bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency treatment of chemical and thermal eye burns
Authors: Kuckelkorn Ralf , Schrage Norbert , Keller Gabriela , Redbrake Claudia 
Published: March 2003

ABSTRACT.Chemical and thermal eye burns account for a small but significant fraction of ocular trauma. The speed at which initial irrigation of the eye begins, has the greatest influence on the prognosis and outcome of eye burns. Water is commonly recommended as an irrigation fluid. However, water is hypotonic to the corneal stroma. The osmolarity gradient causes an increased water influx into the cornea and the invasion of the corrosive substance into deeper corneal structures. We therefore recommend higher osmolarities for the initial rinsing to mobilize water and the dissolved corrosives out of the burnt tissue. Universal systems such as amphoteric solutions, which have an unspecific binding with bases and acids, provide a convenient solution for emergency neutralisation. Both conservative anti‐inflammatory therapy and early surgical intervention are important to reduce the inflammatory response of the burnt tissue. In most severe eye burns, tenonplasty re‐establishes the conjunctival surface and limbal vascularity and prevents anterior segment necrosis.
Cataract surgery on diabetic patients. A prospective evaluation of risk factors and complications
Authors: Flesner Per , Sander Birgit , Henning Vibeke , Parving Hans‐Henrik , De La Cour Morten Dornonville , Lund‐Andersen Henrik 
Published: March 2003

ABSTRACT.Purpose: This study presents an evaluation of cataract surgery on diabetic patients. One experienced surgeon carried out phaco emulsification on all subjects and the same surface‐coated one‐piece PMMA‐lens‐type was implanted. The lens fluorescence and the blood‐aqueous barrier (BAB) were then evaluated as experimental preoperative risk indicators.
Results:
During follow‐up, 10 out of 39 diabetic patients progressed unilaterally in diabetic retinopathy or developed macular oedema, a significant relative risk. Neither lens fluorescence, BAB, HbA1c, level of retinopathy, type/duration of diabetes, diabetes treatment or antihypertensive treatment differed significantly between the group of patients with postoperative progression of retinopathy/macular oedema and those without. Results indicated NIDDM (non‐insulin‐dependent diabetes mellitus/type 2 diabetes) patients might have increased risk of a postoperative macular oedema.Conclusion: When diabetic retinopathy (DR) is not in a proliferative phase it should not be regarded as a contraindication to modern cataract surgery. Neither lens fluorescence nor BAB is valuable as a risk indicator for postoperative progression of DR.
Primary transpupillary thermotherapy (TTT) for malignant choroidal melanoma
Authors: Stoffelns B. M. 
Published: March 2003

ABSTRACT.Purpose:  To evaluate the efficacy of transpupillary thermotherapy (TTT) as the only method of treatment for small choroidal melanoma.Patients and Methods:  In a prospective non‐randomized analysis, 20 patients with primary choroidal melanoma (posterior to the equator with base ≤ 2 and thickness ≤ 4.5 mm) were treated with TTT as the only method of treatment (diode laser at 810 nm, beam diameter 3 mm, power setting 0.3–0.9 W, exposure time 20–37 min). During follow‐up of at least 6 months, clinical aspects, ultrasonographic tumour thickness, fluorescein and indocyanine green angiographic patterns, visual acuity and ocular side‐effects were recorded.Results:  In 17 eyes the tumour regressed significantly within 3 months after one treatment session (to a flat chorioretinal scar in 15 eyes). Despite a clinically flattened chorioretinal scar, fluorescein and indocyanine green angiography revealed that choriocapillary vessels in the heat‐treated areas of 15 eyes remained perfused. Three amelanotic melanomas showed almost no response to TTT after repeated treatment at higher power settings. Visual acuity remained unchanged or improved in 12 eyes. Ocular side‐effects included posterior synechia of the iris (1), macular oedema (2) and temporary retrobulbar pain (2). No patient showed tumour recurrence or metastases during follow‐up.Conclusions:  Preliminary results obtained by this study demonstrate good efficacy and visual outcome following TTT as the only method of treatment for small choroidal melanoma. However, indocyanine green angiographic findings suggest that tissue damage in the choroidal layer might be less effective, which perhaps may lead to a higher rate of tumour regrowth. Long‐term follow‐up is required to obtain data on late ocular side‐effects, tumour recurrence and metastasis.
Vitreous surgery combined with internal limiting membrane peeling for traumatic macular hole with severe retinal folds
Authors: Ikeda Tomohiro , Sato Keiko , Otani Hiroshige , Yu Saiyuu , Ikeda Naohiro , Mimura Osamu 
Published: March 2003

ABSTRACT.Purpose: To report a case of a traumatic macular hole with severe retinal folds in which vitreous surgery combined with internal limiting membrane (ILM) peeling was beneficial. To demonstrate that the area from which the ILM was peeled can be clearly differentiated by scanning laser ophthalmoscopy.
Methods:
A posterior hyaloid detachment was created during vitreous surgery on a 34 year old man with a traumatic macular hole. The remaining vitreous was resected and the ILM was peeled. The fundus was examined through a scanning laser ophthalmoscope before and after the surgery.Results: The retinal folds disappeared concurrently with the detachment of the ILM, resulting in closure of the macular hole. The area from which the ILM was peeled was clearly observed through the scanning laser ophthalmoscope.Conclusion: In this patient, it was helpful to perform not only posterior hyaloid detachment but also ILM peeling. The scanning laser ophthalmoscope was highly useful for observing the area from which the ILM was peeled.
A case of Coats' disease with a peeling of premacular fibrosis after photocoagulation
Authors: Sugimoto Masahiko , Sasoh Mikio , Ito Yoshikazu , Miyamura Masataka , Uji Yukitaka , Chujo Shinya 
Published: March 2003

ABSTRACT.We report a 26‐year‐old man with Coats' disease associated with premacular fibrosis. As an initial treatment, the peripheral exduative area was treated with argon laser photocoagulation. Six weeks later, the premacular fibrosis was peeled off and the posterior vitreous membrane was also detached. The patient's visual acuity improved to 20/20. We also observed a change of the vitreous component before and after the treatment that was similar to posterior vitreous detachment (PVD). This is the first reported case in which a distinct vitreous change was observed after premacular fibrosis peeling in Coat's disease.
Acquired anomalous head posture following loss of vision in one eye
Authors: Nucci Paolo , Rosenbaum Arthur 
Published: March 2003

ABSTRACT.Background:  We studied the anomalous head postures (AHPs) of five monocular viewing patients and investigated the possible causes and the appropriate surgical strategies to correct each condition.Methods:  Five patients with acquired visual loss in one eye and associated head tilt and/or turn were examined and treated for correcting the head posture according to the etiology of their respective AHPs.Results:  Three types of anomalous head position have been detected: head tilt related to cyclotropia, face turn associated with adduction blocked monocular nystagmus, and face turn to centre the visual field. Surgical plans were prepared according to the mechanism of the AHP in question. After surgery, all patients showed a marked reduction of the head tilt, except one who had a recurrence of the face turn 1 week postoperatively. Mean follow‐up time was 19 months.Horizontal transposition of the vertical muscles for correcting cyclotropia offered stable normalization of the AHP in three monocular viewing patients with head tilt, and represents a safe, viable and easy alternative to the Harada Ito procedure. Horizontal recession of the medial rectus of the fixing eye minimized the abduction nystagmus and relieved the need to adduct the fixing eye and subsequently rotate the head toward the fixing eye in one patient. Recurrence of the AHP occurred in one patient.Conclusion:  Different mechanisms may account for AHP in monocular viewing patients. Different surgical procedures may be used to correct the anomalous position. Careful patient selection and etiological diagnosis of AHP is required prior to developing a surgical strategy.
John G. Lindberg and the discovery of exfoliation syndrome
Authors: Tarkkanen Ahti , Kivelä Tero 
Published: March 2003

ABSTRACT.John G. Lindberg, a young Finnish ophthalmology resident, started a research project in 1914 aiming at an academic dissertation. His plan was to elucidate Axenfeld's observations on iris changes in senile eyes. Axenfeld had described two types of degeneration of the iris: a hyaline degeneration of the iris pupillary zone causing poor pupillary dilatation with mydriatics and an atrophy of the iris pigment epithelium at the pupillary border. For his research Lindberg had to construct a slit‐lamp biomicroscope by studying Gullstrand's monograph on the matter; slit‐lamp biomicroscopes were not commercially available at that time. A Sach's lamp was used for transillumination of the iris. While conducting his research Lindberg paid attention to greyish flakes and fringes at the pupillary border. He also noted how this strange material formed a membrane on the anterior lens surface. Documentation was made by skilful hand drawings. The new phenomenon was found to be as common in cataract patients as in non‐cataractous controls older than 55 years. The phenomenon was observed in 50% of glaucoma patients. Age was the decisive factor; the phenomenon was more prevalent with advancing age. Lindberg published his results as a thesis at the University of Helsinki in 1917. When attending a Nordic Congress of Ophthalmology in 1921, Lindberg met Norwegian ophthalmologist, Birger Malling, and gave him his thesis and explained the new findings. In 1920–21 Lindberg worked at Axenfeld's clinic in Freiburg, Germany. During this period he met in Basel, Switzerland, a Swiss ophthalmologist, Alfred Vogt. He told Vogt about his research and provided him with copies of his thesis. Both Malling and Vogt published papers on exfoliation in 1923 without referring to Lindberg's work. Lindberg did not, however, interfere with these papers. Thus Lindberg was forgotten by his contemporaries as a scientist. However, his main conclusions on exfoliation are still valid today. The life of this remarkable ophthalmologist is described in the present paper.
Uveal effusion and ultrasonic imaging: a clinical series
Authors: Fledelius Hans C. , Fuchs Helle Josefine , Jensen Peter Koch , Scherfig Erik 
Published: March 2003

ABSTRACT.Purpose:  To establish the diagnostic role of imaging by ultrasound for the diagnosis of uveal effusion syndrome.Methods:  Using ultrasonic imaging features as the main criteria for evaluation, the recorded data from 16 patients with presumed uveal effusion seen between 1994 and 2000 were reviewed and analysed for clinical manifestations and current diagnostic suggestions. Eventually, as cumulating experience suggested that ultrasound is capable of indicating uveal effusion, the study set‐up became in part more prospective.Results:  The two main ultrasonic features found were: (1) extended multi‐layered detachment patterns by B‐scan, often kinetically mobile; (2) a spongy oedematous ciliary body region, often with interstitial lacunae, as demonstrated by high‐resolution ultrasound biomicroscopy (50 Mhz).Conclusions:  In patients with visual loss and ambiguous detachment‐like fundus pathology, ultrasonic features are often of practical guidance for diagnosing uveal effusion syndrome.
Cataract in children after bone marrow transplantation: relation to conditioning regimen
Authors: Holmström Gerd , Borgström Birgit , Calissendorff Berit 
Published: March 2003

ABSTRACT.Purpose:  To compare the frequency of cataract development in bone marrow transplanted children who have been given either total body irradiation (TBI) or busulphan as conditioning treatment before bone marrow transplantation (BMT).Material and methods:  Forty‐five children who underwent BMT between 1987 and 1994 were included in the study. Twenty‐one children were conditioned with TBI and 24 with busulphan before BMT. All children underwent an ophthalmic examination before BMT in order to exclude lens opacities. Yearly examinations for 2–10 years were performed after BMT.Results:  Cataracts developed in 20 of the 21 (95%) children conditioned with TBI and in five of the 24 (21%) children conditioned with busulphan. There was no relationship between cataract development and age at BMT, or between cataract development and prednisolone given before or after BMT.Conclusion:  The present study confirms earlier reports of the high risk of cataract development after TBI and suggests that busulphan is related to cataract development, although less frequently than TBI. The report discusses the possible additive effect of the disease itself, of any corticosteroid treatment and of other cytostatic drugs. It then stresses the importance of early diagnosis of cataracts in children in order to prevent the development of amblyopia.
ON‐pathway disturbance in two siblings
Authors: Shinoda Kei , Ohde Hisao , Inoue Rikako , Ishida Susumu , Mashima Yukihiko , Oguchi Yoshihisa 
Published: March 2003

ABSTRACT.Purpose:  To present two clinical cases diagnosed with predominant cone dystrophy and demonstrating early disturbance in the on‐centre bipolar cells (ON‐pathway).Methods:  Electrophysiological findings are presented in two siblings with predominant cone dystrophy. The subjects showed no remarkable ophthalmoscopic or fluorescein angiographic retinal changes, but demonstrated progressive visual disturbance during their 20s.Results:  The electroretinograms (ERGs) showed reduced dark‐adapted responses but the positive component of the photopic ERG was absent. Response to 30 Hz flicker was severely reduced. Electroretinograms elicited by long‐duration stimuli showed a loss of the b‐wave, and the off‐response was slightly reduced. In both patients, multifocal ERGs (m‐ERGs) were more reduced within the central 10 °, where the ON‐pathway is normally a major contributor.Conclusion:  We conclude that these patients may be affected by an abnormality of the synapses of the cone receptors and that their decrease in vision might, at least initially, be due to selective ON‐pathway dysfunction.
Comparison of the cardiovascular effects of unoprostone 0.15%, timolol 0.5% and placebo in healthy adults during exercise using a treadmill test
Authors: Stewart William C. , Stewart Jeanette A. , Crockett Steve , Kubilus Christine , Brown Alison , Shams Naveed 
Published: March 2003

ABSTRACT.Purpose: To compare the cardiovascular effects of unoprostone 0.15%, timolol 0.5% and placebo in healthy adults during exercise using a treadmill test.Methods:  Thirty subjects aged 18–37 years (mean age = 24.1 years) were randomized to one of six treatment sequences in a three‐treatment, three‐period crossover study (William's design). Study medication was instilled b.i.d. for 5 days before visits 2, 3, and 4. Between treatments, study medication was washed out for 9–10 days. Each subject underwent a submaximal treadmill test at visits 2 through 4, 15 min after dosing.Results:  After 15 min of exercise, average heart rates were 143.1 ± 21.2, 134.5 ± 20.0 and 145.4 ± 20.8 bpm for the unoprostone, timolol and placebo treatments, respectively. At no timepoint was there a statistically significant difference between the unoprostone and placebo treatments (p > 0.05). Beginning with the second minute of exercise, timolol produced a greater decrease in heart rate at all timepoints from placebo than unoprostone (p < 0.05). No consistent differences in systolic or diastolic blood pressure were observed between drug treatments (p > 0.05).Conclusions:  Unlike timolol, unoprostone 0.15% does not reduce exercise‐induced heart rate, indicating a lack of clinical effect on systemic β‐adrenergic receptors in young and healthy subjects.
Subretinal pigment dispersion following transpupillary thermotherapy for choroidal melanoma
Authors: Kiratli Hayyam , Bilgiç Sevgül 
Published: March 2003

ABSTRACT.Purpose:  To report the case of a patient who developed considerable subretinal pigment/debris dispersion following transpupillary thermotherapy (TTT). This type of tumour response is extremely rare with this relatively new therapeutic modality.Methods:  A 50‐year‐old man with a left juxtapapillary choroidal melanoma measuring 8 × 6 × 4.3 mm was treated with 810 nm diode laser TTT administered in two sessions. Spot size was 3 mm and the power setting was 450 mW.Results:  Four months after the first treatment session, a considerable amount of pigment/debris was seen to have dispersed in the subretinal space, accumulating mainly in the macular area. Over a 12‐month follow‐up, the tumour showed progressive shrinkage without any change in the amount or location of the shed pigment/debris. No new tumour formation, recurrence or systemic metastases were detected.Conclusion:  Subretinal pigment/debris dispersion is an unusual complication after TTT and requires close follow‐up. There has been no short‐term compromise on the life or visual acuity of this patient.
Pilot study on the time course of apoptosis in the regenerating corneal epithelium
Authors: Estil Svein , Kravik Katherine , Haaskjold Erling , Refsum Sigvald B. , Bjerknes Rolf , Wilson Graeme 
Published: March 2003

ABSTRACT.Purpose:  To determine whether apoptosis contributes to regeneration of the corneal epithelium following erosion and following ultraviolet irradiation.Methods:  Central corneal erosions were made on one eye of 16 rats. One eye of another set of 16 rats was exposed to UVB irradiation. The rats were killed at time intervals varying from 12 hours to 7 days after treatment. Enucleated eyes were fixed in buffered formaldehyde and evaluated by terminal deoxynucleotidyl transferase‐mediated deoxyuridinetriphosphate (dUTP) nick‐end labelling (TUNEL) and morphology. The total number of cells and the number of TUNEL positive cells were counted in perpendicular sections using light microscopy.Results:  Following central erosion the total epithelial cell number was restored by day 3. During the first 5 days, TUNEL positive cells were observed only in small numbers, but an increase occurred by days 6 and 7. After UVB, an increase in TUNEL positive cells was noted for at least 3 days, and by day 7 there was a small increase of TUNEL positive cells. This differed from the results seen in control animals.Conclusions:  The present study indicates that after injury, apoptosis occurs in two distinct phases. There is an initial early phase of apoptosis which subsides at about the time the cell mass is being restored and after damaged cells have been removed. A later phase of apoptosis occurs suggests it has a homeostatic role which contributes to the regulation of the cell population.
A comparison of glaucoma patients identified through mass screening and in routine clinical practice
Authors: Grødum Kirsti , Heijl Anders , Bengtsson Bo 
Published: March 2003

ABSTRACT.Purpose:  To study differences between glaucoma patients identified through a population screening and glaucoma patients diagnosed in routine clinical practice (self‐selected patients).Methods:  A total of 402 individuals with newly detected open‐angle glaucoma were identified through a large population screening programme that ran from October 1992 to January 1997. The screening programme was attended by a total of 32 918 citizens of Malmö, Sweden, aged between 57 and 79 years. Citizens who had visited the Eye Department of Malmö University Hospital in the year before the screening of their birth cohort were not invited to participate (n = 4117). Among the latter, we identified 354 patients with open‐angle glaucoma through a retrospective examination of patient records.Results:  At detection, 52.9% of the glaucoma patients identified through screening had normal tension glaucoma (NTG), defined as intraocular pressure (IOP) < 21 mmHg in both eyes, compared to 13.5% of the self‐selected patients (p < 0.0001). Mean IOP at the time of diagnosis was 22.9 mmHg in the screened group and 32.5 mmHg in the self‐selected group. Pseudoexfoliation was present in 16.4% of the screened group and 44.0% of the self‐selected group (p < 0.01). Bilateral disease was present in 40.1% of the screened group and 34.6% of the self‐selected group (p = 0.1160). Median MD (mean deviation from the age‐corrected normal visual field) in the worse eye was −8.0 dB in the screened group and −16.2 dB in the self‐selected group (p < 0.0001). Visual acuity was lower in the self‐selected group, which was also on average slightly more myopic. Of the patients detected through screening, 62% had seen an ophthalmologist previously, 17% within the preceding 2‐year period.Conclusions:  Normal tension glaucoma was four times as common in patients identified through population screening as in self‐selected patients, suggesting that patients with NTG are easily overlooked in clinical practice. Even though the patients detected through population screening had lower mean IOP, lower prevalence of pseudoexfoliation, better visual fields and a lower incidence of bilateral disease than self‐selected patients, many still had considerable damage. Special efforts, such as glaucoma screening, are needed if manifest glaucoma, and especially NTG, is to be detected at an earlier stage than it currently is.
Bax, Bcl‐2, Fas and Fas‐L antigen expression in human seminoma: Correlation with the apoptotic index
Authors: GROBHOLZ RAINER , ZENTGRAF HANSWALTER , KÖHRMANN KAI‐UWE , BLEYL UWE 
Published: March 2003

Apoptosis plays a crucial role in the regulation of spermatogenesis in male germ cells and is, at least in part, modulated by Bcl‐2, Bax, and the Fas pathway. Seminomas have a favourable outcome and respond to radio‐/chemotherapy with an increased rate of apoptosis. The expression of Bax, Bcl‐2, Fas and Fas‐ligand (Fas‐L) in human seminoma was evaluated and correlated with the apoptotic index.Twenty‐nine classical seminomas were examined by immunohistochemistry and Western blotting using antibodies against Bax, Bcl‐2, Fas and Fas‐L. Apoptosis was detected by in‐situ end‐labeling of fragmented DNA and the apoptotic index (AI) was determined.Expression of Fas was found in 26 (89.7%) of Fas‐L in 24 seminomas (82.2%); none of the tumours expressed Bcl‐2. No correlation between the AI and Fas, Fas‐L or Bcl‐2 expression was found. Bax was demonstrated in 20/29 tumours (69%). Bax‐positive tumours showed an increased AI of 4.75±2.38% in contrast to 2.60±1.23% of the Bax‐negative tumours (P=0.002). The number of Bax‐positive tumour cells and apoptotic cells revealed a significant correlation using χ2‐test (P=0.04) and linear regression (r=0.54, P=0.001).Therefore, Bax seems to play a determinant role in the modulation of apoptosis in human seminoma that may be linked to a favourable outcome.