1: Br J Ophthalmol. 2009 Mar 30; [Epub ahead of print] 

Use of Combination Therapy with Cisplatin and Calcitriol in the Treatment of
Y-79 Human Retinoblastoma Xenograft Model.

Kulkarni AD, Van Ginkel PR, Darjatmoko SR, Lindstrom MJ, Albert DM.

Madison, United States.

BACKGROUND: Retinoblastoma is the most common primary malignant intraocular
neoplasm of childhood. The poor outcomes of patients with metastatic
retinoblastoma have encouraged the search for new therapies. In the current
study, the efficacy of combination therapy with calcitriol and cisplatin in
athymic mice with subcutaneous Y-79 human retinoblastoma tumors was assessed.
METHODS: 60 athymic mice were subcutaneously injected with human Y79
retinoblastoma cells. Animals were randomized into four groups: group 1 - 50
microg of cisplatin; group 2 - 0.05 microg of calcitriol; group 3 - 0.05microg
of calcitriol and 50 microg of cisplatin; group 4 - control.The cisplatin was
administered once a week, and the calcitriol was given 5 times a week. RESULTS:
There was a significant inhibition of tumor growth in animals treated with the
combination therapy of calcitriol and cisplatin as compared to controls and
cisplatin alone (p=0.0001 and p=0.0041 respectively). In terms of toxicity,
serum calcium levels were increased, but there was no mortality and minimal
nephrotoxicity in any of the groups. CONCLUSION: The present study shows that
cisplatin given in combination with calcitriol may be a viable multidrug therapy
option in the treatment of high risk retinoblastoma.

PMID: 19336429 [PubMed - as supplied by publisher]

2: Br J Ophthalmol. 2009 Mar 30; [Epub ahead of print] 

A randomised comparison of bilateral recession vs. unilateral
recession-resection as surgery for infantile esotropia.

Polling JR, Eijkemans MJ, Esser J, Gilles U, Kolling GH, Schulz E, Lorenz B,
Roggenkamper P, Herzau V, Zubcov A, Ten Tusscher MP, Wittebol-Post D,
Gusek-Schneider GC, Cruysberg JR, Simonsz HJ.

Rotterdam, Netherlands.

OBJECTIVE: Infantile esotropia, a common form of strabismus, is treated either
by bilateral recession (BR) or unilateral recession-resection (RR). Differences
in degree of alignment achieved by these two procedures have never been examined
in a randomised controlled trial. DESIGN: Controlled, randomised multicenter
trial. SETTING: 12 University clinics. Participants and intervention: We
randomly assigned 124 patients to either BR or RR. MAIN OUTCOME MEASURE:
Alignment assessed as the variation of the postoperative angle of strabismus
during alternating cover. RESULTS: The mean postoperative angle of strabismus at
distance was +2.3 degrees (SD+/-5.1) for BR and +2.9 degrees (SD+/-3.5) for RR
(P=0.46 for reduction of the angle and P=0.79 for the within-group variation).
The mean reduction of the angle of strabismus was 1.41 degree per millimetre of
muscle displacement (SD+/-0.45) for RR and 1.47 (SD+/-0.50) for BR (P=0.85 for
reduction of the angle and P=0.22 for the within-group variation). Alignment was
associated with postoperative binocular vision (P=0.001) in both groups.
CONCLUSIONS: We did not find a statistically significant difference between BR
and RR as surgery for infantile esotropia. Trial registration: Clinical trials
NCT 00304577.

PMID: 19336428 [PubMed - as supplied by publisher]

3: Br J Ophthalmol. 2009 Mar 30; [Epub ahead of print] 

Fundus autofluorescence in subfoveal choroidal neovascularization secondary to
pathologic myopia.

Parodi M, Iacono P, Ravalico G.

Azienda Ospedaliero-Universitaria of Trieste, Italy.

PURPOSE: to describe the fundus autofluorescence (FAF) characteristics of
choroidal neovascularization (CNV) associated with Pathologic Myopia (PM), and
their modification after photodynamic therapy (PDT). DESIGN: Open-label,
prospective, interventional case series. METHODS: Forty-two patients affected by
subfoveal CNV in PM underwent PDT with a 24-month follow-up. Each patient
underwent an ophthalmological examination every three months, including FAF and
fluorescein angiography. FAF distribution was qualitatively evaluated at the CNV
site, around the CNV and outside the area affected by CNV. RESULTS: CNV at
baseline showed high FAF signal with uniform distribution, or with some spots of
low FAF internally, in 64% and 36% of cases, respectively. At the 3-month
control after PDT, the CNV retained the same response, but a round halo of
increased signal extending beyond the site of the PDT application was detectable
around the CNV. At the end of the follow-up, a high or a low FAF signal was
detected in 40% and 60% of cases, respectively. CONCLUSION: CNV secondary to PM
shows a specific, high signal, FAF pattern. A round halo of increased FAF signal
surrounding the CNV was detectable after PDT application, whereas a FAF signal
progressive reduction was visible at and around the CNV site from the sixth
month. A high FAF signal at the CNV site is associated with an improved visual
acuity outcome at the 2-year follow-up. Further studies to correlate the
morphological and functional features are advisable, especially by means of
microperimetric analyses and with a longer-term follow-up.

PMID: 19336427 [PubMed - as supplied by publisher]

4: Br J Ophthalmol. 2009 Mar 30; [Epub ahead of print] 

Use of hydroxypropylmethylcellulose 2% for removing adherent silicone oil from
silicone intraocular lenses.

Wong SC, Ramkissoon YD, Lopez M, Page K, Parkin IP, Sullivan PM.

United Kingdom.

Background / aims: To investigate the effect of hydroxypropylmethylcellulose
(HPMC) on the physical interaction (contact angle) between silicone oil and a
silicone intraocular lens (IOL). METHODS: In vitro experiments were performed,
to determine the effect of HPMC (0.5%, 1% or 2%), with or without an additional
simple mechanical manoeuvre, on the contact angle of silicone oil at the surface
of both silicone and acrylic (control) IOLs. A balanced salt solution chamber
was used. The study group comprised of 21 silicone and 9 acrylic IOLs. RESULTS:
Median contact angle of silicone oil on silicone IOL was 99 degrees . The
addition of HPMC 2% alone did not significantly alter contact angle. HPMC 2%
combined with an additional single mechanical manoeuvre increased contact angle
to 180 degrees (greater non-wetting), with complete separation of silicone oil
from silicone IOL within 1 minute. The manoeuvre alone, or in conjunction with a
lower concentration of HPMC (0.5 or 1%), was ineffective in increasing the
contact angle. CONCLUSION: We present a novel, non-toxic technique of using
hydroxypropylmethylcellulose 2% combined with a simple mechanical manoeuvre, for
the removal of adherent silicone oil droplets from silicone intraocular lenses.

PMID: 19336426 [PubMed - as supplied by publisher]

5: Br J Ophthalmol. 2009 Mar 30; [Epub ahead of print] 

Blood Pressure and Glaucoma.

Costa V, Arcieri ES, Harris A.

Brazil.

Although intraocular pressure (IOP) is considered the main risk factor for the
development of glaucoma and the only parameter subject to treatment, there is
sufficient evidence to suggest that glaucoma may continue to progress despite
lowering patients\' IOP to targeted levels. Several studies have implicated
vascular risk factors in the pathogenesis of glaucoma. Among them, blood
pressure (BP) and ocular perfusion pressure have become increasingly important.
Although clinicians cannot currently visualize ocular blood flow directly, they
can easily measure glaucoma patients\' BP and IOP to calculate their ocular
perfusion pressure and quantify the vascular changes. The purpose of this review
article is to discuss the relationship between BP and IOP, BP and glaucoma, and
perfusion pressure and glaucoma. We discuss the importance of autoregulation to
maintain the adequate perfusion of the optic nerve head, and suggest that ocular
perfusion pressure and its fluctuation may be parameters that need to be
measured in glaucoma patients.

PMID: 19336425 [PubMed - as supplied by publisher]

6: Br J Ophthalmol. 2009 Mar 30; [Epub ahead of print] 

A randomized cross-over study comparing bimatoprost and latanoprost in subjects
with primary angle closure glaucoma.

How AC, Kumar RS, Chen YM, Su DH, Gao H, Oen FT, Ho CL, Seah SK, Aung T.

Singapore.

BACKGROUND/AIMS: To compare the intraocular pressure (IOP) lowering efficacy and
side effects of latanoprost 0.005% and bimatoprost 0.03% in subjects with
chronic primary angle closure glaucoma (PACG). METHODS: This was an
observer-masked randomized cross-over study of 60 PACG subjects who received
either latanoprost or bimatoprost for 6 weeks, after which they were crossed
over to the other medication for another 6 weeks. The IOP-reducing effect of the
medications was assessed by the reduction in IOP after 6 weeks of treatment
compared to baseline. RESULTS: Fifty-four subjects (80 eyes) completed the
study. Latanoprost reduced IOP (mean +/- SD) by 8.4 +/- 3.8 mmHg and bimatoprost
by 8.9 +/- 3.9 mmHg from a baseline of 25.2 + 3.6 mmHg and 25.2 + 3.6 mmHg
respectively (p=0.23). Adverse events were mild in both groups; however there
were twice as many reports of an adverse event in the bimatoprost group (81%)
compared to the latanoprost group (40%, p<0.01). Ocular irritation was the most
frequently reported adverse events in both groups; 22 subjects (37.9%) treated
with bimatoprost experienced ocular hyperemia as compared to 13 subjects (22.4%)
treated with latanoprost (p=0.11). CONCLUSIONS: Bimatoprost once daily was
similarly effective in reducing IOP compared to latanoprost once daily in
subjects with chronic PACG. Both drugs were well tolerated with mild ocular
adverse events.

PMID: 19336424 [PubMed - as supplied by publisher]

7: Br J Ophthalmol. 2009 Mar 26; [Epub ahead of print] 

Salvage external beam radiotherapy after failed primary chemotherapy for
bilateral retinoblastoma: rate of eye & vision preservation.

Chan MP, Hungerford JL, Kingston JE, Plowman PN.

United Kingdom.

BACKGROUND: Radiation is implicated in the induction of second malignancies in
children with bilateral retinoblastoma. There is a need to determine whether
this risk can be justified by good visual outcome when external beam
radiotherapy (EBRT) is used as a salvage treatment. AIM: To study the
effectiveness of EBRT as a salvage treatment after failed primary chemotherapy
and focal treatment in bilateral retinoblastoma. METHODS: This is a
retrospective observational case series. The outcome measures after EBRT are:
rate of eye preservation, rate of tumour control, visual potential, visual
acuity, and radiation-induced side-effects. RESULTS: Thirty-six eyes (22
patients) were included. The median follow-up after EBRT was 40 months (19-165
months). Thirty-two eyes received lens-sparing radiotherapy and 4 received
whole-eye radiation. The rate of eye preservation was 83.3% (30/36 eyes).
Twenty-four eyes (66.6%) were controlled by EBRT and required no further
treatment. Of the 30 preserved eyes, 20 eyes (66.7%) had extra-macular tumours
without retinal detachment and therefore potential for central vision. The final
visual acuity was recorded for 19 eyes. Ten eyes (52.6%) read 6/9-6/5, 3 eyes
(15.8%) read 6/18- 6/36, 6 eyes (31.6%) read 6/60 or worse. Significant
radiation- induced side effects were limited to cataracts and dry eyes with
whole-eye radiation. There were no second cancers or deaths. CONCLUSION: Salvage
EBRT is highly effective in preserving eyes with useful vision in bilateral
retinoblastoma after failed chemotherapy and focal treatments. These results
will help the parents and ophthalmologists of such patients to reach an informed
decision when weighing up the benefits of EBRT against its potential oncogenic
effect.

PMID: 19329423 [PubMed - as supplied by publisher]

8: Br J Ophthalmol. 2009 Apr;93(4):559-60. 

Tobacco smoking influences on eye diseases and vision.

Grzybowski A.

Department of Ophthalmology, Szwajcarska 6, 61-285 Poznan, Poland.
grzyb@am.poznan.pl

PMID: 19321487 [PubMed - in process]

9: Br J Ophthalmol. 2009 Apr;93(4):558-9. 

Safety of DSAEK in pseudophakic eyes with anterior chamber lenses and Fuchs
endothelial dystrophy.

Esquenazi S.

LSU Eye and Neuroscience Center, 2020 Gravier Street, Suite D, 8th Floor, New
Orleans, LA 70112, USA. sesque@lsuhsc.edu

Publication Types:
    Research Support, N.I.H., Extramural

PMID: 19321486 [PubMed - in process]

10: Br J Ophthalmol. 2009 Apr;93(4):557-8. 

Trabecular meshwork in neovascular glaucoma eyes after the intravitreal
injection of bevacizumab.

Kubota T, Aoki R, Harada Y, Tou N, Kohno Y, Tawara A, Satoh H, Shimajiri S.

Department of Ophthalmology, School of Medicine, University of Occupational and
Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555,
Japan. tkubota@med.uoeh-u.ac.jp

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

PMID: 19321485 [PubMed - in process]

11: Br J Ophthalmol. 2009 Apr;93(4):556-7. 

Unilateral leucocoria in clinically normal eyes.

Batra R, Rowe F, Rowlands A, Noonan C.

Birmingham and Midland Eye Centre, Dudley Road, Birmingham B18 7QH, UK.
ruchikabatra@aol.com

PMID: 19321484 [PubMed - in process]

12: Br J Ophthalmol. 2009 Apr;93(4):554-6. 

Primary orbital lymphomatoid granulomatosis.

Araki F, Mimura T, Fukuoka S, Tsuji H, Izutsu K, Yamamoto H, Takazawa Y, Kojima
T.

Department of Ophthalmology, University of Tokyo Graduate School of Medicine,
7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan.

PMID: 19321483 [PubMed - in process]

13: Br J Ophthalmol. 2009 Apr;93(4):553-4. 

Surgical management of macular holes: a national survey of current UK practice.

Khan RS, Khan KN, Costen MT.

Hull and East Yorkshire Eye Hospital, Fountain Street, Anlaby Road, Hull HU3
2JZ, UK. kamronkhan@yahoo.com

PMID: 19321482 [PubMed - in process]

14: Br J Ophthalmol. 2009 Apr;93(4):552-3. 

Short-term effect of intravitreal anti-VEGFs delivery on intraocular pressure.

Nabili S, Stevenson M, Chakravarty U, Moutray T.

Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK.

PMID: 19321481 [PubMed - in process]

15: Br J Ophthalmol. 2009 Apr;93(4):551-2. 

Ramadan and eye-drops: perspective of Muslims in the UK.

Kumar N, Dherani M, Jivan S.

St Paul\'s Eye Unit, Royal Liverpool University Hospital, Liverpool L3 8XP, UK.
nishant6377@gmail.com

PMID: 19321480 [PubMed - in process]

16: Br J Ophthalmol. 2009 Apr;93(4):550-1. 

The use of a second instrument during phacoemulsification: does it really
protect the posterior capsule?

Tee J, Shah A, Little BC.

Department of Ophthalmology, Royal Free Hospital, London NW3 2QG, UK.
brianlittle@blueyonder.co.uk

PMID: 19321479 [PubMed - in process]

17: Br J Ophthalmol. 2009 Apr;93(4):549-50. 

Compression sutures with autologous blood injection for leaking trabeculectomy
blebs.

Biswas S, Zaheer I, Monsalve B, Diamond JP.

Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK.
s.biswas@doctors.org.uk

PMID: 19321478 [PubMed - in process]

18: Br J Ophthalmol. 2009 Apr;93(4):546-8. 

Rituximab for treatment of ocular inflammatory disease: a series of four cases.

Kurz PA, Suhler EB, Choi D, Rosenbaum JT.

Mail Code L467AD, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
rosenbaj@ohsu.edu

Rituximab may be effective in the treatment of ocular inflammatory disease.
Dosing is less frequent than many medications currently available. Four cases
are reported, each of which appeared to have responded well to treatment with
rituximab, although patient 2 was able to remain on a low dose of prednisone for
only 2 months. The ongoing pilot study will hopefully provide additional insight
into the benefit of rituximab for treatment of scleritis and idiopathic orbital
inflammatory disease.

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

PMID: 19321476 [PubMed - in process]

19: Br J Ophthalmol. 2009 Apr;93(4):422. 

VHL Awareness Month.

Singh AD, Dua HS.

PMID: 19321474 [PubMed - in process]

20: Br J Ophthalmol. 2009 Apr;93(4):421-2, 548. 

The use of rituximab in refractory mucous membrane pemphigoid with severe ocular
involvement.

Ross AH, Jaycock P, Cook SD, Dick AD, Tole DM.

Bristol Eye Hospital, Lower Maudlin Street, Bristol BS1 2LX, UK.
adamross@doctors.org.uk

PMID: 19321473 [PubMed - in process]

21: Br J Ophthalmol. 2009 Apr;93(4):420-1. 

Systemic antiangiogenic therapy: what goes around...

Pulido JS, Itty S.

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

PMID: 19321472 [PubMed - in process]

22: Br J Ophthalmol. 2009 Apr;93(4):419. 

Comment on:
    Br J Ophthalmol. 2009 Apr;93(4):439-42.
    Br J Ophthalmol. 2009 Apr;93(4):443-7.

Ocular alignment following strabismus surgery.

Lee J.

Publication Types:
    Comment
    Editorial

PMID: 19321471 [PubMed - in process]

23: Br J Ophthalmol. 2009 Mar 24; [Epub ahead of print] 

Efficacy and tolerability of interferon alpha treatment in patients with chronic
cystoid macular edema due to non-infectious uveitis.

Deuter CM, Kotter I, Gunaydin I, Stubiger N, Doycheva DG, Zierhut M.

University of Tubingen, Germany.

AIM: To assess the efficacy and tolerability of interferon (IFN) alpha in
chronic cystoid macular edema (CME) due to non-infectious uveitis. METHODS:
Retrospective analysis of an interventional case series. IFN alpha-2a was
administered at an initial dose of 3 or 6 million IU per day subcutaneously and
tapered afterwards to the lowest possible dose to maintain the absence of CME.
Treatment efficacy was assessed by optical coherence tomography. RESULTS:
Twenty-four patients with chronic CME (median duration 36.0 months) due to
non-infectious anterior (n=2), intermediate (n=18) or posterior (n=4) uveitis
have been analysed. Ineffective pre-treatment included systemic corticosteroids
(all patients), acetazolamide (22 patients) and at least one immunosuppressive
drug (18 patients). IFN therapy was shown to be effective (= complete resolution
of CME within 3 months, able to taper IFN) in 15 patients (62.5%), partly
effective (= incomplete resolution of CME, unable to taper IFN) in 6 patients
(25.0%) and not effective (= no response or recurrence of CME) in 3 patients
(12.5%). IFN treatment was generally well tolerated. Common side effects
including flu-like symptoms, fatigue or increased liver enzymes were dose
dependent and led to discontinuation of IFN in only 1 patient. CONCLUSION: Our
data demonstrate IFN alpha to be an effective and well-tolerated therapy for
chronic refractory uveitic CME.

PMID: 19321469 [PubMed - as supplied by publisher]

24: Br J Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Small Margin Excision of Periocular Basal Cell Carcinomas.

Chadha V, Wright M.

United Kingdom.

AIMS: To analyse the outcome of small margin (up to 2mm) excision of primary
clinically well-defined peri-ocular basal cell carcinomas (BCCs). METHODS:
Retrospective evaluation of 90 well-demarcated primary basal cell carcinomas
having a minimum follow-up of 36 months. All patients underwent excision of the
tumour with maximum margins of 2mm. Resulting defects were, if possible, closed
directly. Reconstruction of defects requiring flaps or grafts was delayed until
receipt of the histological report which was obtained in all cases. RESULTS:
One-stage excision and direct closure was performed in 67 patients (74.4%). In
23 patients (25.6%) excision was performed on one day and reconstruction was
done four days later, after receipt of the histopathology report. Histological
assessment confirmed complete excision after the first excision in 78 (86.7%)
rising to 83 (92.2%) after 2 excisions. The mean follow-up was 47.5 + 9.1
months. Of the 12 cases with incompletely excised lesions, seven of the patients
chose not to have any more surgery and only one of these recurred. There were
two other recurrences, and in both of them the lesion had initially been
reported as completely excised. Overall the recurrence rate in our study was
3.3% (n=3). CONCLUSIONS: Our recurrence rate compares well with published
results following conventional excision of BCCs. In the absence of availability
of Mohs surgery, well demarcated nodular basal cell carcinomas can be safely
excised using smaller margins than conventionally practised.

PMID: 19304655 [PubMed - as supplied by publisher]

25: Br J Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Expression of Reverse Cholesterol Transport Proteins ABCA1 and SR-BI in the
Retina and RPE.

Duncan KG, Hosseini K, Bailey KR, Yang H, Lowe RJ, Matthes MT, Kane JP, Lavail
MM, Schwartz DM, Duncan JL.

San Francisco, United States.

BACKGROUND/AIMS: Excessive lipid accumulation in Bruch\'s membrane (BrM) is a
hallmark of aging, the major risk factor for age-related macular degeneration
(AMD). Excessive lipid accumulation in Bruch\'s membrane (BrM), thought to
originate from photoreceptor outer segments (POS), is a hallmark of early
age-related macular degeneration (AMD). Retinal pigment epithelial (RPE) cells
may utilize reverse cholesterol transport (RCT) activity to move lipid into BrM,
mediated through ATP-binding cassette A1 (ABCA1) and scavenger receptor BI
(SR-BI). METHODS: ABCA1 expression was assessed by reverse transcription
polymerase chain reaction (RT-PCR) and Western blotting of human RPE cell
extracts. Lipid transport assays were performed using radiolabeled POS. ABCA1
and SR-BI expression was examined in normal mouse eyes by immunofluorescence
staining. BrMs of ABCA1 and SR-BI heterozygous mice were examined
microscopically. RESULTS: Human RPE cells expressed ABCA1 mRNA and protein. The
ABCA1 and SR-BI inhibitor glyburide abolished basal transport of POS-derived
lipids in RPE cells in the presence of HDL. Mouse retina and RPE expressed ABCA1
and SR-BI. SR-BI was highly expressed mainly in RPE. BrMs were significantly
significantly thickened in SR-BI heterozygous mice, but not ABCA1, heterozygous
mice. CONCLUSION: RPE cells express ABCA1 and SR-BI. The results imply a
significant role for SR-BI and ABCA1 in lipid transport and RCT in the retina
and RPE.

PMID: 19304587 [PubMed - as supplied by publisher]

26: Br J Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Agreement between Spectral-Domain and Time-Domain OCT for measuring RNFL
thickness.

Vizzeri G, Weinreb RN, Gonzalez-Garcia AO, Bowd C, Medeiros FA, Sample PA,
Zangwill LM.

Department of Ophthalmology, University of California, San Diego, United States.

BACKGROUND/AIMS: To evaluate Spectral-Domain (SD) OCT reproducibility and assess
the agreement between SD-OCT and Time-Domain (TD) OCT RNFL measurements.
METHODS: Three Cirrus-SD-OCT scans and one Stratus-TD-OCT scan were obtained
from Diagnostic Innovations in Glaucoma Study (DIGS) healthy participants and
glaucoma patients on the same day. Repeatability was evaluated using Sw (within
subject standard deviation), CV (coefficient of variation) and ICC (intraclass
correlation coefficient). Agreement was assessed using correlation and
Bland-Altman plots. RESULTS: 16 healthy participants (32 eyes) and 39 patients
(78 eyes) were included. SD-OCT reproducibility was excellent in both groups.
The CV and ICC for Average RNFL thickness were 1.5% and 0.96, respectively, in
healthy eyes and 1.6% and 0.98, respectively, in patient eyes. Correlations
between RNFL parameters were strong, particularly for Average RNFL thickness
(R2=0.92 in patient eyes). Bland-Altman plots showed good agreement between
instruments, with better agreement for average RNFL thickness than for sectoral
RNFL parameters (for example, at 90 microns Average RNFL thickness, 95% limits
of agreement were -13.1 to 0.9 for healthy eyes and -16.2 to -0.3 microns for
patient eyes). CONCLUSIONS: SD-OCT measurements were highly repeatable in
healthy and patient eyes. Although agreement between instruments was good,
TD-OCT provided thicker RNFL measurements than SD-OCT. Measurements with these
instruments should not be considered interchangeable.

PMID: 19304586 [PubMed - as supplied by publisher]

27: Br J Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Differences between type 1 and type 2 diabetics in retinal neovascular tissue
and vitreous humour.

Kinnunen K, Puustjarvi T, Terasvirta M, Nurmenniemi P, Heikura T, Laidinen S,
Paavonen T, Uusitalo H, Yla-Herttuala S.

Finland.

AIMS: Evaluate the histopathology of neovascular tufts and vitreous samples
collected from diabetic patients. METHODS: Vitreous samples and neovascular
tufts were collected from type 1 (n=13) and type 2 diabetics (n=17) with
proliferative retinopathy and controls with macular hole (n=5). Neovessels were
analyzed using immunohistochemistry and vitreous samples with Enzyme-linked
immunosorbent assay (ELISA). Main outcome measure was to find differences in
growth factors in proliferative retinopathy between type 1 and type 2 diabetics.
RESULTS: VEGF-A was most strongly present in the samples in type 1 diabetics. In
type 2 diabetics, VEGF-D was more abundantly present than in type 1 diabetics.
Also ANG-2 was abundantly present. Macrophages and nuclear factor kappa B
(NFkappaB) were found indicating the presence of an inflammatory process in the
neovascular tissues. CONCLUSIONS: VEGF-A and ANG-2 are equally important in
neovascular process in both type 1 and type 2 diabetics. In type 2 diabetics,
VEGF-D is abundantly present. To achieve better control of diabetic retinopathy,
it might be beneficial to target also against the actions of ANG-2 and VEGF-D.

PMID: 19304585 [PubMed - as supplied by publisher]

28: Br J Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Polypoidal Choroidal Vasculopathy and Late Geographic Hyperfluorescence on
Indocyanine Green Angiography.

Kang SW, Chung SE, Shin WJ, Lee JH.

Samsung Medical Center, Korea, Republic of.

Backgroud/ AIMS: To report the clinical significance of late geographic
hyperfluorescence (LGH) on indocyanine green angiography (ICGA) in cases of
polypoidal choroidal vasculopathy (PCV). METHODS: We retrospectively analyzed
the medical records of 43 eyes with PCV, all of which had undergone at least 12
months of follow-up, 40 eyes with exudative age-related macular degeneration
(AMD), and 20 eyes of age matched normal subjects. The incidence of LGH, defined
as a well-demarcated geographic hyperfluorescent lesion on late phase ICGA, was
compared in each respective group. The natural course of the LGH and its changes
after photodynamic therapy (PDT) were analyzed. RESULTS: LGH was noted in all of
the eyes with PCV, whereas LGH was noted in 3 eyes (7.5%) of the eyes with
exudative AMD and was not noted in any of the normal subjects (P< .01). Of the
27 eyes (62.8%) with PCV, LGH was matched to the total area of the branching
vascular network and polyps. The extent of LGH was enlarged over time in
approximately one half of the cases. As compared with the eyes demonstrating
persistent LGH after PDT, the eyes with fading or disappearing LGH evidenced a
lower recurrence of active PCV (P < .05). CONCLUSION: LGH is a highly sensitive
and specific ICGA finding for the diagnosis of PCV. Increased surveillance
should be implemented in eyes in which LGH persists after PDT.

PMID: 19304584 [PubMed - as supplied by publisher]

29: Br J Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Subclinical keratoconus and inflammatory molecules from tears.

Lema I, Sobrino T, Duran JA, Brea D, Diez-Feijoo E.

Hospital de Conxo, Santiago de Compostela, Spain.

BACKGROUND/AIMS: Tissue degradation in corneal thinning disorders, such as
keratoconus (KC), involves the expression of inflammatory mediators. The purpose
of this study was to determine the levels of proinflammatory cytokines and
matrix metalloproteinase 9 (MMP-9) in tears from both eyes of unilateral
keratoconus (KC) patients. METHODS: Thirty patients diagnosed with asymmetric KC
(30 KC eyes, and 30 subclinical KC eyes) and 20 normal control subjects (1 eye)
were studied in a prospective, cross sectional study. Keratoconus screening
programs were performed on these participants. Ten microliters of tears were
collected from each eye. The concentrations of cytokines (interleukin-6 [IL-6]
and tumor necrosis factor alpha [TNF-alpha]), and MMP-9 were measured by ELISA.
RESULTS: Mean values for IL-6 levels were similar in KC and subclinical KC
samples (5.5 [4.9 - 6.9] vs. 5.7 [4.5 - 6.2] pg/mL, p= 0.131), but significantly
higher in relation to the control group (2.2 [1.0 - 4.1] pg/ml, p<0.0001).
Significant differences were found in TNF-alpha levels between KC and
subclinical KC eyes (5.4 [4.1 - 6.8] vs. 4.8 [4.2 - 6.0] pg/mL, p= 0.032) and
control group (1.8 [1.5 - 2.3] pg/mL, p<0.0001). Increased values of MMP-9 were
found in KC (59.4 [50.6-66.1] ng/mL) vs. subclinical KC eye (7.0 [4.8-8.6]
ng/mL) (p<0.0001). MMP-9 levels in the control group (6.1 [3.9 - 8.3] ng/mL) and
subclinical KC were similar (p= 0.203). CONCLUSIONS: IL-6 and TNF-alpha are
overexpressed in the tears of subclinical and KC eyes. Increased MMP-9 levels
were found only in the KC eye. These results indicate that the pathogenesis of
KC may involve chronic inflammatory events.

PMID: 19304583 [PubMed - as supplied by publisher]

30: Br J Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Comparison of clinical and photographic assessment of trachoma.

Roper KG, Taylor HR.

Australia.

AIMS: To determine the rates of trachoma in Aboriginal communites and to compare
clinical versus photographic assessment for the presence of signs of trachoma.
METHODS: Five Aboriginal communities in the Katherine region of the Northern
Territory were assessed for the presence of trachoma. Trachoma was diagnosed by
clinical eye examination using a fine grading based on the World Health
Organization (WHO) simplified grading system. Photographs were taken of the left
eye of every person and graded using the fine grading system. The clinical
assessment was compared with the photographic assessment for each person using
the fine grading system. RESULTS: A total of 1316 people out of 1545 (85.2%)
were screened for trachoma from five communities, with 1254 photographs being
compared with clinical assessment scores. The overall prevalence of active
trachoma was greater than 10% across the five communities, and greater than 20%
in two communities. CONCLUSION: Active trachoma in young people and scarring in
older people remain a problem in Aboriginal communities. Photographic assessment
is a useful technique but in comparison with clinical assessment, can result in
overestimation of scoring for trachoma for inflammation (TI).

PMID: 19304582 [PubMed - as supplied by publisher]