bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular rigidity in living human eyes in health and disease
Authors: PALLIKARIS IG 
Published: September 2009

Abstract Purpose It is known that the balance between aqueous humor secretion and outflow rate controls the steady ‐ state average intraocular pressure (IOP). It has been also early identified that blood circulation results to IOP fluctuations practically synchronous to cardiac function. IOP is the primary mechanical load to several ocular structures including the optical nerve head. Methods In‐vivo intraoperative measurement of these quantities as well as secretion/outflow coefficients in humans allowed us to quantify ocular rigidity, IOP and its fluctuations (and pulsatile blood flow) in a series of physiological and pathological eyes. Ocular rigidity, outflow facility and pulsatile ocular blood flow were measured intraoperatively in a cohort of 63 patients undergoing cataract surgery. Measurements were also performed in a series of age related macular degeneration (AMD) patients. Results The eye, is a living structure under a continuously varying mechanical load that is strongly related to ocular haemodynamics. Ocular rigidity ranged from 0.0122 to 0.0343 (mean 0.0208)μl‐1. Outflow facility coefficient (derived from pressure decay curves) was 0.33 (sd 0.15)μl/min/mmHg. Pulsatile ocular blood flow exhibited a strong negative correlation to IOP in all subjects. The ocular rigidity coefficient was higher in wet AMD patients compared to patients with dry AMD and healthy controls. Conclusion There are indications that this mechanical load, associated also to ocular rigidity, can not only inter‐modulate blood flow but also have a long‐term effect on other structures in the eye. Understanding the role of these parameters may contribute to the understanding of ocular disease.
Evidence for altered ocular rigidity in glaucoma
Authors: SCHMETTERER L , GARHOFER G 
Published: September 2009

Abstract Purpose Based on theoretical models and animal studies altered biomechanical properties of the optic nerve head and the sclera have been implicated in the pathophysiology of glaucoma. Only few data have, however, demonstrated such biomechanical alterations in vivo. We tested the hypothesis that patients with primary open angle glaucoma (POAG) have an abnormal structural stiffness based on measurements of intraocular pressure amplitude and ocular fundus pulsation amplitude. Methods Seventy patients with POAG and 70 healthy control subjects matched for age, gender, intraocular pressure and systemic blood pressure were included in this study. The ocular pulse amplitude (PA) was assessed with pneumotonometry. The fundus pulsation amplitude (FPA) was measured using laser interferometry. Based on the Friedenwald equation a coefficient of structural stiffness (E1) was calculated relating PA to FPA. Results Systemic blood pressure, intraocular pressure, and ocular perfusion pressure was comparable between glaucoma patients and healthy control subjects. FPA as well as PA was lower in patients with glaucoma than in healthy controls. The calculated factor E1 was significantly higher in patients with POAG (0.0454 ± 0.0085 a.u.) than in healthy control subjects (0.0427 ± 0.0058 a.u., p = 0.03). Conclusion This study is indicative of increased structural stiffness of the sclera in patients with POAG. This is in agreement with a number of previous animal experiments and supports the idea that the biomechanical properties of ocular tissues play a role in the process of glaucomatous ONH damage.
Ocular motor development in normal and premature children
Authors: YGGE J 
Published: September 2009

AbstractThe ocular motor system is immature at birth and the different types of eye movements develop at different stages of child development. This presentation aims to discuss the normal ocular motor development and the often delayed development of the ocular motor functions seen in premature children. For example, the visual fixation is often more instable in the premature child. Also the saccadic as well as the smooth pursuit and vergence systems exhibit delays in development in the premature child. The delayed development has implications for the clinical investigation and must be taken into consideration when examining the visual functions of the premature child.
Visual impairment in children born before 25 gestational weeks ‐ boys are more vulnerable than girls
Authors: JACOBSON L 
Published: September 2009

Abstract Purpose To describe the frequency of ROP and visual impairment with respect to gender in children born at gestational ages (GA) before 25 weeks. Methods In a population‐based group of children born at GA <25+0 1990‐2002, who survived to 4 years of age (n=114), maximal ROP stages, treatment and visual outcome were followed up. Results Almost all (97,4%) children had ROP and 63,2% were treated with retinal ablation. Visual impairment (VA<0.33) was more common in boys (32,6%)than in girls (9,2%). All visually impaired children but one had severe ROP as the primary cause of their visual impairment. Almost all visually impaired children had additional functional deficits. Conclusion A large proportion of children born before 25 gestational weeks are visually impaired in spite of screening and treatment of ROP. Almost all visually impaired children in this group have additional functional deficits due to cerebral dysfunction.
Human retinal pigment epithelium expressed tight junction markers in spheroid cultures
Authors: PINILLA I , WRIGHT LS , GARCIA MARTIN E , GAMM DM , CUENCA NICOLAS 
Published: September 2009

Abstract Purpose To determine if spheroid cultures generated from human prenatal retinal pigment epithelium (RPE) express markers for mature RPE and tight‐junction proteins and secrete components of the Bruchs membrane. Methods RPE was dissected from human prenatal donor eyes, chopped into 200 µm sections and place in suspension culture in serum‐free defined medium containing the commercially formulated supplement B27. Cultures were grown as spherical aggregate suspensions. At various times darkly spheroids were removed from the suspension and fixed with 4% PFA for one hour and cryoprotected with sequential sucrose solution. The spheroids were embedded in OCT, cut in 16 µm cryosections, and stained for different RPE and membrane markers including RPE65, CRALBP, PEDF, Occludin, Ezrin, Zo‐1 and laminin. EM was also performed. Results Inside the spheroids, RPE cells were located around a central space containing secreted laminin without a clear structure. Cells expressed tight‐junctions markers including ZO‐1, ezrin and occludin. Some of the cells had intracytoplasmic expression on CRALBP, RPE65 and PEDF. Long term culture spheroids showed a decrease in the number of RPE cells and increased pigment and debris. When examined with EM, RPE cells were located over a layer of fibroblasts, showing microvilli towards the outside of the spheroid and intracellular pigment. Conclusion Prenatal RPE maintained as spheriods show some RPE mature markers expression as well as tight junction markers. The cells are able to secrete laminin, an important component of the Bruch membrane.
Evaluation of anterior chamber depth in aphakic and pseudophakic patients with Boston type 1 keratoprosthesis
Authors: DE LA CRUZ J , GUPTA S , ELDERKIN S , GARCIA J 
Published: September 2009

Abstract Purpose To assess anterior chamber depth in aphakic and pseudophakic patients with Type 1 Boston Keratoprosthesis using anterior segment optical coherence tomography. Methods Sixteen patients who underwent Boston Type 1 Keratoprosthesis implantation were evaluated for anterior chamber depth by the non‐contact technique of AS‐OCT. Longitudinal cuts were used in evaluation of AC depth. Functional AC depth was defined as the distance between the back plate of the KPro and the anterior surface of the iris. Anatomic AC depth was defined as the distance from the posterior surface of donor cornea to the iris. Both functional and anatomic AC depths were measured nasally and temporally. The distance between the back plate of the KPro and anterior surface of the posterior chamber intraocular lens (PCIOL) was also measured in pseudophakic patients. Results A total of 16 patients were included in this study. There were 9 pseudophakic and 7 aphakic patients. Anatomic AC depths ranged between 0.86mm to 3.2mm. Functional AC depths ranged from 0mm to 2.2mm. Pseudophakic patients had anatomic AC depths between 0.92mm and 3.1mm and functional AC depths between 0mm and 2.2mm. Aphakic patients had anatomic AC depths between 0.86mm and 3.2mm, and functional AC depths between 0mm and 2.2mm. The distance between the back plate of the KPro and PCIOL in pseudophakic patients ranged from 0.14mm to 2mm. Conclusion Anterior chamber depth measurement, combined with AC angle data provide valuable information in the setting of KPro implantation. This may be helpful in monitoring patients post‐operatively for anterior segment complications such as crowding of the AC, or occlusion of the angle.
Screening for retinal detachment using a wide field scanning laser ophthalmoscope
Authors: BONNAY G , NGUYEN F , NABHOLZ N , BOUSQUET E , DUCASSE A , ARNDT C 
Published: September 2009

Abstract Purpose The development of non‐mydriatic retinal photography has changed the clinical practice, allowing detection of abnormalities in the posterior pole without clinical examination in mydriasis. However the field of view does not exceed 60° and peripheral retinal detachments are likely to be missed on these images. The purpose of this study was to evaluate a wide field (200°) imaging system (Optos, UK ) using a scanning laser ophthalmoscope (SLO) for screening purposes in retinal detachment. Methods All patients referred for retinal detachment from November 2007 to April 2008 were examined by one retinal surgeon who also performed the fundus drawing. An SLO image was taken by an orthoptist in training. A masked image lecture of the entire data base was performed by a resident. Both were unaware of the details of the retinal examination. The number of breaks and the extent of the detachment on the drawing were compared with the findings detected on the SLO image. Results 56 eyes with retinal detachment were documented. In 40 out of 56 eyes the retinal breaks could be detected on the SLO images obtained. The retinal breaks situated superiorly between 11 and 1o’clock or inferiorly between 5 and 7 o’clock and two retinal detachments, one superior and one inferior, were not detected on the SLO images. SLO image analysis enabled correct diagnosis of retinal breaks in more than 7/10 cases. Retinal detachments were detected in more than 9/10 cases. Conclusion Although the wide field SLO imaging system is not suitable as a diagnostic tool of retinal breaks and retinal detachment replacing the fundus examination by a retinal specialist, it represents a reliable screening method.
Commercial interest
Phenotype‐genotype relationship of TGFβI corneal dystrophies among Polish families
Authors: NOWINSKA A , WYLEGALA E 
Published: September 2009

Abstract Purpose To analyze clinical, histologic and genetic features of TGFβI corneal dystrophies. Methods 43 patients from 14 unrelated families were recruited. The clinical examination consisted of inheritance pattern and medical history analysis, slit lamp biomicroscopy and anterior segment optical coherence tomography. Light microscopy was performed on 9 corneal specimen obtained during keratoplasty. PCR and sequencing of all coding exons of TGFβI was performed. Results Based on the study we diagnosed 3 families with GCD1. The clinical pattern of all families with GCD1 was similar. OCT revealed hiperreflective focal changes in the stroma and distinct irregularity of Bowman layer. Histological analysis showed Masson trichrome positive deposits. R555W mutation was revealed. 1 family was diagnosed with TBCD. We noticed increased reflectivity, irregularity of Bowman layer and increased central corneal thickness (CCT) to 608 µm during OCT exam. R555Q mutation was revealed. Two mutations were detected in patients with LCD. Patients from 8 families had R124C mutation. Those patients had thin lattice lines in anterior stroma and CCT increased to 628 µm. Two families had atypical LCD with H626R mutation. There were differences in phenotype between those two families. The first one had asymmetric, late‐onset dystrophy with thin fragile lines extending to DM on OCT scan, while the other family had both eyes involved with thick, distinct lines accompanied with stromal haze, also extended to DM. Corneal buttons of LCD patients showed Congo red positive deposits. Conclusion Among Polish families R124C TGFBI mutation is the most common genetic pattern coexisting clinically with increased CCT. Genetic analysis plays an important role in corneal dystrophy diagnosis.
Rarebit visual field follow‐up in pediatric glaucoma
Authors: MARTIN L , LUNDVALL NILSSON A 
Published: September 2009

Abstract Purpose To evaluate the long term change of the Rarebit (RB) visual fields and optic disc images in a group of children, maximally treated for paediatric glaucoma of various origin and severity, and compare them to normal RB visual field development during adolescence. Methods Thirteen subjects (24 eyes) with pediatric glaucoma and 14 control subjects from the total group of 15 glaucoma and 15 control subjects in a previous study were included in the current follow‐up study. For comparison, RB visual field data from 4 other studies including healthy children were used. Data regarding best corrected visual acuity, refraction (spherical equivalent), intra‐ocular pressure, optic nerve appearance, diagnosis and treatment in the glaucoma group was collected from the medical records. In the control children, best corrected visual acuity was measured after determination of the refractive errors using an autorefractor. All participating subjects underwent RB visual field test and optic disc topography measurements using the Heidelberg Retina Tomograph. Results A majority of both glaucoma eyes and control eyes showed visual field improvement. Using the same limit of normality as in the previous study (MHR above 90% and less than 5 depressed locations), 6 out of the 23 RB visual fields, previously classified as pathological, were now classified as normal. Some visual fields, both in the control and the glaucoma group showed slight deterioration, not leading to re‐classification. Twenty‐one of 26 eyes in the glaucoma group were examined with both RBP and HRT3. The concordance between the methods was 0.6 (Cohen´s kappa). Conclusion In adolescents, maximally treated for glaucoma, both the optic nerve heads and the visual fields remain stable during 5 years of follow‐up.
Zone‐I retinopathy of prematurity, progression and scheduling of treatment
Authors: AKKOYUN I , OTO S , YILMAZ G , TARCAN A , AKOVA AY 
Published: September 2009

Abstract Purpose To evaluate the progression celerity and scheduling of suitable treatment time for Zone‐I Retinopathy of Prematurity (ROP). Methods Records of 36 eyes (18 infants) with Zone‐I ROP, which were screened for ROP at the Neonatal Intensive Care Unit of Baskent University, Ankara, Turkey, between January 2004‐March 2009, were evaluated retrospectively. Birth weight ranged between 480‐1000g, gestational age ranged from 24‐28 weeks. First fundus examination was performed at 29‐31 weeks gestational age, and was repeated once or more per week. The first treatment was performed using laser photocoagulation and the progression criteria for laser photocoagulation treatment were: (1) Zone‐I ROP less than stage‐3 with plus disease (ETROP‐type 1); (2) Zone‐I stage 3 ROP with or without plus disease (ETROP‐type 1). Results Twenty eyes of 10 infants showed criterion (1) and 16 eyes of 8 infants criterion (2). Corneal opacity, pupillary rigidity, tunica vasculosa lentis and vitreous haze were observed until 31‐33 weeks gestational age. The time period for the progression of stage‐1 to stage‐3 retinopathy ranged between 0.7‐3.7 weeks. The mean age at the first treatment was 33 weeks (range 30‐35 weeks). The mean time between the development of stage‐1 retinopathy and the laser treatment was 9.8 days in mean (5‐23 days), and 69.3 % of the infants were treated within 12 days after the diagnosis of stage‐1 ROP. Additional treatments were performed in 7 eyes, scleral buckling+cryotherapy in 5 eyes, vitrectomy in 2 eyes.Thirty‐two eyes had favorable and 4 eyes had unfavorable outcomes. Conclusion The diagnosis of Zone‐I ROP requires close‐meshed follow‐up and immediate treatment.
Efficacy of systemic ganciclovir as a therapeutic strategy for cytomegalovirus‐associated anterior uveitis in immunocompetent patients
Authors: ANGI M , CASSOUX N , FARDEAU C , LE HOANG P , BODAGHI B 
Published: September 2009

Abstract Purpose Cytomegalovirus (CMV)‐associated anterior uveitis is a newly recognized entity that accounts for half of patients with Posner‐Schlossman syndrome. To date, the therapeutic management of these patients remains controversial. The aim of this study was to assess the efficacy of systemic Ganciclovir as a treatment for PCR‐proven CMV‐associated hypertensive anterior uveitis. Methods Retrospective interventional study of 27 consecutive patients treated in a single centre between 2002 and 2008. Main outcome measures included intraocular pressure (IOP) and anterior chamber inflammation. Results All patients responded to systemic Ganciclovir, with mean IOP dropping from 32 to 14 mmHg (p<0,05). Relapses occurred in 50% of cases within one year from the first antiviral course. Repeated treatment allowed control of the disease in 75% of cases (follow‐up range: 12‐78 months). Conclusion Ganciclovir is effective but remains a suspensive therapeutic strategy.
DSAEK grafted corneas remain clear with low endothelial cell counts
Authors: OLESEN H 
Published: September 2009

Abstract Purpose Presentation of observations on endothelial viability and visual outcome in 30 consecutive eyes operated with Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) Methods DSAEK for Fuchs' dystrophy was introduced in October 2006 at the Eye Dept. at Rigshospitalet. The first 7 eyes were grafted with pre‐cut donor tissue, the remaining operations involved tissue preparation with a Moria keratome. All patients were monitored at regular post‐operative intervals for an average of 20 months (range 7 ‐ 34 months). Donor tissue condition was evaluated in terms of detachment rate, primary graft failure and rejection events. Endothelial cell counts (ECC) were done with a digital Topcon SP‐3000P specular microscope camera. Final visual outcome was recorded. Results A fairly large loss of endothelial cells during transplantation was noted. Average cell density of the donor buttons was 2400/mm². At one year follow‐up the recorded ECC had declined to 1129/mm² on average. At two years the average cell density was 1083/mm² indicating a slow progressive cell loss. At the latest follow‐up cell counts ranged from 429 to 2332/mm². Nonetheless all corneas were clear except for one, which was developing secondary bullous keratopathy. Patient satisfaction and visual performance and comfort did not seem correlated to the ECC. Median acuity was 20/40. No case of classical rejection was seen. Conclusion DSAEK is a tempting alternative to PKP in Fuchs' dystrophy. The learning curve, however, is steep even for experienced surgeons at the cost of endothelial cells during the tissue handling. Corneal clarity as well as visual funtion is retained even with very low cell densities.
Anatomy of the Meibomian gland
Authors: KNOP E , KNOP N 
Published: September 2009

Abstract Purpose The Meibomian gland (MG) is a large sebaceous gland in the eye lid that produces the lipids for the superficial tear film layer. Although it is an indispensable component of the functional anatomy of the ocular surface, its importance is still underestimated. Increasing evidence points to a high impact of MG dysfunction (MGD) as a major cause of a dysfunctional tear film and evaporative dry eye disease. Increasing new information has occurred in recent years an will be explained. Methods Results of a Pubmed based literature review on the anatomy, cell biology and physiology are explained together with own results. Results The Meibomian gland shares distinct similarities in embryology with the pilo‐sebaceous unit of the cilia. The keratinised skin epithelium extends into the terminal part of the central duct. Signs of incipient keratinisation continue downstream in the central duct and ductules. The innervation of the MG is characterized by the structure of a dense network of nerve fibres and terminals around the basement membrane of the secretory acini and ducts. The MG is, similar to the lacrimal gland, mainly under parasympathetic control. The orifice of the central duct opens onto the free lid margin close to the posterior lid border and directly anterior to the line of Marx, that represents the surface of the muco‐cutaneous junction which is followed proximally by the epithelial lip of the lid wiper Conclusion The MG is the provider of the superficial lipid layer of the tear film and is regulated similar to the lacrimal gland which may allow coordinated secretion. It preserves a commitment to keratinisation which explains why hyper‐keratinisation of the MG is an important cause for obstructive MGD. Deeper knowledge of the MG will allow better understanding of MGD and its therapy.
Physiological impact of the Meibomian gland on ocular surface integrity
Authors: BRON AJ 
Published: September 2009

Abstract Purpose To review Meibomian gland physiology, including the secretory process, role of the Meibomian lipids, their delivery to the tear film and the maintenance and stability of the tear film lipid layer. Methods A Review Results The Meibomian gland is innervated and possesses androgen and oestrogen receptors. The latter play a part in secretory regulation. Current evidence suggests that Meibomian oil is delivered in the absence of blinking but that delivery is aided by the blink. Only a proportion of the glands are active at any one time, which may reflect their holocrine nature; secretion involves total disgorgement of acinar contents.It may be envisioned that the glands go through a cycle in which some are active all of the time (maybe less than 50%) while all of the glands are inactive, some of the time. Studies of gland expressibility suggest that, for the lower lid, a far greater proportion of the nasal than temporal glands are active at any one time. Ninety percent of the meibomian oil consists of non‐polar lipids while the rest is polar, phospholipid, thought to be essential for lipid spread across the aqueous tear film. Secretion maintains a basal level of about 300 mg of lipid in the oil reservoirs, of which about a tenth is delivered to the TFLL. Lipid is drawn across the tear film in the upstroke of each blink to form a lipid layer that stabilizes in about 1 second and remains stable for the remainder of the interblink. In the normal eye, the structure of the TFLL remains almost unchanged from blink to blink and then changes abruptly as the lipid from the TFLL mixes with that of the two oil reservoirs. Conclusion These events ensure that the TFLL retards evaporative water loss from the tear film and conserves moisture at the surface of the eye.
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