1: Eur J Ophthalmol. 2010 Jul 19; [Epub ahead of print] 

Augmented medial rectus recession, medial rectus recession plus Faden, and
slanted medial rectus recession for convergence excess esotropia.

Khalifa YM.

Ophthalmology Department, Suez Canal University, Ismailia - Egyp.

Purpose. To evaluate the efficacy of 3 different surgical techniques for
convergence excess esotropia: augmented medial rectus recession, medial rectus
recession plus Faden, and slanted medial rectus recession. Methods. Twenty-nine
patients with convergence excess esotropia were divided into 3 groups. Group A
included 9 patients treated with medial rectus muscle recession augmented with
1-2 mm more of the standard recession. Group B included 10 patients treated with
standard recession plus Faden. Group C included 10 patients treated with slanted
medial rectus recession. Surgical success was defined as esotropia (ET) 10 prism
diopters or less at distance and near with collapse of distance/near disparity.
Results. Satisfactory alignment with elimination of bifocal correction was noted
in group A (66.6%). In groups B and C, the results were 70%. Group A patients
had a mean reduction in distance/near disparity from 15.5+/-1.5 prism diopters
preoperatively to 4.7+/-2.5 prism diopters postoperatively, while in group B the
preoperative distance/near disparity was 16.5+/-1.8 prism diopters and decreased
to 3.8+/-3.1 prism diopters postoperatively, and group C also showed reduction
in distance/near disparity from 18.1+/-1.6 prism diopters preoperatively to
4.5+/-3.6 prism diopters postoperatively. There were no statistically
significant differences among the 3 groups. Conclusions. The 3 procedures are
effective surgical options to treat convergence excess esotropia with acceptable
motor outcomes.

PMID: 20658460  [PubMed - as supplied by publisher]

2: Eur J Ophthalmol. 2010 Jul 19; [Epub ahead of print] 

Assessment of anterior chamber inflammation after intravitreal bevacizumab
injection in different ocular exudative diseases.

Yeniad B, Ayranci O, Tuncer S, Kir N, Ovali T, Tugal-Tutkun I, Akarcay K.

Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology,
Istanbul - Turkey.

Purpose. To investigate the inflammation of the anterior chamber after
intravitreal bevacizumab injection in different ocular exudative diseases.
Methods. The study included 76 eyes from 62 consecutive patients with different
ocular exudative diseases. The patients were divided into the 3 following
groups: group 1 (nonproliferative diabetic retinopathy), group 2 (choroidal
neovascularization secondary to age-related macular degeneration), and group 3
(macular edema with branch or central retinal vein occlusion). The study also
included 32 age-matched control patients. Inflammation of the anterior chamber
was examined with flare-cell photometry before and after an intravitreal
injection of 1.25 mg of bevacizumab. Results. There were no statistically
significant differences between the measurements at baseline and postoperative
day 1, 3, 7, or 30 in any of the groups (p>0.05). Conclusions. The extent of
inflammation in the anterior chamber did not change after intravitreal
bevacizumab injection in patients with nonproliferative diabetic retinopathy,
choroidal neovascularization secondary to age-related macular degeneration, or
macular edema due to branch or central vein occlusion.

PMID: 20658459  [PubMed - as supplied by publisher]

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

Vitrectomy for treatment of a lamellar hole in a patient with exudative macular
degeneration: the role of vitreous traction elimination.

Theodossiadis P, Charonis A, Panagiotidis D, Papathanassiou M, Petrou P.

Ophthalmology Department, "Attikon" Hospital, University of Athens, Athens -
Greece.

Purpose. Lamellar macular hole (LMH) represents a well-defined clinical entity
with variable pathophysiologic mechanisms and a controversial therapeutic
approach. The purpose of the present work is to present a patient with an
epiretinal membrane (ERM)-associated LMH on the background of exudative
age-related macular degeneration (AMD) that was successfully managed with pars
plana vitrectomy.?Methods. Interventional case report. Results. A 67-year-old
man presented with progressive visual loss OS of 5 months' duration. He was
diagnosed with an ERM-associated LMH with coexisting subretinal fluid arising by
a neovascular membrane on the background of exudative AMD confirmed with fundus
fluorescein angiography. He underwent a 3-port pars plana vitrectomy with
ERM-internal limiting membrane peeling and gas tamponade (14% C3F8) for
treatment of the LMH and ERM with a view to undergo anti-vascular endothelial
growth factor treatment for the exudative AMD. Postoperative optical coherence
tomography demonstrated complete closure of the LMH with simultaneous total
subretinal fluid absorption that was maintained at the 2-month follow-up period.
Conclusions. To our knowledge, this is the first report whereby pars plana
vitrectomy in a patient with an ERM-associated LMH on the background of
exudative AMD resulted in improvement of both clinical entities. The latter
strengthens the role of vitreous traction elimination in exudative AMD and
highlights the need for further research.

PMID: 20658458  [PubMed - as supplied by publisher]

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

Oxygen saturation in premature infants at risk for threshold retinopathy of
prematurity.

Thomas WJ, Rauser M, Dovich JA, Dustin L, Flaxel CJ.

Loma Linda University, Loma Linda, California - USA; and Private practice,
Omaha, Nebraska - USA.

Purpose. We aimed to determine if oxygen saturation, desaturations, and
saturation variability play a role in progression of retinopathy of prematurity
(ROP) and need for laser treatment. Methods. This was a retrospective
case-control study. We performed chart review of premature infants in a
university hospital neonatal intensive care unit consecutively examined for ROP
between May 2000 and December 2001. We compared birthweight, postmenstrual age,
and oxygen saturation for 3 weeks before laser treatment for threshold ROP in
group 1 (n=19) (average weight at treatment 2508 grams) and group 2 (n=18)
before they reached 2500 grams. Outcome measures were retinopathy progression
and need for treatment. Results. Adjusting for birthweight and postmenstrual
age, known predictors of ROP progression, we found that babies requiring laser
treatment (group 1) had lower average daily oxygen saturation levels in the
study period, significantly on 5/20 days (25%). These babies had saturations
below 95% on 18/20 days (90%). Babies not requiring laser (group 2) had
saturations below 95% on 2/20 days (10%). The last day on which pretreatment
saturations differed significantly was 2 days before laser. Group 1 had more
desaturations below 80% (6.0+/-3.2) than group 2 (3.2+/-1.2), p=0.0002
(independent samples t tests). Saturations varied more for individual group 1
infants. Conclusions. Decreased oxygen saturation as early as 3 weeks and as
late as 2 days before laser, increased number of desaturations, and saturation
variability were seen in babies eventually requiring laser treatment for ROP.

PMID: 20658457  [PubMed - as supplied by publisher]

5: Eur J Ophthalmol. 2010 Jul 15; [Epub ahead of print] 

Quality of Vision Index: a new method to appraise visual function changes in
age-related macular degeneration.

Piemarocchi S, Varano M, Parravano M, Oddone F, Sartore M, Ferrara R, Sera F,
Virgili G.

Ophthalmology Department, University of Padua, Padua - Italy.

Purpose. To explore the correlation between psychophysical measures of visual
function and vision-related quality of life (QOL) in exudative age-related
macular degeneration (AMD) and to obtain a new quality of vision index expressed
as corrected visual acuity (cVA) that is scaled like visual acuity (VA), but
that incorporates the weighted contribution of VA, contrast sensitivity (CS),
and reading ability. Methods. Visual acuity, CS, and reading ability were
measured in 293 patients with AMD in this multicenter prospective study.
Vision-related QOL was quantified by the 25-item National Eye Institute Visual
Function Questionnaire (NEI-VFQ-25). The validity of the questionnaire was
assessed using Rasch analysis. The relationship between psychophysical tests and
NEI-VFQ-25 scores was investigated. A cVA index was developed integrating
Rasch-scaled NEI-VFQ-25 score with VA, CS, and reading ability as a tool to be
used for evaluating vision-related QOL on the same scale as VA. Results. A total
of 27.5% of the variability of VFQ score was found to be explained by VA alone
in patients with AMD. The proportion of Rasch-scaled QOL estimate variance
explained by cVA was 33.2% as compared to 27.5% explained by VA and 24.5% by CS,
which was a statistically significant improvement in both cases (p=0.015 and
p<0.001, respectively). The correlation of reading ability with vision-related
QOL was largely mediated by VA and CS and therefore it was not retained in the
vision index. Conclusions. Visual acuity is poorly correlated with
vision-related QOL in patients with AMD. Even though the new cVA index is a new
method which better correlates with vision-related QOL, the major components of
the individual perception of vision remain unexplained by common psychometric
tests.

PMID: 20640999  [PubMed - as supplied by publisher]

6: Eur J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

Combined Ex-PRESS LR-50/IOL implantation in modified deep sclerectomy plus
phacoemulsification for glaucoma associated with cataract.

Gindroz F, Roy S, Mermoud A, Schnyder CC.

From the Jules Gonin Eyes Hospital, Department of Ophthalmology, Lausanne
University, Lausanne - Switzerland.

Purpose. This is a prospective study reporting on modified deep sclerectomy (DS)
using the Ex-PRESS LR-50 in combined cataract and glaucoma surgery. Methods.
Twenty-four eyes of 24 patients with medically uncontrolled glaucoma underwent
modified DS. After phacoemulsification and intraocular lens implantation, the
Ex-PRESS LR-50 was inserted into the anterior chamber under a scleral flap. A
partial posterior DS was performed to provide an intrascleral bleb. The complete
success rate was intraocular pressure (IOP) without medication =18 mmHg; the
qualified success rate was IOP =18 mmHg with or without medication.
Postoperative bleb management (subconjunctival mitomycin C injections +/-
needling) was performed in case of postoperative hypertension or bleb fibrosis.
Results. Follow-up was 40.1+/-10.8 (mean +/- SD) months. Preoperatively, IOP was
18.1+/-5.3 mmHg, best-corrected visual acuity (BCVA) was 0.6+/-0.3, and number
of medications was 2.3+/-1.1. The IOP decreased by 25.4% at 24 months and by
27.0% at 48 months. At 24 months, 19 patients (86.3%) achieved a BCVA of 0.5 or
better, and at 48 months the mean BCVA was 0.7+/-0.3. At the last visit, the
mean number of medications was 0.6+/-0.8 (p<0.05). The complete and qualified
success rates were 45.6% and 85.2%. Mitomycin C injections were performed in 5
eyes. No conjunctival erosions over the Ex-PRESS LR-50 were seen. Conclusions.
The Ex-PRESS LR-50 inserted into the anterior chamber after modified DS
efficiently lowers IOP in combined surgery, preventing conjunctival erosion, a
significant complication when using this device without scleral flap coverage.

PMID: 20623471  [PubMed - as supplied by publisher]

7: Eur J Ophthalmol. 2010 Jul 6; [Epub ahead of print] 

Unusual presentation of giant cell angiofibroma of the eyelids.

Surace D, Blandamura S, Bernardini FP, Galan A, Lo Giudice G.

Department of Ophthalmology, Santa Maria del Carmine Hospital, Rovereto - Italy.

Purpose. To describe a case of bilateral eyelid-confined giant cell angiofibroma
(GCAF) in a patient with a slowly progressive bilateral eyelid swelling.
Methods. A 40-year-old man with a 5-year history of slowly progressive bilateral
eyelid swelling, severe functional impairment, and bilateral cosmetic deformity
was studied. An extensive ophthalmologic evaluation, laboratory examinations,
and orbital magnetic resonance imaging were carried out. Results. Clinical
examination showed nonpitting lymphedema affecting both upper and lower eyelids,
with orange peel skin. Orbital magnetic resonance imaging revealed diffuse
thickening of the preseptal structures in the eyelids without extension to the
orbit. Histologic specimen revealed the presence of spindle and multinucleated
giant cells surrounding pseudovascular spaces strongly positive to CD34 and
vimentin. A diagnosis of GCAF was made and radiation therapy was performed 3
weeks after surgical debulking with partial recovery of visual and anatomic
function. Conclusions. Giant cell angiofibroma involving the eyelid is rare and
can represent a diagnostic and therapeutic challenge to the ophthalmologist.

PMID: 20623470  [PubMed - as supplied by publisher]

8: Eur J Ophthalmol. 2010 Jul 5; [Epub ahead of print] 

Regression of peripapillary choroidal neovascularization after oscillatory
transpupillary thermotherapy and anti-VEGF pharmacotherapy.

Peyman G, Tsipursky M, Gohel P, Conway M.

Department of Ophthalmology, Tulane University, New Orleans, LA - USA; and
University of Arizona Biomedical Sciences, Phoenix, AZ - USA.

Purpose. We prospectively evaluated a new treatment for recalcitrant choroidal
neovascularization (CNV) in 4 patients. We used an infrared laser (810 nm) in
oscillatory thermotherapy (OTT) mode combined with indocyanine green (ICG) dye,
utilizing the beneficial effect of both thermotherapy and photodynamic therapy.
We describe preliminary experiences with ICG-assisted OTT (I-OTT) combined with
intravitreal bevacizumab/dexamethasone for refractory peripapillary CNV
resistant to standard therapy. Methods. Clinical examination, funduscopy,
fluorescein angiography, and optical coherence tomography were performed at
baseline and postoperatively. Infrared laser spot size was approximately
one-half the lesion size (oscillation 2-3 Hz). Intravitreal injections of
bevacizumab (1.25 mg) and dexamethasone (1000 microg) were done during the same
visit. Results. Mean follow-up was 12.5 months (range 5-17). Mean energy level
was 325 mW (range 200-500) in oscillatory mode (2-3 Hz/sec) pre- and post-ICG
infusion. Indocyanine green dose was approximately 1 mg/kg (75 mg/patient). All
patients had a single treatment. Mean visual acuity improved in 1 patient from
20/60 to 20/30 and remained the same in the other 3 (20/20, 20/40, and 20/400).
At final examination, there was no evidence of clinical or angiographic activity
of CNV. Conclusions. Indocyanine green-assisted OTT has the potential to treat
CNV in wet age-related macular degeneration. It may reduce thermal side effects
and eliminate or reduce the need for frequent intravitreal treatment. We
postulate that I-OTT has a synergistic effect of thermal energy combined with a
weak photosensitizer (ICG) applied in an individualized manner, which minimizes
thermal damage to retinal and choroidal tissue. Additional anti-vascular
endothelial growth factor pharmacotherapy enhances the effect of I-OTT on
abnormal new vessels.

PMID: 20623469  [PubMed - as supplied by publisher]

9: Eur J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

National survey of day-case vitreoretinal surgery in the United Kingdom.

Hussain R, Matare T, Zambarakji H.

Eye Treatment Centre, Whipps Cross University Hospital NHS Trust, London - UK.

Introduction. Day-case surgery has become uniformly accepted in ophthalmology
for most procedures but not for complex, lengthy ones, including vitreoretinal
surgery. There is a need for uniform practice that is not only financially and
resource efficient, but also convenient for patients. Purpose. To describe
current practice patterns of day-case vitreoretinal (DCVR) surgery in the United
Kingdom. Methods. A 16-part e-mail questionnaire was sent to UK vitreoretinal
consultants, with day-case surgery defined as patients admitted and discharged
following surgery on the same day. The questionnaire was sent to all consultant
members of the Britain and Eire Association of Vitreoretinal Surgeons using the
e-mail address beavrs@yahoogroups.com to increase the response rate.?Results.
The overall response rate was 41%. Of 55 responders, 9% do not undertake DCVR
surgery, but 61% perform DCVR surgery in >75% of patients. Of all undertaking
DCVR surgery, 85% of responders discharge patients home and 13% to a hostel. A
total of 76% of responders use local/sub-Tenon anesthesia in >50% of patients
undergoing DCVR surgery. A total of 15% of responders were not in favor of DCVR
surgery. Common reasons for not undertaking DCVR surgery were significant
traveling distances for patients, patient choice, and the need for support
during posturing. Conclusions. The practice of DCVR surgery across the United
Kingdom is variable and is influenced by local factors, patient factors, and
surgeon views. There is a lack of guidelines to help decision-making. Common
standards are required to maximize clinical outcomes and patient satisfaction,
as well as reduce the cost burden of hospital admissions.

PMID: 20623468  [PubMed - as supplied by publisher]

10: Eur J Ophthalmol. 2010 Jul 7; [Epub ahead of print] 

Cataract-related acute vitreomacular traction syndrome.

Panagiotidis D, Karagiannis D, Theodossiadis P, Alonistiotis D, Charonis A,
Tsoumbris I, Vergados I.

Second Ophthalmology Department of Athens University, Attikon Hospital, Athens -
Greece.

Purpose. To report the acute and transient (within 10 days) presentation of
vitreomacular traction following routine cataract surgery. Methods. This is a
case series of 5 patients with no evidence of posterior vitreous detachment
preoperatively who presented with acute vitreomacular traction following routine
cataract surgery. All patients presented the first postoperative day with
dramatically reduced visual acuity. The patients underwent optical coherence
tomography and if necessary fundus fluorescein angiography. Images were
suggestive of vitreomacular syndrome. Results. In all 5 cases, there was
spontaneous resolution of the traction within 10 days. The latter was probably
related to the development of posterior vitreous detachment due to the
uncomplicated cataract surgery. In 2 cases there were significant retinal
pigment epithelium changes and decreased retinal thickness following the
resolution of the traction leaving permanent metamorphopsia and slightly
decreased visual acuity. Conclusions. Cataract-related acute vitreomacular
traction is a rare phenomenon and not well-recognized; however, it resolves
spontaneously within 10 days.

PMID: 20623467  [PubMed - as supplied by publisher]

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

Long-term follow-up of spontaneous retinal pigment epithelium tears in
age-related macular degeneration treated with anti-VEGF therapy.

Lesniak SP, Fine HF, Prenner JL, Roth DB.

University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical
School, New Brunswick, NJ - USA.

Purpose. To describe the clinical response following anti-vascular endothelial
growth factor (VEGF) therapy in patients with spontaneous retinal pigment
epithelium (RPE) tears secondary to age-related macular degeneration (AMD).
Methods. Retrospective chart review of patients with AMD who developed a
spontaneous RPE tear and were subsequently treated with anti-VEGF therapy at a
single institution. Results. In 5 patients included in the study, the median
number (range) of injections received was 14.2 (5-18). The median baseline
acuity was 20/200, which remained stable at 12 months and improved to 20/60 at
24 months. These changes were not statistically different. Conclusions.
Anti-VEGF therapy appears safe in eyes with spontaneous RPE tear secondary to
AMD and may help to stabilize or even improve acuity in some cases.

PMID: 20623466  [PubMed - as supplied by publisher]

12: Eur J Ophthalmol. 2010 Jun 29; [Epub ahead of print] 

Calcification of a Rayner Centerflex 570H hydrophilic acrylic intraocular lens
following vitrectomy for retinal detachment: a clinicopathologic report.

Purbrick RM, Stavrakas P, Porooshani H, Patel CK, Ferguson DJ.

Oxford Eye Hospital, John Radcliffe Hospital, Oxford - UK.

Purpose. The case of a 71-year-old man who complained of progressive, unilateral
visual blurring following vitrectomy for retinal detachment due to opacification
of his Rayner Centerflex 570H intraocular lens (IOL) implant is reported.
Intraocular lens exchange was carried out and the explanted lens analyzed. The
same model lens in his fellow eye has remained clear. Method. Clinicopathologic
case report. Results. Scanning electron microscopy and energy-dispersive x-ray
analysis confirmed the presence of hydroxyapatite deposits within the anterior
surface of the IOL. Conclusions. To our knowledge, this is the first
clinicopathologic case report of calcification of this model IOL in an adult
patient. The sequence of events, unilaterality, and pathologic findings suggest
secondary calcification, which could have been related to severe postoperative
inflammation and associated blood?aqueous barrier breakdown.

PMID: 20602329  [PubMed - as supplied by publisher]

13: Eur J Ophthalmol. 2010 Jun 21; [Epub ahead of print] 

Pars plana vitrectomy in the treatment of severe complicated toxoplasmic
retinochoroiditis.

Papadopoulou DN, Petropoulos IK, Mangioris G, Pharmakakis NM, Pournaras CJ.

Department of Ophthalmology, Faculty of Medicine, University of Geneva, Geneva -
Switzerland.

Purpose. To present the anatomic and functional results of pars plana vitrectomy
performed in severe complicated toxoplasmic retinochoroiditis. Methods. Three
patients, 2 women and 1 man aged 57, 22, and 57 years, are presented. The first
patient was under immunosuppressive therapy for dermatomyositis and underwent
diagnostic/therapeutic vitrectomy for severe toxoplasmic panuveitis with dense
vitritis. The other 2 patients underwent vitrectomy for macula-off
rhegmatogenous retinal detachment that developed after severe toxoplasmic
panuveitis. Results. Preoperative visual acuity was hand movement for the first
2 patients and 20/400 for the third. All patients received pars plana vitrectomy
with epiretinal membrane peeling, laser photocoagulation, and SF6 gas tamponade.
The second and third patients needed 5 and 3 additional operations,
respectively, including extensive retinotomies and silicone-oil tamponade, for
recurrent retinal detachment due to proliferative vitreoretinopathy. At the end
of the follow-up period (11, 5, and 1 year, respectively), the retina was
attached and visual acuity was 20/30 for the first patient but counting fingers
for the other 2 patients. Conclusions. Severe panuveitis and/or recurrent
retinal detachment may develop in some cases of ocular toxoplasmosis,
compromising the visual prognosis. Retinal detachment due to toxoplasmosis is
generally complex, and long-acting tamponade with silicone oil should be
contemplated for anatomic retinal reattachment.

PMID: 20602328  [PubMed - as supplied by publisher]

14: Eur J Ophthalmol. 2010 Jun 21; [Epub ahead of print] 

Retreatment of residual refractive errors with flap lift laser in situ
keratomileusis.

McAlinden C, Moore JE.

School of Biomedical Sciences, University of Ulster, Coleraine - UK; and
Cathedral Eye Clinic, University of Ulster, Belfast - UK.

Purpose. To investigate the outcomes of flap lift laser-assisted in situ
keratomileusis (LASIK) for residual refractive errors.?Methods. In this
prospective study, 60 eyes of 48 patients (mean age 36 years; age range 23-53
years) underwent flap lift retreatment surgery following initial LASIK for the
correction of residual refractive errors. All treatments were wavefront guided
using the VISX S4 Star excimer laser. The main outcome measures were
predictability, safety, efficacy, and stability.?Results. Following retreatment,
epithelial ingrowth occurred in 23.3% (n=14) of eyes, which required a flap lift
and scrape procedure in 4 eyes and a second flap lift and scrape procedure in 2
eyes. De novo dry eye occurred in 8.3% (n=5) of eyes. At 6 months, the mean
(+/-SD) post-retreatment Snellen decimal uncorrected visual acuity (UCVA),
sphere, cylinder, spherical equivalent (SE), defocus equivalent (DE), and best
corrected visual acuity (BCVA) was 1.03+/-0.23, 0.08+/-0.34 diopters (D) (range
-0.75 to +1.25 D), -0.53+/-0.37 D (range 0 to -1.75 D), -0.04+/-0.34 D (range
-1.11 to +1.04 D), 0.29+/-0.41 D (range 0 to 1.94 D), and 1.13+/-0.15 (range 0.5
to 1.5), respectively. Seventy-three percent (n=44) of eyes had an UCVA equal to
or greater than 1 (6/6), 88.3% (n=53) and 98.3% (n=59) of eyes were within
+/-0.50 D and +/-1.00 D of SE, respectively, and 3.3% (n=2) of eyes lost 1 line
of BCVA.?Conclusions. A high incidence (23.3%, n=14) of epithelial ingrowth
occurred following retreatment surgery and de novo dry eye occurred in 8.3%
(n=5) of eyes. Despite this, reasonable visual and refractive outcomes were
achieved at 6 months post-retreatment.

PMID: 20602327  [PubMed - as supplied by publisher]

15: Eur J Ophthalmol. 2010 Jun 23; [Epub ahead of print] 

Detection of Alzheimer peptides and chemokines in the aqueous humor.

Janciauskiene S, Westin K, Grip O, Krakau T.

Department of Pulmonology, Hannover Medical School, Hannover - Germany.

Purpose. Alzheimer disease (AD) and age-related ocular diseases are
characterized by inflammation and accumulation of insoluble proteins. We aimed
to investigate the detectability and clinical relevance of a panel of AD-related
markers, such as Alzheimer peptides and chemokines, in the aqueous humor (AH)
samples taken from patients with cataract only, or cataract and 1 other ocular
disease. Methods. The AH samples were obtained during cataract surgery from
patients with cataract only (n=162), cataract and glaucoma (n=21), cataract and
exfoliation (PEX) (n=31), cataract and macular degeneration (n=36), and cataract
and diabetic retinopathy (n=16). The AD peptides (Ass1-42, Ass1-40, Ass1-38) and
chemokines (eotaxin, eotaxin 3, interleukin [IL]-8, inducible protein-10,
monocyte chemotactic protein [MCP]-1, MCP-4, macrophage-derived chemokine,
macrophage inflammatory protein-1ss, thymus and activation-regulated chemokine)
were quantified by using multiplex immunoassays. Results. The levels of the AH
peptides (Ass1-38, Ass1-40, Ass1-42) did not differ between disease groups.
Independently of disease group, the Ass1-38 levels correlated with Ass1-40 and
Ass1-42 (p<0.001, n=277). Notably, the ratio Ass1-42 to Ass1-38 differed between
PEX and macular degeneration (mean 95% confidence interval [CI] = 8.12
[11.3-3.99] vs 2.23 [2.67-0.52], p=0.003). Among chemokines examined, only MCP-1
and IL-8 were detected in about 90% to 46% of all analyzed (n=266) samples.
Higher levels of AH IL-8 were found in the glaucoma group than in cataract only
(p=0.011). Independently of disease group, a correlation was observed between AH
MCP-1 and IL-8 (rho=0.275, p<0.001, n=266) and between MCP-1 and Ass1-40
(rho=0.239, p<0.001, n=266). Conclusions. Our findings highlight pathologic
similarities between AD and eye diseases, and show the potential of modern
technologies to detect AD biomarkers in age-related eye diseases.

PMID: 20602326  [PubMed - as supplied by publisher]

16: Eur J Ophthalmol. 2010 Jul 2; [Epub ahead of print] 

Severe global inflammatory involvement of ocular segments and optic disc
swelling in a 12-year-old girl with Kawasaki disease.

Grouteau E, Debuisson C, Brochard K, Paranon S, Lesage Beaudon C, Pajot C,
Claudet I.

Pediatric Rheumatology, Children's Hospital, Toulouse - France.

Purpose. Pediatric Kawasaki ocular involvement is dominated by bulbar
conjunctival injection and mild, self-limited anterior uveitis. Posterior
segment involvement is rare. Case Report. Despite early efficient treatment
including aspirin and intravenous immunoglobulins, a 12-year-old girl developed
a severe bilateral global inflammatory ocular involvement including punctuated
keratitis, retrodescemetic precipitates, anterior uveitis, vitritis, and
bilateral optic disc swelling with papillitis. Discussion. This is the first
description of severe bilateral global inflammatory involvement of the eyes in
Kawasaki disease (KD). Usually subclinical and self-limited, eye involvement in
KD can lead to severe visual impairment. Conclusions. Inflammation of both
anterior and posterior segments does not seem to respond to KD-specific
treatment and could justify a specific ophthalmologic therapeutic approach.

PMID: 20602325  [PubMed - as supplied by publisher]

17: Eur J Ophthalmol. 2010 Jun 30; [Epub ahead of print] 

Morphologic changes and functional retinal impairment in patients with Parkinson
disease without visual loss.

Moschos MM, Tagaris G, Markopoulos I, Margetis I, Tsapakis S, Kanakis M,
Koutsandrea C.

Department of Ophthalmology, University of Athens, Athens - Greece.

Purpose. To investigate the anatomic and electrophysiologic changes of the
macula and the optic nerve in patients with Parkinson disease (PD) without
visual impairment. Methods. Thirty-two eyes of 16 patients with PD (group A)
without visual impairment were tested. Visual acuity was 20/20 or better and
visual fields as well as color vision testing results were normal. Also, no
retinal lesions were assessed. Patients in group B (40 eyes of 20 patients) were
age- and sex-matched control subjects. All study participants underwent a
comprehensive ophthalmic examination, multifocal electroretinogram (mfERG)
recording, and optical coherence tomography (OCT) scan. Thickness of retinal
nerve fiber layer (RNFL) along a 3.4-mm-diameter circle centered on the optic
nerve head was evaluated using third-generation OCT. Results. The mean
P1-response density amplitude of ring 1 of mfERG was 136.69 nV/deg2 in patients
with PD and 294 nV/deg2 in control subjects and the difference was highly
significant. On the contrary, these values in ring 2 and 3 did not differ
statistically between controls and patients with PD. The mean inferior and
temporal RNFL thickness was significantly lower in patients with PD than in
control subjects (p<0.0001 and p=0.0045, respectively). Conclusions. In patients
with PD with normal vision, we found a decrease in the electrical activity of
the fovea as well as in the thickness of the RNFL. Multifocal electroretinogram
and OCT scan objectively detect early subclinical PD-associated visual
functional impairment.

PMID: 20602324  [PubMed - as supplied by publisher]

18: Eur J Ophthalmol. 2010 Jun 30; [Epub ahead of print] 

Impact of AREDS in a developing country 5 years after publication of the study.

Fahed DC, Ghazi NG, Jabbour NM, Fahed CD, Fahed JC, Salti HI.

Department of Ophthalmology, American University of Beirut Medical Center,
Beirut - Lebanon; and Foresight Foundation, Beirut - Lebanon.

Purpose. The Age-Related Eye Disease Study (AREDS) is the only large-scale study
to demonstrate a reduction in the risk of progression to end-stage age-related
macular degeneration (AMD) when vitamin supplementation was given to patients
with advanced forms of the disease. Our study assesses the impact of this study
on vitamin supplementation in patients with advanced AMD from 5 years before
publication of the AREDS results until 5 years after. Methods. Medical records
of patients with AMD presenting between September 1996 and October 2006 were
reviewed. Patients were subclassified according to AREDS categories. The
proportion of advanced cases on vitamin replacement before October 2001 was
compared to that after October 2001. Since October 2001, the different reasons
for abstinence were investigated and analyzed. Results. Only 2403 patients of
the 40,000 medical records reviewed met the AREDS AMD criteria. Of these, 137
patients verifying categories 3 and 4 were diagnosed prior to October 2001.
Fourteen were on supplements then. Fifty-three patients complied with the
represcribed vitamins during subsequent visits after October 2001, raising the
percentage significantly to 48.9% (p<0.001). Also, from October 2001 until
October 2006, an additional 76 patients verified categories 3 and 4. Fifty-three
(69.7%) of them were on vitamins (p=0.001). Financial burden was the principal
reason for abstinence in 67.7% of patients prescribed vitamins after October
2001. Conclusions. The results of AREDS had an impressive impact on prescribing
supplements in AREDS category 3 and 4 patients in Lebanon. The main reason for
noncompliance is financial.

PMID: 20602323  [PubMed - as supplied by publisher]

19: Eur J Ophthalmol. 2010 Jun 29; [Epub ahead of print] 

Prevalence and determinants of diabetic retinopathy among persons =40 years of
age with diabetes in Qatar: a community-based survey.

Elshafei M, Gamra H, Khandekar R, Al Hashimi M, Pai A, Ahmed MF.

Department of Ophthalmology, Hamad Medical Corporation, Doha - Qatar.

Purpose. We present the prevalence and determinants of diabetic retinopathy (DR)
in persons 40 years and older with diabetes in Qatar. Methods. This
community-based survey was held in 2009 at 49 randomly selected clusters.
Demographic details and history of diabetes mellitus (DM) and its management
were collected by nurses. Ophthalmologists examined the retina by slit-lamp
biomicroscopy using +90 D lens and/or indirect ophthalmoscopy. Digital
photographs of retina were obtained. The best-corrected visual acuity of each
eye was noted. Diabetic retinopathy was graded as mild, moderate, or severe
nonproliferative DR, proliferative DR, or diabetic macular edema. Results. We
examined 540 (97.3%) participants with DM. Diabetes mellitus status of 487
persons could be confirmed from medical records. The age- and sex-adjusted
prevalence of DR among the diabetic population 40 years and older was 23.5% (95%
confidence interval [CI] 19.7-27.3), with 8192 cases of DR among patients with
DM. Longer duration of diabetes (odds ratio 1.14 [95% CI 1.10-1.19]) and poor
glycemic control (odds ratio 1.12 [95% CI 1.02-1.23]) were risk factors for DR.
Awareness of regular eye checkup was found in 62% of participants. Only 20% of
persons with sight-threatening DR had undergone laser treatment in at least 1
eye. Visual acuity in the better eye was 6/6 to 6/18 in 90% of persons with DR.
Conclusions. Universal and periodic eye screening of patients with diabetes is
recommended in Qatar. Health promotion for primary prevention and resource
review are needed for early detection and management of sight-threatening DR.

PMID: 20602322  [PubMed - as supplied by publisher]

20: Eur J Ophthalmol. 2010 Jun 22; [Epub ahead of print] 

Fine needle aspiration biopsy with liquid-based cytology and adjunct
immunohistochemistry in intraocular melanocytic tumors.

Pelayes DE, Zarate JO.

Department of Ophthalmology, LIOCiV (Laboratory of Ophthalmic Research and
Visual Sciences), School of Medicine, Buenos Aires University, Buenos Aires -
Argentina.

Purpose. To determine the efficacy of liquid-based cytology (LBC) and
immunohistochemistry in the evaluation of fine needle aspiration biopsy (FNAB)
of intraocular melanocytic tumors. Methods. Cytologic diagnosis was necessary in
25 patients with intraocular melanocytic tumors to deliver a therapeutic course
of treatment. The patients' clinical, cytologic, and histologic diagnoses were
correlated. All samples were stained with hematoxylin and eosin, and studied
through standardized monolayer techniques, with a mean cellular concentration of
60,000 cells/mm2. Immunohistochemistry was performed using Vimentin, S 100, HMB
45, Melan A, cytokeratin, and as prognostic factors, B and T lymphocyte, CD68
(macrophage), and antibody Ki 67 (growth factor). Results. The positive
predictive value was 100%; the negative predictive value was 80%. Sensitivity
and specificity of LBC for detecting malignancy were 95.2% and 100%,
respectively. The FNAB LBC with immunohistochemistry findings resulted in a
revision of treatment in 32% of patients. There was no evidence of local tumor
dissemination or a recurrence associated with biopsy in any patient.
Conclusions. Fine needle aspiration biopsy (LBC and immunohistochemistry) is a
safe, sensitive, and specific method of establishing tissue diagnosis in a
subset of patients with intraocular melanocytic tumors, particularly in cases
where sample material is scarce. The routine use of immunohistochemical stain
increases the diagnostic utility, and prognosis factor determination may change
clinical management.

PMID: 20602321  [PubMed - as supplied by publisher]

21: Eur J Ophthalmol. 2010 Apr 21;20(4):807-808 [Epub ahead of print] 

Episcleral hemangioma as an isolated finding and Author's reply.

Berk DR.

Division of Dermatology, Departments of Medicine and Pediatrics, Washington
University School of Medicne and St. Louis Children's Hospital, St. Louis - USA.

.

PMID: 20597064  [PubMed - as supplied by publisher]

22: Eur J Ophthalmol. 2010 July-August;20(4):805-806. 

Prospective study of risk factors for conjunctival bacterial contamination in
patients undergoing intraocular surgery and Author's reply.

Fernandez-Rubio ME, Cuesta-Rodriguez T, Urcelay-Segura JL, Cortes-Valdes C.

Ophthalmic Institute, Clinical Analyses Laboratory Ophthalmology, Hospital
General Universitario Gregorio Maranon, Madrid - Spain.

.

PMID: 20597063  [PubMed - as supplied by publisher]