1: Br J Ophthalmol. 2010 Jul 23; [Epub ahead of print] 

Gene-expression analysis of polyI:C-stimulated primary human conjunctival
epithelial cells.

Ueta M, Mizushima K, Yokoi N, Naito Y, Kinoshita S.

Faculty of Life and Medical Sciences, Doshisha University, Doshisha, Kyoto,
Japan.

Background The authors previously reported that human ocular surface epithelium
expressed TLR3 and that its ligand polyI:C stimulated the secretion of IL-6,
IL-8 and IFN-beta. In this study, to examine comprehensive effects of polyI:C
stimulation of primary human conjunctival epithelial cells (PHCjECs), the
authors performed a gene-expression analysis of the polyI:C-stimulated PHCjECs
using oligonucleotide microarrays, GeneChip. Methods The transcripts upregulated
upon polyI:C stimulation in PHCjECs from two individuals were examined using
GeneChip. Eleven new upregulated transcripts of interest were confirmed by
quantitative real-time PCR (RT-PCR), and seven proteins produced by those
transcripts were examined by ELISA or immunoblot analysis in PHCjECs from three
other individuals, respectively. Results GeneChip analysis showed that 150
transcripts were upregulated more than threefold and that 47 transcripts were
upregulated more than 10-fold upon polyI:C stimulation in the PHCjECs. Eleven of
the 47 upregulated transcripts (CXCL11, RIG-I, IL28A, CXCL10, CCL5, CCL4, MDA5,
IL7R, TSLP, CCL20 and ICAM-1) were significantly upregulated upon polyI:C
stimulation by quantitative RT-PCR, and the levels of seven proteins of the
transcripts CXCL11, CXCL10, CCL5, CCL20, TSLP, RIG-I and MDA5 were confirmed by
ELISA or immunoblot analysis to increase significantly in polyI:C-stimulated
PHCjECs. Conclusions Our results might show that TLR3 of conjunctival epithelium
could not only induce antiviral innate immune responses but also regulate the
allergic reactions.

PMID: 20657019  [PubMed - as supplied by publisher]

2: Br J Ophthalmol. 2010 Jul 23; [Epub ahead of print] 

Evaluation of an open-field autorefractor's ability to measure refraction and
hence potential to assess objective accommodation in pseudophakes.

Wolffsohn JS, Davies LN, Naroo SA, Buckhurst PJ, Gibson GA, Gupta N, Craig JP,
Shah S.

School of Life and Health Sciences, Ophthalmic Research Group, Birmingham, UK.

Background To evaluate the accuracy of an open-field autorefractor compared with
subjective refraction in pseudophakes and hence its ability to assess objective
eye focus with intraocular lenses (IOLs). Methods Objective refraction was
measured at 6 m using the Shin-Nippon NVision-K 5001/Grand Seiko WR-5100K
open-field autorefractor (five repeats) and by subjective refraction on 141 eyes
implanted with a spherical (Softec1 n=53), aspherical (SoftecHD n=37) or
accommodating (1CU n=22; Tetraflex n=29) IOL. Autorefraction was repeated 2
months later. Results The autorefractor prescription was similar (average
difference: 0.09+/-0.53 D; p=0.19) to that found by subjective refraction, with
approximately 71% within +/-0.50 D. The horizontal cylindrical components were
similar (difference: 0.00+/-0.39 D; p=0.96), although the oblique (J(45))
autorefractor cylindrical vector was slightly more negative (by -0.06+/-0.25 D;
p=0.06) than the subjective refraction. The results were similar for each of the
IOL designs except for the spherical IOL, where the mean spherical equivalent
difference between autorefraction and subjective was more hypermetropic than the
Tetraflex accommodating IOL (F=2.77, p=0.04). The intrasession repeatability was
<0.55 D (95% CI) and intersession repeatability <0.50 D in >/=85%. Conclusions
The autorefractor gives valid and repeatable measures of pseudophakic eye
refraction and hence objective accommodation.

PMID: 20657018  [PubMed - as supplied by publisher]

3: Br J Ophthalmol. 2010 Jul 23; [Epub ahead of print] 

Comparative study of retinal nerve fibre layer measurement by RTVue OCT and GDx
VCC.

Wang X, Li S, Fu J, Wu G, Mu D, Li S, Wang J, Wang N.

Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and
Visual Science Key Laboratory, Beijing, PR China.

Aim To evaluate the diagnostic performances and correlations of retinal nerve
fibre layer (RNFL) thickness measured by RTVue OCT and GDx variable corneal
compensation (VCC). Methods The total and regional RNFL thickness were measured
by RTVue OCT and GDx VCC in 62 normal eyes and 72 glaucomatous eyes of Chinese
subjects. The RNFL thickness profiles of normal and glaucomatous eyes by RTVue
OCT are plotted. Correlations of RNFL thickness measured by RTVue OCT and GDx
VCC were assessed using the Pearson correlation. The discriminating abilities of
the two techniques for detection of glaucoma were compared by the area under the
receiver operating characteristic curves (AUC). Results RTVue OCT demonstrated
double hump patterns in the RNFL profiles. In both normal and glaucomatous
subjects, the peaks were located in the superotemporal (ST) and inferotemporal
(IT) regions, and the troughs were located at the nasal (NU+NL) and temporal
(TU+TL) regions. Despite poor agreement, a high correlation (r=0.821) was found
between the mean RNFL measurements by RTVue OCT and GDx VCC. For RTVue OCT, the
highest AUCs were mean RNFL (AUC=0.914) and inferior mean RNFL (AUC=0.909). The
nerve fibre indicator (AUC=0.856) and inferior RNFL (AUC=0.852) achieved the
highest AUCs among all the GDx VCC measurements. The mean RNFL in RTVue OCT had
the greatest AUC in the two devices. There was a significant difference in
comparing the AUCs of the mean RNFL thickness obtained by RTVue OCT and GDx VCC
(p=0.009). Conclusions Although there were absolute value differences in RNFL
thickness, a high correlation was observed between RTVue OCT and GDx VCC. RTVue
OCT shows a reasonable ability to distinguish normal from glaucomatous eyes.

PMID: 20657017  [PubMed - as supplied by publisher]

4: Br J Ophthalmol. 2010 Jul 23; [Epub ahead of print] 

Giant orbital schwannoma with fluid-fluid levels.

Pushker N, Meel R, Sharma S, Bajaj MS, Kashyap S, Sen S.

Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of
Medical Sciences, New Delhi, India.

PMID: 20657016  [PubMed - as supplied by publisher]

5: Br J Ophthalmol. 2010 Jul 21; [Epub ahead of print] 

Changing the composition of buffered eye-drops prevents undesired side effects.

Schrage NF, Frentz M, Reim M.

Hospital Cologne-Merheim, Cologne, Germany.

Purpose The Ex Vivo Eye Irritation Test (EVEIT) is used to analyse the clinical
observations of corneal calcification attributed to the presence of phosphate
within applied eye-drops used in treating glaucoma, Still-Chauffard syndrome,
ocular burns and dry eyes. Method Live corneas from abattoir rabbit eyes were
cultured in order to study epithelial healing following mechanical abrasion of
the corneal surface combined with repeated exposure to various eye-drops.
Results Obvious corneal calcification of the wound area along with a complete
epithelial healing covering the calcified area was observed following exposure
to phosphate hyaluronate eye-drops. Epithelial healing without calcification was
achieved using citrate hyaluronate eye-drops. Conclusion Clinical observations
show that topical use of artificial tears containing phosphate on injured eyes
may lead to sight-threatening corneal complications. Simulation of such
treatment conditions by the EVEIT convincingly demonstrates that changes in the
composition of the pharmaceutically used treatments can prevent this undesired
side effect. Although considerable healing was achieved during the repeated
application of eye-drops, using either a phosphate or citrate buffer, only the
drops containing citrate did not develop corneal calcification on the eye. The
authors therefore recommend discontinuing the use of phosphate-buffered
eye-drops, or other topically applied solutions, to avoid further injury to the
patient.

PMID: 20650912  [PubMed - as supplied by publisher]

6: Br J Ophthalmol. 2010 Jul 22; [Epub ahead of print] 

Detecting glaucomatous progression using GDx with variable and enhanced corneal
compensation using Guided Progression Analysis.

Grewal DS, Sehi M, Greenfield DS.

University of Miami Miller School of Medicine, Palm Beach Gardens, Florida, USA.

Objective To compare detection of glaucoma progression with scanning laser
polarimetry using two methods for corneal compensation. Methods Normal, glaucoma
suspects and glaucoma patients with 36 months' follow-up meeting the eligibility
criteria were prospectively enrolled. All subjects underwent complete eye exam,
standard automated perimetry (SAP) and scanning laser polarimetry with variable
and enhanced corneal compensation (GDxVCC, GDxECC). SAP progression was
determined using the visual-field index (VFI). GDx progression was determined
using Guided Progression Analysis software (GDxGPA) and was defined as a
repeatable change on two consecutive scans compared with two baseline images
using any of three strategies: >/=150 contiguous pixels on the image progression
map (A), four or more adjacent segments on the Temporal Superior Nasal Inferior
Temporal graph (B) or a significant change in slope of the summary parameter
chart (C). Kappa statistics and logistic regression were used for the analysis.
Results Thirteen normal, 30 glaucoma suspect and 25 glaucomatous eyes
participating in the Advanced Imaging in Glaucoma Study were included.
Progression was identified in six eyes (8.8%) using GDxVCC and in eight eyes
(11.8%) using GDxECC. SAP progression was detected in seven (10.3%) eyes.
Agreement among progression methods using GDxVCC and GDxECC was strongest for
method C (kappa=0.57, p=0.002) compared with methods A (kappa=0.41, p=0.01) and
B (kappa=0.41, p=0.01). The association between typical scan score (TSS) and
overall or individual methods of progression was not significant using VCC or
ECC (p>0.05). Conclusions GDxGPA represents a novel approach for detection of
glaucomatous progression. GDxVCC and GDxECC demonstrate moderate agreement.

PMID: 20650911  [PubMed - as supplied by publisher]

7: Br J Ophthalmol. 2010 Jul 20; [Epub ahead of print] 

Therapeutic potential of valproic acid for retinitis pigmentosa.

Clemson CM, Tzekov R, Krebs M, Checchi JM, Bigelow C, Kaushal S.

University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Background/aim To examine the efficacy and safety of valproic acid (VPA) in
patients with retinitis pigmentosa (RP). Methods Thirteen eyes were examined
before and after brief treatment (average 4 months) with VPA. Visual fields (VF)
for each eye were defined using digitised Goldmann Kinetic Perimetry tracings.
VF areas were log-transformed and VF loss/gain relative to baseline was
calculated. Visual acuity was measured using a Snellen chart at a distance of 20
feet (6.1 m). Values were converted to the logarithm of the minimum angle of
resolution (logMAR) score. Results Nine eyes had improved VF with treatment, two
eyes had decreased VF and two eyes experienced no change, with an overall
average increase of 11%. Assuming typical loss in VF area without treatment,
this increase in VF was statistically significant (p<0.02). An average decrease
(0.172) in the logMAR scores was seen in these 13 eyes, which translates to a
positive change in Snellen score of approximately 20/47 to 20/32, which was
significant (p<0.02) assuming no loss in acuity without treatment. Side effects
were mild and well tolerated. Conclusion Treatment with VPA is suggestive of a
therapeutic benefit to patients with RP. A placebo-controlled clinical trial
will be necessary to assess the efficacy and safety of VPA for RP rigorously.

PMID: 20647559  [PubMed - as supplied by publisher]

8: Br J Ophthalmol. 2010 Jul 19; [Epub ahead of print] 

Retinoblastoma in the Beijing Tongren Hospital from 1957 to 2006:
clinicopathological findings.

Bai S, Ren R, Shi J, Xu X, Zhao J, Gao F, Li L, Shen L, Li B, Jonas JB.

Beijing TongRen Hospital, Capital Medical University, Beijing, PR China.

Background To investigate the clinical and histopathological features of eyes
enucleated due to retinoblastoma in a 50-year period in China. Methods The study
included all eyes enucleated for retinoblastoma in the Beijing TongRen Hospital
in the study period from 1957 to 2006. The clinical and histological charts, and
histological slides were assessed for demographic and clinical data, and
histological findings. Results The study included 1234 eyes. The mean age at the
time of diagnosis (2.8+/-1.8 years) with a peak at 1 year of age decreased
significantly (p<0.001) during the study period. Children with a unilateral
retinoblastoma were significantly (p<0.001) older than children with bilateral
retinoblastoma. The mean delay in the diagnosis (5.5+/-7.2 months) was
significantly (p<0.0001) associated with the age at the time of diagnosis and
significantly (p<0.0001) decreased during the study period. The presenting
symptoms were leucocoria (67.2%), poor vision (10.8%), a detectable tumour mass
(6.4%), red and painful eye (5.3%), strabismus (4.4%), exophathalmos (2.1%) and
trauma (2.3%). Prevalence of an extraocular tumour extension decreased
significantly (p<0.0001) during the study period. The frequency of a tumour
invasion into the retro lamina cribrosa tissue or into the choroid decreased
from 45.5% and 60.6% in the period 1956-1961 to 21.5% and 18.6%, respectively,
in the period 2002-2006. Conclusions In the last 50 years, the diagnosis of
retinoblastoma in China has been improved markedly with a shorter delay in the
diagnosis, an overall earlier diagnosis and a decrease in the clinical and
histological stage at the time of treatment.

PMID: 20644215  [PubMed - as supplied by publisher]

9: Br J Ophthalmol. 2010 Jul 19; [Epub ahead of print] 

Comparative study of patients with central serous chorioretinopathy undergoing
focal laser photocoagulation or photodynamic therapy.

Lim JW, Kang SW, Kim YT, Chung SE, Lee SW.

Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Republic of Korea.

Aims To compare clinical outcomes for patients with central serous
chorioretinopathy (CSC) undergoing either focal laser photocoagulation or
photodynamic therapy (PDT). Methods 26 eyes of 26 patients with symptomatic CSC
underwent focal laser photocoagulation or half-dose PDT, as appropriate.
Best-corrected visual acuity, optical coherence tomography and multifocal
electroretinography were assessed prospectively prior to treatment and at 1, 3
and 6 months after treatment. Results 12 eyes in the focal laser group and 14
eyes in the PDT group were evaluated. One month after PDT, all eyes, except one,
showed complete absorption of subretinal fluid, whereas five eyes in the focal
laser group showed residual subretinal fluid (p=0.022). Visual acuity and
parameters of multifocal electroretinography improved from baseline at 1, 3 and
6 months after treatment, without any significant differences between the two
groups. However, compared with those in the PDT group at 1 month after
treatment, P1 latencies in the first annuli of the focal laser group were
delayed (40.1+/-5.5 ms and 34.9+/-2.5 ms, respectively; p=0.047). Conclusions
Compared with focal laser, half-dose PDT may facilitate earlier resolution of
macular detachment and earlier recovery of central retinal function. However, at
3 months after treatment and thereafter, no difference in anatomical and
functional recovery was noted between the two modalities of treatment.

PMID: 20644214  [PubMed - as supplied by publisher]

10: Br J Ophthalmol. 2010 Jul 19; [Epub ahead of print] 

Presence of free radicals in intracameral agents commonly used during cataract
surgery.

Lockington D, Macdonald EC, Young D, Stewart P, Caslake M, Ramaesh K.

UK.

Background Free radicals are known to cause cellular damage and are present in
ophthalmic preparations. Corneal defence mechanisms are bypassed in intra-ocular
surgery. We evaluated commonly used intracameral agents to ascertain the
presence of free radicals and investigate the possibility of anterior segment
and endothelial toxicity. Methods Samples of 19 commonly used intracameral
preparations were analysed for total free radical presence on an Instrument
Laboratory IL600 using a Randox Kit for Total Antioxidant Status (RANDOX
Laboratories Ltd, Crumlin, UK). Results Free radical concentrations for the 19
intracameral agents ranged from 0 to 3.59 mmol/l, with median value of 0.34
mmol/l (mean value 0.933+/-1.19 mmol/l). Phenylephrine had the highest presence
of free radicals, which were considerably higher than those for 0.5% hydrogen
peroxide at all tested dilutions. Other notable results included cefuroxime
(0.61 mmol/l), 2% undiluted lidocaine (0.34 mmol/l) and bevacizumab (0.59
mmol/l). Conclusion The results indicate that free radicals are present in
intracameral surgical agents and some are in the order of 0.5% hydrogen
peroxide. The risks of endothelial damage must be considered when using multiple
intracameral preparations in complicated cataract surgery. Free radicals in
intracameral preparations may be a contributing cause in cases of toxic anterior
segment syndrome.

PMID: 20644213  [PubMed - as supplied by publisher]

11: Br J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

Human retinal pigment epithelium (RPE) transplantation: outcome after autologous
RPE-choroid sheet and RPE cell-suspension in a randomised clinical study.

Falkner-Radler CI, Krebs I, Glittenberg C, Povazay B, Drexler W, Graf A, Binder
S.

Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria.

Aims To evaluate the outcome after two types of retinal pigment epithelium (RPE)
transplantation techniques. Methods Fourteen consecutive patients with advanced
exudative age-related macular degeneration (AMD) were randomly assigned to
RPE-choroid sheet transplantation (group 1) or RPE cell-suspension
transplantation (group 2). Outcome measures included best corrected distance and
near visual acuity (BCVA), complication and recurrence rates, autofluorescence
(AF), angiography, and time-domain and spectral-domain optical coherence
tomography (TD- and SD-OCT). Results A gain of three or more lines in BCVA at 24
months was found in two patients in group 1 and in one patient in group 2,
whereas a loss of vision of three or more lines occurred in one patient in each
group. Revision surgery for proliferative vitreoretinopathy was required in one
patient in group 1. Epiretinal membranes developed in two patients in group 1
and in one patient in group 2. No recurrence occurred in this series. AF showed
hyperfluorescence coincident with the graft in group 1, and hyper- and
hypofluorescence in irregular patterns in group 2. Revascularisation of the
graft was present in all patients in group 1, and a normal choroidal vasculature
in the area of RPE atrophy in all patients in group 2. OCT showed a decrease in
retinal thickness in all patients, with an improved visualisation of inter- and
intralaminar structures with SD-OCT. Conclusion The anatomical and functional
outcome after both RPE transplantation techniques was comparable.
Intrastructural irregularities of the sheet assessed using SD-OCT might explain
the rather limited visual gain in otherwise successful sheet transplants.
Clinical Trial Registration NCT00401713.

PMID: 20610478  [PubMed - as supplied by publisher]

12: Br J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

Expression of the interleukin-4 receptor {alpha} in human conjunctival
epithelial cells.

Ueta M, Mizushima K, Yokoi N, Naito Y, Kinoshita S.

Kyoto Prefectural University of Medicine, Kyoto, Japan.

Aim To investigate the expression and function of interleukin-4 receptor alpha
(IL-4Ralpha) in human conjunctival epithelial cells (HCjECs). Methods The
presence of IL-4Ralpha mRNA and protein was examined by reverse transcription
(RT) PCR and immunohistology, respectively. Cell surface expression was examined
by flow cytometry. The effects of interleukin (IL)-4 or IL-13 on the tyrosine
phosphorylation of signal transducer and the activator of transcription 6
(STAT6) were evaluated by immunoblot analyses. The transcripts upregulated upon
IL-4 stimulation were examined using GeneChip, and confirmed by quantitative
RT-PCR. Results IL-4Ralpha mRNA and protein were detected in human conjunctival
epithelium. IL-4Ralpha protein was expressed on the cell surface of HCjECs. IL-4
and IL-13 induced tyrosine phosphorylation of STAT6. GeneChip analysis showed
that nine transcripts were upregulated more than fourfold by IL-4 stimulation in
the primary HCjECs from two individuals. Quantitative RT-PCR assay confirmed the
upregulation of these transcripts: lecithin retinol acyltransferase (LRAT),
calpain (CAPN14), tumour necrosis factor alpha-induced protein 6 (TNFAIP6), RAS
guanyl-releasing protein 1 (RASGRP1), endothelin receptor type A (EDNRA),
hyaluronan synthase 3 (HAS3), cathepsin C (CTSC), carbonic anhydrase II (CA2)
and cytokine-inducible SH2-containing protein (CISH). Conclusions HCjECs
expressed functioning IL-4Ralpha, and IL-4 stimulation induced the expression of
several genes.

PMID: 20610477  [PubMed - as supplied by publisher]

13: Br J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

Comparisons of anterior segment biometry between Chinese and Caucasians using
anterior segment optical coherence tomography.

Shun Leung CK, Palmiero PM, Weinreb RN, Li H, Sbeity Z, Dorairaj S, Leung D, Liu
S, Liebmann JM, Congdon N, Chiu Lam DS, Ritch R.

The Chinese University of Hong Kong, Hong Kong, P. R. China.

Purpose To compare anterior segment parameters between eyes of Chinese and
Caucasians using anterior segment optical coherence tomography and to evaluate
the association between these parameters and anterior chamber angle width
between the two ethnic groups. Methods 60 Chinese and 60 Caucasians, 30 with
open angles and 30 with narrow angles (defined as Shaffer grade /=3
quadrants during dark room gonioscopy) in each group, were consecutively
enrolled. One eye of each subject was randomly selected for imaging in a
completely darkened room. Measurements, including anterior chamber depth (ACD),
scleral spur-to-scleral spur distance (anterior chamber width (ACW)), anterior
chamber angle width, iris convexity and iris thickness, were compared between
the groups. The associations between angle opening distance and biometric
measurements were evaluated with univariate and multivariate regression
analyses. Results There were no differences in age, axial length, anterior
chamber angle measurements, pupil diameter and iris convexity between Chinese
and Caucasians in both open-angle and narrow-angle groups. However, the ACD and
ACW were smaller and the iris was thicker in Chinese. In the multivariate
analysis, the ACD was the most influential biometric parameter for angle opening
distance in both Chinese and Caucasians. After adjusting the effects of axial
length, age and sex, ACD and ACW were significantly smaller in Chinese.
Conclusions Chinese eyes had smaller ACD, smaller ACW and greater iris thickness
than Caucasians. ACD was the most influential parameter in determining the angle
width in both ethnic groups.

PMID: 20610476  [PubMed - as supplied by publisher]

14: Br J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

Angiography features of early onset drusen.

Guigui B, Leveziel N, Martinet V, Massamba N, Sterkers M, Coscas G, Souied EH.

Faculte de Medecine Henri Mondor, Creteil, France.

Aims Drusen are rarely observed in patients <50 years of age. Two types of early
onset drusen (EOD) are commonly described: basal laminar drusen (BLD) and drusen
associated with Malattia Leventinese (ML). Our purpose was to classify the
phenotype of EOD on the basis of fundus examination, and fluorescein angiography
(FA) and indocyanine green angiography (ICGA) features. Methods We performed a
prospective study including 48 consecutive EOD patients. All of them had a
complete ophthalmologic examination including FA and ICGA. Results BLD (67%)
were extremely hyperfluorescent on FA and ICGA. ML (10%) was characterised by a
combination of small radial and large round drusen with differences in staining
in both FA and ICGA. We evidenced a third type of EOD (23%) harbouring an aspect
of large colloid drusen (LCD), mildly hyperfluorescent in the early phases of
FA, with a progressive staining in late phases. In intermediate and late phases
of ICGA, LCD presented as hypofluorescent dot surrounded by a hyperfluorescent
halo bordered by a thin hypofluorescent ring. Conclusion Three types of EOD are
distinguished by their FA and ICGA features. We report a new kind of juvenile
drusen, distinct from BLD and ML, named LCD, associated with a good vision and
absence of complications.

PMID: 20610475  [PubMed - as supplied by publisher]

15: Br J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

Temporal trends in retinal detachment incidence in Scotland between 1987 and
2006.

Mitry D, Chalmers J, Anderson K, Williams L, Fleck BW, Wright A, Campbell H.

Princess Alexandra Eye Pavilion, Edinburgh, UK.

Aim Rhegmatogenous retinal detachment (RRD) is a common and sight-threatening
condition. The reported incidence of RRD has varied considerably in published
literature and few studies have examined the temporal trends in incidence rate
over a long time period. Our aim is to examine the time trends of primary RRD in
Scotland. Methods We obtained linked hospital episode statistics data for all
patients admitted with a primary diagnostic code of RRD in Scotland between 1987
and 2006. Using this database as an estimate of RRD incidence, we calculated the
annual age- and sex-specific incidence rates of RRD in Scotland. Log-linear
Poisson regression analysis was used to explore age, period and cohort trends.
Results The overall age-standardised incidence of RRD in Scotland has steadily
increased from 9.36 per 100 000 (95% CI 8.19 to 10.53) in 1987 to 13.61 per 100
000 (95% CI 12.25 to 14.97) in 2006 with an average annual increase of 1.9%
(p<0.001) during the 20-year period. Men have been affected more frequently than
women in all age groups with a significant temporal trend towards earlier age of
onset. The peak incidence of RRD in men and women is in the sixth decade of
life. No significant period or recent birth cohort trend effects were found.
Conclusions The estimated incidence of RRD is within the range reported from
previous population-based studies worldwide. The rise in RRD incidence between
1987 and 2006 is attributed in part to the changing demographic in Scotland.
There is an increasing sex imbalance in incidence, with men being affected more
frequently and at a younger age.

PMID: 20610474  [PubMed - as supplied by publisher]

16: Br J Ophthalmol. 2010 Jul;94(7):956-7; author reply 957-8. 

MUC1 biosynthesis in human corneal and conjunctival epithelia.

Mantelli F, Argueso P.

Publication Types:
    Comment
    Letter

PMID: 20606033  [PubMed - in process]

17: Br J Ophthalmol. 2010 Jul;94(7):954-5. 

Isolated superior division oculomotor palsy in neurocysticercosis: a rare
presentation.

Meena MK, Khuteta A, Vashishtha R.

Publication Types:
    Letter

PMID: 20606032  [PubMed - in process]

18: Br J Ophthalmol. 2010 Jul;94(7):953-4. 

Iris melanoma in a child treated with iridectomy and a phakic iris repair
implant lens: a case report of 8 years postoperative follow-up.

de Keizer RJ, Razzaq L, Tassignon MJ, Verbeek AM.

Publication Types:
    Letter

PMID: 20606031  [PubMed - in process]

19: Br J Ophthalmol. 2010 Jul;94(7):951-3. 

Radial graft contraction may relate to subnormal visual acuity in Descemet
stripping (automated) endothelial keratoplasty.

Moutsouris K, Ham L, Dapena I, van der Wees J, Melles GR.

Publication Types:
    Letter

PMID: 20606030  [PubMed - in process]

20: Br J Ophthalmol. 2010 Jul;94(7):949-50. 

Nidek MP-1 microperimetry and Fourier domain optical coherence tomography
(FD-OCT) in X linked retinoschisis.

Biswas S, Funnell CL, Gray J, Bunting R, Lloyd IC, Stanga PE.

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

PMID: 20606028  [PubMed - in process]

21: Br J Ophthalmol. 2010 Jul;94(7):940-6. 

Minocycline is cytoprotective in human corneal endothelial cells and induces
anti-apoptotic B-cell CLL/lymphoma 2 (Bcl-2) and X-linked inhibitor of apoptosis
(XIAP).

Kernt M, Hirneiss C, Neubauer AS, Kampik A.

Department of Ophthalmology, Ludwig-Maximilians-Universitat, Munich, Germany.
marcus.kernt@med.uni-muenchen.de

INTRODUCTION: Loss of corneal endothelial cells (CECs) is one major factor
limiting transplant clarity and survival after keratoplasty. Amongst other
factors, apoptosis due to cellular stress is responsible for these problems.
This study investigates the possible anti-apoptotic and cytoprotective effects
of minocycline on a human corneal endothelial cell line (HCEC-SV40) cultured
under oxidative stress and with transforming growth factor beta (TGF-beta).
METHODS: CECs were treated with 1-150 microM minocycline. Cell viability and the
median inhibitory concentration (IC(50)) were evaluated after 48 h and after
H(2)O(2) treatment (tetrazolium dye reduction assay and live-dead assay).
Expression of B-cell CLL/lymphoma 2 (Bcl-2) and X-linked inhibitor of apoptosis
(XIAP) and their mRNA were assessed by reverse transcriptase (RT)-PCR and
western blot analysis after treatment with minocycline alone and consecutive
incubation with 200 microM H(2)O(2) and TGF-beta2. A quantitative detection of
histone-associated DNA fragmentation by ELISA was performed. RESULTS:
Minocycline concentrations from 1-50 microM showed no toxic effects on CECs.
Pre-treatment with 10-40 microM minocycline led to an increase in viability
after H(2)O(2) treatment. In addition, minocycline pre-treatment attenuated the
increase of histone-associated DNA fragmentation after treatment with H(2)O(2)
and TGF-beta2 significantly. When CECs were treated with minocycline and then
consecutively with H(2)O(2) or TGF-beta2, RT-PCR and western blot analysis
yielded an overexpression of Bcl-2 and XIAP. CONCLUSION: In this study
minocycline prevented apoptotic cell death in cultured CECs in vitro. Our
results suggest that minocycline might offer cytoprotective properties that
might help to prevent loss of corneal endothelial cells in vivo.

PMID: 20606027  [PubMed - in process]

22: Br J Ophthalmol. 2010 Jul;94(7):933-9. 

Alcohol delamination in the treatment of recurrent corneal erosion: an electron
microscopic study.

Mencucci R, Paladini I, Brahimi B, Menchini U, Dua HS, Romagnoli P.

Department of Ophthalmology, University of Florence, Italy.
rita.mencucci@unifi.it

AIM: To investigate by electron microscopy the plane of separation of the
epithelial sheet from its substratum in the procedure of alcohol delamination
(ALD) in patients with recurrent corneal erosion syndrome. METHODS: Ten cases of
recurrent corneal erosions (RCE) secondary to trauma and seven cases related to
map-dot-fingerprint dystrophy (MDFP) were treated with ALD. The epithelial
sheets obtained from these patients were examined by transmission electron
microscopy. Similarly sheets obtained from 20 patients undergoing
photorefractive keratectomy (10 by mechanical removal and 10 by ALD) were also
examined as control group. Five further corneal buttons obtained at keratoplasty
were treated with ALD and the epithelial sheet and corresponding stroma were
both examined. RESULTS: In all specimens, whether removed mechanically or by
ALD, the intercellular surfaces did not show any disruption and desmosomes were
preserved. In patients with traumatic RCE and in corneal buttons obtained at
keratoplasty, tissue separation occurred along the lamina lucida, whereas in
patients with MDFP the whole basal lamina was removed along with the epithelium.
Focal areas of basal cell degeneration and epithelial detachment from the basal
lamina were also noted. CONCLUSIONS: ALD enables efficient removal of the
epithelium with an almost complete preservation of the lamina densa in traumatic
RCE. In RCE due to MDFP the epithelium separates from the stroma below the basal
lamina and may reflect the pathology of the condition.

PMID: 20606026  [PubMed - in process]

23: Br J Ophthalmol. 2010 Jul;94(7):915-7. 

The effect of genetic variants in SERPING1 on the risk of neovascular
age-related macular degeneration.

Lee AY, Kulkarni M, Fang AM, Edelstein S, Osborn MP, Brantley MA.

Department of Ophthalmology and Visual Sciences, Washington University School of
Medicine, St Louis, Missouri 63110, USA.

PURPOSE: Genetic factors influence an individual's risk for developing
age-related macular degeneration (AMD), a leading cause of irreversible vision
loss. Previous studies investigating the potential association between all AMD
subtypes and the SERPING1 gene, which encodes a key regulator of the classic
complement pathway, have yielded conflicting results. The purpose of this study
is to determine whether variations in SERPING1 are associated with neovascular
AMD. METHODS: A total of 556 patients with neovascular AMD and 256 ethnically
matched controls were genotyped for polymorphisms in SERPING1. A tagging single
nucleotide polymorphism (tSNP) approach was used to cover the SERPING1 gene plus
2 kb on each side, spanning the promoter and the 3' untranslated regions. Ten
SNPs with a minor allele frequency of 0.10 were covered by three tSNPs
(rs1005510, rs11603020, rs2511989). RESULTS: SERPING1 SNPs rs1005510 and
rs2511989 were significantly associated with neovascular AMD in our cohort, with
rs1005510 conferring an adverse risk effect (OR 1.49, 95% CI 1.18 to 1.88) and
rs2511989 conferring a protective effect (OR 0.73, 95% CI 0.59 to 0.90). For
both tSNPs, logistic regression of individual genotypes demonstrated
statistically significant stepwise changes in the risk of developing AMD.
Combined analysis of rs1005510 with variants in CFH and HTRA1 confirmed an
independent risk effect. The rs11603020 variant had no effect on AMD
susceptibility in this study (OR 0.98, 95% CI 0.78 to 1.24). CONCLUSIONS: The
SERPING1 gene is comprehensively investigated in this study (using three tSNPs),
and its genetic variants are evaluated in the largest neovascular AMD cohort to
date. The hypothesis that SERPING1 has a modest effect on the risk of
neovascular AMD is supported by our results.

Publication Types:
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 20606025  [PubMed - in process]

24: Br J Ophthalmol. 2010 Jul;94(7):858-63. 

Intravitreal triamcinolone and bevacizumab as adjunctive treatments to
panretinal photocoagulation in diabetic retinopathy.

Cho WB, Moon JW, Kim HC.

Department of Ophthalmology, Konkuk University Medical Center, Konkuk University
School of Medicine, Seoul, Republic of Korea.

BACKGROUND/AIMS: To evaluate efficacy of intravitreal triamcinolone (IVTA) and
bevacizumab (IVB) as adjunctive treatments to panretinal photocoagulation (PRP).
METHODS: In 91 eyes of 76 patients (clinically significant macular oedema (CSME)
46 eyes; no CSME 45 eyes) with severe diabetic retinopathy, PRP with IVTA (IVTA
group, 30 eyes) or PRP with IVB (IVB group, 31 eyes) or PRP only (PRP group, 30
eyes) was performed. Primary outcome measures were changes in best corrected
visual acuity (BCVA) and central macular thickness (CMT) at 1 and 3 months.
Secondary outcome measures were proportion of visual gain or loss, and decreased
or increased CMT. RESULTS: There was significant worsening in BCVA from 0.26 to
0.29 at 1 and 3 months (p=0.031) in the PRP group. In eyes with CSME, there was
significant improvement of BCVA from 0.33 to 0.27 at 1 and 3 months (p=0.012) in
IVTA group. In eyes without CSME, PRP group showed significant worsening in BCVA
from 0.18 to 0.26 at 1 month (p=0.008) and 0.27 at 3 months (p=0.005). There was
significant improvement in CMT in IVTA and IVB groups: in eyes without CSME,
there was significant increase in CMT from 209.75 to 259.00 microm at 1 month
(p=0.023) and to 276.14 microm at 3 months (p=0.011) in the PRP group; in eyes
with CSME, the proportion of eyes with visual gain and decreased CMT was
significantly higher in the IVTA group (75% and 100%, respectively) than in the
IVB group (37.5% and 62.5%, respectively). CONCLUSIONS: IVTA and IVB may be
effective adjunctive treatments to PRP, minimising the risk of PRP-induced
macular oedema and visual loss.

PMID: 20606024  [PubMed - in process]

25: Br J Ophthalmol. 2010 Jul;94(7):848-53. 

Adverse effects of smoking on patients with ocular inflammation.

Galor A, Feuer W, Kempen JH, Kacmaz RO, Liesegang TL, Suhler EB, Foster CS, Jabs
DA, Levy-Clarke GA, Nussenblatt RB, Rosenbaum JT, Thorne JE.

Bascom Palmer Eye Institute, University of Miami, USA.

BACKGROUND: To evaluate how smoking affects the time to disease quiescence and
time to disease recurrence in patients with ocular inflammation. METHODS: A
retrospective cohort study of patients with ocular inflammation who were
followed longitudinally and had smoking information available in the Systemic
Immunosuppressive Therapy for Eye Diseases Cohort Study database. RESULTS: Among
2676 patients with active ocular inflammation, smokers were more likely to have
bilateral ocular disease and poorer visual acuity on presentation compared with
non-smokers and previous smokers. In a multivariate analysis, there was no
statistically significant difference in the time to disease quiescence between
groups. However, the median time to recurrence of ocular inflammation was
statistically significantly longer for non-smokers (9.4 months) and for previous
smokers (10.7 months) than for current smokers (7.8 months) (p=0.02). The RR of
ocular inflammation recurrence was higher for smokers than for non-smokers
(adjusted HR=1.19, 95% CI 1.03 to 1.37) and tended towards significance in
previous smokers (adjusted HR=1.11, 95% CI 0.93 to 1.35). CONCLUSIONS: Smoking
was associated with an increased likelihood of bilateral ocular inflammation and
reduced vision upon presentation, and an increased risk of recurrence compared
with not smoking. These results suggest that patients with ocular inflammation
should be counselled to stop smoking as part of routine management.

Publication Types:
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 20606023  [PubMed - in process]

26: Br J Ophthalmol. 2010 Jul;94(7):843-7. 

Visualisation of active subretinal implants with external connections by
high-resolution CT.

Gekeler F, Kopp A, Sachs H, Besch D, Greppmaier U, Zrenner E, Bartz-Schmidt KU,
Szurman P.

Centre for Ophthalmology, University of Tubingen, Tubingen, Germany.
gekeler@uni-tuebingen.de

Two patients carrying an active subretinal implant with extra-ocular parts were
examined by high-resolution CT. Cranial scans were acquired in the primary
position and in eight additional directions of gaze with eyes open and closed to
demonstrate the mobility of the eyeball and the implant within the orbital
cavity. Three-dimensional images were constructed to visualise the path of the
implant from the retro-auricular space around the lateral orbital rim through
the orbit and within the subretinal space up to the device's final para-foveal
position. Images were obtainable in high quality, resulting in three-dimensional
models illustrating all parts of the implant including the micro-photodiode
array at the tip in the subretinal space. The implant followed eye movements in
all directions of gaze; eye movements were only minimally restricted as
described in previous publications. Since all, except intra-ocular, parts of the
implant evade direct examination, CT can be useful to assess the technical
integrity and the biocompatibility and biostability of retinal implants.

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

PMID: 20606022  [PubMed - in process]

27: Br J Ophthalmol. 2010 Jul;94(7):827-30. 

Refractive error, axial length and anterior chamber depth of the eye in British
adults: the EPIC-Norfolk Eye Study.

Foster PJ, Broadway DC, Hayat S, Luben R, Dalzell N, Bingham S, Wareham NJ, Khaw
KT.

Division of Genetics and Epidemiology, UCL Institute of Ophthalmology,
University College London, London, UK. p.foster@ucl.ac.uk

PURPOSE: To describe the distribution, and demographic and socioeconomic
correlates of refractive error and related ocular biometry in an older British
population. METHODS: Refractive error was measured using an auto-refractor
without cycloplegia. Pseudophakic individuals and those who had undergone
refractive surgery were excluded from analysis. Axial length and anterior
chamber depth were measured using partial coherence laser interferometry.
Occupation category and highest educational achievement were recorded. RESULTS:
Biometric data were available for 2519 people (1090 men, 1429 women; 93.2% of
all participants) aged 48 to 88 years. Refractive data were available for both
eyes in 2210 bilaterally phakic participants. Among phakic individuals, axial
length of the eye was strongly inversely correlated with refractive error in
both men and women (p<0.001). Axial length of the eye was strongly,
independently related to height, weight and social class, but most strongly
related to educational achievement. In contrast, anterior chamber depth varied
with age and sex, but not with socioeconomic status. There was a significant
inverse association between anterior chamber depth and refraction in women
(p<0.001) but not in men (p=0.495). CONCLUSION: Refractive error in this
predominantly white older UK population was associated with axial biometry and
sociodemographic characteristics. Educational status was the strongest
determinant of axial length.

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

PMID: 20606021  [PubMed - in process]

28: Br J Ophthalmol. 2010 Jul;94(7):813-4. 

Exogenous factors influencing endogenous inflammation: what can patients do to
improve control of their own uveitis?

Cunningham ET Jr.

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

PMID: 20606019  [PubMed - in process]

29: Br J Ophthalmol. 2010 Jul 5; [Epub ahead of print] 

Hypo-accommodation responses in hypermetropic infants and children.

Horwood AM, Riddell PM.

Reading UK and Royal Berkshire Hospital, Reading, UK.

Aims Accommodation to overcome hypermetropia is implicated in emmetropisation.
This study recorded accommodation responses in a wide range of emmetropising
infants and older children with clinically significant hypermetropia to assess
common characteristics and differences. Methods A PlusoptiXSO4 photorefractor in
a laboratory setting was used to collect binocular accommodation data from
participants viewing a detailed picture target moving between 33 cm and 2 m. 38
typically developing infants were studied between 6 and 26 weeks of age and were
compared with cross-sectional data from children 5-9 y of age with clinically
significant hypermetropia (n=15), corrected fully accommodative strabismus
(n=14) and 27 age-matched controls. Results Hypermetropes of all ages
under-accommodated compared to controls at all distances, whether corrected or
not (p<0.00001) and lag related to manifest refraction. Emmetropising infants
under-accommodated most in the distance, while the hypermetropic patient groups
under-accommodated most for near. Conclusions Better accommodation for near than
distance is demonstrated in those hypermetropic children who go on to
emmetropise. This supports the approach of avoiding refractive correction in
such children. In contrast, hypermetropic children referred for treatment for
reduced distance visual acuity are not likely to habitually accommodate to
overcome residual hypermetropia left by an under-correction.

PMID: 20603431  [PubMed - as supplied by publisher]

30: Br J Ophthalmol. 2010 Jul 2; [Epub ahead of print] 

Optical coherence tomographical findings in a case of varix of the vortex vein
ampulla.

Ismail RA, Sallam A, Zambarakji HJ.

Surrey, UK.

PMID: 20601664  [PubMed - as supplied by publisher]