bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality assurance in episcleral brachytherapy
Authors: DE FRUTOS‐BARAJA JM , SAORNIL MA , GARCIA‐ALVAREZ C , RUIZ‐BUENO A , CEBALLOS‐GARCIA A , MUINOS Y , LOPEZ‐LARA F
Published: October 2007

Purpose: The treatment of choroidal melanoma and other ocular tumors can be approached by means of epiescleral brachytherapy. The process involves several specialiced professionals, different methods to obtain measurements (radioactive sources, tumor) and a complex process to apply every treatment. A program of quality assurance would minimize the possibility of inaccuracy and would optimize the information flow. The purpose of this work is to establish a flow chart that guarantees the information efficiency and a protocol for episcleral brachytherapy.

Methods: The flow chart of the process is elaborated, explaining each of the points of information, delimiting responsibilities and fixing period of performance identifying the most important steps for coordination

Results: The scheme of the process flow chart is:

Diagnosis; treatment Indication; epiescleral brachytherapy Protocol; ultrasound, funduscopy; CT, MR; Record and analysis of information; treatment volume definition; treatment planning and optimization; Quality assurance of sources and applicators; Preparation of the set applicator – sources; Plaque placement; Patient and radiation surveillance; Plaque recovery; Follow‐up.

Conclusions: The example gathered in the present work shows the importance of the establishment of programs of quality assurance in treatments as episcleral brachytherapy or any other radiation treatment.

Acknowledgments:

This work has been financed partly by a grant of the Junta de Castilla y León (Order SAN/1322/2006 of August 22, BOCYL of August 29, 2006)
Full field ERG values before and after anti‐VEFG treatment in AMD affected subjects
Authors: VARANO L , CAMPAGNA F , RUSSO C , SCORCIA V , SCORCIA GB , BRUZZICHESSI D , PARISE S , CARNOVALE SCALZO G , SCORCIA G
Published: October 2007

Purpose: To compare ERG b‐wave amplitude differences before and after treatment with sodium pegaptanib intra‐vitreal injection.

Methods: 14 patients all affected by exudative AMD were submitted to scotopic, combined and fotopic full field ERG, to estimate photoreceptorial electric activity through b‐wave amplitude. All patients have then been treated with 1 to 4 intravitreal injections of 0,3 ml sodium pegaptanib. Time between each injection was 2‐4 weeks. After one and two months than first injection all patients were again submitted to full field ERG. Data were related with ERGs obtained before first injection.

Results: In 6 patients we found a b‐wave amplitude increase of about 20% two months after first injection. Remaining 8 patients showed no valuable differences in ERG amplitude before and after treatment.

Conclusions: In a valuable number of subjects, sodium pegaptanib intravitreal injection, seem to emprove photoreceptorial electric activity. Other studies are needed to confirm this hypothesis.
Corneal hysteresis in patients with corneal pathologies
Authors: HERDENER S , PFEIFER N , LAUTEBACH S , PACHE M
Published: October 2007

Purpose: To investigate the corneal hysteresis (CH), the corneal resistance factor (CRF) and the corneal compensated intraocular pressure (IOPcc) of subjects with normal corneas and with corneal pathologies with the Ocular Response Analyzer (ORA).

Methods: IOP was measured using Goldmann applanation tonometry (GAT), dynamic contour tonometry (DCT) and ORA in 102 subjects with normal corneas and in patients with keratoconus (KC, n=32), Fuchs endothelial corneal dystrophy (FD, n=34) and penetrating keratoplasty (KP, n=50). Additionally central corneal thickness (CCT) and CH were quantified.

Results: CH and CRF were significantly reduced in all groups with corneal pathologies in comparison to the normal group (CH: 7.7 (KC), 8.9 (KP), 7.3 (FD) versus 10.3 (N), CRF: 6.4 (KC), 9.3 (KP), 8.2 (FD) versus 10.8 (N) mmHg). High significant differences were also observed in mean IOP between the control group and the groups with corneal pathologies. There was a significant correlation between CH and CCT for normal corneas and corneas with KC and KP.

Conclusions: CH and CRF are significantly decreased in patients with KC, FD and KP compared to subjects with normal corneas. Patients with corneal pathologies showed a substantial variability of mean IOP‐values evaluated by using different methods of IOP‐measurement in comparison to subjects with normal corneas suggesting that corneal properties strongly influence the validity of IOP‐measurements.
In vitro comparison of the oxidative and proapoptotic effects of preserved latanoprost, travoprost, bimatoprost and preservative‐free tafluprost on conjunctival epithelial cells
Authors: BRASNU E , BRIGNOLE‐BAUDOUIN F , RIANCHO L , GUENOUN JM , WARNET JM , BAUDOUIN C
Published: October 2007

Purpose: Prostanoid F2α (PF2α) analogues are used for the treatment of glaucoma and ocular hypertension. This study compared the toxicity profiles of three commercially available preserved PF2α analogues—latanoprost, travoprost and bimatoprost—with tafluprost, a new preservative‐free fluorinated PF2α analogue.

Methods: Cells from an immortalised epithelial cell line from normal human conjunctiva

(IOBA‐NHC) were exposed (30 mins) to solutions of latanoprost, travoprost, bimatoprost (benzalkonium chloride [BAC] concentrations of 0.02%, 0.015%, 0.005%, respectively), PgF2α (0.0001M) and tafluprost. Membrane integrity/cellular viability, pro‐apoptotic effects and oxidative stress were assessed. Standard immunofluorescence was used to study morphologic patterns of cells under the same conditions.

Results: Of the agents studied, preservative‐free tafluprost resulted in significantly (P<0.001) higher membrane integrity (91.5 vs 37.4=latanoprost; 54.2=travoprost; 64.7=bimatoprost), lower oxidative stress (129.5 vs 359.7=latanoprost; 226.3=travoprost; 183.0=bimatoprost) and lower proapoptotic effects (117.6 vs 412.3=latanoprost; 355.1=travoprost; 148.1=bimatoprost). Immunofluorescence showed that cell shrinkage increased in a BAC‐concentration dependant manner, with the least shrinkage observed with BAC preservative‐free tafluprost. The increase in harmful effects with ascending BAC concentrations of preserved PF2α analogues was observed for all parameters measured.

Conclusions: These results suggest that tafluprost, a new preservative‐free PF2α analogue, has low proapoptotic, pronecrotic and prooxidative effects in vitro.
A model of paediatric eye screening program for educators
Authors: STOJANOVIC N , KOZEIS N , GOGAKI EG
Published: October 2007

Purpose: Presentation of a paediatric eye screening program which is based on the educators’ performance

Methods: 4400 children(n1=2200 3‐3 ½ y.o., n2=2200 4‐6 y.o.),10 ophthalmologists and 20 teachers participated in this study.Children were tested for visual acuity(Va),using the NK test and manifest horizontal strabismus,using the Hirschberg test.Criteria for further evaluation:n1: Va<0.55 and/or manifest strabismus& in n2:Va<0.75and/or manifest strabismus

Results: In n1=2200, doctors found:105 children(4.77%) appeared with Va<0.55, 1938 children(88.1%)with Va=0.55 and 157 children(7.13%)with Va>0.55. In n1 teachers found:191 children(8.68%) appeared with Va<0.55,1799 children(81.78%)with Va=0.55 and 210 children(9.54%)with Va >0.55. In (n1) doctors found:2111children(95.95%)were orthophoric,62 children(2.81%)were esotropic and 27 children(1,23%) were exotropic. Teachers found:2051 children(93.22%)were orthophoric, 106 children(4.81%) were esotropic and 43 children(1.97%)were exotropic.In n2=2200,doctors found:164 children(7.45%) appeared with Va<0.75,1695 children(77.05 %)with Va=0.75 and 341 children(15.5%)with Va>0.75. In n2, teachers found:160 children(7.27%)with Va<0.75,1639 children(74.50 %)with Va=0.75 and 401 children(18.22 %)with Va>0.75. In the same sample(n2), doctors found:2121 children(96.40%)were orthophoric, 62children(2.81%)were esotropic and 17 children(0.79%)were exotorpic.Teachers found:2041 children(92.77%)were orthophoric,64 children(2.90%)were esotropic and 95 children(4.32 %)were exotropic

Conclusions: In a screening eye program false positive referrals are more welcome than false negative,especially in a very cost effective program as this one is. We recommend this model in countries where no paramedics as screeners exist
ATD perimetry in glaucoma and ocular hypertensive patients. A preliminar study
Authors: MORILLA A , ANTON A , JIMENEZ B , RODRIGUEZ C , MARTINEZ V , FALLON M , CAPILLA P , LUQUE MJ , FELIPE A , ARTIGAS JM
Published: October 2007

Purpose: The new ATD perimetry assesses contrast sentivity thresholds for the three afferent sensory pathways of the visual system. Our aim is to compare contrast sensitivity to stimuli with different spatio‐temporal frequencies in glaucomatous (G) and ocular hypertensive (OHT) subjects.

Methods: Twenty three G and OHT subjects were selected from the ophthalmic clinic, all subjects signed an informed consent. Inclusion criteria were diagnosis of G or OHT, normal Farnsworth‐Munsell color test, ametropia less than 6 D, visual acuity over 20/30, absence of previous ocular surgery and experience in perimetry. Twenty locations and the fovea were evaluated in a 60º x 40º fovea‐centered field. Eight gabor stimuli were used: 0.5cpd‐12Hz, 0.5cpd‐24Hz, 4cpd‐2Hz and 4cpd 12Hz, modulated along the achromatic (A) direction, 0.5cpd‐12Hz and 4cpd‐2Hz along the red/green (T) and blue/yellow (D) directions. Statistical analysis included ANOVA and Schéffé tests.

Results: Mean thresholds for G and OHT were respectively, 0.4872 ± 0.5323 and 0.1077 ± 0.1922, for A 0.5cpd‐12Hz; 0.7296 ± 0.5925 and 0.2280 ± 0.2246 for stimulus A 0.5cpd‐24Hz; 1.4444 ± 0.5244 and 1,2671 ± 0.6138 for A 4cpd‐2Hz; and 0.7751 ± 0.1937 and 0.6851 ± 0.2379 for D 0.5cpd‐12Hz. Significant statistical differences (p<0.05) were found between G and OHT groups only with these stimuli.

Conclusions: These preliminary results show that certain stimuli may differentiate between G and OHT subjects. A larger population sample, including glaucoma suspects, is currently under study.
Intravitreal Triamcinolone Acetonide to control the diabetic macular edema
Authors: SANCHEZ CHICHARRO DI , LOPEZ GALVEZ MI
Published: October 2007

Purpose: To asses the efficacy of intravitreal Triamcinolone Acetonide (TA) in diffuse diabetic macular edema (DME) refractory to laser coagulation

Methods: Descriptive, retrospective, non randomized study without control group done on 35 eyes of 27 patients with DME and negative dexamethasone test, treated with 4mg intravitreal TA between January‐2006 and March‐2007. Variation in Visual Acuity (VA)(Snellen Chart) was considered as main outcome, and angiographic (AFG) edema was consider as secondary outcome. The statistic analysis was performed by contingency tables, Chi‐square test and Fisher exact test

Results: The median basal VA was 0.16, observing an improvement of two or more lines in 31.4% at first month post op and 34.3% at the end of follow up(7 months). Although the edema was resolved in 42.9% at the first month by AFG, it persisted in 77.1% by the end of the study. A mayor effect was observed in patients treated with insulin+oral hypoglucemiants+diet(p:0.021), cystic CSME(p:0.018), or previous grill laser(p:0.055).A statistically significant relation was observed between VA and the absent of edema in the AFG. Three eyes developed ocular hypertension during the first 24 hours and 4 eyes at first month, all them controlled by topical treatment. No endophthalmitis was observed

Conclusions: Results were similar to bibliography. A strong relation was observed between VA and AFG during entire follow up. Systemic treatment with diet‐insulin‐oral hypoglucemiants seemed to induce a better respond to the intravitreal TA in the control of DME
Retinal layer thickness changes in eyes with diffuse diabetic macular edema
Authors: SOMFAI GM , TATRAI E , FERENCZ M , PULIAFITO CA , CABRERA FD
Published: October 2007

Purpose: The leading cause of visual impairment among patients with diabetes is diabetic macular edema, which has several patterns. In our study we aimed to assess which retinal layers show thickness changes in diffuse diabetic macular edema (dDME).

Methods: 11 eyes with background retinopathy and dDME on optical coherence tomography (OCT) examination and 8 control healthy eyes were enrolled in our study with 1.0 best corrected visual acuity (mean age 54 [37‐67] years and 53 [36‐67] years, respectively). Standard macular mapping was performed in all eyes using a Stratus OCT™ device. All OCT images were segmented using an algorithm of our own design, average thickness data were obtained for the following cellular layers: retinal nerve fiber layer (RNFL), ganglion cell layer and internal plexiform layer complex (GCL+IPL), inner nuclear layer (INL), outer plexiform layer (OPL) and outer nuclear layer (ONL).

Results: Average layer thickness significantly increased in all layers in the dDME group except for the RNFL. (RNFL: 41.93±2.05 vs. 42.91±2.84 [p=0.62], GCL+IPL: 71.99±1.04 vs. 75.80±3.42 [p=0.006], INL: 34.34±1.90 vs. 37.55±1.39 [p=0.003], OPL: 34.47±2.25 vs. 37.40±2.01 [p=0.013], ONL: 83.48±4.34 vs. 94.67±11.65 [0.025], results are mean μm±SD).

Conclusions: Our results show that all cellular layers of the retina except for the RNFL are thicker in eyes with diffuse diabetic macular edema. It remains an open question how various cellular layers of the retina are involved in retinal thickening in the case of diffuse diabetic macular edema.
Ophthalmoscopic estimation of cup‐to‐disc ratio and its relation to the evening intraocular pressure in normal individuals
Authors: CHATZIBALIS T , KARAMPATAKIS V , GKIKA M , BENOS A
Published: October 2007

Purpose: To record and relate the cap‐to‐disc ratio (C/D ratio), as assessed by ophthalmoscopy and the evening intraocular pressure (IOP) of normal individuals of various age groups.

Methods: 467 normal individuals, randomly selected, were examined by the same experienced ophthalmologist. The C/D ratio was assessed by ophthalmoscopy and the IOP was measured in the evening by Applanation Tonometry. The individuals were divided into three age groups (Group A: 120 individuals 20‐40 years old, Group B: 233 individuals 41‐60 years old, Group C: 114 individuals 61‐80 years old).

Results: Group A: C/D ratio ranged from 0 to 0.9 (mean±SD 0.496±0.221) and IOP ranged from 8 to 22 mmHg (mean±SD 13.35±2.650 mmHg). Group B: C/D ratio ranged from 0 to 0.85 (mean±SD 0.452±0.212) and IOP ranged from 8 to 22 mmHg (mean ± SD 14.079 ± 2.781 mmHg). Group C: C/D ratio ranged from 0 to 0.85 (mean±SD 0.499±0.221) and IOP ranged from 10 to 20 mmHg (mean±SD 14.133±2.419 mmHg). The relation (r) between IOP and C/D ratio was as follows: Group A: r = 0.268 (p<0.001), Group B: r = 0.063 (p<0.001), Group C: r = 0.109 (p<0.001).

Conclusions: The C/D ratio values were, in general, larger in individuals with higher IOP values. However, this relation was weak though statistically significant. In Group B the relation was of lower statistical significance than in the Group A and in the Group C. This weak relation is possibly indicative that other factors except for IOP contribute to the final C/D ratio of normal individuals. There are individuals with high C/D ratios and relatively low IOP values and vice versa. The examiner is responsible for identifying cases which should undergo further investigation.
Ocular motility disorders in a Fabry patient
Authors: LANZL IM , MAIER M , ZIMMERMANN P , HAEFELE V , FIORE B
Published: October 2007

Purpose: M. Fabry is a rare lysosomal storage disease affecting among other organs the vascular endothelium.

Methods: We present a 38 years old male Fabry patient with a prior history of 6 different episodes of stroke. We examined him 3 months after his last stroke in our department for newly developing ocular motility disorders.

Results: Slit lamp exam revealed bilateral cornea verticillata, conjunctival vessel anomalies and tortuous retinal vessels. Bilateral blepharospasm pronounced on the right side was present. Bilateral rotatory nystagm was also noted. MRI showed diffuse white matter lesions. For the blepharospasm botolinum therapy was instituted.

Conclusions: Most likely Fabry disease causes cerebral ischemia in an atypical pattern, in our patient affecting among others different nuclei responsible for ocular motility.
Intravitreous bevacizumab to treat subfoveal choroidal neovascularization in highly myopic eyes
Authors: RUIZ MORENO JM , MONTERO‐MORENO JA , AMAT‐PERAL P , LUGO F , STAICU C , DE LA VEGA C
Published: October 2007

Purpose: To describe the anatomical and visual outcome of subfoveal and juxtafoveal choroidal neovascularization (CNV) in highly myopic (HM) eyes treated with intravitreal bevacizumab

Methods: Prospective, non randomized, multicentric, interventional case series. 17 highly myopic eyes from 16 patients with subfoveal or juxtafoveal choroidal neovascularization were treated by three monthly intravitreal injections with 1.25 mg bevacizumab. Patients were evaluated for best corrected visual acuity (BCVA) and optical coherence tomography (OCT) at baseline, and monthly before the injections were performed. Fluorescein angiography (FA) was performed at baseline and at month 3

Results: Patients averaged 48.1 years‐of‐age (SD 15.3; range 29 to 72). Five patients were males and 11 were females. All eyes were followed for six months or longer. BCVA at baseline averaged 20/67 (range 20/160 to 20/32) (61.0 letters, SD 10, range 40 to 75) and 20/48 (range 20/125 to 20/20) (69.6 letters, SD 12.6, range 45 to 85) at the end of follow‐up (p=0.003 and p=0.002 respectively). Average central foveal thickness was (CFT) 253.5 microns (SD 40.1, range 205 to 340) at baseline and 202.1 microns (SD 31.7; range 154 to 251) at the end (p=0.001). Leakage from CNV ceased in all eyes at month three. No ocular or systemic safety issues appeared during follow‐up

Conclusions: Intravitreal bevacizumab seems to be an effective and safe therapeutical procedure to treat subfoveal or juxtafoveal CNV in HM eyes. Further studies are required to verify the efficacy and usefulness of this therapy compared with established treatments for CNV in HM eyes
Epidemiology and follow‐up of pigmentary glaucoma in Calabria
Authors: MATTACE A , MANGIALAVORI D , SCANDALE M , PESCE G , CARNOVALE SCALZO G , SETTINO G , SCORCIA V , SCORCIA GB , RECHICHI M , SCORCIA G
Published: October 2007

Purpose: To evaluate the incidence of pigmentary glaucoma (POAG) in Calabria.

Methods: Subjects were patients newly diagnosed with pigmentary glaucoma during 2006 who came to our Centre of Glaucoma. We performed a full ofthalmological examination: Best Corrected Visual Acuity, slit lamp biomicroscopy, pachimetry, gonioscopy, measurement of intraocular pressure (IOP) with applanation tonometry,tonometric IOP curve, fundus oculi, Heidelberg Retina Tomograph, Heidelberg Retina Flowmeter, Nerve fiber analyzer, visual field, Optical Coherence Tomography, Ocular Blood Flow System, monitorated ambulatory pressure, sovraortic vessels doppler and transcranic doppler. Criteria for POAG were: pigment dispersion (mild, intermediate, severe), IOP greater than 21 mmHg, optic nerve damage and visual field loss.

Results: A total of 87/150 (58%) patients presenting open angle glaucoma have been examined at the “Glaucoma Clinic Center” during the study (three times for year). 41/87 ( 47.12%) of them had POAG (with open angle grade 2‐4), 22 females and 19 males (mean age 48+/‐12 years old, M+F). The male‐female ratio was 1:1,1.

Conclusions: The incidence of POAG in Calabria was 1:500 (0,2%).

Owing the high frequency of POAG in Calabrian glaucoma patients we believe that performing at least a one time year follow‐up in these patients is helpful in preventing ocular complications.
Is AZOOR an autoimmune disease?
Authors: SEIDOVA SF , WIESCHER A , FIORE B , LANZL IM , MAIER M , ZIMMERMANN P
Published: October 2007

Purpose: Acute zonal occult outer retinopathy (AZOOR) is one of the "white dot syndromes" a clinically heterogeneous group of inflammatory chorioretinopathies. The etiology is not yet clear.

Methods: We present a 50 years female patient with a prior history of migraine. She experienced progressive visual loss and visual field defects in the last 3 years. Preceding each episode she experienced blue flickering photopsias.

Results: Visual acuity was 0,3 in the right eye and 0,6 in the left eye. Biomicroscopy showed a normal anterior segment, fundus exam revealed pigment epithelial atrophy more pronounced in the worse eye. Electrophysiology showed a marked reduction in the photopic ERG in the more affected eye. MRI demonstrated multiple white matter lesions including a corpus callosum location. Lumbar puncture showed oligoclonal bands. Further tests demonstrated hearing impairment.

Therapy was instituted during the three years course of the disease with steroids, immune suppressants and plasmapheresis with visual loss being progressive. New photopsia is currently present.

Conclusions: The etiology of AZOOR remains unclear. With our patient being one of the few described in the literature with concomitant multiple sclerosis, the question remains on whether there is an underlying common process of inflammatory autoimmune reactions. Whether treatment is possible, remains to be evaluated.
Effect of Mitomycin‐C on the conjunctival goblet cell density after lasik
Authors: RODRIGUEZ AE , RODRIGUEZ‐PRATS JL , MEZQUIDA G , ALIO JL
Published: October 2007

Purpose: To study the effect of mitomycin‐C (MMC) on the conjunctival epithelium after LASIK ablation.

Methods: This preliminary study comprised 18 patients scheduled for LASIK to correct myopia. The patients were divided into 2 groups of 9 patients each. In Group 1, the flap was performed with a mechanical microkeratome (M2, Moria), wereas in Group 2 a femtosecond laser (IntraLase) was used. For each patient topical MMC 0.02% was applied on the right eye with a Merocell sponge for 60 seconds, over the bulbar superior conjunctiva covering an area of 64 mm2 before the surgery. Conjunctival goblet cell density was studied by impression cytology pre‐operatively, and at one, two and three months after surgery.

Results: Analysis by impression cytology of the ocular surface showed that preoperative goblet cell density was not significantly different between the eyes with and without MMC (G1: P=0.81 and G2: P=0.50).1 month after LASIK surgery there was a significant decrease in the goblet cell density in both groups (G1: P<0.008 and G2: P<0.022). However, there were no statistically significant differences in the goblet cell density between the right and left eye, at any time after the surgery, in any of the two groups (G1: P>0.62 and G2: P>0.08).

Conclusions: Topical MMC 0.02% for 60 seconds over the bulbar conjunctiva before the LASIK surgery does not seem to affect the conjunctival goblet cell density in this preliminary study.
Morphological and functional analyses of diabetic macular edema in diurnal fluctuation by optical coherence tomography and fundus related microperimetry in patients with type 1 diabetes
Authors: CARNOVALE SCALZO G , RECHICHI M , SCORCIA GB , AHMETAJ M , LEONE A , PAOLA A , BRUZZICHESSI D , SCORCIA V , ALOI M , SCORCIA G
Published: October 2007

Purpose: To determine the significant correlations between retinal sensitivity measured by fundus‐related microperimetry and the visual acuity and the foveal thickness measured by optical coherence tomography (OCT) in eyes with Diabetic Macular Edema (DME) during diurnal variations of blood glucose levels.

Methods: 30 eyes with macular edema of 40 consecutive patients with type1 diabete and 20 eyes of 20 normal subjects were included in our study. Best corrected visual acuity (ETDRS charts), macular thickness, macular sensitivity, and blood glucose concentration were quantified in all patients twice a day (10 am, 5 pm). Optical coherence tomography (Stratus OCT, Zeiss) was used to quantify macular thickness; macular sensitivity and retinal fixation were evaluated with fundus related microperimeter (MP1,Nidek).

Results: The mean sensitivities in examinated area were significantly lower in patients with DME than in normal subjects (P<0.0001). The mean retinal sensitivities were inversely correlated with visual acuity and foveal thickness, in according with glucose plasmatic level. ).

Conclusions: The mean retinal sensitivities measured with fundus‐related microperimetry were significantly lower in eyes with DME than in normal eyes. A significant correlation between the microperimeter‐determined retinal sensitivity and visual acuity and foveal thickness was observed in the course of the day compared to blood glucose level. MP1 and OCT could be useful techniques in morphological and functional macular analyses of DME.
Metabolic stress as a contributor to physiological opening of TRP channels in blowfly (Calliphora vicina)
Authors: PEROVSEK D , ZUPANCIC G
Published: October 2007

Purpose: TRP channels in blowflies can be reversibly activated by metabolic stress. Activation can be caused by hypoxia or mitochondrial uncoupling and results in membrane depolarization. The changes where traced as changes in extracellular ionic composition, photoreceptor membrane currents and changes in membrane potential. Idea of specific signaling pathway opening TRP channels was rejected with findings that impairment of PIP2 under lack of ATP, results in activation of TRP channels. Even though the mechanism of metabolic stress TRP channel activation is elucidated, it remained unanswered what rate of metabolic stress is needed to open the channels and whether under physiological conditions photoreceptor cells encounter the rate of metabolic stress that can significantly contribute to opening of TRP channels.

Methods: Extracellular concentrations of [K+]o, [Na+]o and [Ca2+]o were measured using the ion‐selective microelectrodes. The redox states of respiratory pigments (flavoproteins and cytochromes) in the eyes of blowflies (Calliphora vicina) were measured with time‐resolved absorption spectroscopy and use of principal components analysis. Anoxia was reached in under 2s time.

Results: Changes in [K+]o, [Na+]o and [Ca2+]o appeared with latency of 8.06 ± 1.38 s, 10.38 ± 2.48 s and 13.11 ± 3.09 s, respectively (mean ± s.e.m., n=7). First detectable changes in redox state of cytochrome c respiratory pigment started at 1.79 ± 0.19 s and reached 39.4% ± 5.4 % of the maximal reduction by the time changes in ionic composition were detectable.

Conclusions: Our conclusion was that high degree of maximal redox state change is needed (39.4%) to open TRP channels, what is unlikely to happen under physiological conditions.
Local tolerability of Timolol 0,5% / Travoprost 0,004% (Duotrav ®) fixed combination in patients with open‐angle glaucoma
Authors: PESCE G , RECHICHI M , CATALANO C , SCORCIA V , CARNOVALE SCALZO G , SCORCIA G
Published: October 2007

Purpose: To evaluate short‐middle time tolerability (8 months follow‐ up) of timolol 0,5%/ travoprost0,004% (Duotrav ®) fixed combinantion in patients with open‐angle glaucoma.

Methods: Prospective, open trial in which 50 patients was involved with a 8 months follow‐up. Inclusion criteria was primarily failure of beta‐blockers or prostaglandins in monotherapy and need for better IOP control and compliance . Exclusion criteria was patients with clinical contraindications to beta‐blockers and history of allergy to prostaglandins.

Follow‐up parameters was: corneal erosions, conjunctival flogosis, ocular symptomatology, intraocular pressure, break‐up time , visual acuity.

Primary objectives of the study was analysis of side effects and IOP shift . Secondary objective was patient compliance evaluated by questionnaire.

Results: Patients compliance was improved despite to lower rate of side effects.No clinically relevant ocular signs or symptoms regarding lids, conjunctiva and anterior chamber were observed after the drug switch. DUOTRAV® produced a mean IOP reduction of 2.5 mm/Hg (range 1.8 to 3.3) (p< 0.001) .

Visual acuity analysis showed no loss of letters at the end of follow‐up and slit lamp examination showed a break‐up time of 9.2 sec for monotherapy and 10 sec for fixed combination group (p >0.01).

Conclusions: Results show that in daily‐dosing DUOTRAV seems to be more effective respect to single‐drug treatment in reason of better tolerability®, IOP control , compliance and clinic management.
Effects of sodium pegaptanib intravitreal therapy in subjects affected by wet age‐related macular degeneration not‐responsive to photodynamic therapy: angiographic, OCT and microperimetric data
Authors: PARISE S , RANDAZZO G , VARANO L , CARNOVALE SCALZO G , RECHICHI M , PAOLA A , SCORCIA V , SCORCIA GB , BRUZZICHESSI D , SCORCIA G
Published: October 2007

Purpose: to evaluate the effects of antiangiogenic treatment with sodium pegaptanib intravitreal injections in subjects with wet age related macular degeneration (AMD) already treated with verteporfin photodynamic therapy (PDT) and reactivation of choroideal neovascularization (CNV)

Methods: 6 eyes with CNV due to AMD previously treated with PDT that showed new vessels and leakage at FA, were treated with an anti‐VEGF, pegaptanib sodium. We performed 3 intravitreal injections (each 0.3 mg of drug) at distance of 6 weeks, a biweekly analisys by fundus‐related microperimeter and OCT, and a monthly examination by FA

Results: we observed in all patients a reduction of membrane size and leakage at FA, a reduction of membrane thickness at OCT and an increase of retinal sensitivity at microperimetric analisys. The treatment for CNV due to AMD with PDT is directed to the neovascularizations that proliferate and leak blood and fluid. The mean number of treatments to obtain a therapeutic success with this therapy is 5,4 in two years. However sometimes it is not efficacious. The anti‐angiogenic agents target key mediators of the angiogenic cascade that leads to the development of neovascularization. This different mechanism of action can be useful in those patients not‐responsive to PDT

Conclusions: the effects of anti‐angiogenic treatment with pegaptanib sodium intravitreal injections in subjects with wet AMD already treated with verteporfin PDT and reactivation of CNV are reduction of size,leakage and thickness of membrane and also an increase of retinal sensitivity
Pain in the different stages of cataract surgery by phacoemulsification technique in topical anaestesia
Authors: KALMAN R , GOMBOS K , NAGY ZZS
Published: October 2007

Purpose: The aim of this survey was the determination of the painful stages of the cataract surgery performed by topical anaesthetic.Does the supplementary anaesthetic decrease the pain,and what can be the reason?

Methods: 69 patients waiting for cataract surgery were involved in our prospective study.Our patients recieved 0,25 mg alprazolam premedication,15 minutes before the surgery 3,and right before the operation 1 drop of oxybuprocaine was used as topical anaesthetic.

Results: There were no significant difference in ultrasound time and energy,and duration of the operation among the patients who had intraoperative pain or who didn’t have.14 patients reported pain: 6 during the outwash,7 during the phacoemulsifcation.All patients recieved one more drop immediatley after any pain occured.The anaesthetic drop elliminated the pain in a few seconds.

Conclusions: The reason of the signalled pain durnig the outwash can be that the anaesthetic drop didn’have effect in the upper fornix.The cause of the pain during phaco can be the fluctuation of the depth of the anterior chamber and the manipulation of the wound.The drop can’t penetrate to the anterior chamber as quick as the patients’pain relieved,so we believe that the reported is not caused by the change of the chamber depth.It is possible that during those operation which were not lead in verbal communication properly, patients will signal pain because the appearance of unfamiliar noise of the phaco.As a conclusion, we do not recommend intracameral lidocaine usage in general.We believe that suitable verbal communication is very important in topical anaesthesia.
Photodynamic therapy with Verteporfin combined with intravitreal injection of Bevacizumab for central serous chorioretinopathy
Authors: MAIER M
Published: October 2007

Purpose: To discuss the effect and outcome of a combined photodynamic therapy and intravitreal injection of Bevacizumab in treating central serous chorioretinopathy (CSC)

Methods: A 52 year old patient with central serous chorioretinopathy (CSC) on his right eye was treated with intravitreal injection of Bevacizumab administered within 12 to 24 hours after standard PDT . Before, 1, and 3 month after treatment visual acuity and OCT examinations (retinal thickness) and flluorescein angiography were performed

Results: VA increased from baseline 20/40, to 20/20 after 1 month and remained 20/20 after 3 month. Subretinal fluid resolved completely after treatment. OCT‐ and FLA‐ findings are presented in our patient 1 and 3 month after combination therapy showed a normalized retinal thickness compared to baseline

Conclusions: Photodynamic therapy combined with injection of intravitreal Bevacizumab was very effective in our patient. Further experience is necessary to evaluate the treatment option of PDT and Avastin combination therapy esp. in chronic central serous chorioretinopathy (CSC)
Incidence of endophtalmitis after cataract surgery: standard diagnosis versus molecular diagnosis
Authors: BATAILLE L , FERRER C , RODRIGUEZ AE , ABAD JL , ALIO JL
Published: October 2007

Purpose: New techniques as Molecular Biology (PCR) could reveal new data about the incidence of endophthalmtitis after cataract surgery. The aim of this work is to know the real incidence of endophthalmitis when we use both methods as diagnosis of endophthalmitis.

Methods: We have collected 72 samples from 57 patients showing clinical signs of endophthalmitis. These samples were taken from year 2000 to 2006, both included. Ocular samples were taken for microbiological study, including classical culture, Gram and Giemsa stains and PCR. All the samples obtained from the 17 patients were negative by the three methods used and all patients improved with steroid therapy. In total 53 aqueous and 19 vitreous samples were colleted.

Results: The results were positive using stains in 27% of the aqueous samples (AS) and 55% of the vitreous samples (VS), but without identifying the species in any samples. Classical culture could detect the pathogen in 53% of the AS and 89% of the VS. The PCR was positive for fungal or bacterial primers in 85% of the AS and in 95 % of the VS from the patients with infectious endophthalmitis. We have ascertained the incidence of endophthalmitis in our centre after cataract surgery, between years 2000 to 2006. If we only take into account the cases which were positive by culture the incidence is 0.14%. However, if we test the samples by molecular methods the incidence is greater due to the fact that sensitivity is higher. In this case the incidence is 0.19%.

Conclusions: Application of PCR and molecular methods can help us to discover new pathogens involved in ocular infections. The higher sensitivity of molecular methods may reveal that the incidence of endophthalmitis is higher than previously suspected.
Histopathological findings after intreavitreal injection of Linezolid
Authors: ALCOCER YUSTE P , PERIS MARTINEZ C , AVINO‐MARTINEZ J , VILA C
Published: October 2007

Purpose: To evaluate the retinal toxicity in rabbits of Linezolid after a intravitreal injection.

Methods: We selected 10 New Zealand albino rabbits and divided them in two groups of 5. The rabbits in the treatment group received a 0,1 ml. intravitreal injection of linezolid 2 mg/ml, while the ones of the control group received 0,1 ml. of saline solution. All the injections were performed in the right eye of the animals using 30‐Gauge needle. We examine the fundus before and after the injection using indirect ophthalmoscopy to rule out pathology or adverse effect due to the injection. 30 days after the inoculation of the drugs the fundus was reexamined and the eyes were enucleated. We carried out an anatomopathological study of the retina to evaluate the efects of the drugs on it.

Results: No sign of retinal toxicity were found in the fundus examination and in histological study of the retina of the two groups.

Conclusions: Linezolid injected intravitreally appeared safe at concentration of 2 mg/ml in albino rabbits. Intravitreal linezolid may be beneficial and safe and could be used in the treatment of bacterial endophthalmitis, particularly against resistant Staphylococcus aureus organisms.
Ocular conservation in patients with uveal melanoma by a multimodality approach to treatment
Authors: GARCIA‐ALVAREZ C , SAORNIL MA , MUNOZ MF , ALMARAZ A , LOPEZ‐LARA F , MUINOS Y , FRUTOS J
Published: October 2007

Purpose: To analyse eye survival in patients with uveal melanoma with a multimodality approach to treatment

Methods: 273 patients with uveal melanoma diagnosed at Ocular Oncology Unit of the University Hospital of Valladolid from 1997 September to 2007 April. Pearson’s Chi‐square test was used to identify between variables and primary enucleation. Logistic regression was used to identify independent variables predicting primary enucleation. Cox’s univariate proportional hazards model was used to identify associations between variables and time to secondary enucleation.Kaplan‐Meier estimates were used to draw survival curves for time to secondary enucleation

Results: 273 patients were included in the study. Primary enucleation was performed in 80 patients. Secondary enucleation in 12. Gender (p=0,032), basal tumour diameter >15mm (p<0,001), tumour weight >10mm (p<0,001), anterior tumour margin (p<0,001) and extraocular spread (p<0,001) were associated with primary enucleation. Predictive factors for primary enucleation were largest basal tumor diameter (odds ratio [OR], 3,8; 95% confidence interval [IC], 1,5‐9,1) and tumour weight (OR, 2,7; IC, 1‐7,5). Ocular conservation probability 5 years after conservative treatment was 88%. Largest basal tumor diameter, anterior tumour margin and extraocular spread had influence in ocular survival after conservative treatment. Only largest basal tumor diameter was a predictive factor of secondary enucleation

Conclusions: In the present series 69,9% of patiens had a conservative treatment and 88% of them conserved treated eye 5 years
The assessment of retinal layer thickness and volume segmentation reproducibility of optical coherence tomography images
Authors: TATRAI E , SOMFAI GM , FERENCZ M , PULIAFITO CA , CABRERA FD
Published: October 2007

Purpose: Optical coherence tomography (OCT) enables high resolution, cross‐sectional imaging of the retina. The various retinal layers can be distinguished on OCT images using an algorithm of our own design. In the present study we aimed to assess the intraobserver variability of the segmentation algorithm.

Methods: Ten eyes of five healthy subjects were involved in the study (mean age 29 years). Standard macular mapping was performed using a Stratus OCT™ device. All OCT images were segmented using an algorithm of our own design, average thickness and volume data were obtained for the following cellular layers: retinal nerve fiber layer (RNFL), ganglion cell layer and internal plexiform layer complex (GCL+IPL), inner nuclear layer (INL), outer plexiform layer (OPL) and outer nuclear layer (ONL). A manual correction tool was developed to overwrite the automatic segmentation in particular cases where the algorithm failed. The segmentation of the same OCT scans was repeated after one week, and the Coefficient of Repeatability (CR) was calculated in order to assess the accuracy of all measurements.

Results: The CR results for the thickness of the various cellular layers of the retina (in the order as they appeared above) were as follows: 0.47μm, 1.47μm, 0.50μm, 0.57μm, and 0.26μm. Similarly, the CR for the volumetric measurements were 0.054mm3, 0.057mm3, 0.017mm3, 0.015mm3, 0.014mm3, 0.025mm3, respectively.

Conclusions: The volumetric and thickness results for the various cellular layers of the retina obtained with our custom segmentation algorithm are highly reproducible. According to our results the measurement accuracy of our algorithm is below the resolution of the Stratus OCT device.
Optical coherence tomography in patients with cone‐rod dystrophy
Authors: VA'MOS R , VARSANYI B , LESCH B , FARKAS A
Published: October 2007

Purpose: To analyze morphologic characteristic features in patients with cone‐rod dystrophy (CORD) and examine correlation between visual function and morphometric parameters.

Methods: 8 patients (aged 16‐33, mean 22 yrs) with the clinical diagnosis of CORD underwent OCT (Stratus OCT 3, Zeiss) examination. Foveal thickness (FT) and total macular volume (TMV) were evaluated. Disturbance of central visual acuity was detected at the age of 6‐7 yrs. Photoaversion is a common clinical symptom.

Results: FT of patients ranged 96‐182 micrometers (mean 139.75 +/‐ 26,1 ), TMV ranged 4,6‐7,5 mm³ (mean 5.63 +/‐ 0,94 ). FT and TMV of the normal cohort in our Institute range between 130‐180 micrometers and 6.2‐7.2 mm³.

Both parameters of the patients showed a decrease of the lower limit compared to the normal values.

Alterations observed in the foveal architecture were retinal thinnig and blunting of the foveal pit. There was only a weak positive correlation (r=0,443) between visual acuity and foveal thickness, and it was moderately stronger (r=0,527) between visual acuity and total macular volume

Conclusions: OCT is a useful non‐invasive additional method in the differential diagnosis of cone‐rod dystrophy.
The suppression of early angiogenic markers by the antiangiogenic aptamer Macugen® is dose dependent
Authors: BOURGHARDT PEEBO B , KOULIKOVSKA M , FAGERHOLM P
Published: October 2007

Purpose: Pegaptanib sodium(Macugen®) is an RNA aptamer known to inhibit VEGF 165. We found it interesting to study the effect of Macugen® on the expression of the early angiogenic markers: CEACAM1, PCNA and PINCH, in a corneal alkali wound model where early events of VEGF induced neovascularization can be seen.

Methods: 24 New Zealand rabbits were used.The animals received, in the right eye, subconjunctival injection of either 1.8 mg Macugen® (Mg), 0.45 mg Mg, 0.2 mg triamcinolone(Kenaloge®) or solute. The cornea was after the injection, inflicted with an alkali wound. The rabbits were killed after 48 hours, the corneas excised, fixed in 4 % formaldehyde and embedded in paraffin.

Sections were prepared and stained for morphology with eosin and immunohistochemically for PCNA and PINCH. Cells in the limbal stroma, positive for PCNA, were counted.

RNA was isolated from paraffin sections from the limbal parts for RT‐PCR analyse.

Results: There was a significantly reduced number of PCNA positive cells in the Macugen® (Mg) 0.45 mg and triamcinolone sections compared to the solute group. In the Mg 1.8 mg sections there were a high expression of PCNA positive cells, with no difference compared to the solute group. RT‐PCR showed expression of CEACAM1 in 6 out of 7 in solute group, 7 out of 7 in Mg 1.8 mg group and in 2 out 5 in Mg 0.45 mg group. There was no expression of CEACAM1 in the triamcinolone group. The results from PINCH staining will be presented.

Conclusions: Pegaptanib in a low dose and triamcinolone inhibits the expression of the angiogenic cell adhesion molecule CEACAM1 and PCNA in alkali wounded rabbit corneas. These angiogenic markers may be useful for evaluating early events in antiangiogenesis.
Descemet membrane endothelial keratoplasty using descemetorhexis and organ‐cultured donor corneal tissue
Authors: MURAINE M , GARDEA E , TOUBEAU D , BRASSEUR G
Published: October 2007

Purpose: To report results of two surgical procedures of endothelial keratoplasty

Methods: Prospective, noncomparative study. Thirty height eyes of 38 patients with 21 corneal edema Fuchs dystrophy, 11 pseudophakia dystrophy, 4 decompensation of penetrating graft and 2 corneal edema after herpes endothelitis

In all eyes, the recipient Descemet membrane was excised using descemetorhexis through a 3.2 mm corneal incision. In 17 cases endothelial transplant was harvested by lamellar manual dissection. In 21 cases separation of endothelium was made performed with viscoelastic dissection.

A temporary gas bubble was used for donor tissue adherence.

Preoperative and postoperative best spectacle‐corrected visual acuity (BCVA), manifest refraction, astigmatism, pachymetry and endothelial cell density (ECD) were evaluated 2 and 6 months after surgery.

Results: At the end of follow‐up 37 grafts remained transparent and grafts were healed in good position. One eye required conversion to standard penetrating keratoplasty.

At 2 months, BSCVA in the group of Fuchs dystrophy is 20/40 and 20/25 at 6 months. In the group of pseudophakia keratopathy BSCVA is 20 /100 and 20/63 at 2 and 6 months respectively.

The average MR astigmatism was 1.3 D. The mean pachymetry is stable after 1 month at 540 mm .

The average ECD at 2 months was 1500 cells/mm2 and 1300 cells/mm2 at 6 months.

Conclusions: This procedure, with its absence of corneal surface incisions and sutures, is a safe procedure that preserves the normal corneal topography, minimizes astigmatism and corneal power changes. This technique offers considerable advantages over penetrating keratoplasty in the treatment of endothelial dysfunction.
Influence of optic disc size in retinal nerve fiber analysis by OCT : could a customizable circular algorithm help to solve the problem?
Authors: RECHICHI M , SCORCIA V , SCORCIA GB , CARNOVALE SCALZO G , BRUZZICHESSI D , SCORCIA G
Published: October 2007

Purpose: To investigate the correlation between two different type of optical coherence tomography circular scan algorithms for retinal nerve fiber layer (RNFL) analysis and optic nerve head (ONH) size in normal subjects.

Methods: 94 eyes of 94 healthy subjects (60 females, 34 males) underwent ONH analysis performed by StratusOCT(Zeiss Meditec), with six radial scans centered on the optic disc (Fast Optic Disc scan).

RNFL thickness was analyzed with two different type of circular scan: a 3.4 mm fixed‐diameter ring (Stratus OCT, RNFL Thickness 3.4 scan) and a circular scan protocol which analysis a ring 2.27 mm far from a inner circle with a customizable diameter (Stratus OCT, RNFL Thickness 2.27 x disc scan).

Correlation between RNFL thickness and optic disc size data was calculated for each algorithm .

Results: Analysis performed by 3.4 scan showed a significant (p<0.01 ) correlation with the optic disc area(OPD) (R= 0.47) and the vertical(VD) and horizontal(HD) disc diameters of the ONH (R = 0.51, ), (R = 0.45).Analysis performed by 2.27 x disc scan showed R value of 0.15, 0.21 and 0.17 for OPD, VD and HD respectively that are not statistically relevant (p> 0.05)

Conclusions: RNFL thickness measurements obtained by StratusOCT with 3.4 scan increase significantly with optic disc size, vertical and horizontal diameter. This relationship is not verified with 2.27 x disc algorithm that seems to be less influenced by optic disc size.It is not clear if eyes with large ONHs show a thicker RNFL as a result of shorter distance between the circular scan and the optic disc edge or an increased amount of nerve fibers.