1: Eye. 2008 May 2; [Epub ahead of print] 

Intravitreal bevacizumab and augmented trabeculectomy for neovascular glaucoma
in young diabetic patients.

Cornish KS, Ramamurthi S, Saidkasimova S, Ramaesh K.

1Department of Ophthalmology, Tennent Institute of Ophthalmology, Gartnavel
General Hospital, Glasgow, Scotland.

PurposeTo report two cases of young diabetic patients with intractable
neovascular glaucoma (NVG) who were successfully managed with bevacizumab and
mitomycin C-augmented trabeculectomy.ResultsTwo young patients present with
severe NVG secondary to diabetic proliferative retinopathy. The glaucoma was
unresponsive to conventional medical therapy and complete panretinal
photocoagulation. Both patients underwent augmented trabeculectomy with MMC and
intravitreal injection of bevacizumab. Iris rubeosis resolved within 48 h. Both
patients have a follow-up period of 6 months and the intraocular pressure (IOP)
remain between 10-15 mmHg.ConclusionsControlling IOP due to NVG in young
diabetic patients is difficult and augmented trabeculectomy has a very high
failure rate. The addition of intravitreal bevacizumab in the management of NVG
particularly in young diabetic patients may improve the success rate of IOP
control. It is known that bevacizumab retards neovascularisation. It may also be
modulating wound-healing response as well. Bevacizumab may have a potential role
in the surgical management of NVG.Eye advance online publication, 2 May 2008;
doi:10.1038/eye.2008.113.

PMID: 18451875 [PubMed - as supplied by publisher]

2: Eye. 2008 May 2; [Epub ahead of print] 

Initial results of QuantiFERON-TB Gold testing in patients with uveitis.

Itty S, Bakri SJ, Pulido JS, Herman DC, Faia LJ, Tufty GT, Bennett SR, Falk NS.

1Mayo Clinic College of Medicine, Mayo Medical School, Rochester, MN, USA.

PurposeTo describe the use of the second-generation QuantiFERON-TB Gold (QFT-G)
test in a series of patients in an ophthalmic practice.MethodsThe charts of all
patients who had QFT-G tests ordered by Mayo Clinic ophthalmologists in the past
3 years were reviewed.ResultsA total of 27 QFT-G tests were ordered. Thirteen
(48%) tests were negative, six (22%) were indeterminate, two (7%) tests were
re-ordered after a lab accident or an improper cancellation, four (15%) were
positive and represented infection, and two (7%) were positive but negative when
re-tested. Of the four truly positive cases, three were treated for tuberculosis
(TB): one had tuberculous iritis, one had retinal vasculitis and haemorrhage,
and one had asymptomatic TB but was on immunosuppressive therapy. The fourth
patient had previously been treated for latent infection.ConclusionsIn a series
of selected patients with uveitis, the QFT-G test was able to detect TB
infection in 15% of the patients, though it does not differentiate between
active and latent TB infection. QFT-G should be considered in place of purified
protein derivative testing in those with uveitis that have had prior BCG
vaccination and in immunocompromised patients. Patients with a positive QFT-G,
but who have little risk for TB infection and a negative systemic work-up,
should be re-tested.Eye advance online publication, 2 May 2008;
doi:10.1038/eye.2008.115.

PMID: 18451874 [PubMed - as supplied by publisher]

3: Eye. 2008 May 2; [Epub ahead of print] 

Bilateral intraorbital haematomata following thrombolysis for pulmonary
embolism.

Gough-Palmer A, Harman F.

1Department of Radiology and Ophthalmology, St Mary\'s Hospital, London, UK.

PMID: 18451873 [PubMed - as supplied by publisher]

4: Eye. 2008 Apr 25; [Epub ahead of print] 

Barriers to adherence with glaucoma medications: a qualitative research study.

Lacey J, Cate H, Broadway DC.

1Department of Ophthalmology, Glaucoma Research Unit, Norfolk and Norwich
University Hospital NHS Trust, Norwich, UK.

PurposeGlaucoma is initially asymptomatic, but untreated can result in
progressive visual field loss and eventual blindness. With adequate therapy
progression can be halted, but poor adherence with medical therapy is a
significant issue requiring further research. The aim of the present study was
to gain a better understanding of the obstacles to, and the motivations for,
adherence with glaucoma medication and explore potential methods to improve
adherence.MethodsParticipants had moderate/severe glaucoma diagnosed for >1
year, had seen >/=2 NHS ophthalmologists, and were prescribed >/=2 topical
medications. Qualitative methodology was utilized to investigate aspects of
adherence. Recruited patients either attended a focus group or had a home-based
semi-structured interview. The transcripts were member-checked and the resulting
data were analysed using \'Framework\' analysis. The analysis was verified by a
co-investigator and NVIVO Software was used to check data
reliability.ResultsMultiple obstacles to adherence were identified, including
poor education, lack of motivation, forgetfulness, drop application, and other
practical issues, together with specific individual and age differences.
Motivation for adherence was determined by fear of blindness and a faith in drop
efficacy.ConclusionsSpecific obstacles to adherence with anti-glaucomatous
therapy should be identified as early as possible after diagnosis. A tailored
approach to patient care with initial education about the consequences of
non-adherence and longer-term feedback about drop efficacy may improve patients\'
motivations for adherence. Future research should focus on investigating methods
by which initial education about glaucoma and its management should best be
delivered to patients.Eye advance online publication, 25 April 2008;
doi:10.1038/eye.2008.103.

PMID: 18437182 [PubMed - as supplied by publisher]

5: Eye. 2008 Apr 25; [Epub ahead of print] 

Dramatic resolution of massive retinal hard exudates after correction of extreme
dyslipidaemia.

Waller S, Thyagarajan S, Kaplan F, Viljoen A.

1Department of Ophthalmology, East and North Hertfordshire NHS Trust, UK.

PMID: 18437181 [PubMed - as supplied by publisher]

6: Eye. 2008 Apr 25; [Epub ahead of print] 

Optic disc cupping after optic neuritis evaluated with optic coherence
tomography.

Rebolleda G, Noval S, Contreras I, Arnalich-Montiel F, Garcia-Perez JL,
Munoz-Negrete FJ.

[1] 1Ophthalmology Department, Glaucoma Unit, Hospital Ramon y Cajal, Madrid,
Spain [2] 2Surgery Department, Alcala University, Alcala de Henares, Spain.

PurposeTo determine whether the optic disc experiences cupping after an episode
of optic neuritis as assessed by optical coherence tomography (OCT).MethodsA
total of 50 patients with unilateral optic neuritis and 50 age- and sex-matched
controls were studied. A complete examination, including visual acuity (VA),
visual fields, and OCT scanning of the optic nerve head was performed. Mean
cup-to-disc (C/D) ratios in the affected eyes were compared with fellow and
control eyes.ResultsMean C/D area ratio (CDAR), C/D vertical ratio (CDVR), and
C/D horizontal ratio (CDHR) were significantly larger in the affected eyes
compared to fellow (P<0.001) and control eyes (P<0.05). The asymmetry in CDAR,
CDVR, and CDHR between both eyes in the patients with optic neuritis was equal
to or greater than 0.2 in 24, 28, and 30% respectively. A significant inverse
correlation was found between the C/D ratios asymmetry and retinal nerve fibre
layer (RNFL) thickness (P<0.05).ConclusionA significant increase in C/D ratio
can be detected by OCT after unilateral optic neuritis, inversely correlated
with RNFL thickness, and VA.Eye advance online publication, 25 April 2008;
doi:10.1038/eye.2008.117.

PMID: 18437180 [PubMed - as supplied by publisher]

7: Eye. 2008 Apr 25; [Epub ahead of print] 

Myopic tractional maculopathy associated with rhegmatogenous retinal detachment.

Shukla D, Muraly P.

1Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of
Ophthalmology, Madurai, Tamil Nadu, India.

PMID: 18437179 [PubMed - as supplied by publisher]

8: Eye. 2008 Apr 25; [Epub ahead of print] 

Changes of macular and RNFL thicknesses measured by Stratus OCT in patients with
early stage diabetes.

Oshitari T, Hanawa K, Adachi-Usami E.

[1] 1Department of Ophthalmology, Center for Sensory Organ Diseases, Sannoh
Medical Center, Chiba, Japan [2] 2Department of Ophthalmology and Visual
Science, Chiba University Graduate School of Medicine, Chiba, Japan.

PurposeTo examine the early differences in the thicknesses of the macula and
retinal nerve fibre layer (RNFL) by Stratus optical coherence tomography in
patients with diabetes mellitus.MethodsThirty-one normal participants without
any optic nerve and retinal diseases (control), 45 diabetic patients without
diabetic retinopathy (NDR), and 24 diabetic patients with preproliferative
diabetic retinopathy (PPDR), who did not have clinically significant macular
oedema, were used for the macular thickness measurements. Thirty control
participants, 45 patients classified as NDR, and 22 patients classified as PPDR
were used for the RNFL thickness measurements.ResultsIn patients with NDR,
macula was significantly thinner than that of control eyes. In patients with
PPDR, the mean RNFL thickness was significantly thinner but the macula was
thicker than that of control eyes. In women with NDR, the macula was
significantly thinner than that of men with NDR and that of normal women. In men
with PPDR, the RNFL thickness was significantly thinner than that of the control
eyes.ConclusionsAt the early stage of diabetic retinopathy, the maculas and RNFL
thicknesses are altered. The macular and RNFL thicknesses are different in men
and women.Eye advance online publication, 25 April 2008;
doi:10.1038/eye.2008.119.

PMID: 18437178 [PubMed - as supplied by publisher]

9: Eye. 2008 Apr 25; [Epub ahead of print] 

Acute irreversible corticol cataracts in prolonged topical corticosteriod
overuse for chronic eczema.

Sim DA, Chen RP, Hove M, Verma S.

1Moorfields Eye Hospital, London, UK.

PMID: 18437177 [PubMed - as supplied by publisher]

10: Eye. 2008 Apr 25; [Epub ahead of print] 

Intravitreal bevacizumab (Avastin) for primary treatment of diabetic macular
oedema.

Ozkiris A.

1Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri,
Turkey.

BackgroundTo evaluate the effectiveness of intravitreal bevacizumab injection as
primary treatment of diabetic macular oedema.Material and methodsThirty eyes of
30 diabetic patients were treated with 2.5 mg of intravitreal bevacizumab
injection as the primary therapy for diabetic macular oedema. The main outcome
measures included best-corrected visual acuity, fundus fluorescein angiography,
and macular oedema map values of Heidelberg retinal tomograph II (HRT II) before
and after intravitreal injection.ResultsThe visual acuity increased in 24 of 30
eyes (80%) during a mean follow-up time of 5.6 months. The mean baseline
best-corrected LogMAR value for visual acuities of the patients before
intravitreal bevacizumab injection was 1.09+/-0.23. After treatment, it was
0.90+/-0.17 at the 1-month, 0.81+/-0.24, at 3-month, and 0.77+/-0.26 at the last
visit examinations and the differences were significant when compared with
baseline values (for each, P<0.001). The mean oedema map values significantly
decreased by 33.3% at the last visit examination when compared with preinjection
values (P<0.001). Mild anterior chamber inflammation was observed in four eyes
(13.3%), which resolved in a week with topical corticosteroid. No other
injection- or drug-related complications were observed.ConclusionIntravitreal
bevacizumab application provides significant improvement in visual acuity of
diabetic patients and clinical course of macular oedema, and may therefore be a
promising approach in the primary treatment of diabetic macular oedema.Eye
advance online publication, 25 April 2008; doi:10.1038/eye.2008.40.

PMID: 18437176 [PubMed - as supplied by publisher]

11: Eye. 2008 Apr 25; [Epub ahead of print] 

Vitrectomy for diabetic macular oedema.

Laidlaw DA.

1Department of Ophthalmology, St Thomas\' Hospital, London, UK.

AimTo briefly review and discuss the literature on vitrectomy for diabetic
macular oedema.MethodsLiterature review.ResultsThere is a copious literature on
the subject of vitrectomy for diabetic macular oedema (DMO). The most commonly
hypothesised mechanism for the potential benefit of vitrectomy is relief of
vitreomacular traction; however, both transvitreal oxygenation and improved
growth factor diffusion away from the premacular retina have also been suggested
to be potentially beneficial effects. Other systemic and local factors including
duration of oedema, extent of ischaemia and exudation, and extent of laser may
result in permanent photoreceptor and capillary damage, which precludes
anatomical or visual benefit. Much of the literature on the subject of
vitrectomy for DMO is retrospective and uncontrolled but strongly suggestive of
a benefit in terms of improved acuity and reduced macular thickness following
vitrectomy. There are five published small randomised controlled trials on this
subject. Taken as a whole, these studies do not suggest a benefit from surgery.
Selection of patients for surgery on the basis of OCT partial vitreomacular
separation or clinical signs of traction such as an epiretinal membrane or taut
thickened hyaloid has been reported to be associated with a modest improvement
in prospective studies but this has not been subjected to controlled
study.ConclusionThe evidence at present suggests that vitrectomy for DMO should
be restricted to those with clinical or OCT signs of traction.Eye advance online
publication, 25 April 2008; doi:10.1038/eye.2008.84.

PMID: 18437175 [PubMed - as supplied by publisher]

12: Eye. 2008 Apr 18; [Epub ahead of print] 

Antioxidant supplements to prevent or slow down the progression of AMD: a
systematic review and meta-analysis.

Evans J.

1International Centre for Eye Health, London School of Hygiene and Tropical
Medicine (LSHTM), London, UK.

IntroductionThe aim of this review was to examine the evidence as to whether
antioxidant vitamin or mineral supplements prevent the development of AMD or
slow down its progression.MethodsRandomised trials comparing antioxidant vitamin
and/or mineral supplement to control were identified by systematic electronic
searches (updated August 2007) and contact with investigators. Data were pooled
after investigating clinical and statistical heterogeneity.ResultsThere was no
evidence that antioxidant (vitamin E or beta-carotene) supplementation prevented
AMD. A total of 23 099 people were randomised in three trials with treatment
duration of 4-12 years; pooled risk ratio=1.03 (95% CI, 0.74-1.43). There was
evidence that antioxidant (beta-carotene, vitamin C, and vitamin E) and zinc
supplementation slowed down the progression to advanced AMD and visual acuity
loss in people with signs of the disease (adjusted odds ratio=0.68, 95% CI,
0.53-0.87 and 0.77, 95% CI, 0.62-0.96, respectively). The majority of people
were randomised in one trial (AREDS, 3640 people randomised). There were seven
other small trials (total randomised 525).ConclusionsCurrent evidence does not
support the use of antioxidant vitamin supplements to prevent AMD. People with
AMD, or early signs of the disease, may experience some benefit from taking
supplements as used in the AREDS trial. Potential harms of high-dose antioxidant
supplementation must be considered. These may include an increased risk of lung
cancer in smokers (beta-carotene), heart failure in people with vascular disease
or diabetes (vitamin E) and hospitalisation for genitourinary conditions
(zinc).Eye advance online publication, 18 April 2008; doi:10.1038/eye.2008.100.

PMID: 18425071 [PubMed - as supplied by publisher]

13: Eye. 2008 Apr 18; [Epub ahead of print] 

Early response of retinal angiomatous proliferation treated with intravitreal
pegaptanib: a retrospective review.

Mahmood S, Kumar N, Lenfestey PM, Murjaneh S, Heimann H, Harding SP.

1St Paul\'s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.

Aims To evaluate the early functional and anatomical responses to intravitreal
pegaptanib in patients with retinal angiomatous proliferation (RAP).Methods
Retrospective review of consecutive patients newly diagnosed with RAP treated
with intravitreal pegaptanib (0.3 mg). Examination at baseline and 12 weekly
intervals included refraction protocol best corrected visual acuity (BCVA),
fluorescein angiography (FA), and optical coherence tomography (OCT). At
intervening 6 weekly visits a reduced protocol assessment included BCVA and
OCT.Results A total of 16 eyes of 16 patients (12 female, mean age 76.0 years)
with RAP at baseline (15 stage 3, one stage 2) were treated. One patient had
poor response, losing 20 ETDRS letters after one injection and was switched to
photodynamic therapy combined with intravitreal triamcinolone. Mean BCVA (n=15)
was baseline 45+/-11 (mean+/-SD) letters, 12 weeks 43+/-14 letters, 24 weeks
40+/-14 letters; the reduction from baseline to 24 weeks was statistically
significant (P=0.04). Vision remained stable defined as +/-15 letters of
baseline BCVA in 13 (87%) of patients 2 (13%) lost >15 letters. Mean OCT central
foveal thickness (CFT) (n=13) was: baseline 325+/-123 mum, 12 weeks 343+/-130
mum, 24 weeks 321+/-115 mum; difference at 24 weeks was not statistically
significant (P=0.9). A pigment epithelial detachment was present in 12 cases;
height was reduced in 10 cases at 24 weeks. Persistent leakage on FA was seen in
13 out of 15 cases at 24 weeks.Conclusion Early results of treatment of RAP with
intravitreal pegaptanib suggest some stabilizing effect on this normally
progressive disease.Eye advance online publication, 18 April 2008;
doi:10.1038/eye.2008.101.

PMID: 18425070 [PubMed - as supplied by publisher]

14: Eye. 2008 Apr 18; [Epub ahead of print] 

Risk factors for early angle-closure disease in a Burmese population: the
Meiktila Eye Study.

Casson RJ, Marshall D, Newland HS, McGovern S, Muecke J, Tan EW, Selva D, Aung
T.

1South Australian Institute of Ophthalmology, Department of Ophthalmology and
Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia.

PurposeTo determine risk factors for early angle-closure disease (AD) in a
Burmese population.MethodsA cross-sectional, population-based survey of the
inhabitants, 40 years of age and over, from villages in the Meiktila District
was performed; 2481 eligible participants were identified, 2076 participated in
the study, and 2050 could be categorized as having early AD (defined by the
presence of so-called occludable angles (<90 degrees of posterior trabecular
meshwork visible on gonioscopy), but without glaucomatous optic neuropathy). The
ophthalmic examination included Snellen visual acuity, slit-lamp examination,
tonometry, gonioscopy, biometry, and dilated stereoscopic fundus
examination.ResultsThe mean axial length (AL) and anterior chamber depth (ACD)
in those with occludable angles were 21.9 and 2.60 mm, respectively; in those
with non-occludable angles, the corresponding lengths were 22.74 and 2.84 mm,
respectively (P<0.001 for both comparisons). In the univariate analyses, age,
female gender, nuclear and cortical cataract, steeper corneal curvature, more
anterior lens position, and myopia were also significantly associated with
occludability. In the multivariate analysis, age, AL, ACD, and nuclear cataract
were significantly associated with occludability.ConclusionIn this Burmese
population, those with occludable angles had significantly shorter ALs, ACDs,
and thicker lenses than those without occludable angles. In multivariate
analysis, increasing age, decreasing AL, decreasing ACD, and nuclear cataract
were significant predictors of early AD. The presence of nuclear cataract per se
should raise clinical suspicion of the possibility of AD in this population.Eye
advance online publilcation, 18 April 2008; doi:10.1038/eye.2008.102.

PMID: 18425069 [PubMed - as supplied by publisher]

15: Eye. 2008 Apr 18; [Epub ahead of print] 

Age-specific changes in the prevalence and management of optically correctable
visual impairment between 1988 and 2000: the Ponza Eye Study.

Cedrone C, Ricci F, Nucci C, Mancino R, Corsi A, Culasso F.

1Physiopathological Optics, Department of Biopathology and Diagnostic Imaging,
University of Rome \'Tor Vergata\', Rome, Italy.

PurposeTo obtain age-specific data on changes in the prevalence and management
of optically correctable visual impairments (OCVIs) in Ponza,
Italy.MethodsOphthalmologic examinations were carried out to 1000 Ponzans aged
40-87 years in 1988 and to 836 persons in 2000. Visual acuity (VA) was evaluated
under uncorrected (VA(UC)), presenting (VA(PR)), and best-corrected (VA(BC))
conditions. We calculated the prevalence of total OCVIs (subjects with
VA(UC)>0.5 logMAR and VA(BC)0.5 logMAR), and corrected OCVIs (VA(PR)0.05).ConclusionPrevious acute angle-closure attack
correlated with more extensive synechial angle closure in chronic PACG patients
in this study.Eye advance online publication, 18 April 2008;
doi:10.1038/eye.2008.108.

PMID: 18425065 [PubMed - as supplied by publisher]

19: Eye. 2008 Apr 18; [Epub ahead of print] 

The prevalence of cystoid macular oedema on optical coherence tomography in
retinitis pigmentosa patients without cystic changes on fundus examination.

Hajali M, Fishman GA.

1Department of Ophthalmology and Visual Sciences, University of Illinois at
Chicago, Chicago, IL, USA.

PurposeTo determine the prevalence of cystoid macular oedema (CME) by optical
coherence tomography (OCT) in retinitis pigmentosa (RP) patients with no
evidence of cystic macular lesions on fundus examination.MethodsWe included 63
RP patients with no evidence of cystic-appearing macular changes on fundus
examination. All patients underwent a complete ocular examination including
best-corrected visual acuity using an ETDRS (Early Treatment Diabetic
Retinopathy Study) chart, intraocular pressure measurement, anterior segment
examination, and a detailed fundus examination. On 50 of the 63 patients,
Fourier-domain OCT was performed using the radial slicer protocol. An additional
13 of the 63 patients were scanned using the macular thickness protocol on a
time-domain OCT unit. The diagnosis of CME was defined by the presence of
hyporeflective lacunae with well-defined boundaries on at least two of the
scans.ResultsThe mean age of patients included in the study was 36 years (range
9-71 years). Out of the 63 patients examined, 20 showed CME in at least one eye
(32%), whereas 11 patients showed CME in both eyes (18%).ConclusionsOur findings
demonstrate that a substantial number of RP patients with CME, as determined by
OCT, may not show cystic changes by direct ophthalmoscopy or contact lens
biomicroscopy. Knowledge of the high frequency for CME in such patients can
serve to identify those who may be amenable to current or future treatment
strategies of their macular oedema and can potentially impact on future
therapeutic trials where visual acuity is used as an outcome measure.Eye advance
online publication, 18 April 2008; doi:10.1038/eye.2008.110.

PMID: 18425064 [PubMed - as supplied by publisher]

20: Eye. 2008 Apr 18; [Epub ahead of print] 

Pain response and follow-up of patients undergoing panretinal laser
photocoagulation (PRP) with reduced exposure times.

Toufeeq A.

1Eye Department, Wycombe Hospital, High Wycombe, Buckinghamshire, England.

PMID: 18425063 [PubMed - as supplied by publisher]

21: Eye. 2008 Apr 18; [Epub ahead of print] 

Intravitreal pegaptanib sodium for refractory pseudophakic macular oedema.

Cervera E, Diaz-Llopis M, Udaondo P, Garcia-Delpech S.

1Department of Ophthalmology, Hospital General de Valencia, Valencia, Spain.

PurposeEvaluate the efficacy of intravitreal pegaptanib sodium (Macugen((R))) in
refractory pseudophakic cystoid macular oedema (CME).Design and
methodsProspective, nonrandomized, interventional case series. Four eyes of four
patients with refractory pseudophakic CME to pars plana vitrectomy and
intravitreal bevacizumab and triamcinolone, were treated with pegaptanib sodium,
with a mean follow up of 4 months. Pre- and postinfection examinations included
assessment of best-corrected visual acuity (BCVA) using the Early Treatment
Diabetic Retinopathy Study chart (ETDRS), fluorescein angiography (FA), and
optical coherence tomography (OCT).ResultsVisual acuity increased in all
patients after intravitreal pegaptanib sodium. OCT showed improvement of the
retinal thickness in the macular area.ConclusionIntravitreal pegaptanib sodium
(Macugen((R))) is a promising treatment for pseudophakic cystoid macular oedema
resistant to other medical treatment strategies. However, further study is
needed to assess the treatment\'s long term efficacy and the need for
retreatment.Eye advance online publication, 18 April 2008;
doi:10.1038/eye.2008.2.

PMID: 18425062 [PubMed - as supplied by publisher]

22: Eye. 2008 Apr 18; [Epub ahead of print] 

Clinicopathological changes at the vitreoretinal junction: posterior vitreous
detachment.

Snead MP, Snead DR, James S, Richards AJ.

1Vitreoretinal Service, University of Cambridge Addenbrooke\'s NHS Trust,
Cambridge, UK.

Separation of the vitreous and posterior hyaloid membrane (PHM) or posterior
vitreous detachment (PVD) typically occurs between the ages of 45 and 65 years
in the general population, but may occur earlier in myopic or otherwise
predisposed individuals. Age-related synergetic changes occurring within the
cortical and central gel must be distinguished from the PHM, which envelopes it.
This study reports on the correlation between \'true\' PVD seen clinically by the
physician using dynamic examination, high-power slit-lamp biomicroscopy, and
oblique illumination with some of its histological, immunohistochemical, and
ultrastructural features post-mortem. The presence of the Weiss ring does not
necessarily indicate total clean separation of PHM, nor does its absence confirm
that the PHM remains attached, since it may be destroyed during the process of
separation. Immediately prior to PVD with the vitreous gel attached, the PHM
must, by definition, form part of the inner limiting membrane. The detached PHM
frequently exhibits basement membrane (BM) and its indigenous laminocytes stain
focally for GFAP and type IV collagen. The PHM is distinct from and much thicker
than the BM of Muller cells alone and the factors that initiate or limit
separation of the PHM require greater study, particularly the role of laminocyte
proliferation and migration.Eye advance online publication, 18 April 2008;
doi:10.1038/eye.2008.41.

PMID: 18425061 [PubMed - as supplied by publisher]

23: Eye. 2008 Apr 18; [Epub ahead of print] 

Vitreous management in penetrating trauma: primary repair and secondary
intervention.

Aylward GW.

1Vitreoretinal Surgical Unit, Moorfields Eye Hospital, London, UK.

Ocular trauma involving the vitreous produces a very wide range of pathology,
the treatment of which can confuse. In the past, the prognosis for vision
following such injuries was poor. Modern closed intraocular surgical techniques
have transformed the management of penetrating trauma and allowed salvage of
vision in many previously hopeless cases. However, many controversies remain,
including the timing of surgical intervention, the use of encircling buckles,
and the type of internal tamponade. This article will discuss those
controversies, and make some practical recommendations for the management of
penetrating and perforating trauma involving the vitreous.Eye advance online
publication, 18 April 2008; doi:10.1038/eye.2008.74.

PMID: 18425060 [PubMed - as supplied by publisher]

24: Eye. 2008 Apr 18; [Epub ahead of print] 

Ocular manifestations in oculodentodigital dysplasia resulting from a
heterozygous missense mutation (L113P) in GJA1 (connexin 43).

Musa FU, Ratajczak P, Sahu J, Pentlicky S, Fryer A, Richard G, Willoughby CE.

1Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK.

PurposeTo characterize the ophthalmic findings, intrafamilial variability, and
molecular genetic basis of oculodentodigital dysplasia (ODDD; MIM no.
164200).MethodsOphthalmic examination included best-corrected visual acuity,
slit-lamp biomicroscopy, direct and indirect ophthalmoscopy, Goldmann
applanation tonometry and A-scan ultrasonography. Blood samples were taken for
DNA extraction and mutation screening of GJA1 (connexin 43).ResultsAll three
affected individuals had characteristic features of ODDD. The ophthalmic
features were epicanthus, microcornea, and the presence of glaucoma. The ocular
phenotype resulted from a heterozygous T>C transition at nucleotide 338 in GJA1
(L113P) that was not detected in 120 chromosomes of unaffected individuals. The
L113P mutation results in a nonconservative substitution in the cytoplasmic loop
of Cx43 (GJA1) and is predicted to disrupt the high-order structure of
Cx43.ConclusionsThis report describes the ocular phenotype in a molecularly
characterized ODDD syndrome family. The ocular features in this family highlight
the key role Cx43 plays in eye development and in the development of glaucoma.
L113P represents a pathogenic mutation in GJA1 (Cx43) and results in ODDD with
marked intrafamilial variation in glaucoma type and severity.Eye advance online
publication, 18 April 2008; doi:10.1038/eye.2008.77.

PMID: 18425059 [PubMed - as supplied by publisher]

25: Eye. 2008 Apr 18; [Epub ahead of print] 

Alterations of the tear film and ocular surface health in chronic smokers.

Matsumoto Y, Dogru M, Goto E, Sasaki Y, Inoue H, Saito I, Shimazaki J, Tsubota
K.

1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

ObjectiveTo investigate the effects of chronic smoking on ocular surface and
tear functions.MethodsFifteen right eyes of 15 healthy chronic smokers (9 men, 6
women; age range: 36-47 years) who smoked 20 cigarettes per day for 20 years and
20 eyes of 20 control non-smokers (12 men, 8 women; age range: 38-43 years) were
included in this prospective study. All subjects underwent measurements of
breath and haemoglobin CO concentration, tear lipid layer interferometry,
evaporimetry, tear film break-up time (TBUT), Schirmer\'s I test, corneal
fluorescein staining, conjunctival impression, and brush cytology.ResultsThe
mean Hb CO level was significantly higher in smokers compared to non-smokers.
TBUT was also significantly shorter in smokers. Tear lipid layer showed
significant slowing in spread over the tear film with a concomitant significant
increase in tear evaporation rate. Conjunctival impression cytology revealed
significant loss of goblet cells and squamous metaplasia in smokers. Brush
cytology showed significant conjunctival neutrophil infiltration in smoker
subjects.ConclusionChronic smoking induced distinctive quantitative and
qualitative disturbances on the ocular surface health.Eye advance online
publication, 18 April 2008; doi:10.1038/eye.2008.78.

PMID: 18425058 [PubMed - as supplied by publisher]

26: Eye. 2008 Apr 11; [Epub ahead of print] 

Floppy Iris Syndrome Hull Hooks (FISH Hooks): a new technique for managing IFIS
in trabeculectomy surgery.

Norris JH, Mall S, Burnett CA.

1Department of Ophthalmology, Hull and East Yorkshire Eye Hospital, Hull, UK.

PMID: 18404162 [PubMed - as supplied by publisher]

27: Eye. 2008 Apr 11; [Epub ahead of print] 

Inadvertent administration of Olbas oil into the eye: a surprisingly frequent
presentation.

Adams MK, Sparrow JM, Jim S, Tole DM.

1Department of Ophtalmology, Bristol Eye Hospital, Lower Maudlin Street,
Bristol, UK.

PMID: 18404161 [PubMed - as supplied by publisher]

28: Eye. 2008 Apr 11; [Epub ahead of print] 

The application of human anterior lens capsule autotransplantation in
phacotrabeculectomy: a prospective, comparative and randomized clinical study.

Lu D, Liu W, Li H, Ji J.

1Tianjin Medical University Eye Center, Tianjin, China.

PurposeTo determine whether the autotransplantation of human anterior lens
capsule (ALC) in the trabeculectomy site can aid filtration.MethodsWe conducted
a prospective, randomized, and masked clinical trial to evaluate the outcome of
human ALC autotransplantation in phacotrabeculectomy. Fifty patients with
coexisting cataract and uncontrolled glaucoma despite maximum medical therapy
were enrolled in this study. In the ALC group, combined phacoemulsification,
posterior chamber intraocular lens implantation, and trabeculectomy were
performed in 29 eyes, the anterior lens capsule was then put under the scleral
tunnel. In the mitomycin-C (MMC) group, phacoemulsification, posterior chamber
intraocular lens implantation, and trabeculectomy were performed in 21 eyes, MMC
was used intraoperatively. Follow-up period was 12 months. The appearance of
filtering bleb, intraocular pressure, and best corrected visual acuity were
evaluated.Results(1) There was no statistical difference between the ALC group
and the MMC group in the formation of functional filtering blebs (chi(2)=0.132,
P>0.05), intraocular pressure (t=0.007, P>0.05), the number of antiglaucoma
medications (Z=-0.800, P>0.05), and best corrected visual acuity (chi(2)=0.055,
P>0.05). (2) The anterior lens capsule could be detected in the filtering site
by ultrasound biomicroscopy 1 month after surgery.ConclusionsAnterior lens
capsule autotransplantation could get comparable outcome as MMC in
phacotrabeculectomy with few complications.Eye advance online publication, 11
April 2008; doi:10.1038/eye.2008.96.

PMID: 18404160 [PubMed - as supplied by publisher]

29: Eye. 2008 Apr 11; [Epub ahead of print] 

Bevacizumab (Avastin) as a surgical adjunct in diabetic vitrectomy for
fibrovascular disease.

Gandhi JS, Tan LT, Pearce I, Charles SJ.

1The Retinal Unit, Manchester Royal Eye Hospital, Manchester, UK.

PMID: 18404159 [PubMed - as supplied by publisher]