bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strabismus, epilepsy vs. motor & neurological disorders in quadriplegia
Authors: TIGANITA S , KOZEIS N , GOGAKI H , STOJANOVIC N , MOUTLIAS A , DIMOPOULOS A 
Published: September 2008

Abstract Purpose To correlate strabismus and epilepsy with the severity of the motor and brain disorder in spastic quadriplegic children. Methods 52 quadriplegic children (2‐9 years of age) participated in this study. Strabismus (Krimsky test), gross motor function (GMFCS) were estimated and EEG and brain MRI were also performed. Results 29 children were premature and 23 were full terms. 30 out of 52 (57.69%) had epilepsy, 29 out of 52 (55.76%) had strabismus (19 (36.53%) esotropia & 10 (19.23%) exotropia). 73.07% of the children had moderate to very severe motor disorders. 32 children (61.53%) had periventricular leukomalacia and 20 (38.47%) had various brain damages. Conclusion Epilepsy and strabismus are very common in quadriplegia and there is a statistically significant relationship between epilepsy, strabismus and neurological and brain damage.
Treatment of acquired periodic alternating nystagmus with memantine
Authors: MCLEAN RJ , THOMAS S , FAROOQ SJ , PROUDLOCK FA , GOTTLOB I 
Published: September 2008

Abstract Purpose To report a patient with acquired periodic alternating nystagmus secondary to sarcoidosis successfully treated with memantine Methods A 43 year old man had a four year history of acquired horizontal periodic alternating nystagmus (PAN) with oscillopsia secondary to sarcoidosis. Visual acuity (VA) was measured and eye movement recordings were performed with an infra‐red eye tracker (Eyelink I, 250 Hz) before and after treatment with 5 mg memantine per day Results The visual acuity (VA) was 6/36 in the right eye and 6/24 in the left eye during maximum nystagmus amplitude. The duration of the right beating and left beating phases was 105‐110 seconds and of the quite phases was 4‐5 seconds. During the quiet phase the nystagmus was insignificant. On memantine the patient became significantly less symptomatic. The right visual acuity improved to 6/6 and the left to 6/4 during the entire cycle of PAN. Before treatment the nystagmus reached a maximum intensity of 11.9°/sec (frequency 3.6 Hz and amplitude 3.3°) during right beating periods and 14.0°/sec (frequency 3.5Hz and amplitude 4.0°) during left beating. Again the quiet phases in between were insignificant in terms of nystagmus. After treatment of 5mg of memantine per day the intensity was reduced to a maximum intensity of 0.41°/sec (frequency 1.54 Hz and amplitude 0.26°) during right beating period and 0.54°/sec (frequency 1.28 Hz and amplitude 0.42°) during left beating. Conclusion We showed for the first time that memantine can reduce PAN dramatically (4% of the original amount). Treatment with memantine should be investigated systematically in PAN.
Biochemical markers in the vitreous
Authors: VAN AKEN E 
Published: September 2008

Abstract Purpose Prealbumin is a 55kDa protein (transthyretin) which plays an important role in the plasma transport of retinol in complex with retinol‐binding protein. It is also synthesized by the retinal pigmentepithelium (RPE) but the functional significance of ocular prealbumin is still unclear. In this study, we wanted to explore the use of prealbumin as a biochemical marker in human vitreous fluid in various conditions. Methods Prealbumin concentration was assayed in vitreous fluid using a BN II nephelometer (Dade Behring). Cadaver eyes (n =59) served as a reference. Vitreous fluid was investigated in 64 patients where therapeutic vitrectomy was indicated: 9 eyes were operated on for retinal detachment less than 1 week old, 25 eyes for longstanding retinal detachment (more than 1 week old), another 13 for proliferative diabetic retinopathy, 17 patients had vitreoretinal retraction at the macula, and in 1 case floaterectomy was performed. Results In the reference group, median prealbumin value was 6.0 mg/l (IQR: 2‐19.8 mg/l); total protein: median 567 mg/l; IQR: 271‐996 mg/l). For patients operated for retinal detachment, prealbumin values were lowest in patients with retinal detachment less than 1 week old (median: 3 mg/l, IQR: 0‐12 mg/l) and highest for patients with longstanding retinal detachment (median: 17 mg/l, IQR: 1‐25 mg/l)(P<0.05). Conclusion Prealbumin is abundant in human vitreous fluid. In pathological conditions, prealbumin values may vary. No correlation was found between prealbumin levels and total protein levels in vitreous fluid. In particular, patients with longstanding retinal detachment showed highest prealbumin values. This might be due to increased synthesis of prealbumin by RPE cells. Prealbumin concentrations in the vitreous may be used as a marker for retinal dysfunction.
Zonal differentiation of the epithelium including the lid wiper at the human lid margin
Authors: KNOP E , KNOP N , ZHIVOV A , KRAAK R , KORB D , GREINER JV , GUTHOFF R 
Published: September 2008

Abstract Purpose The lid margin represent the “other end” of the tear film and appear critically important for ocular surface integrity, in addition to the glandular structures that produce the tears. It guarantees the thin expansion of the tear film with every blink and prevents the leakage of tears over the lid border. However, the differentiation of the lid margin zones is insufficiently known as yet. Methods The upper and lower lid margin in human whole‐mount specimens from ten body donors was investigated in serial section histology and compared to the image by in‐vivo confocal microscopy in four eyes with a Heidelberg retina tomograph and Rostock cornea module (RLSM). Results At the inner lid border, following the keratinised epidermis of the free lid margin, a narrow zone (100‐150µm) of para‐keratinised squamous epithelium represented the muco‐cutaneous junction (MCJ) corresponding to the line of Marx. This was followed by a much broader zone of epithelial thickening (50‐100µm) that formed a kind of cushion, reclined sharply at the inner lid border and represented the so called lid wiper which extended for about 1mm and finally transformed into the epithelium of the sub‐tarsal fold. MCJ and lid wiper extended all along the lid margin from nasal to temporal in upper and lower lid. Details of the epithelial structure as well as the underlying dermal papillae in these zones were also detectable by RLSM. Conclusion Due to its location and structure, the lid wiper appears as the structure that actually spreads the tear film and is distinct from the MCJ/line of Marx. Better knowledge of the lid margin structure and its different zones appears important for the understanding of ocular surface disease, in particular the dry eye disease.
New surgical techniques for reconstruction of the lid margin
Authors: GICQUEL JJ 
Published: September 2008

AbstractThe lid margins are extremely important to the health of the ocular surface. They play a major role in the distribution of the tear film over the eye. It is therefore important that disease of the eyelid margins be controlled before significant scarring of the ocular surface occurs. Two or three rows of eyelashes are present in the upper eyelid margin and one or two rows of eyelashes in the lower one. The tarsal plates include the meibomian glands. The objectives of eyelid margin surgery are both functional and cosmetic. Structural eyelid margin defects should be corrected with surgical techniques that return the anatomy to as close to normal as possible. Upper eyelashes should be preserved during the surgical procedures because defects of eyelashes in the upper eyelid are very visible. Restoring normal three dimensional anatomy (good lid contour, continuity of the lashes, etc) allows the eyelid margins to keep their functions for ocular surface protection and tear film distribution and gives optimal cosmetic result. In the time we will have in this session, we will seek to focus on the up to date surgical techniques that can be employed to correct inherited or acquired eyelid margin structural defects.
Genetic epidemiology studies of cataract in a population‐based biobank
Authors: MCCARTY CA 
Published: September 2008

Abstract Purpose To describe genetic epidemiology studies of cataract in the Marshfield Clinic Personalized Medicine Research Project (PMRP) Methods The PMRP is the largest population‐based biobank in the US. Nearly 20,000 adults aged 18 years and older have participated, with stored DNA, plasma and serum samples, and access to the Marshfield Clinic medical records. Subjects complete a brief questionniare that includes questions about smoking and alcohol intake. Height and weight are measured and body mass index is calculated. A candidate gene study of age‐related cataract has been completed and a genome‐wide association study (GWAS) of age‐related cataract is currently underway. Cataract cases are identified through diagnostic codes for cataract and procedure codes for lens extraction. Exclusionary diagnoses and procedures include congenital cataract, after‐cataract, traumatic cataract and steroid‐induced cataract. Controls are identified by the absence of any of the inclusion diagnoses and procedures in the context of an eye exam in subjects aged 50 years and older in the previous five years. Cataract location (cortical, nuclear, PSC) is identified through manual chart abstraction and natural language processing of dictated notes. Results In the candidate gene study of 1618 cataract surgery cases and 495 controls aged 60+, a SNP in the CRYGB gene proposed for study by Dr. Jochen Gray was found to be significantly associated with cataract surgery for females only. Electronic algorithms to accurately identify cases and controls for the GWAS study will be presented. Conclusion It is possible to conduct scientifically rigorous genetic epdiemiology studies of cataract in the context of a group medical practice. Care needs to be taken to accurately classify case and control status.
Risk factors for cataract in India: the INDEYE study
Authors: CAMPARINI M , MARAINI G , MURTHY GVS , RAVINDRAN RD , CHAKRAVARTHY U , FLETCHER AE 
Published: September 2008

Abstract Purpose To describe the prevalence of lens opacities and to assess risk factors in older people in India. Methods People aged 60 years and older identified using random cluster‐sampling in 2 study centres in north and south India, attended an eye examination. Digital images of lens opacities were graded using the Lens Opacity Classification System III. To identify lifestyle and environmental factors associated with lens opacities, assessment of different potential risk factors was performed, with a focus on cooking fuels, tobacco and alcohol use, sunlight exposure, diet and antioxidant blood levels. Results 2821 people in north India and 3079 in south India attended an eye examination. The prevalence of any cataract was 73.6% and similar in the two centres (p=0.2). Type of cataract differed in prevalence between the centres: nuclear 60.0% in north India, 48.0% in south India; posterior subcapsular 26.5% in north India, 21.7% in south India; cortical 9.6% in north India and 12.8 % in south India. Prevalence of any cataract rose with age (54.9%, age group 60‐64 years; 90.3%, age group 70 years and older, p<0.001) and was higher in women than in men (76.7%, women; 70.1%, men, p<0.001). Similar patterns with age and gender were observed for each type of cataract. Among risk factors, tobacco use, exposure to cooking fuels and antioxidants levels were significantly associated with cataract (p<0.001). Conclusion Cataract prevalence, especially posterior subcapsular cataract, is very high in older Indians compared to comparable age groups in western populations. Factors as tobacco use, exposure to cooking fuels and low antioxidant blood levels may in part explain the high prevalence of cataract in this population.
Microperimetry, PERG and mfERG in patients with Stargardt dystrophy
Authors: JARC‐VIDMAR M , POPOVIC P , LENASSI E , BRECELJ J 
Published: September 2008

Abstract Purpose The aim of our study was to evaluate retinal function in patients with genetically determined mutation in the ABCR gene by correlating retinal morphology with functional and electrophysiological tests. Methods 12 patients (10F, 2M, VA: 0,2±0,2) were included in the study. The central 10º visual fields were tested with Octopus M2 TOP and microperimetry (MP1, Nidek technologies), that enables one to compare central retinal sensitivity and fixation patterns in relation to the fundus image. PERG and mfERG were recorded in all the patients according to the ISCEV standards. Results mfERG showed reduced responses mostly in the inner three rings (ring 1: 33,9% of mean normal value, ring 2: 35,4%, ring 3: 57,5%, ring 4: 75,5%, ring 5: 84% of mean normal value). There was good correlation between mfERG and pattern P50 (r=0,7, p=0,0001) and N95 responses (r= 0,6, p=0,004). mfERG appears more sensitive for central retinal testing than pattern ERG. There was a high correlation found between microperimetry (MP) and static perimetry (MD, r = 0.6, p=0.008). Shift of fixation to the preferred retinal locus(seen on MP) was found in 8 out of 16 eyes tested with VA 0,2 and less. In patients with absolute central scotoma and shifting of fixation, scotoma may erroneously be interpreted as eccentric when seen only with static perimetry. Conclusion In patients with visual acuity 0,2 and lower, the fixation shift to the preferred retinal locus was observed. Cautious interpretation of the static perimetry and mfERG as well as PERG is needed in patients with eccentric and nonstable fixation.
Ocular rigidity and hydrodynamics of the human eye
Authors: PALLIKARIS IG , GINIS HS , DASTIRIDOU AI , DE BROUWERE D , KYMIONIS G , TSILIMBARIS MK 
Published: September 2008

Abstract Purpose The intraocular pressure (IOP) is the primary mechanical load to several ocular structures. It fluctuates over time as a result of a dynamic equilibrium between the systems of aqueous and blood flow. The purpose of this study is to characterize the eye’s pressure volume relationship and quantify hydro and haemodynamic parameters in the living human eye. Methods An invasive manometric dynamic measurement procedure was developed and used in a series of healthy and pathological eyes measured intraoperatively before cataract surgery. Different measurement protocols involving injection of predetermined doses of saline and monitoring the IOP in a time‐resolved manner, allow the measurement of ocular rigidity, outflow facility and pulsatile ocular blood flow. In addition, a new non‐invasive ultrasound based technique enabled us to visualize and define the elastic properties of the ocular globe and periocular structures. Results Measurements in humans indicate that the above techniques are safe and effective. A non‐linear pressure‐volume relationship is established. The ocular pulse amplitude (and therefore pulsatile ocular blood flow) is shown to correlate with IOP. Conclusion A model that incorporates ocular rigidity is proposed in order to describe and quantify the relationship between hydrodynamic and hemodynamic parameters of the human eye. These measurements along with the use of new non invasive techniques may improve our understanding of the relationship between these parameters and their significance in health and disease.
Biomechanics of the eye tunic, especially the sclera and the cornea
Authors: SPOERL E , TERAI N , BOEHM AG , RAISKUP‐WOLF F , PILLUNAT LE 
Published: September 2008

Abstract Purpose The biomechanics of the cornea is not only important for IOP‐measurement but also for the outcome of refractive surgery. In recent studies, a thin cornea was also identified as an independent risk factor for the onset and progression of glaucoma. Besides, the rigidity of the sclera was proposed to play an important role in glaucoma and myopia. Methods An overview of biomechanical properties of the cornea and the sclera, based on own research results and on recent literature references, was performed. Results A stiffer cornea led to an overestimation of true IOP measured by applanation tonometry. The stiffness of the cornea increased by age compared to a decreasing corneal thickness. The Ocular Response Analyzer (ORA) measures the viscosity of the cornea. Paradoxically, ORA measurement revealed a reduction of corneal hysteresis with age which may indicate that corneal hysteresis is not equal to stiffness. In glaucoma the scleral and corneal rigidity increased in contrast to a reduced corneal hysteresis (CH) which may indicate that a damping effect of these tissues is reduced in glaucoma patients. Conversely, a more flexible and distensible sclera, lamina cribrosa and cornea were proposed to be beneficial to protect against experimentally induced IOP‐spikes. Conclusion A biomechanical concept of the eye tunic (cornea, sclera and lamina cribrosa) may further help to explain the relationship between IOP measurements, refractive surgery and glaucoma.
Cone electroretinograms to blue flashes on various backgrounds
Authors: SUSTAR M , BRECELJ J 
Published: September 2008

Abstract Purpose To observe the S‐cone and LM‐cone responses of the photopic electroretinogram (ERG), to study their interactions, and to define under which stimulus conditions the ERG waveform reflect the function of the S‐cone as well as the L‐ and M‐cone systems. Methods The photopic ERG was recorded from 10 control subjects in a full‐field stimulator (Diagnosys LLC, Littleton, MA). Responses were elicited with intensity series (0.004 to 1 cd*s/m2) of the blue (449 nm) stimuli on a 100 ph cd/m2 amber background (=40 sc cd/m2), as well as on a 100 ph cd/m2 green and a 40 sc cd/m2 red backgrounds. Results The S‐cone response appeared at the implicit time of 43 ms, with lower stimulus intensities on the amber, green and red backgrounds. With higher stimulus intensities (0.028 cd*s/m2), it showed with a similar implicit time, but as a second peak subsequent to the LM‐cone response (b‐wave). With a further increase in intensity (0.15 cd*s/m2), the S‐cone response passed into the i‐wave of the LM‐cone system. The LM‐cone response appeared as a double peak (first peak: 24 ms; second peak: 28 ms) on an amber background at intensities from 0.028 cd*s/m2 and above. On a green background, the first peak was more prominent, while on a red background, the second peak dominated the LM‐cone response. This pattern of double‐peak appearance might indicate that the first peak originates mostly from the L‐cone system and the second peak from the M‐cone system. Conclusion The S‐cone response can be elicited with various backgrounds as a single peak to a blue flash at lower intensities, while with brighter intensities it probably interacts with the LM‐cone system. The double peak of the LM‐cone response is an interesting finding, which might indicate selective monitoring the L‐ and M‐cone systems.
Autofluorescence and microperimetry in clinically significant diabetic macular edema
Authors: BOTTEGA E , VUJOSEVIC S , PILOTTO E , BENETTI E , CASCIANO M , MIDENA E 
Published: September 2008

Abstract Purpose Clinically significant diabetic macular edema (CSME) shows variable retinal structural and functional impairment. The aim of this study was to assess the correlation between different macular parameters, mainly fundus autofluorescence (FAF) and macular sensitivity, in diabetics with CSME. Methods Sixty diabetic patients with untreated CSME (104 eyes) underwent: best corrected visual acuity determination (BCVA, logMAR), slit lamp biomicroscopy, fluorescein angiography, OCT, FAF and microperimetry. Results Thirty eyes had normal FAF , whereas 74 increased (IFAF) pattern. Retinal sensitivity over areas with IFAF was significantly lower than over areas with normal FAF (p<0.001). Cystoid OCT‐pattern correlated to both presence and dimension of IFAF (p<0.05), whereas sponge‐like and subfoveal neuroretinal detachment did not. BCVA did not correlate either to FAF pattern or area of IFAF. Conclusion Functional impact of CSME correlate with IFAF and is better determined with macular microperimetry rather than VA. Increased FAF seems to be a relevant characteristic of cystoid CSME. New structural and functional parameters should be used to better predict the prognosis of (treated and untreated) eyes affected by CSME.
Segmentation of spectral domain OCT volume scans of patients with no or minimal diabetic retinopathy
Authors: VAN DIJK HW , VAN VELTHOVEN MEJ , GRAVIN‐HAEKER M , KOK PHB , VERBRAAK FD , ABRAMOFF MD 
Published: September 2008

Abstract Purpose A comparison of thickness measurements of segmented spectral domain optical coherence tomography (OCT) derived topographic maps of patients with no or minimal diabetic retinopathy (DR) versus healthy controls. Methods Ninety‐nine patients, 44 with type 1 DM, and 36 with type 2 DM, with no or minimal DR underwent full ophthalmic examination, fundus photography and spectral domain OCT (3D OCT‐1000, Topcon). Following automated segmentation the mean thickness was calculated for 6 layers: 1/ Retinal Nerve Fibre Layer (RNFL), 2/ Ganglioncell layer (GCL) + Inner Plexiform Layer (IPL), 3/ Inner Nuclear Layer, 4/ Outer Plexiform Layer, 5/ Outer Nuclear Layer + Inner Segments (photoreceptor), 6/ Outer Segments (photoreceptor), in the ETDRS defined regions of the macula and compared to 76 age and sex matched healthy controls. Results The total retinal thickness in the diabetic patients was reduced compared to the healthy controls. In the diabetic patients both the mean RNFL and the mean OPL were significantly (p<0.05) thinner. Conclusion The decreased total retinal thickness in diabetic patients with no or minimal retinopathy may be due to a selective loss of thickness in several retinal layers and supports the concept of early DR as a neuro‐degenerative disease.
The extraocular muscles in Amyotrophic Lateral Sclerosis (ALS)?
Authors: PEDROSA DOMELLOF F , BRÄNNSTRÖM T , ANDERSEN PM , LIU JX 
Published: September 2008

Abstract Purpose To investigate the morphology, fiber type composition, contractile proteins, extracelluar matrix (ECM), innervation and capillarisation, of the extraocular muscles (EOM) of patients deceased with ALS, in order to evaluate the possible involvement of EOMs in this disease. Methods EOM and limb muscle samples obtained from 5 ALS patients and age matched controls at autopsy were processed for immunocytochemistry, with monoclonal antibodies against myosin heavy chain isoforms; laminin chains (Ln) α1, α2, α4, α5 and β2; etc. Hematoxylin and eosin, NADH‐TR, acetylcholinesterase and alpha‐bungarotoxin were also used. Results The EOMs of ALS patients appeared remarkably unaffected, in strong contrast to the limb muscles. Wider variation in fiber diameter than normally seen in EOMs, including apparently atrophic and hypertrophic groups of fibers, was noted. MyHC embryonic was only present in sporadic fibers and the pattern of distribution of MyHC slow‐tonic was also affected. In most ALS cases, Ln α4, α5 and β2 isoforms were lost from the basement membrane of the EOM fibers . The laminin content of the neuromuscular junctions was altered, Ln α2 and β2 isoforms were missing in perineurium and endoneurium and Ln α5 was absent in endoneurium. In capillary and blood vessels, Ln α4, α5 were maintained whereas Ln β2 was absent. Conclusion The changes observed in EOMs with ALS suggest that they are not completely spared in this motoneuron disease although they are significantly less affected that limb muscles. The altered contractile protein content and structure‐specific changes in the composition of the ECM are likely to be functionally relevant. Further studies are underway to determine the functional implications of our findings.