bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acanthamoeba keratitis: a sobering case and a promising new treatment
Authors: Gray Trevor B , Gross Keith A , Cursons Ray TM , Shewan Jane F 
Published: November 2007

AbstractThis case report describing Acanthamoeba keratitis in a 41‐year‐old male disposable contact lens wearer, adds some sobering and some encouraging information for the future management of this infection. Initial treatment with topical propamidine isethionate (Brolene) and polymyxin B/neomycin/ gramicidin (Neosporin) led to an unsatisfactory clinical response. Topical miconazole 1%, prednisolone acetate 0.12% and oral itraconazole were then added to his treatment. This was later discontinued on noticing ipsilateral toxic cataract formation and an unresponsive pupil. The above medications were replaced with topical polyhexamethylene biguanide (PHMB) 0.02%, which we had shown to have superior in‐vitro amoebicidal activity when compared to the other antiamoebic agents used in this case. Withdrawal of the multitreatment schedule and commencement of PHMB was associated with resolution of his keratitis, healing of a large epithelial defect and settling of severe conjunctivitis. The identical Acanthamoeba strain was isolated from the patient's contact lens storage case and cornea, possibly implicating the contaminated contact lens case in the aetiology of his keratitis. This is the first Australasian experience using PHMB to treat Acanthamoeba keratitis. It appears to be a promising new treatment for this infection.
Phialophora corneal ulcer
Authors: Hirst Lawrence W. , Stallard Ken , Whitby Michael , Perrin Russell 
Published: November 2007

Abstract Background: A corneal fungal ulcer, which appeared to be quite superficial clinically, was found by histologic examination to unexpectedly involve the full thickness of the cornea. Methods: A patient with an apparent superficial corneal fungal ulcer due to Phialophora species was resistant to topical and intravenous antifungal therapy. Results: Penetrating keratoplasty cured the condition with retention of normal vision with a follow‐up of two years. Conclusions: If keratomycosis is unresponsive to topical and intravenous antifungal therapy, penetrating keratoplasty may be required to eliminate the infection. Resistance to medical therapy might suggest presence of fungus far deeper in the cornea than suspected clinically.
Validity of the Bruckner reflex in the detection of amblyopia
Authors: Gole Glen A. , Douglas Lisa M. 
Published: November 2007

Abstract Purpose: To establish the sensitivity and specificity of the Bruckner reflex (comparison of the fundus red reflexes) in the detection of amblyopia or its risk factors. Methods: A single masked study using a medical student's diagnostic ability against the gold standard of a full clinical examination by a paediatric ophthalmologist. Setting: A university teaching hospital outpatient facility. Patients: Three hundred and one patients consecutively referred for ophthalmic assessment. Results: The sensitivity of the test for the detection of children with amblyopia risk factors was 86% and the specificity was 65%. Of 70 children with a definite diagnosis of amblyopia, the sensitivity of the test was 95%. Conclusions: The Bruckner reflex is a useful screening test for primary eye care personnel. However, there is a significant false‐positive rate which will result in unnecessary referrals. We recommend that it form part of a battery of tests, including, for example, the modified base down prism test, which are useful in assessing the vision of preverbal children.
Uveitis associated with rifabutin therapy
Authors: Gioulekas John , Hall Anthony 
Published: November 2007

Abstract Purpose: To highlight the association of uveitis with the use of rifabutin. Methods: Retrospective study of two patients with acute anterior uveitis. Results: Both patients were receiving rifabutin for treatment of atypical Mycobacterium infection associated with AIDS when they developed unilateral acute anterior uveitis and arthritis. The inflammation resolved and vision improved with introduction of topical corticosteroids, mydriatics and cessation of rifabutin treatment. Conclusion: Use of rifabutin with clarithromycin may precipitate acute uveitis in patients with AIDS being treated for systemic Mycobacterium avium complex infection. Uveitis produced by rifabutin may be analogous to Herxeimer reaction as seen in syphilis. Clarithromycin and fluconazole elevate levels of rifabutin due to inhibition of metabolism through cytochrome p‐450 pathway. The differential diagnosis includes Reiter's syndrome, syphilis causing uveitis, metastatic endophthalmitis, and direct HIV‐related uveitis.
Activated protein C resistance — low incidence in glaucomatous optic disc haemorrhage and central retinal vein occlusion
Authors: Graham Stuart L. , Goldberg Ivan , Murray Barbara , Beaumont Paul , Chong Beng H. 
Published: November 2007

Abstract Purpose: Activated protein C (APC) resistance has recently been reported as conferring a sevenfold increase in the risk of venous thrombosis. It is linked to a genetic mutation in the factor V gene which occurs commonly (about 2% to 4% of the community have the mutation). Glaucoma patients with nerve fibre layer (NFL) haemorrhages on the optic disc and patients with central retinal vein occlusion (CRVO) were tested for APC resistance to determine if there was an association. Methods: Twenty‐three patients with glaucomatous NFL haemorrhages and 23 patients with CRVO were tested. The CRVO cases included 11 with relatively young age of onset (mean 45.1 ± 6.9 years) without conventional vascular risk factors. Eighty randomly selected Red Cross blood donor samples and 33 staff members were tested as controls. Clotting times with and without exogenous APC were recorded and an APC ratio determined. Cases with APC resistance were tested to confirm that they had the factor V Leiden gene. Results: No cases of APC resistance were identified in the glaucoma patients and only one of the younger CRVO patients tested positive, but four of 113 controls tested positive. The difference in prevalence between groups is not significant. The mean APC ratios for the three groups were very similar: NFL haemorrhages 5.46(±1.62), CRVO 5.70(±1.56), controls 5.34(±1.19) p>0.5. Conclusion: There was no clear association detected between glaucomatous NFL haemorrhages or CRVO and APC resistance in this sample of patients. This negative finding is important due its known association with venous thrornbosis elsewhere in the body.
Management of fixed divergent squint in third nerve palsy using traction sutures
Authors: Daniell Mark D. , Gregson Richard MC , Lee John P. 
Published: November 2007

Abstract Background: Long‐standing fixed divergent squint is a difficult management problem, presenting marked cosmetic and functional symptoms in the patient, and a significant challenge for the squint surgeon to overcome. Methods: We describe use of through‐the‐lid traction sutures in 24 consecutive patients with fixed divergent squint secondary to long‐standing third nerve palsy. Very large recessions of the lateral rectus were combined with large resections of the medial rectus and traction sutures placed through the insertions of the superior and inferior rectus were brought out through the extreme medial for‐nices and skin of the upper and lower lids. Sutures were tied overtarsorrhaphy bolsters and left in situ for six weeks. Results: After removal of the traction sutures, the eye maintained a good cosmetic position in all but two cases. Postoperative motility was extremely limited or absent. Complications were limited to transient skin ulceration in two cases. Conclusions: Supramaximal horizontal recess‐resect procedure combined with adducting traction sutures left in situ for six weeks is a safe and effective procedure to restore the eye to the centre of the palpebral fissure.
Acute posterior multifocal placoid pigment epitheliopathy: A long‐term study
Authors: Roberts Timothy V , Mitchell Paul 
Published: November 2007

Abstract Purpose: To study the long‐term visual outcome in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Methods: Fifteen patients (28 eyes) with APMPPE were reassessed at Westmead Hospital Eye Clinic (Westmead, NSW, Australia) up to 18 years (mean 6.4 years) after their initial presentation to one of the authors (PM) or to their pnvate ophthalmologist. Stereo retinal photographs and visual acuities taken at the initial presentation were compared with those obtained at the most recent follow‐up visit. Results: The last recorded visual acuity was 6/6 or better in 16 eyes (57%), 6/9–6/18 in four eyes (14%) 6/24–6/60 in five eyes (18%) and worse than 6/60 in three eyes (11%). Nine patients (60%) were treated with oral prednisone during the acute episode with little therapeutic effect observed. Six patients (40%) described a prodromal flu‐like illness. Conclusion: This study suggests that the long‐term visual outcome following an acute episode of APMPPE may not be as favourable as initially portrayed by Gass. It confirms other study findings suggesting that APMPPE may not be a benign self‐limiting disease. Older age at onset and initial foveal involvement were associated with a worse visual outcome.
Detection and specificity of anti‐Staphy/ococcus intermedius secretory IgA in human tears
Authors: Lan J , Willcox MDP , Jackson GDF 
Published: November 2007

ABSTRACTPurpose:Secretory IgA (slgA) is the predominant immunoglobulin present in tears that protects the ocular surface against various antigens. Staphylococcus intermedius is a member of the normal ocular microbiota.Methods:The presence and the specificity of immunoglobulin A to S. intermedius was determined by fluorescent assay, ELISA and western blots.Results:Three immunodominant antigens of S. intermedius were detected of 145, 127 and 61 kDa. Staphylococcus inter‐med/us‐specific IgA cross reacted with Staphylococcus aureus but not with Gram negative bacteria.Conclusions:This indicates that specific IgA may play an important role in the protection of the eye by limiting the levels of Gram positive normal microbiota and defending against the more pathogenic S. aureus.
Changes in the receptive fields of cat retinal ganglion cells affected by pressure on the optic nerve
Authors: Rose KA , (Neuroscience) GradDip , Levick WR , Burke W 
Published: November 2007

ABSTRACTIn the cat optic nerve a lesion was induced by brief application of pressure. It selectively blocked impulse conduction in large diameter fibres of the retinal ganglion cells. Electrophysiological examination of single optic axons several weeks later demonstrated a gross alteration of the visual properties of the affected BT/Y ganglion cells. It is suggested that the alteration of receptive field properties may reflect the cellular and dendritic response to distant focal injury of the axon.
Duane's retraction syndrome and juvenile Batten's disease: A new association?
Authors: Marshman WE , Lee JP , Jones B , Schalit C , Holder CE 
Published: November 2007

Abstract Background: Although Duane's retraction syndrome (DRS) represents less than 5% of strabismus patients presenting to an ophthalmology department, it is a difficult management problem that is often poorly treated. The developmental defect has been isolated to early in the embryonic period, but to date a chromosomal location is still uncertain. Neuronal ceroid lipofuscinosis (NCL) or Batten's disease is a lysosomal storage disease with autosomal recessive inheritance, which has been categorized according to the age of onset of symptoms. Methods/Results: We report on a patient with DRS who developed juvenile Batten's disease. Conclusions: These two abnormalities can both be inherited, but their association has not been previously documented.
Failure of sorivudine therapy in progressive outer retinal necrosis caused by varicella zoster virus
Authors: Rosenthal G , Bartz‐Schmidt KU , Walter P , Kirchhof B , Heimann K 
Published: November 2007

Abstract Background: We report on the case of a 23‐year‐old female who presented with ocular signs of progressive outer retinal necrosis (PORN) syndrome and who failed to respond to acyclovir, ganciclovir, foscamet and oral sorivudine. Methods: The patient was treated with the antiviral drugs acyclovir, ganciclovir, foscarnet and oral sorivudine. Results: The patient failed to respond to a combination of antiviral drugs. Unfortunately, progression of the retinitis occurred, which led to blindness. Conclusion: Despite new drugs, the prognosis of PORN is poor and recurrence is common.
Orbital cysticercosis
Authors: Pluschke M , Bennett G 
Published: November 2007

Abstract Background: We report on a case of orbital cysticercosis in a 27‐year‐old Burmese man who presented with an orbital swelling 7 months after arriving in Australia. Methods: The presenting history and findings are reviewed and treatment options are discussed. A brief review of the life cycle of the tapeworm Taenia solium is provided. Results: The orbital lesion was successfully treated by surgical excision. Conclusion: Cysticercosis should not be forgotten as a possible cause of unusual orbital lesions.
Optic neuritis following albendazole therapy for orbital cysticercosis
Authors: Tandon Radhika , Sihota Ramanjit , Dada Tanuj , Verma Lalit 
Published: November 2007

Abstract Purpose: To report the occurrence of optic neuritis following oral albendazole therapy for orbital cysticercosis. Methods: Two patients having definitively diagnosed orbital cysticercosis at the orbital apex developed an acute visual loss I week after initiation of oral albendazole. Ultrasonography and magnetic resonance imaging determined that the cause was optic neuritis due to disorganization of the cyst with inflammation of the adjacent optic nerve. Results: Oral corticosteroids (prednisolone 1 mg/kg per day) given for a period of 4 weeks led to resolution of the optic neuritis, with full visual recovery. Conclusion: Corticosteroids should be given in addition to albendazole in the treatment of orbital cysticercosis when cysts are in close proximity to the optic nerve.
Effect of tear secretory IgA on chemotaxis of polymorphonuclear leucocytes
Authors: Lan Jenny X , Willcox Mark DP , Jackson Graham DF , Thakur Archana 
Published: November 2007

Abstract Purpose: The aim of the present study was to examine the effect of tear and purified colostrum secretory Iga (sIga) on polymorphonuclear leucocyte (PMN) chemotaxis. Methods: The chemotactic effect of tear and purified sIga for PMN was studied using a modified Boyden chamber. Tears treated with anti‐human Iga, complement‐inactivated tears and albumin were used as controls. Results: The data indicate that both tear and purified sIga are highly chemotactic for PMN. Anti‐sIga antibodies reduced the chemotactic effect of closed‐eye tears (34%) and tear collected during ocular inflammation. Conclusion: The massive recruitment of PMN in tears during sleep may be partially attributed to the increased levels of tear sIga. This may play an important role in protecting the eye against bacterial infection.
Isolation, culture and characteristics of human foetal and adult retinal pigment epithelium
Authors: Zhu M , Provis JM , Penfold PL 
Published: November 2007

Abstract Background: Current methods for the isolation and culture of adult retinal pigment epithelium (RPE) provide successful primary culture. However, most methods result in contamination with other cell types and low cell yields. The isolation and culture of human foetal RPE presents further problems associated with the limited size of the eye cup and adherence among cells. Reliable methods are necessary for the culture of human RPE and subsequent functional studies. Methods: The present procedure is based on mechanical peeling of the whole RPE layer under the dissecting microscope. Dissected pieces are subsequently explanted to a 35 mm culture dish and are cultured with Dulbecco's modified Eagle's medium containing 10% foetal bovine serum. Peroxidase immunohistochemical methods were used to investigate cell phenotypes. Results: Primary cultures were obtained within 10–14 days with high yields, good viability and purity in subsequent culture. Cultured cells were vimentin and cytokeratin positive and CD31 negative. Conclusions: This mechanical dissection technique is recommended for the isolation of foetal and young adult RPE cells, while the enzyme digestion method is preferred for aged adult tissue.
Modulation of the resistance of a human endothelial cell line by human retinal glia
Authors: Diaz CM , Penfold PL , Provis JM 
Published: November 2007

Abstract Background: Human umbilical endothelial cells were used to model the vascular component of the blood–retinal barriers and to examine the capacity of glial cultures to modulate endothelial cell resistivity in vitro. Methods: Endothelial cell resistivity was monitored with and without cocultured human retinal glia. Immunohistochemistry indicated that both macroglia and microglia were present in one culture, while only macroglia were detectable in the second culture. Results: Both cocultures produced increased resistivity in the target endothelial cells; however a further significant increase in resistivity was noted with the glial coculture containing microglia. The results suggest that the presence of microglia significantly increases the capacity of astrocytes and Müller cells to modulate endothelial cell resistivity.
Enkephalin, neurotensin and somatostatin increase cAMP levels in the chicken retina
Authors: Firth SI , Boelen MK , Morgan IG 
Published: November 2007

Abstract Purpose: Enkephalin, neurotensin and somatostatin are released at high rates in the dark and at low rates in the light in the chicken retina. The present study examines the effects of these peptide transmitters on retinal cAMP. Methods: Chicken retinas were incubated in vitro with various drugs for 10 min. Cyclic AMP was extracted with acidified ethanol and retinal levels of cAMP were measured using a radioassay kit. Results/Conclusions: These peptides increased cAMP levels in the chicken retina in vitro, which is surprising as their receptors are generally thought to be negatively coupled to adenylate cyclase. The paradoxical increase in retinal cAMP may be due to unique types of peptide receptors that are positively coupled to adenylate cyclase. A more plausible explanation is that these peptides act indirectly and change the rate of release of another transmitter, whose receptor is coupled to adenylate cyclase.
Pirfenidone reduces fibronectin synthesis by cultured human retinal pigment epithelial cells
Authors: Zhang S , Shiels IA , Ambler JS , Taylor SM 
Published: November 2007

Abstract Purpose: Pirfenidone is a novel anti‐fibrotic drug that has been shown to inhibit fibroblast growth and collagen synthesis induced by transforming growth factor (TGF)‐β1. In the present study we investigated the ability of pirfenidone to moderate fibronectin synthesis by cultured human retinal pigment epithelial (RPE) cells maintained in media containing 1% foetal bovine serum when stimulated with TGF‐β1. Methods: Primary human RPE cultures were used. Treatments included TGF‐β1, pirfenidone and pirfenidone with TGF‐β1. After 72 h treatments, cell growth was determined by cell counting and fibronectin was measured by ELISA. Results: Transforming growth factor‐β1 (1–10 ng/mL) increased the production of soluble fibronectin, while pirfenidone (300 μmol/L) significantly reduced the TGF‐β1‐induced synthesis of fibronectin. Pirfenidone alone had no effect on fibronectin synthesis by cultured RPE cells. Conclusion: We conclude that the anti‐fibrotic effect of pirfenidone may be partly mediated through inhibition of TGF‐β1‐induced fibronectin synthesis.
Tele‐ophthalmic screening using digital imaging devices
Authors: Yogesan Kanagasingam , Constable Ian J , Eikelboom Robert H , van Saarloos Paul P 
Published: November 2007

Abstract Background: Digital imaging systems provide immediate, magnified images that can easily be analysed, enhanced, archived, printed on near photographic‐quality paper and transferred electronically to remote computers. We have assembled a digital ophthalmic system and tested it on patients with some common causes of blindness: corneal scarring and cataract, diabetic retinopathy, macular degeneration and glaucoma. Methods: Digital images were obtained using a variety of ophthalmic imaging devices ranging from slit‐lamp, fundus camera, indirect ophthalmoscope and scanning laser ophthalmoscope. These images were compressed in order to concentrate image information (image size reduced by 90–95%) and minimize transmission time (reduced by 97–98%). Standard or mobile telephone lines were used to transmit images to remote terminals. Results/Discussion: Transmission time was reduced from 15–20 min to 20‐30s and the image size was reduced from 1.3MB to 20‐30kB by compressing the images before transmission. Image quality is still excellent
Electrode position and the multi‐focal visual‐evoked potential: Role in objective visual field assessment
Authors: Klistorner Alexander I , Graham Stuart L , Grigg John R , MB Francis A Billson 
Published: November 2007

Abstract Purpose/Methods: To improve the performance of visual‐evoked potentials (VEP) in the assessment of the human visual field, the multi‐focal cortically scaled pattern VEP was recorded up to 25° of eccentricity in normal subjects. Monopolar and varying bipolar electrode positions were used. Results: The monopolar response was strongly biased towards the lower hemifield. Bipolar leads straddling the inion (2 cm above and below) achieved approximately equal signals from the upper and lower visual field. Division into sectors of similar wave‐form augments the analysis compared with summed full‐field responses. Conclusion: With this technique, the multi‐focal VEP can be used to objectively assess the visual field.
Extracapsular cataract surgery in Vietnam: A I year follow‐up study
Authors: Tobin Sean , Dat Nguyen Q , Bình Phàm , Nauze James La , Gillies Mark 
Published: November 2007

Abstract Purpose: Unoperated cataract is the leading cause of blindness in the developing world. Many developing countries now use extracapsular cataract extraction (ECCE) with intra‐ocular lens insertion (IOL) in their cataract blindness‐prevention programmes. To date, little research has been directed at visual outcomes and complication rates of ECCE/IOL surgery in developing countries. Methods: We conducted a follow‐up study of 155 eyes approximately 12 months after ECCE/IOL surgery by eight local eye surgeons in Central Vietnam. We report the findings for the 144 eyes (93%) successfully reviewed. All subjects underwent manual ECCE with insertion of a three‐piece posterior chamber IOL. All eyes were also assessed for the presence and severity of posterior capsule opacification (PCO) using a newly developed grading system. Results: Overall, 110 eyes (75%) had uncorrected visual acuities ≥6/24 and 107 eyes (74%) had best spherically corrected visual acuities ≥6/18. Some degree of PCO was found in 40% of eyes, but was graded as visually significant in only 4% of eyes. No major sight‐threatening complications were noted. A portable neodymium: yttrium aluminium garnet (Nd: YAG) laser was used to perform capsulotomies on all eyes with visually significant PCO. There were no laser complications noted. Conclusions: At approximately I year after ECCE/IOL, the visual outcomes for subjects in this cohort were favourable and complication rates were low. Posterior chamber opacification was not a major cause of vision impairment in this cohort. Portable Nd: YAG lasers may provide an effective solution to the problem of visually significant PCO occurring in developing countries as a late complication of extracapsular surgery. These findings support an increasing role for ECCE/PCIOL surgery by trained local eye surgeons in developing countries.