bluuebunny/crossref_metadata_2025 huggingface dataset:
Swept source‐optical coherence tomography analysis of choroidal involvement in patients with uveitis
Authors: DIWO E , RAZAVI S , LEHOANG P , BODAGHI B
Published: November 2013

Purpose Swept source OCT (SS‐OCT) is currently the best visualization technique of the choroid. The aim of our study is to describe its thickness and vascular structures in patients with choroiditis.

Methods We have completed a choroidal map with SS‐OCT, using 12‐mm horizontal vertical scans through the macula, for a group of patients with choroiditis, referred to Pitie Hospital, from October 2012 to March 2013.

Results Eight patients have been included with a sex ratio of 1, an average age of 56.5 years : 5 birdshot retinochoroidopathies (BRC), 1 multifocal choroiditis , 1 Vogt‐Koyanagi‐Harada (VKH) disease, 1 acute posterior placoid chorioretinitis concomitant with a syphilitic seroconversion. In four active BRC, the average choroidal thickness was increased to 339 µm (389 µm ±41.93), among whom one BRC patient experienced a decrease of 30 µm in choroidal thickness immediately after corticotherapy. On the contrary the fifth patient, an advanced form of BRC, showed signs of atrophy with a choroidal thickness of 194 µm. Choroidal thickness in the VKH patient was unchanged in both eyes. There was a significant asymmetry in the patient with syphilitic chorioretinitis, with a choroidal thickness of 334 µm in the affected eye versus 387 µm in the contralateral eye. Yet, we observed that Haller’s layer of the affected eye was harder to visualize, due to possible inflammatory infiltrations

Conclusion These choroidal maps are among the first choroiditis cases explored by SS‐OCT, first step of a mapping project which we wish to amplify in order to determine a possible threshold of choroidal thickness indicating a subclinical relapse. This could make SS‐OCT an additional tool besides ICG angiography for the exploration of the choroid.
Femtosecond laser capsulotomy versus manual technique: A clinico‐morphological study of the resected capsules
Authors: MEYER P , PRUENTE CH
Published: November 2013

Purpose To compare resected lens capsules created by femtosecond laser system with the conventional manual techniques.

Methods A prospective, observational case series of 6 patients who underwent capsulotomies performed by an optical coherence tomography‐guided femtosecond laser compared with 6 patients which capsulotomies created with the conventional manual technique. The resected capsules were evaluated histologically. Electron microscopy was performed to examine their capsule edge.

Results Histologically the capsule edges produced by manual were smooth and continuous however performed by femtolaser the capsule edges showed small microgrooves in high magnification. Electronmiocroscopically these microgrooves presented as pointed serrated structure like a lacerated jeans.

Conclusion The femtosecond laser produced capsulotomies were clinically more precise in diameter and in size however their capsules showed irregular stripped edges than those created with the conventional manual technique. The microgrooves were produced by the laser pulses. A certain weakness of the laser produced edges is to expect and needs more clinical experiences.
Metastases inhibition and cellular damage in melanoma cells irradiated with proton beam
Authors: ROMANOWSKA DIXON B , KEDRACKA‐KROK S , SKALNIAK L , JURA J , ZUBA‐SUMA E , JASINSKA K , PAWLAK A , SOWA U , OLKO P , URBANSKA K , ELAS M
Published: November 2013

Purpose Proton beam therapy has been used in clinic with a great success, however, not many experimental studies has been performed. The goal of our study was to determine the cellular response to low, sublethal doses of proton beam irradiation, in particular DNA damage, cell cycle arrest, changes in expression of proteins, and effect on metastases in vivo.

Methods BLM cells were irradiated with 1‐7 Gy of proton beam irradiation. The source of the 58 MeV proton beam was the AIC‐144 cyclotron at Institute of Nuclear Physics, Polish Academy of Sciences, Kraków. Tumors of Bomirski Hamster Melanoma (BHM) implanted into the anterior chamber of the hamster eye grew aggressively and completely filled the anterior chamber within 8‐10 days. Metastases, mainly in the lung, were found in 100% of untreated animals 30 days after enucleation. The protons were accelerated using AIC‐144 isochronous cyclotron, operating at 60 MeV and BHM tumors located in the anterior chamber of the eye were irradiated with 10 Gy, for the depth of 3.88 mm.

Results Slow accumulation of damage was observed reflected in slowing of the proliferation rate, and increase in caspases activity with time. The number of cells in G2/M and >2n increased with proton beam dose. Proton beam irradiation caused upregulation of proteins involved in: DNA repair, RNA functioning (i.e. stress granule and P‐bodies components), apoptosis and survival processes and downregulation of enzymes engaged in glycolysis. Of particular interest was heavy downregulation of vimentin (2.4 times), involved in structural integrity of cells and tissues, adhesion and migration, and other processes. Irradiation led to changes in cell migratory properties. Proton beam irradiation caused inhibition of tumor growth by about 10 days and inhibition of metastastic spread.
Cases of choroidal metastasis revealing lung cancer
Authors: BARCATALI M , MIOCQUE S , HADDAD M , MOURIAUX F
Published: November 2013

Purpose Choroidal metastases are the most common intraocular malignant tumor but rarely reveal cancer. However the role of the ophthalmologist is central to diagnose this disease. Ophthalmological examination, optical coherence tomography, ultrasound and angiography may help for differentiate metastasis to other choroidal tumors. The aim to this presentation is to describe to identical cases of choroidal metastasis revealing lung cancer.

Methods We report 2 cases, a 53‐year‐old woman and a 63‐year‐old man, with no prior history of neoplasia who consulted for decreased visual acuity of the right eye. In both, eye fundus examination reveals a suspicious yellowish choroidal lesion. Fundus examination, optical coherence tomography (confirming the serous retinal detachment), ultrasound (confirming the plan or thick appearance) and angiography (showing blocking defect in early stage and hyperfluorescence with pin points in late stage for fluorescein angiography and diffuse hypofluorescence in late stage for indocyanin angiography) led us to the conclusion of choroidal metastasis. Then, next investigations were mammography (for woman) and body scan (for both). The results reveal an adenocarcinoma of the lung for both cases.

Conclusion Choroidal metastases are rarely inaugural of a cancer but an early diagnosis is essential. The role of ophthalmologist is central to the diagnosis and both cases allow remembering the main diagnostic criteria.
PKC activation affects, via ELAVL1/HuR protein, VEGF expression in pericytic/endothelial coculture
Authors: AMADIO M , OSERA C , LUPO G , MOTTA C , DRAGO F , GOVONI S , PASCALE A
Published: November 2013

Purpose To explore whether, following direct contact, there is a mutual influence between pericytes (PC) and endothelial cells (EC), and to establish whether PKC activation, a condition associated with hyperglycaemia in diabetic retinopathy (DR), can affect, via the mRNA‐binding ELAVL1/HuR protein, VEGF expression.

Methods Retinal PC and EC were cultured separately (MONO) or in direct contact (1:1 ratio; coculture; COCU), and exposed or not to PKC activator phorbol esthers (100 nM PMA, 15 min.). PKCβI/βII, HuR, VEGF proteins were analysed by Western blotting; VEGF secretion in cell culture medium was evaluated by ELISA. VEGF mRNA analysis was performed by real‐time qPCR. Immunocytochemistry was performed to evaluate PMA‐induced HuR translocation.

Results In MONO, VEGF mRNA/protein basal levels are higher in PC than EC. In COCU, VEGF protein amount is up‐regulated in EC and down‐regulated in PC, respectively. VEGF release is favoured by physical contact between PC and EC and further increased by PMA exposure. PKCβ activation induces HuR translocation from nucleus to cytoplasm, and it increases the protein levels of the kinase itself, HuR and VEGF in PC and EC in both culture conditions.

Conclusion VEGF expression varies in function of the cell culture conditions. In all cultures, PKC activation increases PKCβI/βII, HuR and VEGF protein levels, changes which may occur also at very early stages of DR. The COCU model may be useful to study PC/EC interactions in both physiological and pathological conditions.
Macro and microglial retinal cells in rat organotypic cultures
Authors: GALLEGO B , ROJAS B , SALAZAR JJ , RAMíREZ AI , DIERSTEIN M , DE HOZ R , TRIVIñO A , RAMíREZ JM , UEFFING M , ARANGO‐GONZáLEZ B
Published: November 2013

Purpose Organotypic retinal cultures constitute a useful tool to perform preclinical drug testing. The aim of the present study was characterize the morphologic changes in macro‐ and microglial cells in this culture system.

Methods Retinas were isolated from 7‐day‐old Crl:CD(SD) rats with the retinal pigment epithelium attached. Retinal explants were cultured for 4, 10, and 14 days (DIV4, DIV10, and DIV14). Cryosections and whole‐mounts of age‐matched control and cultured retinas were used to analyze macro‐ and microglial cells by immunostaining using antibodies against GFAP, vimentin and CD11‐b.

Results In comparison with in vivo, in DIV4 and DIV10 cultures, GFAP‐positive astrocytes were more robust, the astrocytic network being thicker in some retinal areas while in other regions astrocytes were sparsely distributed. Few thin GFAP‐positive astrocytes were observed at DIV14. Müller cells in the cultures exhibited GFAP up‐regulation in comparison with in vivo retinas. CD11‐b+ microglial cells at DIV4 and DIV10 showed more robust somas and thicker and more retracted processes than in vivo. Overall, at DIV14 CD11‐b+, microglial cells exhibited a rounded morphology.

Conclusion In rat organotypic culture both macro‐ and microglial cells showed progressive changes: i) reactive macrogliosis, ii) rearranged astrocytic distribution, iii) GFAP up‐regulation in Müller cells, and iv) microglial activation. Given that this glial response is a hallmark of several retinal diseases, organotypic retinal culture is a valuable resource for future investigations in retinal degenerative processes and therapy.
A new automatic method for microglial‐cell quantification in whole‐mount mouse retinas
Authors: DE HOZ R , GALLEGO BI , ROJAS B , RAMIREZ AI , SALAZAR JJ , TRIVIÑO A , DE GRACIA PACHECO P , RAMIREZ JM
Published: November 2013

Purpose To study the proliferative microglial behavior in a laser‐induced ocular hypertension (OHT) model with an automatic method that allows the assessment of the number of microglial cells and comparisons of the results with those found by direct human observation.

Methods Albino Swiss mice were divided into: age‐matched control, n=6; and lasered, n= 6. Retinal whole‐mounts were immunostained with anti‐Iba1. In Matlab, new algorithms of segmentation and control of distances were developed to determine the number of Iba‐1+ cells. The automatic results were compared with those from direct human observation of the images.

Results The algorithm method automatically detected the number of Iba‐1+ retinal cells in the inner and outer plexiform layers, both in naïve and OHT retinas. The number of cells present in the image samples was not an obstacle for the program to run properly. The time required for counting Iba 1+ cells decreased from the human guide to the program‐based counting method from days to one hour. the results showed a strong correlation between automatic and manual methods (Pearson correlation test, R = 0.979; P=0.000 and R= 0.942; P=0.000 for outer and inner plexiform layer, respectively) indicating the reliability of the automatic counting.

Conclusion A new consistent and fast algorithm method was developed with Matlab to quantify Iba‐1+ microglial cells as well as cellular density maps through retinal whole‐mounts, in both naïve and OHT. Through this new automatic method, a larger set of images or samples could be included in future studies to analyze the behavior of microglial cells under proliferative conditions.
Biological lasers theory, vol.II vision holographic theory ‐ Eye and vision
Authors: MANU MD , PLESU GH
Published: November 2013

Purpose The romanian book deals with the Biological Laser Theory BLT and its applications ‐ the Vision Holographic Theory VHT. The book has about 465 pages, 7 chapters, and 151 figures (85 original figures), 15 tables. After introduction of the actual problems in ophthalmology, are presented: the purpose of the book ‐ to verify some old theory about an up‐down image on retina, to demonstrate by theoretical and experimental studies that human eye structure is a bifocal laser system with holographic system included, the bio luminescence is a biological laser phenomena, laser holographic biophotonic mechanism of the sight, and applications;

Methods Theoretic method: a short history of the sight mechanism. Our old studies on characteristics of cell biological laser systems; the VHT hypothesis about eye and vision, the coherent transformation of light in bio luminescence, as laser phenomena; multidisciplinary arguments for laser‐holographic structures and function hypothesis are from ophthalmology, lasers, holography, liquid crystals, electronics, biophotonic and bionics.As experimental method we present two original apparatus for human vision study acknowledged at EuroInvent Iași 2011, and CIGIG 2012.

Results Both apparatus proves the right position of holograms on retina, due to eye, not to brain. We describe some other holographic‐biophotonic mechanism for biological (muscle contraction) and psychic processes (vision, memory, thinking, speech etc), and increasing the power and information along nervous system.

Conclusion Important applications are in medicine teaching, physics and bionics. Keywords: eye, bioluminescence, bifocal laser system, holography, image, nervous system, biophotonic mechanism, biologic process, psychic process

Commercial interest
Simultaneous VEP and EOG in dyslexic children
Authors: HERAVIAN J , SOBHANI D , LARI YAZDI S , AZIMI A , KHOSHSIMA MJ , HOSSEINI YAZDI SH , OSTADI MOGHADDAM H , YEKTA AA
Published: November 2013

Purpose We used Pattern visual evoked potential (PVEP) and Electrooculogram (EOG) to clarify the confilicting evidence of neurophysiological abnormalities in dyslexic children.

Methods PVEP and EOG were recorded simultaneously in 72 children including 36 dyslexic and 36 normal children that were matched for age, sex and intelligence. Two check sizes of 60 and 15 min arc were used with temporal frequencies of 1.5 Hz for transient and 6 Hz for steady state methods.

Results Our findings show no differences in VEP components between dyslexia and normal that did not support the magnocellular hypothesis. High contrast EOG stimulus in detection of dyslexia is more reliable than VEPs.

Conclusion The results are not consistent with the evidence of an isolated deficit of the magnocellular function. The high contrast stimulus used in this study is thought to be involved to paravocellular system.
Hyperstereopsis is attenuated by the addition of secondary visual cues
Authors: PRIOT AE , PHILIPPE M , SALASC CA , NEVEU P , PLANTIER J , ROUMES C
Published: November 2013

Purpose Telestereoscopic (or hyperstereo‐) viewing which increases effective interocular distance has been a subject of interest since Helmholtz’s pioneering work. Increased disparities and vergence alter 3D‐space perception. In particular, apparent egocentric distances decrease, owing to the increased vergence (Priot et al., 2010; Rogers, 2011). This study sought to investigate how the enrichment of stimulus information influences its perceived distance.

Methods We assessed distance perception through open‐loop pointing before and during exposure to a telestereoscope in three stimulus viewing conditions: i) a red pinpoint of light (pinhole) providing vergence cue only; ii) a red cross with randomized diameter preventing size cue, providing vergence and some accommodative cues and iii) a real‐size coin slide providing vergence, accommodation, relative‐ and familiar‐size cues.

Results Before exposure (normal viewing), we observed an improved perceived‐distance accuracy induced by enriched stimulus information. During exposure (with vergence discrepancy), we found that, on average: i) telestereoscopic viewing altered perceived distance; ii) this effect was modulated by the stimulus viewing condition; iii) the mean slope of the perceived distance of the cross stimulus vs. its physical distance was not different from that predicted by vergence changes according to Helmholtz’s scaling theory; and iv) the hyperstereo effect was attenuated by the enriched stimulus information.

Conclusion We ascribe the attenuation of hyperstereopsis by the addition of secondary visual cues to a down‐weighting of vergence contribution relative to those of the other cues.
Effects of Quensyl on the ERG a‐wave amplitude from the isolated superfused vertebrate retina
Authors: SIAPICH SA , GOEBEL A , WALTER P
Published: November 2013

Purpose Long‐term therapy with quensyl is known to cause neurodegenerative changes in the retina. In our present research we study acute toxic effects of quensyl on the a‐wave response of electroretinogram (ERG) of isolated superfused bovine retinas.

Methods Isolated bovine retinae were mounted in a temperature‐controlled recording chamber. After light stimulation electric field potentials were recorded as a transretinal potential using Ag/AgCl‐electrodes. Isolated bovine retinas were perfused with phosphate buffered saline (PBS) containing 1mM L‐aspartate to block further synaptic transmission in order to record the effects of quensyl on photoreceptors. We tested the low and high light intensities of 100 mlux and 10 lux. After reaching a stable ERG amplitude, quensyl (190 µM, 570 µM or 1,9 mM) was added to the perfusing solution. After 90 min quensyl was washed out for 90 min with PBS containing 1mM L‐aspartate. Changes in a‐wave amplitude were calculated and plotted.

Results 190 µM quensyl showed a 1,3 fold stimulation of the a‐wave amplitude at 100 mlux, the effect at 10 lux was not significant. 570 µM quensyl reduced the a‐wave amplitude by 3‐folds independent of light‐intensity. The inhibition was good reversible by washing with PBS containing 1mM L‐aspartate only at low light intensity (2 folds), there was almost no recovery at 10 lux. 1,9 mM quensyl showed a massive depression of a‐wave amplitude (6 to 7 folds) and no wash out effect over 90 minutes at both light intensities.

Conclusion Quensyl has a toxic effect on photoreceptors, even with slight increase of concentration showing a huge progression of inhibition and reduction of recovery. An exact dosage of quensyl is of great importance to avoid an irreversible neuronal damage.
Keep an eye on the Pi – Using the Raspberry Pi as inexpensive, yet powerful platform for vision research
Authors: WIRTH M , WEICHMANN F , SCHAEFFEL F , ZRENNER E , STRASSER T
Published: November 2013

Purpose In vision research as well as in other research disciplines, like psychology or psychophysiology, there is often a need for presenting visual stimuli and for registration of a physiological responses, like the pupil diameter, to them. Commonly, this is realized by making use of notebooks or desktop computers, therefore, wasting resources and energy. Here, we present a new platform for vision research based on the Raspberry Pi (RPi), an inexpensive, yet powerful system‐on‐a‐chip (SoC).

Methods The ARM based RPi, running up to 1GHz with 512MB RAM and offering interfaces like HDMI, RJ‐45, USB and GPIO at a price of $35 only, is a convinient basis for vision research. We took a recently published study dealing with pupil responses to pictures of light sources as draft to test its suitabilty for this usage. One RPi was used for controlling stimulus presentation, a second one for measuring the pupil diameter based on a video stream. The software was implemented using Java on a debian linux.

Results Due to the limited memory and processor performance, the framerate was restricted to about 20fps. However, it allowed for the recording of changes in the pupil diameter in response to the presented stimuli. We successfully comprehended a previous study, and thus showed that the RPi is a serious and cheap alternative to using notebooks or desktop computers for vision research.

Conclusion In spite of its size, the RPi provides surprising high performance. Based on open‐source software, applications can be implemented in languages like Java or Python, leveraging existing software packages. After the advent of the Raspberry Pi, similar devices became available, providing even more performance for low prices.
Differential diagnosis of endogeneous visual phenomena
Authors: KRASTEL H , UDODOV E , GOLUBKINA L , HARDER B , KOLLING G , JONAS J
Published: November 2013

Purpose To draw attention to either goal‐targeted or misleading features of phantom images originating from the optical media of the eye, retina, visual pathways and cortex.

Methods Retrospective analysis of cases, connecting patient reports on various patterns of endogeneous visual phenomena with pathology at different levels of the visual system, by keratotopography, refractometry, perimetry, biomicroscopy, OCT and electrophysiology.

Results Common features of our case histories are patient reports on visual phenomena which lack clear correlates to the outside visual environment. We demonstrate how the above diagnostic tools discern optical photic phenomena from mechanical phosphenes, vitreous traction phosphenes from photopsias arising due to retinal pathology and from lightning due to optic neuropathy. Criteria are defined for discerning these alltogether from the various appearances of filling‐in phenomena in visual field scotomas.

Conclusion A thorough interpretation of a patient’s report on endogeneous visual phenomena provides a valuable starter into ophthalmologic diagnosing and into some better understanding of disease mechanisms.
The effect of vitreous opacities on stray light measurements
Authors: DE SMET MD , CASTILLA M
Published: November 2013

Purpose To evaluate in patients with unilateral complaint of floaters there is an increase in stray light measurements as compared to the contralateral eye.

Methods A retrospective series of patients with a unilateral complaint of floaters having undergone a straylight measurement (SM) with a C‐Quant (Oculus, Germany). Data was collected on age and status of the lens. Patients having undergone vitreous surgery in either eye were excluded. The contralateral unaffected eye measurements were used as controls. A second control group consisted in patients with a posterior vitreous detachment (PVD).

Results Thirty‐four study eyes (n=34) were included, 11 with a diagnosis of PVD and 23 with floater complaints. The mean age for all eyes (floaters and PVD) was 59.29 years, with no statistically significant differences between groups. Distributed by sex, 14 cases were males, and 20 females. Mean straylight values in the eyes with floaters was of 1.436 (SD=0.208), in the control eye 1.258 (SD=0.199); p<0.01. Straylight in eyes with a PVD 1.241 (SD= 0.251) were similar to the control eye 1.197 (SD=0.139) and did not reach statistical significance.

Conclusion Straylight measurements are increased in the eyes with symptomatic floaters. A PVD even when clearly visible on OCT does not increase retinal straylight.
24‐hour intraocular pressure rhythm in young healthy subjects evaluated with continuous monitoring using contact lens sensor
Authors: MOTTET B , APTEL F , ROMANET JP , HUBANOVA R , PEPIN JL , CHIQUET C
Published: November 2013

Purpose To evaluate 24‐h intraocular pressure (IOP) rhythm reproducibility during repeated continuous 24‐h IOP monitoring with non‐contact tonometry (NCT) and a contact lens sensor (CLS) in healthy subjects.

Methods Twelve young healthy subjects were housed in a sleep laboratory and underwent four 24‐h sessions of IOP measurements over a 6‐month period. After randomized attribution, the IOP of the ﬁrst eye was continuously monitored using the CLS Sensimed TriggerFish® and the IOP of the fellow eye was measured hourly using the Pulsair Intellipuﬀ® non‐contact tonometer. A nonlinear least‐squares dual harmonic regression analysis was used to model the 24‐h IOP rhythm. Comparison of acrophase, bathyphase, amplitude, the midline estimating statistic of rhythm (MESOR), IOP values, IOP changes and agreement were evaluated in the two tonometry methods.

Results A significant nyctohemeral IOP rhythm was found in 31 out of 36 sessions (86%) using NCT and in all sessions (100%) using CLS. Hourly awakening during NCT IOP measurements did not significantly change the mean phases of the 24‐h IOP pattern evaluated using CLS in the contralateral eye. Throughout the sessions, intraclass correlation coefficients (ICCs) of the CLS acrophase (0.6 [0–0.9]; p=0.03), CLS bathyphase (0.7 [0.1–0.9]; p=0.01), NCT amplitude (0.7 [0.1–0.9]; p=0.01) and NCT MESOR (0.9 [0.9–1]; p<0.01) were significant.

Conclusion The CLS is an accurate and reproducible method to characterize the nyctohemeral IOP rhythm in healthy subjects but does not allow to estimate the IOP value in millimeters of mercury corresponding to the relative variation of the electrical signal measured.
Sleep apnea syndrome screening in patients with normal‐tension glaucoma
Authors: AGARD E , DESMAIZIERES C , RUSSO A , RACTMADOUX G , COSTE O , DOT C
Published: November 2013

Purpose To determine the prevalence of sleep apnea syndrome (SAS) in patients with normal‐tension glaucoma (NTG) and to evaluate the SAS screening in patients with NTG.

Methods Prospective study of 35 patients with NTG. Patients answered an abbreviated questionnaire of SAS : louder snoring, long silent period during which there is no breathing, night awakenings and excessive daytime sleepiness. Then, the patients answered the Epworth sleepiness scale. All patients were tested by the sleep clinic and received a dual recording RU‐Sleeping©/ polysomnography for the diagnosis of SAS. The RU‐sleeping© is an interesting medical device easy to use, lightweight, compact and economic. It allows SAS screening at home and it permits to determine with the Epworth scale, patients first go into sleep recording.

Results The mean age of patients was 73 years +/‐1,4 years. The positive predictive value (PPV) of abbreviated questionnaire was 54%. And the PPV of Epworth scale was 50% (33% of them had a Epworth score of 8‐14 and 17% had a Epworth score of 15 and above). The apnea/hypopnea index (AHI) was 36,9/h. The mean oxygen saturation was 85,5%. The PPV of RU‐Sleeping for SAS screening was 78%. The SAS prevalence in patients with NTG was 60%, and 66 % of them were severe (AHI>30).

Conclusion Routine screening SAS should be recommended to any patient with normal‐tension glaucoma. So, in case of NGT diagnosis in ophthalmology, a simple interrogation evocative associated with a RU‐sleeping© could determine the patients to take charge of a priority especially in case of shortage of beds recordings. Our preliminary results suggest high prevalences of NTG or SAS, a larger sample in this prospective study will allow to confirm it in the future.
Comparative effectiveness of bimatoprost 0.03% preservative free for the treatment of open‐angle glaucoma and ocular hypertension
Authors: BRERETON N , STRADWICK S , HARVEY B , SHERGILL C , PATEL V , WONG W
Published: November 2013

Purpose To evaluate the comparative effectiveness of bimatoprost 0.03% preservative‐free solution (BimPF) in single dose vials for the treatment of glaucoma/ocular hypertension compared to other preservative‐free (PF) and non‐BAK preserved prostaglandin analog and prostamide (PGA) therapies. Primary outcome of interest was change from baseline in intraocular pressure.

Methods A systematic literature review was conducted to identify relevant randomized controlled trials investigating the IOP lowering efficacy of glaucoma treatments. The initial literature search was done in December 2011, and subsequently updated in April 2013. Trials involving preserved formulations were included to indirectly connect the efficacy evidence of PF and non‐BAK preserved PGA therapies. A Bayesian mixed treatment comparison was used to synthesize the network of evidence. Timolol was used as the reference comparator, as it was the most common comparator in the glaucoma medication trials.

Results The initial literature search resulted in 151 trials to be included in the network. The updated literature search resulted in the addition of 4 additional trials. In total, 84 comparator arms were included in the network. Relative to timolol, BimPF showed a significant difference in IOP lowering efficacy relative to timolol, while all other PF and non‐BAK preserved PGA therapies did not. Additionally, BimPF showed the greatest mean change from baseline in IOP compared to all the PF and non‐BAK preserved PGA therapies, although the differences were non‐significant.

Conclusion BimPF is the only PF or non‐BAK preserved PGA therapy to show a significantly greater IOP lowering efficacy than timolol.
Comparative effectiveness of bimatoprost 0.03% / timolol 0.5% preservative free fixed combination (BTFC PF) for the treatment of open‐angle glaucoma and ocular hypertension
Authors: BRERETON N , STRADWICK S , HARVEY B , SHERGILL S , WONG W
Published: November 2013

Purpose To evaluate the comparative effectiveness of BTFC PF solution in single dose vials for the treatment of glaucoma/ocular hypertension compared to other preservative‐free (PF) fixed combination and PF monotherapies. Primary outcome of interest was change from baseline in intraocular pressure.

Methods A systematic literature review was conducted to identify relevant randomized controlled trials investigating the IOP lowering efficacy of glaucoma treatments. The literature search was performed in December 2012. Trials involving preserved formulations were included to indirectly connect the efficacy evidence of PF treatments. A Bayesian mixed treatment comparison was used to synthesize the network of evidence.

Results The initial literature search resulted in 148 papers meeting the inclusion criteria. Of these 135 could be connected to form the evidence network, which consisted of 23 comparator arms, 6 of which were PF fixed combinations or PF monotherapies. BTFC PF showed an improvement in IOP lowering efficacy relative to all other PF therapies and the greatest mean change from baseline in IOP, although this difference was non‐significant for 3 out of 5 comparisons, likely due to limited evidence for comparator PF therapies. The analysis showed a 93% probability that BTFC PF was the best of the PF treatments based on the full network analysis. All other PF therapies have a <3% chance of being best.

Conclusion The MTC analysis showed numerical superiority of BTFC PF over all other PF treatments within the network of evidence for combination therapies.
Outcome of fornix‐based versus limbal‐based conjuctival flaps in trabeculectomy
Authors: IBANEZ J , PéREZ GARCíA D , ASCASO PUYUELO FJ , PINILLA LOZANO I , JIMENEZ DEL RIO B , CRISTOBAL BESCOS JA
Published: November 2013

Purpose To compare the surgical outcomes and bleb morphology of limbal‐ based group with that of fornix‐based group undergone trabeculectomy with mitomycin C (MMC).

Methods 50 eyes of 50 patients with trabeculectomy with MMC who were observed for 1 year were included in the study. A limbal‐based conjunctival flap was used for 25 eyes of 25 patients and a fornix‐based conjunctival flap for the other 25 eyes of 25 patients. We classified and compared the bleb morphology according to the Moorfield Bleb Grading Sistem after 1 year postoperatively, and evaluated intraocular pressure, success rates.

Results There was no significant difference in the IOP and success rate in two groups. The central bleb vascularity of the limbal‐based group was stadistically lower than that of fornix‐based group (1,69±0,56 : 2,08 ±0,69, p=0,042). The risk of cystic bleb formation was higher in the limbal‐based group (34,2% : 14,6% , p = 0,047).

Conclusion There was no difference between the groups in the IOP and cumulative succes rate, but fornix‐based group was recommendable concerning the low risk of cystic bleb formation.
Treatment of refractory glaucoma using UC3 procedure with HIFU (High Intensity Focused Ultrasound). Prospective series
Authors: ROULAND J , APTEL F
Published: November 2013

Purpose To assess the safety and efficacy of Ultrasound Circular Cyclo‐Coagulation (UC3 procedure) using HIFU (high intensity focused ultrasound) in patients with refractory glaucoma.

Methods Prospective clinical series performed in two centers, on twenty‐seven eyes of twenty‐seven patients with refractory glaucoma, treated with the EyeOP1 medical device equipped with six miniaturized cylindrical piezoelectric transducers. All eyes were treated with a 6‐second exposure time from each transducer. The main assessment criteria were safety and efficacy as indicated by the incidence of complications and by the IOP reduction. Ophthalmic, ultrasound biomicroscopy and flare examinations were performed before treatment and during clinical follow‐up at D1, D7, M1, M2, M3 and M6

Results No major intra‐ or post‐operative complications occurred. Clinical examination showed no lesions of the ocular structures other than the ciliary body and no or few signs of intraocular inflammation after treatment. Visual acuity was not modified after the procedure. The mean intraocular pressure was reduced from 27.5 ± 7.0 mmHg before treatment to 18.3 ± 4.4 mmHg at last follow‐up. Four patients needed to be re‐treated. The success rate, as defined by an IOP reduction >20%, was 67%.The mean IOP reduction achieved was 33%. Ocular inflammation evidenced by flare was very limited and non‐significant.

Conclusion Coagulation of the ciliary body using high intensity focused ultrasound delivered by miniaturized transducers is a simple, well‐tolerated procedure which enables to significantly reduce the intraocular pressure in patients with refractory glaucoma.

Commercial interest
Backwards compatibility of HRT3 and HRT II before and after cataract surgery and intraocular lens implantation
Authors: FALCK A , SAARELA V
Published: November 2013

Purpose To assess the backwards compatibility of HRT3 and HRT II examinations in cataractous eyes before and after surgery.

Methods 43 patients waiting for first eye cataract surgery, 12 men and 31 women aged 75 ± 5 years, took part in the study. Optic nerve head (ONH) topographies were performed before cataract surgery and one month postoperatively using the HRT II software. These examinations were later accessed using the HRT3 software. The calculation of topography, the topography standard deviation (TSD), and the image alignment of the preoperative and the postoperative scans were evaluated. TSD ≤50 was considered acceptable.

Results The recorded data was accessed using the HRT3 software, and in 34 cases the topography could be calculated. The mean TSD of the 34 examinations obtained of the eyes before cataract surgery was 33 ± 18. Considering TSD ≤50 as acceptable, there were 28 reliable scans. Of the data obtained one month after cataract surgery, topographies using HRT3 could be calculated in 39 of 43 examinations. TSD was 21 ± 12 indicating improvement of the quality of the HRT after cataract surgery. The HRT3 software was able to calculate both the preoperative and the postoperative topography in 31 of 43 eyes (72 %); three of the baseline examinations were considered unreliable because of high TSD values, though. The contour line was correctly aligned in all 31, and the image size was unchanged in all cases.

Conclusion Successful topographies using HRT3 software could be calculated in two thirds of the eyes both before and one month after cataract surgery with stable image alignment and image size in all cases. Follow‐up of the ONH topography over cataract surgery was possible in all eyes with reliable examinations.
Comparaison of two anterior segment OCT: CASIA (Tomey) versus OCT Visante (Zeiss)
Authors: GIMBERT A , CAMPOLMI N , THURET G , GAIN P , ROMANET JP , CHIQUET C , APTEL F
Published: November 2013

Purpose To compare the anterior chamber (AC) and AC angle measurements obtained with a spectral‐domain and a time‐domain anterior segment optical coherence tomography (AS‐OCT), and to evaluate their repeatability

Methods Prospective cross‐sectional study conducted on healthy subjects. The AC was imaged with a spectral‐domain (Casia SS‐100, Tomey) and a time‐domain AS‐OCT (Visante, Zeiss) in one eye of each patient in a random order. The central corneal thickness (CCT), anterior chamber depth (ACD), angle opening distance at 500 and 700 µm (AOD 500 and AOD 750), trabecular iris space area at 500 and 700 µm (TISA 500 and TISA 750) and scleral spur angle (SSA) were measured. The repeatability measurements were evaluated by the intraclass correlation coefficients (ICCs)

Results 101 eyes of healthy subjects were analyzed. The repeatability was excellent with the Casia and the Visante for CCT (ICC 0.90‐0.94 and 0.95‐0.97), ACD (ICC 0.95‐0.98 and 0.93‐0.96), AOD 500 (ICC 0.92‐0.96 and 0.90‐0.94) and 750 (ICC 0.93‐0.96 and 0.91‐0.94), TISA 750 (ICC 0.81‐0.97 and 0.9‐0.94) and SSA (ICC 0.9‐0.94 and 0.89‐0.94), and moderate for TISA 500 (ICC 0.68‐0.97 and 0.7‐0.93). For all parameters, Casia and Visante measurements were significantly correlated (r 0.76‐0.98; p<0.002). Differences were non‐significant for CCT, AOD500 and 750, TISA 500 and 750. ACD measured with Casia was significantly larger than that measured with the Visante, and SSA measured with Casia was significantly lower than that measured with Visante

Conclusion Both Casia and Visante AS‐OCTs demonstrate high repeatability. Excepted for the ACD and SSA, the two AS‐OCTs agree well in AC and AC angle measurements
Inter‐test variability in normals and glaucomatous patients tested by Optopol PTS‐910, Glaucoma program
Authors: POPA CHERECHEANU A , DASCALU AM , STANA D , SERBAN D
Published: November 2013

Purpose To quantify the inter‐test variability (dB) for the Optopol automated perimeter, Glaucoma Fast Treshold program, in normals and glaucoma patients.

Methods A prospective study was performed on 204 glaucoma patients and a control group of 30 normal subjects, tested by complete ophthalmological exam and automated perimetry (Optopol PTS‐910). The visual field was tested weekly for 4 consecutive weeks, using the Glaucoma Fast Threshold strategy. The visual field defects were classified according to the Aulhorn‐Karmeyer descriptive scale.

Results For the control group, the average inter‐test variability was of 1.57+/‐ 0.24 dB, lower next to fixation and increasing towards the 50 degree isopter. The average inter‐test variability increases along with the perimetric stage: 1.57+/‐0.66 dB for pre‐perimetric glaucoma, 2.13+1.04 dB for non‐specific defects group, 3.23 + 1.01dB for the stage 1, 3.52 + 2.61dB, for the stage 2, 3.65 + 1.19dB for the stage 3 and 5.82 +/‐ 1.67dB for the stage 4. For the cases of preperimetric glaucoma and non‐specific defects, a similar profile of variability as for the normal subjects could be observed. For the stages 2‐4, the profile of the areas with maxim inter‐test variability moves towards the relative scotoma and the surrounding area.

Conclusion A better description of the inter‐test variability and the evolution of this intricate parameter of the retinal light sensitivity is useful for the differential diagnostic between the real change and the « background noise » in early detection of the functional progression in glaucoma.
Progression of visual field in patients with primary open‐angle glaucoma (2): Level of progression
Authors: GIRAUD JM , EL CHEHAB H , APTEL F , ARYAL‐CHARLES N , MAY F , CHIQUET C , ROMANET JP , RENARD JP
Published: November 2013

Purpose To compare the visual field rate (VF) of progression of non evolutive and evolutive patients with treated ocular hypertension (OHT) or primary‐open angle glaucoma (POAG).

Methods From a multicentric database, 441 eyes of 228 patients with treated OHT or POAG followed up at least 6 years with Humphrey 24.2 Sita‐Standard VF exam at least twice a year were identified and classified in 5 groups: 104 OHT, 205 early glaucoma (MD>‐6dB), 45 moderate glaucoma (MD‐6 to ‐12dB), 41 advanced glaucoma (MD‐12 to ‐18dB) and 46 severe glaucoma (MD<‐18dB). With final datas, patients were classified in 2 sub groups: “evolutive” or “stable” patients if worsening or not to upper grade. Rate of progression during follow‐up period was calculated using the trend analysis of the Guided Progression Analysis software.

Results The mean follow‐up was 8.4 years. We found respectively for “stable” and “evolutive” sub‐groups, following rates of progression : MD =‐0.01 and ‐0.13dB/year (‐0.03& ‐0.41%VFI/year) in eyes with OHT, ‐0.07& ‐0.80dB/year (‐0.23 & ‐2.39%VFI/year) in early glaucoma group, ‐0.02& ‐0,91 dB/year (‐0.46 & ‐3.04%VFI/year) in moderate glaucoma, ‐0.21 & ‐0.82dB/year (‐1.13 & ‐3.57%VFI/year) in advanced glaucoma.

Conclusion In early to advanced stages of glaucoma, “stable” patients showed a low rate of progression, compared to “evolutive” subgroup with a common rate around ‐0.80dB/year. These values could represent a landmark of evolution in glaucoma.
Primary health care model for detection of ophtalmological visual disturbances in a population of employees of Universidad de Tarapaca, Chile
Authors: CHAVEZ C , VETTERLEIN V , RAMIREZ JM , DE HOZ R
Published: November 2013

Purpose Implement a primary health care model for the Universidad de Tarapacá personnel in Arica, Chile, which is a desert region.

Methods The model was applied at 510 employees and consisted of applying a survey and eye exams such as: Visual acuity for near and far, autorefractometria, biomicroscopy, IOP. In the analysis measures of central tendency, proportions, means and standard deviation were used. The ratio differences were analyzed in in bivariate statistic chi2 and T Student.

Results The average age was 48 years old, 57% female and 43% male. The 27% have Aymara ancestry and of these, 13% have ocular disorders. The 18% have systemic diseases and 73% have just one family member with an ocular disease. One of every 4 states to have a diagnosed eye disease. The 50% of the total has 100% of AV without optical devices. The 34% use optical lenses that do not alter their visual acuity. Of those over 40 years old, 3% has IOP above 24 mm Hg, 7% over 21 and 90% less than 21. The 16% has Pterigion symptomatic and 5% are bilateral. The 61% of the total study population reports to feel the need to be assisted an eye professional.

Conclusion It is important to take measures for public health action and modify the regional and national public policies of our country through implementation models resolutive primary eye care for improving the access to healthcare systems. This makes better use of the specialized medical resources.
Clinical findings in a Roma family with autosomal dominant cone‐rod dystrophy
Authors: KOEV K , CHERNINKOVA S , KAMENAROVA K , GEORGIEV R , KANEVA R
Published: November 2013

Purpose To make a clinical assessment of patients affected by autosomal dominant cone‐rod dystrophy (adCORD).

Methods A three‐generation autosomal dominant pedigree of Romani origin with non syndromic CORD was identified. Eight affected and 14 unaffected individuals were clinically ascertained. All affected relatives were studied. Clinical evaluation included best corrected visual acuity determination, funduscopy, Humphrey perimetry, Farnsworth Hue‐28 color testing, fluorescein angiography, and full‐field electroretinogram (ERG).

Results All affected individuals presented reduced visual acuity (0.01 ‐ 0.4) and photophobia with slightly variable but early age of onset (around 13 years of age). Funduscopic examination and fluorescein angiography revealed advanced changes including bone spicule‐like pigment deposits in the midperiphery and macular area along with retinal atrophy, narrowing of the vessels, and waxy optic discs. Visual fields demonstrated central scotoma. Electrophysiologic examination of the patients detected an abnormal cone‐rod ERG (20‐30μV) with photopic amplitudes more markedly reduced than the scotopic. Flicker responses were missing and Farnsworth Hue‐28 test found protanopia.

Conclusion In this study we report a family of Gypsy origin affected by autosomal dominant cone‐rod dystrophy. Identification of the disease causing gene may eventually contribute to new knowledge on the pathogenesis of this condition.
Retigabine‐induced retinal dystrophy: First reported case
Authors: ASCASO FJ , MAURI JA , MATEO J , CAMACHO JL , DEL BUEY MA , IBAñEZ J , PéREZ D , CRISTóBAL JA
Published: November 2013

Purpose A recent FDA warning reported that retigabine (ezogabine in the US), a third‐generation antiepileptic drug introduced in 2011 for the management of refractory epilepsy, can cause blue skin discoloration and retinal pigmentary changes.Our purpose is to present the first documented case of retinal dystrophy secondary to this drug.

Methods This case report shows the characteristics of the so‐called "blue person syndrome", such as blue pigmentation around lips, fingernails and toenails. Likewise, the patient developed a bilateral and asymptomatic retinal distrophy confirmed by color and red‐free fundus photographs.

Results A 53‐year‐old woman noted blue pigmentation around lips, fingernails and toenails for 6 months. She suffered from refractory epilepsy and underwent 1200 mg daily of retigabine (Trobalt®) for 6 years.BCVA was 20/20 bilaterally. Slit‐lamp examination showed no conjunctival discoloration. IOP, ocular motility, pupillary reactions and color vision test were normal. Ophthalmoscopy revealed bilateral retinal pigmentary changes running outward from the optic disk, with an appearance similar to that seen in angioid streaks. Several grey, fine subretinal branching bands radiated out from an area of peripapillary pigment alteration. Red‐free fundus photographs showed, along the temporal vascular arcades, a thinned and depigmented retina, allowing visualization of underlying choroidal vessels. Visual field testing, fluoresceingraphy, autofluorescence and SD‐OCT were unremarkable.

Conclusion Ophthalmologists and neurologists should be aware of the possibility of ophthalmological toxic effects in patients taking retigabine. When such effects are detected, the drug should be discontinued.