to be a good indicator of retinal dopaminergic activity.

Methods/Results:

Dopaminergic activity was highest during the light, with vitreal DOPAC levels rising within in 3 hof light exposure. Form deperivation attenuated dopaminergic activity, as the rise in vitreal DOPAC levels on light exposure was rediced in form‐depeived eyes, compared with control eyes.

Conclusion:

The lack sustained activation of DA release may explain the role of DA in the control of eye‐growth.
Deprivation of form vision suppresses diurnal cycling of retinal levels of leu‐enkephalin
Authors: McKenzie C , Megaw P , Morgan I , Boelen MK
Published: November 2007

Deprivation of form vision by the fitting of translucent occluders suppressed the diurnal cycling of enkephalinergic amacrine cells (the ENSLI amacrine cells), in the chicken. Daily periods of normal vision or enforcing temporal contrast using strobe lighting appeared to restore normal functioning of the ENSLI cells. These results suggest that the ENSLI cells are involved in retinal circuits that assess the quality of the visual image and control eye growth.
Absence of ganglion cell subcomponents in multifocal luminance electroretinograms
Authors: Vaegan PhD  , Sanderson G
Published: November 2007

Multifocal flash electroretinograms (ERG) were recorded binocularly (n= 18). Areas were equal or scaled with excentricity. The latter were expected to increase the total amplitude if ganglion cell subcomponents were involved. Amplitudes were intercorrelated and the factor structure was established. Scaling had no influence on amplitudes or on factors. Reliability and sensitivity were high. The second kernel first slice from the nine hexagons across the midline showed differences near the macula but no component increasing in latency with distance from the disc. Thus, multifocal flash ERG have linear spatial summation and no ganglion cell subcomponents.
Management of intra‐ocular foreign bodies impacting or embedded in the retina
Authors: Pavlovic Sima , Schmidt Karl Georg , Tomic Zoran , Dzinic Miroslav
Published: November 2007

Purpose: To identify both the clinical features of eyes suffering penetrating ocular injury with intra‐ocular foreign bodies (FB) impacting or embedded in the retina and the results of surgical outcome and complication rates.

Methods: Thirty‐eight consecutive cases of penetrating ocular injuries with intra‐ocular FB impacting or embedded in the retina were retrospectively analysed.

Results: The FB were metallic in 30 eyes (78.9%; 19 ferromagnetic) and were non‐metallic in eight eyes (21.1%). Magnetic extraction was performed in 17 cases (44.7%) and instrumental extraction was performed in 21 cases (55.3%). In two cases, pars plana vitrectomy and FB removal was combined with penetrating keratoplasty, temporary keratoprosthesis and anterior segment reconstruction because of severe explosive injury to the eye. At the final postoperative examination, 32 eyes (84.2%) had completely attached retinas. Visual acuity (VA) improved postoperatively in 18 eyes (47.4%). A final VA of 0.5 or better was achieved in nine of 23 eyes (39.1%) with FB in the peripheral retina and in one of 15 eyes (6.7%) with posterior pole and/or optic nerve head involvement. There was no difference in the final VA regarding the time elapsed between trauma and the removal of the FB.

Conclusion: The late anatomical and functional outcome in eyes with penetrating ocular injury and FB impacting or embedded in the retina is mostly uncertain, despite immediate and complex surgery. Final anatomical and functional outcome in the present study was influenced by location and extent of the initial damage to the posterior pole. The time that had elapsed between trauma and removal of the FB did not influence final visual function.
Diagnosing the systemic associations of anterior uveitis
Authors: Smith Justine R , Coster Douglas J
Published: November 2007

Up to one‐half of patients with anterior uveitis suffer from related systemic diseases. The common associations are the seronegative arthropathies and, in children, juvenile chronic arthritis. Anterior uveitis may also occur in the context of sarcoidosis or Behçet's disease. Syphilis and tuberculosis remain a significant problem for specific populations and may be the cause of anterior uveitis in these groups. By thorough clinical history and the correct selection and interpretation of simple investigations, it is generally possible for the ophthalmologist to make or exclude a systemic diagnosis, predict the ocular prognosis and direct selected patients to the appropriate physician. Diseases that threaten the patient's wellbeing must certainly be recognized. In the present review we present a method for identifying the systemic associations of anterior uveitis.
Nocardia choroidal abscess in a patient with systemic lupus erythematosus
Authors: Yap EY , Fam HB , Leong KP , Buettner H
Published: November 2007

Purpose:

Nocardia asteroides, a respiratory saprophyte in humans, may cause localized infection of the lungs in debilitated or immunosuppressed individuals. Haematogenous spread to the eye via the choroidal circulation may result in choroidal abscess formation.

Method: We report the development of a choroidal abscess in the left eye of a woman treated with steroids and cyclophosphamide for systemic lupus erythematosus. Haematogenous spread of N. asteroides from a localized infection of the lung (empyema) is thought to have been the cause of the choroidal abscess.

Results: Surgical drainage of the empyema combined with intravenously administered antibiotics resulted in resolution of the choroidal abscess and improvement of vision.

Conclusions: A choroidal abscess, caused by haematogenous spread of N. asteroides, may respond to appropriate systemic antibiotic treatment alone and not require ocular treatment.
Detecting the orientation of short lines in the periphery
Authors: Davey Matthew P , Zanker Johannes M
Published: November 2007

Purpose: Visual information processing in the human cortex is based on a highly ordered representation of the surrounding world. In addition to the retinotopic mapping of the visual field, systematic variations of the orientation tuning of neurons have been described in the primary visual cortex. As a step to understanding the relationship between position and orientation representation, we investigated psychophysically the minimum spatial requirements for the determination of orientation at various positions across the visual field. We know that the shortest line whose orientation can be resolved varies with eccentricity, such that its length corresponds to slightly less than 0.2 mm projected onto the cortical surface. Along the horizontal meridian horizontal lines are detected with higher precision than vertical or oblique lines. In the present experiments, we tested whether this is a preference for horizontal lines or for lines that are orientated radially away from the fovea.

Methods: Human observers were tested with lines positioned at one vertical, two horizontal and two oblique meridians at eccentricities between 5 and 25°.

Results/Conclusion: Three of the four subjects were most sensitive for targets aligned with the meridian of presentation. This suggests that the visual system has the highest resolution in directions radiating from the fovea, which may be particularly useful for the analysis of flow fields resulting from forward translation.
Effects of migraine on visual function
Authors: McKendrick Allison M , Badcock David R , Heywood John , Vingrys Algis J
Published: November 2007

Background: Data is reported from an ongoing trial considering whether visual loss associated with migraine is consistent with a selective deficit in M‐ or P‐cell functioning.

Methods: The psychophysical tests used include spatiotemporal contrast thresholds and luminance increment thresholds for a spot drifting across a spatially or temporally modulated background. A migraineur and 15 non‐headache controls participated in the present study. Measurements were made foveally and at 10° in the superior field. Static and flicker perimetry were conducted.

Result/Conclusion: Regionalized losses occurred for stimuli with moderate temporal frequencies (16 Hz). which is consistent with M‐cell dysfunction.
Patterns of glaucoma medication use in urban and rural Victoria
Authors: Weih LeAnn M , Newkirk Mylan Van , McCarty Catherine A , Taylor Hugh R
Published: November 2007

Purpose: The purpose of the present study was to describe patterns of glaucoma medication use among people who self‐report a history of glaucoma in a population‐based study of age‐related eye disease.

Methods: The present study was comprised of a population‐based cluster stratified sample of 5000 Victorians aged 40 years and older. Participants completed an interview regarding demographic characteristics, medical history and use of medications. Participants also completed orthoptic and dilated fundus examinations, including measurement of intra‐occular pressure (IOP) and visual fields. Glaucoma history and use of glaucoma medication was self reported. Glaucoma disease status was confirmed by a specialist consensus group.

Results: The most common glaucoma medications used were β‐adrenoceptor blocking agents (63%), followed by sympathomimetics (18%) and cholinergic agents (16%). There were no differences in glaucoma medication use by gender, age, years since diagnosis, rural or urban residence or a history of glaucoma surgery. Among participants using medication, 16.1% exceeded 21 mmHg IOP.

Conclusion: The high prevalence of the use of β‐adrenoceptor blocking agent medication reflects the shift from the use of pilocarpine over the past 20 years. The prevalence of IOP greater than 21 mmHg highlights the difficulty in managing high IOP.