The Scientific World Journal: Ophthalmology The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. A New Surgical Approach for the Treatment of Conjunctivochalasis: Reduction of the Conjunctival Fold with Bipolar Electrocautery Forceps Thu, 21 Apr 2016 08:14:55 +0000 Aim. To report a new surgical technique for the treatment of conjunctivochalasis. Methods. A new surgical technique in which specially designed bipolar electrocautery forceps facilitate the complete reduction of the conjunctival folds without creating lesions near the corneoscleral limbus was designed. A retrospective revision of the medical records of patients treated with this technique between the years 2011 and 2013 was made, and eighteen eyes of sixteen patients with conjunctivochalasis treated with this new technique were included. Results. All the eyes treated showed a significant improvement with no evidence of scar lesions after a mean follow-up time of 10 months. Conclusions. The surgical technique presented here could be a good alternative for the management of conjunctivochalasis. Eduardo Arenas and Diana Muñoz Copyright © 2016 Eduardo Arenas and Diana Muñoz. All rights reserved. Retracted: Changes of Radial Diffusivity and Fractional Anisotopy in the Optic Nerve and Optic Radiation of Glaucoma Patients Thu, 24 Mar 2016 07:21:28 +0000 The Scientific World Journal Copyright © 2016 The Scientific World Journal. All rights reserved. Comparison of Modifications in Flap Anastomosis Patterns and Skin Incision Types for External Dacryocystorhinostomy: Anterior-Only Flap Anastomosis with W Skin Incision versus Anterior and Posterior Flap Anastomosis with Linear Skin Incision Sun, 21 Jun 2015 12:05:18 +0000 Purpose. To compare the outcomes of external dacryocystorhinostomy (E-DCR) by using two different flap anastomosis patterns and skin incision types. Methods. This study included 79 patients (88 eyes) with lacrimal drainage system disorders who underwent E-DCR surgery. Fifty eyes of 44 patients (group A) underwent E-DCR by suturing anterior and posterior flaps (H-flap) of the lacrimal sac with curvilinear skin incision whereas in 38 eyes of 35 patients (group B) DCR was performed by suturing only anterior flaps (U-flap) with W skin incision. Results. The success rate was evaluated according to lacrimal patency and scar assessment scores. Patency was achieved in 78 patients (88.6%). In terms of groups, patency was 44 eyes (88.0%) in group A and 34 eyes (89.5%) in group B. There was no statistically significant difference in the success rates of lacrimal patency between the two groups. Further, there was no statistically significant difference concerning cutaneous scar scores. Conclusion. Our study suggests that anastomoses of only anterior flaps or both anterior and posterior flaps have similar success rates; suturing only anterior flaps is easier to perform and shortens the operative time. In addition, W skin incision is a reasonable alternative to curvilinear incision for reducing scar formation. Burcu Dirim, Selam Yekta Sendul, Mehmet Demir, Erdem Ergen, Zeynep Acar, Ali Olgun, Semra Tiryaki, Hakan Sensoz, and Dilek Guven Copyright © 2015 Burcu Dirim et al. All rights reserved. Towards an Analytical Age-Dependent Model of Contrast Sensitivity Functions for an Ageing Society Wed, 20 May 2015 09:21:34 +0000 The Contrast Sensitivity Function (CSF) describes how the visibility of a grating depends on the stimulus spatial frequency. Many published CSF data have demonstrated that contrast sensitivity declines with age. However, an age-dependent analytical model of the CSF is not available to date. In this paper, we propose such an analytical CSF model based on visual mechanisms, taking into account the age factor. To this end, we have extended an existing model from Barten (1999), taking into account the dependencies of this model’s optical and physiological parameters on age. Age-dependent models of the cones and ganglion cells densities, the optical and neural MTF, and optical and neural noise are proposed, based on published data. The proposed age-dependent CSF is finally tested against available experimental data, with fair results. Such an age-dependent model may be beneficial when designing real-time age-dependent image coding and display applications. Karine Joulan, Roland Brémond, and Nicolas Hautière Copyright © 2015 Karine Joulan et al. All rights reserved. Diagnosing and Ranking Retinopathy Disease Level Using Diabetic Fundus Image Recuperation Approach Tue, 07 Apr 2015 11:37:06 +0000 Retinal fundus images are widely used in diagnosing different types of eye diseases. The existing methods such as Feature Based Macular Edema Detection (FMED) and Optimally Adjusted Morphological Operator (OAMO) effectively detected the presence of exudation in fundus images and identified the true positive ratio of exudates detection, respectively. These mechanically detected exudates did not include more detailed feature selection technique to the system for detection of diabetic retinopathy. To categorize the exudates, Diabetic Fundus Image Recuperation (DFIR) method based on sliding window approach is developed in this work to select the features of optic cup in digital retinal fundus images. The DFIR feature selection uses collection of sliding windows with varying range to obtain the features based on the histogram value using Group Sparsity Nonoverlapping Function. Using support vector model in the second phase, the DFIR method based on Spiral Basis Function effectively ranks the diabetic retinopathy disease level. The ranking of disease level on each candidate set provides a much promising result for developing practically automated and assisted diabetic retinopathy diagnosis system. Experimental work on digital fundus images using the DFIR method performs research on the factors such as sensitivity, ranking efficiency, and feature selection time. K. Somasundaram and P. Alli Rajendran Copyright © 2015 K. Somasundaram and P. Alli Rajendran. All rights reserved. Conjunctival Flap Covering Combined with Antiviral and Steroid Therapy for Severe Herpes Simplex Virus Necrotizing Stromal Keratitis Sun, 15 Feb 2015 06:57:32 +0000 Herpes simplex virus (HSV) necrotizing stromal keratitis is a common type of herpetic stromal keratitis (HSK). Antiviral medication alone cannot control the disease, and corticosteroid eye drops may aggravate the ulcer and result in corneal perforation. Amniotic membrane transplantation effectively treats superficial corneal ulcer resulting from necrotizing stromal HSK. However, the efficacy of this approach seems to be limited for more serious cases. This study presented the clinical treatment of severe HSV necrotizing stromal keratitis (ulcer depth greater than half of the corneal stroma) by conjunctival flap covering surgery in 25 patients (25 eyes) combined with antivirus and corticosteroid treatment at Shandong Eye Hospital from January 2007 to December 2013. Clinical results showed that the mean best spectacle-corrected visual acuity improved from preoperative 20/333 to postoperative 20/40 (). All patients recovered ocular surface stabilization. There was recurrence in two eyes, which was cured with antiviral medication. Conjunctival flap covering combined with antivirus and corticosteroid treatment is effective in treating severe HSV necrotizing stromal keratitis. Hua Gao, Yanni Jia, Suxia Li, Ting Wang, Yaohong Tan, and Weiyun Shi Copyright © 2015 Hua Gao et al. All rights reserved. Phantom Eye Syndrome: A Review of the Literature Sun, 07 Dec 2014 08:38:33 +0000 The purpose of this literature review was to describe the main features of phantom eye syndrome in relation to their possible causes, symptoms, treatments, and influence of eye amputation on quality of life of anophthalmic patients. For this, a bibliographical research was performed in Pubmed database using the following terms: “eye amputation,” “eye trauma,” “phantom eye syndrome,” “phantom pain,” and “quality of life,” associated or not. Thirteen studies were selected, besides some relevant references contained in the selected manuscripts and other studies hallowed in the literature. Thus, 56 articles were included in this review. The phantom eye syndrome is defined as any sensation reported by the patient with anophthalmia, originated anophthalmic cavity. In phantom eye syndrome, at least one of these three symptoms has to be present: phantom vision, phantom pain, and phantom sensations. This syndrome has a direct influence on the quality of life of the patients, and psychological support is recommended before and after the amputation of the eyeball as well as aid in the treatment of the syndrome. Therefore, it is suggested that, for more effective treatment of phantom eye syndrome, drug therapy should be associated with psychological approach. Agda M. Andreotti, Marcelo C. Goiato, Eduardo P. Pellizzer, Aldiéris A. Pesqueira, Aimée M. Guiotti, Humberto Gennari-Filho, and Daniela M. dos Santos Copyright © 2014 Agda M. Andreotti et al. All rights reserved. Nasopupillary Asymmetry Thu, 04 Dec 2014 00:10:16 +0000 Purpose. To establish the prevalence of nasopupillary asymmetry (difference in nasopupillary distances) in the population and its relation with the interpupillary distance. Methods. A retrospective descriptive study was conducted by reviewing of 1262 medical records. The values of nasopupillary asymmetry and the interpupillary distance were obtained. A statistical analysis was made and the correlation between these variables was established. Results. Seventy-nine percent of the population presented some degree of nasopupillary asymmetry. The interpupillary distance had a very low correlation with the nasopupillary asymmetry . Conclusion. It is advisable to use the nasopupillary distance of each eye as a standard measurement. Eduardo Arenas, Diana Muñoz, Evelyn Matheus, and Diana Morales Copyright © 2014 Eduardo Arenas et al. All rights reserved. NMR Spectroscopy of Human Eye Tissues: A New Insight into Ocular Biochemistry Wed, 26 Nov 2014 13:29:35 +0000 Background. The human eye is a complex organ whose anatomy and functions has been described very well to date. Unfortunately, the knowledge of the biochemistry and metabolic properties of eye tissues varies. Our objective was to reveal the biochemical differences between main tissue components of human eyes. Methods. Corneas, irises, ciliary bodies, lenses, and retinas were obtained from cadaver globes 0-1/2 hours postmortem of 6 male donors (age: 44–61 years). The metabolic profile of tissues was investigated with HR MAS 1H NMR spectroscopy. Results. A total of 29 metabolites were assigned in the NMR spectra of the eye tissues. Significant differences between tissues were revealed in contents of the most distant eye-tissues, while irises and ciliary bodies showed minimal biochemical differences. ATP, acetate, choline, glutamate, lactate, myoinositol, and taurine were identified as the primary biochemical compounds responsible for differentiation of the eye tissues. Conclusions. In this study we showed for the first time the results of the analysis of the main human eye tissues with NMR spectroscopy. The biochemical contents of the selected tissues seemed to correspond to their primary anatomical and functional attributes, the way of the delivery of the nutrients, and the location of the tissues in the eye. Tomasz Kryczka, Edward Wylęgała, Dariusz Dobrowolski, and Anna Midelfart Copyright © 2014 Tomasz Kryczka et al. All rights reserved. Cone-Like Rectification Properties of cGMP-Gated Channels in Transmutated Retinal Photoreceptors of Nocturnal Geckoes Sun, 23 Nov 2014 00:00:00 +0000 Photoreceptors of nocturnal geckoes are scotopic, with rod-shaped outer segments, and sensitivities to light similar to the one of retinal rods from other species of lower vertebrates. However, these cells are not rods, but they originated from cones of ancestral diurnal geckoes with pure-cone retinas, after being forced to adapt to a nocturnal behavior. Several interesting adaptations of these rod-like cones have been studied to date; molecular biology and functional studies confirmed that several proteins of the phototransductive cascade display structural and functional properties that indicate their origin from cones rather than from rods. In this paper, we investigate, with whole cell voltage clamp in the photoreceptor detached outer segment preparation, the voltage rectification properties of cGMP-gated channels in three species, Gekko gecko, Tarentola mauritanica, and Hemidactylus frenatus. We show that the current-voltage properties in the physiological voltage range are reminiscent of the ones of cGMP-gated channels from cones rather than from rods of other cold-blooded vertebrates. The origin and the relevance of the mechanisms investigated are discussed. Vittorio Vellani and Chiara Giacomoni Copyright © 2014 Vittorio Vellani and Chiara Giacomoni. All rights reserved. Zone Specific Fractal Dimension of Retinal Images as Predictor of Stroke Incidence Tue, 18 Nov 2014 07:07:38 +0000 Fractal dimensions (FDs) are frequently used for summarizing the complexity of retinal vascular. However, previous techniques on this topic were not zone specific. A new methodology to measure FD of a specific zone in retinal images has been developed and tested as a marker for stroke prediction. Higuchi’s fractal dimension was measured in circumferential direction (FDC) with respect to optic disk (OD), in three concentric regions between OD boundary and 1.5 OD diameter from its margin. The significance of its association with future episode of stroke event was tested using the Blue Mountain Eye Study (BMES) database and compared against spectrum fractal dimension (SFD) and box-counting (BC) dimension. Kruskal-Wallis analysis revealed FDC as a better predictor of stroke (, , ) compared with SFD (, , ) and BC (, , ) with overall lower median value for the cases compared to the control group. This work has shown that there is a significant association between zone specific FDC of eye fundus images with future episode of stroke while this difference is not significant when other FD methods are employed. Behzad Aliahmad, Dinesh Kant Kumar, Hao Hao, Premith Unnikrishnan, Mohd Zulfaezal Che Azemin, Ryo Kawasaki, and Paul Mitchell Copyright © 2014 Behzad Aliahmad et al. All rights reserved. The Anterior Chamber Depth and Retinal Nerve Fiber Layer Thickness in Children Sun, 09 Nov 2014 00:00:00 +0000 Purpose. To investigate the correlation of anterior chamber depth (ACD) with the peripapillary retinal nerve fiber layer (RNFL) thickness, age, axial length (AL), and spherical equivalent in children. Subjects. Consecutive subjects aged 4 to 18 were recruited. Visually disabling eye conditions were excluded. Only the right eye was included for analysis. The ACD was correlated with RNFL thickness, age, spherical equivalent, and AL for all subjects. Subjects were then divided into 3 groups based on their postcycloplegic spherical equivalent: myopes (<−1.0 D), emmetropes (≥−1.0 to ≤+1.0 D), and hyperopes (>+1.0 D). The ACD was compared among the 3 groups before and after age adjustment. Results. In 200 subjects (mean age years), a deeper ACD was correlated with thinner global RNFL (, , ), older age (, , ), myopic spherical equivalent (, , ), and longer AL (, , ). The ACD was deepest in myopes ( mm, ), followed by emmetropes (, ) and then hyperopes (, ) (all ). After age adjustment, myopes had a deeper ACD than the other 2 groups (all ). Conclusions. In children, a deeper ACD was associated with thinner RNFL thickness, older age, more myopic spherical equivalent, and longer AL. Myopes had a deeper ACD than emmetropes and hyperopes. Jacky W. Y. Lee, Gordon S. K. Yau, Tiffany T. Y. Woo, Doris W. F. Yick, Victor T. Y. Tam, and Can Y. F. Yuen Copyright © 2014 Jacky W. Y. Lee et al. All rights reserved. Differences in Risk Factors for Retinopathy of Prematurity Development in Paired Twins: A Chinese Population Study Thu, 23 Oct 2014 06:57:36 +0000 Purpose. To determine the differences in risk factors for retinopathy of prematurity (ROP) in paired twins. Methods. A retrospective medical record review was performed for all paired twins screened for ROP between 2007 and 2012. Screening was offered to very low birth weight (≤1500 grams) and preterm (≤32 weeks) neonates. Twins 1 and 2 were categorized based on the order of delivery. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP. Results. In 34 pairs of Chinese twins, the mean gestational age (GA) was 30.2 ± 2.0 weeks. In Twin 1, smaller GA (OR = 0.44, ), higher mean oxygen concentration (OR = 1.34, ), presence of thrombocytopenia (OR = 1429.60, ), and intraventricular hemorrhage (OR = 18.67, ) were significant risk factors for ROP. For Twin 2, a smaller GA (OR = 0.45, ) was the only risk factor. There were no significant risk factors for ROP in Twin 1 or Twin 2 on multivariate analysis. Conclusion. In Chinese twin pairs, smaller GA was the only common risk factor for ROP while Twin 1 was more susceptible to the postnatal risks for ROP. Gordon S. K. Yau, Jacky W. Y. Lee, Victor T. Y. Tam, Stan Yip, Edith Cheng, Catherine C. L. Liu, Benjamin C. Y. Chu, and Can Y. F. Yuen Copyright © 2014 Gordon S. K. Yau et al. All rights reserved. A Comparison of Intralesional Triamcinolone Acetonide Injection for Primary Chalazion in Children and Adults Wed, 15 Oct 2014 09:09:35 +0000 Purpose. To investigate outcome differences of intralesional triamcinolone acetonide (TA) injection for primary chalazia in children versus adults. Methods. A retrospective review of consecutive subjects with primary chalazion who received intralesional TA injection was conducted. A single investigator injected 0.05–0.15 mL of TA (40 mg/mL) intralesionally. Patients were stratified into the pediatric (<18 years old) and adult (≥18 years old) group. In both groups, the correlation of resolution time with chalazion size and TA dose was performed. Results. 17 children and 24 adults were enrolled, with a mean age of and years, respectively. Both groups had statistically similar baseline characteristics. There was no significant difference between the resolution time in the pediatric ( days) and adult ( days) group (). There were no significant complications from the TA injection. There was no significant correlation of resolution time to chalazion size () nor TA dose () in both groups. Conclusion. TA for the treatment of primary chalazion was equally effective in children and adults, without any significant complications, and the rate of clinical response did not appear to be dose-dependent. Jacky W. Y. Lee, Gordon S. K. Yau, Michelle Y. Y. Wong, and Can Y. F. Yuen Copyright © 2014 Jacky W. Y. Lee et al. All rights reserved. Retrospective Review on the Use of Topical Cyclosporin A 0.05% for Paediatric Allergic Conjunctivitis in Hong Kong Chinese Wed, 15 Oct 2014 08:13:40 +0000 Purpose. To evaluate the efficacy of using topical cyclosporin A 0.05% (Restasis) for the treatment of paediatric allergic conjunctivitis. Methods. This retrospective study included consecutive cases of paediatric allergic conjunctivitis treated with Restasis between 2010 and 2013. Subjects with follow-up time less than 3 months after using Restasis were excluded. Itch severity score, symptom score, and sign score were compared before (baseline) and 3 months after using Restasis. Results. In 27 eyes of 14 patients (mean age years), 44.4% had allergic conjunctivitis, 33.3% had vernal keratoconjunctivitis, and 22.2% had atopic keratoconjunctivitis. The mean duration of ocular symptoms was months. 92.6% of subjects were using steroid eye drop before Restasis. After 3 months of topical Restasis, there were statistically significant reductions in the symptom, sign, and itch severity scores compared with baseline (all ) and 78.6% of subjects were able to be tapered off steroid eye drops. Conclusion. Topical Restasis was effective and safe in significantly reducing ocular itchiness, sign, and symptom scores at 3 months after use in paediatric allergic ocular conditions. Macy M. S. Wu, Gordon S. K. Yau, Jacky W. Y. Lee, Amy L. Wong, Victor T. Y. Tam, and Can Y. F. Yuen Copyright © 2014 Macy M. S. Wu et al. All rights reserved. Wide-Field Fluorescein Angiography in Wet Age-Related Macular Degeneration Tue, 14 Oct 2014 08:16:54 +0000 Purpose. The aim of our study was to investigate if peripheral retinal ischaemia contributed to the pathogenesis of neovascular AMD (NvAMD), using wide-field fluorescein angiography (WFFA). Methods. This prospective study included 30 consecutive patients with newly diagnosed NvAMD in the index eye. Wide-field colour fundus images and fluorescein angiograms were obtained using P200C optomap FA and analysed using a grid with three concentric circles of 50°, 100°, and 200° centred on the fovea to define zones Z1, Z2, and Z3. Results. Areas of peripheral retinal nonperfusion were seen in 2 (7%) eyes, peripheral vascular leakage in 5 (17%) eyes, and diffuse dye leakage close to the ora in 5 (17%) eyes. A total of one-third of the study eyes showed changes on WFFA in Z2 and Z3. On comparing index eyes to nonindex eyes in these patients, the presence of NvAMD was associated with peripheral FA changes (, Fisher’s test). Conclusion. Frank peripheral retinal non-perfusion does not appear to be associated with NvAMD. In some patients with active NvAMD there is degradation of the peripheral blood-retina barrier. Smoking was also found to be associated with the above-mentioned abnormalities. Savitha Madhusudhan and Nicholas Beare Copyright © 2014 Savitha Madhusudhan and Nicholas Beare. All rights reserved. Comprasion of ICare Rebound Tonometer and Goldmann Applanation Tonometer in High Myopia Tue, 14 Oct 2014 07:18:07 +0000 Purpose. To compare intraocular pressure (IOP) measurements with the Goldmann applanation tonometer (GAT) and the ICare rebound tonometer (RBT) in high myopic eyes. Patients and Methods. This randomized prospective study included 40 eyes of 40 patients with high myopia. All patients’ central corneal thickness (CCT), anterior chamber depth (ACD), axial length (AXL), keratometry, and refractive measurements were recorded and followed by IOP measurement with RBT and GAT. Results. The average CCT, AXL, and ACD were determined to be  μm,  mm, and  mm, respectively. Mean K was  D and mean spherical equivalent was  D. The mean IOP values obtained by RBT and GAT were  mmHg and  mmHg, respectively. The deviations of RBT readings from corrected GAT values were highly correlated with CCT values (, ). The mean corrected GAT reading was  mmHg. Linear regression analysis showed that a CCT change of 10 μm resulted in an RBT reading deviation of 0.57 mmHg. The Bland-Altman scatter-plot and McNemar test showed a clinically good level of agreement between the two tonometers. Conclusion. This study found a good agreement level between the two tonometers in high myopic patients and that RBT measurements are influenced by CCT variations. Halil Huseyin Cagatay, Metin Ekinci, Zeliha Yazar, Gokcen Gokce, and Erdinc Ceylan Copyright © 2014 Halil Huseyin Cagatay et al. All rights reserved. Comparison of Medpor Coated Tear Drainage Tube versus Silicon Tear Drainage Tube in Conjunctivodacryocystorhinostomy: Problems and Solutions Tue, 14 Oct 2014 07:01:45 +0000 Purpose. This study aims at comparing two different types of drainage tubes in conjunctivodacryocystorhinostomy, which are used for upper lacrimal system obstruction or damage, with respect to their respective postoperative problems and solutions. Methods. Nineteen eyes of 17 patients who underwent conjunctivodacryocystorhinostomy (CDCR) or conjunctivorhinostomy (CR) surgery with a Medpor coated tear drainage tube or silicon tube placement between October, 2010, and February, 2014, were included in this retrospective comparative study. Results. In the initial surgery, Medpor coated tear drainage tubes were used in 11 eyes by CDCR, whereas silicon tear drainage tubes were implanted into 2 eyes by CR and 6 eyes by CDCR. In group 1, proximal and distal obstructions developed postoperatively in 4 eyes, while 1 eye showed tube malposition and 3 eyes developed luminal obstruction by debris 3 times. In group 2, tube extrusion developed in 4 eyes, whereas tube malposition developed in 6 eyes and luminal obstruction by debris developed in 6 eyes at different times, for a total of 20 times. Conclusions. In our study, the most significant complication we observed in the use of silicon tear drainage tubes was tube extrusion,whereas the leading complication related to the use of Medpor coated tear drainage tubes was tube obstruction. Selam Yekta Sendul, Halil Huseyin Cagatay, Burcu Dirim, Mehmet Demir, Ali Atakhan Yıldız, Zeynep Acar, Sonmez Cinar, and Dilek Guven Copyright © 2014 Selam Yekta Sendul et al. All rights reserved. Influence of Refractive Condition on Retinal Vasculature Complexity in Younger Subjects Mon, 13 Oct 2014 14:04:37 +0000 Objective. The aim of this study was to compare the retinal vasculature complexity between emmetropia, and myopia in younger subjects. Methods. A total of 82 patients ( years) with two types of refractive conditions, myopia and emmetropia were enrolled in this study. Refraction data were converted to spherical equivalent refraction. These retinal images (right eyes) were obtained from NAVIS Lite Image Filing System and the vasculature complexity was measured by fractal dimension (), quantified using a computer software following a standardized protocol. Results. There was a significant difference () in the value of between emmetropic () and myopic () groups. A positive correlation (, ) between the and the spherical equivalent refraction was detected in this study. Using a linear model, it was estimated that 6.7% of the variation in could be explained by spherical equivalent refraction. Conclusions. This study provides valuable findings about the effect of moderate to high myopia on the fractal dimension of the retinal vasculature network. These results show that myopic refraction in younger subjects was associated with a decrease in , suggesting a loss of retinal vessel density with moderate to high myopia. Mohd Zulfaezal Che Azemin, Norsyazwani Mohamad Daud, Fadilah Ab Hamid, Ilyanoon Zahari, and Abdul Halim Sapuan Copyright © 2014 Mohd Zulfaezal Che Azemin et al. All rights reserved. Vitamin C Protected Human Retinal Pigmented Epithelium from Oxidant Injury Depending on Regulating SIRT1 Tue, 22 Jul 2014 08:43:19 +0000 The purpose was to investigate the protective effects of Vitamin C (Vit C) and the regulatory mechanism between Vit C and sirtuin 1 (SIRT1) in PREs during oxidative stress as Vit C and SIRT1 exerted famous effects as antioxidants. We found that moderate Vit C (100 µM) prevented ARPE-19 cells from damages induced by H2O2, including increasing viability, reducing apoptosis, and attenuating intracellular ROS levels. But lower and higher concentration of Vit C had no effects. Further results indicated that Vit C caused the dysregulation of some stress responses factors (SIRT1, p53 and FOXO3) in ARPE-19 cells response to H2O2. Moreover we found that SIRT1 activator resveratrol (SRV) stimulated significantly the protective effects of moderate Vit C, provided the property of antioxidative stress for the lower and higher concentration of Vit C in ARPE-19 cells as well. Consistently, nicotinamide (NA) relieved the protective functions of moderate Vit C. Interestingly, data also revealed the dysregulation of p53 and FOXO3 was dependent on the regulation of SIRT1 rather than Vit C. Summarily, the protective effect of Vit C against oxidative stress was involved in regulation of SIRT1. It suggested that combined application of Vit C and RSV might be a promising therapeutic method for AMD. Wei Wei, Langen Li, Yufeng Zhang, Geriletu, Jia Yang, Yanmei Zhang, and Yiqiao Xing Copyright © 2014 Wei Wei et al. All rights reserved. Protective Effects of Trehalose on the Corneal Epithelial Cells Wed, 18 Jun 2014 06:56:27 +0000 Purpose. Aim of the present work was to evaluate the effects of the trehalose on the corneal epithelium undergoing alcohol delamination. Methods. Twelve patients undergoing laser subepithelial keratomileusis (LASEK) were consecutively included in the study. The right eyes were pretreated with 3% trehalose eye drops, whilst left eyes were used as control. Epithelial specimens were processed for cells vitality assessment, apoptosis, and light and transmission electron microscopy; a morphometric analysis was performed in both groups. Results. In both trehalose-untreated eyes (TUE) and trehalose-treated eyes (TTE), the percentage of vital cells was similar and no apoptotic cells were observed. In TUE, the corneal epithelium showed superficial cells with reduced microfolds, wing cells with vesicles and dilated intercellular spaces, and dark basal cells with vesicles and wide clefts. In TTE, superficial and wing cells were better preserved, and basal cells were generally clear with intracytoplasmatic vesicles. The morphometric analysis showed statistically significant differences between the two groups: the TTE epithelial height was higher, the basal cells showed larger area and clearer cytoplasm. The distribution of desmosomes and hemidesmosomes was significantly different between the groups. Conclusions. Trehalose administration better preserved morphological and morphometric features of alcohol-treated corneal epithelium, when compared to controls. Pasquale Aragona, Pietro Colosi, Laura Rania, Francesca Colosi, Antonina Pisani, Domenico Puzzolo, and Antonio Micali Copyright © 2014 Pasquale Aragona et al. All rights reserved. Culture and Characterization of Microglia from the Adult Murine Retina Thu, 29 May 2014 11:41:22 +0000 Purpose. To develop a protocol for isolating and culturing murine adult retinal microglia and to characterize the phenotype and function of the cultured cells. Method. Retinal single-cell suspensions were prepared from adult MF1 mice. Culture conditions including culture medium, growth factors, seeding cell density, and purification of microglia from the mixed cultures were optimised. Cultured retinal microglial cells were phenotyped using the surface markers CD45, CD11b, and F4/80. Their ability to secrete proinflammatory cytokines in response to lipopolysaccharide (LPS) stimulation was examined using cytometric bead array (CBA) assay. Results. Higher yield was obtained when retinal single-cell suspension was cultured at the density of cells per cm2 in Dulbecco’s modified Eagle medium (DMEM)/F12 + Glutamax supplement with 20% fetal calf serum (FCS) and 20% L929 supernatant. We identified day 10 to be the optimum day of microglial isolation. Over 98% of the cells isolated were positive for CD45, CD11b, and F4/80. After stimulating with LPS they were able to secrete proinflammatory cytokines such as IL-6 and TNF-α and express CD86, CD40, and MHC-II. Conclusion. We have developed a simple method for isolating and culturing retinal microglia from adult mice. Gayathri Devarajan, Mei Chen, Elizabeth Muckersie, and Heping Xu Copyright © 2014 Gayathri Devarajan et al. All rights reserved. Spectral-Domain Optical Coherence Tomography for Macular Edema Wed, 14 May 2014 00:00:00 +0000 Optical coherence tomography (OCT) is a rapid noncontact method that allows in vivo imaging of the retina and it has become an important component in clinical practice. OCT is a useful ancillary tool for assessing retinal diseases because of its ability to provide cross-sectional retinal images and quantitatively analyze retinal morphology. The introduction of spectral-domain OCT provided major improvements in image acquisition speed and image resolution. Future studies will address how these major technologic advances will impact the use of OCT in research and clinical practice. Emmerson Badaró, Eduardo Novais, Larissa Maria Prodocimo, and Juliana M. Ferraz Sallum Copyright © 2014 Emmerson Badaró et al. All rights reserved. Knockdown of Zebrafish Blood Vessel Epicardial Substance Results in Incomplete Retinal Lamination Thu, 06 Mar 2014 13:06:19 +0000 Cell polarity during eye development determines the normal retinal lamination and differentiation of photoreceptor cells in the retina. In vertebrates, blood vessel epicardial substance (Bves) is known to play an important role in the formation and maintenance of the tight junctions essential for epithelial cell polarity. In the current study, we generated a transgenic zebrafish Bves (zbves) promoter-EGFP zebrafish line to investigate the expression pattern of Bves in the retina and to study the role of zbves in retinal lamination. Immunostaining with different specific antibodies from retinal cells and transmission electron microscopy were used to identify the morphological defects in normal and Bves knockdown zebrafish. In normal zebrafish, Bves is located at the apical junctions of embryonic retinal neuroepithelia during retinogenesis; later, it is strongly expressed around inner plexiform layer (IPL) and retinal pigment epithelium (RPE). In contrast, a loss of normal retinal lamination and cellular polarity was found with undifferentiated photoreceptor cells in Bves knockdown zebrafish. Herein, our results indicated that disruption of Bves will result in a loss of normal retinal lamination. Yu-Ching Wu, Ruei-Feng Chen, Chia-Yang Liu, Fung Rong Hu, Chang-Jen Huang, and I-Jong Wang Copyright © 2014 Yu-Ching Wu et al. All rights reserved. Temperament and Character Personality Profile and Illness-Related Stress in Central Serous Chorioretinopathy Sun, 16 Feb 2014 11:40:00 +0000 Psychological stress is a risk factor as well as a consequence of central serous chorioretinopathy (CSC). Impulsiveness, overachievement, emotional instability, and hard-driving competitiveness have been discussed as personality features in CSC patients. We investigated 57 consecutive CSC patients and 57 age- and gender-matched controls by means of the Symptom Checklist 90-R and the Temperament and Character Inventory. Somatic risk factors, illness characteristics, subjective assessment of severity of illness, and illness-related stress in different areas of life (work, private life) were evaluated. CSC patients showed significantly higher emotional distress as measured by the Global Severity Index. The CSC personality was characterized by lower scoring on the character dimension cooperativeness and the temperament dimension reward dependence. Cooperativeness as well as subjective assessment of severity of CSC has been recognized as significant predictors of illness-related work stress accounting for 30% of variance. Implicating competitiveness, hostility and emotional detachment, lower level of cooperativeness, and reward dependence support the existence of specific aspects of type A behaviour in CSC patients. Low perceived social support and loss of control may explain the significant contribution of this personality dimension to illness-related work stress. Treatment of CSC should thus incorporate psychoeducation about factors contributing to illness-related stress. Rupert Conrad, Franziska Geiser, Alexandra Kleiman, Berndt Zur, and Andrea Karpawitz-Godt Copyright © 2014 Rupert Conrad et al. All rights reserved. Aquaporin-1 Expression in Proliferative Vitreoretinopathy and in Epiretinal Membranes Tue, 04 Feb 2014 13:14:47 +0000 Purpose. Aquaporin-1 (AQP1) is involved in cell migration and proliferation; therefore, the purpose of the study was to investigate its expression in proliferative vitreoretinopathy (PVR) and epiretinal membranes (ERM). Methods. 19 membranes from PVR and ERM were collected following eye surgery. AQP1 mRNA and protein expressions were determined by RT-qPCR and immunofluorescence in the membranes from PVR and ERM. Results. AQP1 mRNA and protein were expressed in both PVR and ERM as shown by RT-qPCR and immunofluorescence. AQP1 protein expression was heterogeneous among and between PVR and ERM and colocalized with alpha-smooth muscle actin (αSMA) and with glial fibrillary acidic protein (GFAP). There were a higher percentage of cells coexpressing AQP1 and αSMA than AQP1 and GFAP. GFAP and αSMA did not colocalize. Conclusion. Our data show for the first time AQP1 expression in both PVR and ERM. AQP1 is expressed mostly by the αSMA-positive cells, presumably myofibroblasts, but also by GFAP-positive cells, assumed to be glial cells. These original findings warrant further functional investigations aiming at studying the potential role of AQP1 in cell migration and proliferation occurring during the development of PVR and ERM. Elie Motulsky, Dany Salik, Xavier Janssens, Bart Pion, Rebecca Dufrane, Florence Chaput, Nargis Bolaky, Françoise Gregoire, Laure Caspers, Jason Perret, François Willermain, and Christine Delporte Copyright © 2014 Elie Motulsky et al. All rights reserved. Protective Effect of Hesperetin and Naringenin against Apoptosis in Ischemia/Reperfusion-Induced Retinal Injury in Rats Thu, 30 Jan 2014 15:28:37 +0000 Purpose. Hesperetin and naringenin are naturally common flavonoids reported to have antioxidative effects. This study was performed to investigate whether either hesperetin or naringenin has a protective effect against apoptosis on retinal ischemia/reperfusion (I/R) injury. Methods. Retinal I/R was induced by increasing the intraocular pressure to 150 mmHg for 60 minutes. Thirty-three male Wistar albino rats were randomised into 5 groups named control, I/R + sham, I/R + solvent (DMSO), I/R + hesperetin, and I/R + naringenin. Animals were given either hesperetin, naringenin, or the solvent intraperitoneally immediately following reperfusion. Thickness of retinal layers and retinal cell apoptosis were detected by histological analysis, tunel assay, and immunohistochemistry assay. Results. Hesperetin and naringenin attenuated the I/R-induced apoptosis of retinal cells in the inner and outer nuclear cells of the rat retina. Retinal layer thickness of the naringenin treatment group was significantly thicker than that of the hesperetin, sham, and solvent groups (). Conclusions. Hesperetin and naringenin can prevent harmful effects induced by I/R injury in the rat retina by inhibiting apoptosis of retinal cells, which suggests that those flavanones have a therapeutic potential for the protection of ocular ischemic diseases. Selcuk Kara, Baran Gencer, Turan Karaca, Hasan Ali Tufan, Sedat Arikan, Ismail Ersan, Ihsan Karaboga, and Volkan Hanci Copyright © 2014 Selcuk Kara et al. All rights reserved. Hypobaric Hypoxia: Effects on Intraocular Pressure and Corneal Thickness Thu, 16 Jan 2014 13:19:40 +0000 Objective. The purpose of this study focused on understanding the mechanisms underlying ocular hydrodynamics and the changes which occur in the eyes of subjects exposed to hypobaric hypoxia (HH) to permit the achievement of more detailed knowledge in glaucomatous disease. Methods. Twenty male subjects, aged years, attending the Italian Air Force, were enrolled for this study. The research derived from hypobaric chamber, using helmet and mask supplied to jet pilotes connected to oxygen cylinder and equipped with a preset automatic mixer. Results. The baseline values of intraocular pressure (IOP), recorded at T1, showed a mean of  mmHg, while climbing up to 18,000 feet the mean value was  mmHg, recorded at T2. The last assessment was performed returning to sea level (T4) where the mean IOP value was  mmHg, with a significant change () compared to T1. Pachymetry values related to corneal thickness in conditions of hypobarism revealed a statistically significant increase (). Conclusions. The data collected in this research seem to confirm the increasing outflow of aqueous humor (AH) in the trabecular meshwork (TM) under conditions of HH. Marcella Nebbioso, Stefano Fazio, Dario Di Blasio, and Nicola Pescosolido Copyright © 2014 Marcella Nebbioso et al. All rights reserved. Canaloplasty in Open-Angle Glaucoma Surgery: A Four-Year Follow-Up Thu, 16 Jan 2014 12:33:36 +0000 Canaloplasty is a new nonperforating surgical technique for open-angle glaucoma, in which a microcatheter is inserted within Schlemm’s canal for the entire 360 degrees. A 10-0 prolene suture, which is tied to the distal tip of the microcatheter, is then positioned and left tensioned in Schlemm’s canal, thus facilitating aqueous outflow through natural pathways. A small amount of viscoelastic agent is delivered in Schlemm’s canal while the catheter is withdrawn. The mid-term results are very promising. Based on our cohort of 214 patients, the percentages of eyes that obtained postoperative IOP 21 mmHg, 18 mmHg, and 16 mmHg with or without medical therapy after 2 and 3 years were 88.7%, 73.7%, and 46.2% (2 years); 86.2%, 58.6%, and 37.9% (3 years), respectively. The most frequent complications observed included hyphema; descemet membrane detachment; IOP spikes; and hypotony. The advantages of canaloplasty over trabeculectomy include (1) no subconjunctival bleb; (2) no need for antimetabolites; (3) fewer postoperative complications; and (4) a simplified follow-up. The disadvantages include the following: (1) a long and rather steep surgical learning curve; (2) the need of specific instruments; (3) average postoperative IOP levels tend not to be very low; and (4) impossibility to perform the entire procedure in some cases. Paolo Brusini Copyright © 2014 Paolo Brusini. All rights reserved. In Vitro Vitamin K3 Effect on Conjunctival Fibroblast Migration and Proliferation Wed, 08 Jan 2014 16:39:07 +0000 Purpose. To evaluate the dose effect of vitamin K3 on wound healing mechanisms. Methods. Conjunctival fibroblasts were incubated for 24 hours. An artificial wound was made and the cells were incubated with fresh medium plus doses of vitamin K3 to be tested. Wound repair was monitored at 0, 18, 24, and 48 hours. Proliferation was measured in actively dividing cells by [3H]thymidine uptake. Six different groups were tested: group 1/no drugs added, group 2/ethanol 0.1%, group 3/vitamin K3 1 mg/L, group 4/vitamin K3 2 mg/L, group 5/vitamin K3 4 mg/L, and group 6/vitamin K3 6 mg/L. Each experiment was carried out in triplicate and 4 times. Results. There were no differences among groups at the initial time. In vitro wound repair was slower in groups 4, 5, and 6. There were no differences between control and ethanol groups and between control and vitamin K3 1 mg/L groups. Fibroblast mitogenic activity was statistically decreased in all vitamin K groups; statistical differences were found among vitamin K3 1 mg/mL and higher doses too. In groups 5 and 6, cellular toxicity was presented. Conclusions. Vitamin K3 is able to inhibit fibroblast proliferation. Vitamin K3 2 mg/L or higher doses inhibit wound healing repair, exhibiting cellular toxicity at 4 and 6 mg/L. I. Pinilla, L. B. Izaguirre, F. J. Gonzalvo, E. Piazuelo, M. A. Garcia-Gonzalez, A. I. Sanchez-Cano, and F. Sopeña Copyright © 2014 I. Pinilla et al. All rights reserved. Intravitreal Steroids for the Treatment of Retinal Diseases Wed, 08 Jan 2014 09:41:22 +0000 Diabetic macular edema (DME), pseudophakic cystoid macular edema (CME), age-related macular degeneration (AMD), retinal vascular occlusion (RVO), and uveitis are ocular conditions related to severe visual impairment worldwide. Corticosteroids have been widely used in the treatment of these retinal diseases, due to their well-known antiangiogenic, antiedematous, and anti-inflammatory properties. Intravitreal steroids have emerged as novel and essential tools in the ophthalmologist’s armamentarium, allowing for maximization of drug efficacy and limited risk of systemic side effects. Recent advances in ocular drug delivery methods led to the development of intraocular implants, which help to provide prolonged treatment with controlled drug release. Moreover, they may add some potential advantages over traditional intraocular injections by delivering certain rates of drug directly to the site of action, amplifying the drug’s half-life, contributing in the minimization of peak plasma levels of the drug, and avoiding the side effects associated with repeated intravitreal injections. The purpose of this review is to provide an update on the use of intravitreal steroids as a treatment option for a variety of retinal diseases and to review the current literature considering their properties, safety, and adverse events. Valentina Sarao, Daniele Veritti, Francesco Boscia, and Paolo Lanzetta Copyright © 2014 Valentina Sarao et al. All rights reserved. Prospective Study on Retinal Nerve Fibre Layer Thickness Changes in Isolated Unilateral Retrobulbar Optic Neuritis Wed, 25 Dec 2013 15:49:57 +0000 Purpose. To investigate the retinal nerve fibre layer (RNFL) thickness after unilateral acute optic neuritis using optical coherence tomography (OCT). Patients and Methods. This prospective cohort study recruited consecutive patients with a first episode of isolated, unilateral acute optic neuritis. RNFL thickness and visual acuity (VA) of the attack and normal fellow eye were measured at presentation and 3 months in both the treatment and nontreatment groups. Results. 11 subjects received systemic steroids and 9 were treated conservatively. The baseline RNFL thickness was similar in the attack and fellow eye (). At 3 months, the attack eye had a thinner temporal () and average () RNFL compared to the fellow eye. At 3 months, the attack eye had significant RNFL thinning in the 4 quadrants and average thickness () compared to baseline. The RNFL thickness between the treatment and nontreatment groups was similar at baseline and 3 months (). Treatment offered better VA at 3 months (0.1 0.2 versus 0.3 0.2 LogMAR, ). Conclusion. Generalized RNFL thinning occurred at 3 months after a first episode of acute optic neuritis most significantly in the temporal quadrant and average thickness. Visual improvement with treatment was independent of RNFL thickness. Gordon S. K. Yau, Jacky W. Y. Lee, Patrick P. K. Lau, Victor T. Y. Tam, Winnie W. Y. Wong, and Can Y. F. Yuen Copyright © 2013 Gordon S. K. Yau et al. All rights reserved. Chronologic versus Biologic Aging of the Human Choroid Wed, 25 Dec 2013 13:27:20 +0000 Several aspects of chronologic and biologic aging in the human choroid are reviewed from the literature. They often reveal methodological problems for age-dependent changes of the following parameters: choroidal thickness, choroidal pigmentation, choroidal vasculature and blood flow, and choroidal innervation. On reinterpreting some data of studies concerning Bruch’s membrane, changes observed at different age points seem more likely to be nonlinear. Concluding from the data presented so far, chronologic aging should not be used as a factor for physiological changes in the human choroid. Longitudinal study designs are necessary to further establish the impact of age. Meanwhile, a more biologic oriented model of aging processes in the choroid should be established, including specified conditions (e.g., light exposure and refractory state). This would help to define more individual strategies for prevention and early stages of a certain defined disease. Christian Albrecht May Copyright © 2013 Christian Albrecht May. All rights reserved. The Role of Epiretinal Membrane on Treatment of Neovascular Age-Related Macular Degeneration with Intravitreal Bevacizumab Tue, 24 Dec 2013 18:15:59 +0000 Purpose. To determine the effect of epiretinal membranes (ERM) on the treatment response and the number of intravitreal bevacizumab injections (IVB) in patients with neovascular age-related macular degeneration (nAMD). Methods. A retrospective chart review was performed on 63 eyes of 63 patients. The patients were divided into AMD group () and AMD/ERM group (). Best corrected visual acuity (BCVA) and central retinal thickness (CRT), as well as the number of injections, were evaluated. Results. There was a significant improvement in BCVA at 3 months for the AMD and AMD/ERM groups (, , resp.). At 6, 12, and 18 months, BCVA did not change significantly in either of the groups compared to baseline ( for all). At 3, 6, 12, and 24 months, the AMD group had an improvement in BCVA (logMAR) of 0.09, 0.06, 0.06, and 0.03 versus 0.08, 0.07, 0.05, and 0.03 for the AMD/ERM group (, , , , resp.). A significant decrease in CRT occurred in both groups for all time points ( for all). The change in CRT was not statistically different between the two groups at all time points ( for all). The mean number of injections over 24 months was 8.8 in the AMD group and 9.2 in the AMD/ERM group (). Conclusion. During 24 months, visual and anatomical outcomes of IVB in nAMD patients were comparable with those in nAMD patients with ERM with similar injection numbers. Zeynep Alkin, Abdullah Ozkaya, Ozen Ayranci Osmanbasoglu, Alper Agca, Yalcin Karakucuk, Ahmet Taylan Yazici, and Ahmet Demirok Copyright © 2013 Zeynep Alkin et al. All rights reserved. Contrast Sensitivity of Thyroid Associated Ophthalmopathy Patients without Obvious Optic Neuropathy Tue, 24 Dec 2013 18:15:17 +0000 Purpose. To compare the contrast sensitivity levels of thyroid associated ophthalmopathy (TAO) patients without obvious optic neuropathy with those of healthy people. Methods. Forty eyes of 20 TAO patients without dysthyroid optic neuropathy and 40 eyes of 20 healthy subjects were evaluated in this prospective case-controlled study. The contrast sensitivity functions (CSFs) of all subjects were measured by the functional acuity contrast test (FACT) in five frequencies which were 1,5 cpd (A), 3 cpd (B), 6 cpd (C), 12 cpd (D), and 18 cpd (E). Results were compared for both groups, and a correlation of CSF with Hertel and clinical activity scores was assessed. Results. There was no statistically significant difference between TAO patients and control groups for age and sex. TAO patients had lower levels than the control group in all the frequencies of CSFs () and the difference in contrast sensitivity functions between the groups seems to be more significant in higher frequencies (B, C, D, and E) (). Conclusions. TAO patients without DON can have contrast sensitivity loss and this would probably imply subtle optic nerve dysfunction in early disease phase. Ümit Beden, Sümeyra Kaya, Volkan Yeter, and Dilek Erkan Copyright © 2013 Ümit Beden et al. All rights reserved. Blockage of Notch Signaling Inhibits the Migration and Proliferation of Retinal Pigment Epithelial Cells Sun, 22 Dec 2013 14:55:44 +0000 The Notch signaling is an evolutionarily conserved cell-cell communication pathway that plays critical roles in the proliferation, survival, apoptosis, and fate determination of mammalian cells. Retinal pigment epithelial (RPE) cells are responsible for supporting the function of the neural retina and maintaining vision. This study investigated the function of Notch signaling in RPE cells. We found that the members of the Notch signaling pathway components were differentially expressed in RPE cells. Furthermore, blockage of Notch signaling inhibited the migration and proliferation of RPE cells and reduced the expression levels of certain Notch signaling target genes, including HES1, MYC, HEY2, and SOX9. Our data reveal a critical role of Notch signaling in RPE cells, suggesting that targeting Notch signaling may provide a novel approach for the treatment of ophthalmic diseases related to RPE cells. Weiwei Liu, Guorong Jin, Chongde Long, Xin Zhou, Yan Tang, Shan Huang, Xielan Kuang, Lizi Wu, Qingjiong Zhang, and Huangxuan Shen Copyright © 2013 Weiwei Liu et al. All rights reserved. Corneal Sensitivity in Keratoconus: A Review of the Literature Thu, 31 Oct 2013 11:23:45 +0000 Corneal sensitivity has recently received much attention given the crucial role the corneal nerves play in maintaining normal corneal structure and function. An increased understanding of the corneal sensitivity and dry eye disease in keratoconus, including alterations of the conjunctival cells, may help explain the pathogenesis of this disorder. There is histological evidence of the involvement of corneal nerves in the pathology of keratoconus and it has been suggested that this plays a role in the pathophysiological features and progression of the disease. In this review, the impaired corneal sensitivity found on keratoconus and corneal sensitivity changes after cross-linking performed in patients with keratoconus are reported. Leopoldo Spadea, Serena Salvatore, and Enzo Maria Vingolo Copyright © 2013 Leopoldo Spadea et al. All rights reserved. Arteriovenous Passage Times and Visual Field Progression in Normal Tension Glaucoma Thu, 24 Oct 2013 15:13:11 +0000 Purpose. Fluorescein angiographic studies revealed prolonged arteriovenous passage (AVP) times and increased fluorescein filling defects in normal tension glaucoma (NTG) compared to healthy controls. The purpose of this study was to correlate baseline AVP and fluorescein filling defects with visual field progression in patients with NTG. Patients and Methods. Patients with a follow-up period of at least 3 years and at least 4 visual field examinations were included in this retrospective study. Fluorescein angiography was performed at baseline using a confocal scanning laser ophthalmoscope (SLO, Rodenstock Instr.); fluorescein filling defects and AVP were measured by digital image analysis and dye dilution curves (25 Hz). Visual field progression was evaluated using regression analysis of the MD (Humphrey-Zeiss, SITA-24-2, MD progression per year (dB/year)). 72 patients with NTG were included, 44 patients in study 1 (fluorescein filling defects) and 28 patients in study 2 (AVP). Results. In study 1 (mean follow-up years, visual field tests), MD progression per year ( dB/year) was significantly correlated to the age (, ) but not to fluorescein filling defects, IOP, or MD at baseline. In study 2 (mean follow-up years, visual field tests), MD progression per year ( dB/year) was significantly correlated to AVP (, ) but not to age, IOP, or MD at baseline. Conclusion. Longer AVP times at baseline are correlated to visual field progression in NTG. Impaired retinal blood flow seems to be an important factor for glaucoma progression. Eva Charlotte Koch, Kay Oliver Arend, Marion Bienert, Andreas Remky, and Niklas Plange Copyright © 2013 Eva Charlotte Koch et al. All rights reserved. Mean Platelet Volume in Ocular Behçet’s Disease Tue, 22 Oct 2013 14:27:53 +0000 Objective. To determine whether mean platelet volume (MPV) is an indicator of disease severity in ocular Behçet’s Disease (BD). Materials and Methods. The study population was 30 newly diagnosed ocular BD patients who presented with active uveitis. These patients had no past history of smoking, drug use, or systemic diseases including diabetes mellitus, hypertension, cardiovascular disease, and renal disease. A control group consisting of 34 healthy individuals was included for comparison. MPV measurements were performed serially upon presentation with active uveitis and at one and three month thereafter in BD group whereas only at presentation in the controls. Results. Upon presentation with active uveitis, the mean MPV levels were 7.88 ± 1.14 femtoliters (fL) for BD group. During the posttreatment follow-up period at first and third months, BD patients demonstrated a mean MPV level of 7.71 ± 1.12 fL and 7.65 ± 1.04 fL, respectively. The mean MPV value of control group, was 8.39 ± 0.66 fL at presentation. Fluctuations in MPV values were not significant in the BD group, while there was a significant difference between the initial measurements of the BD and control groups. Conclusion. MPV measurement in ocular BD is not a predictive laboratory test to determine the clinical improvement in early stages following classical immunosuppressive treatment. Fatih Mehmet Türkcü, Abdullah Kürşat Cingü, Harun Yüksel, Yasin Çınar, Meltem Akkurt, Muhammed Şahin, Zeynep Özkurt, Alparslan Şahin, and İhsan Çaça Copyright © 2013 Fatih Mehmet Türkcü et al. All rights reserved. The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis Tue, 22 Oct 2013 10:32:02 +0000 Objective. To assess the value of routine polymerase chain reaction (PCR) analysis on intraocular fluid from patients presenting with a first episode of suspected active infectious posterior uveitis in a population with a high prevalence of human immunodeficiency virus infection. Design. Retrospective, interventional case series. Participants. 159 consecutive patients presenting at a tertiary care hospital over a five-year period. Methods. PCR analysis was performed for cytomegalovirus, varicella zoster virus, herpes simplex virus types 1 and 2, Toxoplasma gondii, and Mycobacterium tuberculosis. Results. PCR analysis confirmed the initial clinical diagnosis in 55 patients (35%) and altered the initial clinical diagnosis in 36 patients (23%). The clinical diagnosis prior to PCR testing was nonspecific (uncertain) in 51 patients (32%), with PCR providing a definitive final diagnosis in 20 of these patients (39%); necrotizing herpetic retinopathy and ocular toxoplasmosis were particularly difficult to diagnose correctly without the use of PCR analysis. Conclusion. The clinical phenotype alone was unreliable in diagnosing the underlying infectious cause in a quarter of patients in this study. Since the outcome of incorrectly treated infective uveitis can be blinding, PCR analysis of ocular fluids is recommended early in the disease even in resource poor settings. Marius A. Scheepers, Karin A. Lecuona, Graeme Rogers, Catey Bunce, Craig Corcoran, and Michel Michaelides Copyright © 2013 Marius A. Scheepers et al. All rights reserved. Epidemiological Study of Hospital-Acquired Bacterial Conjunctivitis in a Level III Neonatal Unit Mon, 20 May 2013 14:39:34 +0000 Background. Conjunctivitis is one of the most frequently occurring hospital-acquired infections among neonates, although it is less studied than potentially life-threatening infections, such as sepsis and pneumonia. Objectives. The aims of our work were to identify epidemiologic characteristics, pathogens, and susceptibility patterns of bacterial hospital-acquired conjunctivitis (HAC) in a level III neonatal unit. Materials and Methods. Data were collected retrospectively from patient charts and laboratory databases. Hospital-acquired conjunctivitis was defined in accordance with the Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) diagnostic criteria. Results. One or more episodes of HAC were diagnosed in 4,0% () of 1492 neonates admitted during the study period. Most of the episodes involved premature (75,4%) and low birth weight (75,4%) neonates. Infection rates were higher among patients undergoing noninvasive mechanical ventilation (46,7%), parenteral nutrition (13,6%), and phototherapy (6,8%). Predominant pathogens included Serratia marcescens (27,9%), Escherichia coli (23%), and Pseudomonas aeruginosa (18%). Susceptibility patterns revealed bacterial resistances to several antibiotic classes. Gentamicin remains the adequate choice for empirical treatment of HAC in our NICU. Conclusion. It is important to know the local patterns of the disease in order to adjust prevention strategies. Our work contributes to the epidemiological characterization of a sometimes overlooked disease. Catarina Dias, Márcia Gonçalves, and Anabela João Copyright © 2013 Catarina Dias et al. All rights reserved. Will the SAFE Strategy Be Sufficient to Eliminate Trachoma by 2020? Puzzlements and Possible Solutions Sun, 19 May 2013 08:40:45 +0000 Since the inception of (the Global Elimination of Blinding Trachoma) GET 2020 in 1997 and the implementation of the SAFE strategy a year later, much progress has been made toward lowering the prevalence of trachoma worldwide with elimination of the disease in some countries. However, high recurrence of trichiasis after surgery, difficulty in controlling the reemergence of infection after mass distribution of azithromycin in some communities, the incomplete understanding of environment in relation to the disease, and the difficulty in establishing the prevalence of the disease in low endemic areas are some of the issues still facing completion of the GET 2020 goals. In this narrative review, literature was searched from 1998 to January 2013 in PubMed for original studies and reviews. Reasons for these ongoing problems are discussed, and several suggestions are made as avenues for exploration in relation to improving the SAFE strategy with emphasis on improving surgical quality and management of the mass treatment with antibiotics. In addition, more research needs to be done to better understand the approach to improve sanitation, hygiene, and environment. The main conclusion of this review is that scale-up is needed for all SAFE components, and more research should be generated from communities outside of Africa and Asia. Diane K. Lavett, Van C. Lansingh, Marissa J. Carter, Kristen A. Eckert, and Juan C. Silva Copyright © 2013 Diane K. Lavett et al. All rights reserved. Long-Term Effects of Cataract Surgery on Tear Film Parameters Sun, 20 Jan 2013 14:37:01 +0000 Purpose. To examine the differences in tear film parameters more than 3 months postsurgery in eyes with cataract surgery (surgical eyes) versus eyes without cataract surgery (nonsurgical eyes). Methods. 29 patients were seen at the Miami Veterans Affairs Medical Center (VAMC) who had cataract surgery by phacoemulsification in one eye more than 3 months prior to the study date and had no history of surgical intervention in their fellow eye. Tear film parameters were measured in both eyes and compared using McNemar tests for dichotomous variables and paired and single sample t-tests for continuous variables. Results. Mean patient age was 73 (standard deviation (SD): 11); 26 patients (90%) identified themselves as White and 7 (24%) as Hispanic. The mean number of days between surgery and this study was 952 (SD: 1109). There were no statistical differences between the surgical eye and the nonsurgical eye with respect to any of the measured tear film parameters. Confidence intervals around these differences were narrow enough to exclude a substantial effect of cataract surgery. The elapsed time between cataract surgery and measurement of the tear parameters did not appear to affect the difference in parameters between the two eyes. Conclusion. We found that eyes that had cataract surgery more than 3 months prior to testing had no differences in their tear film parameters compared to eyes without a history of surgery. Vincent D. Venincasa, Anat Galor, William Feuer, David J. Lee, Hermes Florez, and Michael J. Venincasa Copyright © 2013 Vincent D. Venincasa et al. All rights reserved. Knowledge, Attitude, and Practice of Dry Eye Treatment by Institutional Chinese Physicians in Singapore Thu, 08 Nov 2012 09:46:16 +0000 Dry eye is a common health problem worldwide, causing significant discomfort and inconvenience to sufferers. The conventional treatment of dry eye via topical administration of eye drops is deemed palliative and unsatisfactory to many. Traditional Chinese medicine (TCM) has shown some promise in dry eye treatment; however, the extent of its use and acceptance is uncertain. We evaluated the knowledge, attitude, and practice of institutional TCM practitioners in the treatment of dry eye in Singapore. A questionnaire was generated to address the study aims and sent to TCM practitioners listed in the Singapore TCM practitioners’ board database. About three quarters of respondents thought that dry eye was not severe enough to be a public health burden but most thought that TCM was effective in the treatment of dry eye. Acupuncture and herbal medicine were most commonly used TCM modalities in dry eye treatment, and a single TCM treatment session would be charged S$20–50 by the practitioner. The majority of surveyed institutional TCM practitioners in Singapore believe that TCM is relevant in dry eye treatment. Public awareness should be raised regarding the availability of TCM as alternative medicine for dry eye. Wanwen Lan, Sze Yee Lee, Man Xin Lee, and Louis Tong Copyright © 2012 Wanwen Lan et al. All rights reserved. The Dry Eye Disease Activity Log Study Wed, 24 Oct 2012 10:39:41 +0000 Prolonged visually stressful activities aggravate dry eye disease (DED). The duration spent on such activities and their relationship with DED clinical features were investigated. Patients completed an activity log as they performed their usual activities over 1 typical rest day and 1 typical work day. The log included time spent in an air-conditioned environment, windy environment, driving, watching television, computer use, reading, watching a movie in the theatre, and wearing contact lens. Average daily activity hours were calculated and correlated with clinical features of DED. Thirty-five logs were returned. Positive correlation was found between watching television and episodic blurred vision (). Computer use was negatively correlated with episodic blur vision, burning sensation, and gritty sensation (). Negative correlation was found between time spent in windy environments, driving, reading, and certain DED symptoms (). Reading correlated positively with severity of corneal fluorescein staining and reduced Schirmer’s values (). The use of air conditioning correlated negatively with episodic blur vision but positively with visual blurring that improves with lubricants (). This study is the first to evaluate the relationship between time spent on DED-aggravating activities and DED clinical features. Negative correlations between certain activities and DED symptoms suggest an unconscious modification of lifestyle to alleviate symptoms. Jayant V. Iyer, Sze-Yee Lee, and Louis Tong Copyright © 2012 Jayant V. Iyer et al. All rights reserved. Comparison of Central Macular Thickness Measured by Three OCT Models and Study of Interoperator Variability Wed, 22 Aug 2012 10:32:33 +0000 Purpose. To compare central macular thickness (CMT) measurement on healthy patient using 3 different OCT devices by two operators. Methods. Prospective, monocentricstudy. Right eye’s central macular thickness (CMT) of 30 healthy patients has been measured three times using a time-domain (TD) OCT (Stratus OCT, Carl Zeiss Meditec, Dublin, Ca) and two spectral domain (SD) OCTs (Cirrus HD-OCT, Carl ZeissMeditec, Dublin, Ca) and 3D-OCT 1000 (Topcon, Tokyo, Japan) by two operators. Six measurements were taken randomly for each patient the same day. Results. No significant difference between measurements obtained by the two operators has been observed, whatever the studied OCT. P value was 0.164, 0.193, and 0.147 for Stratus OCT, Cirrus HD-OCT and 3D-OCT, respectively. Mean CMT significantly differed from instrument to instrument (𝑃<0.001) and was, respectively, 197 μm, 254 μm, and 236 μm using Stratus OCT, Cirrus HD-OCT, and 3D-OCT 1000. Using Cirrus OCT and 3D-OCT 1000, CMT was, respectively, 57 μm and 39 μm thicker than using Stratus OCT (𝑃<0.05). Conclusions. Whatever the OCT device, on healthy patients CMT was not operator dependent. CMT measurements obtained by SD-OCTs are greater than those obtained by TD-OCT. These data imply that the different OCT devices cannot be used interchangeably in clinical monitoring. Zaïnab Bentaleb-Machkour, Eléonore Jouffroy, Muriel Rabilloud, Jean-Daniel Grange, and Laurent Kodjikian Copyright © 2012 Zaïnab Bentaleb-Machkour et al. All rights reserved. The rs2071559 AA VEGFR-2 Genotype Frequency Is Significantly Lower in Neovascular Age-Related Macular Degeneration Patients Wed, 01 Aug 2012 09:17:29 +0000 In this prospective, case-control genetic study, 120 consecutive neovascular age-related macular degeneration (AMD) cases and 78 controls were enrolled. Two SNPs (rs2071559 and rs1870377) of VEGF-A receptor-2 (VEGFR-2) gene were analyzed with the technique of Real-Time PCR to investigate a genetic link between AMD and VEGFR-2 gene polymorphisms in Italian patients. The frequency of the VEGFR-2 genotype rs2071559 AA was significantly lower (18.33%) in patients with AMD than in the control subjects (34.62%; 𝑃=0.0095, chi-square test; 𝑃corr=0.038; OR=0.42, 95% CI 0.22 to 0.82). In conclusion, although with the limitations of a small sample size and the few SNPs studied, this study demonstrates a lower frequency of VEGFR-2 rs2071559 AA genotype in an AMD patient population, suggesting future studies on the role VEGFR-2 SNPs. Stefano Lazzeri, Paola Orlandi, Michele Figus, Anna Fioravanti, Elisa Cascio, Teresa Di Desidero, Elisa Agosta, Bastianina Canu, Maria Sole Sartini, Romano Danesi, Marco Nardi, and Guido Bocci Copyright © 2012 Stefano Lazzeri et al. All rights reserved. Both Freshly Prepared and Frozen-Stored Amniotic Membrane Cells Express the Complement Inhibitor CD59 Tue, 22 May 2012 15:49:09 +0000 Amniotic membrane proved to be very effective tool in the treatment of a number of ocular surface diseases. The amniotic membrane, however, has to be stored before its transplantation onto the ocular surface followed by mandatory serologic control in order to exclude the transmission of certain viruses. Therefore it is most important to study if cryopreservation of the membrane affects cell surface expression of the molecules. We measured cell surface expression of CD59, a membrane-bound complement inhibitor on the cells of freshly prepared and cryopreserved amniotic membrane. Cells of amniotic membrane were separated mechanically. Epithelial and mesenchymal cells were identified by the intracellular expression of nanog and the cell surface ICAM1 positivity, respectively. Multicolor flow cytometric immunophenotyping was used for determination of the CD59 expression. CellQuest-Pro software program (Becton Dickinson) was used both for measurements and analysis. CD59-positive cells could be detected in all investigated samples and in all investigated cell types, although the expression level of CD59 differed. CD59 was expressed both on freshly prepared and frozen-stored samples. Higher level of CD59 was detected on ICAM1+ mesenchymal cells than on nanog+ epithelial cells. Our findings indicate that amniotic membranes maintain their complement inhibiting capacity after cryopreservation. Ágnes Füst, Éva Pállinger, Adrienn Stündl, Eszter Kovács, László Imre, Sára Tóth, and János Németh Copyright © 2012 Ágnes Füst et al. All rights reserved. Algorithms and Results of Eye Tissues Differentiation Based on RF Ultrasound Wed, 02 May 2012 13:52:26 +0000 Algorithms and software were developed for analysis of B-scan ultrasonic signals acquired from commercial diagnostic ultrasound system. The algorithms process raw ultrasonic signals in backscattered spectrum domain, which is obtained using two time-frequency methods: short-time Fourier and Hilbert-Huang transformations. The signals from selected regions of eye tissues are characterized by parameters: B-scan envelope amplitude, approximated spectral slope, approximated spectral intercept, mean instantaneous frequency, mean instantaneous bandwidth, and parameters of Nakagami distribution characterizing Hilbert-Huang transformation output. The backscattered ultrasound signal parameters characterizing intraocular and orbit tissues were processed by decision tree data mining algorithm. The pilot trial proved that applied methods are able to correctly classify signals from corpus vitreum blood, extraocular muscle, and orbit tissues. In 26 cases of ocular tissues classification, one error occurred, when tissues were classified into classes of corpus vitreum blood, extraocular muscle, and orbit tissue. In this pilot classification parameters of spectral intercept and Nakagami parameter for instantaneous frequencies distribution of the 1st intrinsic mode function were found specific for corpus vitreum blood, orbit and extraocular muscle tissues. We conclude that ultrasound data should be further collected in clinical database to establish background for decision support system for ocular tissue noninvasive differentiation. R. Jurkonis, A. Janušauskas, V. Marozas, D. Jegelevičius, S. Daukantas, M. Patašius, A. Paunksnis, and A. Lukoševičius Copyright © 2012 R. Jurkonis et al. All rights reserved. Characterization and Comparison of the 10-2 SITA-Standard and Fast Algorithms Wed, 02 May 2012 13:29:16 +0000 Purpose: To compare the 10-2 SITA-standard and SITA-fast visual field programs in patients with glaucoma. Methods: We enrolled 26 patients with open angle glaucoma with involvement of at least one paracentral location on 24-2 SITA-standard field test. Each subject performed 10-2 SITA-standard and SITA-fast tests. Within 2 months this sequence of tests was repeated. Results: SITA-fast was 30% shorter than SITA-standard (5.5±1.1 vs 7.9±1.1 minutes, 𝑃<0.001). Mean MD was statistically significantly higher for SITA-standard compared with SITA-fast at first visit (Δ=0.3 dB, 𝑃=0.017) but not second visit. Inter-visit difference in MD or in number of depressed points was not significant for both programs. Bland-Altman analysis showed that clinically significant variations can exist in individual instances between the 2 programs and between repeat tests with the same program. Conclusions: The 10-2 SITA-fast algorithm is significantly shorter than SITA-standard. The two programs have similar long-term variability. Average same-visit between-program and same-program between-visit sensitivity results were similar for the study population, but clinically significant variability was observed for some individual test pairs. Group inter- and intra-program test results may be comparable, but in the management of the individual patient field change should be verified by repeat testing. Yaniv Barkana, Erez Bakshi, Yakov Goldich, Yair Morad, Audrey Kaplan, Isaac Avni, and David Zadok Copyright © 2012 Yaniv Barkana et al. All rights reserved. Standard Enucleation with Aluminium Oxide Implant (Bioceramic) Covered with Patient's Sclera Mon, 30 Apr 2012 15:31:19 +0000 Purpose. We describe in our study a modified standard enucleation, using sclera harvested from the enucleated eye to cover the prosthesis in order to insert a large porous implant and to reduce postoperative complication rates in a phthisis globe. Methods. We perform initially a standard enucleation. The porous implant (Bioceramic) is then covered only partially by the patient's sclera. The implant is inserted in the posterior Tenon's space with the scleral covering looking at front. All patients were followed at least for twelve months (average followup 16 months). Results. We performed nineteen primary procedures (19 patients, 19 eyes, 𝑥 M; 𝑥 F) and secondary, to fill the orbital cavity in patients already operated by standard evisceration (7 patients, 7 eyes). There were no cases of implant extrusion. The orbital volume was well reintegrated. Conclusion. Our procedure was safe and effective. All patients had a good cosmetic result after final prosthetic fitting and we also achieved good prothesis mobility. Gian Luigi Zigiotti, Sonia Cavarretta, Mariachiara Morara, Sang Min Nam, Stefano Ranno, Francesco Pichi, Andrea Lembo, Stefano Lupo, Paolo Nucci, and Alessandro Meduri Copyright © 2012 Gian Luigi Zigiotti et al. All rights reserved. Transcaruncular Medial Wall Orbital Decompression: An Effective Approach for Patients with Unilateral Graves Ophthalmopathy Mon, 30 Apr 2012 11:13:21 +0000 Purpose. To evaluate the reduction in proptosis, incidence of postoperative diplopia, and postoperative globe symmetry after transcaruncular medial wall decompression in patients with unilateral Graves ophthalmopathy. Methods. Retrospective review of 16 consecutive patients who underwent unilateral transcaruncular medial wall orbital decompression from 1995 to 2007. The diagnosis of Graves ophthalmopathy was based on history and clinical findings including proptosis, lagophthalmos, lid retraction, motility restriction, and systemic thyroid dysfunction. Results. The mean reduction in proptosis was 2.3 mm. The mean difference in exophthalmometry preoperatively between the two eyes in each patient was 3.1 mm whereas postoperatively the mean difference was 1.1 mm (𝑃=0.0002). Eleven of 16 patients (69%) had 1 mm or less of asymmetry postoperatively. There was no statistically significant difference in the incidence of diplopia pre- and postoperatively (𝑃=1.0). Conclusions. Medial wall orbital decompression is a safe and practical surgical approach for patients with unilateral Graves orbitopathy. The procedure carries a low risk of morbidity and yields anatomic retrusion of the globe that is comparable to other more invasive methods and may yield more symmetric postoperative results. Robert H. Hill, Craig N. Czyz, and Thomas A. Bersani Copyright © 2012 Robert H. Hill et al. All rights reserved. An Overview on Dry Eye Treatment: Approaches for Cyclosporin A Delivery Tue, 24 Apr 2012 13:32:29 +0000 Dry eye syndrome (DES, Keratoconjunctivitis sicca) is a common disorder of the tear film caused by decreased tear production or increased evaporation. Changes in tear composition also promote inflammation on the ocular surface by various mechanisms. Artificial tear drops, tear retention treatment, stimulation of tear secretion, or anti-inflammatory drugs may be used for dry eye treatment according to the severity of the disease. For untreated patients, the risk of ocular infection increases at considerable level and clinical course of the disease may proceed up to infection, corneal ulcer, and blindness. Artificial tears and/or punctual occlusions are used for tear replacement or preservation. New treatment approaches are designed to modify the underlying disease process. For the treatment of severe dry eye disease, cyclosporin A (CsA), the first one of the new generation immunomodulatory drugs, which has an anti-inflammatory effect, is frequently used. CsA has immunosuppressive effects following systemic application. Following local administration of CsA, it is expected to obtain effective drug concentration at the target area and to avoid the various side effects associated with systemic delivery. Microspheres, implants, and liposomes have been developed for administration of CsA subconjunctivally in order to enhance its efficiency. Burçin Yavuz, Sibel Bozdağ Pehlivan, and Nurşen Ünlü Copyright © 2012 Burçin Yavuz et al. All rights reserved. Endothelial Cell Markers in Patients with Pseudoexfoliation Syndrome Thu, 19 Apr 2012 16:34:25 +0000 The aim of the study was the assessment of the von Willebrand antigen (vWF Ag), E-selectin, and P-selectin concentration in blood plasma of patients with pseudoexfoliation syndrome (PEX). The group studied comprised 30 patients with PEX, aged from 50 to 86 years (mean 73, SD ± 8 years). Patients with cardiovascular and cerebrovascular diseases, diabetes mellitus, infectious disease, cancer, renal or liver insufficiency, connective tissue disease, current smoking, and hormone, antiplatelet, hypolipidemic, antioxidant, or antihypertensive drug therapy were excluded from the study. Each subject underwent a complete ophthalmological examination. Venous blood samples from the cubital vein were taken into sodium citrate solution. VWF Ag, sP-selectin, and sE-selectin concentration were determined by a commercially available enzyme-linked immunosorbent assay (MedSystems, Diagnostica Stago/Roche, R&D). Concentrations of vWF Ag, soluble E-selectin, and soluble P-selectin in blood plasma in the study group were compared with the levels in blood plasma in the control group. No significant differences were found between the groups. Our results indicate that there might be no correlation between PEX and such endothelial cell markers as vWF Ag, sP-selectin, and sE-selectin concentrations. Since the study size is limited, further investigations to confirm that there is no association between endothelial dysfunction in PEX and risk of future cardiovascular disease are necessary. Joanna Stafiej, Grażyna Malukiewicz, Hanna Lesiewska-Junk, Danuta Rość, and Karolina Kaźmierczak Copyright © 2012 Joanna Stafiej et al. All rights reserved. A Prospective Study Evaluating IOP Changes after Switching from a Therapy with Prostaglandin Eye Drops Containing Preservatives to Nonpreserved Tafluprost in Glaucoma Patients Thu, 19 Apr 2012 13:53:05 +0000 Purpose. To compare the ocular hypotensive effect of tafluprost with prostaglandin analogues (PGAs) in glaucoma patients. Methods. 89 primary open-angle glaucoma patients treated with bimatoprost, latanoprost, or travoprost for at least 3 months complaining for ocular discomfort were switched to tafluprost. IOP was assessed at baseline and 3 months after switching the therapy by daily curve. Primary outcome was to compare the mean daily IOP of tafluprost with PGAs. Results. The mean daily IOP was 16±2.1 and 16.6±2.0?mm Hg at baseline and after switching to tafluprost, respectively (??>0.05). When analysis was carried out between tafluprost and each previous PGAs, the comparison between latanoprost and tafluprost and travoprost and tafluprost did not show any statistically significant difference in mean daily IOP and at each time point. The comparison between bimatoprost and tafluprost showed a statistically significant difference in mean daily IOP (??<0.05) and at each time point (??<0.05). Conclusions. After 3 months of switching tafluprost showed an overall IOP lowering effect similar to others PGAs. When each PGA was compared with tafluprost, bimatoprost showed to provide a statistically significant additional IOP lowering effect. Stefano Ranno, Matteo Sacchi, Cinzia Brancato, Daniela Gilardi, Andrea Lembo, and Paolo Nucci Copyright © 2012 Stefano Ranno et al. All rights reserved. Changes of Radial Diffusivity and Fractional Anisotopy in the Optic Nerve and Optic Radiation of Glaucoma Patients Thu, 19 Apr 2012 10:59:24 +0000 Purpose of this study was to evaluate with diffusion-tensor imaging (DTI) changes of radial diffusivity (RD) and fractional anisotropy (FA) in the optic nerve (ON) and optic radiation (OR) in glaucoma and to determine whether changes in RD and FA correlate with disease severity. Therefore, glaucoma patients and controls were examined using 3T. Regions of interest were positioned on RD and FA maps, and mean values were calculated for ON and OR and correlated with optic nerve atrophy and reduced spatial-temporal contrast sensitivity (STCS) of the retina. We found, that RD in glaucoma patients was significantly higher in the ON (0.74 ± 0.21 versus 0.58 ± 0.17·10−3 mm2 s−1; 𝑃<0.05) and OR (0.79 ± 0.23 versus 0.62 ± 0.14·10−3 mm2 s−1; 𝑃<0.05) compared to controls. Aside, FA was significantly decreased (0.48 ± 0.15 versus 0.66 ± 0.12 and 0.50 ± 0.20 versus 0.66 ± 0.11; 𝑃<0.05). Hereby, correlation between changes in RD/FA and optic nerve atrophy/STCS was observed (𝑟>0.77). In conclusion, DTI at 3 Tesla allows robust RD and FA measurements in the ON and OR. Hereby, the extent of RD increase and FA decrease in glaucoma correlate with established ophthalmological examinations. Tobias Engelhorn, Georg Michelson, Simone Waerntges, Marlen Otto, Ahmed El-Rafei, Tobias Struffert, and Arnd Doerfler Copyright © 2012 Tobias Engelhorn et al. All rights reserved. The Diagnosis and Treatment of Infantile Nystagmus Syndrome (INS) Mon, 01 Jan 1900 00:00:00 +0000 The successful treatment of infantile nystagmus syndrome (INS) depends primarily on accurate and repeatable diagnosis of the type(s) of nystagmus present as well as their variation with gaze and convergence angles or fixating eye. Research over the past 40 years has demonstrated that the only way to achieve both is by making and analyzing ocular motility recordings. Determination of the direct effects of peripheral and central INS therapies can only be made by pre- and post-therapy comparisons of the nystagmus characteristics, specifically of the quality of the foveation periods within each cycle. If one is only interested in cosmetic improvements, diminution of the nystagmus amplitude is all that need be measured. However, if improvement of visual function is the primary goal of therapy, then measurement of the pre- and post-therapy foveation quality must be made, both in primary position and over a broad range of gaze angles. The use of the eXpanded Nystagmus Acuity Function (NAFX) on nystagmus data yields both an accurate measure of foveation quality and a prediction of maximum potential acuity for the patient's waveform. When used with the patient's measured, pre-therapy visual acuity, the NAFX demonstrates the amount of visual acuity loss that is due to sensory abnormalities, demonstrates the amount due to the nystagmus waveform, and estimates the measured post-therapy acuity for all values of improved NAFX and gaze angles measured. The ability to predict visual acuity improvement was not possible before the use of the NAFX. The failure to incorporate accurate measures of nystagmus waveform and foveation quality into their diagnostic evaluation continues to deprive patients of the best possible standard of care and results in mistaken diagnoses as well as inappropriate and, in some cases, unneeded multiple surgeries. Sangeeta Khanna and Louis F. Dell'Osso Copyright © 2006 Sangeeta Khanna and Louis F. Dell’Osso. All rights reserved. Ocular Defects in Photosensitive Epilepsy Mon, 01 Jan 1900 00:00:00 +0000 Patients with photosensitive epilepsy are susceptible to seizures due to photoparoxysmal response (PPR). This response adversely precipitates factors that modify the functional status of the visual system. Such factors may or may not be evident superficially, but may lead to ocular defects due to trauma, hormonal imbalance, abnormal intraocular pressure (IOP), or any other reflex-inducing stimuli. The extent to which photosensitive epileptic patients suffer from PPR-related ocular defects has not been documented fully. In this investigation, ocular defects in patients with photosensitive epilepsy are studied using visual-evoked response (VER). A total of 212 photosensitive epileptic patients were studied to ascertain the magnitude and distribution of ocular defects using the changes in EEG and visual-evoked potential (VEP); 51% of the patients were female, the age range was 1–46 years. The major ocular defects and complications found were visual field defects, optic nerve abnormalities, nystagmus, cataracts, amblyopia, and migraine. These findings were analyzed according to age and sex. The relationship between the ocular abnormalities and the interpretations of the changes in the characteristics of the VEP indicated that optic-related atrophies, visual defects, optic neuritis, chiasmal compression, nystagmus, migraine headache, cataracts, and amblyopia were prevalent in photosensitive epileptic patients at varying degrees. The results showed that although ocular defects in photosensitive epilepsy may not be obvious differentially, VEP can be used in their diagnosis, contrary to earlier studies reporting that VEP is not of much value in epilepsy diagnosis. Ebere C. Anyanwu and John Ehiri Copyright © 2004 Ebere C. Anyanwu and John Ehiri. All rights reserved. Reversal of Bilateral Rosette Cataracts with Glycemic Control Mon, 01 Jan 1900 00:00:00 +0000 Hema Ramkumar and Surendra Basti Copyright © 2008 Hema L Ramkumar and Surendra Basti. All rights reserved. Crystal Structure of Rhodopsin: Implication for Vision and Beyond. Mechanisms of Acti Mon, 01 Jan 1900 00:00:00 +0000 Krzysztof Palczewski Copyright © 2002 Krzysztof�Palczewski. All rights reserved. Light-induced Photoreceptor Apoptosis in vivo is Caspase Independent and Mediated by Nitric Oxide Mon, 01 Jan 1900 00:00:00 +0000 Maryanne Donovan, Ruaidhri J. Carmody, and Thomas G. Cotter Copyright © 2001 Maryanne Donovan et al. All rights reserved.