bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute irreversible cataracts in diabetes mellitus
Authors: Cornwell Mark , Lepre Frank 
Published: November 2007

Abstract Aim: To report an unusual cause of blindness in a patient newly diagnosed with insulin‐dependent diabetes mellitis (IDDM). Method: A 19‐year‐old man presented with classical symptoms of hyperglycaemia. On presentation his visual acuity and ophthalmic examination were normal. He was prescribed twice‐daily insulin therapy and six weeks later presented with visual loss. He had only light and dark perception and was noted to have bilateral, dense, mature cataracts. Outcome: Right cataract extraction and intraocular lens implant was performed with restoration of vision. Despite good diabetic control the left cataract did not resolve. Seven months later the patient had left cataract extraction and intraocular lens implant, again with good result. Conclusion: Mature dense cataracts rarely occur and appear not to resolve with control of hyperglycaemia, as in this case, and require surgical treatment.
Bronchopulmonary atypical carcinoid tumour metastatic to the orbit
Authors: Aburn Neil S. , Whitehead Kevin , Sullivan Timothy J. 
Published: November 2007

Abstract Background: Bronchopulmonary carcinoid tumours metastatic to the orbit are rare. A case is presented demonstrating presentation, histopathology and treatment. Methods: A 64‐year‐old man with a history of bronchopulmonary atypical carcinoid presented with an orbital mass. The nature of this metastasis was confirmed with histology and it was surgically excised and, in addition, loeal radiotherapy and chemotherapy were administered. Results: There was a good response to the treatment for the orbital mass but other metastases developed, causing death. Conclusions: In this case of atypical carcioid, orbital metastasis was the first sign of disease progression. Histological confirmation of the diagnosis was important in this case to allow planning of oncological therapy and for appropriate patient counselling. A good local response was obtained with a combination of surgical excision, local radiotherapy and chemotherapy. The systemic prognosis remains poor in cases of metastatic bronchopulmonary atypical carcinoid tumour, in contrast to typical carcinoid.
A preliminary report on a DNA‐based screening method for retinitis pigmentosa: A trial on a West Australian population
Authors: Rakoczy P , Di Grandi S , Kelloway L , Chelva E 
Published: November 2007

Abstract Purpose and background: Recent reports have linked numerous point mutations in the human genome to retinitis pigmentosa (RP), suggesting that in the near future molecular biology based genetic counselling for patients with RP might become a reality. In this paper we assess the viability of a DNA‐based screening method for RP. Specifically, we screened rhodopsin and the beta‐subunit of phosphodiesterase (6‐PDE) genes for the presence of abnormalities in West Australian RP patients. Methods: Blood was collected from 27 patients. Leukocyte DNA was extracted from patients and 50 randomly selected controls. Exons 1–19 and 21 of B‐PDE and exons 1, 3 and 5 of rhodopsin were analysed using single‐strand conformational polymorphism (SSCP) following DNA amplification. The nature of anomalies detected by SSCP was classified with DNA sequencing. Results: In RP patient samples, we found anomalous bands in exons 5, 9,10,15 and 16 and 17 of B‐PDE and in exons 1 and 3 of rhodopsin genes. In 6‐PDE none of the anomalous bands represented mutations. Some of the anomalous bands in the rhodopsin gene, however, corresponded to silent mutations at nucleotide positions 269 and 3982 in four patients. Conclusions: In this study we have demonstrated that SSCP in combination with DNA sequencing is a powerful tool to identify new mutations and to provide information for a ‘mutational panel’ for future screening.
Comparison of growth rates of bovine retinal and brain microvascular pericytes in different oxygen concentrations in vitro
Authors: Wong HC , Thompson S , Yu DY , Cringle SJ , Alder VA , Taylor SJ 
Published: November 2007

Abstract Background: The hyperoxic injury of the microcirculation in the central nervous system appears to be specific to the retina in premature mammals. Oxygen tensions in normal adult mammalian retina and brain vary between nearly 0 and 90 mmHg. This study sought to compare the in vitro replication of retinal and brain microvascular pericytes in normal glucose medium and in 1 %, 5% and 20% oxygen (equivalent to 15 mmHg, 35 mmHg and 150 mmHg, respectively). Methods: A preliminary study, using oxygen micro‐electrodes, confirmed that the pericellular oxygen tension of pericytes, cultured in medium under air, was within 13 mmHg of the tension of the gas phase above the media.Pericytes were highly enriched by magnetic antibody cell sorting with the anti‐pericyte monoclonal antibody (3G5) to 95% to 99% purity, to remove cell contaminants which may have invalidated the mitogenic assay. Results: Mitogenic assays showed that brain pericytes replicated faster than their counterparts from retina (f< 0.0001, averaged for data from all culture conditions using three‐way ANOVA). Reduction of oxygen tension from 150 to 15 mmHg led to significantly increased replication of retinal pericytes (P=0.01), but an insignificant increase for brain pericytes. Conclusions: We have found that pericytes from the brain and retina cultured conventionally in fetal calf serum consume a relatively low amount of oxygen. Decreasing the oxygen tension to 1% (15 to 20 mmHg) increased the replication of retinal pericytes but not brain pericytes in normal glucose concentrations and in fetal calf serum. That retinal pericyte replication is sensitive to variation in oxygen tensions, indicates that the retinal microvascular cells have a unique biological response. This growth sensitivity to oxygen may be important in the pathogenesis of retinopathy of prematurity.
Multiple endocrine neoplasia type two B A case report with light and electron microscopic and immunohistochemical correlation
Authors: Koh Lee K. , Francis Ian C. , Kappagoda Medduma B. , Hooper Michael J. , Filipic Marijan 
Published: November 2007

Abstract Purpose: To describe a case of multiple endocrine neoplasia type two B (MEN IIB) where ocular and systemic clinicopathological findings are correlated, in association with light and electron microscopic and immunohistochemical findings. Methods: A 23‐year‐old man presented with mucosal neuromas of the lips, tongue and eyelids, a Marfanoid habitus and prominent corneal nerves. These findings led to the diagnosis of multiple endocrine neoplasia type two B. The patient subsequently developed phaeochromocytoma and metastatic medullary thyroid carcinoma (MTC) which led to his demise. Correlation of light and electron microscopic and immunohistochemical findings with the systemic and ocular findings is presented to emphasise the aggressiveness of MTC in MEN IIB. Clinicopathological correlation was obtained by examining the eyes post mortem. Results and conclusions: Three new findings in MEN IIB have been established by this study. The enlarged corneal nerves can now be regarded as ganglioneuromas. Medullary thyroid carcinoma metastases were found in the choroid. Light and electron microscopic examination of the eye showed ganglioneuromas of the nerves in the limbus, trabecular meshwork, uveal tract and posterior ciliary nerves; this finding may account for the glaucoma occasionally seen in patients with MEN IIB.
Silicone oil insertion: A review of 127 consecutive cases
Authors: Fisk M J , Cairns J D 
Published: November 2007

AbstractSilicone oil was used in combination with vitrectomy to treat 127 cases of complicated retinal detachments. An initial anatomic success in 120 cases (94%) was reduced to 68 (54%) after an average follow‐up of 32 months and was attributable to ongoing proliferative vitreo‐retinopathy (PVR). The indications for the use of silicone oil were:1. Retinal detachment complicated by PVR (107 cases), 20 of which required multiple operations. Anatomic success was achieved in 59 (55%) and of these 23 (40%) had visual acuity of 6/60.2. Giant retinal tears (GRT) (7 cases). Four (57%) of these remained attached, three (75%) having final vision of 6/36.3. GRTs complicated by PVR (8 cases). Four (50%) were anatomically successful and two had final vision of 6/60.4. Proliferative diabetic retinopathy (5 cases). Two (40%) remained attached and one of these (50%) had hand movements vision.The silicone oil was removed electively in 23 eyes, 16 (70%) of these being anatomically successful. Oil was removed in 43 eyes because of complications, and in 20 (46%) of these, the retina remained attached at the end of follow‐up. Complications included cataract in all 14 phakic eyes; rubeosis in 19 eyes (15%); corneal opacification in 52 eyes (41%), there being no clear cut difference between those eyes with an inferior iridectomy (35 of 85 eyes — 41%) and those without (12 of 29 eyes — 41%); and raised intraocular pressure in 55 eyes (43%). We conclude that although far from being ideal, silicone oil appears to have played some part in achieving the successful results reported in this study.
Retinopathy of prematurity in a South Australian neonatal intensive care unit
Authors: Smith Justine , Spurrier Nicola , Goggin Michael 
Published: November 2007

Abstract
Purpose:
To establish the incidence and severity of retinopathy of prematurity (ROP) in an Australian population of premature infants, and define risk factors for this population.
Methods:
A survey of neonates born weighing less than 1501 g and/or with gestational age below 33 weeks, was undertaken at a neonatal intensive care unit in South Australia.
Results:
ROP was diagnosed in 16.0% of the 94 neonates who were screened until retinal vascularisation was complete. Threshold disease occurred in 4.2%. Logistic regression identified three significant risk factors for the development of ROP: days of mechanical ventilation, multiple birth and female sex.
Conclusions:
The incidence of ROP was relatively low when compared with figures recently published for two large populations studied in the United States and England. This difference was due to a lower incidence of mild forms of the disease. Days of mechanical ventilation, multiple birth and female sex were independently predictive of the occurrence of ROP. As small numbers of infants with ROP are managed at individual Australian centres each year, a national ROP register is recommended to facilitate the study of the disease in this country.
Steroid‐induced ocular hypertension in the presence of a functioning Molteno seton
Authors: Muecke James , Brian Garry 
Published: November 2007

Abstract
Background:
Steroid‐induced ocular hypertension is generally attributed to alterations in the trabecular meshwork, reducing aqueous outflow.
Method and Results:
A case with several episodes of steroid‐induced ocular hypertension is presented. Later, with unremitting intraocular pressures above 50 mmHg, despite maximal hypotensive medication, there is evidence of extensive failure of aqueous egress. A successful Molteno seton bypasses the failed trabecular meshwork to lower the pressure into the teens. The eye is then challenged with topical steroid on two occasions. The pressure rises, only to fall again with steroid withdrawal.
Conclusion:
Here is a case where the trabecular meshwork has been bypassed, but ocular hypertension was still induced with the application of topical steroid.
Prophylactic perifoveal laser treatment of soft drusen
Authors: Sarks Shirley H. , Arnold Jennifer J. , Sarks John P. , Gillies Mark C. , Walter Clement J. 
Published: November 2007

Abstract Purpose:To assess the efficacy and safety of perifoveal laser to cause drusen to resorb, and establish a treatment protocol. Methods:Treatment technique was determined by the outcome in one patient with 15‐year follow‐up. In an uncontrolled series a perifoveal ring of gentle laser was applied to 30 eyes of 28 patients, 18 with bilateral drusen and 10 with exudative disease in the fellow eye. Comparison was made between treated and untreated eyes in 14 patients with bilateral drusen. Mean follow‐up was 16.8 months (range, three to 42 months). Results:Soft drusen resorbed in all treated eyes in the vicinity of laser and within the fovea. Large soft confluent drusen (>500 μm) responded most rapidly. Visual acuity improved one or more lines in 12 (40%) treated eyes, was unchanged in 16 (53%) and deteriorated in two (7%). In 14 patients with bilateral drusen in whom only one eye was treated, VA remained unchanged in 10 eyes and improved in four treated eyes while none of the untreated eyes improved (P= 0.03, χ2) and decreased in four eyes. Atrophic expansion of laser burns was minimal. CNV developed in two of 30 eyes (7%). Conclusion:Perifoveal laser treatment appears to expedite the regression of soft drusen within the fovea. The risks of complications may be reduced by treating eyes early, before pigment changes develop and by applying a minimum number of burns at a distance greater than 750 μm from the foveal centre. Treatment should currently be administered only in the context of a prospective clinical trial, which is required to assess whether this treatment results in lowered risk of visual loss from CNV or geographic atrophy.
Corneal topographic lagoons: a potential new marker for post‐traumatic recurrent corneal erosion syndrome
Authors: McGhee Charles NJ , Bryce Iain G. , Anastas Constantine N. , Webber Suzanne K. , Burvill Malcolm , Murray AidanT 
Published: November 2007

Abstract Background:Post‐traumatic recurrent corneal erosion syndrome is a common clinical problem in which a definitive diagnosis is not always possible based solely upon biomicroscopic corneal signs. Indeed, in some cases archetypical symptoms or a preceding history of epithelial trauma cannot always be elucidated. Methods:Four groups of patients underwent corneal analysis using computer videokeratography. Group 1 (n=11), subjects who presented with simple corneal epithelial trauma approximately three months before the study. Group 2 (n=11), prospective analysis of subjects presenting with simple corneal epithelial trauma. Group 3 (n=12), prospective analysis of subjects with an established diagnosis of post‐traumatic recurrent erosion syndrome. Group 4 (n=135), prospective analysis of healthy control subjects. Results:Small, well delineated areas (1.0 to 1.5 mm in diameter) of markedly reduced corneal dioptric power (greater than 2 dioptres), which we have termed ‘corneal topographic lagoons’, were identified more commonly in eyes with recurrent corneal erosion syndrome and in eyes that had recently sustained corneal epithelial trauma; being found in 18.2% of Group 1, 9.1 % of Group 2, 58.3 % of Group 3 but only 1.5% of Group 4 (control). Conclusions:The identification of areas of focal abnormality in the corneas of patients with post‐traumatic recurrent corneal erosion syndrome remains a significant clinical problem. Corneal topographic analysis has demonstrated a focal abnormality, the ‘corneal topographic lagoon’, which is much more prevalent in cases of recent corneal trauma and recurrent corneal erosion syndrome than in the ‘normal’ population. Computerised videokeratography therefore adds a new tool to the armamentarium of the clinician seeking to identify and locate abnormalities in these difficult cases.
Trabeculectomy and manual clot evacuation in traumatic hyphaema with corneal blood staining
Authors: Verma Nitin 
Published: November 2007

Abstract Background:The management of traumatic hyphaema with raised intraocular pressure and corneal blood staining is difficult. Residual blood clots after anterior chamber washout are responsible for sustained postoperative elevation of intraocular pressure, even after trabeculectomy and clot evacuation. Methods:Thirty‐five patients with traumatic hyphaema, elevated intraocular pressure and varying degrees of corneal blood staining underwent a combined trabeculectomy with manual clot evacuation from the anterior chamber in a general hospital. Results:The postoperative control of intraocular pressure was found to be adequate in all patients at the end of two months. Examination of the posterior segment was made possible earlier. Although the procedure is more complex, no significant complications were encountered. Conclusion:In patients presenting with traumatic hyphaema, secondary glaucoma and corneal blood staining, trabeculectomy with manual extraction of the clot through a large incision appears to be a safe and reliable procedure where medical therapy fails to control the intraocular pressure.
A controlled clinical trial of Dorzolamide: a single‐centre subset of a multicentre study
Authors: Simpson Allan J. , Gray Trevor B. , Ballantyne Claire 
Published: November 2007

Abstract Purpose:To assess the safety and intraocular pressure (IOP)‐lowering activity of 2% dorzolamide (topical carbonic anhydrase inhibitor), compared to 0.5% timolol and 0.5% betaxolol eyedrops. Methods:A parallel, masked, randomised one‐year clinical trial was conducted in 16 patients with open‐angle glaucoma or ocular hypertension, being a subset of a multicentre study which enrolled 523 subjects. Patients had IOP > 22 mmHg in one eye at baseline following washout of ocular hypotensive medications and were then randomised in a 3:l:l ratio to receive 2% dorzolamide thrice daily, 0.5% timolol twice daily or 0.5% betaxolol twice daily respectively. IOP was measured at Hour 2 (morning peak), Hour 5 and Hour 8 (afternoon trough for dorzolamide) at baseline, Weeks 2 and 4 and Months 2, 3, 6, 9 and 12. Results:Topical dorzolamide 2% solution was well tolerated and safe. Mean IOP for dorzolamide at Hour 2 was 29.1 mmHg at baseline and 20.8 mmHg on treatment at one year, a 28.5% change. Mean IOP for dorzolamide at Hour 8 was 24.5 mmHg at baseline and 20.2 mmHg on treatment at one year, a 17.6% change. Comparable percent changes for timolol and betaxolol were 43.2/25.7 mmHg at Hour 2 and 21.9/13.5 mmHg at Hour 8 respectively. Conclusions:Dozolamide 2% given thrice daily was well tolerated and safe, with a clinically significant effect on IOP comparable to betaxolol 0.5% twice daily, but not as great as timolol 0.5% twice daily.
Precipitous visual loss secondary to optic nerve toxoplasmosis as an unusual presentation of AIDS
Authors: Wei Marc E. , Campbell Stephen H. , Taylor Chris 
Published: November 2007

AbstractLife‐threatening conditions requiring urgent medical treatment rarely present to the ophthalmolgist. This case report describes a patient with precipitious visual loss as the primary complaint and which subsequently led to the diagnosis of Toxoplasmic papillitis and life‐threatening cerebral involvement as an initial manifestation of AIDS.
The revolution in molecular genetics and its impact on ophthalmology
Authors: Della Neil G. 
Published: November 2007

AbstractRapid advances in molecular technology have led to the identification of many genes responsible for inherited disease in ophthalmology. These discoveries also portend an understanding of the pathogenesis of more common ophthalmic disorders which have a genetic component, such as open‐angle glaucoma and age‐related macular degeneration. This review comprises a summary of these advances in molecular genetics, particularly the contribution of the Human Genome Project; a tabulation of the genes recently proven to be mutated in hereditary ocular conditions; and a discussion of the implications for the practising ophthalmologist.
Excirner phototherapeutic keratectomy for recurrent granular dystrophy
Authors: Maclean Hunter , Robinson Lyon P. , Wechsler Alfred W. , Goh Alvin 
Published: November 2007

Abstract Purpose: Corneal grafting is a standard treatment for visually disabling granular dystrophy. The visual results of this procedure are generally good, but can be marred by recurrences of granular deposits some years later. We report the results of phototherapeutic keratectomy (PTK) for recurrent granular dystrophy in three eyes from two patients and discuss the possibilities of treating de novo granular dystrophy with excimer laser. Methods: The records of two patients (three eyes) treated with excimer PTK for recurrent granular deposits on the donor cornea were reviewed. Results: In all cases visual acuity was improved and repeat corneal grafting avoided. No significant complications occurred although one eye had further recurrence of granular deposits which was also successfully retreated with excimer PTK. Follow‐up on these cases varies between five months and three years. Conclusions: We believe that excimer PTK offers a simple, safe and repeatable way of restoring visual acuity to most cases of recurrent granular dystrophy. Visual recovery is fast and all the incumbent problems of repeat grafting are avoided.
Evaluation of topical 0.03% flurbiprofen drops in the treatment of herpetic stromal keratitis
Authors: Vajpayee Rasik B. , Dhakal Bhim P. , Gupta Suresh K. , Sachdev Mahipal S. , Satpathy Geeta , Honavar Santosh G. , Panda Anita 
Published: November 2007

Abstract Purpose: The management protocol for herpetic stromal keratitis (HSK) is still controversial. We have attempted to compare the relative efficacy of topical dexamethasone 0.01 % and flurbiprofen 0.03% in combination with topical acyclovir 3% in HSK. Methods: In this institutional, prospective, randomized, controlled, double‐blind study, 45 clinically diagnosed cases of HSK were randomly distributed into three coded treatment groups — topical placebo, dexamethasone 0.01 %, and flurbiprofen 0.03% each in tapering frequency and in combination with acyclovir 3% ointment five times per day for four weeks. Therapeutic response was assessed every third day for four weeks. Decoding of the treatment groups was done at the conclusion of the study and data analysed. Results: Four‐week success rate was 93.3% (14 of 15) in the dexamethasone‐acyclovir treatment group, 66.7% (10 of 15) in the flurbiprofen‐acyclovir treatment group and 20% (3 of 15) in the placeboacyclovir treatment group. Conclusion: While dexamethasone in combination with acyclovir gives the best results in HSK with minimal side‐effects, the role of topical flurbiprofen seems promising.
Disturbance of central vision after carbonmonoxide poisoning
Authors: Fine Ronald D. , Parker Geoffrey D. 
Published: November 2007

Abstract Background: Cerebral achromatopsia is a disturbance of colour perception which may be complete or partial. Clinical record: A 28‐year‐old male patient presented five months after carbon monoxide poisoning with achromatopsia. The achromatopsia was unaccompanied by an inability to recognise faces (prosopagnosia) nor was there any disorder of form or depth perception. Results: Magnetic resonance imaging showed bilateral sharply defied areas of haemorrhagic infarction in the globus pallidus with extensive infarction involving temporal and occipital lobes and with apparent partial sparing of the visual cortex, presumably due to arterial insufficiency. The disturbance of central colour vision resolved spontaneously after a further period of 6 months. Conclusion: The symptom of achromatopsia is analysed with particular reference to the recent work of Professor Zeki on disturbance of central colour vision following CO poisoning and the unusual MRI findings.
Macula toxicity after intravitreal amikacin
Authors: Seawright Ashley A. , Bourke Robert D. , Cooling Robert J. 
Published: November 2007

Abstract Background: Although intravitreal aminoglycosides have substantially improved visual prognosis in endophthalmitis, macular infarction may impair full visual recovery. Methods: We present a case of presumed amikacin retinal toxicity following treatment with amikacin and vancomycin for alpha‐haemolytic streptococcal endophthalmitis. Results: Endophthalmitis resolved with improvement in visual acuity to 6/24 at three months. Fundus fluorescein angiography confirmed macular capillary closure and telangiectasis. Conclusions: CurrentIy accepted intravitreal antibiotic regimens may cause retinal toxicity and macular ischaemia. Treatment strategies aimed at avoiding retinal toxicity are discussed.