1: Acta Ophthalmol Scand. 2007 Dec;85(8):911-3. 

Expression of interleukin-6, tumour necrosis factor-alpha and nitric oxides
during episodes of ocular toxoplasmosis in an HIV patient.

Prada J, Liekfeld A, Bergmann F, Grobusch MP.

Publication Types:
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't

PMID: 18028121  [PubMed - indexed for MEDLINE]

2: Acta Ophthalmol Scand. 2007 Dec;85(8):907-8. 

Varicella chorioretinitis.

Aslan O, Soykan E, Ozkan SS.

Department of Retina, M.H. Ulucanlar Eye Education and Research Hospital,
Ankara, Turkey. aslanozlem@hotmail.com

Publication Types:
    Case Reports

PMID: 18028120  [PubMed - indexed for MEDLINE]

3: Acta Ophthalmol Scand. 2007 Dec;85(8):822-7. 

Pseudoexfoliation in the Reykjavik Eye Study: prevalence and related
ophthalmological variables.

Arnarsson A, Damji KF, Sverrisson T, Sasaki H, Jonasson F.

Department of Ophthalmology, University of Iceland, Reykjavik, Iceland.

PURPOSE: To examine the age and sex-specific prevalence of pseudoexfoliation
syndrome (PEX) and its relationship with some ophthalmological variables.
METHODS: We carried out a population-based study using a random sample taken
from the national population census for citizens of Reykjavik, aged > or = 50
years. A total of 1045 individuals participated in all parts of the study.
Pseudoexfoliation was established by slit-lamp examination with a maximally
dilated pupil carried out by two experienced ophthalmologists, who were masked
to one another's results except in cases of disagreement where they had to reach
a consensus. RESULTS: In all, 108 (10.7%) persons were found to have PEX in at
least one eye. Prevalence increased from 2.5% in those aged 50-59 years to 40.6%
in those aged > or = 80 years. Women were more frequently affected than men
(12.3% versus 8.7%). This difference remained statistically significant after
controlling for the effect of age (p < 0.001). Eyes with PEX were found to have
higher intraocular pressure (IOP) than eyes without PEX (p < 0.05). However, PEX
was not found to be related to central corneal thickness, anterior chamber
depth, lens thickness, nuclear lens opacifications or optic disc morphology in a
multivariate model. CONCLUSIONS: Pseudoexfoliation is an age-related phenomenon
commonly found in Iceland. It is more commonly found in women than in men and is
associated with elevated IOP.

Publication Types:
    Research Support, Non-U.S. Gov't

PMID: 18028119  [PubMed - indexed for MEDLINE]

4: Acta Ophthalmol Scand. 2007 Dec;85(8):808-9. 

Solving the enigma of exfoliation glaucoma: a breakthrough in glaucoma research.

Jonasson F.

Publication Types:
    Editorial

PMID: 18028118  [PubMed - indexed for MEDLINE]

5: Acta Ophthalmol Scand. 2007 Dec;85(8):832-7. Epub 2007 Nov 6. 

Incidence and prevalence of pseudoexfoliations and open-angle glaucoma in
northern Sweden: II. Results after 21 years of follow-up.

Astrom S, Stenlund H, Linden C.

Department of Clinical Sciences, Ophthalmology, Umea University, Umea, Sweden.
siv.astrom@vll.se

PURPOSE: To prospectively evaluate the prevalence and incidence of
pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) with and without
PEX and to evaluate PEX as a risk factor for glaucoma in a population born in
1915 and living in the municipality of Skelleftea in northern Sweden. METHODS: A
randomized population study comprising 339 individuals. The cohort was followed
for 21 years at 7 year intervals. The examination included tonometry, dilated
slit-lamp biomicroscopy, optic disc evaluation and, if glaucoma was suspected, a
visual field analysis. RESULTS: The prevalence of PEX increased from 23%[95%
confidence interval (CI): 20-26] at 66 years of age to 61% (CI 50-71) at 87
years. The annual incidence of PEX was 1.8% (CI 1.3-2.4). In the group of
subjects with unilateral PEX, 55% converted to bilateral PEX during follow-up.
The prevalence of OAG was 2.1% (CI 0.8-4.3%) at 66 years of age and 25% (CI
16-35) at 87 years. Of the glaucoma cases, 59% had PEX. There was no difference
in incidence between the sexes. The annual incidence of PEX and OAG did not
increase with time. The overall annual incidence of OAG was 0.9% (CI 0.6-1.3%)
[0.5% (CI 0.2-0.9) without PEX and 2.1% (CI 1.2-3.3) with PEX]. PEX increased
the risk of glaucoma four fold in both sexes. There was no significant
difference in mortality between individuals with or without PEX. CONCLUSION: PEX
syndrome and OAG are common in the north of Sweden. Prevalences increase with
age. PEX increases the risk of glaucoma four fold. The consequences of this
situation demand guidelines for handling patients with PEX, with or without
other risk factors. In order to issue guidelines, more information is needed on
the impact of the disease on the general health in the ageing population.

Publication Types:
    Research Support, Non-U.S. Gov't

PMID: 17986292  [PubMed - indexed for MEDLINE]

6: Acta Ophthalmol Scand. 2007 Dec;85(8):828-31. Epub 2007 Nov 6. 

Incidence and prevalence of pseudoexfoliation and open-angle glaucoma in
northern Sweden: I. Baseline report.

Astrom S, Linden C.

Department of Clinical Sciences, Ophthalmology, Umea University, Umea, Sweden.
siv.astrom@vll.se

PURPOSE: To evaluate the prevalence of pseudoexfoliation (PEX) syndrome and
open-angle glaucoma (OAG) among 66-year-old people in the municipality of
Skelleftea in northern Sweden. METHODS: A population-based study comprising 339
individuals, representing 40% of the age group and 87% of those randomly
selected. The examination included tonometry, dilated slit-lamp biomicroscopy,
optic disc evaluation and a visual field analysis if glaucoma was suspected.
RESULTS: The overall prevalence of PEX syndrome was 23%[95% confidence interval
(CI): 20-26%], 29% (CI: 24-34%) in women and 15% (CI: 10-19%) in men (P < 0.01).
The intraocular pressure (IOP) in PEX eyes was higher (17.3 mmHg, SD 4.5 mmHg)
than in eyes without PEX [15.7 mmHg, SD 3.7 mmHg; P < 0.001]. IOP exceeded 22
mmHg in 17% (CI: 11-23%) of the PEX eyes and in 3.0% (CI: 1.9-4.1%) of the
non-PEX eyes. Seven individuals (2.1%) had OAG. Six were associated with PEX,
i.e. 7.7% of the PEX individuals. CONCLUSION: PEX syndrome is common in northern
Sweden, affecting every fourth individual reaching the age of 66 years. The
prevalence in women is twice that in men. Elevated IOP is roughly six times more
frequent in eyes with PEX than in eyes without PEX syndrome. The prevalence of
OAG is 2.1%.

Publication Types:
    Research Support, Non-U.S. Gov't

PMID: 17986290  [PubMed - indexed for MEDLINE]

7: Acta Ophthalmol Scand. 2007 Nov;85(7):772-6. 

Glycaemic control and control of risk factors in diabetes patients in an
ophthalmology clinic: what lessons have we learned from the UKPDS and DCCT
studies?

Higgins GT, Khan J, Pearce IA.

St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
chanhiggins@tiscali.co.uk

PURPOSE: The Diabetes Control and Complications Trial (DCCT) and UK Prospective
Diabetes Study (UKPDS) have studied glycaemic control as well as other risk
factors in preventing the progression of diabetic end-organ disease, including
diabetic retinopathy. We wished to determine to what extent a cross-section of
diabetes patients attending our eye clinic met the targets laid down by recent
landmark studies. METHODS: We prospectively assessed 44 consecutive diabetes
patients attending outpatient clinics for assessment of diabetic retinopathy.
Each patient had HbA1c levels, serum cholesterol and blood pressure checked. A
proforma was completed for each patient. RESULTS: Of the 44 patients studied, 11
had type 1 diabetes mellitus (DM) and 33 had type 2 DM (11 insulin-dependent DM
[IDDM], 22 non-insulin-dependent DM [NIDDM]). The mean age of type 1 DM patients
was 43 years; that of type 2 DM patients was 62 years. Five of 11 (46%) type 1
DM patients had poorly controlled diabetes (HbA1c > 9%) compared with four of 33
(12%) type 2 DM patients. Overall, 27 of 44 (62%) patients were on
antihypertensive medication. The prevalence of poorly controlled blood pressure
(> 150/85 mmHg treated; > 160/90 mmHg untreated) was 16 of 44 (36%) patients
overall, and was higher for type 2 DM patients (13/33, 39%) than for type 1 DM
patients (3/11, 27%). Random serum cholesterol levels > 5.2 were found in 10 of
44 (23%) patients overall (4/11 [36%] type 1 and 6/33 [18%] type 2 DM patients).
CONCLUSIONS: Control of HbA1c, hypertension and hypercholesterolaemia can slow
progression of retinopathy and other DM end-points. Many of our patients were
poorly controlled in terms of these risk factors. More attention should be
addressed to these primary preventative factors in the management of diabetes
patients.

PMID: 17944626  [PubMed - indexed for MEDLINE]

8: Acta Ophthalmol Scand. 2007 Nov;85(7):711-23. 

Strabismus and eye muscle function.

Lennerstrand G.

Department of Ophthalmology, Karolinska Institutet, St Erik's Eye Hospital,
Bernadotte Laboratories, Stockholm, Sweden. Gunnar.Lennerstrand@ste.ki.se

Studies of external eye muscle morphology and physiology are reviewed, with
respect to both motor and sensory functions in concomitant strabismus. The eye
muscles have a more complex fibre composition than other striated muscle, and
they are among the fastest and most fatigue-resistant muscles in the body.
However, it is not generally believed that concomitant strabismus is due to a
primary abnormality of the eye muscles or the ocular motor system. The gross
anatomy of eye muscles, including the shape and position of the eye muscle
pulleys, was not changed in strabismus. The histology of the eye muscle fibres
was also basically the same, but changes have been observed in the cellular and
biochemical machinery of the fibres, most notably in the singly innervated
orbital fibres. Functionally, this was seen as slower contractions and reduced
fatigue resistance of eye muscles in animals with strabismus and defects of
binocular vision. Most likely the changes represented an adaptation to modified
visual demands on the ocular motor control, because of the defects of binocular
vision in strabismus from an early age. Adaptation of eye muscle function to
visual demands could be seen also in the adult human ocular motor system, but
here the effects could be reversed with treatment in some conditions. External
eye muscles in the human have sensory organs, muscle spindles and tendon organs,
responding to changes in muscle force and length. It is not known how these
proprioceptors are used more specifically in ocular motor control, and there is
no stretch reflex in the external eye muscles. However, a clear influence on
space localization and eye position can be demonstrated with vibratory
stimulation of the eye muscles, presumably activating muscle spindles. Different
effects were observed in normal subjects and in adult patients with strabismus,
which would indicate that the proprioceptive input from one eye of strabismic
patients could be suppressed by the other eye, similar to visual suppression in
concomitant strabismus. Such an interaction would most likely occur in the
visual cortex, and not in the ocular motor system. Further studies of
proprioceptive mechanisms, during the postnatal developmental stage and in adult
concomitant strabismus may shed light on the mechanisms of childhood strabismus
and may, in this respect, be a more fruitful avenue for further research than
eye motor studies.

Publication Types:
    Research Support, Non-U.S. Gov't
    Review

PMID: 17944625  [PubMed - indexed for MEDLINE]

9: Acta Ophthalmol Scand. 2007 Nov;85(7):698-710. 

Paediatric cataract surgery.

Zetterstrom C, Kugelberg M.

Eye Department, Ulleval University Hospital, University of Oslo, Oslo, Norway.
charlotta.zetterstrom@medisin.uio.no

Bilateral congenital cataract is the most common cause of treatable childhood
blindness. Nuclear cataract is usually present at birth and is non-progressive,
while lamellar cataract usually develops later and is progressive. Prompt
surgery has to be performed in cases with dense congenital cataract: if
nystagmus has developed, the amblyopia is unfortunately irreversible. A
treatment regime based on surgery within 2 months of life, combined with prompt
optical correction of the aphakia and occlusion therapy with frequent follow-up,
have been successful in both unilateral and bilateral cases. The surgery ought
to include anterior and posterior capsulorexis in all children at the present
time. Intraocular lens implantation has been safely performed below the age of 1
year and has also been successfully performed in bilateral cases. Anterior dry
vitrectomy should be performed in preschool children to avoid visual axis
opacification. Visual axis opacification is the most common complication found
after cataract surgery in children. Secondary glaucoma is by far the most
sight-threatening complication and is, unfortunately, common in the newborn so
lifelong follow-up is essential in these cases.

Publication Types:
    Review

PMID: 17944624  [PubMed - indexed for MEDLINE]

10: Acta Ophthalmol Scand. 2007 Nov;85(7):696-7. 

Intraocular lenses in children.

O'Keefe M.

Publication Types:
    Editorial

PMID: 17944623  [PubMed - indexed for MEDLINE]