bluuebunny/crossref_metadata_2025_split huggingface dataset:
Betaxolol eye drops: A clinical trial of safety and efficacy
Authors: BS Ivan Goldberg MB , BS Hazel Goldberg MB 
Published: November 2007

Abstract
Objective:
To study the cardiopulmonary safety and ocular hypotensive efficacy of topical betaxolol hydrochloride 0.5% (a selective beta‐1 blocker) in patients with unacceptably elevated intraocular pressure (IOP) and respiratory dysfunction.
Methods:
Thirty‐one patients with poor control of elevated IOP were selected on the basis of coexistent respiratory disease which could be exacerbated by beta‐antagonist administration and/or who had past adverse reactions to topical timolol. Using an open‐label design, the ophthalmic, cardiovascular and pulmonary parameters of these patients were measured before betaxolol therapy, for four hours immediately after the first administration of the drug, and after one, four and 12 weeks of therapy. The screening and 12‐week examinations included a bronchial challenge with methacholine, a non‐specific bronchoconstricting agent.
Results:
IOP reduction was significant at all time points measured after first instillation of betaxolol, with a mean maximum fall of 8.4 (SD, 3.2) mmHg (95% Cl ‐9.545 to ‐7.261) from a baseline mean IOP of 23.9 (SD, 3.8) mmHg. Over 12 weeks of therapy, the mean reduction from baseline in IOP was 3.9 (SD, 2.6) mmHg (95% Cl ‐4.908 to ‐2.988). After first instillation of betaxolol, mean arterial pressure (MAP) fell transiently to a mean maximum fall of 3.9 (SD, 9.3) mmHg (95% Cl ‐7.159 to ‐0.582), from a mean baseline MAP of 107.7 (SD, 9.4) mmHg. Heart rate did not change. There were no changes in any of the respiratory parameters measured: forced expiratory volume in one second, forced vital capacity and peak expiratory flow rate. Over 12 weeks of betaxolol therapy, there were no changes in any of the above systemic parameters and no change in mean bronchial reactivity as measured by methacholine challenge. Of the 31 patients, who included 13 patients with previous intolerance to timolol (a non‐selective beta‐antagonist), only one showed intolerance to betaxolol.
Conclusions:
Betaxolol appears to be an effective and well tolerated ocular hypotensive agent in a typical glaucoma population, which includes many patients with cardiopulmonary disease. Individual intolerance to betaxolol will continue to occur and care is always required when patients with cardiac or respiratory dysfunction are exposed to any beta‐antagonist.
Sporadic Leber hereditary optic neuropathy in Australia and New Zealand
Authors: Chan Christopher , Mackey David A. , Byme Edward 
Published: November 2007

Abstract Background:Leber hereditary optic neuropathy (LHON) is one of the more common forms of hereditary optic neuropathy and one of the few mitochondrial neuropathies. Prior to the advent of molecular DNA testing, the diagnosis depended on the recognition of typical fundal changes, as well as a family history of maternal transmission. Sporadic cases were therefore diagnosed with a level of uncertainty. The aim of this study is to identify the proportion of patients with idiopathic bilateral optic neuropathy/atrophy who are suffering from LHON. Methods:Requests were sent to all ophthalmologists and neurologist in Australia and New Zealand for blood or hair follicle samples of patients with diagnosis of bilateral optic neuropathy/atrophy of uncertain aetiology for DNA testing by restriction endonuclease analysis. Results:One hundred and fourty‐four samples were received, of which 96 were sporadic cases of idiopathic optic atrophy. Eleven of these sporadic patients were found to harbour pathogenetic mitochondrial point mutations associated with LHON. Conclusions:Our results indicated that 11% of patients with bilateral optic neuropathy/atrophy of uncertain aetiology are suffering from LHON. Comparing this data with all the known familial cases of LHON, we report that at least 8% of all LHON cases in Australia are sporadic. We concluded that mtDNA testing for LHON in patients with idiopathic optic atrophy should be included in the initial laboratory work‐up.
AIDS and the eye A 10‐year experience
Authors: Maclean Hector , Hall Anthony JH , McCombe Mark F. , Sandland A Murray 
Published: November 2007

Abstract Background:The AIDS database at Fairfield Hospital, Melbourne, maintains information on eye pathology as identified by the three visiting ophthalmologists. Patients underwent an eye consultation: if they had ocular symptoms; if signs were seen on direct ophthalmoscopy by physicians; or when their CD4+ve cell count fell below 50/μL. The first AIDS‐associated eye signs were identified in mid‐1984. In the subsequent decade, 3257 patients in Victoria tested positive for HIV, and 845 of the 1123 who developed AIDS were treated at Fairfield Hospital. Methods:We undertook a retrospective review of the Fairfield Hospital database to identify the AIDS‐associated ocular problems seen. Results:Some 723 patients had an eye consultation. In the earliest stage of HIV infection, minor non‐specific ophthalmic involvement may occur. As the disease progresses, microvasculopathy (cottonwool spots and haemorrhages) appears. External disease also occurs such as molluscum contagiosum and Kaposi's sarcoma of the conjunctiva. With more suppression of the immune system, opportunistic infections become common, and have a considerable visual morbidity. Cerebral toxoplasmosis (117 patients) is only rarely associated with ocular involvement (three patients), but cytomegalovirus (CMV) commonly causes retinitis [204 patients (24%)]. It has been the AIDS‐defining illness in 26 patients. A majority had the disease confined to one eye. Mean CD4 cell count at onset is 15±5 μL and it has been associated with a viraemia in all but two patients. Late complications of CMV retinitis include relapse in 41 (20%), spread to the other eye in 24 (12%), and retinal detachment in 30 (15%). Visual impairment follows from retinal destruction, optic nerve involvement, and retinal detachment. Conclusion:The ophthalmic workload from late ocular complications of AIDS is increasing. Newer and more effective methods of treatment are being developed. Ophthalmologists are becoming more aware of the need for universal precautions to avoid risks from this and other blood‐borne infections.
Oedipism
Authors: Aung Tin , Yap EngYiat , Fam Han Bur , Law Ngai Mun 
Published: November 2007

Abstract Background: Oedipism or self‐enucleation is a rare form of self‐mutilation, and most often described in acutely psychotic patients, who have religious or sexual delusions. Clinical record: A 47‐year‐old Chinese man with a history of chronic schizophrenia enucleated his own left eye and mutilated his right eye. The reason for his behaviour was unknown. The history and legends surrounding autoenucleation and the medical literature are reviewed. Results: The patient was managed jointly with the psychiatrist. He suffered extensive injury to his right eye, resulting in loss of vision. Conclusion: The management of Oedipism requires close cooperation between ophthalmologists and psychiatrists. Precautions must be taken to prevent repeated attempts or other self‐mutilatory behaviour.
Molecular genetics of central retinal dystrophies
Authors: Moore Anthony T. , FRCOphth Kevin Evans MD 
Published: November 2007

AbstractA range of chorioretinal dystrophies that principally affect the central retina have recently been associated with either specific genetic mutations or mapped to refined genomic loci. Mutations of two genes, peripherin/RDS (chromosome 6p) and TIMP3 (chromosome 22q) have been shown to be of particular importance to this group of disorders. Other conditions such as Stargardt's disease, Best's disease, pattern dystrophy, cone dystrophy and cone‐rod dystrophy have been mapped to different regions of the genome, however the underlying genetic mutations await identification. Molecular genetic diagnostic techniques are now available for a number of central choroidoretinal dystrophies allowing for earlier, accurate diagnosis and laying the groundwork for future studies of potential therapeutic protocols.
Perimetric and angiographic effects of retinotomy
Authors: Bourke Robert D. , Dowler JGF , Milliken AB , Cooling RJ 
Published: November 2007

Abstract Aim: We sought to characterise the morphological and functional effects of drainage retinotomy on the vascular, neural, subretinal and epiretinal components of the affected retina. Patients and methods: Following successful retinal reattachment surgery involving drainage retinotomy in 15 cases (retinotomy group) and no retinotomy in 14 cases (control group), the existence, nature and quadrantic area of visual field loss to a white III4e target was determined using kinetic Goldmann perimetry. Vascular alterations were characterised using fluorescein angiography with peripheral sequences. Results: Visual field defects within 30° of fixation were present in 12 of 14 (86%) of the retinotomy group (including all eyes in which the retinotomy was sited within five disc diameters of fixation) and none of the control group (Fisher exact test, P=0.00005). Following superonasal retinotomy, inferotemporal field area (median area 82 units, range 44 to 128) was approximately half that following superotemporal retinotomy (median area 167 units, range 119 to 192) (Wilcoxon's ranksum P=0.003). No vascular abnormalities distal to the retinotomy were identified, although subretinal neovascularisation (two eyes) and epiretinal membrane formation (one eye) occurred at the retinotomy site. Conclusion: We recommend that where possible subretinal fluid be drained via existing breaks, and if retinotomy is necessary, that it should be sited more than five disc diameters from fixation in the superotemporal quadrant to minimise visual field loss.
Weill‐Marchesani syndrome complicated by secondary glaucoma: Case management with surgical lens extraction
Authors: Taylor J Norton 
Published: November 2007

Abstract Background: A case of the rare Weill‐Marchesani syndrome is presented with characteristic spherophakia, lenticular myopia and secondary glaucoma. The difficulties of management are described. Methods and results: Following failure of conservative medical treatmen't with timoptol, pilocarpine drops and diamox; laser iridotomies temporarily improved but did not halt progress of the glaucoma. Ultimate removal of the lens was required adequately to control the tensions, although this surgical procedure proved hazardous. Conclusions: The difficulties of management in the Weill‐Marchesani syndrome as reported in the literature, are confirmed in this case. Surgical removal of the lens to control the glaucoma may ultimately be the only option, but this procedure can be hazardous with vitreous loss and other complications to be expected.
Surgery for refractory glaucoma
Authors: Kitazawa Yoshiaki , Yamamoto Tetsuya , Sawada Akira , Hagiwara Yoko 
Published: November 2007

Abstract Purpose:To determine the surgical outcome of mitomycin trabeculectomy in patients with refractory glaucoma. Methods:Sixty‐six eyes of 52 patients with refractory glaucoma underwent mitomycin trabeculectomy. Mitomycin was applied for five minutes only once during trabeculectomy. The follow‐up period was six to 61 months. Results:Cumulative success probability was calculated using Kaplan‐Meier life‐table analysis assuming the cut‐off postoperative IOP to be 20 mmHg or IOP reduction by at least 20% in eyes with preoperative IOP 24mmHg. At the end of 61‐month follow‐up the success probability was 80%± 6% without postoperative ocular hypotensive medication (complete success) and was 95%± 3% regardless of postoperative antiglaucoma medication (overall success), respectively. Conclusion:The data suggest that mitomycin trabeculectomy is efficacious in reducing IOP in patients with refractory glaucoma.
Retinal detachment caused by retinal dialysis
Authors: Kennedy CJ , Parker CE , McAllister IL 
Published: November 2007

Abstract Purpose:To determine the characteristics of patients developing retinal detachment secondary to retinal dialysis in Western Australia and to confirm the clinical impression that these patients had a low rate of proliferative vitreoretinopathy (PVR). Methods: A retrospective analysis of the records of 1601 consecutive patients with rhegmatogenous retinal detachment identified 71 patients in whom the retinal detachment was caused by a retinal dialysis. Results: The majority of these patients were young adults (mean age of 30 years) and the male to female ratio was 1.3: 1. Seventy percent of patients provided a history of significant trauma to the affected eye. Sporting injuries, assault, and motor vehicle injuries together accounted for 72% of identifiable trauma. Examination revealed a dialysis of the inferotemporal quadrant in 75% of cases and despite obvious signs of chronicity of the associated retinal detachment (such as intraretinal macrocysts and demarcation lines) in approximately one‐third of the eyes, only 5.6% developed grade C1 PVR either pre‐ or postoperatively. Conclusion: The present study supports the view that it is the low rate of PVR that explains the good prognosis and high surgical success rate for retinal detachments caused by retinal dialysis. It is postulated that a major reason for the low rate of PVR is that the vitreous base attachment to the posterior margin of a retinal dialysis acts as a significant barrier to the migration of potentially proliferative retinal pigment epithelial cells. This may lead to containment of the responsible proliferative cells within the loculated subretinal space.
Botulinum toxin in fourth nerve palsies
Authors: Garnham L , Lawson JM , O'Neill D , Lee JP 
Published: November 2007

Abstract Background: Botulinum toxin A (BTXA) has not been used routinely in the management of fourth nerve (IV N) palsy. However, it is known that the results of surgery can be unpredictable with a risk of over‐ or undercorrection. Methods: The results were reviewed of 20 patients, aged 19–70 years, with unilateral and bilateral IV N palsies who received BTXA injections to the inferior oblique or inferior rectus muscles. The aetiology was congenital in 12 (60%), traumatic in six (30%), due to myasthenia in one (5%), and unclear in one (5%). Fifty per cent of patients had had previous strabismus surgery to a maximum of four procedures. The mean pre‐injection vertical deviation was 11 prism dioptres. All but two patients had a single injection. Average follow‐up was 19 months. Results: Ten patients (group 1) received BTXA as a primary therapy. Following inferior oblique injection, six patients received little benefit and went on to surgery (83%) or continued with prisms (17%). Five patients from group 1 who had inferior rectus toxin were discharged symptomfree. Group 2 (10 patients) received BTXA for residual deviations postoperatively; in this group all except one patient with no fusion achieved long‐term benefit following inferior rectus BTXA. In those who had inferior oblique injections, BTXA was useful in one patient (25%). Inferior rectus injection produced a greater chance of temporary reversal of the deviation. Conclusions: BTXA is of greatest benefit in patients with residual deviations particularly when the inferior rectus is injected, but is of limited value as a primary therapy in chronic IV N palsy.
Penetrating eye injuries in rural New South Wales
Authors: Thompson CG , Griffits RKS , Nardi W , Tester MP , Noble MJ , Cottee L , Weir P 
Published: November 2007

Abstract Purpose: To determine the epidemiology and outcomes of penetrating eye injuries in a rural Australian setting. Methods: A retrospective study of an 11 year period to identify 77 cases of penetrating eye injury in Lismore, New South Wales. Results: The commonest cause of penetrating eye injury was fencing wire followed by hammering metal. The average age was 32.6 years, and males were involved in 88% of cases. A final visual acuity of 6/12 or better was achieved in 61% of cases. Enucleation was performed in 14%. Visual outcome was best for wounds involving the cornea only. Conclusions: Penetrating eye injuries are potentially devastating to vision, but with modern surgical techniques patients are likely to achieve reasonable vision. Prevention requires education to ensure adequate protective measures are taken in potentially hazardous settings.
Intracapsular cataract extraction: Experience of a general surgeon in Niger, West Africa
Authors: Chew A 
Published: November 2007

AbstractBackground:Cataract is the major cause of blindness in the world and affects an estimated 20 million persons globally. In Africa, there is an incidence of half a million new cases of cataract blindness annually, with a backlog of 3 million persons requiring sight‐restoring surgery. The burden of this form of curable blindness resides mainly in less developed nations, which typically have limited numbers of ophthalmologists and medical resources. The experience and results of a general surgeon working in rural West Africa, without prior ophthalmic skills but with limited training in the field, are reported. Methods: Data on all consecutive planned intracapsular cataract extractions performed between January 1994 and July 1995 inclusive were collected prospectively and the visual outcome as well as surgical complications were analysed. Results: A total of 243 planned intracapsular cataract extractions were performed. Data were incomplete or missing in five cases leaving 238 for analysis. All the patients were blind pre‐operatively, with visual acuities of 3/60 or less. Functional vision (6/60 or better) was restored in 95% of all cases. Conclusions: General surgeons can be satisfactorily trained in the art of intracapsular cataract extractions, with good visual outcomes. This is very useful in the setting of undeveloped countries where there are severe limitations of resources, and the recruitment of trained general surgeons will help reduce the burden of curable blindness in these regions.
Changing indications for penetrating keratoplasty: A newly developed country's experience
Authors: Wong TY , Chan C , Lim L , Lim T , Tan DTH 
Published: November 2007

Abstract Purpose: To study the changing indications for penetrating keratoplasty in Singapore and compare local indications with developed countries with established corneal graft programs. Methods: A descriptive study of all penetrating keratoplasty cases performed in the Singapore National Eye Center over a 5 year period, from 1 January 1991 to 31 December 1995 using records of the Singapore Eye Bank registry. Results: A total of 327 penetrating keratoplasties were performed. Bullous keratopathy was the indication in more than a quarter of all cases (26.3%). Aphakic bullous keratopathy (11.6%) and pseudophakic bullous keratopathy (11.3%) accounted for the majority of the bullous keratopathy cases. The other leading indications were: regrafts (11.9%), corneal dystrophies (10.4%), traumatic scarring (10.1%) and keratoconus (9.8%). A higher proportion of aphakic and pseudophakic bullous keratopathy as well as regrafts was noted in this series, compared to a previous report on corneal transplantation in the 1980s. A rising indication rate of pseudophakic bullous keratopathy, in conjunction with a declining indication rate of herpetic keratitis was observed over the 5 year study period. Conclusions: The indications for penetrating keratoplasty in Singapore appear to follow the trend seen in developed Western countries over the past few decades.
Profile of ocular trauma in Papua New Guinea
Authors: Verma Nitin , Verma Anu , Jacob George , Demok Steven 
Published: November 2007

Abstract Background: Ocular trauma is a significant cause of blindness in Papua New Guinea (PNG). This study was done to determine the pattem and rates of ocular and adnexal injuries so as to determine the size and extent of the problem. Methods: A retrospective study of 4157 cases presenting with ocular trauma in three regions of PNG was carried out. The data were analysed with respect to the age, sex, province, type and cause of injury, time interval between injury and presentation to the hospital and the final visual outcome after treatment. Results: Ocular trauma rates in PNG were alarmingly high (39.1 per 100 000). The commonest cause of injury in the younger age group was due to lime. Alcohol‐related violence and fights resulted in injuries in the adult age group. Most of the injuries were grievous and 60.7% of patients were left with a visual acuity of less than 6/60 in the injured eye. In addition, 78.7% of the patients were under 30 years of age. Conclusions: Ocular injuries in PNG are an important cause of visual disability. Some specific injuries, such as those due to lime in children, can easily be prevented by health education.
Pythium insidiosum keratitis
Authors: Murdoch D , Parr D 
Published: November 2007

AbstractA case of Pythium insidiosum keratitis is described. It is an unusual organism that is difficult to isolate. Cases in animals and humans have been reported from tropical and subtropical parts of the world but this is the first case from a temperate region and was acquired from a hot pool. Although resembling a fungus, it is insensitive to all antifungals and requires wide surgical excision for cure.
Human papillomavirus in corneal and conjunctival carcinoma
Authors: Tabrizi Sepehr N. , McCurrach Fiona E. , Drewe Ross H. , Borg Anthony J. , Garland Suzanne M. , Taylor Hugh R. 
Published: November 2007

Abstract Purpose: To investigate the role of human papillomavirus (HPV) types 6, 11, 16 and 18 in corneal and conjunctival carcinoma, we examined 88 dysplastic corneal and conjunctival specimens and 66 controls that had been formalin‐fixed and paraffin‐embedded. Methods: Sections were graded for histological abnormality by light microscopy and the presence of HPV DNA was determined by polymerase chain reaction using LI consensus primers. Results: Human papillomavirus DNA was detected in 34 (39%) dysplasias and in five (7.5%) controls. Of dysplasias that were HPV‐positive, 20 (59%) contained either types 16 or 18, 13 (38%) contained only types 6/11, while combinations of HPV types were present in 11 (32%). A histological correlation was found with HPV positivity (all genotypes) and unusually large (‘epithelioid’) dysplastic cells. Conclusion: The present study demonstrates a lower incidence of HPV in corneal and conjunctival carcinoma than previously reported, but shows an unexpectedly high incidence of HPV 6/11 in conjunctival carcinomas.
Spectrum of sarcoidosis involving the eye and brain
Authors: Ghabrial Raf , McCluskey Peter J. , Wakefield Denis 
Published: November 2007

Abstract Purpose: To illustrate the spectrum of sarcoidosis involving the eye and brain and the difficulties of confirming its clinical diagnosis Methods: The presentation of two unusual case reports of patients with ocular and cerebral involvement with sarcoidosis. Results: Tissue biopsy, an essential component in the differential diagnosis, was required to confirm the diagnosis of sarcoidosis in each patient. Conclusions: Sarcoidosis remains an enigmatic disease with protean manifestations and widely differing outcomes.
Delayed microbial keratitis following radial keratotomy
Authors: Lu Yi , Snibson GR 
Published: November 2007

Abstract Background: We report on the case of a 46‐year‐old female who presented with delayed microbial keratitis 10 years after uncomplicated radial keratotomy. Methods: The pre‐ and postoperative clinical record was reviewed following her presentation to the Corneal Clinic. Slit‐lamp examination revealed a stromal inflammatory infiltrate at the site of an earlier radial keratotomy incision. The lesion was scraped and a coagulase‐negative Staphylococcus aureus was cultured in enrichment broth. Results: The keratitis was treated successfully with combination fortified topical antibiotics without loss of vision. Conclusions: Although microbial keratitis is a well documented complication of incisional refractive procedures, it is rarely encountered as late as one decade after surgery. Patients should be warned of this possibility and the need for prompt treatment.