Journal of Ophthalmology The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Trabecular-Iris Circumference Volume in Open Angle Eyes Using Swept-Source Fourier Domain Anterior Segment Optical Coherence Tomography Tue, 19 Aug 2014 12:00:29 +0000 Purpose. To introduce a new anterior segment optical coherence tomography parameter, trabecular-iris circumference volume (TICV), which measures the integrated volume of the peripheral angle, and establish a reference range in normal, open angle eyes. Methods. One eye of each participant with open angles and a normal anterior segment was imaged using 3D mode by the CASIA SS-1000 (Tomey, Nagoya, Japan). Trabecular-iris space area (TISA) and TICV at 500 and 750 µm were calculated. Analysis of covariance was performed to examine the effect of age and its interaction with spherical equivalent. Results. The study included 100 participants with a mean age of 50 (±15) years (range 20–79). TICV showed a normal distribution with a mean (±SD) value of 4.75 µL (±2.30) for TICV500 and a mean (±SD) value of 8.90 µL (±3.88) for TICV750. Overall, TICV showed an age-related reduction . In addition, angle volume increased with increased myopia for all age groups, except for those older than 65 years. Conclusions. This study introduces a new parameter to measure peripheral angle volume, TICV, with age-adjusted normal ranges for open angle eyes. Further investigation is warranted to determine the clinical utility of this new parameter. Mohammed Rigi, Lauren S. Blieden, Donna Nguyen, Alice Z. Chuang, Laura A. Baker, Nicholas P. Bell, David A. Lee, Kimberly A. Mankiewicz, and Robert M. Feldman Copyright © 2014 Mohammed Rigi et al. All rights reserved. Theoretical Basis, Laboratory Evidence, and Clinical Research of Chemical Surgery of the Cornea: Cross-Linking Mon, 18 Aug 2014 08:20:44 +0000 Corneal cross-linking (CXL) is increasingly performed in ophthalmology with high success rates for progressive keratoconus and other types of ectasia. Despite being an established procedure, some molecular and clinical aspects still require additional studies. This review presents a critical analysis of some established topics and others that are still controversial. In addition, this review examines new technologies and techniques (transepithelial and ultrafast CXL), uses of corneal CXL including natural products and biomolecules as CXL promoters, and evidence for in vitro and in vivo indirect effectiveness. Amanda C. da Paz, Patrícia A. Bersanetti, Marcella Q. Salomão, Renato Ambrósio Jr., and Paulo Schor Copyright © 2014 Amanda C. da Paz et al. All rights reserved. Inhibition of Corneal Neovascularization by Topical and Subconjunctival Tigecycline Sun, 17 Aug 2014 00:00:00 +0000 Objective. To investigate the effects of topical and subconjunctival tigecycline on the prevention of corneal neovascularization. Materials and Methods. Following chemical burn, thirty-two rats were treated daily with topical instillation of 1 mg/mL tigecycline (group 1) or subconjunctival instillation of 1 mg/mL tigecycline (group 3) for 7 days. Control rats received topical (group 2) or subconjunctival (group 4) 0.9% saline. Digital photographs of the cornea were taken on the eighth day after treatment and analyzed to determine the percentage area of the cornea covered by neovascularization. Corneal sections were analyzed histopathologically. Results. The median percentages of corneal neovascularization in groups 1 and 3 were 48% (95% confidence interval (CI), 44.2–55.8%) and 33.5% (95% CI, 26.6–39.2%), respectively. The median percentages of corneal neovascularization of groups 1 and 3 were significantly lower than that of the control group ( and , resp.). Histologic examination of samples from groups 1 and 3 showed lower vascularity than that of control groups. Conclusion. Topical and subconjunctival administration of tigecycline seems to be showing promising therapeutic effects on the prevention of corneal neovascularization. Furthermore, subconjunctival administration of tigecycline is more potent than topical administration in the inhibition of corneal neovascularization. Sertan Goktas, Ender Erdogan, Rabia Sakarya, Yasar Sakarya, Mustafa Yılmaz, Muammer Ozcimen, Nejat Unlukal, Ismail Alpfidan, Fatih Tas, Erkan Erdogan, Abdulkadir Bukus, and Ismail Senol Ivacık Copyright © 2014 Sertan Goktas et al. All rights reserved. Aging: A Predisposition to Dry Eyes Thu, 14 Aug 2014 11:19:48 +0000 Dry eye syndrome is a disease of the ocular surface and tear film that is prevalent in older adults. Even though the degree of visual acuity loss in dry eye patients is commonly mild-to-moderate, in the aging population, this minimal change in visual status can lead to a significant decrease in visual function and quality of life. A healthy ocular surface is maintained by appropriate tear production and tear drainage, and deficiencies in this delicate balance can lead to dryness. In the aging eye, risk factors such as polypharmacy, androgen deficiency, decreased blink rates, and oxidative stress can predispose the patient to developing dry eye that is frequently more severe, has higher economic costs, and leads to worse consequences to the well-being of the patient. Understanding why elderly patients are at higher risk for developing dry eyes can provide insights into the diagnosis and management of the growing number of older adults struggling with dry eye and minimize the burden of disease on our aging population. Anushree Sharma and Holly B. Hindman Copyright © 2014 Anushree Sharma and Holly B. Hindman. All rights reserved. Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review Wed, 13 Aug 2014 09:15:13 +0000 Objective. To perform an evidence-based review of treatments for Toxoplasma retinochoroiditis (TRC). Methods. A systematic literature search was performed using the PubMed database and the key phrase “ocular toxoplasmosis treatment” and the filter for “controlled clinical trial” and “randomized clinical trial” as well as OVID medline (1946 to May week 2 2014) using the keyword ‘‘ocular toxoplasmosis’’. The included studies were used to evaluate the various treatment modalities of TRC. Results. The electronic search yielded a total of 974 publications of which 44 reported on the treatment of ocular toxoplasmosis. There were 9 randomized controlled studies and an additional 3 comparative studies on the treatment of acute TRC with systemic or intravitreous antibiotics or on reducing the recurrences of TRC. Endpoints of studies included visual acuity improvement, inflammatory response, lesion size changes, recurrences of lesions, and adverse effects of medications. Conclusions. There was conflicting evidence as to the effectiveness of systemic antibiotics for TRC. There is no evidence to support that one antibiotic regimen is superior to another so choice needs to be informed by the safety profile. Intravitreous clindamycin with dexamethasone seems to be as effective as systemic treatments. There is currently level I evidence that intermittent trimethoprim-sulfamethoxazole prevents recurrence of the disease. Meredith Harrell and Petros E. Carvounis Copyright © 2014 Meredith Harrell and Petros E. Carvounis. All rights reserved. Evaluation of Epithelial Integrity with Various Transepithelial Corneal Cross-Linking Protocols for Treatment of Keratoconus Tue, 12 Aug 2014 09:18:28 +0000 Purpose. Corneal collagen cross-linking (CXL) has been demonstrated to stiffen cornea and halt progression of ectasia. The original protocol requires debridement of central corneal epithelium to facilitate diffusion of a riboflavin solution to stroma. Recently, transepithelial CXL has been proposed to reduce risk of complications associated with epithelial removal. Aim of the study is to evaluate the impact of various transepithelial riboflavin delivery protocols on corneal epithelium in regard to pain and epithelial integrity in the early postoperative period. Methods. One hundred and sixty six eyes of 104 subjects affected by progressive keratoconus underwent transepithelial CXL using 6 different riboflavin application protocols. Postoperatively, epithelial integrity was evaluated at slit lamp and patients were queried regarding their ocular pain level. Results. One eye had a corneal infection associated with an epithelial defect. No other adverse event including endothelial decompensation or endothelial damage was observed, except for epithelial damages. Incidence of epithelial defects varied from 0 to 63%. Incidence of reported pain varied from 0 to 83%. Conclusion. Different transepithelial cross-linking protocols have varying impacts on epithelial integrity. At present, it seems impossible to have sufficient riboflavin penetration without any epithelial disruption. A compromise between efficacy and epithelial integrity has to be found. Suphi Taneri, Saskia Oehler, Grace Lytle, and H. Burkhard Dick Copyright © 2014 Suphi Taneri et al. All rights reserved. Age-Related Changes of the Ocular Surface: A Hospital Setting-Based Retrospective Study Mon, 11 Aug 2014 11:33:20 +0000 Purpose. To investigate the effects of age on the prevalence of ocular surface diseases (OSD), adherence to treatment, and recovery rates. Patients and Methods. Retrospective analysis of 3000 clinical records from a first-level general ophthalmology clinic. Patients with OSD were prospectively submitted a questionnaire to assess compliance and recovery rates. Results. OSD prevalence was 10.3%. Patients with OSD were significantly older than patients without it: versus years . No significant difference in season distribution was shown. Dry eye disease (DED) represented 58% of OSD; its prevalence increased with age until 80 years old and suddenly decreased thereafter. Asymptomatic DED was 37%. Adherence to treatment in OSD was very high (94%); recovery rates were lower in patients aged 21–40 and 61–80 (resp., 65.5% and 77.8%) and this was associated with higher OSDI scores. Tear substitutes represented 50% of all prescribed medications; their use increased with age. Discussion. In a “real-life” low-tech setting, OSD showed a prevalence of 10.3%. DED was the most prevalent disease, and it was asymptomatic in more than 1/3 of cases. Laura Ottobelli, Paolo Fogagnolo, Marta Guerini, and Luca Rossetti Copyright © 2014 Laura Ottobelli et al. All rights reserved. Surgical and Visual Outcome for Recurrent Retinal Detachment Surgery Mon, 11 Aug 2014 06:56:06 +0000 Purpose. To evaluate the anatomical and functional outcome of repeated surgeries for recurrent retinal detachment. Methods. We retrospectively reviewed 70 cases with refractory retinal detachment of various etiologies that required multiple operations. Anatomical success (attached retina) or failure (totally/partially-detached retina) was assessed biomicroscopically. The BCVA was used for the evaluation of the functional outcome, at presentation and at the end of follow-up. Various pre-, intra-, and postoperative factors were associated with anatomical success or failure as well as with final functionality. Results. The mean number of surgeries was 4 (range: 2 to 10). The anatomical success rate was 80% (56 attached cases, 14 detached cases). 29% of the attached cases had a BCVA better than 20/40 (Snellen chart). The number of operations doesn’t seem to affect significantly the final visual acuity. The PVR was found to affect both the anatomical and functional outcome ( & , respectively). Conclusions. In the present study, it is suggested that multiple operations for refractory retinal detachment may result in successful anatomic results, with a fare functional outcome at the same time. Eventually, we verified that the existence of PVR worsens the prognosis. Constantin Pournaras, Chrysanthi Tsika, Catherine Brozou, and Miltiadis K. Tsilimbaris Copyright © 2014 Constantin Pournaras et al. All rights reserved. Cell Models to Study Regulation of Cell Transformation in Pathologies of Retinal Pigment Epithelium Thu, 07 Aug 2014 10:41:43 +0000 The retinal pigment epithelium (RPE) plays a key role in the development of many eye diseases leading to visual impairment and even blindness. Cell culture models of pathological changes in the RPE make it possible to study factors responsible for these changes and signaling pathways coordinating cellular and molecular mechanisms of cell interactions under pathological conditions. Moreover, they give an opportunity to reveal target cells and develop effective specific treatment for degenerative and dystrophic diseases of the retina. In this review, data are presented on RPE cell sources for culture models, approaches to RPE cell culturing, phenotypic changes of RPE cells in vitro, the role of signal pathways, and possibilities for their regulation in pathological processes. Alla V. Kuznetsova, Alexander M. Kurinov, and Maria A. Aleksandrova Copyright © 2014 Alla V. Kuznetsova et al. All rights reserved. New Trends in Anterior Segment Diseases of the Eye Tue, 05 Aug 2014 12:56:23 +0000 Francisco Javier Romero, Bjørn Nicolaissen, and Cristina Peris-Martinez Copyright © 2014 Francisco Javier Romero et al. All rights reserved. Anterior Chamber Angle Shape Analysis and Classification of Glaucoma in SS-OCT Images Tue, 05 Aug 2014 12:28:48 +0000 Optical coherence tomography is a high resolution, rapid, and noninvasive diagnostic tool for angle closure glaucoma. In this paper, we present a new strategy for the classification of the angle closure glaucoma using morphological shape analysis of the iridocorneal angle. The angle structure configuration is quantified by the following six features: (1) mean of the continuous measurement of the angle opening distance; (2) area of the trapezoidal profile of the iridocorneal angle centered at Schwalbe's line; (3) mean of the iris curvature from the extracted iris image; (4) complex shape descriptor, fractal dimension, to quantify the complexity, or changes of iridocorneal angle; (5) ellipticity moment shape descriptor; and (6) triangularity moment shape descriptor. Then, the fuzzy k nearest neighbor (fkNN) classifier is utilized for classification of angle closure glaucoma. Two hundred and sixty-four swept source optical coherence tomography (SS-OCT) images from 148 patients were analyzed in this study. From the experimental results, the fkNN reveals the best classification accuracy () and AUC () with the combination of fractal dimension and biometric parameters. It showed that the proposed approach has promising potential to become a computer aided diagnostic tool for angle closure glaucoma (ACG) disease. Soe Ni Ni, J. Tian, Pina Marziliano, and Hong-Tym Wong Copyright © 2014 Soe Ni Ni et al. All rights reserved. Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results Sun, 03 Aug 2014 11:54:15 +0000 Purpose. To compare functional results in two cohorts of patients undergoing epithelium-off pulsed (pl-ACXL) and continuous light accelerated corneal collagen crosslinking (cl-ACXL) with dextran-free riboflavin solution and high-fluence ultraviolet A irradiation. Design. It is a prospective, comparative, and interventional clinical study. Methods. 20 patients affected by progressive keratoconus were enrolled in the study. 10 eyes of 10 patients underwent an epithelium-off pl-ACXL by the KXL UV-A source (Avedro Inc., Waltham, MS, USA) with 8 minutes (1 sec. on/1 sec. off) of UV-A exposure at 30 mW/cm2 and energy dose of 7.2 J/cm2; 10 eyes of 10 patients underwent an epithelium-off cl-ACXL at 30 mW/cm2 for 4 minutes. Riboflavin 0.1% dextran-free solution was used for a 10-minutes corneal soaking. Patients underwent clinical examination of uncorrected distance visual acuity and corrected distance visual acuity (UDVA and CDVA), corneal topography and aberrometry (CSO EyeTop, Florence, Italy), corneal OCT optical pachymetry (Cirrus OCT, Zeiss Meditec, Jena, Germany), endothelial cells count (I-Conan Non Co Robot), and in vivo scanning laser confocal microscopy (Heidelberg, Germany) at 1, 3, 6, and 12 months of follow-up. Results. Functional results one year after cl-ACXL and pl-ACXL demonstrated keratoconus stability in both groups. Functional outcomes were found to be better in epithelium-off pulsed light accelerated treatment together with showing a deeper stromal penetration. No endothelial damage was recorded during the follow-up in both groups. Conclusions. The study confirmed that oxygen represents the main driver of collagen crosslinking reaction. Pulsed light treatment optimized intraoperative oxygen availability improving postoperative functional outcomes compared with continuous light treatment. Cosimo Mazzotta, Claudio Traversi, Anna Lucia Paradiso, Maria Eugenia Latronico, and Miguel Rechichi Copyright © 2014 Cosimo Mazzotta et al. All rights reserved. Epigenetic Modifications and Potential New Treatment Targets in Diabetic Retinopathy Sun, 03 Aug 2014 11:28:35 +0000 Retinopathy is a debilitating vascular complication of diabetes. As with other diabetic complications, diabetic retinopathy (DR) is characterized by the metabolic memory, which has been observed both in DR patients and in DR animal models. Evidences have provided that after a period of poor glucose control insulin or diabetes drug treatment fails to prevent the development and progression of DR even when good glycemic control is reinstituted (glucose normalization), suggesting a metabolic memory phenomenon. Recent studies also underline the role of epigenetic chromatin modifications as mediators of the metabolic memory. Indeed, epigenetic changes may lead to stable modification of gene expression, participating in DR pathogenesis. Moreover, increasing evidences suggest that environmental factors such as chronic hyperglycemia are implicated DR progression and may also affect the epigenetic state. Here we review recent findings demonstrating the key role of epigenetics in the progression of DR. Further elucidation of epigenetic mechanisms, acting both at the cis- and trans-chromatin structural elements, will yield new insights into the pathogenesis of DR and will open the way for the discovery of novel therapeutic targets to prevent DR progression. Lorena Perrone, Carmela Matrone, and Lalit P. Singh Copyright © 2014 Lorena Perrone et al. All rights reserved. Obstructive Sleep Apnea Patients Having Surgery Are Less Associated with Glaucoma Thu, 24 Jul 2014 10:07:07 +0000 Objective. To investigate if different treatment strategy of obstructive sleep apnea (OSA) was associated glaucoma risk in Taiwanese population. Methods. Population-based retrospective cohort study was conducted using data sourced from the Longitudinal Health Insurance Database 2000. We included 2528 OSA patients and randomly selected and matched 10112 subjects without OSA as the control cohort. The risk of glaucoma in OSA patients was investigated based on the managements of OSA (without treatment, with surgery, with continuous positive airway pressure (CPAP) treatment, and with multiple modalities). The multivariable Cox regression was used to estimate hazard ratio (HR) after adjusting for sex, age, hypertension, diabetes, hyperlipidemia, and coronary artery disease. Results. The adjusted HR of glaucoma for OSA patients was 1.88 (95% CI: 1.46–2.42), compared with controls. For patients without treatment, the adjusted HR was 2.15 (95% CI: 1.60–2.88). For patients with treatments, the adjusted HRs of glaucoma were not significantly different from controls, except for those with CPAP (adjusted HR = 1.65, 95% CI = 1.09–2.49). Conclusions. OSA is associated with an increased risk of glaucoma. However, surgery reduces slightly the glaucoma hazard for OSA patients. Hsin-Yi Chen, Yue-Cune Chang, Che-Chen Lin, Fung-Chang Sung, and Wen-Chi Chen Copyright © 2014 Hsin-Yi Chen et al. All rights reserved. Role of Intravitreal Antivascular Endothelial Growth Factor Injections for Choroidal Neovascularization due to Choroidal Osteoma Wed, 23 Jul 2014 08:33:59 +0000 We treated 26 eyes of 25 young patients having a mean age of 30 years with intravitreal vascular endothelial growth factor (VEGF) inhibitor for choroidal new vessel (CNV) formation overlying choroidal osteoma over a mean follow-up of 26 months. Mean number of injections was 2.4 at 6 months, 3.2 at 12 months, and 5.5 at 24 months. CNV was subfoveal in 14 eyes, juxtafoveal in 5, extrafoveal in 5, and peripapillary in 2. By paired comparison, mean decrease from baseline was 119.7 microns at 6 months (; ), 105.3 microns at 1 year (; ), and 157.6 microns at 2 years (; ). BCVA improved by 3.3 lines at 6 months after therapy (; ), 2.8 lines (; ) at 1 year, and 3.1 lines (; ) at 2 years. We conclude that intravitreal anti-VEGF injections improve vision in majority of eyes with CNV from choroidal osteoma. Ahmad M. Mansour, J. Fernando Arevalo, Eman Al Kahtani, Hernando Zegarra, Emad Abboud, Rajiv Anand, Hamid Ahmadieh, Robert A. Sisk, Salman Mirza, Samuray Tuncer, Amparo Navea Tejerina, Jorge Mataix, Francisco J. Ascaso, Jose S. Pulido, Rainer Guthoff, Winfried Goebel, Young Jung Roh, Alay S. Banker, Ronald C. Gentile, Isabel Alonso Martinez, Rodney Morris, Neeraj Panday, Park Jung Min, Emilie Mercé, Timothy Y. Y. Lai, Vicky Massoud, and Nicola G. Ghazi Copyright © 2014 Ahmad M. Mansour et al. All rights reserved. Sustained-Release Corticosteroid Options Wed, 23 Jul 2014 00:00:00 +0000 Sustained-release corticosteroid treatment has shown to be a promising strategy for macular edema due to retinovascular disease (i.e., diabetes and retinal vein occlusion) and for the treatment of noninfectious posterior uveitis. Clinicians now have the option of three sustained-release corticosteroid implants: Ozurdex (Allergan Inc., Irvine, CA) which releases dexamethasone and two devices that release fluocinolone acetonide, Retisert (Bausch & Lomb, Rochester, NY), and Iluvien (Alimera Science, Alpharetta, GA). Each has different physical characteristics and duration effect and has been approved for different indications. Herein we provide a summary of the current clinical knowledge regarding these implants. Mariana Cabrera, Steven Yeh, and Thomas A. Albini Copyright © 2014 Mariana Cabrera et al. All rights reserved. Gender and Uveitis Tue, 22 Jul 2014 09:22:34 +0000 Chi-Chao Chan, Debra A. Goldstein, Janet L. Davis, and H. Nida Sen Copyright © 2014 Chi-Chao Chan et al. All rights reserved. Evaluation of the Repeatability and the Reproducibility of AL-Scan Measurements Obtained by Residents Tue, 22 Jul 2014 07:32:10 +0000 Purpose. To assess the repeatability and reproducibility of ocular biometry and intraocular lens (IOL) power measurements obtained by ophthalmology residents using an AL-Scan device, a novel optical biometer. Methods. Two ophthalmology residents were instructed regarding the AL-Scan device. Both performed ocular biometry and IOL power measurements using AL-Scan, three times on each of 128 eyes, independently of one another. Corneal keratometry readings, horizontal iris width, central corneal thickness, anterior chamber depth, pupil size, and axial length values measured by both residents were recorded together with IOL power values calculated on the basis of four different IOL calculation formulas (SRK/T, Holladay, and HofferQ). Repeatability and reproducibility of the measurements obtained were analyzed using the intraclass correlation coefficient (ICC). Results. Repeatability (ICC, 0.872-0.999 for resident 1 versus 0.905-0.999 for resident 2) and reproducibility (ICC, 0.916-0.999) were high for all biometric measurements. Repeatability (ICC, 0.981-0.983 for resident 1 versus 0.995-0.996 for resident 2) and reproducibility were also high for all IOL power measurements (ICC, 0.996 for all). Conclusions. The AL-Scan device exhibits good repeatability and reproducibility in all biometric measurements and IOL power calculations, independent of the operator concerned. Mehmet Kola, Hikmet Duran, Adem Turk, Suleyman Mollamehmetoglu, Ahmet Kalkisim, and Hidayet Erdol Copyright © 2014 Mehmet Kola et al. All rights reserved. Comment on “Intravitreal Ampicillin Sodium for Antibiotic-Resistant Endophthalmitis: Streptococcus uberis First Human Intraocular Infection Report” Tue, 22 Jul 2014 05:43:25 +0000 Luigi Toma, Enea Gino Di Domenico, Grazia Prignano, and Fabrizio Ensoli Copyright © 2014 Luigi Toma et al. All rights reserved. The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema Mon, 21 Jul 2014 12:16:56 +0000 Background/Aims. To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides. Design. Retrospective interventional case series. Methods. A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted. Results. The mean age of patients was years with a mean followup of months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet’s disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from at baseline to at 1 month and at 3 months (, at 3 months). The mean macular thickness was  μm at baseline. Following IVBI macular thickness improved to  μm at 1 month and to  μm at 3 months of followup (, at 3 months). Conclusion. Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents. Hassan Al-Dhibi, Issam H. Hamade, Ali Al-Halafi, Maan Barry, Charbel Bou Chacra, Vishali Gupta, and Khalid F. Tabbara Copyright © 2014 Hassan Al-Dhibi et al. All rights reserved. Eye Movement Control Mon, 21 Jul 2014 08:41:37 +0000 Stefanie I. Becker, Gernot Horstmann, and Arvid Herwig Copyright © 2014 Stefanie I. Becker et al. All rights reserved. Risk Factors for Glaucoma Suspicion in Healthy Young Asian and Caucasian Americans Mon, 21 Jul 2014 08:18:59 +0000 Purpose. To determine the prevalence of certain risk factors for glaucoma in a healthy, young population and to compare these risk factors between Asian Americans and Caucasians. Methods. 120 healthy graduate students (mean age years) underwent a comprehensive ophthalmic examination. Regression analyses controlling for age, sex, and refraction, comparing glaucoma risk factors in Asians () and Caucasians (), were performed. Outcome variables included family history, intraocular pressure (IOP), spherical equivalent, central corneal thickness (CCT), mean deviation (MD) and pattern standard deviation (PSD), and disc and retinal nerve fiber layer (RNFL) parameters. Results. 61% of subjects were female; the mean spherical equivalent was D; and the mean axial length (AL) was  mm. Regression analysis showed race affected spherical equivalent (), AL (), IOP (), and cup to disc area ratio (CDAR) (). Family history, CCT, MD, and PSD did not vary between Asians and Caucasians (). In this study, we found Asian Americans, compared to Caucasians, had  D greater myopia; greater IOP by  mmHg; and larger CDAR by . Conclusions. In our study population, young, healthy Asian Americans had greater myopia, IOP, and CDAR as compared to Caucasians, suggesting that racial variations can be important when diagnosing glaucoma. E. Lauren Doss, Linden Doss, Ying Han, Susan Huang, Travis Porco, Melike Pekmezci, and Shan Lin Copyright © 2014 E. Lauren Doss et al. All rights reserved. Evaluation of Pachymetric Measurements with Scheimpflug Photography-Based System and Optical Coherence Tomography Pachymetry at Different Stages of Keratoconus Sun, 20 Jul 2014 07:40:51 +0000 The aim of this study was to compare the central and peripheral pachymetric measurements determined with Sirius system and Visante OCT and evaluate the agreement between them at different stages of keratoconus. Measurements were not significantly different in all patients and subgroups and showed high correlation for the corneal thicknesses of the entire cornea in different stages of keratoconus. Betül İlkay Sezgin Akçay, Engin Bilge Özgürhan, Ercüment Bozkurt, Tuğba Kurt, Yusuf Yıldırım, Mediha Gülen Coşar, Aydın Yıldırım, Jülide Canan Umurhan Akkan, and Ahmet Demirok Copyright © 2014 Betül İlkay Sezgin Akçay et al. All rights reserved. Correlation between Intraocular Pressure Fluctuation with Postural Change and Postoperative Intraocular Pressure in Relation to the Time Course after Trabeculectomy Thu, 17 Jul 2014 12:16:41 +0000 Background. To investigate the correlation between intraocular pressure (IOP) fluctuation with postural change and IOP in relation to the time course after trabeculectomy. Methods. A total of 29 patients who had previously undergone primary trabeculectomy with mitomycin C were examined. IOP was obtained at 1, 2, 3, 6, and 12 months and then every 6 months postoperatively. Results. The postural IOP difference before surgery was  mmHg, which was reduced to  mmHg at 1 month,  mmHg at 2 months,  mmHg at 3 months,  mmHg at 6 months,  mmHg at 12 months, and  mmHg at 18 months after trabeculectomy ( each visit). The filtering surgery failed in 7 out of 29 eyes. Postural IOP changes were less than 3 mmHg in those patients who did not require needle revision at every visit. However, in patients who did require needle revision, the increase in the posture-induced IOP was greater than 3 mmHg prior to the increase in the sitting position IOP. Conclusions. Assessment of postural IOP changes after trabeculectomy might be potentially useful for predicting IOP changes after trabeculectomy. Kazuyuki Hirooka, Kaori Tenkumo, Eri Nitta, and Shino Sato Copyright © 2014 Kazuyuki Hirooka et al. All rights reserved. The Mitochondria-Targeted Antioxidant SkQ1 Downregulates Aryl Hydrocarbon Receptor-Dependent Genes in the Retina of OXYS Rats with AMD-Like Retinopathy Mon, 14 Jul 2014 12:04:43 +0000 The mitochondria-targeted antioxidant SkQ1 is a novel drug thought to retard development of age-related diseases. It has been shown that SkQ1 reduces clinical signs of retinopathy in senescence-accelerated OXYS rats, which are a known animal model of human age-related macular degeneration (AMD). The aim of this work was to test whether SkQ1 affects transcriptional activity of AhR (aryl hydrocarbon receptor) and Nrf2 (nuclear factor erythroid 2-related factor 2), which are considered as AMD-associated genes in the retina of OXYS and Wistar rats. Our results showed that only AhR and AhR-dependent genes were sensitive to SkQ1. Dietary supplementation with SkQ1 decreased the AhR mRNA level in both OXYS and Wistar rats. At baseline, the retinal Cyp1a1 mRNA level was lower in OXYS rats. SkQ1 supplementation decreased the Cyp1a1 mRNA level in Wistar rats, but this level remained unchanged in OXYS rats. Baseline Cyp1a2 and Cyp1b1 mRNA expression was stronger in OXYS than in Wistar rats. In the OXYS strain, Cyp1a2 and Cyp1b1 mRNA levels decreased as a result of SkQ1 supplementation. These data suggest that the Cyp1a2 and Cyp1b1 enzymes are involved in the pathogenesis of AMD-like retinopathy of OXYS rats and are possible therapeutic targets of SkQ1. M. L. Perepechaeva, A. Yu. Grishanova, E. A. Rudnitskaya, and N. G. Kolosova Copyright © 2014 M. L. Perepechaeva et al. All rights reserved. A Clinical and Confocal Microscopic Comparison of Transepithelial PRK and LASEK for Myopia Thu, 10 Jul 2014 11:43:43 +0000 Purpose. To compare the clinical and confocal microscopic results of transepithelial PRK versus LASEK for correction of myopia. Materials and Methods. Twelve patients with myopia received transepithelial PRK in one eye and LASEK in the other. In transepithelial PRK-treated eyes, the corneal epithelium was removed with 40 microns of excimer laser ablation and in LASEK-treated eyes with 25-second application of 18% ethanol. Time to epithelial healing, ocular discomfort, uncorrected and best corrected visual acuities, manifest refraction, haze, greyscale value, and keratocyte apoptosis in confocal microscopy were recorded. Results. The mean time to epithelial healing was significantly longer after LASEK (4.00 ± 0.43 versus 3.17 ± 0.6 days). On day 1, ocular discomfort was significantly higher after transepithelial PRK. The grade of haze, keratocyte apoptosis, and greyscale value in confocal microscopy were significantly higher in transepithelial PRK-treated eyes at 1 month. All transepithelial PRK- and LASEK-treated eyes achieved 20/25 or better UCVA and were within ±1.00 D of emmetropia at final visits. Conclusions. Both transepithelial PRK and LASEK offer effective correction of myopia at 1 year. However, LASEK appeared to induce less discomfort and less intense wound healing in the early postoperative period. Safak Korkmaz, Kamil Bilgihan, Sabahattin Sul, and Ahmet Hondur Copyright © 2014 Safak Korkmaz et al. All rights reserved. Aqueous Interleukin-6 Levels Are Superior to Vascular Endothelial Growth Factor in Predicting Therapeutic Response to Bevacizumab in Age-Related Macular Degeneration Thu, 10 Jul 2014 09:16:54 +0000 Objective. To prospectively evaluate the effect of intravitreal bevacizumab on aqueous levels of interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) in patients with exudative age-related macular degeneration (AMD) and correlate clinical outcomes with cytokine levels. Methods. 30 eyes of 30 patients with exudative AMD underwent intravitreal injection of bevacizumab three times at monthly intervals. The aqueous samples prior to the 1st injection (baseline) and 3rd injection were analyzed for VEGF and IL-6 levels. Subjects were subgrouped based upon change in the central subfield (CSF) macular thickness on SD-OCT at 8 weeks. Group 1 included patients () with a decrease in CSF thickness greater than 10% from the baseline (improved group). Group 2 included patients () who had a decrease in CSF thickness 10% or less (treatment-resistant). Results. In subgroup analysis, in both groups 1 and 2 patients, compared to aqueous VEGF, aqueous IL-6 levels showed a better correlation with CSF thickness on SD-OCT ( and 0.71, resp.). Conclusions. Aqueous IL-6 may be an important marker of treatment response or resistance in wet macular degeneration. Future therapeutic strategies may include targeted treatment against both VEGF and IL-6, in patients who do not respond to anti-VEGF treatment alone. Kakarla V. Chalam, Sandeep Grover, Kumar Sambhav, Sankarathi Balaiya, and Ravi K. Murthy Copyright © 2014 Kakarla V. Chalam et al. All rights reserved. Evaluation of the New Digital Goldmann Applanation Tonometer for Measuring Intraocular Pressure Thu, 10 Jul 2014 08:43:42 +0000 Purpose. To compare a new digital Goldmann applanation tonometer (dGAT) that measures intraocular pressure (IOP) in 0.1 mmHg increments to a standard Goldmann applanation tonometer (sGAT). Methods. This study included 116 eyes of 60 subjects. A single examiner first measured IOP in triplicate using either sGAT or dGAT, which was randomly chosen. After a 5-minute interval, the next set of three consecutive IOP was measured using the other GAT. Results. The mean IOP measured with sGAT was 16.27 ± 6.68 mmHg and 16.35 ± 6.69 mmHg with dGAT. Pearson’s correlation coefficient was 0.998 (). The subjects were divided into three groups based on the mean IOP: IOP < 14 mmHg, 14–20 mmHg, or >20 mmHg. The Pearson’s correlation coefficient within each group was 0.935, 0.972, and 0.997 (), respectively. The difference within the three consecutive IOP measurements (maximum–minimum) for dGAT (0.72 ± 0.34 mmHg) was significantly smaller than those with sGAT (0.92 ± 0.42 mmHg, ). Even in patients with equal IOP (zero left-right difference) with sGAT (), dGAT detected IOP differences between the left and right eyes (0.47 ± 0.31 mmHg). Conclusion. Compared to sGAT, dGAT measurements are highly reproducible and less variable. Yuta Sakaue, Jun Ueda, Masaaki Seki, Takayuki Tanaka, Tetsuya Togano, Takaiko Yoshino, and Takeo Fukuchi Copyright © 2014 Yuta Sakaue et al. All rights reserved. Intravitreal Bevacizumab Alone or Combined with Macular Laser Photocoagulation for Recurrent or Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion Mon, 07 Jul 2014 11:37:41 +0000 Background. To evaluate the efficacy of intravitreal bevacizumab (IVB) injection with or without macular laser photocoagulation (MLP) for recurrent or persistent macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. Thirty-four eyes underwent IVB injection for ME secondary to BRVO as a primary treatment. Twenty of the 34 eyes experienced recurrent or persistent ME after the first IVB. Nine of the 20 eyes (Group 1) were retreated with IVB combined with MLP. The remaining 11 eyes (Group 2) were retreated with IVB alone. Results. In Group 1, the postoperative best corrected visual acuity (BCVA) improved compared with the preoperative value at all follow-up visits, although no statistically significant improvement was observed at 6 months. In contrast, BCVA significantly improved from 0.53 to 0.40 at 6 months () in Group 2. Conclusion. Combined therapy tended to have a smaller effect on visual acuity compared with IVB monotherapy. Takafumi Hirashima, Tomoyuki Chihara, Toshitaka Bun, Takao Utsumi, Miou Hirose, and Hideyasu Oh Copyright © 2014 Takafumi Hirashima et al. All rights reserved. Inhibition of Return in Fear of Spiders: Discrepant Eye Movement and Reaction Time Data Thu, 03 Jul 2014 00:00:00 +0000 Inhibition of return (IOR) refers to a bias against returning the attention to a previously attended location. As a foraging facilitator it is thought to facilitate systematic visual search. With respect to neutral stimuli, this is generally thought to be adaptive, but when threatening stimuli appear in our environment, such a bias may be maladaptive. This experiment investigated the influence of phobia-related stimuli on the IOR effect using a discrimination task. A sample of 50 students (25 high, 25 low in spider fear) completed an IOR task including schematic representations of spiders or butterflies as targets. Eye movements were recorded and to assess discrimination among targets, participants indicated with button presses if targets were spiders or butterflies. Reaction time data did not reveal a significant IOR effect but a significant interaction of group and target; spider fearful participants were faster to respond to spider targets than to butterflies. Furthermore, eye-tracking data showed a robust IOR effect independent of stimulus category. These results offer a more comprehensive assessment of the motor and oculomotor factors involved in the IOR effect. Elisa Berdica, Antje B. M. Gerdes, Andre Pittig, and Georg W. Alpers Copyright © 2014 Elisa Berdica et al. All rights reserved.