Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Cornea
Curr Eye Res
Eur J Ophthalmol
Eye
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
JPOS
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Ophthalmologica
Ophthalmology
Retina
Surv Ophthalmol
Ophthalmology Review Journal
Graefes Arch Clin Exp Ophthalmol[JOUR] Established 1995
1. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 18. [Epub ahead of print]

Mycobacterium w administration for steroid resistant optic neuritis with
long-term follow-up.

Sudhalkar A(1), Khamar M, Khamar B.

Author information: 
(1)Eye Hospital and Retinal Laser Centre, Mahajan Lane, Raopura Baroda, 390002,
Gujarat, India, adityasudhalkar@yahoo.com.

BACKGROUND: We report the long-term safety and outcomes of off-label
Mycobacterium W (Mw) administration in steroid resistant optic neuritis.
METHODS: In a case series, six patients with documented idiopathic corticosteroid
refractory unilateral optic neuritis were treated with immuvac (Mycobacterium W
extract). The dose was repeated at three months. Outcomes measures included the
best corrected visual acuity (BCVA), pupillary reaction, colour vision, visual
field(VF) examination (when possible), fundus examination and photography, and
visually evoked potential (VEP) testing. BCVA, pupillary reaction, and color
vision were monitored immediately prior to steroid therapy on days 1 and 7
post-steroid therapy, pre-Mw administration (i.e., 30 days after the last dose of
steroids had been completed) and post-Mw administration on days 1, 7, 30, 90,
120, and 180. VF, VEP, and fundus photography were performed immediately prior to
steroid administration, 30 days after the last dose of steroids (i.e.,
immediately prior to Mw), and at days 30, 90,120 and, 180. The patients were
assessed six-month intervals thereafter for visual acuity, colour vision, and
visual fields.
RESULTS: There were five females and three males in the age range of 30-54 years.
Minimum follow-up was five years. All patients showed improvement in visual
acuity, colour vision, and pupillary reaction. The patients showed stable
improvement. There was no recurrence of the disease and no adverse events till
the end of the follow-up period.
CONCLUSIONS: Mw appears to be safe in the long term and to improve steroid
resistant optic neuritis; future randomized clinical trials would help affirm
this observation.

PMID: 25231916   [PubMed - as supplied by publisher]


2. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 17. [Epub ahead of print]

Next generation sequencing uncovers a missense mutation in COL4A1 as the cause of
familial retinal arteriolar tortuosity.

Zenteno JC(1), Crespí J, Buentello-Volante B, Buil JA, Bassaganyas F,
Vela-Segarra JI, Diaz-Cascajosa J, Marieges MT.

Author information: 
(1)Genetics Department and Research Unit, Institute of Ophthalmology "Conde de
Valenciana" and Biochemistry Department, Faculty of Medicine, National Autonomous
University of Mexico (UNAM), Chimalpopoca 14, Col. Obrera, Mexico City, CP,
06800, Mexico, jczenteno@institutodeoftalmologia.org.

OBJECTIVES: Our aim was to determine the molecular cause of autosomal dominant
familial retinal arteriolar tortuosity (FRAT) in a family with three affected
subjects.
MATERIAL AND METHODS: Ophthalmologic evaluation included determination of
best-corrected visual acuity (BCVA), slit-lamp and dilated fundus inspection,
applanation tonometry, fundus photography, and fluorescein retinal angiography
(FA). Molecular methods included whole exome sequencing analysis and Sanger
sequencing validation of putative causal mutation in DNA from affected
individuals.
RESULTS: Typical signs of familial retinal arteriolar tortuosity were observed in
all three patients. Exome sequencing identified a heterozygous c.1528G > A (p.
Gly510Arg) mutation in COL4A1. Sanger sequencing confirmed that all three
patients harbored the same pathogenetic mutation in COL4A1. The p. Gly510Arg
variant in COL4A1 was absent in DNA from an available unaffected daughter, from a
set of control alleles, and from publicly available databases.
CONCLUSIONS: The molecular basis of familial retinal arteriolar tortuosity was
identified for the first time, thus expanding the human phenotypes linked to
COL4A1 mutations. Interestingly, the COL4A1 p.Gly510Arg mutation has been
previously identified in a family with HANAC (Hereditary Angiopathy with
Nephropathy, Aneurysm and Cramps), a multisystemic disease featuring retinal
arteriolar tortuosity. No cerebral, neurologic, renal, cardiac or vascular
anomalies were recognized in the pedigree described here. These data indicate
that identical mutations in COL4A1 can originate both eye-restricted and systemic
phenotypes.

PMID: 25228067   [PubMed - as supplied by publisher]


3. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 17. [Epub ahead of print]

Comparison of optotypes of Amsterdam Picture Chart with those of Tumbling-E, LEA 
Symbols, ETDRS, and Landolt-C in non-amblyopic and amblyopic patients.

Engin O(1), Despriet DD, van der Meulen-Schot HM, Romers A, Slot X, Sang MT,
Fronius M, Kelderman H, Simonsz HJ.

Author information: 
(1)Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 50-60,
3015 GE, Rotterdam, The Netherlands, simonsz@compuserve.com.

PURPOSE: To compare optotypes of the Amsterdam Picture Chart (APK) with those of 
Landolt-C (LC), Tumbling-E (TE), ETDRS and LEA symbols (LEA), to assess their
reliability in measuring visual acuity (VA).
METHODS: We recruited healthy controls with equal VA and amblyopes with ≥2 LogMAR
lines interocular difference. New logarithmic charts were developed with LC, TE, 
ETDRS, LEA, and APK with identical size and spacing (four optotypes) between
optotypes. Charts were randomly presented at 5 m under DIN EN ISO 8596 and 8597
conditions. VA was measured with LC (LC-VA), TE, ETDRS, LEA, and APK, using six
out of ten optotypes answered correctly as threshold.
RESULTS: In 100 controls aged 17-31, LC-VA was -0.207 ± SD 0.089 LogMAR. Visual
acuity measured with TE differed from LC-VA by 0.021 (positive value meaning less
recognizable), with ETDRS 0.012, with Lea 0.054, and with APK 0.117. In 46
amblyopic eyes with LC-VA <0.5 LogMAR, the difference was for TE 0.017, for ETDRS
0.017, for LEA 0.089, and for APK 0.213. In 13 amblyopic eyes with LC-VA ≥0.5
LogMAR, the difference was for TE 0.122, ETDRS 0.047, LEA 0.057, and APK 0.019.
APK optotypes had a lower percentage of passed subjects at each LogMAR line
compared to Landolt-C. The 11 APK optotypes had different thresholds.
CONCLUSIONS: Small APK optotypes were recognized worse than all other optotypes, 
probably because of their thinner lines. Large APK optotypes were recognized
relatively well, possibly reflecting recognition acuity. Differences between the 
thresholds of the 11 APK optotypes reduced its sensitivity further.

PMID: 25228066   [PubMed - as supplied by publisher]


4. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 16. [Epub ahead of print]

Safety evaluation of "retina implant alpha IMS"-a prospective clinical trial.

Kitiratschky VB(1), Stingl K, Wilhelm B, Peters T, Besch D, Sachs H, Gekeler F,
Bartz-Schmidt KU, Zrenner E.

Author information: 
(1)Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076,
Tübingen, Germany.

BACKGROUND: To restore vision in patients with retinitis pigmentosa, several
types of electronic devices have been developed to stimulate neurons at different
levels along the visual pathway. Subretinal stimulation of the retina with the
Retina Implant Alpha IMS (Retina Implant AG, Reutlingen, Germany) has been
demonstrated to provide useful vision in daily life. Here we evaluated the safety
of this device.
METHODS: An interventional, prospective, multi-center, single-arm study was
conducted in patients with retinitis pigmentosa with the Retina Implant Alpha
IMS. The results from the first nine patients of a single center regarding safety
of the device are reported. Any untoward medical occurrence related or unrelated 
to the tested device was documented and evaluated.
RESULTS: Nine adult subjects were included in the study at the Tübingen site.
Seventy-five adverse events occurred in total, and 53 affected the eye and its
adnexa. Thirty-one ocular adverse events had a relationship to the implant that
was classified as "certain" while 19 had a probable or possible relationship;
three had no relationship to the implant. Thirty-nine ocular adverse events
resolved without sequelae, two resolved with sequelae, 11 remained unresolved,
and in one the status was unknown. The intensity of ocular adverse events was
mild in the majority of cases (n = 45), while six were of moderate and two of
severe intensity. There was no non-ocular adverse event with certain relationship
to the device. One subject lost light perception (without light localization) in 
her study eye.
CONCLUSIONS: In conclusion, this prospective study, "Safety and Efficacy of
Subretinal Implants for Partial Restoration of Vision in Blind Patients," shows
that the Retina Implant Alpha IMS is an option for restoring vision using a
subretinal stimulation device with a clinically acceptable safety profile.

PMID: 25219982   [PubMed - as supplied by publisher]


5. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 14. [Epub ahead of print]

Novel insights provided by spectral-domain coherent tomography in pediatric
ophthalmology.

Abitbol MM.

Author information: 
Department of Ophthalmology, Necker-Enfants Malades University Hospital of Paris,
Paris Descartes University, 149 rue de Sèvres, 75015, Paris, France,
marc.abitbol@nck.aphp.fr.

PMID: 25216740   [PubMed - as supplied by publisher]


6. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 13. [Epub ahead of print]

Estrogen prevents high-glucose-induced damage of retinal ganglion cells via
mitochondrial pathway.

Hao M(1), Li Y, Lin W, Xu Q, Shao N, Zhang Y, Kuang H.

Author information: 
(1)Department of Endocrinology, The First Clinical Hospital of Harbin Medical
University, No. 23 Youzheng Street, NanGang District, Harbin, Heilongjiang
Province, China.

BACKGROUND: Diabetic retinopathy (DR) is a leading cause of acquired blindness in
adults. Previous research has shown that the apoptosis of retinal ganglion
cells(RGCs) plays an important role in the initiation and development of diabetic
retinopathy. The positive effect of estrogen on the nervous system is currently
attracting increasing attention. In this study, we investigated
whether17β-estradiolum (E2) has protective effects on RGCs in a high-glucose
environment.
METHODS: The cell survival rates were measured by Cell Counting Kit-8, the
apoptosis was detected by flow cytometry, the intracellular reactive oxygen
species (ROS) levels were examined by immunofluorescence method, and the
intracellular mitochondrial membrane potential was examined by confocal
microscopy. The expression levels of cytochrome C, Bcl-2, and Bax were analyzed
by Western blot method. The effect of estrogen receptor blocker tamoxifen on the 
RGCs was also evaluated.
RESULTS: It was found that E2 stabilizes the mitochondrial membrane potential,
reduces intracellular ROS levels, up-regulates Bcl-2 expression, inhibits Bax
expression, decreases the generation of cytochrome C, and finally reduces the
apoptosis of RGC-5 cells in a high-glucose environment. These protective
functions could be attributed to E2 receptors, which make E2 a prospective patent
application candidate in the treatment of DR. Furthermore, when cells were
pre-cultured with tamoxifen, we found that tamoxifen inhibited the shielding
effects of E2.
CONCLUSION: E2 has a broad application prospect in the treatment of DR.

PMID: 25216739   [PubMed - as supplied by publisher]


7. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 14. [Epub ahead of print]

Testing the effects of the dye Acid violet-17 on retinal function for an
intraocular application in vitreo-retinal surgery.

Tura A(1), Alt A, Haritoglou C, Meyer CH, Schneider T, Grisanti S, Lüke J, Lüke
M; for the International Chromovitrectomy Collaboration.

Author information: 
(1)University Eye Hospital, University of Lübeck, Ratzeburger Allee 160, D-23538,
Lübeck, Germany.

PURPOSE: To facilitate epiretinal or inner limiting membrane peeling, dyes like
Indocyanine Green (ICG) as well as Trypan Blue (TB) were used so far. However,
toxic effects on the retina were described for both dyes. The aim of our study
was to investigate the effects of a novel vital dye Acid violet-17 (AV-17) on
retinal histology and function to assess a possible application in vitreo-retinal
surgery.
METHODS: AV-17 was dissolved in a solvent with heavy water. An electroretinogram 
was recorded on perfused bovine retina. After reaching stable b-wave amplitudes, 
AV-17 (0.125-0.5 mg/ml) or the solvent was applied epiretinally for
30-300 seconds. The b-wave amplitudes were recorded before, during, and after
treatment. Cultures of bovine retina were incubated for 30 or 300 seconds with
the dye or solvent and processed for live/dead staining, immunohistochemistry,
and immunoblotting.
RESULTS: Reductions of the b-wave amplitudes were observed directly after the
exposure to AV-17, which were rapidly and completely reversible within the
recovery period for all exposure times at the concentrations of 0.125 and
0.25 mg/ml as opposed to the partial recovery after exposure to 0.5 mg/ml. A high
degree of damage in the ganglion cell layer (GCL) and glial reactivity were
detected at the concentrations of 0.25 and 0.5 mg/ml but not after exposure to
lower concentrations or the solvent.
CONCLUSION: Application of AV-17 at a concentration of up to 0.125 mg/ml was well
tolerated in terms of retinal function, survival in the GCL, and glial reactivity
whereas higher concentrations are not recommended.

PMID: 25216738   [PubMed - as supplied by publisher]


8. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 12. [Epub ahead of print]

A new surgical triple procedure in pseudoexfoliation glaucoma using cataract
surgery, Trabectome, and trabecular aspiration.

Widder RA(1), Dinslage S, Rosentreter A, Jordan JF, Kühnrich P, Cursiefen C,
Lemmen KD, Dietlein TS.

Author information: 
(1)Department of Ophthalmology, St. Martinus-Krankenhaus, Gladbacher Str. 26, 40219,
Düsseldorf, Germany, r.widder@martinus-duesseldorf.de.

BACKGROUND: To evaluate the potential of lowering intraocular pressure in
pseudoexfoliation glaucoma with combined phacoemulsification, Trabectome, and
trabecular aspiration (triple procedure) compared to phacoemulsification and
trabecular aspiration alone.
METHODS: Using a case-matched retrospective study design, 30 patients were
included into each group. The main outcome measures were the reduction of
intraocular pressure and medication score at the end of follow-up. Clinical data 
were collected from the patients' medical records.
RESULTS: Mean follow-up was 15 months in both groups. Intraocular pressure
decreased from 25.3 ± 6.3 mmHg to 14.4 ± 3.7 mmHg (p < 0.0001) in the triple
procedure group and from 25.3 ± 4.2 mmHg to 18.1 ± 4.2 mmHg (p < 0.0001) in the
control group. The medication score was lowered from 3.4 ± 1.7 to 2.1 ± 1.2
(p = 0.0017) in the triple procedure group and from 3.8 ± 1.8 to 2.3 ± 1.5
(p < 0.008) in the control group. The reduction of intraocular pressure was
higher (p < 0.004) in the triple procedure group (38.4 ± 17.3 %) compared to the 
control group (26.8 ± 19.6 %) The reduction of the medication score did not
differ significantly.
CONCLUSIONS: The triple procedure is more effective in lowering intraocular
pressure compared to phacoemulsification and trabecular aspiration alone in
pseudoexfoliation glaucoma.

PMID: 25212496   [PubMed - as supplied by publisher]


9. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 12. [Epub ahead of print]

Rapid regression of a subset of class 1 uveal melanomas after Iodine-125 plaque
radiotherapy suggests an inflammatory mechanism.

Chen RW(1), Harbour JW.

Author information: 
(1)Ocular Oncology Service, Bascom Palmer Eye Institute and Sylvester Comprehensive 
Cancer Center, University of Miami Miller School of Medicine, 900 NW 17th St,
Miami, FL, 33136, USA, rc2631@cumc.columbia.edu.

PMID: 25212495   [PubMed - as supplied by publisher]


10. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 11. [Epub ahead of print]

Methicillin-resistant Staphylococcus aureus biofilm formation on
dacryocystorhinostomy silicone tubes depends on the genetic lineage.

Cirković I(1), Knežević M, Božić DD, Rašić D, Larsen AR, Dukić S.

Author information: 
(1)Institute of Microbiology and Immunology, Faculty of Medicine, University of
Belgrade, Dr Subotića 1, Belgrade, 11000, Serbia, cirkoviciv@yahoo.com.

PURPOSE: The aim of this study was to investigate biofilm formation on silicone
tubes by genetically diverse methicillin-resistant Staphylococcus aureus (MRSA)
strains.
METHODS: Capacity of biofilm formation on dacryocystorhinostomy silicone tubes
was tested on 30 MRSA strains. Identification and methicillin resistance were
confirmed by PCR for nuc and mecA genes. Strains were genotypically characterised
(SCCmec, agr and spa typing). Biofilm formation was tested in microtiter plate
and on silicone tubes.
RESULTS: Tested MRSA strains were classified into SCCmec type I (33.3 %), II
(3.3 %), III (20.0 %), IV (26.7 %) and V (16.7 %), agr type I (56.7 %), II
(36.7 %) and III (6.6 %), and eight spa clonal complexes (CCs). All tested MRSA
strains showed ability to form biofilm on microtiter plate. Capacity of biofilm
formation on silicone tubes was as follows: 33.3 % of strains belonged to the
category of low biofilm producers, and 66.7 % to moderate biofilm producers.
There was statistically significant correlation between spa CC and the category
of biofilm production on silicone tubes (p = 0.01): CC5 and CC45 with moderate
amount of biofilm, and CC8 with low amount of biofilm. A moderate amount of
biofilm formed on silicone tubes correlated with agr type II MRSA strains
(p = 0.008).
CONCLUSIONS: Biofilm formation by MRSA on silicone tubes is highly dependent on
genetic characteristics of the strains. Therefore, MRSA genotyping may aid the
determination of the possibility of biofilm-related ocular device infections.
Genotyping and biofilm quantification may be helpful in determining when
decolonisation and cohort isolation are required to prevent device-related
infections.

PMID: 25209953   [PubMed - as supplied by publisher]


11. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 10. [Epub ahead of print]

Intravitreal Ranibizumab for neovascular Age-related macular degeneration in
clinical practice: five-year treatment outcomes.

Zhu M(1), Chew JK, Broadhead GK, Luo K, Joachim N, Hong T, Syed A, Chang AA.

Author information: 
(1)Sydney Institute of Vision Science, Level 13, 187 Macquarie Street, Sydney, 2000,
Australia.

BACKGROUND: Intravitreal anti-vascular endothelial growth factor (anti-VEGF)
agents are the established standard of care for neovascular age-related macular
degeneration (nAMD). However, data on long-term outcomes of this therapy are
limited. The purpose of this study was to assess the visual and anatomical
outcomes and safety profile of intravitreal ranibizumab in treating nAMD over a
period of five years.
METHODS: 208 patients (208 eyes) were included in this retrospective case series 
study. Intervention was an "as-needed" treatment model. Visual acuity (VA),
central macular thickness (CMT), ophthalmic examination, and adverse events (AEs)
were assessed in each visit. Snellen VA was converted to Early Treatment Diabetic
Retinopathy Study letters for analysis.
RESULTS: The average VA improved by 1.9 letters after one year (p = 0.017), and
decreased by 2.4 letters over five years of treatment (p = 0.043). At the end of 
year five, 11.1 % of patients (23/208) had improved VA by more than 15 letters
and 68.8 % (143/208) had VA improvement or loss less than or equal to 15 letters,
while 20.2 % of patients (42/208) had a loss of more than 15 letters. Patients
with VA of less than 35 letters at baseline showed significant VA improvement
after five years of treatment. There was a positive relationship between
injection numbers and VA improvement over the five-year period, after adjusting
for age and baseline VA (p < 0.0005). Mean CMT decreased by 28.3 μm (p < 0.0005) 
over five years. Ocular AEs, serious adverse events (SAEs), and systemic SAEs
occurred in 4.6 %, 0.48 %, and 2 % of patients, respectively, during the
follow-up period.
CONCLUSIONS: The use of intravitreal ranibizumab in an as-needed treatment
regimen over a five-year period was effective in maintaining vision in patients
with nAMD and in reducing macular thickness, with a relatively low rate of
adverse and serious adverse events.

PMID: 25205618   [PubMed - as supplied by publisher]


12. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 10. [Epub ahead of print]

Inhibitory effect of discoidin domain receptor 2 (DDR2) on oxygen-induced
retinopathy in mice.

Li R(1), Huang T, Zhu T.

Author information: 
(1)Department of Ophthalmology, The Affiliated Hospital, Xi'an Medical University,
No.48 West Fenghao Road, Xi'an, 710077, Shaanxi, China, rechelrong198222@163.com.

BACKGROUND: Retinal neovascularization (RNV) of retinopathy of prematurity (ROP) 
is a complex disorder, and the mechanisms that are involved have been difficult
to decipher. Accumulating evidence indicates that extracellular matrix (ECM) and 
its receptors are critical in angiogenesis. Discoidin domain receptor 2 (DDR2),
an ECM receptor in cellular membrane, is involved in control of vascular
endothelial activity and tumor angiogenesis. However, there are no relevant
reports about the role of DDR2 in RNV of ROP. Thus, we investigated the
regulatory effect of DDR2 on oxygen-induced retinopathy (OIR) model in the mouse.
METHODS: DDR2 mutant mice (slie) and their wild type littermates were used. OIR
was induced in wild type and sile mice at postnatal day 7 (P7) by exposure to
hyperoxia (75 % O2) for 5d and normoxia (21 % O2) for 5d. At P17, Real-time PCR, 
western blot and immunohistochemistry were used to detect the expression of the
DDR2 gene in the retinas. The severity of OIR was evaluated by retinal flatmounts
and histopathological analysis. Images of the retinas and retinal sections were
observed under a confocal laser-scanning microscope and light microscope,
respectively.
RESULTS: DDR2 mRNA and protein were found in wild type mice and their levels
decreased in the OIR group compared with the normal group. DDR2 was expressed
mainly in neovascular endothelial cells in OIR mice. As for the OIR model, sile
mice had larger areas of retinal nonperfusion and more vascular endothelial cells
penetrating the internal limiting membrane than wild type mice.
CONCLUSIONS: The data from this study revealed that DDR2 negatively regulates the
development of experimental ROP in vivo, which may provide a novel target for
preventing human pathological ocular neovascularization.

PMID: 25205617   [PubMed - as supplied by publisher]


13. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 9. [Epub ahead of print]

Change in the antioxidative capacity of extraocular muscles in patients with
exotropia.

Jung SK(1), Choi JS, Shin SY.

Author information: 
(1)Department of Ophthalmology and Visual Science, The Catholic University of Korea,
Seoul St. Mary's Hospital, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.

BACKGROUND: We compared the oxidative stress and antioxidant capacities of the
medial rectus muscles (MRMs) between the patients with constant exotropia and
control subjects.
METHODS: A total of 40 MRMs from patients with constant exotropia and 40 MRMs
from normal donor eyes (controls) were assessed. Neuronal nitric oxide synthase
(nNOS), superoxide dismutase (SOD), and catalase levels were compared between the
two groups using western blot analysis. In addition, the lipofuscin accumulation 
level was compared between the exotropic and control groups.
RESULTS: According to western blot analysis, the nNOS level was significantly
higher in the exotropic group than in the control group (P < 0.05). On the other 
hand, a catalase expression level was higher in the control group than in the
exotropic group (P < 0.05). The SOD1 level did not show a significant difference 
between the two groups. The relative lipofuscin fluorescence intensity was higher
in the exotropic group than in the control group (P < 0.001).
CONCLUSIONS: Based on these findings, the MRMs of patients with exotropia had a
redox imbalance status. Further study is needed to investigate whether this
imbalance in antioxidant capacity is present in the extraocular muscles of
patients with other strabismus.

PMID: 25196461   [PubMed - as supplied by publisher]


14. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 9. [Epub ahead of print]

Fluorescein angiography versus spectral domain optical coherence tomography in
idiopathic juxtafoveal retinal telangiectasia.

Chhablani J(1), Narayanan R.

Author information: 
(1)Srimati Kanuri Santhamma Vitreo-Retina Service, L.V. Prasad Eye Institute, L.V.
Prasad Marg, Banjara Hills, Hyderabad, India.

PMID: 25196460   [PubMed - as supplied by publisher]


15. Graefes Arch Clin Exp Ophthalmol. 2014 Aug 30. [Epub ahead of print]

CCL20/MIP-3 alpha mRNA expression in the conjunctival epithelium of normal
individuals and patients with vernal keratoconjunctivitis.

Inada N(1), Ishimori A, Shoji J.

Author information: 
(1)Division of Ophthalmology, Department of Visual Sciences, Nihon University School
of Medicine, 30-1 Oyaguchi-Kamichou, Itabashi-ku, Tokyo, 173-8610, Japan,
inada.noriko@nihon-u.ac.jp.

BACKGROUND: CCL20, the single chemokine ligand for CCR6, contributes to
recruiting CCR6-expressing memory B cells, memory T cells, Th17 cells and
dendritic cells, and is involved in regulating immune responses, homeostasis, and
inflammation in mucosal tissues.
METHODS: CCL20 messenger RNA (mRNA) expression was analyzed in the conjunctival
epithelium in an in vivo study of patients with vernal keratoconjunctivitis (VKC 
group) and healthy volunteers (control group) using impression cytology. In vitro
analysis of CCL20 mRNA was performed using cultured conjunctival epithelial cells
(CECs). Real-time polymerase chain reaction was used to assess IL-8 and eotaxin-2
mRNA expression for comparison with CCL20 mRNA expression.
RESULTS: In the control group, CCL20 mRNA expression was present in all
conjunctival locations. However, CCL20 mRNA expression was significantly higher
in the upper palpebral conjunctiva in the severe VKC group than in the mild VKC
and control groups (p < 0.05, Steel test). In vitro stimulation of CECs with
lipopolysaccharide (LPS) significantly increased CCL20 expression in a
concentration-dependent manner that was significantly correlated with expression 
of IL-8 (p < 0.001, Spearman's rank correlation coefficient), but not eotaxin-2.
CONCLUSION: We conclude that CCL 20 mRNA expression in the conjunctival
epithelium plays a crucial role in regulating homeostasis at the ocular surface
and in exacerbation of VKC.

PMID: 25172034   [PubMed - as supplied by publisher]


16. Graefes Arch Clin Exp Ophthalmol. 2014 Aug 28. [Epub ahead of print]

Structures affecting recovery of macular function in patients with age-related
macular degeneration after intravitreal ranibizumab.

Nishimura T(1), Machida S, Hashizume K, Kurosaka D.

Author information: 
(1)Department of Ophthalmology, Iwate Medical University School of Medicine, 19-1
Uchimaru, Morioka, Iwate, 020-8505, Japan.

PURPOSE: To determine the retinal structures affecting the recovery of macular
function in patients with exudative age-related macular degeneration (AMD)
treated with intravitreal ranibizumab (IVR).
METHOD: Thirty eyes of 30 patients with exudative AMD who were treated with IVR
at monthly intervals for 3 months were studied. Focal macular electroretinograms 
(fmERGs) and spectral-domain optical coherence tomography (SD-OCT) were performed
before and 3 months after beginning the IVR injections. The fmERGs were elicited 
by a 15° white stimulus spot centered on the fovea. The thickness of different
retinal layers, presence of a serous retinal detachment (SRD), and presence of a 
pigment epithelial detachment (PED) at the fovea was determined in the SD-OCT
images. Measurements were made of the inner, middle, and outer layers of the
retina and also of the SRD and PED in the horizontal and vertical meridians at
1.2 mm from the fovea (parafoveal regions). The significance of the correlations 
between these structural parameters and the a-wave amplitude of the fmERG was
determined.
RESULTS: There was no significant correlation between the structural parameters
of the fovea and the a-wave amplitude. In the parafoveal regions, the thickness
of the outer retinal layer was significantly correlated with an increase of the
a-wave amplitude (R = 0.56, P = 0.001). In addition, the SRD thickness was
negatively and significantly correlated with the a-wave amplitude (R = -0.54,
P = 0.002). The change in the parafoveal SRD thickness after IVRs was the only
independent determinant of recovery of the a-wave amplitude after the treatments 
(P < 0.05).
CONCLUSIONS: The macular function measured by the fmERGs was determined by the
parafoveal outer layer and SRD thickness in patients with exudative AMD. Of
these, changes in the SRD thickness by IVRs most strongly affected the recovery
of macular function.

PMID: 25163415   [PubMed - as supplied by publisher]


17. Graefes Arch Clin Exp Ophthalmol. 2014 Aug 27. [Epub ahead of print]

Cytotoxic activity and degradation patterns of structural proteins by corneal
isolates of Acanthamoeba spp.

Sant'ana VP(1), Carrijo-Carvalho LC, Foronda AS, Chudzinski-Tavassi AM, de
Freitas D, de Carvalho FR.

Author information: 
(1)Department of Ophthalmology and Visual Sciences, Paulista School of Medicine,
Federal University of Sao Paulo, São Paulo, Brazil.

BACKGROUND: Proteolytic enzymes secreted by trophozoites (amoebic secretome) are 
suggested as the main virulence factor involved in the severity of Acanthamoeba
keratitis. The degradation profile of the main glycoprotein components of
anterior and posterior portions of the cornea and the cytopathic effect of
secretomes on endothelial cells by contact-independent mechanism were evaluated.
METHODS: Trophozoites were isolated primarily from corneal tissue samples
(n = 11) and extracellular proteins were collected from axenic cell culture
supernatants. The molecular weights of proteolytic enzymes were estimated by
zymography. Enzymatic cleavage of laminin and fibronectin substrates by amoebic
secretome was investigated and cluster analysis was applied to the proteolysis
profiles. Primary cultures of endothelial cells were used in both qualitative and
quantitative assays of cytophatogenicity.
RESULTS: Differential patterns of proteolysis were observed among the
Acanthamoeba secretomes that were analysed. The uniformity of laminin degradation
contrasted with the diversity of the proteolysis profiles observed in the
fibronectin substrate. Acanthamoeba secretome extracted from four clinical
isolates was shown to be toxic when in contact with the endothelial cell
monolayer (p < 0.01). Induction of apoptosis and membrane permeability, at
different percentual values, were suggested as the main mechanisms that could
induce endothelial cell death when in contact with amoebic secretome.
CONCLUSIONS: Our results provide evidence that virulence factors secreted by
Acanthamoeba trophozoites can be related to an increased pathogenicity pattern by
an independent contact-trophozoite mechanism, through induction of endothelial
cell death by apoptosis at a higher percentage than providing the lack of cell
viability by the membrane-associated pore-forming toxin activity.

PMID: 25161076   [PubMed - as supplied by publisher]


18. Graefes Arch Clin Exp Ophthalmol. 2014 Aug 27. [Epub ahead of print]

Factors affecting laser power in retinal Navilas laser treatment.

Hoeh AE(1), Pollithy S, Dithmar S.

Author information: 
(1)Department of Ophthalmology, University Hospital Heidelberg, Im Neuenheimer Feld 
400, 69120, Heidelberg, Germany, alexandra.hoeh@med.uni-heidelberg.de.

PURPOSE: To evaluate the effect of patient-associated factors on the minimum
laser power needed for a mild visible burn in focal laser treatments using the
532 nm Navilas laser system.
METHODS: We conducted a monocentric prospective pilot study of 58 eyes of 40
patients with diabetic macular edema. The following parameters were analysed:
axial length, refraction, iris pigmentation, lens status, lens grading and
densitometry, retinal and choroidal thickness and focus setting during treatment.
Laser power was adjusted to produce mild, barely visible burns. Retinal laser
burn size was measured 30 min after treatment.
RESULTS: Focus setting is significantly correlated with retinal lesion size
(r = 0.50, p = 0.001) and laser power (r = 0.44, p < 0.001). Axial length only
correlated with laser power when the effect of focus was controlled. Phakic eyes 
needed more laser power than pseudophakic eyes (78.3 versus 67.2 mW, p = 0.051). 
No correlation of laser power with any other factor could be found.
CONCLUSIONS: Among the examined parameters, focus setting had the strongest
effect on the laser power needed to produce a mild visible burn. The association 
of focus with laser power can be explained by the focus-dependent change of
retinal spot size. Lens status (phakic versus pseudophakic patients) seems to
influence laser light transmission in the examined age group.

PMID: 25161075   [PubMed - as supplied by publisher]


19. Graefes Arch Clin Exp Ophthalmol. 2014 Aug 23. [Epub ahead of print]

Pharmacokinetics of intravenously administered tigecycline in eye compartments:
an experimental study.

Ozcimen M(1), Sakarya Y, Ozcimen S, Goktas S, Sakarya R, Alpfidan I, Erdogan E.

Author information: 
(1)Department of Ophthalmology, Konya Training and Research Hospital, Konya, 42090, 
Turkey, mozcimen@gmail.com.

PURPOSE: The purpose of this study was to evaluate the ocular distribution of
intravenously administered tigecycline in a rabbit uveitis model.
METHODS: Tigecycline, which has a broad spectrum of activity against many
gram-positive, gram-negative, and anaerobic organisms, was given intravenously to
rabbits at 7 mg/kg of body weight starting 24 h after induction of uveitis by
intravitreal endotoxin injection. Tigecycline concentrations were determined by
high performance liquid chromatography-mass spectrometry (LC-MS/MS) assay in the 
aqueous humor, vitreous humor, and plasma 1, 3, 6, and 24 h after administration 
of a single dose.
RESULTS: The maximum concentrations were found within 1 h after the end of the
intravenously given tigecycline, and were 1,308.60 ± 301.76 ng/mL in plasma,
181.40 ± 51.32 ng/mL in vitreous humor and 145.00 ± 55.29 ng/mL in aqueous humor 
of the inflamed eye. After 24 h, no drug was detectable in the aqueous and
vitreous of the normal eyes, whereas small amounts of drug were detectable in
inflamed eyes and in plasma.
CONCLUSIONS: Tigecycline did not reach therapeutically significant levels in the 
aqueous and the vitreous humor of rabbit eyes. The findings suggest a limited
role for intravenously administered tigecycline in the treatment of bacterial
endophthalmitis.

PMID: 25150050   [PubMed - as supplied by publisher]


20. Graefes Arch Clin Exp Ophthalmol. 2014 Aug 23. [Epub ahead of print]

Comparison of Wavelight Allegretto Eye-Q and Schwind Amaris 750S excimer laser in
treatment of high astigmatism.

Bohac M(1), Biscevic A, Koncarevic M, Anticic M, Gabric N, Patel S.

Author information: 
(1)Specialty Eye Hospital "Svjetlost", Heinzelova 39, 10000, Zagreb, Croatia,
maja.bohac@svjetlost.hr.

PURPOSE: To compare functional outcomes of Wavelight Allegretto Eye-Q 400Hz and
Schwind Amaris 750S excimer laser for astigmatism between 2 and 7 diopters(D).
METHODS: Prospective comparative non-randomized case series of 480 eyes assigned 
in two laser groups and further divided into myopic and mixed astigmatism
subgroups. All treatments were centered on corneal vertex. One-year results were 
compared between the groups. Statistical analysis was performed using z-test.
RESULTS: Both Allegretto and Amaris postoperative uncorrected distance visual
acuity (UDVA) improved in comparison to preoperative corrected distance visual
acuity (CDVA). The difference was significant in the Allegretto group for myopic 
astigmatism (p = 0.017). There was no difference in postoperative UDVA between
lasers. Average sphere decreased in all groups for both lasers (p < 0.001)
without difference in effectiveness of spherical correction between lasers for
both groups. In Allegretto, average cylinder decreased from -3.30D to -0.55D in
myopic astigmatism (p < 0.001) and from -3.84D to -0.85D in mixed astigmatism
(p < 0.001). In Amaris average cylinder decreased from -3.21D to -0.43D in myopic
astigmatism (p < 0.001) and from -3.66D to -0.58D in mixed astigmatism
(p < 0.001). Amaris group had less residual astigmatism (myopic astigmatism
p = 0.023, mixed astigmatism p < 0.001). Mean spherical aberration shifted from
positive to negative in mixed astigmatism for both lasers.
CONCLUSION: Both lasers are effective in terms of UDVA, CDVA, spherical
correction, and preservation of high-order aberrations. However, Amaris was more 
effective in cylinder correction.

PMID: 25150049   [PubMed - as supplied by publisher]


21. Graefes Arch Clin Exp Ophthalmol. 2014 Mar;252(3):375-81.

Branch retinal vein occlusion and vitreovascular traction: a preliminary spectral
domain OCT case-control study.

Ascaso FJ, Padgett E, Núñez E, Villén L, Grzybowski A, Cristóbal JA.

OBJECTIVE: Branch retinal vein occlusion (BRVO) typically occurs at an
arteriovenous (AV) crossing site. Although the pathogenesis is unclear,
vitreovascular traction might have a significant role in some BRVO cases. The
purpose of present study was to determine the incidence of vitreoretinal traction
at the obstruction site in patients diagnosed with BRVO.
METHODS: In this prospective observational case–control study, 32 consecutive
BRVO patients were studied with spectral-domain optical coherence tomography
(SD-OCT) to detect the presence of vitreovascular traction or vitreous adherence 
at the occlusion site.
RESULTS: SD-OCT directed to the occlusion site revealed a vitreovascular traction
at this point in eight eyes (25 %). Fourteen eyes (43.75 %) were associated with 
an adherence of posterior hyaloids without signs of retinal traction, whereas ten
eyes (31.25 %) had neither vitreoretinal adherence nor vitreous traction.
Regarding either the same vessel segment of the fellow eye, none of the cases
revealed vitreovascular traction in the correspondent AV crossing site; 12 cases 
(37.5 %) presented vitreoretinal adherence; and the remaining 20 cases (62.5 %)
showed neither traction nor adhesion. Thus, vitreovascular traction in the
occlusion site was significantly associated with BRVO (p = 0.024, chi-squared
test). B-scan ultrasonography showed that the posterior vitreous cortex remains
more frequently attached in eyes with BRVO compared to unaffected fellow eyes
(p = 0.041, chi-squared test).
CONCLUSIONS: A common firm vitreous adhesion at the obstruction site is reported 
herein, pointing out the possible role of vitreovascular traction in the etiology
of some cases of BRVO. Likewise, although not all BRVO cases can be explained by 
this pathogenic mechanism, an attached posterior vitreous cortex might be a
cofactor in the origin of this entity.

PMID: 25147879   [PubMed - indexed for MEDLINE]