1: Eur J Ophthalmol. 2010 Mar-Apr;20(2):492. 

Author's Reply to: Perfluorocarbon liquid vitreous delamination and wide-angle
viewing system in the management of complicated diabetic retinal detachment.

Yadarola M, Gramajo A, Arrambide M, Colombres G, Juarez C, Luna J.

Centro de Ojos Romagosa-Fundacion VER, Cordoba - Argentina.

PMID: 20213626  [PubMed - in process]

2: Eur J Ophthalmol. 2010 Mar-Apr;20(2):490-1. 

Letter to Editor: Perfluorocarbon liquid vitreous delamination and wide-angle
viewing system in the management of complicated diabetic retinal detachment.

Arevalo JF.

Retina and Vitreous Service, Clinica Oftalmologica Centro Caracas - Venezuela.

PMID: 20213625  [PubMed - in process]

3: Eur J Ophthalmol. 2010 Mar-Apr;20(2):490. 

Author's Reply to: Argon-laser iridoplasty in the management of uveitis-induced
acute angle-closure glaucoma.

Mansouri K, Ravinet E.

Jules Gonin Eye Hospital, Lausanne - Switzerland.

PMID: 20213624  [PubMed - in process]

4: Eur J Ophthalmol. 2010 Mar-Apr;20(2):489. 

Letter to Editor: Argon-laser iridoplasty in the management of uveitis-induced
acute angle-closure glaucoma.

Sakarya Y, Sakarya R.

Gozmer Eye Center, Denizli - Turkey.

PMID: 20213623  [PubMed - in process]

5: Eur J Ophthalmol. 2010 Jan 18;20(2):476-478 [Epub ahead of print] 

Partial regression of degenerative retinoschisis associated with epiretinal
membrane after vitrectomy.

Stopa M, Rogalinska I, Kociecki J.

Department of Ophthalmology, Poznan University of Medical Sciences, Poznan -
Poland.

Purpose. To report a new and atypical pathology of epiretinal membrane formation
on the top of the retinoschisis (schisis-membrane). Methods. We describe a
patient with recent visual acuity and visual field deterioration due to a rapid
progression of retinoschisis in the macular area resulting from shrinking
membrane on the top of the schisis. The patient underwent vitrectomy with
membrane removal. Results. Partial regression of the schisis was observed and
visual acuity improved from 5/12 to 5/5. Perimetry demonstrated that the
corresponding visual field deterioration partially regressed. Conclusions.
Release of traction exerted by a shrinking membrane is a surgical option to
promote regression of retinoschisis and improvement in visual field and vision
in schisis-membrane cases.

PMID: 20213622  [PubMed - as supplied by publisher]

6: Eur J Ophthalmol. 2010 Jan 19;20(2):442-450 [Epub ahead of print] 

Prevalence and causes of bilateral blindness and visual impairment among
institutionalized elderly people in Pamplona, Spain.

Sainz-Gomez C, Fernandez-Robredo P, Salinas-Alaman A, Montanes JM, Escudero
Berasategui JM, Guillen-Grima F, Ruiz-Moreno JM, Garcia-Layana A.

Department of Ophthalmology, Clinica Universidad de Navarra - Spain.

Purpose. To estimate the prevalence and causes of bilateral blindness and visual
impairment in an urban institutionalized population aged 65 years and older.
Methods. A total of 392 nursing home residents completed a standardized eye
examination, including measurement of visual acuity (VA), intraocular pressure,
lens opacity grading, indirect ophthalmoscopy, and photography of the macular
area. The major causes of vision loss identified for all participants were
blindness and visual impairment. Results. The average subject age was 82 years
(65-97); women outnumbered men 263 to 129. The prevalence of bilateral blindness
(VA >/=1.0 logarithm of the minimum angle of resolution [logMAR]) was 14.9%
(43/288); the prevalence of visual impairment (VA >/=0.5 and 1.0 logMAR) was
31.9% (92/288). Blindness and visual impairment increased significantly with age
(p<0.05), odds ratio (OR) 1.047 and 1.088, respectively. Cataract was the most
common cause of bilateral blindness and visual impairment (27.9% and 44.6%,
respectively) followed by pathologic myopia (23.3%) and age-related macular
degeneration (AMD) (20.9%) for blindness, and by AMD (27.2%) and pathologic
myopia (12%) for visual impairment. Fifty percent of subjects with visual loss
had the potential for improved vision with medical or surgical intervention.
Conclusions. Although the prevalences were high, these data are important since
it is difficult for epidemiologic studies to include aged, institutionalized
individuals, although their numbers are increasing. Recognition of the
predominant causes of visual loss dependent on age is fundamental for early
diagnosis and treatment of ocular diseases. Many cases of low vision can be
treated with appropriate ophthalmologic care.

PMID: 20213621  [PubMed - as supplied by publisher]

7: Eur J Ophthalmol. 2010 Jan 12;20(2):306-309 [Epub ahead of print] 

Broader corneal characterization with PulseESPI applied to elasticity
measurements.

Gualini MM, Iqbal S, Sixt W, Khan WA, Zulfiqar K.

Electronics Engineering Department, Politecnico di Torino, Torino - Italy.

Purpose. A novel application of pulsed electronic speckle pattern interferometry
(PulseESPI) techniques in important corneal elasticity measurements is presented
in this pilot study. For laser-ablative procedures like laser-assisted in situ
keratomileusis, it has been found that elastic properties of the cornea have a
role in the outcome of corneal refractive surgery, while for optimal ablative
laser power calculations this measurement method may possibly be helpful. It may
also help in earlier diagnosis of degenerative corneal disorders such as
keratoconus. Methods. The approach of this study is to observe dynamic behavior
of cornea against stresses as mapped with PulseESPI. For this purpose, strain
was induced to the cornea using a fine rod with a mechanical vibrator. Results.
It was found that cornea has a response pattern to the dynamic stressing. Its
surface exhibits a resonance frequency which can be measured with PulseESPI.
This information of resonance frequency can be characteristic to the cornea.
Conclusions. PulseESPI may help in important corneal elasticity measurements
used for complication-free optimized ophthalmic surgery. It seems to be a
promising method to conduct stress-related investigations on biological samples.
To our knowledge, this is the first time that PulseESPI has been used for such
ophthalmic measurements.

PMID: 20213620  [PubMed - as supplied by publisher]

8: Eur J Ophthalmol. 2009 Dec 28;20(2):283-289 [Epub ahead of print] 

Early bubble modification of the big bubble technique for deep anterior lamellar
keratoplasty.

Hosny MH, Shalaby AM, Badr El Din N.

Faculty of Medicine, Cairo University; and Dar Eloyoun Eye Hospitals - Egypt.

Purpose. We modified the deep anterior lamellar keratoplasty big bubble
technique to improve safety and ease of performance. Methods. We describe a
modification of the big bubble technique that involves injecting the air bubble
through a peripheral corneal incision 1 mm from the limbus. The incision is made
with a limbal relaxing incision knife. This is done before trephination of the
recipient cornea, hence the name "early bubble." The goal of this technique is
to reduce the risk of intraoperative corneal perforation and to obtain a large
air bubble between Descemet membrane and the corneal stroma. We report outcomes
of this technique in 21 eyes. Results. At 6 months, 16 eyes showed a
best-corrected visual acuity of 20/50; the remaining eyes had a best-corrected
visual acuity of 20/80 or better. The postoperative corneal astigmatism was
3.6+/-0.9 diopters at 3 months and 3.15+/-0.67 diopters at 6 months. The rate of
conversion to penetrating keratoplasty was 14%. Conclusions. We found that the
"early bubble" technique improved the ease of performance, safety, and
predictability of deep anterior lamellar keratoplasty.

PMID: 20213619  [PubMed - as supplied by publisher]

9: Eur J Ophthalmol. 2010 Mar 1; [Epub ahead of print] 

Comparison of Tearscope-plus versus slit lamp measurements of inferior tear
meniscus height in normal individuals.

Fodor E, Hagyo K, Resch M, Somodi D, Nemeth J.

Department of Ophthalmology, Semmelweis University, Budapest - Hungary.

Purpose. To measure the lower tear meniscus height (LTMH) with image by
Tearscope and using slit-lamp biomicroscopy with or without fluorescein
staining. Patients and Methods. The lower tear meniscus height was measured in
31 eyes of 31 healthy volunteers (mean age 31.29 years; SD 4.83) with Tearscope
and slit lamp with and without fluorescein staining. The mean values of LTMH
were measured with different methods and the repeatability of the measurements
was statistically analyzed. Measurement of fluorescein tear film break up time
(FBUT) and Schirmer test were also performed.Results. The mean value of LTMH was
0.21 mm (SD 0.07) with Tearscope, 0.20 mm (SD 0.06) with slit lamp without
fluorescein staining, and 0.23 mm (SD 0.07) with fluorescein staining. There was
no significant difference among the mean values of LTMH with these 3 different
measurement methods. Based on the random effect analysis of variance (p=0.05),
the measurements were more repeatable with Tearscope-plus than with the other 2
methods. No correlation was found between the LTMH and the results of Schirmer
test or FBUT. Conclusions. The LTMH could be reliably measured with slit-lamp
biomicroscopy without staining, but the measurements were more repeatable with
Tearscope.

PMID: 20213618  [PubMed - as supplied by publisher]

10: Eur J Ophthalmol. 2010 Mar 2; [Epub ahead of print] 

Long-term visual acuity and its predictors after cataract surgery in patients
with uveitis.

Yoeruek E, Deuter C, Gieselmann S, Saygili O, Spitzer MS, Tatar O, Bartz-Schmidt
KU, Szurman P.

University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University
Tuebingen, Tuebingen - Germany.

Purpose. To analyze the outcomes of phacoemulsification and posterior
intraocular lens (IOL) implantation in patients with uveitis and to determine
factors responsible for poor visual outcome.Patients and Methods. The records of
155 patients (180 eyes) with uveitis who had phacoemulsification and IOL
implantation between August 2001 and March 2008 were examined retrospectively.
Best-corrected visual acuity (BCVA) was recorded at the immediate preoperative
visit and at follow-up examinations every 3 months. At each postoperative visit,
a complete ophthalmologic examination was performed. The postoperative visual
outcomes and complications were analyzed. Univariate regression analysis was
done to determine risk factors for poor visual acuity during follow-up. Results.
The mean follow-up was 31.4 months (range 3-78 months). An underlying systemic
disease was present in 70 (45.2%) patients (82 eyes, 45.6%). The mean
preoperative logMAR BCVA was 1.13+/-0.62 (95% CI: 0.85-1.02) and increased to
0.42+/-0.57 (95% CI: 0.32-0.59) at last medical visit (p<0.001). A total of 107
eyes (59.4%) had postoperative complications including posterior capsular
opacification, newly developed macular edema, recurrence of uveitis, macular
epiretinal membrane, and deposits on the IOL surface. Preoperatively observed
macular lesions was the factor most strongly associated with poor visual outcome
after cataract surgery (odds ratio: 5.43; 95% CI: 3.41-7.34; p<0.001). Anterior
segment pathologies, age at surgery, etiology of uveitis (idiopathic, uveitis
associated systemic disease, and gender did not influence visual rehabilitation
after surgery (p>0.05). Conclusions. The outcomes of phacoemulsification and IOL
implantation in patients with uveitis were satisfactory. Patients with observed
preoperative macular lesions are at risk for poor visual outcome.

PMID: 20213617  [PubMed - as supplied by publisher]

11: Eur J Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Adjustable superior oblique tendon spacer with application of nonabsorbable
suture for treatment of isolated inferior oblique paresis.

Fard MA, Ameri A, Anvari F, Jafar AK, Yazdian Z.

Farabi Eye Research Center, Department of ophthalmology, Tehran University of
Medical Sciences, Tehran - Iran.

Purpose. To evaluate and report the outcomes of a superior oblique tendon spacer
procedure using nonabsorbable adjustable sutures in patients with inferior
oblique (IO) paresis.Methods. This interventional case series included 6 eyes of
6 patients with IO paresis. All met Bielschowsky/Parks Three-step Test criteria
to identify an isolated IO paresis. In all patients, the superior oblique tendon
was exposed; 2 nonabsorbable polyester sutures were placed 3 mm apart, and the
tendon was cut. With the use of a slipknot, the cut ends of the tendon were
separated 5 to 7 mm. Tendon separation was adjusted intraoperatively according
to the fundus torsion and exaggerated traction test.Results. The mean duration
of follow-up was 16.5 months (range, 10-23 months). Four patients had congenital
IO paresis and 2 had iatrogenic IO paresis following denervation/myectomy of IO.
Mean primary position hypotropia improved from 15.2 prism diopters (PD) before
surgery to 2.7 PD in congenital IO paresis and from 11.5 PD to 2.5 PD in
iatrogenic IO paresis. In congenital IO paresis, mean preoperative superior
oblique overaction and IO underaction was +2 and -2, which decreased to 0 and
-1.25 respectively; fundus incyclotorsion resolved in all patients. Superior
oblique overaction and IO underaction improved in iatrogenic IO paresis as well.
In no patient did an overcorrection develop.Conclusions. The adjustable superior
oblique tendon suture spacer procedure is an effective and safe option for
correcting IO paresis without developing iatrogenic superior oblique paresis.

PMID: 20213616  [PubMed - as supplied by publisher]

12: Eur J Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Anesthesiologist intervention during cataract surgery under topical or
peribulbar anesthesia: a propensity model comparison.

Gemma M, Gioia L, Dedola E, Basta B, Bianchi I, Fasce F, Beretta L.

Anesthesia and Intensive Care Unit, San Raffaele Scientific Institute, Milano -
Italy.

Purpose. To compare the incidence and type of anesthesiologist intervention
during cataract surgery under peribulbar (PA) or topical (TA) anesthesia in a
day-surgery monitored anesthesia care setting (monitoring provided by nurses
with the anesthesiologist available on an on-call basis).Methods. From a
prospective database of all phacoemulsifications performed in our hospital
(January 2008-January 2009), 97 patients submitted to cataract surgery under PA
were matched with 97 patients submitted to the same surgery under TA by a
propensity model. The resulting groups were homogeneous as to history of
antihypertensive therapy administered on the day of surgery and not administered
on the day of surgery, cardiologic history, neurologic history, psychiatric
history, anxiolytic assumption, and history of diabetes mellitus. We compared
the incidence of intervention of the anesthesiologist between groups and the
type of adverse event triggering such interventions.Results. The
anesthesiologist was called in 37 (38.14%) cases in the PA group and in 27
(27.84%) cases in the TA group (37 [38.14%]) (p=0.123). Only the occurrence of
agitation differed significantly between groups (9 [9.28%] patients in the TA
group vs 24 [24.74%] patients in the PA group; p=0.004).Conclusions. Monitored
anesthesia care is feasible for cataract surgery both under PA or TA. PA still
remains an appealing alternative to TA during cataract surgery for patients
incapable of keeping the operating eye in the primary position or with
incoercible blinking, photophobia, or phacodonesis. A greater incidence of
agitation is to be expected and adequate premedication with anxiolytics should
be considered if PA is chosen.

PMID: 20213615  [PubMed - as supplied by publisher]

13: Eur J Ophthalmol. 2010 Mar 4; [Epub ahead of print] 

Intravitreal ranibizumab for choroidal neovascularization associated with
retinal astrocytic hamartoma.

Querques G, Kerrate H, Leveziel N, Coscas G, Soubrane G, Souied EH.

Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris
XII, Paris - France.

Purpose. To report on a patient with retinal astrocytic hamartoma, who developed
a choroidal neovascularization (CNV), effectively treated by intravitreal
ranibizumab injections.Methods. A 74-year-old woman who, 12 years before, had
been diagnosed with a yellow-gray lesion in the left eye (OS) presented in our
department for OS decreased vision of recent onset.Results. Upon a complete
ophthalmologic examination including ultrasonography, fluorescein angiography
(FA), and spectral domain optical coherence tomography (SD-OCT), the patient was
diagnosed with retinal astrocytic hamartoma and coincident CNV on its foveal
border. Six months after 3 monthly intravitreal ranibizumab injections, FA and
OCT revealed the CNV closure and absence of intraretinal and subretinal fluid on
the foveal border of the retinal astrocytic hamartoma.Conclusions. Associations
between retinal astrocytic hamartoma and CNV have not been previously reported.
Intravitreal ranibizumab injection appears an attractive therapeutic option for
patients showing such an unusual association.

PMID: 20213614  [PubMed - as supplied by publisher]

14: Eur J Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Cataract and pseudophakia in elderly European drivers.

Nischler C, Michael R, Wintersteller C, Marvan P, Emesz M, Van Rijn LJ, van den
Berg TJ, Wilhelm H, Coeckelbergh T, Barraquer RI, Grabner G, Hitzl W.

Department of Ophthalmology, Paracelsus Private Medical University Salzburg,
Salzburg - Austria.

Purpose. To evaluate the prevalence and association of different types and
severities of cataract or pseudophakia with visual impairments in older European
drivers.Methods. In this prospective European multicenter study, 2211 active
drivers, 45 years of age and older, participated in an ophthalmologic
examination, the measurement of visual functions, and were asked to fill in the
NEI-VFQ-25 and another questionnaire about driving habits, driving difficulties,
and self-reported accidents.Results. Prevalence of moderate and severe forms of
cataract in an active driving population is lower than that in the general
population, but could be found in both eyes in 20% (95% confidence interval [CI]
16%-25%) and 17% (95% CI:13%-21%) of subjects 75 years of age and older. In
addition, there is a strong relationship between severity of cataract and
parameters such as age, visual acuity, intraocular straylight, and contrast
sensitivity.Conclusions. Cataract is not as highly prevalent in the elderly
active driving population as in the general population, but is frequently
present in drivers over 65 years of age. Lower prevalence of severe bilateral
cataracts in countries with mandatory tests of visual functions of drivers
suggest that this could be a suitable measure to detect and to reduce the number
of active drivers with severe bilateral cataracts.

PMID: 20213613  [PubMed - as supplied by publisher]

15: Eur J Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Paraneoplastic exudative retinal detachment associated with adenocarcinoma of
the lung.

Burgess PI, Kenawy N, Pearce IA.

Royal Liverpool University Hospital, Liverpool - UK.

Purpose. To report a case of bilateral paraneoplastic exudative retinal
detachment (ERD) associated with asymptomatic adenocarcinoma of the
lung.Methods. Case report.Results. A 47-year-old man presented with bilateral
ERD accompanied by anterior and posterior segment inflammation. Extensive
investigations for local and systemic causes of ERD were unrewarding. Only when
computed tomography scanning of the thorax was performed were enlarged thorax
lymph nodes demonstrated and revealed biopsy-proven adenocarcinoma.Conclusions.
Paraneoplastic phenomena should be considered in patients presenting with ERD.
Ocular paraneoplastic pathologies may be the initial manifestation of an
underlying malignancy.

PMID: 20213612  [PubMed - as supplied by publisher]

16: Eur J Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

PRPH2 (Peripherin/RDS) mutations associated with different macular dystrophies
in a Spanish population: a new mutation.

Coco RM, Telleria JJ, Sanabria MR, Rodriguez-Rua E, Garcia MT.

Instituto de Oftalmobiologia Aplicada (IOBA), Universidad de Valladolid,
Valladolid - Spain.

Purpose. To assess the occurrence of PRPH2 mutations in patients presenting
macular dystrophies and to describe their phenotype-genotype
correlation.Methods. A total of 32 sporadic cases and 13 individuals from 5
families were studied. The patients presented early onset drusen, suspected
pattern dystrophy (including adult-onset foveomacular vitelliform dystrophy
[AOFVD]), or any presumed macular dystrophy producing neovascularization or
atrophic changes documented before patients reached 50 years of age. In case of
atrophy, this could be confined to the macula, which was considered to be
central areolar choroidal dystrophy (CACD), or extend to the midperiphery of the
retina, which we called diffuse macular dystrophy (DMD). Clinical workup and
analysis of PRPH2, EFEMP1, and TIMP3 genes were done.Results. Four mutations of
the PRPH2 gene were found in 3 sporadic cases and 3 families (n=11). A p.R46X
mutation, previously described in CACD, was found in 3 members of a family with
AOFVD and in a sporadic case with DMD. A p.L45F mutation, described before in
retinitis pigmentosa, was found in a sporadic case of AOFVD. A p.R195L mutation
previously described in CACD was found in 2 members of a family with CACD. The
latter was found in a family and a sporadic case (from the same village as the
family) and all of them presented DMD. A new p.V209I mutation was found in a
patient with AOFVD.Conclusions. New phenotypes were found for known mutations.
No phenotype variation was observed in the members of the 3 families. A new
mutation in PRPH2 gene was found.

PMID: 20213611  [PubMed - as supplied by publisher]

17: Eur J Ophthalmol. 2010 Apr 3; [Epub ahead of print] 

Evaluation of a recently developed noncontact specular microscope in comparison
with conventional pachymetry devices.

Modis Jr L, Szalai E, Nemeth G, Berta A.

Department of Ophthalmology, Medical and Health Science Center, University of
Debrecen, Debrecen - Hungary.

Purpose. The study was conducted to assess the central corneal thickness (CCT)
of the healthy cornea with a recently developed noncontact specular microscope
(EM-3000; Tomey) and compare the results with those measured with a contact
specular microscope and an ultrasound pachymeter. Agreement between measurements
taken by 2 investigators was also studied.Methods. The right eyes of 41 healthy
individuals who had negative history of contact lens wear, ophthalmic disease,
or ocular surgery were examined. The CCT was determined sequentially with a
noncontact specular microscope, a contact specular microscope (EM-1000; Tomey),
and an ultrasound pachymeter (AL-2000; Tomey). Each evaluation with the specular
microscopes was performed by 2 independent operators.Results. A significant
difference was detected in pachymetry measurements among the 3 instruments
(p=0.01; analysis of variance). The mean CCT values were lower measured with the
ultrasound pachymeter (537+/-30 microm) than the contact endothelial microscope
(543+/-37 microm, p=0.17, Student t-test) and the noncontact microscope
(549+/-33 microm, p<0.0001) (operator 1). There was no statistically significant
difference in CCT measurements between the 2 endothelial microscopes (p=0.19).
We found significant correlations (p<0.0001) in thickness measurements between
each pair of instruments (r=0.91, noncontact microscopy and ultrasound
pachymetry; r=0.74, noncontact and contact microscopy; r=0.72, contact
microscopy and ultrasound pachymetry; Spearman rank correlation). Conclusions.
The strong correlations among the 3 pachymetry devices suggest that the tested
instruments provide reliable measurements; however, they cannot be used
interchangeably.

PMID: 20213610  [PubMed - as supplied by publisher]

18: Eur J Ophthalmol. 2010 Feb 20; [Epub ahead of print] 

Comparison of corneal endothelial cell density estimated with 2 noncontact
specular microscopes.

Goldich Y, Marcovich AL, Barkana Y, Hartstein M, Morad Y, Avni I, Zadok D.

Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin - Israel.

Purpose. To assess the repeatability of endothelial cell density (ECD)
measurements by the EM-935 endothelial microscope and their agreement with those
of the Konan-Noncon Robo SP 6000 (Noncon Robo) specular microscope.Methods. We
assessed the agreement between automated and semiautomated methods of analysis
of the EM-935 and the Noncon Robo by measuring ECD in 40 eyes of 20 healthy
subjects and calculating the 95% limits of agreement (LoA) and plotting
Bland-Altman graphs. We then evaluated the repeatability of both the methods of
the EM-935 by calculating the intraclass correlation coefficients (ICC) and
coefficient of variation (CV).Results. The mean ECD of the 40 eyes was
2531+/-244 cells/mm2 for Noncon Robo and 2483+/-159 cells/mm2 for
EM-935-automated. The difference between these 2 methods was not statistically
significant. The mean ECD for EM-935-semiautomated was 2635+/-190 cells/mm2 and
was statistically significantly higher than the 2 other methods (p<0.001). The
95% LoA were -435 to 339 cells/mm2 for the Noncon Robo and EM-935-automated,
-230 to 438 cells/mm2 for the Noncon Robo and EM-935-semiautomated, and -347 to
43 cells/mm2 for the EM-935-automated and EM-935-semiautomated. Repeatability
was better for EM-935-semiautomated method compared with automated method as
expressed by ICC (95% CI) of 0.80 (0.52-0.95) vs 0.50 (0.09-0.84) and
coefficient of variation of 2.43% vs 2.85%, respectively. Conclusions. The
EM-935 specular microscope showed better repeatability for the semiautomated
mode compared with the automated mode. Although measurement agreement with the
Noncon Robo was somewhat better for the semiautomated mode, agreement was only
moderate for both methods. This leads us to recommend that these instruments
should not be used interchangeably.

PMID: 20175056  [PubMed - as supplied by publisher]

19: Eur J Ophthalmol. 2010 Feb 20; [Epub ahead of print] 

Epidemiology and etiologic diagnosis of infectious keratitis in Uberlandia,
Brazil.

Furlanetto R, Andreo EG, Finotti IG, Arcieri ES, Ferreira MA, Rocha FJ.

Department of Ophthalmology, Federal University of Uberlandia, Minas Gerais -
Brazil.

Purpose. To study risk factors, microbiological characteristics, and clinical
course of nonviral infectious keratitis diagnosed in a referral service of
ophthalmology. Methods. A total of 65 charts of patients with microbial
keratitis were retrospectively reviewed at the Clinical Hospital of Federal
University of Uberlandia, Brazil, from July 2001 through August 2004. All cases
were submitted to microbiological tests and treated according to local protocol.
Risk factors, clinical course, therapeutic keratoplasty, and visual outcomes
were analyzed. Results. The mean age of patients was 45.9 years (2-83 years) and
male to female ratio 2.6:1. Symptoms at presentation ranged from 1-3 days in 16
patients out of 65 (24.61%), 4-7 days in 19 cases (19/65; 29.23%), and more than
7 days in 27 patients (27/65; 41.53%). The major risk factor was trauma (28/65;
40%), predominantly by organic material. A total of 32 eyes out of 65 (49.23%)
were culture positive. Fungi were the most common isolates (18/32; 56.25%),
being headed by Fusarium sp. (11/65; 16.92%), and the most common bacteria was
Streptococcus pneumoniae (7/65; 10.77%). Final visual acuity was equal to or
better than 20/60 in 20 patients out of 65 (30.77%), between 20/60 and 20/400 in
7 patients (7/65; 10.77%), and worse than 20/400 in 35 patients out of 65
(53.85%). A total of 48 eyes out of 65 (73.84%) presented corneal scar, 12 eyes
(12/65; 18.46%) needed therapeutic penetrating keratoplasty, and 2 eyes (2/65;
3.08%) were eviscerated. Conclusions. The high incidence of fungal keratitis in
the studied population shows their vulnerability to such infections, which may
result in devastating visual outcomes.

PMID: 20175055  [PubMed - as supplied by publisher]

20: Eur J Ophthalmol. 2010 Jan 25; [Epub ahead of print] 

Keratitis after implantation of intrastromal corneal ring segments (Intacs)
aided by femtosecond laser for keratoconus correction: case report and
description of the literature.

Levy J, Lifshit T.

Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion
University of the Negev, Beer-Sheva - Israel.

Purpose. The majority of reported cases of infectious keratitis after
intrastromal corneal ring segment implantation have been described after
mechanical implantation of the segments. We present a case of keratitis after
implantation of intrastromal corneal ring segments (Intacs) aided by femtosecond
laser for keratoconus correction and review the relevant literature. Methods. A
31-year-old woman with keratoconus underwent uneventful sequential implantation
of intrastromal corneal ring segments (Intacs) aided by femtosecond laser
performed 6 weeks apart. Two months after surgery in the second eye, she
complained of red eye, pain, and decreased vision of 2 days' duration. Left eye
visual acuity was 20/100. Results. Slit-lamp examination of the left eye
revealed a stromal infiltrate at the lower segment near the incision site. The
infiltrate progressed despite topical treatment of vancomycin and ceftazidime.
Cultures were negative. The inferior segment was removed and the inferior
channel irrigated with antibiotics. One day later, significant fibrin and 1-mm
hypopyon were detected in the anterior chamber. Significant improvement was
observed after adding topical amikacin and amphotericin B. Six months later, a
small stromal scar is present at the inferior incision site and best-corrected
visual acuity is 20/25. Conclusions. To our knowledge, this is the second
reported case of keratitis after implantation of intrastromal corneal ring
segments (Intacs) aided by femtosecond laser for keratoconus correction. Prompt
and adequate treatment is essential to prevent irreversible reduction of visual
acuity.

PMID: 20155711  [PubMed - as supplied by publisher]

21: Eur J Ophthalmol. 2010 Feb 5; [Epub ahead of print] 

Retinopathy of prematurity: screening guidelines need to be reevaluated for
developing countries.

Basmak H, Niyaz L, Sahin A, Erol N, Gursoy HH.

Department of Ophthalmology, Eskisehir Osmangazi University Medical Faculty,
Meselik - Turkey.

Purpose. Timely screening of premature babies is an important initial step in
the management of retinopathy of prematurity (ROP) as earlier treatment results
in improved visual prognosis. Screening criteria for ROP currently recommended
by the American Academy of Pediatrics may not be applicable in developing
countries. The aim of the present study is to find out the incidence of ROP in
infants with a gestational age (GA) of >32 weeks in Eskisehir, Turkey, to
provide information to assist in determining screening criteria. Methods. A
total of 96 infants with a GA of 32-35 weeks who were referred for ROP between
January 1, 2004, and December 31, 2008, were studied. ROP screening, follow-up,
and appropriate therapies were applied. Results. During ROP screening, there
were 42 of 96 (43.8%) infants with no ROP. A total of 54/96 (56.2%) infants were
noted to have ROP. Among all infants, 7 (7.3%) had threshold ROP. Two infants
with threshold disease were born at the 32nd, 2 at the 33rd, and 3 at the 34th
week of gestation. The mean birthweight was 1857.9 (range 1060-3200) grams.
Conclusions. In our study, it was found that more mature infants may also
develop threshold ROP and require early treatment. After more information is
gained and widespread screening, screening protocols covering more mature
infants can be designed especially for developing countries.

PMID: 20155710  [PubMed - as supplied by publisher]

22: Eur J Ophthalmol. 2010 Feb 8; [Epub ahead of print] 

Detecting retinal vigabatrin toxicity in patients with partial symptomatic or
cryptogenic epilepsy.

Ardagil Akcakaya A, Gokceer S, Erbil HH, Isik N, Ozdoker L, Salar S, Aykan F,
Aydin T, Yaylali SA, Kesim O.

Department of Ophthalmology, Goztepe Training and Research Hospital, Istanbul -
Turkey.

Purpose. Detecting retinal vigabatrin toxicity in patients with partial
symptomatic or cryptogenic epilepsy can be challenging because of preexisting
visual field defects secondary to a structural abnormality in the brain or lack
of collaboration. The aim of this study was to measure the retinal nerve fiber
layer thickness (RNFLT) with optic coherence tomography (OCT), as well as
contrast sensitivity, color vision, and perimetry, in patients with partial
symptomatic or cryptogenic epilepsy on vigabatrin, and to determine the efficacy
of these tests as markers of vigabatrin-related retinal damage in these
subgroups of epileptic patients.Methods. The study involved 38 patients with
either partial symptomatic or cryptogenic epilepsy and 16 healthy individuals
comprising the control group. At the time of the study, 14 of the patients were
using vigabatrin, 10 were receiving sodium valproate monotherapy, and 14 were on
carbamazepine monotherapy. All the participants underwent RNFLT imaging with
OCT, contrast sensitivity, color discrimination assessment, and
perimetry.Results. The average 360 degrees RNFLT of the vigabatrin group was
significantly lower when compared to the other groups. The average RNFLT of all
quadrants except the temporal one in the vigabatrin group was also significantly
reduced. There was no difference in the mean deviation, contrast sensitivity,
and color discrimination between the study groups, but they were all
significantly lower than the control group.Conclusions. RNFLT measurement with
OCT can efficiently identify vigabatrin toxicity in patients with partial
symptomatic and cryptogenic epilepsy. Perimetry, contrast sensitivity, and color
discrimination assessment might be inconclusive in these particular subgroups of
epileptic patients.

PMID: 20155709  [PubMed - as supplied by publisher]

23: Eur J Ophthalmol. 2010 Feb 5; [Epub ahead of print] 

Surgical treatment of esotropia associated with high myopia: unilateral versus
bilateral surgery.

Morad Y, Pras E, Goldich Y, Barkana Y, Zadok D, Hartstein M.

Department of Ophthalmology, Assaf Harofeh Medical Center, Tel Aviv University,
Zerifin - Israel.

Purpose. To compare unilateral versus bilateral surgical treatment of esotropia
associated with high myopia. Methods. This retrospective study comprised
patients who underwent surgery for esotropia with high myopia performed by the
first author (Y.M.) between 2003 and 2008. Surgical results and complications
were compared between patients who underwent unilateral versus bilateral
surgery.Results. Nine patients were identified with average age of 44.9 years
(range 8-70 years). All had bilateral high myopia (average -13.35 D, range -9.00
to -17.50 D) and esotropia of 20-75 diopters, together with hypotropia in 5
cases. Bilateral displacement of the lateral rectus inferiorly and superior
rectus medially was demonstrated in each patient by computed tomography scan of
the orbits and by observation during surgery. Five patients underwent bilateral
surgery and 4 underwent unilateral surgery. After an average follow-up of 29
months (range 4-47 months), 4/5 patients who underwent bilateral myopexy
achieved good results with postoperative esotropia of less than 8 diopters, as
opposed to 2/4 patients who underwent unilateral surgery. No complications were
noted. Conclusions. Bilateral superior and lateral rectus myopexy is the
preferred method of surgical correction of esotropia associated with high
myopia. Additional unilateral or bilateral medial rectus recession is probably
not indicated in most cases. Patients who prefer unilateral surgery can benefit
from unilateral superior and lateral rectus myopexy together with medial rectus
recession. This unilateral approach may yield good results particularly in young
patients without markedly restricted and tight extraocular muscles.

PMID: 20155708  [PubMed - as supplied by publisher]

24: Eur J Ophthalmol. 2010 Feb 12; [Epub ahead of print] 

Phacoemulsification after deep anterior lamellar keratoplasty.

Leccisotti A, Islam T, McGilligan VE, Moore TC.

University of Ulster, School of Biomedical Sciences, Coleraine - UK; and
Ophthalmic Department, Casa di Cura Rugani, Siena - Italy.

Purpose. To evaluate the results of phacoemulsification and intraocular lens
implantation after deep anterior lamellar keratoplasty (DALK).Methods.
Retrospective, consecutive, noncomparative, single-surgeon series.Results.
Sixteen eyes of 16 patients were included (mean age: 51 years). Five eyes had
phacoemulsification because of cataract, and 11 eyes for myopic refractive lens
exchange. No intraoperative or postoperative complications were noted. Mean
spherical equivalent (SE) improved from -8.69 D (SD 3.74) to -0.97 D (SD 1.13).
Mean preoperative defocus equivalent (DE) improved from 10.32 D (SD 4.04) to
2.57 D (SD 0.92). Mean preoperative best spectacle-corrected visual acuity
improved from 0.48 logMAR (SD 0.60) to 0.13 D (SD 0.005). Mean postoperative
uncorrected visual acuity was 0.675 logMAR (SD 0.252). Safety index was 2.33,
efficacy index was 0.70, and endothelial cell loss was not
significant.Conclusions. Phacoemulsification can provide safe and predictable
visual rehabilitation for cataract and refractive errors resulting after DALK.

PMID: 20155707  [PubMed - as supplied by publisher]

25: Eur J Ophthalmol. 2010 Feb 1; [Epub ahead of print] 

Evaluation of the effect of topical cyclosporine A with impression cytology in
dry eye patients.

Yuksel B, Bozdag B, Acar M, Topaloglu E.

Eye Bank and Cornea Section, Izmir Bozyaka Teaching and Research Hospital,
Bozyaka-Izmir - Turkey.

Purpose. This study evaluated the efficacy of topical cyclosporine A 0.05%
treatment with impression cytology in dry eye patients.Methods. Forty eyes of 40
patients with dry eye were included. Schirmer, tear break-up time, and Ocular
Surface Disease Index (OSDI) scores and goblet cell densities were noted before
and after 6 months of topical cyclosporine A treatment. Patients were graded
clinically and biomicroscopically as follows: grade 1, 12 patients; grade 2, 18;
and grade 3, 10 patients.Results. Mean age was 57.1+/-11.8 (23.0-80.0) years. A
total of 36 (90%) of the patients were female and 4 (10%) were male. Mean
Schirmer test value was 3.2+/-1.6 (0.0-8.0) mm in the beginning and was
8.4+/-4.3 (1.0-19.0) mm after 6 months of cyclosporine A topical treatment
(p=0.00). At the first visit, mean tear break-up time was 4.4+/-1.8 (2.0-8.0)
seconds. It increased to 11.8+/-4.8 (2.0-20.0) seconds at the end of the sixth
month (p=0.00). Mean clinical grading was 1.9+/-0.8 (1.0-3.0) and this value
regressed to 0.8+/-1.2 (0.0-3.0) after the treatment (p=0.00). Mean OSDI score
was 30.0+/-11.7 (9.0-50.0) before the treatment and 21.3+/-11.0 (4.0-47.0) after
the treatment (p=0.00). Mean goblet cell density of all cases was 12.3+/-8.7
before the treatment (2.0-28.0). It increased to 33.0+/-25.4 (6-70) after the
treatment (p=0.04). Conclusions. Topical cyclosporine A treatment is effective
in grade 1 and grade 2 dry eye patients but results are poor in grade 3
patients.

PMID: 20155706  [PubMed - as supplied by publisher]

26: Eur J Ophthalmol. 2010 Jan 26; [Epub ahead of print] 

Cataract surgery in the United Kingdom: a postal survey.

Olali CA, Priya A, Gupta M, Ahmed S.

Department of Ophthalmology, Pilgrim Hospital, Boston, Lincolnshire - United
Kingdom.

Purpose. A postal questionnaire study to evaluate the current practice of
cataract surgery delivery in the United Kingdom including strategies for
postoperative review was performed.Methods. A cataract questionnaire was sent to
all hospital departments delivering ophthalmic services in the United Kingdom
based on a list from the Royal College of Ophthalmologists. It included
questions about the staffing level, number of cases operated on per list, and
the different strategies employed postoperatively. The results were
statistically analyzed.Results. A total of 248 questionnaires were sent and 106
(43%) replies were received. The mean number of consultant teams was 11 (2-20).
The average number of cases per list was 6-7 (range 4-9). In 65 hospitals, all
patients are reviewed postoperatively in the hospital and some consultant teams
review patients postoperatively in 18 hospitals. In 15 hospitals, patients were
seen by the community optician. Most hospitals review their patients
postoperatively within the first 3 weeks with more hospitals seeing them at 2-3
weeks. A wide variety of health professionals review the postoperative cases and
they include doctors, nurses, and opticians (in house and community).
Conclusions. There are varied practices for cataract surgery in the United
Kingdom including the number of cases on the list and postoperative review
protocols. There is room for better service organization in some hospitals in
terms of patient flow and better use of medical staff time to improve output.

PMID: 20155705  [PubMed - as supplied by publisher]

27: Eur J Ophthalmol. 2010 Feb 4; [Epub ahead of print] 

Three-monthly intravitreal bevacizumab injections for neovascular age-related
macular degeneration: short-term visual acuity results.

Ferraz D, Bressanim G, Takahashi B, Pelayes D, Takahashi W.

Department of Ophthalmology, University of Sao Paulo Medical School, Sao Paulo -
Brazil.

Purpose. To evaluate the change in vision after 3 monthly consecutive
intravitreal injections of 1.25 mg of bevacizumab for neovascular age-related
macular degeneration (AMD).Methods. A retrospective analysis of 35 eyes was
performed. Visual acuity (VA) at initial visit and at each follow-up visit was
compared. The injection of bevacizumab was performed at 30-day intervals and
patients were observed for 5 months after the last injection.Results. Of the 35
eyes, 9 had received previous treatment with photodynamic therapy with or
without 4 mg of intravitreal triamcinolone. VA was measured in Snellen table and
transformed into logMAR for statistical purposes. Mean age was 76.66 years
(range, 49-90 years). There were 24 (69%) women and 11 (31%) men. Mean VA at the
initial visit was 0.92+/-0.50. At month 1, mean VA was 0.84+/-0.51 and at month
2 was 0.74+/-0.51. At month 3, mean VA remained 0.74+/-0.49. Six and 8 months
after the initial visit, VA was 0.79+/-0.49 and 0.77+/-0.50, respectively. The
improvement in VA was statistically significant at month 2 and at the end of the
follow-up (8 months) compared with the baseline VA.Conclusions. Three
consecutive monthly injections of intravitreal bevacizumab to treat neovascular
AMD is effective in improving VA in the short term. Longer prospective studies
should be performed to confirm VA stability after the third injection.

PMID: 20155704  [PubMed - as supplied by publisher]

28: Eur J Ophthalmol. 2010 Jan 26; [Epub ahead of print] 

Acute ophthalmoparesis associated with human parvovirus B19 infection.

Le Scanff J, Vighetto A, Mekki Y, Nguyen AM, Dufour JF, Broussolle C, Seve P.

Department of Internal Medicine, Hospices Civils de Lyon, and University Claude
Bernard Lyon 1 - France.

Background. Parvovirus B19 infection (PVB19) has been linked with a broad
spectrum of clinical syndromes. In addition to erythema infectiosum and
asymptomatic infection, other less common manifestations include transient
aplastic crisis in patients with hemoglobinopathies, pure red cell aplasia and
pancytopenia in immunocompromised persons, nonimmune hydrops fetalis, chronic
arthritis, myocarditis, and hepatitis.Purpose. Only 19% of patients had
peripheral nervous system damage, mainly including brachial plexitis and carpal
tunnel syndrome. Two cases of cranial nerves palsies have been described in
children in the literature, including one case of peripheral facial nerve palsy
and one case of velopalatine hemiparalysis. We report the first case of acute
ophthalmoparesis associated with PVB19 infection.Methods. We present a
40-year-old man with PVB19 with acute sixth cranial nerve palsy, diagnosed on
the basis of serology and polymerase chain reaction carried out both on serum
and cerebrospinal fluid.Conclusions. Clinicians should be aware of this possible
clinical presentation.

PMID: 20155703  [PubMed - as supplied by publisher]

29: Eur J Ophthalmol. 2010 Feb 4; [Epub ahead of print] 

Macular congenital hypertrophy of the retinal pigment epithelium: a case report.

Zucchiatti I, Battaglia Parodi M, Pala M, Bandello FM.

Department of Ophthalmology, University of Udine, Udine - Italy.

Purpose. To describe autofluorescence, microperimetry, and electrophysiology
findings in a case of macular congenital hypertrophy of the retinal pigment
epithelium (CHRPE). Methods. A 58-year-old man was referred to the Department of
Ophthalmology of the University of Udine for the evaluation of a pigmented
macular lesion in the right eye. The patient underwent blue-light
autofluorescence (BL-AF), near-infrared autofluorescence (NIR-AF),
electrooculogram, full-field electroretinogram and multifocal electroretinogram
(mfERG), microperimetry, computerized visual field, and optical coherence
tomography (OCT). Results. BL-AF performed using Heidelberg Retinal Angiograph
II revealed a homogeneous hypoautofluorescence, surrounded by a
hyperautofluorescent halo. NIR-AF showed a heterogeneous response combining an
increased signal in the center of the lesion bordered by a decreased and darker
signal. Electrooculogram and full-field electroretinogram were normal in both
eyes. mfERG revealed only a limited area of reduced function in the right eye,
which matched to location of CHRPE. The segments most functionally altered on
mfERG corresponded to the area showing an increased signal in the NIR-AF,
possibly reflecting the presence of increased pigment density within a more
viable retinal pigment epithelium-Bruch membrane complex. Conclusions. In
essence, macular CHRPE is associated with slight defect in retinal sensitivity
and outer retinal dysfunction secondary to the anatomic changes characteristic
of the lesion.

PMID: 20155702  [PubMed - as supplied by publisher]

30: Eur J Ophthalmol. 2010 Feb 2; [Epub ahead of print] 

Pseudophakic eye globe disruption.

Motolese I, Motolese PA, Frezzotti P, Fruschelli M, Motolese E.

Department of Ophthalmology, University of Siena, Siena - Italy.

Purpose. Scleral rupture due to bulb bursting can result from a heavy contusion.
Owing to refined surgical techniques and the use of antibiotics and
cortisone-based medication, more conservative concepts have followed. In major
ruptures, the results were almost always very poor, with atrophy or subatrophy
of the eyes.Methods. A 63-year-old man with major left ocular trauma and
intraocular lens dislocation in the subconjunctival area was referred to the
authors for clinical and surgical evaluation.Results. Surgery was performed 3
weeks after the trauma to allow for improvement in the patient's condition. The
reabsorption of a palpebral-frontal hematoma, which made bulb exploration almost
impossible, was fundamental in order to proceed. After 1 year, the
best-corrected visual acuity was 0.9. In fact, great improvements in surgical
techniques in recent years have allowed us to consider the problem of major
rupture in a new way, both technically and from an organizational point of
view.Conclusions. In terms of organization, the concept of urgent surgical
procedures must be reevaluated, because besides traumatic damage, incomplete
surgical measures may result. This makes all treatment useless, in both barely
equipped and highly specialized centers.

PMID: 20155701  [PubMed - as supplied by publisher]