bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health economics issues
Authors: LEIVO T 
Published: October 2007

Abstract Purpose: To evaluate the cost and cost‐effectiveness of the simultaneous bilateral cataract surgery compared to sequential bilateral cataract surgery. Methods: Design: Helsinki Simultaneous Bilateral Cataract Surgery Study. Prospective randomized comparative trial.Participants: 520 patients scheduled for bilateral cataract surgery were selected based on strict inclusion criteria to be operated in one session or sequentially one month apart. In both groups every second patient was included in the economic cost analysis.Methods: The costs were evaluated from the societal perspective, taking into account health and non‐health care costs in both groups. The cost of surgery, complications, outpatient visits, medication, travel, patient's and care‐taker's time and possible home nurse visits were evaluated. The cost data was obtained from the participant questionnaires and phone interviews at 3 months, hospital cost data and public statistics. The effectiveness was evaluated based on VF‐7 and 15‐D scores.Main Outcome Measures: The cost of simultaneous vs. sequential bilateral surgery per treated patient. The cost‐ effectiveness of simultaneous bilateral surgery compared to sequential bilateral cataract surgery. Economic sensitivity analysis was carried on all main results. Results: The preliminary results show, that cost per treated patient was lower in the simultaneous bilateral cataract surgery group. The effectiveness was similar in both groups. Conclusions: Simultaneous bilateral cataract surgery is cost‐ effective procedure. If additionally the treatment processes are tailored to simultaneous bilateral surgery, more cost savings can be achieved. The proportion of bilateral cataract patients operated in one session has a substantial effect on the use of health care and non‐health care resources in the society.
Mid term results in keratoconus treatment by Riboflavin – UVA corneal collagen Cross‐Linking. Siena eye cross project
Authors: CAPOROSSI A , BAIOCCHI S , MAZZOTTA C , CAPOROSSI T 
Published: October 2007

Abstract Purpose: We present a mid term follow up analysis of 44 keratoconic eyes treated by combined Riboflavin UV‐A collagen cross‐linking. Methods: Progressive keratoconic eyes of 44 patient were treated by combined Riboflavin UV‐A collagen cross linking. UV‐A exposure was delivered by the new CBM X linker 370 nm Led array‐CSO, Italy. Riboflavin 0,1% solution, Ricrolin Sooft, after corneal epithelium debridement in all cases was instilled 15 minutes before starting irradiation and every 5 minutes for 30 minutes. Eyes were dressed with a soft contact lens for 4 days and medicated with levofloxacin drops, flurbiprofen drops and lacrimal substitutes for 15 days. Results: In all treated eyes no progression of keratoconus was detected. the control fellow eye progressed in 30 % of cases in one year follow up. Mean k value improved meanly 2 Diopters with a significative reduction of Comatic aberration, improving corneal simmetry and quality of vision. Conclusions: Corneal crosslinking is indicated in progressive keratoconus particularly in young patients under 26 years. It can delaly or stop keratoconus worsening reducing necessity of donor corneal transplantations.
Full‐field ERG responses in fellow eyes after the monocular trauma: normal values variability and the classification of oculo‐ocular reactions
Authors: ZUEVA MV , TSAPENKO IV 
Published: October 2007

Abstract Purpose: To determine the monocular trauma influence "normal" values of the ERGs in fellow eyes. Methods: Archive data of 845 patients who undergone the ocular trauma were analyzed retrospectively. We tested also ERG responses in 79 fellow eyes in dynamics: during 1 year after the trauma or enucleation. The single‐flash (4.7 cd?s?m‐2) and flicker (1.8 cd?s?m‐2; 12‐40Hz) full field ERGs were elicited after 10 min dark adaptation. The glial index Kg was calculated as the ERG b‐wave/12Hz‐flicker ERG amplitudes ratio. Results: Regularities of ERG alterations in fellow eyes were determined, which depended on a remoteness and severity of the first eye damage. The data suggest that some regularity in oculo‐ocular reactions (OOR) should be considered the reflection of general adaptation (stress‐) syndrome on the retina level. Between all groups, patients with posttraumatic uveitis and subatrophy showed more pronounced disturbances in the ERGs. Two types of b‐wave and Kg dynamics were found in the earlier period after an enucleation or trauma. The first one should be determined as the regular fellow eye reaction, and the second – as a pathological one. The more expressed alterations in Kg and the slower restoration period should be considered the signs of a higher risk of sympathetic ophthalmia in a remote post‐surgical period. The proposed classification of OOR may have application for the more accurate detection of normal and pathological fellow eye reactions for prescriptions in damaged eye removing. Conclusions: The revealed regularities should be taken into account for greater clinical value of electroretinography in trauma and, possibly, in other monocular pathology.
Electrophysiology and autofluorescence imaging in differential diagnosis of retinal and optic nerve disease
Authors: HAWLINA M , JARC‐VIDMAR M , POPOVIC P , BRECELJ J 
Published: October 2007

Abstract Purpose: Electrophysiological methods enable exact layer by layer diagnosis of the retina and help to answer frequent diagnostic ambiguities between macular and optic nerve diseases. Methods: New multifocal techniques enable topographic representation of the retinal function and can provide accurate diagnosis of macular diseases in early stages. Current trends with emphasis on non‐invasive recording of EOG, ERG, pattern ERG, VEP and multifocal testing, with regards to conventional perimetry, microperimetry and scanning laser ophthalmoscope imaging including autofluorescence of the RPE will be reviewed in representative clinical cases. The importance of standardisation on the performing of all tests according to the recommendations of the International Society for Clinical Electrophysiology of Vision (ISCEV) is emphasised. Results: Global retinal function is well assessed by flash evoked ERGs, but these may be normal in macular disease. PERG and multifocal ERG in combination with autofluorescence imaging may delineate macular diseases in very early stages. In such cases, visual loss may, due to the resulting delay in VEP, erroneously be attributed to optic nerve disease. On the other hand, optic nerve diseases usually do not affect multifocal ERG but can affect PERG, especially its N95 component. Combination of reduced N95 component and delay in VEP is strongly suggestive for optic nerve or ganglion cell disease in which autofluorescence imaging would usually be normal. Conclusions: By judging the cause of visual loss, combination of morphological features by RPE autofluorescence with electrophysiological and psychophysical methods usually leads to correct diagnosis.
Clinical trial methodology in dry eye disease
Authors: SCHAUMBERG D 
Published: October 2007

Abstract Purpose: Clinical trials in dry eye disease have often been challenging. This report will summarize some universal concepts with regard to the conduct of clinical trials, and will review other issues that specifically pertain to successful clinical trials of therapeutic interventions in dry eye disease. Methods: The Dry Eye Workshop involved the deliberations of many contributors through an iterative process that ultimately produced a harmonized summary of current knowledge of dry eye disease (2007 Report of the International Dry Eye WorkShop; Ocul Surf 2007;5[2]:65‐206). The subcommitte on clinical trial methodology was given the task of performing an evidence‐based critical review and summary of the design and implementation of clinical trials in dry eye disease. The group systematically reviewed the medical literature, procedures, and concepts related to clinical trials in general, and considered special issues related to clinical trials involving therapeutic interventions in dry eye disease. Results: The Dry Eye Workshop report makes some specific recommendations for the design and implementation of such trials, based on an assessment of the peculiarities of dry eye disease that complicate clinical trial design, such as the lack of correlation of signs and symptoms, as well as the likelihood of control interventions having a lubricant (placebo) effect. The group also points out potential advantages and disadvantage for conduct of trials in the context of a controlled adverse environment. Conclusions: This report provides a summary of established principles of clinical trial design and implementation and makes suggestions for successful trials of therapeutic interventions in dry eye disease.
Deep sclerectomy in normal tension glaucoma
Authors: SUOMINEN S , HARJU M , IHANAMAKI T , VESTI E 
Published: October 2007

Abstract Purpose: To study the effect of deep sclerectomy (DS) on intraocular pressure (IOP) in normal tension glaucoma (NTG) patients. Methods: We retrospectively analysed 21 eyes of 18 consecutive NTG patients to whom DS was performed. A collagen implant was used (Aquaflow, Staar surgical, Nidau, Switzerland) in 20 of 21 operations. Mitomycin‐C (0.4 mg/ml for 3 minutes) was used in 20 of 21 operations. DS was combined with phacoemulsification in three eyes. Results: Median follow‐up time at the last visit was 14 months (range 3 to 27 months). There was a significant reduction from the preoperative IOP (median, range; 16 mmHg, 11 to 22 mmHg) to the IOP at the last visit (10 mmHg, 4 to 20 mmHg; p<0,001). The median percentage of IOP change was ‐42% (‐81 to 19%). A 25% IOP reduction without medication was achieved in 15/21 eyes and 30% IOP reduction in 13/21 eyes. One year follow‐up was available for 13 eyes. In these, IOP was reduced from the preop‐erative 17 mmHg (14 to 22 mmHg) to 10 mmHg (4 to 20 mmHg; p=0,001) The median percentage of IOP change was ‐42% (‐81 to ‐9%). A 25% IOP reduction without medication was achieved in 11/13 eyes and 30% IOP reduction in 10/13 eyes. Goniopuncture had been done in 8/21 eyes until last visit and in 6/13 eyes until one year. Complications included tearing of conjunctiva (n=3), mi‐croperforation (1), flap avulsion (1), prominent subconjunctival bleeding (1), hyphema (1), re‐suturation of conjunctiva (3), dellen (1), loss of ≥2 Snellen lines (5), and later shunt operation (1). IOP was < 4 mmHg in 16/21 eyes on the first postoperative day, and in 2/21 at 4 weeks. None of these persisted. Conclusions: Despite low preoperative IOP, clinically significant IOP reduction was achieved. DS seems to be effec‐tive and safe in reducing IOP in NTG patients.
Disk swelling ‐ differential diagnosis in orbital space occupying lesions
Authors: GUTHOFF RF 
Published: October 2007

AbstractWe frequently cannot decide with certainty whether a disk with blurred margins and slight elevation represents a pathologic condition or not. If unequivocal pathologic findings are lacking, it is up to the examiner to decide how far the diagnostic procedures should be carried out. It may be necessary to obtain neurologic consultation and to perform neuroradiologic investigations, including MRI and possibly angiographic techniques. On the other hand, after weighing the cost‐benefit ratio and the risk of some side effects, the investigator may rely on his clinical acumen and decide that the condition only represents a variant of the norm.Main differential diagnosis are pseudopapilledema in hyperopia, disk drusen, ocular hypotony, posterior scleritis, optic neuritis, disk edema (due to increased intracranial pressure, due to compression of the orbital part of the optic nerve), optic nerve tumours (meningioma, glioma), metastatic carcinoma, blurred disk margins without echographically demonstrable changes, congenital disk anomalies , central vein occlusion and anterior ischemic optic neuropathy.
Microsurgery of canalicular stenosis
Authors: SERRA F 
Published: October 2007

Abstract Purpose: To explain form the clinical finding which microsurgery of the canaliculi can be used to restore a spontaneous tear drainage in localised stenosis. Methods: Design: Clinical and surgical cases demonstration.Methods: we will describe the different types of punctoplasty, the surgical repair of the stenosis located close to the puncti that can be reached by the direct approach and those close the lacrimal sac that reaquire an approach via the common canaliculus Results: The goal of this surgery is to recreate the continutiy of the lacrimal mucosa in order to allow a spontaneous tear flow
Improvement of S‐cone mediated visual fields and rod function after correction of vitamin A deficiency
Authors: HAYASHI T , TAKEUCHI T , GEKKA T , KUBO A , NAKANO T , TSUNEOKA H 
Published: October 2007

Abstract Purpose: To evaluate visual sensitivities mediated via short wavelength sensitive (SWS) cones and retinal function electrophysiologically in a patient with vitamin A deficiency. Methods: This is an interventional case report. Ophthalmological examinations were performed. Full‐field electroretinograms (ERGs) were recorded. Mean deviation (MD), a global index that reflects the overall depression in visual fields, was evaluated using Humphrey standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP). Results: A 65‐year‐old Japanese female, who was diagnosed with primary sclerosing cholangitis, complained of night blindness. Her visual acuity was 1.2 in both eyes. The ERGs showed no rod b‐waves, reduced rod‐plus‐cone responses (negative type) and normal cone and 30‐Hz flicker responses. Plasma vitamin A concentration was 18 IU/dL (normal range 97‐316 IU/dL). The SAP MD was ‐1.09 dB (OD) and ‐0.97 dB (OS), whereas the SWAP MD was ‐10.10 dB (OD) and ‐10.50 dB (OS). The rate of sensitivity decreased in increasing eccentricity in SWAP. The ERG responses were normalized 4 months after oral administration of vitamin A. The SWAP MD was greatly improved to ‐3.47 dB (OD) and ‐4.10 dB (OS) compared with the changes to the SAP MD (OD: +0.67 dB, OS: +0.41 dB). Conclusions: Rod dysfunction and impaired SWS cone mediated pathways were preferentially observed and were subsequently reversed after the treatment. The findings suggest that rods and SWS cones are more susceptible to vitamin A deficiency than long/middle wavelength sensitive cones in the patient.
Effect of induced myopia on scleral mechanics and myofibroblast populations
Authors: BACKHOUSE S , BUMSTED O'BRIEN K , PHILLIPS JR 
Published: October 2007

Abstract Purpose: Determine the effect of induced refractive error on a) ocular compliance and b) scleral contractile cell populations in guinea pig. Methods: One week old guinea pigs (n = 29) were monocularly deprived of form vision (MD) for 14 days. Cycloplegic refractive error was measured with an IR Optometer. Ocular compliance (change in length/mmHg change in IOP) of MD and control eyes was compared by raising the IOP to 50 mmHg for one hour in 8 anaesthetised animals. A‐scan ultrasound measures of axial length were taken every 10 minutes with raised IOP, and after returning IOP to 15 mmHg. Antibodies to DAPI and α‐smooth muscle actin (α‐SMA) were used to determine the total cell population and cell contractile potential respectively in MD and control sclera. Results: MD induced ‐4.06 ± 1.88 D of myopia, which was correlated with 169 ± 267 μm of vitreous chamber depth (VCD) elongation (n = 29; R2 = 0.37). Both deprived and control eyes showed negative creep compliance (eye shortening) over one hour of raised IOP, equivalent to 1.44 μm shortening per minute. On returning the IOP to 15 mmHg the VCD of the control eye was shorter than baseline by 92.86 ± 88 μm while the deprived eye remained 83.48 ± 37 μm longer than baseline (± SEM; n = 8). These differences were not statistically significant (p = 0.173). There was however an increase of 6% in the percentage of the total cell population positive for α‐SMA in myopic versus control sclera (p = 0.015; n = 7). Conclusions: Myopic and control eyes show similar negative creep compliance in vivo with raised IOP, and no difference in their elastic compliance response. However the α‐SMA positive cell population is increased in myopic sclera, suggesting a role in scleral remodelling.
Oxidative stress in the trabecular meshwork – Preventive effects of Prostaglandin analogues
Authors: WELGE‐LUSSEN U , YU AL , KAMPIK A 
Published: October 2007

Abstract Purpose: The trabecular meshwork (TM) of primary open angle glaucoma (POAG) is characterized by an increased accumulation of extracellular matrix, cellular senescence, and the loss of TM cells. One factor in the pathogenesis of POAG is oxidative stress. The goal of this study was to determine whether oxidative stress is able to trigger these POAG specific changes in cultured human TM cells and whether these changes could be reduced or prevented by the application of prostaglandin analogues (PA). Methods: Cultured human TM cells were stressed with hydrogen peroxide (H2O2) for 1 hour. Levels of fibronectin and MMP‐9 mRNA were analyzed by RT‐PCR. Senescence‐associated beta‐galactosidase (SA‐ß‐gal) activity was detected by histochemical staining. Cell loss was investigated by live dead assay. The effects of PA and benzalkonium chloride (BAC) on POAG typical TM changes were investigated by pre‐incubation with solutions of bimatoprost, travoprost and latanprost or its corresponding BAC concentrations of the either non stimulated or H2O2‐treated cells. Results: H202 markedly influenced the mRNA expression of fibronectin (1.8 fold), MMP‐9 (0.4 fold) and increased SA‐ß‐gal activity to 12 fold. Incubation with 600 μM H2O2 for induced 50% of dead cells. Pretreatment with BAC alone induced POAG typical TM changes in non‐stimulated and H2O2‐treated cells. These effects were reduced by preincubation with PA in H2O2‐treated cells and to a lesser extent in non stimulated cells. Conclusions: Oxidative stress is able to induce several characteristic POAG TM changes in vitro and these oxidative stress‐induced TM changes can be minimized by the use of PA. Thus, prevention of oxidative stress exposure to the TM may help to reduce the progression of POAG.
Local and multifocal ERG in age‐related macular degeneratıon.
Authors: ZOLNIKOVA IV , AHMEDZHANOVA EV , KARLOVA IZ , SHAMSHINOVA AM 
Published: October 2007

Abstract Purpose: To assess the macular ERG responses in different forms of AMD with OCT‐visualisation. Methods: 60 patients (120 eyes) wıth AMD, aged 57‐82, were examined. The groups were formed based on clinical examination, OCT and fluorescein angiography data. Local ERG (L‐ERG) to a red and green stımulus was recorded wıth MBN ERG system (Russıa). Multıfocal ERG was recorded wıth RETIscan system (Roland Consult, Germany). Results: In group 1 wıth hard drusen (18 eyes) ERG responses were in normal range. In group 2 with soft confluent drusen (18 eyes) a‐wave implicit tıme (IT) was prolonged (p=0,007);N1 of mfERG in normal range. b‐wave amplitude of L‐ERG to red stimulus was reduced (p=0,014), P1 of mf‐ERG reduced in fovea and parafovea (р<0,001). In a group 3а (31 eyes) wıth focal RPE atrophy,a‐wave IT of M‐ERG prolonged (p=0,002), P1 reduced in fovea (p=0,04). In a group 3b (16 eyes) with focal RPE atrophy and hyperpigmentation (VA 0,4‐0,1) a‐ and b‐wave reduced (p<0,001),P1 reduced in fovea and parafovea (р<0,05), N1 in foveal hexagone (p=0,04). In a group 4a with CNV with CMO foveal and parafoveal b‐wave amplitude reduced (p<0,05), P1 and N1 reduced (р<0,001). P1 in paramacular ring was reduced (р<0,05). In group 4b with RPE‐detachment a‐wave prolonged, a‐and b‐wave reduced, P1 and N1 reduced (р<0,001). Conclusions: The most sensitive indicators of macular dysfunction in AMD are the implicit time of a‐wave to a red stimulus local ERG and P1 response density of mf ERG in foveal hexagone. Normal amplitude and implicit time of N1 in soft drusen and early RPE‐atrophy in eyes with prolonged a‐wave of local ERG provides the evidence of smaller contibution of cones to N1 of FOK of mf ERG.
Prevention of hypoxia/reoxygenation‐, H2O2‐ and TGF‐β2‐mediated increase of alphaB‐crystallin and Hsp27 by the use of antioxidants
Authors: YU AL 
Published: October 2007

Abstract Purpose: Reactive astrocytes in glaucomatous optic nerve changes are characterized by an increased expression of alphaB‐crystallin and heat shock protein 27 (Hsp27). Previously, we could show that hypoxia/reoxygenation (H/R), hydrogen peroxide (H2O2) and transforming growth factor beta 2 (TGF‐β2) induced the expression of both Hsps. Our goal was to determine the ability of various antioxidants to prevent H/R‐, H2O2‐ and TGF‐β2‐mediated increase of alphaB‐crystallin and Hsp27 in cultured human astrocytes. Methods: Cultured astrocytes were incubated under hypoxic conditions (1% O2 for 4 hours) with subsequent reoxygenation (12 to 48 hours). Additionally, cells were treated with 400‐800 μM H2O2 or with 1.0 ng/ml TGF‐β2 for 12 to 48 hours. Expression of alphaB‐crystallin and Hsp27 was examined by real‐time PCR and western blotting. To evaluate the effect of vitamin B1, B12, E, C, alpha lipoic acid and anthocyanin, cells were preincubated with physiological concentrations before stress exposure. Results: H/R, oxidative stress and TGF‐β2 treatment markedly increased the expression of alphaB‐crystallin and Hsp27. This effect of H/R, oxidative stress and TGF‐β2 was diminished when cells were preincubated with 100 μM alpha lipoic acid and 100 μM anthocyanin. In contrast, preincubation of cells with vitamin B5, B12, C and E could not reduce the stress‐induced increase of both Hsps. Conclusions: The antioxidants alpha lipoic acid and anthocyanin are capable to reduce the H/R‐, oxidative stress‐ and TGF‐β2‐mediated increase of alphaB‐crystallin and Hsp27 in cultured human astrocytes. Therefore, the use of these antioxidants in glaucomatous patients may help to lower the incidence of characteristic changes in the optic nerve.
Combination of structural and functional methods for the diagnosis and follow‐up of glaucoma:results of a two‐year‐study
Authors: SKORKOVSKA SS , MICHALEK JM 
Published: October 2007

Abstract Purpose: To determine, whether an appropriate combination of the structural and the functional examination methods can improve the diagnosis and follow‐up of glaucoma Methods: One randomly selected eye of 40 patients with primary open angle glaucoma (POAG) with none or early glaucomatous visual field loss and 40 age‐matched healthy persons were included in the prospective longitudinal study. Structural evaluations were conducted using Heidelberg Retina Tomograph (HRT) and retinal nerve fiber layer (RNFL) loss scoring according to Airaksinen method. Functional parameters were reviewed by means of standard white‐on white (W/W) and blue‐on yellow (B/Y) perimetry. To assess the diagnostic value of different data sets machine learning classifiers , linear discriminant analysis and classification trees were applied. The accuracy of discrimination was described and visualized by the Receiver Operating Characteristic Curves (ROC), and the results of the first and second year of study were compared. Results: There were statistically significant differences between the healthy and glaucomatous group in the scoring of RNFL loss, HRT parameters (CA,CD,RD,RV,CSM) and mean defect of W/W perimetry. Parameters with the highest diagnostic ability obtained by ROC curves were scoring of RNFL loss, HRT analysis of the optic nerve head and W/W perimetry. Conclusions: Combination of different diagnostic methods can enhance precision of early diagnosis and follow‐up of glaucoma. A limitation for a relationship between structure and function is the individual variability of the optic disc morphology and subjective variability of visual field testing.Supported by IGA NR‐8371