BioMed Research International: Ophthalmology The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Heavy Silicone Oil as a Long-Term Endotamponade Agent for Complicated Retinal Detachments Tue, 15 Apr 2014 12:48:20 +0000 We retrospectively evaluated a heavy silicone oil (HSO) as a long-term intraocular endotamponade agent to treat complicated RD by inferior PVR in 25 eyes of 25 patients. Patients underwent PPV and injection of Oxane HD as an internal tamponade agent. A comparison of preoperative and postoperative BCVA at month 1, month 6, and last visit was made in the group in which HSO was removed and in the group in which HSO was not removed. Statistical calculations were performed using the Wilcoxon test. The HSO was removed from 11 patients after a mean of 26.55 ± 21.38 months. The HSO remained inside the vitreous cavity in 14 eyes due to a high chance of PVR recurrence (mean follow-up period, 11.07 ± 7.44 months). Anatomic success was achieved in 92%. The BCVA in the group, in which HSO was not removed, improved significantly during the first 6 months. Among the patients who had the oil removed, there was improvement in BCVA after 1 month. Oil emulsification was the most common adverse effect in 52% of eyes. HSO is an effective tamponade in complex rhegmatogenous and tractional RD complicated by PVR. HSO can remain in the eye for long periods with relative tolerability and safety. Juliana Prazeres, Octaviano Magalhães Jr., Luiz F. A. Lucatto, Rodrigo Milan Navarro, Nilva S. Moraes, Michel E. Farah, André Maia, and Maurício Maia Copyright © 2014 Juliana Prazeres et al. All rights reserved. Clinical Observations and Occurrence of Complications following Heavy Silicone Oil Surgery Mon, 14 Apr 2014 17:19:30 +0000 Purpose. To demonstrate development and complications in heavy silicone oil (HSO) surgery in 100 eyes following primary vitreoretinal surgery. Methods. 100 eyes were included in this retrospective study that underwent vitreoretinal surgery using HSO as endotamponade. Indication diagnoses were retinal detachments , complicated macular holes (MH) , and others . HSO removal was performed after a mean period of 20.2 ± 19.0 weeks. In 18 eyes with poor functional prognosis the silicone oil remained permanently for stabilisation. Overall follow-up time was 35.9 ± 51.8 weeks. Results. The mean IOP before HSO surgery was 13.3 ± 5.6 mmHg and raised to an average maximum of 23.3 ± 8.5 mmHg postoperatively and decreased to 13.7 ± 7.2 mmHg after removal. Secondary IOP raise due to emulsification of the silicone oil endotamponade was seen in 29 eyes after 7.8 ± 4.5 weeks. Other complications being observed with HSO installed were persistent corneal erosion and prolonged anterior chamber inflammation . In 13 eyes recurrent retinal detachments occurred during followup. Conclusions. According to our analysis HSO surgery might deliver satisfying results in complicated cases of ophthalmological surgery. However, potential complications should always be taken into account when making the decision if to use and when to remove HSO in complicated retinal surgery. Hendrik Schwarzer, Babac Mazinani, Niklas Plange, Matthias Fuest, Peter Walter, and Gernot Roessler Copyright © 2014 Hendrik Schwarzer et al. All rights reserved. Selective Laser Trabeculoplasty for Glaucoma Secondary to Emulsified Silicone Oil after Pars Plana Vitrectomy: A Pilot Study Sun, 13 Apr 2014 17:06:33 +0000 Background. To investigate the efficacy of selective laser trabeculoplasty (SLT) for lowering intraocular pressure (IOP) in patients with open angle glaucoma (OAG) secondary to emulsified silicone oil (SO). Methodology/Principal Findings. Prospective, interventional, consecutive case series of 11 eyes with sustained elevation of IOP after SO removal. The mean IOP at baseline, week 1, month 1, month 3, and month 6 was evaluated. The mean baseline IOP was significantly decreased from 25 ± 2.7 mmHg to 18.4 ± 5.5 mmHg at week 1 , 17.9 ± 3.1 mmHg at month 1 , 15.8 ± 3.9 mmHg at month 3 , and 16.2 ± 4.7 mmHg at month 6 . IOP < 21 mmHg was achieved in 91% of the eyes without a significant complication at month 6. Conclusion/Significance. SLT may be successful for lowering IOP in patients with OAG secondary to emulsified SO which was not controlled with maximum antiglaucomatous medical treatment. Zeynep Alkin, Banu Satana, Abdullah Ozkaya, Berna Basarir, Cigdem Altan, Ahmet Taylan Yazici, and Ahmet Demirok Copyright © 2014 Zeynep Alkin et al. All rights reserved. Reproducibility of the Optical Biometer OA-1000 (Tomey) Thu, 10 Apr 2014 14:09:57 +0000 Aim. The OA-1000 (Tomey, Japan) is a new optical biometer, which measures axial length (AL), anterior chamber depth (ACD), and central corneal thickness (CT) utilizing optical interference technology. The aim of this study was to prove the reproducibility which is considered fundamental for other clinical investigations. Methods. 55 healthy volunteers were enrolled in this study. For each measurement of AL, ACD, and CT the biometer is grabbing a sequence of 10 shots and mean value (mean) and standard deviation (SD) are displayed. Five consecutive measurements were performed and average and standard deviation were assessed. Cronbach’s was derived as a quality measure for reproducibility. Results. For AL measurement Cronbach’s was 1.000, for CT 0.999, and for ACD 0.979, respectively. Mean value for AL was  mm, for ACD it was  mm, and for CT it was  μm, respectively. Standard deviation for AL was  mm, for ACD  mm, and for CT  μm. One correlation was found between mean values for AL and ACD (, ); no other correlations were found between mean values or values of standard deviation of AL, ACD, or CT. Conclusion. The OA-1000 shows an excellent reproducibility for measurement of AL, ACD, and CT and can be used in clinical practice. Susanne Christiane Goebels, Berthold Seitz, and Achim Langenbucher Copyright © 2014 Susanne Christiane Goebels et al. All rights reserved. Perfluorocarbon Liquid: Its Application in Vitreoretinal Surgery and Related Ocular Inflammation Sun, 30 Mar 2014 10:59:33 +0000 The application of perfluorocarbon liquids has been well acclaimed in vitreoretinal surgery. Its unique physical properties make it an ideal intraoperative tool to improve the efficiency and safety of surgical procedures in complicated cases. The main functions of perfluorocarbon liquids in vitreoretinal surgery include relocating and fixing the detached retina, displacing the subretinal and subchoroidal to fluid anteriorly, revealing proliferative vitreous retinopathy (PVR) for further maneuvers, protecting the macula from exposure to chemicals with potential toxicity, and assisting the removal of foreign body. The related clinical applications include retinal detachment with severe proliferative vitreoretinopathy, giant tear, diabetic retinopathy (DR), retinopathy of prematurity (ROP), and posterior dislocated crystalline and intraocular lenses. The application of perfluorocarbon liquids has been expended over the past fewer years. Several PFCLs related ocular inflammations have been observed in in vitro studies, animal studies, and clinical follow-up. The complete removal of PFCLs is recommended at the end of the surgery in most cases. Qi Yu, Kun Liu, Li Su, Xin Xia, and Xun Xu Copyright © 2014 Qi Yu et al. All rights reserved. Effect of Intraocular Lens Diameter Implanted in Enucleated Porcine Eye on Intraocular Pressure Induced by Scleral Depression Thu, 27 Mar 2014 13:38:06 +0000 The effect of the diameter of an intraocular lens (IOL) implanted in enucleated porcine eyes on the intraocular pressure induced by scleral depression was investigated. Two IOLs of 6 mm and 7 mm optic diameter were implanted. The intraocular pressure (IOP) was monitored during scleral depression by a transducer placed in the midvitreous through a sclerotomy at 6 o’clock. The area under the curve (AUC) of the IOP changes from the beginning of the indentation to the point when the peripheral retinal surface was observed through the IOL optics was measured. The AUC was significantly larger in eyes with a 6 mm IOL than in eyes with a 7 mm IOL (). The IOP elevation at the endpoint was higher in eyes with the 6 mm IOL than in eyes with the 7 mm IOL. We conclude that the AUC may represent the degree of stress induced by scleral depression. The higher AUC value with the X-60 may be because of the longer distance from the peripheral retina to the edge of the IOL optics. Gaku Terauchi, Celso Soiti Matsumoto, Kei Shinoda, Harue Matsumoto, and Atsushi Mizota Copyright © 2014 Gaku Terauchi et al. All rights reserved. Using Surgical Microscope for Sclera Buckling and Transscleral Cryopexy: An Alternative Procedure of Treatment for Rhegmatogenous Retinal Detachment Thu, 27 Mar 2014 00:00:00 +0000 Purpose. To observe the long-term effectiveness of scleral buckling and transscleral cryopexy conducted under a surgical microscope in the treatment of uncomplicated rhegmatogenous retinal detachment. Methods. This was a retrospective analysis in a total of 227 consecutive patients (244 eyes) with uncomplicated rhegmatogenous retinal detachment (proliferative vitreoretinopathy ≤ C2). All patients underwent scleral buckling and transscleral cryopexy under a surgical microscope without using a binocular indirect ophthalmoscope or a contact lens. Results. After initial surgery, complete retinal reattachment was achieved in 226 eyes (92.6%), and retinal redetachment developed in 18 eyes (7.4%). The causes of retinal redetachment included presence of new breaks in eight eyes (44%), failure to completely seal the breaks in five eyes (28%), missed retinal breaks in four eyes (22%), and iatrogenic retinal breaks in one eye (6%). Scleral buckling surgery was performed again in 12 eyes (66%). Four eyes (22%) developed proliferative vitreoretinopathy and then were treated by vitrectomy. The sealing of retinal breaks and complete retinal reattachment were achieved in 241 eyes (98.8%). Conclusion. Probably because of clear visualization of retinal breaks and being controllable under a surgical microscope, the microsurgery of scleral buckling and transscleral cryopexy for uncomplicated retinal detachment exhibits advisable effectiveness. Liu-xue-ying Zhong, Yi Du, Wen Liu, Su-Ying Huang, and Shao-chong Zhang Copyright © 2014 Liu-xue-ying Zhong et al. All rights reserved. Inflammation Induced by Perfluorocarbon Liquid: Intra- and Postoperative Use Mon, 24 Mar 2014 16:29:08 +0000 Perfluorocarbon liquids (PFCLs) are useful and safe surgical tools in vitreoretinal surgery. The use of PFCL as a tamponade has been controversial due to the corneal toxicity, retinal infiltration, and inflammatory reaction in experimental studies. Several authors have studied in humans the anatomical and functional outcome and adverse effects of perfluorocarbon liquids used as short-, medium-, and long-term tamponade. PFCLs develop dispersion a few days after injection and droplets may move into the anterior chamber and cause corneal endothelial damage. When PFCLs are used as postoperative tamponades for more than one week, a foreign-body inflammatory reaction is observed in up to 30% of cases but such a reaction does not induce PVR, and it resolves after removal of PFCLs. Although most clinical studies have found no signs of retinal toxicity such as progressive visual acuity deterioration or macular anatomical changes, few performed ERG or retinal histological analysis. Marta S. Figueroa and Diego Ruiz Casas Copyright © 2014 Marta S. Figueroa and Diego Ruiz Casas. All rights reserved. Dynamics of Blood Count after Rheohemapheresis in Age-Related Macular Degeneration: Possible Association with Clinical Changes Thu, 06 Mar 2014 13:19:57 +0000 Background. Rheohemapheresis (RHF) is a method that can stop the activity of the dry form of age-related macular degeneration (AMD). The pathophysiologic mechanisms are not well understood, and the effects of the RHF procedures extend beyond the time of the individual procedures. Patients and Methods. We present the data for 46 patients with AMD treated with a series of 8 rheohemapheretic procedures. Blood count parameters were measured before the first and the last procedures. The clinical effect was judged by changes in the drusenoid pigment epithelium detachment (DPED) area before and after the rheopheretic sessions. Results. Rheopheresis caused a decrease in hemoglobin , a decrease in leukocytes , and an increase in platelets . We found a negative correlation between the amount of platelets and their volume (, Pearson correlation coefficient: −0.509). We identified the platelet/MPV ratio as a good predictor of the clinical outcome. Patients with a platelet/MPV ratio greater than 21.5 (before the last rheopheresis) had a significantly better outcome (, sensitivity of 76.9% and specificity of 80%). Conclusion. Several basic blood count parameters after RHF can be concluded to significantly change, with some of those changes correlating with the clinical results (reduction of the DPED area). Milan Košťál, Milan Bláha, Eva Rencová, Miriam Lánská, Pavel Rozsíval, Vera Kratochvilová, and Hana Langrová Copyright © 2014 Milan Košťál et al. All rights reserved. Erratum to “Topical 100% Serum Eye Drops for Treating Corneal Epithelial Defect after Ocular Surgery” Sun, 02 Feb 2014 13:03:38 +0000 Kaevalin Lekhanont, Passara Jongkhajornpong, Lulin Choubtum, and Varintorn Chuckpaiwong Copyright © 2014 Kaevalin Lekhanont et al. All rights reserved. Comparison of Diagnostic Accuracy between Octopus 900 and Goldmann Kinetic Visual Fields Thu, 23 Jan 2014 11:53:22 +0000 Purpose. To determine diagnostic accuracy of kinetic visual field assessment by Octopus 900 perimetry compared with Goldmann perimetry. Methods. Prospective cross section evaluation of 40 control subjects with full visual fields and 50 patients with known visual field loss. Comparison of test duration and area measurement of isopters for Octopus 3, 5, and 10°/sec stimulus speeds. Comparison of test duration and type of visual field classification for Octopus versus Goldmann perimetry. Results were independently graded for presence/absence of field defect and for type and location of defect. Statistical evaluation comprised of ANOVA and paired t test for evaluation of parametric data with Bonferroni adjustment. Bland Altman and Kappa tests were used for measurement of agreement between data. Results. Octopus 5°/sec perimetry had comparable test duration to Goldmann perimetry. Octopus perimetry reliably detected type and location of visual field loss with visual fields matched to Goldmann results in 88.8% of results . Conclusions. Kinetic perimetry requires individual tailoring to ensure accuracy. Octopus perimetry was reproducible for presence/absence of visual field defect. Our screening protocol when using Octopus perimetry is 5°/sec for determining boundaries of peripheral isopters and 3°/sec for blind spot mapping with further evaluation of area of field loss for defect depth and size. Fiona J. Rowe and Alison Rowlands Copyright © 2014 Fiona J. Rowe and Alison Rowlands. All rights reserved. Comparison of Riboflavin/Ultraviolet-A Cross-Linking in Porcine, Rabbit, and Human Sclera Thu, 02 Jan 2014 11:30:29 +0000 Purpose. To compare the biomechanical properties of porcine, rabbit, and human sclera before and after riboflavin/ultraviolet-A (UVA) collagen cross-linking (CXL). Methods. Eight rabbits, 8 porcine eyeballs, and 8 human eyeballs were included. One rabbit eye and half of each bisected human and porcine eyeball were treated with riboflavin/UVA CXL. Untreated fellow rabbit eyes and eyeball halves served as controls. A 10 mm × 20 mm scleral band was harvested from each specimen. From this band, two 3.5 mm × 15.0 mm strips were prepared for biomechanical testing. The biomechanical parameters were ultimate stress, stress and Young’s modulus. Results. Values of stress, and Young’s modulus showed that human sclera was 4 times stiffer than porcine sclera and 3 times stiffer than rabbit sclera. In rabbit sclera, both the stress and Young’s modulus were significantly increased by CXL (). In porcine sclera, only the ultimate stress was significantly increased by CXL (). The biomechanical properties of human sclera were not statistically affected by CXL (). Conclusions. Human sclera has higher biomechanical stiffness than porcine and rabbit sclera. With the same irradiation dose, riboflavin/UVA CXL increases the biomechanical stiffness of rabbit sclera but not porcine or human sclera. Yali Zhang, Zhiwei Li, Lei Liu, Xuguang Han, Xiaomin Zhao, and Guoying Mu Copyright © 2014 Yali Zhang et al. All rights reserved. High-Resolution En Face Images of Microcystic Macular Edema in Patients with Autosomal Dominant Optic Atrophy Thu, 28 Nov 2013 10:55:30 +0000 The purpose of this study was to investigate the characteristics of microcystic macular edema (MME) determined from the en face images obtained by an adaptive optics (AO) fundus camera in patients with autosomal dominant optic atrophy (ADOA) and to try to determine the mechanisms underlying the degeneration of the inner retinal cells and RNFL by using the advantage of AO. Six patients from 4 families with ADOA underwent detailed ophthalmic examinations including spectral domain optical coherence tomography (SD-OCT). Mutational screening of all coding and flanking intron sequences of the OPA1 gene was performed by DNA sequencing. SD-OCT showed a severe reduction in the retinal nerve fiber layer (RNFL) thickness in all patients. A new splicing defect and two new frameshift mutations with premature termination of the Opa1 protein were identified in three families. A reported nonsense mutation was identified in one family. SD-OCT of one patient showed MME in the inner nuclear layer (INL) of the retina. AO images showed microcysts in the en face images of the INL. Our data indicate that AO is a useful method to identify MME in neurodegenerative diseases and may also help determine the mechanisms underlying the degeneration of the inner retinal cells and RNFL. Kiyoko Gocho, Sachiko Kikuchi, Takenori Kabuto, Shuhei Kameya, Kei Shinoda, Atsushi Mizota, Kunihiko Yamaki, and Hiroshi Takahashi Copyright © 2013 Kiyoko Gocho et al. All rights reserved. Vignetting and Field of View with the KAMRA Corneal Inlay Wed, 13 Nov 2013 08:24:02 +0000 Purpose. To evaluate the effect of the KAMRA corneal inlay on the retinal image brightness in the peripheral visual field. Methods. A KAMRA inlay was “implanted” into a theoretical eye model in a corneal depth of 200 microns. Corneal radius was varied to a steep, normal, and flat (7.37, 7.77, and 8.17 mm) version keeping the proportion of anterior to posterior radius constant. Pupil size was varied from 2.0 to 5.0 mm. Image brightness was determined for field angles from −70° to 70° with and without KAMRA and proportion of light attenuation was recorded. Results. In our parameter space, the attenuation in brightness ranges in between 0 and 60%. The attenuation in brightness is not affected by corneal shape. For large field angles where the incident ray bundle is passing through the peripheral cornea, brightness is not affected. For combinations of small pupil sizes (2.0 and 2.5 mm) and field angles of 20–40°, up to 60% of light may be blocked with the KAMRA. Conclusion. For combinations of pupil sizes and field angles, the attenuation of image brightness reaches levels up to 60%. Our theoretical findings have to be clinically validated with detailed investigation of this vignetting effect. Achim Langenbucher, Susanne Goebels, Nóra Szentmáry, Berthold Seitz, and Timo Eppig Copyright © 2013 Achim Langenbucher et al. All rights reserved. Long-Term Effects of Nilvadipine against Progression of the Central Visual Field Defect in Retinitis Pigmentosa: An Extended Study Tue, 12 Nov 2013 13:32:57 +0000 Purpose. To assess the long-term effects of nilvadipine on the progression of central visual field defect in retinitis pigmentosa (RP). Methods. Patients with RP were randomly divided into a treated group receiving oral nilvadipine and a control group. Progression of RP was evaluated with MD slope and the average sensitivity of the central 2° (ΔCENT4). Results. The mean MD slopes were −0.55/−0.39 (right/left eyes, ) dB/year in the treated group and −1.37/−1.15 (right/left eyes, ) dB/year in the control group (, resp.). In both eyes, however, no statistical difference was observed between the two groups for the ΔCENT4 values. Conclusion. Although we confirmed that nilvadipine significantly retarded the progression of the average of MD value defects in the central 10°, it was not specific for the central 2° of the visual field in RP. Mitsuru Nakazawa, Yukihiko Suzuki, Tadashi Ito, Tomomi Metoki, Takashi Kudo, and Hiroshi Ohguro Copyright © 2013 Mitsuru Nakazawa et al. All rights reserved. Changes in Frequency-Doubling Perimetry in Patients with Type I Diabetes prior to Retinopathy Mon, 11 Nov 2013 16:08:54 +0000 Purpose. To evaluate the ability of frequency-doubling technology (FDT) perimetry in detecting visual field defects in young adults with type I diabetes prior to retinopathy or with minor retinovascular changes. Methods. This comparative cross-sectional study included 30 healthy subjects and 73 age-matched patients with type I diabetes mellitus. All subjects underwent a full ocular examination including an FDT with the threshold C-20-5 strategy. Only one eye per subject was randomly included in the statistical analysis. FDT results and time to perform the test were compared between the groups. Results. The mean age was 27.1 years in the control group and 26.6 years in the diabetic group (). The mean period from the onset of diabetes was years, while minimal retinovascular changes were observed in 18 eyes. Mean deviation of FDT did not differ between the groups. Although global indices of FDT were within normal limits, pattern standard deviation of FDT was higher in the diabetic group (). The area under the receiver operating characteristic curve was 0.647 for pattern standard deviation of FDT (standard error = 0.052; ). Conclusion. FDT can detect retinal dysfunctions in diabetic patients prior to the onset of significant vascular complications. Isabel Pinilla, Antonio Ferreras, Miriam Idoipe, Ana I. Sanchez-Cano, Diana Perez-Garcia, Laura X. Herrera, Maria J. Pinilla, and Emilio Abecia Copyright © 2013 Isabel Pinilla et al. All rights reserved. Ocular Dominance and Visual Function Testing Mon, 11 Nov 2013 15:17:37 +0000 Purpose. To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Method. Forty-four presbyopes (48.5 ± 3.5 years) participated in this study. Ocular dominance was determined by eye sighting (hole-in-card) and sensorial (+1.50 D lens induced blur) methods. According to the dominance detected with each method (RE: right eye or LE: left eye), patients were classified in dominance type 1 (RE/RE), type 2 (RE/LE), type 3 (LE/RE) and type 4 (LE/LE). Results. Baseline refractive error (MSE) was RE:−0.36 ± 1.67 D and LE:−0.35 ± 1.85 D (). RE was the dominant eye in 61.4% and 70.5% of times as obtained from sensorial and sighting methods, respectively. Most frequent dominance was of type 1 (52.3%), in this case the RE showed statistically significant better distance low contrast LogMAR VA (0.04 LogMAR units) compared to the LE (). Conclusions. The dominance was more frequent in RE in this sample. The eye sighting and sensorial methods to define ocular dominance agreed in more than half of cases. Amount of MSE was not significantly different between dominant and non-dominant eye. But in case of right dominance, the RE presented better distance low contrast VA compared to the LE. D. Lopes-Ferreira, H. Neves, A. Queiros, M. Faria-Ribeiro, S. C. Peixoto-de-Matos, and J. M. González-Méijome Copyright © 2013 D. Lopes-Ferreira et al. All rights reserved. Epiretinal Membranes in Patients with Uveitis: Morphological and Functional Analysis with Spectral Domain Optical Coherence Tomography Tue, 05 Nov 2013 10:40:10 +0000 Purpose. To correlate the uveitic epiretinal membrane (ERM) features using spectral-domain optical coherence tomography (SD-OCT) with visual acuity (VA). Methods. Forty-one eyes of 32 patients were included in this retrospective study. SD-OCT was performed in all patients and data were collected at the time of ERM diagnosis and at the final visit. Both best corrected visual acuity (BCVA) and ERM thickness were correlated with the morphological and clinical features. Results. Final BCVA was positively correlated with male sex and the focal pattern of ERM attachment and negatively correlated with IS/OS photoreceptor junction disruption . BVCA change showed a positive correlation with the age of ERM onset but a negative correlation with IS/OS photoreceptor disruption at the ERM diagnosis and the increase of central subfield thickness (CST) . Final ERM thickness correlated with the duration of uveitis and the duration of ERM . During the follow-up, ERM thickening correlated with male sex , posterior uveitis , uveitis duration , and broad attachment pattern . Conclusions. In the uveitic ERM, VA negatively correlates with IS/OS photoreceptor junction disruption and the increase of CST. ERM thickness is influenced by longer duration of both uveitis and ERM. Ludovico Iannetti, Paolo Tortorella, Enzo D’Ambrosio, Rossela Spena, Roberta Zito, and Magda Gharbiya Copyright © 2013 Ludovico Iannetti et al. All rights reserved. Microscopic Evaluation, Molecular Identification, Antifungal Susceptibility, and Clinical Outcomes in Fusarium, Aspergillus and, Dematiaceous Keratitis Thu, 24 Oct 2013 09:39:46 +0000 Purpose. Fusarium, Aspergillus, and Dematiaceous are the most common fungal species causing keratitis in tropical countries. Herein we report a prospective study on fungal keratitis caused by these three fungal species. Methodology. A prospective investigation was undertaken to evaluate eyes with presumed fungal keratitis. All the fungal isolates () obtained from keratitis infections were identified using morphological and microscopic characters. Molecular identification using sequencing of the ITS region and antifungal susceptibility tests using microdilution method were done. The final clinical outcome was evaluated in terms of the time taken for resolution of keratitis and the final visual outcome. The results were analyzed after segregating the cases into three groups, namely, Fusarium, Aspergillus, and Dematiaceous keratitis. Results. Diagnosis of fungal keratitis was established in 73 (35.9%) cases out of 208 cases. The spectra of fungi isolated were Fusarium spp. (26.6%), Aspergillus spp. (21.6%), and Dematiaceous fungi (11.6%). The sequence of the ITS region could identify the Fusarium and Aspergillus species at the species complex level, and the Dematiaceous isolates were accurately identified. Using antifungal agents such as fluconazole, natamycin, amphotericin B, and itraconazole, the minimum inhibitory concentrations (MICs) for Fusarium spp. were >32 μg/mL, 4–8 μg/mL, 0.5–1 μg/mL, and >32 μg/mL, respectively. Antifungal susceptibility data showed that Curvularia spp. was highly resistant to all the antifungal agents. Overall, natamycin and amphotericin B were found to be the most effective antifungal agents. The comparative clinical outcomes in all cases showed that the healing response in terms of visual acuity of the Dematiaceous group was significantly good when compared with the Fusarium and Aspergillus groups (). The time required for healing in the Fusarium group was statistically significantly less when compared with the Aspergillus and Dematiaceous groups. Conclusion. This study demonstrates important differences in microscopic features of scraping material and antifungal susceptibility between the three groups. Early and accurate identification coupled with the MIC data, and thereby appropriate treatment is crucial for complete recovery. Devarshi U. Gajjar, Anuradha K. Pal, Bharat K. Ghodadra, and Abhay R. Vasavada Copyright © 2013 Devarshi U. Gajjar et al. All rights reserved. How Ocular Surface Disease Impacts the Glaucoma Treatment Outcome Wed, 09 Oct 2013 15:19:30 +0000 The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients’ quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision. Snježana Kaštelan, Martina Tomić, Kata Metež Soldo, and Jasminka Salopek-Rabatić Copyright © 2013 Snježana Kaštelan et al. All rights reserved. Repeatability and Reproducibility of Measurements Using a NT-530P Noncontact Tono/Pachymeter and Correlation of Central Corneal Thickness with Intraocular Pressure Tue, 08 Oct 2013 09:35:19 +0000 Purpose. To investigate the repeatability and reproducibility of intraocular pressure (IOP) and central corneal thickness (CCT) measurements using a noncontact tono/pachymeter (NT-530P) and to assess the correlation of CCT with IOP. Methods. Forty-six eyes of healthy volunteers were measured by two examiners. Three consecutive measurements per eye were performed. Repeatability was assessed using the coefficient of variation, and reproducibility was assessed using Bland-Altman plots. Linear correlations were used to determine agreement between CCT and noncorrected IOP and CCT and corrected IOP, which was calculated using a formula built into the NT-530P. Results. The coefficient of variation for IOP was 6.4% and for CCT was 0.4%. The 95% limits of agreement between examiners were  mmHg (range: to 2.61 mmHg) for IOP,  μm (range: to 7.64 μm) for CCT. The corrected IOP was significantly higher than the noncorrected IOP (). The noncorrected IOP significantly correlated with CCT (, ). The corrected IOP showed no significant correlation with CCT (, ). Conclusions. NT-530P offered repeatability and reproducibility in both IOP and CCT measurements. The corrected IOP calculated using the NT-530P was independent of the CCT, suggesting that this IOP may be less influenced by the central corneal thickness. Fusako Fujimura, Kazutaka Kamiya, Kazuko Fujiwara, Nobuyuki Shoji, and Kimiya Shimizu Copyright © 2013 Fusako Fujimura et al. All rights reserved. A Comparison between Tube Surgery, ND:YAG Laser and Diode Laser Cyclophotocoagulation in the Management of Refractory Glaucoma Mon, 07 Oct 2013 16:16:07 +0000 Purpose. To compare the results of intraocular pressure (IOP) reduction by 3 treatment modalities, (a) glaucoma tube implants, (b) noncontact YAG laser cyclophotocoagulation (cycloYAG), and (c) contact transscleral diode laser cyclophotocoagulation (cyclodiode), in cases of advanced glaucoma refractory to alternative treatments. Methods. A consecutive group of 45 eyes that received cycloYAG were matched against two control groups of patients who had received tube surgery or cyclodiode, each control group having been derived from a database of patients. Results. Mean pretreatment IOP improved from 41.3, 38.6, and 32.0 mmHg for the tube, cycloYAG, and cyclodiode groups, respectively, to 16.4, 22.1, and 19.3 mmHg, respectively. Treatment success was achieved in 78%, 69%, and 71% of the tube, cycloYAG, and cyclodiode groups, respectively. Visual acuity deteriorated 2 or more Snellen lines in 16%, 7%, and 9% of the patients in the tube, cycloYAG, and cyclodiode groups, respectively. Complications included retinal detachment, hypotony, and phthisis. Conclusions. All 3 methods provided acceptable IOP lowering in the short and medium term. Control of IOP was best in patients receiving tube surgery. Cyclodiode and cycloYAG treatments were similarly effective in lowering IOP. Tube surgery was associated with a greater incidence of sight threatening complications. Philip A. Bloom, Colin I. Clement, Anthony King, Baha Noureddin, Kamal Sharma, Roger A. Hitchings, and Peng T. Khaw Copyright © 2013 Philip A. Bloom et al. All rights reserved. Antioxidant Delivery Pathways in the Anterior Eye Thu, 26 Sep 2013 08:03:40 +0000 Tissues in the anterior segment of the eye are particular vulnerable to oxidative stress. To minimise oxidative stress, ocular tissues utilise a range of antioxidant defence systems which include nonenzymatic and enzymatic antioxidants in combination with repair and chaperone systems. However, as we age our antioxidant defence systems are overwhelmed resulting in increased oxidative stress and damage to tissues of the eye and the onset of various ocular pathologies such as corneal opacities, lens cataracts, and glaucoma. While it is well established that nonenzymatic antioxidants such as ascorbic acid and glutathione are important in protecting ocular tissues from oxidative stress, less is known about the delivery mechanisms used to accumulate these endogenous antioxidants in the different tissues of the eye. This review aims to summarise what is currently known about the antioxidant transport pathways in the anterior eye and how a deeper understanding of these transport systems with respect to ocular physiology could be used to increase antioxidant levels and delay the onset of eye diseases. Ankita Umapathy, Paul Donaldson, and Julie Lim Copyright © 2013 Ankita Umapathy et al. All rights reserved. Plasticity in the Human Visual Cortex: An Ophthalmology-Based Perspective Wed, 25 Sep 2013 16:26:48 +0000 Neuroplasticity refers to the ability of the brain to reorganize the function and structure of its connections in response to changes in the environment. Adult human visual cortex shows several manifestations of plasticity, such as perceptual learning and adaptation, working under the top-down influence of attention. Plasticity results from the interplay of several mechanisms, including the GABAergic system, epigenetic factors, mitochondrial activity, and structural remodeling of synaptic connectivity. There is also a downside of plasticity, that is, maladaptive plasticity, in which there are behavioral losses resulting from plasticity changes in the human brain. Understanding plasticity mechanisms could have major implications in the diagnosis and treatment of ocular diseases, such as retinal disorders, cataract and refractive surgery, amblyopia, and in the evaluation of surgical materials and techniques. Furthermore, eliciting plasticity could open new perspectives in the development of strategies that trigger plasticity for better medical and surgical outcomes. Andreia Martins Rosa, Maria Fátima Silva, Sónia Ferreira, Joaquim Murta, and Miguel Castelo-Branco Copyright © 2013 Andreia Martins Rosa et al. All rights reserved. Age-Related Changes in Trabecular Meshwork Imaging Thu, 19 Sep 2013 15:02:18 +0000 Purpose. To evaluate the normal aging effects on trabecular meshwork (TM) parameters using Fourier domain anterior segment optical coherence tomography (ASOCT) images. Patients and Methods. One eye from 45 participants with open angles was imaged. Two independent readers measured TM area, TM length, and area and length of the TM interface shadow from 3 age groups (18–40, 41–60, and 61–80). Measurements were compared using stepwise regression analysis. Results. The average TM parameters were 0.0487 () mm2 for TM area, 0.5502 () mm for TM length, 0.1623 () mm2 for TM interface shadow area, and 0.7755 () mm for TM interface shadow length. Interobserver reproducibility coefficients ranged from 0.45 (TM length) to 0.82 (TM area). TM area and length were not correlated with age. While the TM interface shadow length did not correlate with age, the TM interface shadow area increased with age. Race, sex, intraocular pressure, and gonioscopy score were not correlated with any TM parameters. Conclusion. Although the TM measurements were not correlated with age, the TM interface shadow area increased with age. Further study is required to determine whether there is any relationship between the age-related ASOCT findings of the TM interface shadow area and physiologic function. Mark E. Gold, Seema Kansara, Kundandeep S. Nagi, Nicholas P. Bell, Lauren S. Blieden, Alice Z. Chuang, Laura A. Baker, Kimberly A. Mankiewicz, and Robert M. Feldman Copyright © 2013 Mark E. Gold et al. All rights reserved. Role of Color Doppler Imaging in Early Diagnosis and Prediction of Progression in Glaucoma Tue, 17 Sep 2013 11:46:23 +0000 This longitudinal and prospective study analyzes the ability of orbital blood flow measured by color Doppler imaging (CDI) to predict glaucoma progression in patients with glaucoma risk factors. Patients with normal perimetry but having glaucoma risk factors and patients in the initial phase of glaucoma were prospectively included in the study and divided, after a five-year follow-up, into two groups: “Progression” and “No Progression” based on the changes in the Moorfields regression analysis (MRA) classification of Heidelberg retina tomograph (HRT). An orbital CDI was performed in all patients and the parameters obtained were correlated with changes in HRT. A logistic discrimination function (LDF) was calculated for ophthalmic artery (OA) and central retinal artery (CRA) parameters. Receiver operating characteristics curves (ROC) were used to assess the usefulness of LDFs to predict glaucomatous progression. A total of 71 eyes were included. End-diastolic velocity, time-averaged velocity, and resistive index in the OA and CRA were significantly different () between the Progression and No Progression groups. The area under the ROC curves calculated for both LDFs was of 0.695 (OA) and 0.624 (CRA). More studies are needed to evaluate the ability of CDI to perform early diagnosis and to predict progression in glaucoma in eyes. Fatima Jimenez-Aragon, Elena Garcia-Martin, Raquel Larrosa-Lopez, Jose M. Artigas-Martín, Pilar Seral-Moral, and Luis E. Pablo Copyright © 2013 Fatima Jimenez-Aragon et al. All rights reserved. Role of Rheum Polysaccharide in the Cytokines Produced by Peripheral Blood Monocytes in TLR4 Mediated HLA-B27 Associated AAU Mon, 16 Sep 2013 08:24:59 +0000 Purpose. To evaluate the effect of a traditional Chinese medicine, Rheum Polysaccharide (RP), on the in vitro production of tumor necrosis factor alpha (TNF-α) and interleukin-10 (IL-10) by lipopolysaccharide- (LPS-)stimulated human monocytes from HLA-B27 associated acute anterior uveitis patients of convalescence stage. Method. PBMC samples were isolated from 10 HLA-B27 associated acute anterior uveitis, incubated, respectively, and divided into 4 groups as follows: (1) controls, PBS was added in final concentration of 1 mg·L−1, (2) stimulated by LPS, LPS was added in final concentration of 1 mg·L−1, (3) stimulated by LPS + HTA125, 30 minutes before the adding of LPS in final concentration of 1 mg·L−1, the final concentration of 5 mg·L−1 of the HTA125 was added, and (4) stimulated by LPS + RP, 30 minutes before the adding of LPS in final concentration 1 mg·L−1, the final concentration 100 mg·L−1 of the RP was added. Supernatants were used to quantify the amounts of TNF-α and IL-10 released in time course using enzyme-linked immunosorbent assay (ELISA). Result. After stimulated by lps, the concentrations of TNF-α and IL-10 in culture supernatants of patients are significantly higher than control group at all time points (). Blockage of TLR-4 by HTA125 can decrease the production of TNF-α and IL-10 compared with lps group (, except at 4 h group of IL-10). Concentration of TNF-α and IL-10 also decreases in the LPS + RP group () but not so significantly as in the LPS + HTA125 group. Conclusion. As anti-TLR4 monoclonal antibodies, rheum Polysaccharide can also inhibit the secretion of cytokines produced by monocytes from HLA-B27 positive AAU patients of convalescence stage. Xuhui Liu, Xiaofeng Hu, Xiaosheng Zhang, Zhongqiu Li, and Hong Lu Copyright © 2013 Xuhui Liu et al. All rights reserved. A Prospective Profile of Visual Field Loss following Stroke: Prevalence, Type, Rehabilitation, and Outcome Mon, 09 Sep 2013 14:30:23 +0000 Aims. To profile site of stroke/cerebrovascular accident, type and extent of field loss, treatment options, and outcome. Methods. Prospective multicentre cohort trial. Standardised referral and investigation protocol of visual parameters. Results. 915 patients were recruited with a mean age of 69 years (SD 14). 479 patients (52%) had visual field loss. 51 patients (10%) had no visual symptoms. Almost half of symptomatic patients () complained only of visual field loss: almost half () also had reading difficulty, blurred vision, diplopia, and perceptual difficulties. 31% () had visual field loss as their only visual impairment: 69% () had low vision, eye movement deficits, or visual perceptual difficulties. Occipital and parietal lobe strokes most commonly caused visual field loss. Treatment options included visual search training, visual awareness, typoscopes, substitutive prisms, low vision aids, refraction, and occlusive patches. At followup 15 patients (7.5%) had full recovery, 78 (39%) had improvement, and 104 (52%) had no recovery. Two patients (1%) had further decline of visual field. Patients with visual field loss had lower quality of life scores than stroke patients without visual impairment. Conclusions. Stroke survivors with visual field loss require assessment to accurately define type and extent of loss, diagnose coexistent visual impairments, and offer targeted treatment. Fiona J. Rowe, David Wright, Darren Brand, Carole Jackson, Shirley Harrison, Tallat Maan, Claire Scott, Linda Vogwell, Sarah Peel, Nicola Akerman, Caroline Dodridge, Claire Howard, Tracey Shipman, Una Sperring, Sonia MacDiarmid, and Cicely Freeman Copyright © 2013 Fiona J. Rowe et al. All rights reserved. Identifying Cell Class Specific Losses from Serially Generated Electroretinogram Components Mon, 09 Sep 2013 08:31:12 +0000 Purpose. Processing of information through the cellular layers of the retina occurs in a serial manner. In the electroretinogram (ERG), this complicates interpretation of inner retinal changes as dysfunction may arise from “upstream” neurons or may indicate a direct loss to that neural generator. We propose an approach that addresses this issue by defining ERG gain relationships. Methods. Regression analyses between two serial ERG parameters in a control cohort of rats are used to define gain relationships. These gains are then applied to two models of retinal disease. Results. The to gain is unity whereas the to and to gains are greater than unity, indicating “amplification” (). Timing relationships show amplification between to and compression for to and to , (). Application of these gains to -3-deficiency indicates that all timing changes are downstream of photoreceptor changes, but a direct pSTR amplitude loss occurs (). Application to diabetes indicates widespread inner retinal dysfunction which cannot be attributed to outer retinal changes (). Conclusions. This simple approach aids in the interpretation of inner retinal ERG changes by taking into account gain characteristics found between successive ERG components of normal animals. Christine T. O. Nguyen, Algis J. Vingrys, Vickie H. Y. Wong, and Bang V. Bui Copyright © 2013 Christine T. O. Nguyen et al. All rights reserved. Analysis of COCH and TNFA Variants in East Indian Primary Open-Angle Glaucoma Patients Mon, 26 Aug 2013 17:36:39 +0000 Glaucoma represents a heterogeneous group of optic neuropathies with a complex genetic basis. It is the second-largest cause of blindness in the world that reduces vision without warning and often without symptoms. Among 3 major subtypes of glaucoma, primary open-angle glaucoma (POAG) is the most common form. The focus of this study is to understand the molecular basis of the disease among Indian patients with respect to two genes, Cochlin (COCH) and tumor necrosis factor alpha (TNFA), selected based on reports of possible association with POAG. The genes were screened in patients and controls by PCR and direct sequencing. Although two novel changes (–450 C/T and –79 G/G) were identified in the 5′upstream region of COCH, no causal variant could be identified in either gene. –450 C/T was detected in 3 patients and 2 controls and –79 G/C in a single patient. Further, we did not observe significant association with the promoter SNPs of TNFA that had been previously reported to be associated with POAG pathogenesis. Thus, our study suggests lack of association of both COCH and TNFA with POAG pathogenesis. Subhadip Chakraborty, Suddhasil Mookherjee, Abhijit Sen, and Kunal Ray Copyright © 2013 Subhadip Chakraborty et al. All rights reserved. Spectrum of Bacterial Keratitis at a Tertiary Eye Care Centre in India Mon, 26 Aug 2013 15:35:08 +0000 Aim. To report the aetiological spectrum and susceptibility patterns of bacteria isolated from patients with corneal ulceration. Method. The microbiological data of all patients with suspected infectious corneal ulceration who presented to the ocular microbiology service at this centre between 2005 and 2012 were reviewed retrospectively. Result. Microorganisms were recovered from 1665 (77%) of the 2170 ulcers. Bacterial isolates accounted for 1205 of the organisms isolated. The most common bacterial pathogens isolated were various species of Staphylococcus, representing 777 (64.5%), followed by Staphylococcus spp. (148; 12.3%) and Pseudomonas aeruginosa (117; 9.7%). High percentages of Gram-positive bacteria were susceptible to gatifloxacin (>94%), followed by ofloxacin and moxifloxacin. Almost 90% of Pseudomonas aeruginosa isolates were susceptible to ciprofloxacin and moxifloxacin. Sixty-two (44%) of 140 isolates of Streptococcus pneumoniae, 79 (14.8%) of 534 isolates of Staphylococcus epidermidis, and 33 (14%) of 234 isolates of Staphylococcus aureus were resistant to three or more antibiotics. Conclusion. Staphylococcus spp. were the most common bacterial pathogens isolated from patients with keratitis in this setting. High percentages of Gram-positive and Gram-negative bacteria were susceptible to gatifloxacin and moxifloxacin, respectively. Interestingly, a high percentage of Streptococcus pneumoniae isolates were found to be resistant to three or more antibiotics. Jayaraman Kaliamurthy, Catti Muniswamy Kalavathy, Pragya Parmar, Christadas Arul Nelson Jesudasan, and Philip A. Thomas Copyright © 2013 Jayaraman Kaliamurthy et al. All rights reserved. Initial Dose of Three Monthly Intravitreal Injections versus PRN Intravitreal Injections of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion Mon, 26 Aug 2013 13:24:00 +0000 Purpose. To compare visual and anatomic outcomes of intravitreal bevacizumab injections administered as needed (PRN group) and initial treatment with 3 monthly injections followed by as-needed injections (3 monthly initial dose group) in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. This retrospective study included 69 and 26 patients in the PRN and 3 monthly initial dose groups, respectively. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared between the 2 groups 6 months after initial injection. Results. At month 6, BCVA change from baseline was (mean ± standard deviation) logMAR in the PRN group and  logMAR in the 3 monthly initial dose group. Mean CRT changes were in the PRN group and  μm in the 3 monthly initial dose group at month 6. There were no statistically significant differences in BCVA or CRT changes between groups at any time point. The number of intravitreal injections over 6 months was significantly lower in the PRN group ( injections) than in the 3 monthly initial dose group ( injections; ). Conclusions. Our results suggest that as-needed intravitreal bevacizumab injections are more tolerable for patients with ME secondary to BRVO. Seong Joon Ahn, Jeeyun Ahn, Se Joon Woo, and Kyu Hyung Park Copyright © 2013 Seong Joon Ahn et al. All rights reserved. Diagnostic Procedures and Management of Dry Eye Mon, 19 Aug 2013 08:19:41 +0000 Dry eye disease or dysfunctional tear syndrome is among the most frequent diagnoses in ophthalmology. It is a multifactorial disease of the ocular surface and tear film which results in ocular discomfort, visual disturbances, and tear instability with potential damage to the cornea and conjunctiva. Risk factors for dry eye syndrome include age, sex (female gender), race, contact lens wear, environment with low humidity, systemic medications, and autoimmune disorders. The aim of this paper is to present the systematic classification, epidemiology, diagnostic procedures, and advances in the management of dry eye disease. The recent improvements in comprehending the underlying etiologic factors will inevitably improve future classifications and diagnostic abilities leading to more effective therapeutic options. Treatment of this highly prevalent condition can drastically improve the quality of life of individuals and prevent damage to the ocular surface. Snježana Kaštelan, Martina Tomić, Jasminka Salopek-Rabatić, and Branko Novak Copyright © 2013 Snježana Kaštelan et al. All rights reserved. SDOCT Thickness Measurements of Various Retinal Layers in Patients with Autosomal Dominant Optic Atrophy due to OPA1 Mutations Mon, 19 Aug 2013 08:09:54 +0000 Purpose. To specify thickness values of various retinal layers on macular spectral domain Optical Coherence Tomography (SDOCT) scans in patients with autosomal dominant optic atrophy (ADOA) compared to healthy controls. Methods. SDOCT volume scans of 7 patients with ADOA (OPA-1 mutation) and 14 healthy controls were quantitatively analyzed using manual grading software. Mean thickness values for the ETDRS grid subfields 5–8 were calculated for the spaces neurosensory retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), a combined space of inner plexiform layer/outer plexiform layer/inner nuclear layer (IPL+INL+OPL), and a combined space of outer nuclear layer/photoreceptor layers (ONL+PL). Results. ADOA patients showed statistically significant lower retinal thickness values than controls (). RNFL () and GCL thicknesses () were significantly lower in ADOA patients. There was no difference in IPL+INL+OPL and in ONL+PL thickness. Conclusion. Manual subanalysis of macular SDOCT volume scans allowed detailed subanalysis of various retinal layers. Not only RNFL but also GCL thicknesses are reduced in the macular area of ADOA patients whereas subjacent layers are not involved. Together with clinical findings, macular SDOCT helps to identify patients with suspicion for hereditary optic neuropathy before genetic analysis confirms the diagnosis. Andrea M. Schild, Tina Ristau, Julia Fricke, Antje Neugebauer, Bernd Kirchhof, Srinivas R. Sadda, and Sandra Liakopoulos Copyright © 2013 Andrea M. Schild et al. All rights reserved. Novel GUCA1A Mutations Suggesting Possible Mechanisms of Pathogenesis in Cone, Cone-Rod, and Macular Dystrophy Patients Wed, 14 Aug 2013 09:17:24 +0000 Here, we report two novel GUCA1A (the gene for guanylate cyclase activating protein 1) mutations identified in unrelated Spanish families affected by autosomal dominant retinal degeneration (adRD) with cone and rod involvement. All patients from a three-generation adRD pedigree underwent detailed ophthalmic evaluation. Total genome scan using single-nucleotide polymorphisms and then the linkage analysis were undertaken on the pedigree. Haplotype analysis revealed a 55.37 Mb genomic interval cosegregating with the disease phenotype on chromosome 6p21.31-q15. Mutation screening of positional candidate genes found a heterozygous transition c.250C>T in exon 4 of GUCA1A, corresponding to a novel mutation p.L84F. A second missense mutation, c.320T>C (p.I107T), was detected by screening of the gene in a Spanish patients cohort. Using bioinformatics approach, we predicted that either haploinsufficiency or dominant-negative effect accompanied by creation of a novel function for the mutant protein is a possible mechanism of the disease due to c.250C>T and c.320T>C. Although additional functional studies are required, our data in relation to the c.250C>T mutation open the possibility that transacting factors binding to de novo created recognition site resulting in formation of aberrant splicing variant is a disease model which may be more widespread than previously recognized as a mechanism causing inherited RD. Kunka Kamenarova, Marta Corton, Blanca García-Sandoval, Patricia Fernández-San Jose, Valentin Panchev, Almudena Ávila-Fernández, Maria Isabel López-Molina, Christina Chakarova, Carmen Ayuso, and Shomi S. Bhattacharya Copyright © 2013 Kunka Kamenarova et al. All rights reserved. Topical 100% Serum Eye Drops for Treating Corneal Epithelial Defect after Ocular Surgery Tue, 30 Jul 2013 10:15:12 +0000 The purpose of this study was to investigate the efficacy and safety of topical 100% serum eye drops for corneal epithelial defect after ocular surgery. A total of 181 patients who received topical 100% serum therapy for the treatment of corneal epithelial defect following several different types of ocular surgery were recruited into this study. Each patient already failed conventional medical therapy before being prescribed 100% serum eye drops. Slit-lamp biomicroscopic examination with fluorescein staining was performed at baseline and all follow-up visits. The main outcome measures were the rate of complete healing of the corneal epithelial defect and incidence of adverse events. One hundred and seventy-eight eyes (98.34%) received autologous serum eye drops, and 3 (1.66%) received allogeneic serum eye drops. The overall success rate of treating persistent postoperative epithelial defect using 100% serum eye drops was 93.92% (95% CI 0.88–0.98). The median time to complete corneal epithelialization was 4 days (95% CI 4-5). Adverse reactions were observed in 3 patients (1.66%), including sticky sensation with minimal eye discomfort and asymptomatic trace corneal subepithelial infiltration. No serious complications were reported. In conclusion, 100% serum eye drops are effective, safe, and tolerable for treating postoperative corneal epithelial defect following ocular surgeries. Kaevalin Lekhanont, Passara Jongkhajornpong, Lulin Choubtum, and Varintorn Chuckpaiwong Copyright © 2013 Kaevalin Lekhanont et al. All rights reserved. Intraoperative Pachymetry Using Spectral-Domain Optical Coherence Tomography during Accelerated Corneal Collagen Crosslinking Thu, 25 Jul 2013 13:25:41 +0000 Purpose. To evaluate the role of spectral-domain optical coherence tomography (SDOCT) to measure corneal thickness during accelerated corneal crosslinking (CXL). Methods. Intraoperative pachymetry was performed using SDOCT and ultrasound pachymetry (USP) in 6 eyes of 6 patients with keratoconus. Pachymetry readings were obtained at baseline, after epithelium removal and after 30 minutes of riboflavin instillation. SDOCT measurements of eyes with and without lid speculum during riboflavin instillation were compared. Results. There was no statistically significant difference in central corneal thickness (CCT) measurements between SDOCT and USP ( for all). A significant decrease in both CCT () and the thinnest corneal thickness (TCT) () was observed during CXL. There was a greater reduction in CCT (38 ± 6%) with the use of lid speculum as compared to the no-speculum eyes (18 ± 9%) (). TCT was also reduced by a greater extent with the use of lid speculum (40 ± 5% versus 26 ± 7%; ). Conclusion. SDOCT can be successfully used to measure intraoperative corneal pachymetry during corneal CXL. SDOCT measurements demonstrated corneal thinning intraoperatively during CXL, which was further accentuated by the use of a lid speculum during the procedure. Vanissa W. S. Chow, Sayantan Biswas, Marco Yu, Victoria W. Y. Wong, and Vishal Jhanji Copyright © 2013 Vanissa W. S. Chow et al. All rights reserved. Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma Thu, 18 Jul 2013 12:22:08 +0000 Purpose. Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG. Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%. Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 ± 1.73 mmHg versus 16.78 ± 1.27 mmHg; ). Mean TBUT decreased from seconds at baseline to 8.30 ± 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 ± 18.48 to 44.41 ± 16.48 (). Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface. Martina Tomić, Snježana Kaštelan, Kata Metež Soldo, and Jasminka Salopek-Rabatić Copyright © 2013 Martina Tomić et al. All rights reserved. Normative Findings for Periocular Anthropometric Measurements among Chinese Young Adults in Hong Kong Wed, 17 Jul 2013 09:33:21 +0000 Measurement of periocular structures is of value in several clinical specialties including ophthalmology, optometry, medical and clinical genetics, oculoplastic surgery, and traumatology. Therefore we aimed to determine the periocular anthropometric norms for Chinese young adults using a noninvasive 3D stereophotography system. Craniofacial images using the 3dMDface system were acquired for 103 Chinese subjects (51 males and 52 females) between the ages of 18 and 35 years. Anthropometric landmarks were identified on these digital images according to standard definitions, and linear distances between these landmarks were calculated. It was found that ocular measurements were significantly larger in Chinese males than females for intercanthal width, biocular width, and eye fissure lengths. No gender differences were found in the eye fissure height and the canthal index which ranged between 43 and 44. Both right and left eye fissure height-length ratios were significantly larger in females. This is the first study to employ 3D stereophotogrammetry to create a database of anthropometric normative data for periocular measurements. These data would be useful for clinical interpretation of periocular pathology and serve as reference values when planning aesthetic and posttraumatic surgical interventions. Yasas S. N. Jayaratne, Curtis K. Deutsch, and Roger A. Zwahlen Copyright © 2013 Yasas S. N. Jayaratne et al. All rights reserved. Increased Expression of CCN2 in the Red Flashing Light-Induced Myopia in Guinea Pigs Sun, 14 Jul 2013 08:34:57 +0000 Visual environment plays an important role in the occurrence of myopia. We previously showed that the different flashing lights could result in distinct effects on the ocular growth and development of myopia. CCN2 has been reported to regulate various cellular functions and biological processes. However, whether CCN2 signaling was involved in the red flashing light-induced myopia still remains unknown. In the present study, we investigated the effects of the red flashing lights exposure on the refraction and axial length of the eyes in vivo and then evaluated their effects on the expression of CCN2 and TGF-β in sclera tissues. Our data showed that the eyes exposed to the red flashing light became more myopic with a significant increase of the axial length and decrease of the refraction. Both CCN2 and TGF-β, as well as p38 MAPK and PI3K, were highly expressed in the sclera tissues exposed to the red flashing light. Both CCN2 and TGF-β were found to have the same gene expression profile in vivo. In conclusion, our findings found that CCN2 signaling pathway plays an important role in the red flashing light-induced myopia in vivo. Moreover, our study establishes a useful animal model for experimental myopia research. Hong Wang, Kang Zhuang, Lei Gao, Linna Zhang, and Hongling Yang Copyright © 2013 Hong Wang et al. All rights reserved. Role of Corneal Epithelium in Riboflavin/Ultraviolet-A Mediated Corneal Cross-Linking Treatment in Rabbit Eyes Thu, 27 Jun 2013 16:23:29 +0000 Purpose. To evaluate the role of corneal epithelium in riboflavin/ultraviolet-A (UVA) mediated corneal collagen cross-linking treatment. Methods. Fifty New Zealand rabbits were divided into 5 groups: UVA treatment with or without corneal epithelium, UVA+riboflavin treatment with or without corneal epithelium, and control without any treatment. All rabbits were sacrificed after irradiation and subsequently 4 mm × 10 mm corneal strips were harvested for biomechanical evaluation. Results. UVA irradiation alone did not enhance the maximal stress and Young’s modulus of corneal specimens with (3.15 ± 0.56 mpa, 1.00 ± 0.09 mpa) or without (3.53 ± 0.85 mpa, 0.94 ± 0.21 mpa) the corneal epithelium, compared to specimens in the control group (4.30 ± 0.68 mpa, 1.03 ± 0.24 mpa). However, UVA irradiation combined with riboflavin significantly increased the maximal stress and Young’s modulus of corneal specimens with (5.27 ± 1.09 mpa, 1.23 ± 0.23 mpa, ) or without (7.16 ± 1.88 mpa, 1.42 ± 0.16 mpa, ) corneal epithelium when compared to the control group. The maximal stress and Young’s modulus of cornea in UVA+riboflavin and “epithelium-off” group were 35.9% and 15.4% higher compared to the UVA+riboflavin and “epithelium-on” group, respectively (). Conclusions. Our study shows that UVA+riboflavin treatment significantly affects the biomechanical properties of the cornea with and without epithelial removal. However, corneas without epithelium seem to benefit more compared to corneas with the epithelium. Xiangchen Tao, Haiqun Yu, Yong Zhang, Zhiwei Li, Vishal Jhanji, Shouxiang Ni, Ya Wang, and Guoying Mu Copyright © 2013 Xiangchen Tao et al. All rights reserved. Role of Dopaminergic Receptors in Glaucomatous Disease Modulation Wed, 26 Jun 2013 11:01:54 +0000 Both studies on animals and humans suggest the presence of dopamine (DA) receptors in the anterior segment of the eye. Their role in the dynamics of intraocular pressure (IOP) is not yet clear. DA2 and DA3 receptors are mainly located on postganglionic sympathetic nerve endings. Their stimulation reduces the release of norepinephrine and suppresses the production of aqueous humor. DA1 receptors seem to be more expressed by the ciliary body and the outflow pathway of aqueous humor. The administration of DA1-selective agonists stimulates the production of aqueous humor, increasing IOP, whereas DA2- and DA3-selective agonists could reduce IOP and, therefore, the risk to develop a glaucoma (GL). GL is a broad spectrum of eye diseases which have in common the damage to the optic nerve and the progressive loss of the visual field. Further studies are desirable to clarify the role of the dopaminergic system and the usefulness of DA2 and DA3 agonists in reducing IOP. Nicola Pescosolido, Francesco Parisi, Paola Russo, Giuseppe Buomprisco, and Marcella Nebbioso Copyright © 2013 Nicola Pescosolido et al. All rights reserved. Spectacle Coverage and Spectacles Use among Elderly Population in Residential Care in the South Indian State of Andhra Pradesh Sun, 23 Jun 2013 11:37:58 +0000 Background. There is limited research conducted on uncorrected refractive errors, presbyopia, and spectacles use among the elderly population in residential care in developing countries such as India. We conducted a cross-sectional study among elderly in residential care to assess the spectacle coverage and spectacles usage in the south Indian state of Andhra Pradesh. Methods. All 524 residents in the 26 “homes for aged” institutions in the district were enumerated. Eye examination was performed that included visual acuity (VA) assessment for distant and near vision. A questionnaire was used to collect information on spectacles use. Results. 494/524 individuals were examined, 78% were women, and 72% had no education. The mean age of participants was 70 years. The spectacle coverage for refractive errors was 35.1% and 23.9% for presbyopia. The prevalence of current use and past use of spectacles was 38.5% (95% CI: 34.2–42.8; ) and 17.2% (95% CI: 13.9–42.8), respectively. Conclusions. There is low spectacle coverage for both refractive errors and presbyopia among elderly individuals in residential care in the south Indian state of Andhra Pradesh. Appropriate service delivery systems should be developed to reach out this vulnerable group of seniors on a priority basis. Srinivas Marmamula, L. V. Chandra Sekhar Ravuri, Mei Ying Boon, and Rohit C. Khanna Copyright © 2013 Srinivas Marmamula et al. All rights reserved. Effect of Pupil Size on Optical Quality Parameters in Astigmatic Eyes Using a Double-Pass Instrument Sun, 23 Jun 2013 11:29:49 +0000 Purpose. To objectively determine the effects of pupil size on optical quality parameters in astigmatic eyes using a double-pass instrument. Methods. We examined twenty-two eyes of 22 healthy volunteers (mean age ± standard deviation, years) who had no ophthalmic diseases other than refractive errors (manifest cylinder ≤0.25 diopters (D)). After we fully corrected cycloplegic refraction, we created with-the-rule astigma tism of 1, 2, and 3 diopters in these eyes and then quantitatively assessed the modulation transfer function (MTF) cutoff frequency and the Strehl2D ratio with 2-, 4-, and 6-mm pupil sizes using the Optical Quality Analysis System. Results. The MTF cutoff frequency and the Strehl2D ratio decreased significantly as the amount of astigmatism increased at each pupil size ( for 2, 4, and 6 mm, analysis of variance). They also decreased significantly with an increase in pupil size at each diopter of astigmatism ( for 0, 1, 2, and 3 D). Multiple comparisons demonstrated a significant difference between measurements made for a 2-mm pupil and for a 6-mm pupil at each diopter of astigmatism ( for 0, 1, 2, and 3 D, Dunnett test) and those made for a 4-mm pupil and for a 6-mm pupil at each diopter of astigmatism ( for 0 D, 1, 2, and 3 D). Conclusions. Eyes with larger pupils had lower optical quality even when they were astigmatic. It may be necessary to correct the preexisting astigmatism to acquire excellent visual performance, especially in astigmatic eyes with larger pupils. Hidenaga Kobashi, Kazutaka Kamiya, Kyohei Yanome, Akihito Igarashi, and Kimiya Shimizu Copyright © 2013 Hidenaga Kobashi et al. All rights reserved. Effect of Fluorometholone/Tetrahydrozoline Fixed Combination on Conjunctival Autograft Morphology after Primary Pterygium Excision Thu, 20 Jun 2013 10:42:27 +0000 Purpose. To evaluate the effect of a fluorometholone/tetrahydrozoline fixed combination on conjunctival graft morphology after primary pterygium excision. Methods. The patients who underwent pterygium excision with conjunctival autograft transplantation were randomized into three groups based on postoperative medications as the fluorometholone/tetrahydrozoline group, fluorometholone group, and dexamethasone group. Conjunctival graft thickness was measured with anterior segment optical coherence tomography. The conjunctival graft hyperemia was evaluated using a high definition external camera. Results. The mean graft thickness was significantly lower in the fluorometholone/tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks ( and , resp.) and at 1 month after surgery ( and , resp.). The conjunctival hyperemia score was significantly lower in the fluorometholone/tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks ( and , resp.) and at 1 month ( and , resp.). The graft thickness and conjunctival hyperemia score were similar among the groups at 1 week and 3 months (). Conclusion. The findings of the present study revealed that treatment with the fluorometholone/tetrahydrozoline fixed combination may be helpful to decrease graft edema and to achieve better cosmetic appearance at 2 weeks and 1 month after pterygium excision. Engin Bilge Ozgurhan, Necip Kara, Ercument Bozkurt, Baran Gencer, Alper Agca, Zeynep Alkin, and Ahmet Demirok Copyright © 2013 Engin Bilge Ozgurhan et al. All rights reserved. Lower Lid Reconstruction Utilizing Auricular Conchal Chondral-Perichondral Tissue in Patients with Neoplastic Lesions Thu, 20 Jun 2013 08:22:19 +0000 Purpose. To assess surgical outcomes of lower lid reconstruction surgery using auricular conchal tissue. Methods. This prospective study included 20 patients that underwent reconstructive lower lid surgery using autologous auricle chondral-perichondral graft tissue. Auricle tissue was used to provide adequate support and protection with similar conjunctiva tarsal structures on overlying soft tissues in patients with pathologic inferior lid tissue loss requiring reconstructive surgery. Biopsies with histopathology and cytology analysis were taken after 1 year. Cytology analysis using CK19 was used to confirm newly formed conjunctiva overlying the graft. Results. All patients showed no graft rejection. Surgical outcomes were generally good, with minimal or no ocular complications. 16 of 20 patients had excellent results, showing good lid symmetry and esthetics, minimal auricular discomfort, patient satisfaction and proper lid function. Surgical outcomes were highly dependent on proper post-op conjunctiva formation. All patients were positive for CK19, thus indicating proper conjunctiva tissue formation. Conclusions. Lower lid reconstruction surgery using auricular chondral-perichondral conchal tissue is a good alternative in patients with neoplastic lesions. Autologous chondral-perichondral tissue provides good functional and mechanical support in the reconstructed lid, thus reducing the risks of ectropion and corneal exposure and ensuring a protected ocular surface. Pier Camillo Parodi, Fabrizio Calligaris, Fabrizio De Biasio, Giovanna De Maglio, Flavia Miani, and Marco Zeppieri Copyright © 2013 Pier Camillo Parodi et al. All rights reserved. Reduction of Orbital Inflammation following Decompression for Thyroid-Related Orbitopathy Tue, 18 Jun 2013 16:32:38 +0000 Purpose. Thyroid-related orbitopathy (TRO) is associated with inflammation, expansion of orbital fat, enlargement of extraocular muscles, and optic neuropathy (ON). We examined the effects of orbital decompression on the inflammatory and congestive signs of TRO in patients who underwent emergent orbital decompression. Methods. This retrospective, consecutive study included patients with ON from TRO who underwent orbital decompression. Pre- and postoperative orbital inflammatory signs in the operated and nonoperated, contralateral eyes were graded with the 10-item clinical activity score (CAS). Results. Thirty-one orbits were included. Postoperatively, 22 patients and 29 orbits had resolution of ON while the remaining 2 patients had improvement in visual acuity. Mean preoperative CAS was 9.5 ± 0.4. At 12 months, postoperative CAS was 2.1 ± 0.6 () in the operated eye and 3.2 ± 0.5 () in the nonoperated, contralateral eye. Conclusion. In our series, 94% of orbits had resolution of ON. There was also a statistically significant postoperative reduction in the CAS in both the operated and nonoperated, contralateral eyes. This phenomenon may be due to lowered venous congestion, decreased intraorbital pressure, and diminution in inflammatory factors. Sang-Rog Oh, Jonathan D. Tung, Ayelet Priel, Leah Levi, David B. Granet, Bobby S. Korn, and Don O. Kikkawa Copyright © 2013 Sang-Rog Oh et al. All rights reserved. Influence of Scleral Buckling Surgery with Encircling Band on Subfoveal Choroidal Thickness in Long-Term Observations Tue, 11 Jun 2013 11:50:24 +0000 Purpose. The aim of this study is the presentation of subfoveal choroidal thickness with enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) several months after scleral buckling with encircling band surgery. Methods. 48 patients who underwent scleral buckling with encircling band surgery for unilateral rhegmatogenous retinal detachment were included in the retrospective observational study. The mean time from scleral buckling surgery to the final EDI-OCT examination was months. We compare choroidal thickness between operated and fellow eyes. Results. In all patients, the macula was detached before the surgery. The subfoveal choroidal thickness in 48 treated eyes was  µm (range 155–383 µm) and in the fellow eyes was  µm (range 98–326 µm). The subfoveal choroidal thickness of eyes after scleral buckling surgery in long-term EDI-OCT examination was significantly thicker () than in fellow eyes. Conclusions. The subfoveal choroid in eyes undergoing encircling band surgery was significantly thicker than in fellow eyes. We suspect that this may be the result of reduced choroidal blood flow. It also seems that the width and size of the material used in scleral buckling surgery may affect a change in the choroid circulation and increase subfoveal choroidal thickness. Dominik Odrobina, Iwona Laudańska-Olszewska, Piotr Gozdek, Mariusz Maroszyński, and Michael Amon Copyright © 2013 Dominik Odrobina et al. All rights reserved. Use of a New Ocular Insert versus Conventional Mydriasis in Cataract Surgery Thu, 30 May 2013 15:28:03 +0000 Background. To compare the efficacy and safety of a new ocular insert versus conventional mydriasis in cataract surgery. Methods. We selected 70 patients undergoing cataract surgery. Thirty five patients (Group 1) received instillation of mydriatic drops (tropicamide 1%, phenylephrine 10%, and cyclopentolate 1%) prior to surgery, and 35 patients (Group 2) had a Mydriasert insert (Théa Pharma) (0.28 mg of tropicamide and 5.4 mg of phenylephrine hydrochloride) placed in the inferior fornix. Pupil size before and after surgery, blood pressure, and heart rate were measured. Results. Before surgery, pupil diameter was  mm in Group 1 and in Group 2 (). Twenty four hours after surgery, pupil diameter was  mm in Group 1 and in Group 2 (). There were no statistically significant differences in blood pressure or heart rate between groups. Conclusions. The effect of the Mydriasert insert was similar to conventional mydriatic agents. Pupil size was restored to normal faster when using the Mydriasert insert compared with conventional mydriatic agents for pupil dilation. C. Torrón, P. Calvo, O. Ruiz-Moreno, J. Leciñena, and A. Pérez-Iñigo Copyright © 2013 C. Torrón et al. All rights reserved. Individual IOL Surface Topography Analysis by the WaveMaster Reflex UV Tue, 28 May 2013 09:03:47 +0000 Purpose. In order to establish inspection routines for individual intraocular lenses (IOLs), their surfaces have to be measured separately. Currently available measurement devices lack this functionality. The purpose of this study is to evaluate a new topography measurement device based on wavefront analysis for measuring individual regular and freeform IOL surfaces, the “WaveMaster Reflex UV” (Trioptics, Wedel, Germany). Methods. Measurements were performed on IOLs with increasingly complex surface geometries: spherical surfaces, surfaces modelled by higher-order Zernike terms, and freeform surfaces from biometrical patient data. Two independent parameters were measured: the sample’s radius of curvature (ROC) and its residual (difference of sample topography and its best-fit sphere). We used a quantitative analysis method by calculating the residuals’ root-mean-square (RMS) and peak-to-Valley (P2V) values. Results. The sample’s best-fit ROC differences increased with the sample’s complexity. The sample’s differences of RMS values were 80 nm for spherical surfaces, 97 nm for higher-order samples, and 21 nm for freeform surfaces. Graphical representations of both measurement and design topographies were recorded and compared. Conclusion. The measurements of spherical surfaces expectedly resulted in better values than those of freeform surfaces. Overall, the wavefront analysing method proves to be an effective method for evaluating individual IOL surfaces. Marc Kannengießer, Achim Langenbucher, and Edgar Janunts Copyright © 2013 Marc Kannengießer et al. All rights reserved. Integrins in Trabecular Meshwork and Optic Nerve Head: Possible Association with the Pathogenesis of Glaucoma Mon, 18 Mar 2013 10:08:53 +0000 Integrins are a family of membrane-spanning proteins that are important receptors for cell adhesion to extracellular matrix proteins. They also provide connections between the extracellular environment and intracellular cytoskeletons and are responsible for activation of many intracellular signaling pathways. In vitro and in vivo data strongly indicate that integrin-mediated signaling events can modulate the organization of the actin cytoskeleton in trabecular meshwork (TM) cells and are associated with astrocyte migration and microglia activation of the optic nerve head in patients with primary open angle glaucoma. Consequently, increase in resistance in the TM outflow pathways and remodeling of the optic nerve head occur, which in turn increases intraocular pressure (IOP), adds additional mechanical stress and strain to optic nerve axons, and accelerates damage of axons initially caused by optic nerve head remodeling. Integrins appear to be ideal candidates for translating physical stress and strain into cellular responses known to occur in glaucomatous optic neuropathy. Yisheng Zhong, Jing Wang, and Xunda Luo Copyright © 2013 Yisheng Zhong et al. All rights reserved. Rabbit and Mouse Models of HSV-1 Latency, Reactivation, and Recurrent Eye Diseases Tue, 02 Oct 2012 12:21:30 +0000 The exact mechanisms of HSV-1 establishment, maintenance, latency, reactivation, and also the courses of recurrent ocular infections remain a mystery. Comprehensive understanding of the HSV-1 disease process could lead to prevention of HSV-1 acute infection, reactivation, and more effective treatments of recurrent ocular disease. Animal models have been used for over sixty years to investigate our concepts and hypotheses of HSV-1 diseases. In this paper we present descriptions and examples of rabbit and mouse eye models of HSV-1 latency, reactivation, and recurrent diseases. We summarize studies in animal models of spontaneous and induced HSV-1 reactivation and recurrent disease. Numerous stimuli that induce reactivation in mice and rabbits are described, as well as factors that inhibit viral reactivation from latency. The key features, advantages, and disadvantages of the mouse and rabbit models in relation to the study of ocular HSV-1 are discussed. This paper is pertinent but not intended to be all inclusive. We will give examples of key papers that have reported novel discoveries related to the review topics. Jody M. Webre, James M. Hill, Nicole M. Nolan, Christian Clement, Harris E. McFerrin, Partha S. Bhattacharjee, Victor Hsia, Donna M. Neumann, Timothy P. Foster, Walter J. Lukiw, and Hilary W. Thompson Copyright © 2012 Jody M. Webre et al. All rights reserved. Diabetic Retinopathy Analysis Mon, 01 Jan 1900 00:00:00 +0000 Diabetic retinopathy is one of the common complications of diabetes. Unfortunately, in many cases the patient is not aware of any symptoms until it is too late for effective treatment. Through analysis of evoked potential response of the retina, the optical nerve, and the optical brain center, a way will be paved for early diagnosis of diabetic retinopathy and prognosis during the treatment process. In this paper, we present an artificial-neural-network-based method to classify diabetic retinopathy subjects according to changes in visual evoked potential spectral components and an anatomically realistic computer model of the human eye under normal and retinopathy conditions in a virtual environment using 3D Max Studio and Windows Movie Maker. R. Sivakumar, G. Ravindran, M. Muthayya, S. Lakshminarayanan, and C. U. Velmurughendran Copyright © 2005 Hindawi Publishing Corporation. All rights reserved.