bluuebunny/crossref_metadata_2025_split huggingface dataset:
Douglas Argyll Robertson (1837‐1909) – what did he do other than describe the Argyll Robertson Pupil?
Authors: GRZYBOWSKI A , PLANT G 
Published: September 2008

Abstract Purpose To study medical achievements of Douglas Argyll Robertson in ophthalmology. Methods The data dealt with in this paper is analysed both from the historical and present‐day perspectives. Results Douglas Argyll Robertson (1837‐1909) was the first surgeon in Scotland to practice entirely in the field of ophthalmology. In this he was no doubt encouraged by the memory of his father, John Argyll Robertson, who was one of the founders of the Edinburgh Eye Dipensary but who had died when his son was only 18 years of age. Douglas completed his medical education under von Arlt in Prague and Albrecht von Graefe in Berlin. Argyll Robertson made major contributions to ophthalmic surgery. He introduced extracts of Calabar bean (Physostigma venenosum), in the treatment of glaucoma. He also described in cases of spinal cord disease that there may be loss of the light reflex of the pupil but retention of its movement in accommodation. This condition was named the "Argyll Robertson pupil" and as a clinical sign is almost always indicative of neurosyphilis. His other contributions include: lupus of the eyelid, aetiology of glaucoma, melanotic tumor, diphtheritic ophthalmia, sympathetic ophthalmia, retinitis pigmentosa, hypertrophy of the lacrimal gland, senile entropion, hydrophthalmos, asteroid hyalitis, pulsating exophthalmos, conjunctival filiariasis, albuminuric retinitis, miner’s nystagmus and microphthalmos. Argyll Robertson is also credited with being the first to recommend trephining the sclera in those cases of glaucoma where extensive degenerative changes in the iris made an iridectomy impracticable. Conclusion As we approach the centenary of his death Argyll Robertson deserves to be celebrated for more than his pupil.
The use of femtosecond laser in corneal transplantation
Authors: NUBILE M 
Published: September 2008

Abstract Purpose Femtosecond laser (FSL) devices, based on the physical phenomena of ultrashort laser pulses in the sub‐picosecond range of duration, have gained significant interest in ophthalmology thanks to their potential for high‐precision microsurgery, particularly in applications involving the transparent tissue of the cornea that take the greatest advantage of these attributes. The potential advantages and limits in using FSL in the field of corneal grafts are presented Methods FSL is applied in performing deep lamellar (DALK), penetrating keratoplasty (PK) and arcuate keratotomy (AK) in human eyes. Clinical and histological analysis was performed. Results FSL technology enables multiple cut configurations and customized‐shaped PK, DALK and AK are feasible techniques. PK with complex wound shapes including top‐hat profile and orientation teeth and notches can be performed. FSL‐deep lamellar dissection both for DALK and endothelial transplantation presents a good morphology of the dissection plane. The graft geometry in DALK for keratoconus, in contrast, shows limits related to the posterior stromal bed shape. Transmission electron microscopy revealed precise geometry and good quality of the cuts. Customised shaped paired AK can be successfully performed to treat high post‐keratoplasty astigmatims. Conclusion Femtosecond laser technology may offer further promising approaches towards customized trephination, and dissection procedures in the field of corneal transplantation.
UVR‐effects in human versus animal eyes: more contradictions or more similarities?
Authors: WEGENER A 
Published: September 2008

Abstract Purpose To compare the characteristics and time scales of UV‐radiation effects in the eye, especially the lens, investigated and documented in human and various animal species. The target is to test the predictability potential of animal experiments for characterization of human UV‐risk scenarios. Methods Experimental studies on UV‐effects to the cornea and lens in mice and rats are critically compared to epidemiological studies on UV‐ effects to the human eye. Results Animal studies provide a broad spectrum of data on genetical and environmental factors leading to various types of cataracts and corneal alterations. Many patho‐physiological factors are identified. Epidemiological studies in humans identify other noxious factors but the most important difference seems to be the time scale and thus the age‐related difference in UV‐sensitivity of the lens and the anterior eye segment. Conclusion Future studies should focus more on species‐ and age‐related sensitivities of the lens to UVR effects and on the influence of systemic effects, also in relation to ocular immunology.
Oxidative stress in lens epithelial cells after UVR exposure
Authors: LÖFGREN S , GALICHANIN K , LOU MF , SÖDERBERG PG 
Published: September 2008

Abstract Purpose The lens epithelium is the primary target in solar photooxidation. Thioltransferase is a repair enzyme capable of reactivating oxidized critical proteins and enzymes in the cells. Methods Primary lens epithelial cell cultures from wild type and thioltransferase knockout mice were exposed to various doses of UV radiation or hydrogen peroxide. The short‐term reaction pattern of several glutathione‐related enzymes were investigated, as well as long‐term growth rate and cell adhesion. Results UV radiation induces a reaction pattern comparable to that of hydrogen peroxide, with initial increase or decrease in activity of antioxidative enzymes, and a subsequent recovery within 1‐2 hours. Low dose UVR exposure induces cell stimulating effects similar to treatment with low peroxide concentration. Conclusion Oxidative stress from peroxide and UVR might be channeled through same oxidant cellular pathway.
Systemic inflammatory response after ocular in vivo UVR‐300 nm exposure
Authors: MEYER L , WEGENER A , LÖFGREN S , GALICHANIN K , HOLZ FG , SÖDERBERG PG 
Published: September 2008

Abstract Purpose To investigate if unilateral in vivo UVR‐B exposure of one eye affects the contralateral eye in a co‐cataractogenic, sympathetic reaction and to determine if an inflammatory response is involved in the pathogenesis. Methods C57BL/6 mice were unilaterally exposed in vivo to UVR‐B for 15 minutes. Groups of 24 animals each received 0x/ 2x/ 3x/ or 4x cataract threshold equivalent dose. 48 hours following UVR ‐ B exposure cataract morphology was documented in dark field illumination photography and light scattering was quantified, in both lenses in vitro. Serum levels of pro‐inflammatory cytokines IL‐1ß, IL‐6 and TNF‐α were analyzed with ELISA. Immunohistochemistry was performed for inflammatory infiltration in exposed and contralateral eyes. Results UVR‐B exposure induced cataract in all exposed lenses. There was additionally a significant UVR dose dependent increase of light scattering in contralateral not exposed lenses. Inflammatory infiltration was detected immunohistochemically in the anterior segment of both eyes. IL‐1β serum concentration increased with increasing UVR‐B exposure dose. There was a similar trend for serum IL‐6 but not for TNF‐α. Conclusion Unilateral UVR‐B exposure increases light scattering also in the contralateral eye and triggers a systemic inflammatory response mediated by IL‐1β and possibly IL‐6. Age related cataract is almost exclusively a bilateral event. Since a systemic inflammatory response might be an important factor in cataractogenesis our results might initiate new strategies in the prevention of the disease.
Perfusion pressure and blood flow: difference and relevance
Authors: ORGUL S 
Published: September 2008

Abstract Purpose Maintenance of appropriate levels of regional blood flow play an essential role in the maintenance of a stable internal environment of an organism. The relative contributions of the different mechanisms vary between and within vascular beds. The ability of vascular beds, especially those not or not particularly responsive to neuronal regulatory mechanisms, to maintain, within certain limits, an independence of regional blood flow from local perfusion pressure is called autoregulation. Methods A proper appraisal of local perfusion pressure is mandatory if one is to understand blood flow and the effects of its perturbation. When speculating about ocular perfusion pressure, it has become customary to estimate mean blood pressure within the ophthalmic artery and to subtract the value of intraocular pressure, assumed to be equal to venous pressure. This concept, likely to be adequate under steady state condition in healthy eyes, may not hold under stress conditions or therapeutic interventions, as well as in disease states. Examples are manifold. Results Simple starvation may put a burden on the circulation to maintain the supply of metabolites, possibly solved by increasing transmural capillary filtration pressure. In glaucoma, an increased venous pressure has been described and, indeed, more force must be applied to the eye to induce retinal venous pulsations. These conditions are simple examples where our current approach in estimating ocular perfusion pressure is probably incorrect. Conclusion The regulatory responses of ocular vascular beds have not yet been elucidated in full detail, and care must be applied when speculating about ocular perfusion pressure, and many of our current assumptions with regards to autoregulation in the ocular circulation may need a very critical scrutiny.
Blood flow and metabolism measurements: are they ready for the clinic?
Authors: HARRIS A 
Published: September 2008

Abstract Purpose A growing number of epidemiological studies clearly identified reduced ocular diastolic perfusion pressure as a significant risk factor for open angle glaucoma (POAG), suggesting that optic nerve ischemia and hypoxia may play a role in the etiology and pathogenesis of POAG. Methods Advances in ultrasound, laser computerized image analysis and Doppler technologies, within the last two decades have made it possible to objectively measure ocular hemodynamics. Each technique, however, examines different facets of the vascular system focusing on varying anatomical location of blood vessels and providing differing hemodynamic outcomes. Results My talk will cover the pros and cons of the existing technologies for measuring ocular blood flow. Focusing on color Doppler imaging, scanning laser ophthalmoscopy with fluorescein, scanning laser ophthalmoscopy with indo‐cyanine green, Heidelberg retinal flowmetry, laser Doppler flowmetry, retinal vessel analyzer (RVA) as well as the new generation of technologies aimed at measuring oxygen saturation in the optic nerve head and retina. Conclusion At present no single technique can accurately assess all relevant vascular beds. More development and emphasis is necessary. This presentation will also focus on possible clinical utilization of ocular blood flow and metabolism measurements.
Available educational material from the European Glaucoma Society on ocular blood flow techniques
Authors: STALMANS I , ORGüL S , SCHMETTERER L , HARRIS A , TRAVERSO C 
Published: September 2008

AbstractOne of the major aims of the European Glaucoma Society is to provide education on glaucoma. Recently, an educational DVD was developed thanks to a joint effort of experts in the field. This DVD provides a comprehensive overview of various techniques that are used in the field of glaucoma. In the chapter on ocular blood flow, the following techniques are described: color Doppler imaging (CDI), retinal vessel analyzer (RVA), laser Doppler flowmetry (LDF) and confocal scanning Doppler flowmetry (HRF). The physical principles, the measured vascular beds and parameters, the clinical protocol, as well as the advantages and disadvantages are discussed and illustrated.
Variation of intraocular pressure (IOP) & central corneal thickness (CCT) in neonates
Authors: AGGELIDOY E , KOZEIS N , FELEKIDIS A , DROSOU‐AGAKIDOU V 
Published: September 2008

Abstract Purpose To record the variation of IOP and CCT during the neonatal period. Also, to investigate the relationship between IOP & CCT. Methods 52 neonates, pre‐ and full terms, with GA 24 to 40 weeks (31.9 w) and BW 720 – 3180 gr (1913 gr) participated in this study. IOP measurement was done by Tono‐Pen applanation tonometer and CCT measurement was done by Accutome ultrasound pachymeter only to the right eye. All the measurements were done between 15.00 and 17.00 am. Babies who had undergone an eye operation, babies with eye dysplasias or anomalies, or using corticosteroids recently, were excluded from the study. Results Average CCT= 651,02 μm (STD= 63,19138) (min 528‐ max 750 μm) and the average IOP= 9.12 mmHg (STD= 2,931129). More specifically, in neonates with GA < 32 w, average CCT= 677.25 μm (STD= 51,13031) and average IOP= 9.4 mmHg (STD= 2,79). In neonates with 32<GA<37 w, average CCT= 638,5 μm (STD= 69,57379) and average IOP= 8.95 mmHg (STD= 2,601282). Finally, in neonates with GA > 37 w, average CCT= 613 μm (STD= 44,38919) and average IOP= 8,15 mmHg (STD= 3,275286). Conclusion CCT is reduced as the neonate grows, while the IOP is increased. Finally, lower IOP is accompanied by thinner CCT.
Epidemiology of conjunctival melanocytic neoplasms
Authors: KIVELÄ T , TUOMAALA S 
Published: September 2008

Abstract Purpose To summarise the epidemiology of conjunctival melanocytic neoplasms. Methods Review of population‐based data on 85 patients with primary conjunctival melanoma (CM) and recently published literature. Results CM accounts for 5‐7% of ocular melanoma in Europe. Its age‐adjusted incidence has increased 2‐fold in North Europe (Finland, from 0.40 to 0.80/million) and North America (USA, from 0.27 to 0.54) during the last 25 y. In both regions, age‐adjusted incidence is higher in men. Different rates between regions result from differences in registries, ethnicity and solar radiation. Age‐adjusted incidence of CM is 3‐fold in non‐Hispanic Caucasians and 2‐fold in Hispanics relative to Asians, African Americans and American Indians; among non‐Hispanic Caucasians it increases 2.5‐fold from 48 deg. (e.g. Paris) to 21 deg. (e.g. Mecca) of latitude. CM is rare below 30 y of age (age‐specific incidence, 0.06) but increases steadily thereafter (0.48, 1.05 and 1.57 for 30‐49, 50‐70 and >70 y, respectively). Median age at diagnosis is 58‐60 y. Most CM arise in limbal (57‐64%) followed by bulbar (12‐13%), palpebral (7‐9%) and caruncular (3%) conjunctiva. Tumor‐specific 5‐and 10‐y mortality estimates are 14‐20% and 29‐38%, respectively. Non‐limbal location, increasing tumor thickness and local recurrence are consistently associated with higher mortality. Clinically detectable primary acquired melanosis (PAM) and nevus precede or accompany CM in 57‐61% and 7‐23% of patients, respectively. Median age at diagnosis of PAM is 56 y. The risk of malignant change is not precisely known and depends heavily on subtype of PAM, ranging from 10 to 90%. Conclusion Recent studies provide epidemiological data on CM which are remarkably consistent. The epidemiology of conjunctival nevi and PAM is less precisely known.
Treatment of conjunctival melanocytic neoplasms: the Liverpool experience
Authors: DAMATO B , COUPLAND SE 
Published: September 2008

Abstract Purpose To audit the results of treatment of conjunctival melanoma in Liverpool. Methods Patients treated between 1993 and 2006 were identified by searching the Ocular Oncology Service database and pathology archives. The casenotes were reviewed. Patients were included if their conjunctival tumour was histologically diagnosed as invasive melanoma. Tumour extent and location were defined using a mapping system we developed. During the course of this study, cryotherapy was abandoned in favour of topical chemotherapy for intra‐epithelial melanocytic neoplasia and brachytherapy for invasive disease. Results Forty patients with invasive conjunctival melanoma were initially treated at our centre and another 36 were referred to us for salvage therapy after a surgical intervention elsewhere (11 with no visible tumour, 9 with intra‐epithelial disease and 16 with invasive melanoma). The patients we initially treated all retained the eye, most without significant visual loss. Recurrence occurred in six patients, none of whom had adjunctive brachytherapy. Four patients died of metastasis, all with caruncular involvement. After salvage therapy in 16 patients referred with recurrent or persistent invasive disease, two eyes were lost and five patients died, only one of whom had caruncular involvement. Conclusion Excision of invasive conjunctival melanoma with adjunctive brachytherapy and topical chemotherapy achieved high rates of local tumour control with little ocular morbidity. Without caruncular involvement, disease‐specific mortality was rare unless the patient was referred with invasive disease after a surgical procedure elsewhere. Our results suggest that inexpert surgical intervention increases the risk of local tumour recurrence and metastatic death.
Conjunctival melanoma : the Curie experience
Authors: LEVY‐GABRIEL C , DENDALE R , SASTRE X , PLANCHER C , LUMBROSO‐LE ROUIC L , ASSELAIN B , DESJARDINS L 
Published: September 2008

Abstract Purpose To evaluate the treatment of conjunctival melanoma at the Institut Curie in term of local recurrences, ocular preservation, distant metastasis and survival Methods Retrospective study of patients with conjunctival melanoma treated for their first tumoral localisation between January 2000 and December 2005. The clinical records, histologic features, ocular treatments were rewiewed. The rate of local recurrences, ocular preservation, regional and distant metastasis, and survival were recorded. Results During the study period, 91 patients were referred for conjunctival melanoma. 67 of them were treated for a first occurrence of malignant melanoma (38 women and 29 men). The mean age was 62 years (25 – 90). 32/67 patients (47 %) presented a primary acquired melanosis (PAM). Most cases (55 patients) were treated by surgical excision and adjunctive radiotherapy (Iodine plaque, protonbeam or external beam irradiation), 5 cases were treated by surgery alone, and the last 6 by surgery and adjunctive cryotherapy or adjunctive topical chemotherapy. 3 patients were lost of follow‐up. With a mean follow‐up of 52 months (15‐101months) 20/64 patients developped at least one local recurrence (between 1 and 7 recurrences). 16 of them presented a PAM. An enucleation was finally necessary for 1 patient and an exenteration for 2 patients. 7 patients developped metastatic disease (all but one presented a PAM) and 6 of them died. Conclusion Local recurrences, metastatic disease and tumor related death appear to occur at higher frequency when melanoma is associated with PAM. This risk must be taken into account in the therapeutic approach of conjunctival melanoma.
Comparison of the Schioetz indentation tonometer with the Tonopen® tonometer and the influence of two different anaesthetic techniques on the IOP in the porcine eye
Authors: BUEHNER E , PIETSCH U , WIEDEMANN P , UHLMANN S 
Published: September 2008

Abstract Purpose The aim of this study was to examine the accuracy of the intraocular pressure (IOP) reading of two portable tonometer in the porcine eye in situ. The influence of two anaesthetic techniques on the IOP was analysed. Methods Experiments were conducted in 20 healthy domestic white pigs. After a standard premedication 9 pigs were investigated under a total IV propofol anaesthesia (A) and 11 pigs under an isoflurane inhalation anaesthesia (B). IOP was measured at two different time points: prior to anaesthesia (time 1) and 15 minutes after induction of anaesthesia (time 2). To compare IOP measurements obtained with the digital Tonopen® with those of Schioetz tonometry, one single measurement, generated by Tonopen® tonometer was compared with a single reading from Schioetz tonometer in 11 pigs at time point 1 and 2 (isoflurane anaesthesia). Results A significant decrease in IOP of 13.8 % (A) and of 10.2 % (B) was measured in comparison to baseline IOP prior to general anaesthesia. There was a high significant (r = 0.68; p<.05) correlation at time 1 between the Schioetz and the Tonopen® tonometer but no significant correlation at time 2. Conclusion The significant IOP‐lowering effect of inhalation and total intravenous anaesthesia has to be considered in animal models. We point out that there are established methods for clinical measurements of the IOP but the user should be aware that there are differences in measured IOP when methods are compared.
Intraocular pressure variation during different surgical procedures in rabbit eyes.
Authors: VIEIRA DE SOUZA N , VIEIRA DE SOUZA E , VERONESE RODRIGUES ML 
Published: September 2008

Abstract Purpose To analyse intraocular and infusion line pressures during vitrectomy and cataract extraction (manual extracapsular extraction, phacofragmentation and phacoemulsification) in rabbit eyes. Methods Twenty‐two rabbits were submetted to vitrectomy (25 eyes) and cataract extraction (42 eyes) ‐ extracapsular approach (14 eyes), phacofragmentation (14 eyes) and phacoemulsification (14 eyes). Their intraocular pressures were recorded through an antertior chamber cannula connected to a computed polygraph. Infusion line pressure was monitored only during vitrectomy and phacofragmentation. Results Intraocular pressure spikes above 100 mmHg and sometimes almost reaching 200 mmHg were observed in this study. Phacoemulsification showed the greatest variation and phacofragmentation the smallest. The minimun pressures in all surgeries were around 0 mmHg. Infusion line pressure showed smaller variations than intraocular pressure. Conclusion During surgical procedures in rabbit eyes, such as vitrectomy, extracapsular cataract extraction, phacofragmentation and phacoemulsification, there is a great intraocular pressure variation. Intraocular pressure did not show a good relation to infusion line pressure.
Invasive measurement of outflow facility in the living human eye
Authors: GINIS H , DE BROUWERE D , DASTIRIDOU A , TSILIMBARIS MK , PALLIKARIS I 
Published: September 2008

Abstract Purpose To measure the pressure‐volume relationship (ocular rigidity) and outflow facility in the living human eye using a manometric device. Methods Fourty cataract patients (aged 63 (13)) were enrolled in the study. An invasive manometric intraoperative dynamic measurement procedure was employed, using a computer controlled device, comprising a pressure sensor and a dosimetric pump. The anterior chamber of the eye is cannulated through a 21 gauge needle, under topical anaesthesia with drops and the initial IOP is recorded. The IOP is artificially set to 10 mmHg and the eye is infused with microvolumes of BSS. The IOP is recorded for 2 seconds after each infusion step in order to calculate the average IOP and its fluctuation during this interval. At 40 mmHg, the infusion stops and the sensor records the IOP decay curve for 60 sec. The ocular rigidity coefficient is calculated by the IOP‐volume relation in the stepping sequence corrected for the volume loss from the outflow pathways. A model incorporating the value of ocular rigidity was developed to calculate the outflow facility from the outflow sequence. The study was approved by the Institutional Board and performed under the patient’s informed consent. Results The average rigidity coefficient of Friedenwald was of 0.0206 (sd 0.0042)μl ‐1. A nonlinear pressure volume relationship is found. The outflow facility was measured to be 0.31(sd 0.08) μl/min/mmHg. There were no complications related to the procedure. Conclusion This invasive method of measuring ocular rigidity and outflow facility is safe and effective. Accurate measurements obtained with this method, avoiding the errors of tonography, may provide a normal database of these parameters in living human eyes.