http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Wed, 08 May 2013 14:51:55 +0000 http://www.hindawi.com/journals/jop/2013/385915/ Purpose. To compare color fundus photography (FP), fluorescein angiography (FA), and spectral domain optical coherence tomography (SDOCT) for the detection of age-related macular degeneration (AMD), choroidal neovascularisation (CNV), and CNV activity. Methods. FPs, FAs, and SDOCT volume scans from 120 eyes of 66 AMD and control patients were randomly collected. Control eyes were required to show no AMD, but other retinal pathology was allowed. The presence of drusen, pigmentary changes, CNV, and signs for CNV activity was independently analyzed for all imaging modalities. Results. AMD was diagnosed based on FP in 75 eyes. SDOCT and FA showed sensitivity (specificity) of 89% (76%) and 92% (82%), respectively. CNV was present on FA in 68 eyes. Sensitivity (specificity) was 78% (100%) for FP and 94% (98%) for SDOCT. CNV activity was detected by SDOCT or FA in 60 eyes with an agreement in 46 eyes. Sensitivity was 88% for SDOCT and 88% for FA. FP showed sensitivity of 38% and specificity of 98%. Conclusions. CNV lesions and activity may be missed by FP alone, but FP may help identifying drusen and pigmentary changes. SDOCT is highly sensitive for the detection of AMD, CNV, and CNV activity; however, it cannot fully replace FA. Nils F. Mokwa, Tina Ristau, Pearse A. Keane, Bernd Kirchhof, Srinivas R. Sadda, and Sandra Liakopoulos Copyright © 2013 Nils F. Mokwa et al. All rights reserved. Tue, 07 May 2013 14:34:50 +0000 http://www.hindawi.com/journals/jop/2013/908017/ Purpose. To evaluate the changes of flash electroretinography (fERG) and pattern visual evoked potentials (pVEP) in ocular hypertension (OHT) patients. Methods. Twenty-five OHT patients and 30 healthy volunteers were enrolled for this cross-sectional study. Opthalmologic examinations, visual field tests, pVEP and fERG were performed. The main outcome measures were the differences between pVEP and fERG parameters. Results. The mean age of OHT patients and volunteers were 57 ± 12.25 years (range 30–65 years), and 53.25 ± 12.0 years (range 30–65 years), respectively. The mean amplitude of the pVEP was statistically lower in the OHT group (P < 0.05). Latency of the two groups was different; however, the difference was not statistically significant (P > 0.05). In fERG of OHT group, there was a significant decrease in the amplitude of the oscillatory potentials (Ops), and a significant delay in latency of rod and cone waves (all P < 0.05). There was no significant change in the flicker fERG waves between the two groups (P > 0.05). Conclusions. Although we found a decrease in Ops amplitude and a prolonged latency in flicker fERG, only the decrease in Ops amplitude was statistically significant between the two groups. The amplitude of Ops wave and amplitude of pVEP may reflect early glaucomatous damage in OHT patients. Ercüment Çavdar, Abdullah Ozkaya, and Burcu Alper Copyright © 2013 Ercüment Çavdar et al. All rights reserved. Tue, 30 Apr 2013 15:40:07 +0000 http://www.hindawi.com/journals/jop/2013/376013/ Aim. To investigate the utility of fundus autofluorescence (FAF) and optical coherence tomography (OCT) in the evaluation of cystoid macular edema (CME) following cataract surgery. Materials and Methods. Forty eyes of 29 patients undergone phacoemulsification, with posterior chamber intraocular lens implantation surgery. Central macular thickness (CMT) of the patients was evaluated using OCT and FAF preoperatively and postoperative 1st, 30th, 60th, 90th, and 180th days. Results. CME was detected in three eyes (7.5%) of two patients using OCT. Hyperautofluorescence (HAF) was detected in two of these three eyes and resolved with treatment. In the remaining 37 eyes without CME, there was a significant increase in visual acuity when compared to preoperative values () Mean macular thicknesses (MMT) of the eyes without CME were 174 ± 20 μm preoperatively and 179 ± 22 μm at day 1, 178 ± 19 μm at 1st month, and 168 ± 10 μm at 6th month postoperatively. In the eyes with CME, the MMTs, measured with OCT were 189 ± 23 μm preoperatively and 432 ± 361 on day 1, 343 ± 123 μm at 1st month, 345 ± 196 at 2nd month, and 200 ± 36 μm at 6th month postoperatively. Conclusion. We found a moderate increase in CMT in the first 3 months postoperatively, in the eyes without CME which did not cause visual disturbances. FAF is a noninvasive, rapid method for the evaluation and follow-up of CME following cataract surgery. Muhammed Şahin, Abdullah Kürşat Cingü, and Nilüfer Gözüm Copyright © 2013 Muhammed Şahin et al. All rights reserved. Wed, 24 Apr 2013 16:16:18 +0000 http://www.hindawi.com/journals/jop/2013/634351/ Introduction. In this retrospective study we evaluated the multimodal visualization of retinal genetic diseases to better understand their natural course. Material and Methods. We reviewed the charts of 70 consecutive patients with different genetic retinal pathologies who had previously undergone multimodal imaging analyses. Genomic DNA was extracted from peripheral blood and genotyped at the known locus for the different diseases. Results. The medical records of 3 families of a 4-generation pedigree affected by North Carolina macular dystrophy were reviewed. A total of 8 patients with Stargardt disease were evaluated for their two main defining clinical characteristics, yellow subretinal flecks and central atrophy. Nine male patients with a previous diagnosis of choroideremia and eleven female carriers were evaluated. Fourteen patients with Best vitelliform macular dystrophy and 6 family members with autosomal recessive bestrophinopathy were included. Seven patients with enhanced s-cone syndrome were ascertained. Lastly, we included 3 unrelated patients with fundus albipunctatus. Conclusions. In hereditary retinal diseases, clinical examination is often not sufficient for evaluating the patient’s condition. Retinal imaging then becomes important in making the diagnosis, in monitoring the progression of disease, and as a surrogate outcome measure of the efficacy of an intervention. Francesco Pichi, Mariachiara Morara, Chiara Veronese, Paolo Nucci, and Antonio P. Ciardella Copyright © 2013 Francesco Pichi et al. All rights reserved. Wed, 24 Apr 2013 08:52:16 +0000 http://www.hindawi.com/journals/jop/2013/763735/ Currently, there are numerous choices for the treatment of pediatric glaucoma depending on the type of glaucoma, the age of the patient, and other particularities of the condition discussed in this review. Traditionally, goniotomy and trabeculotomy ab externo have been the preferred choices of treatment for congenital glaucoma, and a variety of adult procedures adapted to children have been utilized for other types of pediatric glaucoma with variable results and complications. More recently, seton implantations of different types have become more popular to use in children, and newer techniques have become available including visualized cannulation and opening of Schlemm’s canal, deep sclerectomy, trabectome, and milder more directed cyclodestructive procedures such as endolaser and transcleral diode laser cyclophotocoagulation. This paper reviews the different surgical techniques currently available, their indications, results, and most common complications to allow the surgeon treating these conditions to make a more informed choice in each particular case. Although the outcome of surgical treatment in pediatric glaucoma has improved significantly, its treatment remains challenging. Jose Morales, Sami Al Shahwan, Sami Al Odhayb, Ibrahim Al Jadaan, and Deepak P. Edward Copyright © 2013 Jose Morales et al. All rights reserved. Mon, 22 Apr 2013 16:48:15 +0000 http://www.hindawi.com/journals/jop/2013/465169/ Background. Age-related macular degeneration (AMD) is a complex disorder that affects primarily the macula involving the retinal pigment epithelium (RPE) but also to a certain extent the photoreceptor layer and the retinal neurons. Cell transplantation is a promising option for AMD and clinical trials are underway using different cell types. Methods. We hypothesize that instead of focusing on a particular cell source for concurrent regeneration of all the retinal layers and also to prevent exhaustive research on an array of cell sources for regeneration of each layer, the choice should depend on, precisely, which layer is damaged. Results. Thus, for a damage limited to the retinal pigment epithelial (RPE) layer, the choice we suggest would be RPE cells. When the damage extends to rods and cones, the choice would be bone marrow stem cells and when retinal neurons are involved, relatively immature stem cell populations with an inherent capacity to yield neuronal lineage such as hematopoietic stem cells, embryonic stem cells, or induced pluripotent stem cells can be tried. Conclusion. This short review will prove to be a valuable guideline for those working on cell therapy for AMD to plan their future directions of research and therapy for this condition. Sudhakar John, Sundaram Natarajan, Periyasamy Parikumar, Mahesh Shanmugam P, Rajappa Senthilkumar, David William Green, and Samuel J. K. Abraham Copyright © 2013 Sudhakar John et al. All rights reserved. Mon, 22 Apr 2013 11:13:42 +0000 http://www.hindawi.com/journals/jop/2013/309192/ Purpose. To compare the autofluorescence images of the Zeiss versus Topcon eye fundus cameras and design an objective way to quantify it. Procedures. The IMAGEJ software was used to determine the gray level corresponding to the darkest veins and the peripapillary ring (thresholds), the level of white of the brightest perifoveal area, their difference (contrast level), and the suprathreshold area for each photograph. Results. Carl Zeiss has higher contrast values than Topcon. The Topcon contrast presented a crest with further decline as the suprathreshold area continued to increase. On the contrary, the Zeiss profile did not decline in contrast. Conclusions and Message. The Carl Zeiss camera showed superior contrast ability over the Topcon when performing autofluorescence imaging. We set objective parameters to compare fundus cameras FAF images. These parameters could be the base to objectively measure and determine changes and realize followup to areas of hyper- or hypofluorescence. Juan M. Muñoz, Rosa M. Coco, M. Rosa Sanabria, Ruben Cuadrado, and Eduardo Blanco Copyright © 2013 Juan M. Muñoz et al. All rights reserved. Wed, 17 Apr 2013 11:32:20 +0000 http://www.hindawi.com/journals/jop/2013/278135/ The intention is to summarize the body of evidence speaking to the psychological challenges faced by visually impaired older adults, as well as their coping efforts. This evidence is substantiated by a rich set of concepts, theories, and empirical findings that have accumulated under the umbrella of age-related psychoophthalmology (APO). I introduce the field of APO and continue with a discussion of important concepts and theories for a better understanding of adaptational processes in visually impaired older adults. I then summarize the most relevant and most recent data from four areas: (1) everyday competence, (2) cognitive functioning, (3) social functioning, and (4) subjective well-being-related outcomes, depression, and adaptational processes. Thereafter, major insights related to the current state-of-the art psychosocial interventions with visuallyimpaired older adults are reviewed. I close with the need that the public health community should become more aware of and address the psychosocial needs of visually impaired older adults. Hans-Werner Wahl Copyright © 2013 Hans-Werner Wahl. All rights reserved. Wed, 03 Apr 2013 13:43:03 +0000 http://www.hindawi.com/journals/jop/2013/767931/ Objective. To compare central macular thickness (CMT) of diabetic patients with type 2 diabetes without clinical retinopathy and healthy subjects. Materials and Methods. Optical coherence tomography (OCT) measurements were performed in 124 eyes of 62 subjects with diabetes mellitus without clinical retinopathy (study group: 39 females, 23 males; mean age: 55.06 ± 9.77 years) and in 120 eyes of 60 healthy subjects (control group: 35 females, 25 males; mean age: 55.78 ± 10.34 years). Blood biochemistry parameters were analyzed in all cases. The data for central macular thickness (at 1 mm), the levels of fasting plasma glucose, and glycosylated hemoglobin (HbA1c) were compared in both groups. Results. The mean central macular thickness was 232.12 ± 24.41 µm in the study group and 227.19 ± 29.94 µm in the control group. The mean HbA1c level was 8.92 ± 2.58% in the study group and 5.07 ± 0.70% in the control group (). No statistically significant relationship was found between CMT, HbA1c, and fasting plasma glucose level in either group (). Conclusions. Central macular thickness was not significantly thicker in patients with type 2 diabetes without clinical retinopathy than in healthy subjects. Mehmet Demir, Burcu Dirim, Zeynep Acar, Murat Yılmaz, and Yekta Sendul Copyright © 2013 Mehmet Demir et al. All rights reserved. Wed, 03 Apr 2013 11:46:30 +0000 http://www.hindawi.com/journals/jop/2013/518170/ With recent development of spectral-domain optical coherence tomography (SD-OCT), the pathological changes of retina can be observed in much greater detail. SD-OCT clearly delineates three highly reflective lines in the outer retina, which are external limiting membrane (ELM), photoreceptor inner and outer segment (IS/OS) junction, and cone outer segment tips (COST) in order from inside. These lines can serve as hallmarks for the evaluation of photoreceptor condition. In retinitis pigmentosa (RP) leading to photoreceptor degeneration, the ELM, IS/OS, and COST lines are shortened with the progression of the disease. In addition, shortening of the ELM, IS/OS and COST lines is significantly associated with each other. The line length is longest in the ELM, followed by the IS/OS, and COST, suggesting that retinal layer becomes disorganized first at the COST, followed by the IS/OS and finally the ELM. This finding is consistent with the previous report that the earliest histopathological change in RP is a shortening of the photoreceptor outer segments. On the other hand, retinal layer becomes restored first at the ELM, followed by the IS/OS and finally the COST after macular hole surgery. There may be a directionality of photoreceptor impairment or restoration on optical coherence tomographic image. Yoshinori Mitamura, Sayaka Mitamura-Aizawa, Takashi Katome, Takeshi Naito, Akira Hagiwara, Ken Kumagai, and Shuichi Yamamoto Copyright © 2013 Yoshinori Mitamura et al. All rights reserved. Thu, 28 Mar 2013 12:58:31 +0000 http://www.hindawi.com/journals/jop/2013/397680/ Purpose. To evaluate Fourier-domain optical coherence tomography (FD-OCT) as an adjunct to traditional slit lamp examination of donor corneas with suspected Anterior Stromal Opacities. Methods. Seven corneas suspected of having anterior stromal opacities by slit lamp examination were evaluated with FD-OCT. Each cornea was evaluated to confirm the presence of opacity and, if present, the depth of opacity was measured. Results. The opacity depth ranged from 82 μm to 624 μm. The initial slit lamp impressions of five of the seven corneas were confirmed by OCT. In two corneas, the OCT findings were different from the initial slit lamp impressions. Slit lamp examination of the first cornea gave the impression of anterior stromal scarring, but OCT showed that the opacity was limited to the epithelium. Slit lamp examination of the second cornea suggested opacity limited to the epithelium, but OCT identified significant sub-Bowman's scarring. In all cases, the Eye Bank Technicians reported that the location and depth of corneal opacity were more sharply defined by OCT than by slit lamp. Conclusion. The high resolution of OCT makes it easier to determine the location of corneal opacities compared to slit lamp examinations. This enhanced visualization can improve decisions regarding transplant suitability of donor corneas. Matthew R. Bald, Christopher Stoeger, Joshua Galloway, Maolong Tang, Jeffrey Holiman, and David Huang Copyright © 2013 Matthew R. Bald et al. All rights reserved. Wed, 27 Mar 2013 08:46:40 +0000 http://www.hindawi.com/journals/jop/2013/687165/ Purpose. To analyse the diurnal variation of central choroidal thickness (CCT) in healthy emetropic patients during working hours. Methods. Fifty healthy young emmetrpic volunteers were included in this study. CCT was measured at 9 AM and 4 PM with spectral domain optical coherence tomography (Spectralis, Heidelberg Engineering) with enhanced depth imaging. Diurnal variation of CCT, the correlation between rigth and left eyes and the demographic factors affecting this variation were assessed. Findings. The mean CCT at 9 AM and 4 PM was 308.7 ± 64.5 μm and 308.7 ± 62 μm, respectively, with a mean diurnal amplitude of −0.03 ± 14.7 μm, ranging between −55 μm and 47 μm, the difference was statistically insignificant (: 0.9). There were positive correlations between right and left eyes among CCT measurements at 9 AM, 4 PM and the mean amplitude of diurnal change (: 0.65, ; : 0.60, ; : 0.45, : 0.00, resp.). There was a statistically significant negative correlation between the magnitude of diurnal change and age (: −0.27, : 0.01). Conclusion. Although the mean CCT in the all group does not show significant variation during working hours, the pattern of diurnal variation may vary from person to person according to age, and there is a great harmony between the two eyes. Ozen Ayrancı Osmanbasoglu, Zeynep Alkin, Abdullah Ozkaya, Yavuz Ozpınar, Ahmet Taylan Yazici, and Ahmet Demirok Copyright © 2013 Ozen Ayrancı Osmanbasoglu et al. All rights reserved. Sun, 17 Mar 2013 09:14:10 +0000 http://www.hindawi.com/journals/jop/2013/784709/ Purpose. Tube-related exposure is a known complication of glaucoma drainage device (GDD) surgery. Our objective is to report the early (approximately 1 year) tube exposure rate of implants covered with a keraSys (IOP Inc., Costa Mesa, CA, USA) tissue reinforcement graft. Patients and Methods. A retrospective, noncomparative, consecutive case series of 42 eyes with GDD implantation with keraSys patch grafts was performed. Main outcome measurements included patch-related complications: patch exposure, tube exposure, wound dehiscence, and patch migration. Results. Forty-two eyes were followed for an average of months (range 1.0–32.3 months). Four (10%) eyes experienced patch-related complications: two with exposure 8 months postoperatively, one with exposure 13 months postoperatively, and one with exposure 4 weeks postoperatively. Conclusion. The effectiveness of the keraSys patch graft is limited by the higher than expected early exposure rate found in this case series. These results should be confirmed in other studies. Kundandeep S. Nagi, Ricardo J. Cumba, Nicholas P. Bell, Lauren S. Blieden, Alice Z. Chuang, Kimberly A. Mankiewicz, Donna Nguyen, and Robert M. Feldman Copyright © 2013 Kundandeep S. Nagi et al. All rights reserved. Wed, 06 Mar 2013 12:25:31 +0000 http://www.hindawi.com/journals/jop/2013/257381/ Purpose. To investigate aqueous concentrations of vascular endothelial growth factor (VEGF) in eyes with myopic choroidal neovascularization (CNV). Methods. Aqueous samples were collected, and VEGF concentrations were measured by enzyme-linked immunosorbent assay in 16 eyes (16 patients) with active myopic CNV, 23 eyes (16 patients) with high myopia without myopic CNV, and 8 control eyes (7 patients). Differences in the concentrations of VEGF in each group were compared. Results. The estimated mean VEGF concentrations were significantly lower in eyes with myopic CNV (82.0 pg/mL) ( ) and with high myopia without myopic CNV (58.9 pg/mL) () compared with controls (116.6 pg/mL). The estimated mean VEGF concentration was significantly () higher in eyes with myopic CNV than in those without myopic CNV in highly myopic eyes. In eyes with high myopia with and without CNV, the VEGF concentration was significantly (stepwise regression analysis, , ) associated with the presence of myopic CNV but not with age, axial length, or intraocular pressure. Conclusion. Increased levels of VEGF may play a role in the pathogenesis of CNV in highly myopic eyes. Taku Wakabayashi, Yasushi Ikuno, Yusuke Oshima, Toshimitsu Hamasaki, and Kohji Nishida Copyright © 2013 Taku Wakabayashi et al. All rights reserved. Wed, 06 Mar 2013 09:21:55 +0000 http://www.hindawi.com/journals/jop/2013/352917/ The most dominant feature of the electroretinogram, the b-wave, is thought to reflect ON-bipolar cell responses. However, a number of studies suggest that the b-wave is made up of several components. We consider the composition of the rat b-wave by subtracting corneal negative components obtained using intravitreal application of pharmacological agents to remove postreceptoral responses. By analyzing the intensity-response characteristic of the PII across a range of fixed times during and after a light step, we find that the rat isolated PII has 2 components. The first has fast rise and decay characteristics with a low sensitivity to light. GABAc-mediated inhibitory pathways enhance this transient-ON component to manifest increased and deceased sensitivity to light at shorter (<160 ms) and longer times, respectively. The second component has slower temporal characteristics but is more sensitive to light. GABAc-mediated inhibition enhances this sustained-ON component but has little effect on its sensitivity to light. After stimulus offset, both transient and sustained components return to baseline, and a long latency sustained positive component becomes apparent. The light sensitivities of transient-ON and sustained-OFF components are consistent with activity arising from cone ON- and OFF-bipolar cells, whereas the sustained-ON component is likely to arise from rod bipolar cells. Trung M. Dang, Algis J. Vingrys, and Bang V. Bui Copyright © 2013 Trung M. Dang et al. All rights reserved. Mon, 04 Mar 2013 11:19:44 +0000 http://www.hindawi.com/journals/jop/2013/347801/ Purpose. To investigate the in vivo incision architecture using spectral domain optical coherence tomography (SD-OCT) in 23-gauge and 25-gauge transconjunctival sutureless pars plana vitrectomy (TSPPV). Methods. A prospective observational study of 22 eyes of 22 patients that underwent three-port 25-gauge (10 eyes) or 23-gauge (12 eyes) TSPPV was performed. The three sclerotomies sites in each eye were analyzed by Corneal Adapter Model (CAM) RTVue SD-OCT (Optovue Inc., Fremont, CA, USA) with wound cross-section images (longitudinal and transversal) on days 1, 7, and 30 postoperatively. Transversal and longitudinal length, location, angle between the conjunctival surface tangent and the incision plane, and architecture deformations were evaluated. Results. All patients (22 eyes) completed the study and surgeries lasted less than 60 minutes. All wounds were obliquely performed, 23-gauge mean angle was 23 ± 5°, and 25-gauge angule was 21 ± 4°. Twenty-three-gauge sclerotomy transversal mean length was 1122 ± 242 μm and 25-gauge transversal sclerotomy mean length was 977 ± 174 μm; 23-gauge longitudinal mean length was 363 ± 42 μm and 25-gauge longitudinal sclerotomy mean length was 234 ±19 μm; 23-gauge open wound thickness mean was 61 ± 28 μm and 25-gauge open wound thickness mean was 22 ± 6 μm. All results were statistically significant (). No vitreous incarceration or silicone oil residue was observed in incision sites with both gauges. Conclusions. The 23-gauge and 25-gauge architectural wound constructions were well visualized using CAM SD-OCT. Statistical differences between the two gauges were observed throughout the study period. Anderson Teixeira, Flavio A. Rezende, Camila Salaroli, Nonato Souza, Benedito Antonio Sousa, and Norma Allemann Copyright © 2013 Anderson Teixeira et al. All rights reserved. Sun, 03 Mar 2013 16:08:27 +0000 http://www.hindawi.com/journals/jop/2013/209401/ Pterygium is an abnormal fibrovascular tissue extending on the cornea which is a degenerative and hyperplastic disorder. A stromal overgrowth of fibroblast and blood vessels is accompanied by an inflammatory cell infiltrate and abnormal extracellular matrix accumulation. The surgical excision is the main treatment method of pterygium, but recurrence is the most common postoperative complication. In the present study, we aimed to compare the wide conjunctival flap and the conjunctival autografting techniques in pterygium surgery according to time of operation, safety, and effectiveness. Results showed that the effect of wide conjunctival flap techniques on primary pterygium surgery was found close to the conjunctival autograft techniques. In addition, the flap technique has a shorter surgical time, the surgery does not require extreme experience, feeding of the flap is provided with own vessels since the vascular structure is protected on the upper temporal conjunctival area, reverse placement of the flap is not seen, it needs fewer sutures, so that suture disturbances may reduce, and it is less traumatic than autograft technique during conjunctival transport. Therefore, this technique may be preferred in suitable cases. Lokman Aslan, Murat Aslankurt, Adnan Aksoy, Murat Özdemir, and Erdem Yüksel Copyright © 2013 Lokman Aslan et al. All rights reserved. Thu, 28 Feb 2013 15:49:37 +0000 http://www.hindawi.com/journals/jop/2013/517032/ Objective. To investigate the efficacy of two different dosing strategies of radioactive iodine-125 (125I) in the management of small- and medium-sized posterior uveal melanoma. Patients and Methods. The medical records of consecutive patients with choroidal melanomas between 1.5 and 5.0 mm in apical height treated initially with 125I plaque radiotherapy were reviewed. Patients were treated with one of the following two treatment dosing strategies: (1) 85 Gy to the apical height of the tumor (group 1) or (2) 85 Gy to a prescription point of 5.0 mm (group 2). Results. Of 95 patients, 55 patients were treated to the apical height of the tumor, and 40 were treated to a prescription point of 5.0 mm. Comparative analysis of the incidence rates of specific complications between the two groups demonstrates that group 2 had a significantly higher incidence of radiation retinopathy, radiation optic neuropathy, and/or visually significant cataract formation than group 1 (). Conclusion. Treatment of choroidal melanomas less than 5 mm in apical height with 125I brachytherapy to the true apical height is equally effective when compared to treatment with 85 Gy to 5.0 mm. Treatment to the apical height of the tumor may result in lower incidence of radiation-related complications. Timothy G. Murray, Arnold M. Markoe, Aaron S. Gold, Fiona Ehlies, Ernesto Bermudez, Andrea Wildner, and Azeema Latiff Copyright © 2013 Timothy G. Murray et al. All rights reserved. Wed, 27 Feb 2013 08:38:54 +0000 http://www.hindawi.com/journals/jop/2013/312974/ Stacey S. Choi, Ann E. Elsner, Robert J. Zawadzki, and Brian Vohnsen Copyright © 2013 Stacey S. Choi et al. All rights reserved. Thu, 21 Feb 2013 15:38:14 +0000 http://www.hindawi.com/journals/jop/2013/268438/ Purpose. To assess visual function and its response to serial intravitreal ranibizumab (Lucentis, Genentech) in patients with neovascular age-related macular degeneration (nv-AMD). Methods. Forty-seven eyes of 47 patients with nv-AMD, and corrected distance visual acuity (CDVA) logMAR 0.7 or better, undergoing intravitreal injections of ranibizumab, were enrolled into this prospective study. Visual function was assessed using a range of psychophysical tests, while mean foveal thickness (MFT) was determined by optical coherence tomography (OCT). Results. Group mean (±sd) MFT reduced significantly from baseline (233 (±59)) to exit (205 (±40)) (). CDVA exhibited no change between baseline and exit visits ( and , resp.). Measures of visual function that did exhibit statistically significant improvements ( for all) included reading acuity, reading speed, mesopic and photopic contrast sensitivity (CS), mesopic and photopic glare disability (GD), and retinotopic ocular sensitivity (ROS) at all eccentricities. Conclusion. Eyes with nv-AMD undergoing intravitreal ranibizumab injections exhibit improvements in many parameters of visual function. Outcome measures other than CDVA, such as CS, GD, and ROS, should not only be considered in the design of studies investigating nv-AMD, but also in treatment and retreatment strategies for patients with the condition. Sarah Sabour-Pickett, James Loughman, John M. Nolan, Jim Stack, Konrad Pesudovs, Katherine A. Meagher, and Stephen Beatty Copyright © 2013 Sarah Sabour-Pickett et al. All rights reserved. Thu, 21 Feb 2013 14:37:09 +0000 http://www.hindawi.com/journals/jop/2013/103947/ The ocular surface—a continuous epithelial surface with regional specializations including the surface and glandular epithelia of the cornea, conjunctiva, and lacrimal and meibomian glands connected by the overlying tear film—plays a central role in vision. Molecular and cellular events involved in embryonic development, postnatal maturation, and maintenance of the ocular surface are precisely regulated at the level of gene expression by a well-coordinated network of transcription factors. A thorough appreciation of the biological characteristics of the ocular surface in terms of its gene expression profiles and their regulation provides us with a valuable insight into the pathophysiology of various blinding disorders that disrupt the normal development, maturation, and/or maintenance of the ocular surface. This paper summarizes the current status of our knowledge related to the ocular surface development and gene expression and the contribution of different transcription factors to this process. Shivalingappa K. Swamynathan Copyright © 2013 Shivalingappa K. Swamynathan. All rights reserved. Wed, 20 Feb 2013 13:11:02 +0000 http://www.hindawi.com/journals/jop/2013/415974/ Purpose. To evaluate the effects of pars plana vitrectomy (PPV) on recurrent macular edema due to branch retinal vein occlusion (BRVO) after intravitreal injections of bevacizumab (IVB). Methods. This retrospective study included 22 eyes of 22 patients who underwent single or multiple IVB injections for macular edema due to BRVO and showed a recurrence of macular edema. All patients then underwent PPV and were followed up for more than 6 months after the surgery with examinations of best corrected visual acuity (BCVA) and optical coherence tomography (OCT). OCT parameters were central macular thickness (CMT) and average retinal thickness in a 1-mm-diameter circular region at the fovea (MRT). Results. Mean BCVA, CRT, and MRT were significantly improved from the baseline after PPV. Greater improvement of BCVA, CRT, and MRT was obtained after 1 month of IVB than after 6 months of PPV. No eyes showed worsening of macular edema after the surgery. Conclusion. PPV improved BCVA and recurrent macular edema due to BRVO, but PPV that was less effective than IVB had been in the same patients. PPV may be one of the treatment options for recurrent macular edema due to BRVO after IVB. Tatsuya Yunoki, Keiichi Mitarai, Shuichiro Yanagisawa, Tsuyoshi Kato, Nobuo Ishida, and Atsushi Hayashi Copyright © 2013 Tatsuya Yunoki et al. All rights reserved. Thu, 14 Feb 2013 14:21:57 +0000 http://www.hindawi.com/journals/jop/2013/529187/ Objective. To compare 18-fluorodeoxyglucose (FDG) uptake by positron emission tomography (PET) in extraocular muscles (EOMs) of patients with Graves’ ophthalmopathy (GO) versus patients without GO. Design. Prospective, observational, comparative, and cross-sectional study. Participants. Thirty-two eyes of patients with GO and seventy eyes of patients without GO. Methods. We prospectively included patients older than 18 years of age with and without GO. FDG-PET imaging study was performed; standardized unit value () was quantified in EOMs. Standard deviation and significant statistical difference () were calculated. Results. Thirty-two eyes of sixteen patients of the GO group were included, with a mean age of 44.31 (20–71) years. Seventy eyes of thirty-five patients of the group without GO were included, with a mean age of 49.20 (24–77) years. EOMs average uptake of the groups with and without GO were 3.38 ± 1.31 and 1.89 ± 0.51 (), respectively. Conclusion. FDG uptake was significantly increased in EOMs of patients with GO. PET gives valuable information and may be a helpful tool in detecting, localizing, and quantifying GO inflammation. Further research is needed to define the role of PET in detecting, grading, and following up GO in order to optimize treatment in the inflammatory stage. Leonardo García-Rojas, Gloria Adame-Ocampo, Erick Alexánderson, and José Luis Tovilla-Canales Copyright © 2013 Leonardo García-Rojas et al. All rights reserved. Tue, 29 Jan 2013 15:18:56 +0000 http://www.hindawi.com/journals/jop/2013/262467/ Intraocular pressure (IOP) elevation is a key risk factor for glaucoma. Our understanding of the effect that IOP elevation has on the eye has been greatly enhanced by the application of the electroretinogram (ERG). In this paper, we describe how the ERG in the rodent eye is affected by changes in IOP magnitude, duration, and number of spikes. We consider how the variables of blood pressure and age can modify the effect of IOP elevation on the ERG. Finally, we contrast the effects that acute and chronic IOP elevation can have on the rodent ERG. Bang V. Bui, Zheng He, Algis J. Vingrys, Christine T. O. Nguyen, Vickie H. Y. Wong, and Brad Fortune Copyright © 2013 Bang V. Bui et al. All rights reserved. Mon, 28 Jan 2013 09:03:34 +0000 http://www.hindawi.com/journals/jop/2013/315658/ Purpose. MaQaid (MaQ) is a new triamcinolone acetonide commercialised in Japan to visualize the vitreous. Because MaQ is preservative-free, it has a lower risk of ocular toxicities. However, since MaQ is only available as a powder, it needs suspenssion. Suspension does not always result uniformally, which causes poor visibility. This study reports a new MaQ suspension for better visibility. Methods. After medium addition to a MaQ vial, various methods were used. These included the use of (1) vortex mixer, (2) two syringes and a three-way stopcock, and (3) ultrasonic washer. We calculated suspended MaQ concentration (). To evaluate the reproducibility, we estimated the coefficient of variance (CV, ). We used this MaQ for pig eyes, and vitreous visualization was simulated. Subsequently, we used this MaQ suspension for humans. Results. MaQ suspensions were sucessfull, and the concentrations of single particles increased significantly (). The CV was 36.1% for the routine method and 9.03% ffor the new method. Administration of a suspended MaQ made it possible to clearly visualize the vitreous in both pig and human eyes. Conclusions. We devised new techniques for uniformal MaQ suspension. These new methods can compensate for the MaQ disadvantages and ensure a safety surgery. Masahiko Sugimoto, Mineo Kondo, and Masayuki Horiguchi Copyright © 2013 Masahiko Sugimoto et al. All rights reserved. Sun, 20 Jan 2013 07:53:50 +0000 http://www.hindawi.com/journals/jop/2013/863498/ Purpose. To investigate changes of dry eye test results in patients who underwent pterygium surgery. Methods. Seventy-four patients who underwent primary pterygium surgery were enrolled in this study. At the baseline, 3-, 12-, and 18-month visits, measurements of tear osmolarity, BUT, and Schirmer test were performed. The patients were divided into 2 groups: Group 1, which consisted of patients in whom pterygium did not recur, and Group 2, which consisted of patients in whom pterygium recurred after surgery. Results. The patients in Group 1 had lower tear osmolarity levels after surgery than those at baseline (all ). In Group 2 the tear osmolarity levels did not differ from baseline after 18 months (). The prevalence rates of dry eye syndrome (DES) were lower than that at baseline and 18 months after surgery in Group 1 (). In Group 2, the incidence of DES was lower after 3 months than at baseline () but was similar to the baseline rate after 12 and 18 months (both ). Conclusions. Anormal tear film function associated with pterygium. Pterygium excision improved tear osmolarity and tear film function. However, tear osmolarity deteriorated again with the recurrence of pterygium. Kemal Türkyılmaz, Veysi Öner, Mehmet Şahin Sevim, Ali Kurt, Berrak Şekeryapan, and Mustafa Durmuş Copyright © 2013 Kemal Türkyılmaz et al. All rights reserved. Mon, 14 Jan 2013 11:09:51 +0000 http://www.hindawi.com/journals/jop/2013/463710/ Purpose. To determine the presence and type of glaucoma in a cohort of adult Chinese subjects with systemic hypertension. Methods. This prospective cohort study included 200 hypertensive Chinese adults aged >40 years old who underwent screening via frequency doubling technology (FDT) perimetry and intraocular pressure (IOP) measurement by noncontact tonometry (NCT) in a general outpatient clinic. Those with  mmHg and/or visual field (VF) defects on FDT were referred for complete ophthalmological examination. The diagnosis of glaucoma was based on an abnormal VF on Humphrey Field Analyzer (HFA) by Hodapp-Parrish-Anderson's criteria and an increased vertical cup-disc ratio (VCDR). Results. The mean age of the subjects was years, and the male:female ratio was 92 : 108. All patients were hypertensive with a mean blood pressure (BP) of  mmHg whilst on systemic antihypertensive medication. Of the 111 patients that had an abnormal initial screening, 14 (7.9%) were confirmed to have glaucoma with the highest prevalence of normal tension glaucoma (NTG) (6.2%), followed by primary angle closure glaucoma (PACG) (1.1%) and primary open angle glaucoma (POAG) (0.5%). The positive predictive value of FDT perimetry was 71%. Conclusion. Nearly 8% of the adults with systemic hypertension had glaucoma, and NTG was the most prevalent type. Rita A. Gangwani, Jonathan Chan, Jacky Lee, Alfred Kwong, and Jimmy S. M. Lai Copyright © 2013 Rita A. Gangwani et al. All rights reserved. Tue, 08 Jan 2013 15:36:22 +0000 http://www.hindawi.com/journals/jop/2013/369094/ Ocular bacterial infections are universally treated with antibiotics, which can eliminate the organism but cannot reverse the damage caused by bacterial products already present. The three very common causes of bacterial keratitis—Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pneumoniae—all produce proteins that directly or indirectly cause damage to the cornea that can result in reduced vision despite antibiotic treatment. Most, but not all, of these proteins are secreted toxins and enzymes that mediate host cell death, degradation of stromal collagen, cleavage of host cell surface molecules, or induction of a damaging inflammatory response. Studies of these bacterial pathogens have determined the proteins of interest that could be targets for future therapeutic options for decreasing corneal damage. Mary E. Marquart and Richard J. O'Callaghan Copyright © 2013 Mary E. Marquart and Richard J. O'Callaghan. All rights reserved. Wed, 26 Dec 2012 15:33:31 +0000 http://www.hindawi.com/journals/jop/2012/594869/ Ocular gene therapy is rapidly becoming a reality. By November 2012, approximately 28 clinical trials were approved to assess novel gene therapy agents. Viral infections such as herpetic keratitis caused by herpes simplex virus 1 (HSV-1) can cause serious complications that may lead to blindness. Recurrence of the disease is likely and cornea transplantation, therefore, might not be the ideal therapeutic solution. This paper will focus on the current situation of ocular gene therapy research against herpetic keratitis, including the use of viral and nonviral vectors, routes of delivery of therapeutic genes, new techniques, and key research strategies. Whereas the correction of inherited diseases was the initial goal of the field of gene therapy, here we discuss transgene expression, gene replacement, silencing, or clipping. Gene therapy of herpetic keratitis previously reported in the literature is screened emphasizing candidate gene therapy targets. Commonly adopted strategies are discussed to assess the relative advantages of the protective therapy using antiviral drugs and the common gene therapy against long-term HSV-1 ocular infections signs, inflammation and neovascularization. Successful gene therapy can provide innovative physiological and pharmaceutical solutions against herpetic keratitis. Hossein Mostafa Elbadawy, Marine Gailledrat, Carole Desseaux, Diego Ponzin, and Stefano Ferrari Copyright © 2012 Hossein Mostafa Elbadawy et al. All rights reserved. Thu, 20 Dec 2012 07:56:56 +0000 http://www.hindawi.com/journals/jop/2012/350475/ Background. We evaluated the effect of carotid revascularization surgery on ocular circulation and chronic ocular ischemic syndrome (OIS). Methods. We examined ninety patients with carotid artery stenosis (more than 50% stenosis) at its origin treated with carotid endarterectomy () or carotid artery stenting (). Twenty-five patients (28%) complained of chronic OIS. Ocular circulation was examined before and after revascularization surgery using ophthalmic artery (OphAr) and central retinal artery (CRA) color Doppler flow imaging. Results. (1) Ocular circulation: preoperatively, the average OphAr peak systolic flow velocity (Vs) was 0.05 m/sec, and the average CRA Vs was 0.07 m/sec. At 1 week after surgery, the average OphAr Vs significantly increased to 0.32 (), and the average CRA Vs significantly increased to 0.11 m/sec (). These significant improvements were sustained throughout the three months of the followup. (2) OIS: during the follow-up period (mean: 3.6 years), 15 patients (60%) showed visual acuity improvement, and no patients complained of amaurosis fugax or worsening of the chronic OIS. Conclusion. Carotid revascularization surgery was effective in improving the ocular circulation, and it was also useful for the chronic OIS due to the carotid artery stenosis. Shoichiro Kawaguchi, Jun-ichi Iida, and Yoshitomo Uchiyama Copyright © 2012 Shoichiro Kawaguchi et al. All rights reserved.