bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability and interobserver variability of non‐invasive tear film parameters
Authors: KOSINA‐HAGYO K , VERES A , FODOR E , LANG ZS , CSAKANY B , NEMETH J 
Published: September 2009

Abstract Purpose To summarize our experiences with a non‐invasive tear interference device. Methods in thirty‐seven subjects, we measured non‐invasive tear break up time (NIBUT) three times, pictured the lower tear meniscus height (TMH) and the tear film lipid layer pattern five times after complete blinks with Keeler Tearscope Plus. Three independent observers evaluated the photos. Additionally, the lipid pattern was graded by the observers with real‐time examination in thirty‐one subjects. We analysed the repeatability of the tear parameters after different blinks, and the agreement between the observers on assessments of the photos and real‐time examination. Results The results measured after different blinks did not show significant differences in case of any tear film parameters. The intraclass correlation coefficient (ICC) with 95% confidence interval of NIBUT and mean TMH were 0.605 (0.428‐0.754) and 0.901 (0.848‐0.942), respectively. There was significant difference between the measured TMH of the observers (p<0.001). The results showed significant correlations (r≥0.912, p<0.001), but the standard deviation of the three measured TMH was meanly 11.13% of the mean of them. The graded lipid patterns of observers showed significant differences (p=0.01) in case of photos, but did not (p=0.137) during real–time examination. Conclusion The Tearscope Plus is a useful tool of non‐invasive tear film examination. However, the evaluation of the parameters is partly subjective, which reduces the reliability of the methods. The real‐time examination of lipid pattern is recommended, because the kinetics of lipid layer allows additional information for grading, therefore decreasing the interobserver variability.
Protein screening in vitreous samples of patients with retinal vein occlusion
Authors: AGOSTINI HT , MARTIN G , HANSEN LL 
Published: September 2009

Abstract Purpose The aim of the study was to identify proteins involved in the pathogenesis of retinopathy after retinal vein occlusion. In retinal vein occlusion, proteins penetrate from leaky vessels into the vitreous. Alternatively, retinal cells produce protein factors and release them into the vitreous. Methods Vitreous and plasma samples of patients with retinal vein occlusion or macular pucker / macular hole were analyzed by antibody microarrays and ELISA. Results An antibody based microarray with more than 500 target for screening vitreous samples initially was less enlightening than antibody arrays providing the possibility to quantify up to 30 proteins in an ELISA‐like microassay. Standard curves of antibody microarrays are as linear as those of ELISAs. VEGF values were similar to values measured by ELISA. Conclusion In our screen, we found some candidate factors which are currently investigated for their potential of influencing retinopathy after retinal vein occlusion. The use of microarrays to identify protein factors involved in retinal disease in the vitreous will be discussed.
Target oriented selection of electrophysiological endpoints in preclinical and clinical trials
Authors: ZRENNER E , WILHELM B , PETERS T , KURTENBACH A 
Published: September 2009

Abstract Purpose The design of pre‐clinical and clinical studies, especially multi‐centre studies shall be discussed concerning the assessment of retinal function, retinal diseases and retinal circuitry as well as biochemistry and the selection of the proper electrophysiological “markers” for appropriate endpoints on the basis of knowledge on possible actions of particular compounds on visual function. Methods Quality has to be ensured by extended standard operating procedures and case report forms that implement also data that test the quality of procedures and calibrations. This includes harmonized quality standards, quality control, central reading and monitoring as well as data management. Results On the basis of standards and recommendations of International Society for Clinical Electrophysiology of Vision and EVI.CT.SE, extended protocols have been developed, targeted at rod and cone function, including sensitivity assessment of the retina by V‐log I‐functions, submicrovolt recording for clinical trials in patients with very small responses, ON and the OFF pathway differentiation. Additionally, ERG recovery after a strong bleach is recommended to target alterations in the visual cycle that involves photoreceptors as well as RPE cells. Conclusion First investigations with such refined standardized protocols have already been performed successfully showing a clear improvement of quality. Normative data are available for the various protocols.
Separating physiological from pathological effects of drugs tested for retinal toxicity in animal models
Authors: PERLMAN I 
Published: September 2009

Abstract Purpose Drugs tested for retinal toxicity in animal models frequently induce physiological effects with or without pathological effects. The physiological effects may be interpreted to reflect toxic action. Here, different experimental approaches and modes of data analysis are described to separate physiological from pathological effects of drugs on retinal function and structure in laboratory animals. Methods The flash electroretinogram (ERG) and the visual evoked potential (VEP) were used to assess respectively the functional integrity of the distal and proximal parts of the retina following intravitreal administration of drugs. Histology at the light microscopic level and immunocytochemistry were used to evaluate structural damage and to localize the site/s of action of the drugs. Results The ERG responses and the VEP were recorded at different time intervals after intravitreal injection of different drugs in order to assess short‐term and long‐term retinal effects. In some cases severe functional deficit was identified, but it was transient in nature, and partial or even complete recovery was observed during a follow‐up period of at least 4 weeks. Different modes of data analysis were applied in order to separate physiological effects from pathological ones. Conclusion Drugs, used in the ophthalmic clinic, can be retinotoxic and induce permanent retinal damage, or may exert transient changes that can reflect drug interference with the normal physiological function of the retina. Data are analyzed to separate these possibilities in order to allow accurate assessment of drug toxicity. Furthermore, drugs exerting transient physiological effects can be used to study the normal mechanisms of visual information processing in the retina.
The mysterious a‐wave
Authors: LACHAPELLE P , GARON ML , POLOSA A , ZIMAK E 
Published: September 2009

Abstract Purpose The electroretinogram (ERG) waveform usually consists of two major components, the a‐ and b‐waves. Exceptions to the above rule are scotopic ERGs evoked to dim flashes, where only b‐waves are recorded. The aim of this study was to examine if the no a‐wave ERG was a feature of scotopic ERG only and try to explain why it occurs. Methods Photopic (background: 30 cd.s.m‐2; flash:‐1.81 to 2.84 log cd.s.m‐2 in 0.2 log unit steps) and scotopic (‐5.01 to ‐0.96 log cd.s.m‐2 in 0.4 log unit steps) ERG luminance‐response functions were obtained from normal human subjects (n=30) and Long‐Evans (n=8) and Sprague‐Dawley (n=8) rats (scotopic ERGs only). Results Human photopic ERG waveform always included an a‐wave. With flash luminance, its peak time first increased, reached a maximal value and then decreased progressively and could be fitted to a fourth order polynomial function. In contrast, scotopic a‐waves appeared only in ERGs evoked to flashes equal to or brighter than ‐3.01 log cd.s.m‐2. With increasing intensity, the peak time of the a‐wave shortened following a linear model.On average, for each log‐unit of flash attenuation, the scotopic a‐wave shortened by more than 10 ms compared to 1.4 ms for the photopic one. Of interest, in rat scotopic ERGs evoked to the dimmest intensities the a‐wave appeared to be replaced by a group of short latency oscillations that were best seen in recordings where the low frequency cut‐off had been raised to 100 Hz. Conclusion The a‐b‐wave rule seems to apply only to photopic ERGs where an a‐wave was still identifiable in ERGs smaller than 1% of maximal amplitude. One wonders if the submicrovolt oscillations occurring prior to the onset of the b‐wave of rat scotopic ERGs evoked to dim flashes could represent remnant of the original a‐wave. Funded by CIHR
Anterior segment OCT in corneal diseases and surgery
Authors: NUBILE M 
Published: September 2009

Abstract Purpose Optical coherence tomography (OCT) after extended use in diagnosis of retinal diseases has now become a new cross‐sectional imaging approach useful for anterior segment (AS) imaging. The potential advantages and limits using AS‐OCT in corneal diseases and surgery are presented. Methods Systematic literature review search and clinical examples focused in the fields of corneal ulcerations, opacities and corneal graft penetrating and lamellar surgery. Results AS‐OCT technology, using 1310 nm wavelength, offers some advantages as compared to high frequency ultrasound system, the main being the absence of contact with the eye. It provides relatively accurate morphology and measurements of different structures of the AS and of the cornea. Corneal loss of transparency in general permits visualization of the deeper AS structures facilitating surgical choice in complex cases. In contrast ciliary bodies are barely visualized, in contrast to UBM, due to light absorption by pigmented iris layers. Morphometry of corneal structures is particularly useful in the preoperative evaluation of thinning disorders, corneal ulcerations, loss of transparency and after penetrating and lamellar surgery, including assessment of LASIK flaps and of deep anterior keratoplasty interfaces and endothelial keratoplasty lenticules adhesion. Conclusion AS‐OCT presents advantages in the clinical practice in the field of corneal disease and surgery. This technology alone should not substitute a comprehensive clinical examination but may offer valuable insights in the quantification and observation of fine details which can be obscured or not detectable during conventional slit‐lamp examination.
Anterior segment OCT versus UBM in the surgical management of pseudophakic bullous keratopathy
Authors: GICQUEL JJ 
Published: September 2009

AbstractAnterior Segment‐OCT (AS‐OCT) is a non contact high Resolution Imaging system. It uses 1310 nm Coherent light and can scan up to 6 mm in Depth and thanks to a maximum scan width of 16 mm it can provide limbus to limbus cross sectional images even thru an opaque cornea. The acquisition is fast up to 8 Frames per second (almost video like). We decided to compare it to the Ultrasound Biomicroscopy (UBM), that is considered to be the gold standard of AS imaging. In a randomized comparative case series in patients with pseudophakic bullous keratopathy (PBK), we studied with AS‐OCT and UBM the anatomical modifications after a triple procedure involving: formerly implanted AC IOL removal followed by the fixation of a Verisyse Aphakic IOL either over or under the Iris. The AS anatomy was best respected in patients who had the Verisyze IOL implanted behind the iris. Measurements obtained with AS‐OCT and UBM were well correlated. AS‐OCT is a reliable and easy to use option for accurate AS imaging before and after surgery in patients with PBK.
Emergency keratoplasty
Authors: VALYI Z , PEREZ GARCíA D , IBANEZ J , ROJO ARNAO M , MINGUEZ MURO E , CRISTOBAL JA 
Published: September 2009

Abstract Purpose Retrospective study about emergency keratoplasties made in our Service of Ophthalmology between 2006 and 2009. Methods From the total number of 92 penetrating keratoplasties (PKP) 12 were done as an emergency. Of these, 66,7% were women and 33,3% men. Causes leading to surgery, donor and receptor cornea and eye, graft size, surgical technique, postoperative evolution, visual acuity and graft transparency were analysed. Results Range of age was between 25 and 78 years. Corneal perforation was present in 8 cases. Corneal pathologies were: trophic and infectious corneal ulcers of bacterial, herpetic and fungal origin, bullous keratopathy and post‐LASIK hydrops. Best corrected visual acuity was between 0,1 y 0,7. Postoperatve complications were rejection of the graft (1 case), relapsed ulcer (3 cases), infections and calcium deposits. 9 grafts still remain transparent. Conclusion Emergency keratoplasies have worse prognosis, as the corneas suffer from an active inflammation and/or infection, including a possible perforation. Alternatives for penetrating keratoplasty are corneal adhesives, lamellar keratoplasties and the use of amniotic membrane.
Straylight in function of wavelength and refraction
Authors: ROZEMA J , TASSIGNON MJ 
Published: September 2009

Abstract Purpose To determine dependencies of straylight on ocular biometry. Methods This prospective study includes 518 eyes of 277 volunteers with healthy eyes of various iris colors and ethnicities who had their retinal straylight tested using the psychophysical Oculus C‐Quant device. Ocular axial length and refraction were also measured, respectively using the Zeiss IOL master and the Nidek ARK‐700 autorefractometer. Results The measured retinal straylight was validated by comparing our data with the age model described in the literature as log(s) = P1 + log(1+(Age/65)4). Our data was found to agree well, albeit that P1 was slightly higher (0.931 versus 0.87). Subtracting this model from the measured straylight values, a quadratic increase was found in function of axial length L. A similar model was defined for the spherical equivalent refraction SE and retinal image size I. This corresponds to an increasing straylight for increasing degrees of myopia. No correlation with keratometry or corneal astigmatism was found. Conclusion Retinal straylight increases not only with age, but also with axial length. Further study is needed to identify the cause of this dependency.
Quality of life in cataract patients and the role of stray light
Authors: ASPINALL P 
Published: September 2009

Abstract Purpose The aim of this study carried out at the Princess Alexandra Eye Pavilion in Edinburgh was to explore the similarities and differences in criteria for cataract surgery in current practice across 5 consultant teams at the hospital. In addition, a number of specific research questions were addressed. Among these, and the basis of this presentation, is the implication of using quality of life as a key referral criterion; and the relations between pre‐operative measures of stray light and quality of life indicators. Methods 105 patients attending the cataract clinics at the hospital participated in the study. In addition to normal clinical practice, data was gathered on visual function (Snellen, LogMar,Pelli Robson contrast sensitivity); other clinical measures (Oxford cataract grading system and C‐quant); and quality of life indicators (VF‐14 and Vsq questionnaires). Results Results will be presented in two parts. Firstly showing how the quality of life and the C‐quant measures relate to current practice. Secondly exploring inter‐relationships between the C‐quant and individual and aggregate quality of life scales as a basis for alternative referral criteria.. Conclusion General quality of life measures are loosely related to current referral practice for cataract surgery. On the other hand stray light (C‐quant) measures do seem more closely related to current practice
Women in ophthalmology: From bench to boardroom
Authors: GRAVES A 
Published: September 2009

AbstractDr. Adrienne Graves began her career as a visual scientist, with stops at Brown University, Harvard Medical School, University of Michigan, and University of Paris. Her passion for studying the visual system and the pathophysiology of disease processes led her to the pharmaceutical industry. After positions in R&D at Alcon, she is now President/CEO of Santen's US operations. Dr. Graves credits her time in Paris for expanding her horizons in many ways, including an appreciation for cultural diversity. This is especially important in her role as a Corporate Officer for Santen, a global ophthalmic pharmaceutical company based in Japan.
Oncocytic lesions of the ophthalmic region
Authors: HEEGAARD S , ØSTERGAARD J , PRAUSE JU 
Published: September 2009

Abstract Purpose To make a nationwide clinicopathologic study of oncocytic lesions in the ophthalmic region and to characterize their cytokeratin(CK) expression. Methods All histologically diagnosed oncocytic lesions in the ophthalmic region registered in Denmark over a 25‐year period were collected and re‐evaluated using a monoclonal antimitochondrial antibody (MU213‐UC). Clinical data were registered. Immunohistochemical characterization was performed with a panel of anticytokeratin antibodies. Results A total of 34 oncocytic lesions were identified. The incidence that required surgical intervention in the Danish population could be approximated to 0.3 lesions per million capita per year. The age of the patients ranged from 45 to 89 years with a peak incidence in the 8th decade. Female gender was twice as common as male. Lesions were typically described as red‐brown, cystic and slow growing. The antimitochondrial antibody MU213‐UC produced a distinct and intense immunostaining. 26 of the lesions originated from the caruncle, three in the conjunctiva, two in the lacrimal sac, one at the semilunar plica, one on the eyelid margin and one peripunctal. Lesions were histologically classified as adenoma(oncocytoma) (26), hyperplasia (4) and metaplasia (4). Basal‐type oncocytic cells reacted with antibodies against CK5/6, CK7, CK8, CK13, CK14, CK 17, CK18, CK19 and suprabasal cells with CK4, CK7, CK8, CK18 and CK19. Antibodies against CK1+10 and CK20 showed no reaction. Conclusion Oncocytic lesions of the ophthalmic region most frequently present as a caruncular oncocytoma. The cytokeratin profile is similar to the lacrimal ‐ and accessory lacrimal gland duct elements and supports the theory that these lesions originate from lacrimal – and accessory lacrimal glands.
A Western blot analysis of P‐glycoprotein in retinoblastoma
Authors: SETHI S , GHOSE S , PUSHKER N , BAJAJ MS , KAUR J , KASHYAP S , MEHTA M , SAXENA P , CHAWLA B , CHANDRA M 
Published: September 2009

Abstract Purpose Literature regarding role of P‐glycoprotein (P‐gp), a multi‐drug resistance (MDR) protein, in retinoblastoma (Rb) is scanty and research has mainly concentrated upon immunohistochemistry. We analyzed P‐gp expression in Rb by Western blotting (WB) and correlated with histopathology (HP). Methods Prospective analysis of P‐gp was done between May 2008‐May 2009 on 15 human Rb tissue specimens after enucleation, either as primary treatment [Group I;n=10] or secondary to chemotherapy (vincristine, etoposide and carboplatin) [Group II;n:5]. Samples collected immediately after enucleation in RPMI‐1640 supplemented with 10% fetal bovine serum, were subjected to WB. HP details (routine H & E) were considered for tumour differentiation and invasion of optic nerve/ocular coats. P‐gp expression was graded semi‐quantitatively as negative, low or high. Results By WB, P‐gp expression was found in 30% of patients in group I (3/10) and 80% of patients in group II (4/5). All expressions in group II were high expression. On HP, in Group I: 70% poorly differentiated (PD) and 30% well differentiated (WD) tumours; 5/10 had involvement of optic nerve/ocular coats/others. In Group II: 60% PD and 40% WD tumors. 1/5 had involvement of optic nerve/ocular coats. 2/5 chemo‐treated eyes were phthisical. Conclusion By WB analysis, P‐gp was expressed more frequently in Rbs treated by chemotherapy. No significant relation between tumor differentiation, tumor invasion and P‐gp expression was found. Though this may be the first study of its kind with promising results, similar studies could be done in more patients with further parameters, especially while managing chemoresistant cases of Rb in the only remaining eye of a child.
Granular cell tumour of the lacrimal gland
Authors: VON HOLSTEIN SL , ØSTERGAARD J , DAUGAARD S , TOFT PB , HEEGAARD S 
Published: September 2009

Abstract Purpose To report the clinical and histopathological characteristics of a patient with a granular cell tumour (GCT) of the lacrimal gland. Methods Surgical excision and histological examination. Results A 38‐year old male presented with a painful swelling located temporally in the right upper eyelid. Clinical examination revealed proptosis and displacement of the right eye and a tumour was palpated at the site of the lacrimal gland. MRI scan revealed a solid tumour in the lacrimal fossa. The tumour was excised. Microscopically the tumour was composed of tumour cells with coarsely granular cytoplasm. The tumour cells were arranged in clusters and ribbons separated by collagen bundles and no necrosis or mitosis were present. The granules were PAS positive, diastase resistant and the tumour cells expressed focal staining for S100. Electron microscopy showed numerous secondary lysosomes. The diagnosis is consistent with a GCT. Conclusion This case presents for the first time a GCT of the lacrimal gland.
Combined intravitreal bevacizumab and triamcinolone for exudative age‐related macular degeneration
Authors: LIBONDI T , JONAS JB , GOLUPKINA L , SPANDAU UH , SCHLICHTENBREDE F , RENSCH F 
Published: September 2009

Abstract Purpose To report on the combined application of intravitreal bevacizumab with triamcinolone acetonide for treatment of exudative age‐related macular degeneration. Methods The clinical interventional case‐series study included 16 patients (16 eyes) with exudative age‐related macular degeneration who had previously received 3.5±1.8 mono‐injections of bevacizumab (1.5 mg) without significant improvement in visual acuity or reduction in macular exudation. All patients underwent a combined intravitreal injection of bevacizumab (1.5 mg) and triamcinolone acetonide (about 20 mg). Main outcome measures were visual acuity and macular thickness as determined by optical coherence tomography. All patients were re‐examined at 2 to 3 months after the intervention. Results Visual acuity improved significantly (P=0.03) from 0.80±0.40 logMAR prior to the combined injection to 0.65±0.42 log MAR at 3 months after the injection. An improvement by at least one Snellen line was found for 8 subjects, an increase by at least 2 lines for 5 subjects, and an improvement of 3 or more lines for 2 subjects. One patient lost one line, and one patient lost 3 lines. The central retinal thickness decreased significantly from 272±62 to 220±47 micrometer (P=0.03). At the 6 months follow‐up examination, the central retinal thickness increased again to 319± 142 micrometer, which was not significantly (P=0.30) different from the baseline measurements. measurements. Conclusion The combined intravitreal application of bevacizumab and triamcinolone may temporarily be helpful in the treatment of exudative age‐related macular degeneration if previous intravitreal bevacizumab mono‐injections failed to improve vision and reduce macular edema