bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of atmospheric pressureand temperature changes on the intraocular pressure.
Authors: VAN DE VEIRE S , GERMONPRE P , RENIER C , STALMANS I , ZEYEN T 
Published: November 2010

Abstract Purpose Some patients questioned us whether diving and mountaineering can have an effect on their intraocular pressure (IOP). Since the results in the literature concerning mountaineering are often contradictory and the data concerning diving are very limited; we investigated if an increase in atmospheric pressure influences the IOP in a normal population. Since we clinically experienced higher pressures in the summer, we checked the temperature influence on the IOP simultaneously. Methods Twenty‐seven healthy volunteers (aged 18 to 44) were placed in a hyperbaric chamber. Their IOP was measured with a Perkins tonometer at baseline (normal atmospheric pressure of 1 Bar and 24°C), after increasing the atmospheric pressure to 2 Bar both at 14°C and 28°C, and finally at baseline again. A multivariate regression analysis was used to evaluate the results of both eyes. Results The IOP significantly decreased from 11.75mmHg to 10.50mmHg at 2 Bar. The IOP decrease remained constant during the atmospheric pressure rise (40 minutes) and was independent of the temperature change. The IOP returned back to the baseline value when exiting from the hyperbaric chamber. Conclusion A small increase of atmospheric pressure to 2 Bar (= equal effect to diving at 10m below sea level) is sufficient to lead to a significant reduction in IOP independent of temperature changes in a healthy young population. The IOP decrease sustains for the whole hyperbaric chamber period.
Response of the human eye against oxidative stress at high altitudes
Authors: KARAKUCUK S , MUJDECI M , BASKOL G 
Published: November 2010

Abstract Purpose To evaluate the response of the anterior segment of the eye against oxidative stress during acute exposure to high altitudes. Methods Forty volunteers were examined and measurements performed at Erciyes University Medical Faculty,Ophthalmology Clinic, Kayseri,Turkey(1080m). On the following day, participants were transported to Mt. Erciyes Ski Center by bus(2200m); thereafter they climbed to an altitude of 2800m.with a moderate pace. Central corneal thickness, intraocular pressure,spheric equivalent of refraction, arterial oxygen pressure,blood pressure, pulse rate and body temperature were measured at both altitudes. Venous blood samples were taken from volunteers at both altitudes;total oxidant status (TOS),total antioxidant status(TAS),advanced oxidation protein products (AOPP), xanthine oxidase (XO), thiol, adenosine deaminase(ADA)levels were investigated at 1080m and 2800m. Results TOS(7.02µmol H2O2 equiv/L, range:0.49‐22.07) and AOPP(220.74µmol/L,range:103.81‐667.35)significantly increased at high altitude, compared to low altitude levels (3.32µmol H2O2 equiv/L range:0.92‐18.41,and 195.58µmol/L,range:84.77‐663.16, resp; p<0.05).IOP significantly elevated at high altitude (14.45±3.54mmHg vs 13.22±2.74mmHg; p<0.05). There was a significant positive correlation between IOP and TAS levels(p<0.05).No significant correlation was found between spherical equivalent or central corneal thickness with the investigated oxidation parameters at both altitudes Conclusion We conclude that oxidative stress markers, TOS and AOPP are increased along with IOP during acute exposure to hypoxic environment at high altitudes and that antioxidant system may have a limited capacity to counter balance this effect because of acute unacclimatized ascent.
Corneal endothelial decompensation: a novel ocular manifestation of multiple sclerosis
Authors: HILLENAAR T , MOOY CM , REMEIJER L 
Published: November 2010

Abstract Purpose To report the in vivo and ex vivo histopathologic features of the cornea in a patient with endothelial decompensation within the scope of multiple sclerosis (MS). Methods During a 2‐year period a 64‐year‐old male patient, suffering from multiple sclerosis and unilateral bullous keratopathy, was repeatedly examined by slit‐lamp and in vivo confocal microscopy (IVCM). Light microscopy with histochemical staining, transmission electron microscopy (TEM), and scanning electron microscopy (SEM) were performed on the corneal button obtained at penetrating keratoplasty. Results Besides corneal decompensation on his left eye, slit‐lamp examination of both eyes showed a deposition of translucent vesicles on the iris and fine deposits on the corneal endothelium and anterior lens pole. Observation of the endothelium by IVCM confirmed fine precipitates in the right eye, and displayed larger deposits in the left eye. After further deterioration, the left eye showed endothelial denudation. Light microscopy of the corneal button showed periodic acid‐Shiff and Giemsa positive granular deposits in the epithelium and stroma. The same electron dense deposits displayed a fingerprint configuration with TEM. This finding corresponds with a deposition of neurodegenerative origin. SEM disclosed similar unique morphological changes of the endothelial cells as detected by IVCM. Lichen‐like deposits were observed on the endothelial cells. Conclusion IVCM enabled us to obtain high resolution images of the endothelial layer in an obscured cornea. This resulted in the discovery of a new ocular manifestation of multiple sclerosis.
Results of corneal collagen crosslinking with riboflavin and UV‐A radiation
Authors: KONTADAKIS G , KYMIONIS G , KOUNIS G , PORTALIOU D , GRENTZELOS M , LIMNOPOULOU A , DIAKONIS V , PALLIKARIS IG 
Published: November 2010

Abstract Purpose To investigate outcomes after Corneal Collagen Cross Linking with riboflavin and UVA for the treatment of keratoconus. Methods 40 patients, 56 eyes participated in this study. Mean age was 28.9 ± 6.1 (range from 18 to 45 years). All eyes underwent Corneal Cross Linking induced by riboflavin and UV‐A. Postoperative evaluation included Uncorrected Distance Visual Acuity (UDVA), Corrected Distance Visual Acuity (CDVA), mean Keratometric values, topography and confocal microscopy analysis. Results Mean follow up was 18.35+3.12 months (range from 6 to 29 months). No intraoperative complications were observed in this series.UDVA (decimal scale) improved from 0.13±0.15 to 0.20±0.17. CDVA (decimal scale) improved from 0.45±0.24 to 0.54±0.54. No eye lost lines of CDVA. A flattening of the Mean K was observed. (From 48.84 ± 5.83D preoperatively to 47,30 ± 1,34D). Confocal microscopy analysis revealed that collagen fibres in the superior stroma after CXL were distributed unevenly similar to a net like formation. Conclusion Corneal Collagen Cross Linking induced by riboflavin and UVA is a promising new therapeutic technique for the treatment of keratoconus. Longer follow up is necessary.
Treatment of keratoconus by intra‐corneal rings and cross‐linking: about 10 cases treated
Authors: LUSSATO M , DELBARRE M , BLAVIER B , LEDUC C , CREPY P , FROUSSART‐MAILLE F , RIGAL‐SASTOURNE JC 
Published: November 2010

Abstract Purpose Keratoconus is a noninflammatory corneal ectasia resulting in a gradual loss of vision due to the appearance of irregular astigmatism and myopia. We present a prospective study on the treatment of 10 patients with keratoconus treated with cross‐linking and intracorneal rings (ICR). Methods This is a monocentric and prospective study concerning thirteen eyes of ten patients, the average age is 29 years. The gender distribution is of eight men (80%) and two women (20%). Only four patients were treated in both eyes by this protocol and one patient had on his fellow eye a penetrating keratoplasty. The monitoring elements are: the best spectacle‐corrected visual acuity (BSCVA), the spherical equivalent, the average keratometry and the pachymetry. The follow up is six months. The treatment is done in two steps: first step the cross‐linking, second step three months later, insertion of Ferrara ICR, using a Femtosecond laser. The ICR strategy is established with Ferrara normogram achieved with the steeper meridian and design of the ectacic area in preoperative topography. Results The results of this on going study show a stabilization of keratoconus after cross‐linking. Then, after ICR, there is an improvement in best spectacle‐corrected visual acuity with a decrease in spherical equivalent of about 1.8 diopters and an average decrease of two diopters of mean keratometry and ectasia apex recentration. Conclusion The synergistic combination of both techniques seems to be effective in slowing the development and reshaping the cornea.
Update on physiopathology of cystoid macular edema
Authors: MORA P 
Published: November 2010

Abstract Purpose To offer an overview on the historical and most recent acquisitions about the mechanisms that have been proposed to explain how cystoid macular edema (CME) develops. Methods Review of the literature and presentation of personal evidences and imagines. Results CME represents an excessive presence of fluid within the layers of the retina. A breakdown in the blood‐retinal barrier normally is the causative event for fluid to accumulate in cystoid spaces within the retina. Several mechanisms have been proposed to explain the blood‐retinal barrier alteration and consequent CME formation. The intraocular diffusion of inflammatory mediators (eg, prostaglandins), following mechanical or biological insults, remains the most proven evidence. Another mechanism refers to the role of tractional forces on the macula from disruption of the normal vitreoretinal interface. According to this theory, a release of mediators that lead to a breakdown of the blood‐retinal barrier, would have triggered mainly by local forces. Photic injury, finally, has been implicated in the development of pseudophakic or post‐vitrectomy CME. Conclusion A full comprehension of the pathogenesis of CME will significantly help in focussing and developing an effective treatment even for the chronic form of CME.
Anti‐VEGF and corticosteroids therapy in macular edema secondary to venous occlusions
Authors: POURNARAS JAC 
Published: November 2010

Abstract Purpose To assess the evidence on interventions to improve visual acuity (VA) and to treat macular edema (ME) secondary to central (CRVO) and branch retinal vein occlusion (BRVO) Methods Recent randomized studies have evaluated the safety and efficacy of corticosteroids (triamcinolone, dexamethasone) and anti‐VEGF therapies (ranibizumab). Score study evaluates preservative‐free intravitreal triamcinolone with standard care in BRVO and CRVO. In Geneva study, dexamethasone (DEX) intravitreal implant is compared with sham in BRVO and CRVO. BRAVO and Cruise studies evaluate intraocular injections of ranibizumab in patients with ME following BRVO and CRVO, respectively. Results In SCORE study, there was no difference identified in visual acuity at 12 months for the standard care group compared with the triamcinolone groups in BRVO patients. Intravitreal triamcinolone is superior to observation for treating vision loss associated with ME secondary to CRVO. Improvements in BCVA with DEX implant were seen in patients with BRVO and CRVO, although the patterns of response differed. Intraocular injections of 0.3 mg or 0.5 mg ranibizumab provided rapid, effective treatment for ME following BRVO and CRVO Conclusion Grid photocoagulation remains the standard care for patients with vision loss associated with ME secondary to BRVO. Intravitreal triamcinolone is superior to observation for treating vision loss associated with ME secondary to CRVO. Dexamethasone intravitreal implant can both reduce the risk of vision loss and improve the speed and incidence of visual improvement in eyes with ME secondary to BRVO or CRVO. Anti‐VEGF therapies represent new therapeutical option in the treatment of ME secondary to BRVO and CRVO. Further randomized studies are needed
Treatment options of macular edema in uveitis
Authors: GUEX‐CROSIER Y 
Published: November 2010

Abstract Purpose To summarize current concepts on therapeutic approach in inflammatory cystoid macular edema (ICME). Methods A review of relevant literature concerning treatment options of ICME was performed. Results ICME is a major factor related to poor visual acuity in long term follow‐up of uveitis. Topical corticosteroids administration has a minor therapeutic effect on ICME. Local therapies consist mostly of posterior sub‐tenon's, intraocular corticosteroids injections or drug delivery systems. The effect of systemic corticosteroids, immunosuppressive agents or biological therapies will be discussed. Conclusion The recent development of drug delivery systems and biological therapies has considerably improved the prognosis of ICME.
Treatment of postoperative macular edema
Authors: PETROPOULOS I 
Published: November 2010

Abstract Purpose Cystoid macular edema (CME) is a frequent complication of a number of interventions in ophthalmology, such as cataract surgery (Irvine‐Gass syndrome), laser procedures, and trabeculectomy. The purpose of this talk is to present the latest bibliographic data regarding the appropriate treatment of postoperative CME. Methods A review of the existing literature concerning the treatment of postoperative CME is performed. Characteristic personal cases are presented. Results In more than two‐thirds of the cases, postoperative CME resolves spontaneously within weeks or months. Prophylactic topical treatment with indomethacin or flurbiprofen seems to reduce the frequency of clinical and angiographic CME, but its beneficial effect on final visual acuity is not established. Curative therapy includes topical corticosteroids; topical non‐steroidal anti‐inflammatory drugs (e.g. ketorolac); oral acetazolamide; sub‐Tenon or intravitreal injection of triamcinolone acetonide; intravitreal injection of anti‐VEGF drugs; and pars plana vitrectomy. The indications, role, and efficacy of each of the above treatment modalities are discussed, based on the latest bibliographic data. Conclusion Most cases of postoperative CME are mild and resolve spontaneously. In refractory cases, sub‐Tenon or intravitreal injection of triamcinolone acetonide can be effective, but the risk of ocular hypertony is high. Intravitreal injection of anti‐VEGF drugs offers promising results, yet large‐scale randomized studies are necessary to validate their utility. Finally, pars plana vitrectomy is the treatment of choice when vitreomacular traction and/or epiretinal membrane is present.
Surgical therapy of macular edema
Authors: POURNARAS CJ 
Published: November 2010

Abstract Purpose Persistent macular oedema (ME) is the main cause of poor visual outcome during the evolution of retinal ischemic microangiopathies and traction related macular distortion. Among multiples treatment approaches, vitreoretinal surgery is applied with the goal to achieve the release of a traction related component of macular oedema . Methods Vitrectomy with peeling of the posterior hyaloid, epiretinal membranes, vitreoretinal tractions and/or internal limiting membrane removal, were studied in numerous nonrandomized cases series. Results Pars plana vitrectomy has been shown to reduce macular oedema with significant change in best corrected visual acuity, in epiretinal membranes, vitreoretinal traction syndrome and ischemic microangiopathies related macular thickening central, hemiretinal, branch retinal vein occlusion and diabetic macular edema). Evidence to date does not support any therapeutic benefit from radial optic neurotomy and arteriovenous crossing sheathotomy for BRVO and CRVO related macular oedema. Conclusion In the era of intravitreal injection of steroids and anti VEGF substances, vitrectomy seems to have a beneficial effect in traction related, selected pathologies associated to chronic macular edema.
Straylight and vision
Authors: VAN DEN BERG TJTP , VAN DER MEULEN IJE 
Published: November 2010

Abstract Purpose Straylight is considered an important source of patient complaints. They can be voiced like halos, glare, hazy vision and blinding at night. With visual acuity, contrast sensitivity and slit lamp examination little may be found. Yet increased large angle light scattering in the eye media not detected by common tests, may degrade the image projected on the retina, thus decreasing the quality of vision. Aging changes to the crystalline lens and cataract are the most common causes of increased straylight. This study aimed to quantify the importance of straylight for daily life on the basis of patient complaint scores. Methods In a duocenter setting questionnaires were administered before and after cataract surgery. The 37 questions VFQ as well as a self developed 5 question straylight questionnaire were used. A comparison was made between the importance of visual acuity and of straylight to explain the questionnaire outcomes. Results A total of 214 patients were included in the study. For the comparison correlation coefficients were calculated between a weighted average of the 2 functional measures visual acuity and straylight on the one hand, and the questionnaire outcomes on the other. In all 4 cases (2 questionnaires x 2 visits) correlation was lowest for both visual acuity and straylight used in isolation. When visual acuity and straylight were combined to one combined score, correlation improved. Maximum correlation was found when visual acuity and straylight were combined 1:1 (preop) to 2:1 (postop), for both questionnaires. Conclusion For cataract patients, straylight is of about equal importance compared to visual acuity for their appreciation of daily function. In this comparison both were quantified as logarithms (logMAR and log(s)).
Sources of straylight in the human eye
Authors: DE BROUWERE D , GINIS HS 
Published: November 2010

Abstract Purpose Besides refractive aberrations, ocular light scattering is a major parameter affecting image quality on the retina in healthy eyes. Several pathologies in the anterior segment such as corneal scarring and cataract cause significant increase of straylight in the eye. In this study, we link morphologic changes addressed to corneal scarring to a scattering function. Methods Excised rabbit corneas with different grades of scarring following photorefractive keratectomy were optically evaluated for their forward light scattering distribution and consecutively prepared for histology. An absolute parameter for forward scattering was calculated based on the readings in the optical device. We compared this parameter to the relative thickness of the scar tissue observed in the histological data. Results The histological data showed a wide variation of thickness a scar tissue layer in the anterior stroma. The scattering ratio measured using the optical device measuring forward light scattering correlated strongly with the relative thickness of the scar tissue layer with (0.63, Pearson’s coefficient), as well as a standard haze exam (measuring backscattered light) (0.51, Pearson’s coefficient). The light scattering distribution is narrowly forward peaked (FWHM 30 arcmin), suggesting this light scattering is caused by large particles such as myofibroblasts, oedema or irregular scar tissue in the ablated zone. Conclusion Corneal light scattering associated with the increased amount of haze after excimer laser ablation has a narrowly forward distribution that can be attributed to the subepithelial structures observed in treated corneas.This is in contrast to the origin of scatterers linked to cataract, as small protein aggregates and multilamellar bodies that are scattering over wider angles.
Influence of cataract morphology on retinal straylight and straylight changes due to cataract surgery using the Morcher 89A Bag in the LensTM
Authors: TASSIGNON MJ 
Published: November 2010

Abstract Purpose To evaluate straylight and contrast sensitivity (CS) in eyes with various cataract morphologies, to determine which type of cataract presents a higher impairment of visual function with respect to proposed norms car driver safety and to compare retinal straylight and CS before and after implantation of a Morcher 89A IOL. Methods BCVA, CS and straylight were measured in 97 cataractous eyes using respectively a Snellen chart, a Pelli‐Robson chart and the C‐Quant. Cataracts were graded using the LOCS III scale and divided into four groups: nuclear, cortical, nuclear‐cortical and posterior subcapsular cataract. These results were compared to data from 38 cataract‐free control subjects. A separate group of 71 eyes had their straylight measured before and after cataract surgery. Results CS was reduced and straylight increased in all cataract patients, most notably in posterior subcapsular and nuclear‐cortical cataract. CS and BCVA were correlated (r=0.44), whereas straylight and BCVA were not. Applying cut‐off values as proposed by European drivers studies of l.25 log CS and 1.4 log straylight as safe margins for driving, 31% would be considered unfit to drive on the basis of CS and 78% on the basis of straylight although their visual acuity was still above the current European visual acuity requirement for driving. Retinal straylight reduced significantly from 1.560.26 to 1.250.22logunits (P<0.001) after IOL implantation . Conclusion Straylight and, to a lesser extent, CS are complementary to BCVA and should be taken into account when considering driving eligibility. After IOL implantation straylight reduces significantly, resulting in a significant increase in driving eligibility.
Straylight and corneal edema
Authors: PENTARI IG , GINIS HS , PENNOS A , PALLIKARIS IG 
Published: November 2010

Abstract Purpose It is known that corneal edema is associated to increased light scatter. It was the purpose of this study to calculate the intensity and angular distribution of scattered light in a series of corneal samples at different hydration, using a sensitive optical technique. Methods Sixteen fresh porcine eyes were obtained from a local abattoir. To isolate the role of corneal stroma the the epithelium was carefully removed with a mechanical brush. The central 8 mm of each cornea was harvested using a Barron's PKP trephine. To establish corneal hydration, corneal buttons were immersed in Dextran (300kDa) solutions, with concentrations ranging from 5 to 20% w/w, for at least 3 hours. The intensity and angular distribution of scattered light was measured for all corneas by means of a purposely‐developed camera lens that incorporated excised corneas between its glass elements. This lens was used with a CCD camera to record images projected on a computer screen. Before scatter measurements the thichness of each corneal sample was measured by means of a mechanical pachymeter (Mitutoyo IDC 112T, Japan). Results The mean scatter coefficients for the corneas at normal hydration levels was 0.22 (SD=0.059). This value was effectively double (0.46 ; SD= 0.048) at a moderate increase of stromal thickness by 17% and reached a value of 0.56 (SD=0.079) at a relative increase of corneal thickness of 62%. The angular distribution did not significantly deppend on hydration. Conclusion Scattered light intensity increases with corneal edema. Even small changes in corneal hydration affect significantly the narrow angle light scattering properties of corneal stroma.