Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Curr Eye Res
Eur J Ophthalmol
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Surv Ophthalmol
Ophthalmology Review Journal
Graefes Arch Clin Exp Ophthalmol[JOUR] Established 1995
1. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 3. [Epub ahead of print]

Sutureless scleral fixation of intraocular lenses.

Karadag R(1), Bayramlar H, Cakici O.

Author information: 
(1)School of Medicine, Department of Ophthalmology, Istanbul Medeniyet
University, Goztepe, Istanbul, Turkey,

PMID: 25726755   [PubMed - as supplied by publisher]

2. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 1. [Epub ahead of print]

Carbamylated erythropoietin mediates retinal neuroprotection in
streptozotocin-induced early-stage diabetic rats.

Liu X(1), Zhu B, Zou H, Hu D, Gu Q, Liu K, Xu X.

Author information: 
(1)Department of Ophthalmology, Shanghai First People's Hospital, Shanghai
Jiaotong University School of Medicine, Shanghai, China.

PURPOSE: The neuroprotective effect of carbamylated erythropoietin (CEPO), an
erythropoietin (EPO) derivative, in diabetic retinopathy (DR) has not been
clearly verified. We conducted this study to investigate the potential
neuroprotective role of CEPO in a streptozotocin-induced diabetic rat model.
METHODS: Streptozotocin-induced diabetic rats and blank controls were treated
with or without CEPO and EPO for 4 weeks. Retinal functional and histological
changes were quantified by electroretinogram, light microscopy, and terminal dUTP
nick end labeling assay. Gene and protein levels of colony-stimulating factor 2
receptor beta, low-affinity (CD131), EPO receptor (EPOR), THY1, glial fibrillary 
acidic protein (GFAP), and vascular endothelial growth factor (VEGF-A) in retinal
tissues were determined by real-time PCR and western blotting, respectively.
Vascular penetration was assessed by fluorescein retinal angiography.
RESULTS: Diabetic rats had decreased retinal thickness, decreased ganglion cells,
and increased retinal neuron apoptosis. CEPO increased CD131 and THY1 expression,
while EPO increased EPOR expression. High glucose increased GFAP expression in
the diabetic group, but both CEPO and EPO attenuated the trend for increase. CEPO
downregulated VEGF-A expression. The amplitudes of b-wave and oscillatory
potentials were decreased in the untreated diabetic group, whereas neither
parameter decreased in diabetic rats after CEPO or EPO treatment. Vascular
leakage and microaneurysms in the diabetic group were significantly improved
following CEPO treatment.
CONCLUSIONS: CEPO has similar anti-apoptotic effects to EPO in DR, but CEPO does 
not induce neovascularization. CEPO may exert neuroprotective effects via its
receptor CD131.

PMID: 25725621   [PubMed - as supplied by publisher]

3. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 1. [Epub ahead of print]

Clinical features of psoriatic uveitis in Japanese patients.

Tanaka R(1), Takamoto M, Komae K, Ohtomo K, Fujino Y, Kaburaki T.

Author information: 
(1)Department of Ophthalmology, The University of Tokyo Hospital, 7-3-1 Hongo,
Bunkyo-ku, Tokyo, 113-0033, Japan,

PURPOSE: To investigate the clinical features of psoriatic uveitis in Japanese
METHODS: Clinical features of 13 consecutive patients with psoriatic uveitis
treated at our facility were retrospectively examined using medical records. In
this study, we collected data about psoriasis type, uveitis laterality, onset
type, HLA types, visual acuity, ocular inflammation localization, anterior
segment findings, funduscopy findings, complications, recurrence, and medical
treatments for uveitis and skin diseases.
RESULTS: The cohort comprised ten males and three females (43.6 ± 7.1 years old),
and types of psoriasis included psoriasis vulgaris (seven cases), psoriatic
arthritis (four cases), pustular psoriasis (three cases) and psoriatic
erythroderma (one case). Two cases represented complicated cases of pustular
psoriasis and psoriatic arthritis. Seven cases were unilateral, and six cases
were bilateral. All cases had acute non-granulomatous anterior uveitis, whereas
panuveitis occurred in one case. Furthermore, macular edema and vascular leakage 
on fluorescein angiography occurred in four cases, and hyperemic disc occurred in
two cases. Recurrence occurred in nine cases. In addition to topical
corticosteroid treatment, eight cases underwent oral immunosuppressive treatment 
or biologics. All six cases undergoing HLA typing were HLA-A2 positive.
CONCLUSIONS: Cases of psoriatic uveitis in Japan appear to present with acute
non-granulomatous uveitis; other symptoms may include macular edema, retinal
vasculitis, or hyperemic disc.

PMID: 25725620   [PubMed - as supplied by publisher]

4. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 1. [Epub ahead of print]

Influence of anterior chamber depth, anterior chamber volume, axial length, and
lens density on postoperative endothelial cell loss.

Reuschel A(1), Bogatsch H, Oertel N, Wiedemann R.

Author information: 
(1)Department of Ophthalmology, University of Leipzig, Liebigstraße 10-14, 04103,
Leipzig, Germany.

PURPOSE: To evaluate the influence of anterior chamber depth (ACD), anterior
chamber volume (ACV), lens density (LD), and axial length (AL) as risk factors on
endothelial cell loss 3 months after cataract surgery.
METHODS: We enrolled 47 patients with senile cataract who were operated between
July 2012 and March 2013 by the same surgeon using torsional phacoemulsification.
Preoperatively, we measured ACD, ACV, and LD using the Oculus Pentacam®. The AL
was determined using the IOL Master®. Primary outcomes were central endothelial
density (ECD) and corrected distance visual acuity (CDVA) 3 months after surgery 
We evaluated the effect of ACD, ACV, LD, and AL as possible risk factors of
postoperative percentage endothelial cell loss (ECL).
RESULTS: The median age was 72 years. The median CDVA before surgery was 0.5
improving to 1.0 postoperatively. The median ECL was 5.2 % (range 1.7 %-7.6 %).
These results are comparable to our previous study (median ECL 6.9 % after
3 months) [Reuschel et al. (2010) J Cataract Refract Surg]. The median ACD in our
study was 2.56 mm (range 2.26 mm-2.8 mm). Median ACV was 144 mm(3) (range
121 mm(3)-158 mm(3)]. The median LD was 12.4 (range 11.4-13.7). Median AL was
23.1 mm (range 22.7 mm-23.9 mm). Our correlation analysis showed no significant
correlation between ACD, ACV, LD, AL, and postoperative ECL.
CONCLUSION: ACD, ACV, AL, and LD were not identified as risk factors of
postoperative endothelial cell loss in our analysis.

PMID: 25725619   [PubMed - as supplied by publisher]

5. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 26. [Epub ahead of print]

Short-term efficacy of subthreshold micropulse yellow laser (577-nm)
photocoagulation for chronic central serous chorioretinopathy.

Kim JY(1), Park HS, Kim SY.

Author information: 
(1)Nune Eye Hospital, 18-21F LIG Bldg, 2397, Dalgubeol-daero, Suseong-gu, Daegu, 
Republic of Korea.

PURPOSE: To investigate the short-term efficacy of subthreshold micropulse yellow
laser photocoagulation in the treatment of chronic central serous
chorioretinopathy (CSC).
METHODS: A retrospective case series study was performed from April 2012 to June 
2014 at Nune Eye Hospital. A total of ten eyes of ten chronic or chronic
recurrent CSC patients received subthreshold micropulse yellow laser
photocoagulation with a 15 % duty cycle at a reduced energy level from the
micropulse laser test burn. Laser exposure time was 20 ms, and the spot diameter 
was 100 μm. Patients were followed up at the authors' hospital for at least
3 months.
RESULTS: Mean age of patients was 43.9 years. The baseline best-corrected visual 
acuity was 0.21 ± 0.21 logarithm of the minimum angle of resolution (logMAR),
which was improved to 0.055 ± 0.093 logMAR (p = 0.020) at the  3-month follow-up 
and 0.035 ± 0.063 logMAR (p = 0.012) at final follow-up. Central macular
thickness at baseline was 349.2 ± 53.2 μm, which was changed to 250.7 ± 28.8 μm
(p = 0.009) at the 3-month follow-up and 261.2 ± 38.31 μm (p = 0.009) at final
CONCLUSIONS: Subthreshold micropulse yellow laser photocoagulation showed
short-term efficacy in treating chronic CSC without retinal damage. However,
prospective, randomized, and comparative large-scale studies are needed to
evaluate the efficacy and safety of this treatment.

PMID: 25717024   [PubMed - as supplied by publisher]

6. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 25. [Epub ahead of print]

Association of rhinostomy shape and surgical outcome after endoscopic endonasal

Lee J(1), Yang SW, Lee H, Chang M, Park M, Baek S.

Author information: 
(1)Department of Ophthalmology, Korea University College of Medicine, 80,
Guro-dong, Guro-gu, Seoul, South Korea, 152-703.

PURPOSE: The purpose of this study was to investigate surgical outcomes and
complications after endoscopic endonasal dacryocystorhinostomy (EDCR) in relation
to rhinostomy shape.
METHODS: A retrospective electronic medical record review of patients who
underwent EDCR for primary acquired nasolacrimal duct obstruction (PANDO) was
performed. Surgical success rates and postoperative complications were compared
among three groups of patients in relation to rhinostomy shape (alcove, cavern,
or concealed cavern).
RESULTS: A total of 280 patients (358 eyes) were included in the study. Of the
358 eyes, 194 rhinostomies were alcove-shaped, 157 were cavern-shaped, and 7 were
concealed cavern-shaped. There were no patients with flat-shaped rhinostomies.
The nasal cavity was wider in patients in the alcove group than those in the
cavern and concealed cavern groups (p = 0.012). The mean time to tube removal was
longest in the concealed cavern group (p = 0.029). There were no significant
differences in anatomical success rates among the three groups (p = 0.338). With 
regard to functional success for patients with anatomically patent DCR, the
cavern and concealed cavern groups had significantly poorer results than the
alcove group (p = 0.001). Functional success rates were 91.6 %, 84.8 %, and
57.1 % for the alcove, cavern, and concealed cavern groups, respectively.
Development of postoperative granuloma was more frequent in the concealed cavern 
group (85.7 %) than in the alcove (29.3 %) or cavern groups (26.1 %) (p= 0.003). 
Multiple logistic regression models for surgical outcome showed that rates of
functional failure after EDCR were influenced by patient age and rhinostomy shape
(odds ratio 1.824, p = 0.045 for age; odds ratio = 9.605, p = 0.000 for
rhinostomy shape) (Table 5).
CONCLUSIONS: The incidence rate of symptomatic epiphora after EDCR was
approximately 12 %, and this result may have been associated with cavernous and
concealed rhinostomy shapes. For patients with persistent epiphora and
anatomically patent DCR, it is important to identify rhinostomy shape by
endoscopy in order to differentiate causes of functional failure.

PMID: 25712630   [PubMed - as supplied by publisher]

7. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 24. [Epub ahead of print]

Ocular complications in children after hematopoietic stem cell transplantation
without total body irradiation.

Kinori M(1), Bielorai B, Souroujon D, Hutt D, Ben-Bassat Mizrachi I, Huna-Baron

Author information: 
(1)Neuro-Ophthalmology Unit, The Goldschleger Eye Institute, Sheba Medical
Center, Tel Hashomer, Israel,

PURPOSE: The purpose of the study was to evaluate whether hematopoietic stem cell
transplantation (HSCT) without conditioning Total Body Irradiation (TBI) had
lower or milder ocular complication rates in the pediatric population.
METHODS: This study included all children who underwent HSCT without conditioning
TBI at the Chaim Sheba Medical Center between the years 2001 and 2008. All
children had an ophthalmic evaluation prior to and every four months after HSCT.
RESULTS: Of the 33 children who initially comprised this study, ten did not
complete the minimal follow-up of four months, and were, thus, excluded from the 
study. Follow-up of the remaining 23 children ranged from four to 117 months. Dry
eye related to chronic graft-versus-host disease (cGVHD) developed in eight
children (35 %). In three cases, an additional complication was observed :
corneal abscess, herpes zoster ophthalmicus, and bilateral subcapsular cataract
(one case each). Posterior segment or neuro-ophthalmological complications were
not observed in any patient.
CONCLUSION: In our study group, the preclusion of conditioning TBI before HSCT
did not result in a decreased ocular complication rate compared to past
publications, but complications were relatively mild and confined only to the
anterior segment.

PMID: 25708560   [PubMed - as supplied by publisher]

8. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 24. [Epub ahead of print]

Ophthalmic artery visualization and morphometry by computed tomography

Zhang T(1), Fan S, He W, Zhang T, Wang Y.

Author information: 
(1)Department of Ophthalmology, Beijing Friendship Hospital affiliated with
Capital Medical University, 95th Yong'an Road, Xicheng District, Beijing,
People's Republic of China.

We assessed the feasibility of using computed tomography angiography (CTA) to
visualize the opthalmic artery (OA) and conducted three-dimensional (3D)
morphometry. A retrospective analysis of 171 patients was performed using
CTA-confirmed normal internal carotid arteries. To identify the OA, multiplanar
CT reformations were performed. The OA diameter was compared in patients of
different age groups and between males and females. All ophthalmic arteries were 
detected by 3D volume-rendering (VR) CTA. Bone subtraction was successful in all 
patients. The mean OA diameter was 1.37 ±0.25 mm in men, 1.35 ±0.16 mm in women
(P = 0.188 for gender), 1.38 ±0.25 mm in the <40 years-old group, 1.37 ±0.14 mm
in the 40-49 years-old group, 1.36 ±0.16 mm in the 50-59 years-old group,
1.38 ±0.19 mm in the 60-69 years-old group, and 1.34 ±0.17 mm in
the > 70 years-old group (P = 0.662 for age group). CTA is a reliable method for 
visualizing the ophthalmic artery (OA). There are no major differences in OA
diameter among gender or age.

PMID: 25708559   [PubMed - as supplied by publisher]

9. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 19. [Epub ahead of print]

Posterior scleral reinforcement combined with patching therapy for pre-school
children with unilateral high myopia.

Shen ZM(1), Zhang ZY, Zhang LY, Li ZG, Chu RY.

Author information: 
(1)Ningbo Medical Treatment Center, Lihuili hospital of Zhejiang Province, No.
57, Xingning Road, Ningbo, Zhejiang Province, China.

PURPOSE: Our purpose was to investigate the effect of posterior scleral
reinforcement (PSR) combined with patching therapy for pre-school children with
unilateral high myopia.
METHODS: A total of 32 pre-school children with unilateral high myopia were
recruited. They were randomly divided into the PSR and control group, each of
which had 16 patients. The patients in the PSR group underwent the simplified PSR
surgery followed by rigid gas permeable contact lens wear and traditional
patching therapy, while the patients in the control group were only prescribed
contact lens wear and patching. Patients were reviewed and the axial length,
refraction, best-corrected visual acuity, and stereoscopic vision were
respectively examined postoperatively at yearly intervals for three years.
RESULTS: The best-corrected visual acuity was significantly higher in the PSR
group than that in the control group at any study visit. A statistically
significant difference in axial length was found between the PSR group
(27.38 ± 1.30 mm) and the control group (28.29 ± 0.74 mm) at the postoperative
three-year (p = 0.03) time point. There was a statistical difference in
refractive error between the PSR group (-13.13 ± 2.55 D) and the control group
(-15.42 ± 1.83 D) at 3-year follow-up. No significant difference was found
between the two groups with respect to the stereoscopic vision by the end of
follow-up at 3 years (p =0.103).
CONCLUSIONS: PSR combined with the patching therapy has the potential to arrest
the progression of high myopia and to help the treatment for amblyopia.

PMID: 25694153   [PubMed - as supplied by publisher]

10. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 19. [Epub ahead of print]

Clinical manifestation of Fuchs uveitis syndrome in childhood.

Tappeiner C(1), Dreesbach J, Roesel M, Heinz C, Heiligenhaus A.

Author information: 
(1)Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74,
48145, Münster, Germany.

PURPOSE: The aim of this study was to describe clinical signs and complications
of Fuchs uveitis syndrome (FUS) with onset in childhood.
METHODS: Ophthalmologic findings and complications in patients with FUS becoming 
manifest before the age of 16 years were analyzed in a retrospective study at a
tertiary referral uveitis center. Inclusion criteria were the presence of
pathognomonic FUS findings at any time point and exclusion of any systemic
immune-mediated or infectious disease.
RESULTS: A total of 23 patients (male = 16, female = 7) with juvenile FUS
(unilateral n = 20, bilateral n = 3 patients) were included in the study. Mean
ages at uveitis and FUS diagnosis were 12.0 ± 4.2 and 22.7 ± 10.7 years,
respectively. In six patients, inflammation was noted at age ≤ 7 years. The
following inflammatory signs were observed in a total of 26 eyes: ≤ 1+ anterior
chamber cell grade (n = 26), vitreous cells (n = 24), fine keratic precipitates
(KPs; n = 23), stellate KPs (n = 11), mutton-fat KPs (n = 23), diffuse (n = 24)
or inferior (n = 8) distribution of KPs, Koeppe nodules (n = 10), and iris
heterochromia (n = 14). A representative subgroup of patients (n = 5) is shown
who presented with non-specific clinical signs in the beginning and in whom
typical FUS signs became manifest only at a later stage. Secondary complications 
such as cataract (n = 19), ocular hypertension (n = 3), or glaucomatous disc
damage (n = 2) were found after a mean uveitis duration of 11.6, 19.5, and
20.3 years, respectively.
CONCLUSION: FUS may begin in early childhood, and the characteristic findings may
not be present at onset of disease. The diagnosis is often delayed for years,
occasionally with the consequence of overtreatment with anti-inflammatory drugs.

PMID: 25694152   [PubMed - as supplied by publisher]

11. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 18. [Epub ahead of print]

Central serous chorioretinopathy fundus autofluorescence comparison with two
different confocal scanning laser ophthalmoscopes.

Nam KT(1), Yun CM, Kim JT, Yang KS, Kim HJ, Kim SW, Oh J, Huh K.

Author information: 
(1)Department of Ophthalmology, Korea University College of Medicine, 516
Gojan-dong, Danwon-gu, Ansan-si, Kyung gi-do, 425-707, Korea.

PURPOSE: To compare the lesion characteristics of two different types of confocal
scanning laser ophthalmoscopy (cSLO) autofluorescence (AF) images in central
serous chorioretinopathy (CSC).
METHODS: The study included 63 eyes of 61 patients; 63 pairs of fundus
autofluorescence (FAF) images were compared before CSC resolution in 63 eyes, FAF
images of 31 eyes were also compared after CSC resolution. The lesion
characteristics (brightness and composite pattern) were compared between
Heidelberg Retina Angiograph 2 (HRA2; Heidelberg Engineering, Germany) and
Optomap Tx (Optomap; Optos, Scotland) FAF images. The lesion composite pattern
was categorized as diffuse or granular. Diffuse AF was defined as homogenously
increased or decreased AF, and granular AF was defined as dot-like, coarse
changes in AF. The mean disease duration and subretinal fluid (SRF) height in the
spectral domain optical coherence tomography were compared according to the FAF
image characteristics.
RESULTS: Lesion brightness before CSC resolution was hypo-AF in 48 eyes (76.2 %),
hyper-AF in three (4.8 %), and mixed-AF in 12 (19.0 %) in HRA2 FAF images. In
comparison, nine (14.3 %) images were hypo-AF, 44 (69.8 %) were hyper-AF, and 10 
(15.9 %) were mixed-AF in Optomap FAF images (P < 0.0001). There was no
significant difference in lesion composite pattern between the two FAF image
wavelengths. Patients with lesions that were hyper-AF in Optomap FAF and hypo-AF 
in HRA2 FAF had a shorter disease duration and greater SRF height (1 month, 281
um) than those who were hyper-AF in both Optomap and HRA2 images (26 months, 153 
um; P = 0.004, 0.001).
CONCLUSIONS: The two types of FAF images of CSC showed different lesion
brightness before and after CSC resolution but demonstrated similar lesion
composite patterns.

PMID: 25690981   [PubMed - as supplied by publisher]

12. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 18. [Epub ahead of print]

Exit strategies in canaloplasty: intraoperative conversion into 180-degree
trabeculotomy or 360-degree trabeculotomy in cases of unsuccessful
catheterisation of Schlemm's canal: influence of degree of canal cleavage.

Alnahrawy O(1), Blumenstock G, Ziemssen F, Szurman P, Leitritz MA, Dimopoulos S, 
Voykov B.

Author information: 
(1)Centre for Ophthalmology, University Hospital Tübingen, Schleichstr. 12-16,
72076, Tübingen, Germany,

PURPOSE: To investigate the safety and efficacy of intraoperative conversion of
unsuccessful canaloplasty technique into 180-degree metal or 360-degree suture
METHODS: In this retrospective observational case series, 35 eyes of 35 patients 
with open-angle glaucoma (OAG) who had undergone unsuccessful canaloplasty
technique and underwent intraoperative conversion were studied. In 17 eyes (group
A), the procedure was converted into 180-degree metal trabeculotomy because of
unsuccessful circumferential Schlemm's canal (SC) catheterisation. Group B
included 18 eyes that were converted into 360-degree trabeculotomy because of
cheese wiring of tension suture through the trabecular meshwork (TM) after
successful complete catheterisation of SC.
RESULTS: Median preoperative IOP was 22.0 mmHg (range 16-34) in group A, and
22.0 mmHg (range 15-48) in group B. Median IOP was significantly reduced in both 
groups postoperatively, at the 12-month examination to 15.0 mmHg (range 9-21)
representing a reduction of 36 % in group A, and to 14.5 mmHg (range 8-21)
representing a reduction of 34 % in group B. Median glaucoma medication number
decreased significantly from 4 (range 2-4) and 3 (range 1-4) preoperatively to 2 
(range 0-4) and 1 (range 0-3) at 12 months in groups A and B respectively.
Hyphema was the commonest complication, with an incidence of 76 % in group A and 
78 % in group B.
CONCLUSION: 180-degree metal or 360-degree suture/catheter trabeculotomy are safe
and effective surgical backup methods to control IOP in cases of unsuccessful
intracanalicular placement of tension suture during canaloplasty surgery.

PMID: 25690980   [PubMed - as supplied by publisher]

13. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 18. [Epub ahead of print]

Transplantation of PEDF-transfected pigment epithelial cells inhibits corneal
neovascularization in a rabbit model.

Kuerten D(1), Johnen S, Harmening N, Souteyrand G, Walter P, Thumann G.

Author information: 
(1)Department of Ophthalmology, RWTH Aachen University, Pauwelsstraße 30, 52074, 
Aachen, Germany.

BACKGROUND: The purpose of this study was to investigate the effect of
recombinant pigment epithelium-derived factor (rPEDF), secreted by ARPE-19 cells 
transfected with the human PEDF gene and transplanted subconjunctivally in normal
and in rabbits in which corneal neovascularization was elicited by a chemical
METHODS: Twenty grey Chinchilla Bastard rabbits were randomly assigned to four
groups; neovascularization was induced in groups A, B, and C by alkali
cauterization. Seven days later, group A received no cell implantation,
non-transfected ARPE-19 cells were implanted subconjunctivally in group B, and
PEDF-transfected ARPE-19 cells were implanted subconjunctivally in groups C and D
(non-cauterized). In-vivo rPEDF secretion was analyzed by immunoblotting, and
ELISA of extracts of conjunctival tissue samples taken at different time points. 
Digital photographs acquired on days 7, 14, and 21 after cauterization were
evaluated for lead vessel length, vascular invasion area, and overall
neovascularization rate.
RESULTS: At days 14 and 21 after cauterization, significant differences were
observed between groups A, B, and C in lead vessel length (day 21: 5.91 ± 0.45,
5.11 ± 1.22, 3.79 ± 0.59 mm, repectively), vascular invasion area (day 21:
35.5 ± 8.65, 34.86 ± 4.92, 19.2 ± 5.03 mm(2) respectively), and rate of corneal
neovascularization. Compared to controls, neovascularization was reduced by
37.5 % on day 14 and 47 % on day 21. Analysis of conjunctival tissue extracts
showed that rPEDF was secreted by the transplanted PEDF-transfected cells.
CONCLUSION: Subconjunctivally transplanted, PEDF-transfected ARPE-19 cells
secrete rPEDF, which inhibits the corneal neovascularization elicited by alkali

PMID: 25690979   [PubMed - as supplied by publisher]

14. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 18. [Epub ahead of print]

Spectral domain optical coherence tomography imaging of mucopolysaccharidoses I, 
II, and VI A.

Seok S(1), Lyu IJ, Park KA, Oh SY.

Author information: 
(1)Center for Clinical Specialty, Department of Ophthalmology, National Cancer
Center, Goyang, Republic of Korea.

PURPOSE: The purpose of this study was to describe the spectral domain optical
coherence tomography (SD-OCT) characteristics of patients with retinal
manifestations of mucopolysaccharidoses (MPSs) I, II, and IV A.
DESIGN: The research was a prospective, observational study.
METHODS: Fourteen consecutive patients with variants of MPS and 15 healthy
subjects underwent ophthalmic assessments including fundus examinations and
RESULTS: The fundus examinations revealed that four patients (two MPS I and two
MPS II) had pigmented retinopathy in both eyes. In addition, one MPS II patient
had cystoid macular edema and two MPS II patients had abnormal disc morphology.
SD-OCT revealed thinning of the parafoveal photoreceptor inner segment/outer
segment (IS/OS; two MPS I and one MPS II) and perifoveal photoreceptor IS/OS (two
MPS I and five MPS II). All MPS I and II patients exhibited thickening of the
central foveal external limiting membrane (ELM). Fundus and SD-OCT findings were 
normal in MPS IV A and healthy subjects. The foveal ELM was significantly thicker
in MPS I and II patients than in healthy subjects (P =0 .000 and P =0 .000,
respectively). The foveal IS/OS was significantly thinner in MPS I, II, and IV A 
patients than in healthy subjects (P = 0.000, P = 0.000, and P = 0.030,
respectively). The foveal retinal pigment epithelium layer was also thinner in
MPS II patients than in healthy subjects (P = 0.007) CONCLUSIONS: In MPS,
accumulation of glycosaminoglycans in retinal tissue induced retinal degeneration
and pigmentary retinopathy. SD-OCT was a useful tool for detecting retinal
pathology, particularly changes in ELM and IS/OS.

PMID: 25690978   [PubMed - as supplied by publisher]

15. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 17. [Epub ahead of print]

DMEK in phakic eyes: targeted therapy or highway to cataract surgery?

Gundlach E(1), Maier AK, Tsangaridou MA, Riechardt AI, Brockmann T, Bertelmann E,
Joussen AM, Torun N.

Author information: 
(1)Klinik für Augenheilkunde, Charité Universitätsmedizin Berlin, Campus
Virchow-Klinikum, Mittelallee 4, Augustenburgerplatz 1, 13353, Berlin, Germany,

PURPOSE: To investigate outcome and postoperative complications in patients
undergoing isolated DMEK in phakic eyes compared to patients undergoing DMEK
combined with cataract surgery (triple procedure).
METHODS: A retrospective analysis of 13 eyes undergoing DMEK in phakic eyes and
54 eyes undergoing triple procedure. Intraoperative and postoperative
complications were recorded, visual acuity, refraction outcome, central corneal
thickness, endothelial cell count and optical coherence tomography (OCT) of the
anterior eye segment were evaluated 6 months postoperatively.
RESULTS: Graft detachment occurred in two eyes (18 %) undergoing phakic DMEK
surgery and 23 eyes (50 %) undergoing triple procedure. Two eyes of the phakic
group needed subsequent cataract surgery. In all cases, visual acuity
significantly increased with a medium visual acuity of 0.13 ± 0.12 (phakic group,
p = 0.005) and 0.15 ± 0.11 (triple group, p < 0.001) logMAR. Visual acuity of at 
least 0.1 logMAR was found in 55 % (phakic group) and 52 % (triple procedure
group) of eyes. In the group after triple procedure, there were 62.8 % of eyes
within 1 D of emmetropia. Corneal thickness was reduced to 515.3 ± 36.9 μm
(phakic group, p = 0.012) and 516.5 ± 40.4 μm (triple group, p < 0.001).
Endothelial cell count was reduced to 1529.7 ± 695.6/mm(2) (phakic group,
p = 0.008) and 1,676.8 ± 355.2/mm(2) (triple group, p < 0.001).
CONCLUSIONS: DMEK in phakic eyes provides very good visual acuity with lower
postoperative complications compared to eyes undergoing triple procedure. As the 
accommodative power can be preserved, this method is especially interesting for
young patients.

PMID: 25683875   [PubMed - as supplied by publisher]

16. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 14. [Epub ahead of print]

Activated adult microglia influence retinal progenitor cell proliferation and
differentiation toward recoverin-expressing neuron-like cells in a co-culture

Xu Y(1), Balasubramaniam B, Copland DA, Liu J, Armitage MJ, Dick AD.

Author information: 
(1)School of Clinical Sciences, University of Bristol, Bristol, United Kingdom,

PURPOSE: Microglia contribute to immune homeostasis of the retina, and thus act
as a potential regulator determining successful repair or retinal stem cell
transplantation. We investigated the interaction between human microglia and
retinal progenitor cells in cell co-culture to further our exploration on
developing a new therapeutic strategy for retinal degeneration.
METHODS: Microglia and retinal progenitor cultures were developed using CD11b(+) 
and CD133(+), respectively, from adult donor retina. Microglia activation was
developed using interferon-gamma and lipopolysaccharide. Retinal progenitor
differentiation was analysed in co-culture with or without microglial activation.
Retinal progenitor proliferation was analysed in presence of conditioned medium
from activated microglia. Phenotype and function of adult human retinal cell
cultures were examined using cell morphology, immunohistochemistry and real-time 
RESULTS: By morphology, neuron-like cells generated in co-culture expressed
photoreceptor marker recoverin. Neurospheres derived from retinal progenitor
cells showed reduced growth in the presence of conditioned medium from activated 
microglia. Delayed retinal progenitor cell migration and reduced cellular
differentiation was observed in co-cultures with activated microglia. In
independent experiments, activated microglia showed enhanced mRNA expression of
CXCL10, IL-27, IL-6, and TNF-alpha compared to controls.
CONCLUSION: Adult human retina retains retinal progenitors or potential to
reprogram cells to then proliferate and differentiate into neuron-like cells in
vitro. Human microglia support retinal progenitor differentiation into
neuron-like cells, but such capacity is altered following microglial activation. 
Modulating microglia activity is a potential approach to promote retinal repair
and facilitate success of stem-cell transplantation.

PMID: 25680876   [PubMed - as supplied by publisher]

17. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 14. [Epub ahead of print]

The expression of Mas-receptor of the renin-angiotensin system in the human eye.

Vaajanen A(1), Kalesnykas G, Vapaatalo H, Uusitalo H.

Author information: 
(1)Department of Ophthalmology, Tampere University Hospital, P.O. Box 2000,
33521, Tampere, Finland,

PURPOSE: The local renin-angiotensin system has been held to be expressed in many
organs, including the eye. It has an important role in the regulation of local
fluid homeostasis, cell proliferation, fibrosis, and vascular tone. Mas-receptor 
(Mas-R) is a potential receptor acting mainly opposite to the well-known
angiotensin II receptor type 1. The aim of this study was to determine if Mas-R
is expressed in the human eye.
METHODS: Seven enucleated human eyes were used in immunohistochemical detection
of Mas-R and its endogenous ligand angiotensin (1-7) [Ang(1-7)]. Both light
microscopy and immunofluorescent detection methods were used. A human kidney
preparation sample was used as control.
RESULTS: The Mas-R was found to have nuclear localization, and localized in the
retinal nuclear layers and in the structures of the anterior segment of the eye. 
A cytoplasmic immunostaining pattern of Ang(1-7) was found in the inner and outer
nuclear and plexiform layers of the retina and in the ciliary body.
CONCLUSION: To the best of our knowledge, this is the first report showing Mas-R 
expression in the human eye. Its localization suggests that it may have a role in
physiological and pathological processes in the anterior part of the eye and in
the retina.

PMID: 25677099   [PubMed - as supplied by publisher]

18. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 12. [Epub ahead of print]

Fornix triamcinolone injection for thyroid orbitopathy.

Hamed-Azzam S(1), Mukari A, Feldman I, Saliba W, Jabaly-Habib H, Briscoe D.

Author information: 
(1)Technion Faculty of Medicine, Haifa, Emek Medical Center, Erez 2 Nazareth
Illit, 17820, Afula, Israel,

PURPOSE: In this pilot study we aimed to examine the association between eyelid
fornices triamcinolone injections and clinical activity score in patients with
active thyroid orbitopathy.
METHODS: Adult patients aged 18 years or older, diagnosed with active thyroid
orbitopathy and a clinical activity score ≥3 were recruited to this
interventional prospective pilot study between 2010 and 2013. Three upper and
lower fornices injections of triamcinolone acetate 20 mg (40 mg/ml) were
administered at 4-week intervals. Each patient included was followed up for a
period of 6 months. Clinical activity score was estimated at each monthly visit. 
Extraocular muscle thickness was measured by ultrasound examination at entrance
and at the last visit.
RESULTS: Eleven eyes of seven patients were included in our study. Initial
clinical activity score was 3.81 ± 1.80 and fell to 0.63 ± 0.72 during a 6-month 
follow-up. There was a significant difference in clinical activity score between 
the baseline examination and the following visits (p-value < 0.0001). Ultrasound 
examination showed a significant decrease in medial and lateral rectus muscle
thickness following treatment; median difference -0.93 and -0.58, respectively
(p-value < 0.005). Lid retraction was reduced by the treatment. Side effects
included a transitory increase in intraocular pressure in one patient, which was 
controlled with topical medication.
CONCLUSIONS: In this pilot study a series of three separate triamcinolone fornix 
injections at 4-week intervals reduces the inflammatory effects of thyroid
orbitopathy, as measured by clinical activity score. The treatment was simple,
effective, and safe eliminating the side effects associated with systemic
corticosteroid use.

PMID: 25673253   [PubMed - as supplied by publisher]

19. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 13. [Epub ahead of print]

Movement of the inner retina complex during the development of primary
full-thickness macular holes: implications for hypotheses of pathogenesis.

Woon WH(1), Greig D, Savage MD, Wilson MC, Grant CA, Mokete B, Bishop F.

Author information: 
(1)Department of Ophthalmology, St James' Hospital, Beckett St, Leeds, LS9 7LS,

BACKGROUND: The inner retinal complex is a well-defined layer in spectral-domain 
OCT scans of the retina. The central edge of this layer at the fovea provides
anatomical landmarks that can be observed in serial OCT scans of developing
full-thickness macular holes (FTMH). Measurement of the movement of these points 
may clarify the mechanism of FTMH formation.
METHOD: This is a retrospective study of primary FTMH that had a sequence of two 
OCT scans showing progression of the hole. Measurements were made of the
dimensions of the hole, including measurements using the central edge of the
inner retinal complex (CEIRC) as markers. The inner retinal separation (distance 
between the CEIRC across the centre of the fovea) and the Height-IRS (average
height of CEIRC above the retinal pigment epithelium) were measured.
RESULTS: Eighteen cases were identified in 17 patients. The average increase in
the base diameter (368 microns) and the average increase in minimum linear
dimension (187 microns) were much larger than the average increase in the inner
retinal separation (73 microns). The average increase in Height-IRS was 103
CONCLUSION: The tangential separation of the outer retina to produce the macular 
hole is much larger than the tangential separation of the inner retinal layers. A
model based on the histology of the Muller cells at the fovea is proposed to
explain the findings of this study.

PMID: 25673252   [PubMed - as supplied by publisher]

20. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 12. [Epub ahead of print]

Intravitreal dexamethasone implant versus anti-VEGF injection for treatment-naïve
patients with retinal vein occlusion and macular edema: a 12-month follow-up

Chiquet C(1), Dupuy C, Bron AM, Aptel F, Straub M, Isaico R, Romanet JP,
Creuzot-Garcher C.

Author information: 
(1)Department of Ophthalmology, University Hospital, Grenoble, France,

PURPOSE: The objective of his study was to compare the visual and anatomical
outcomes in treatment-naïve patients with macular edema secondary to retinal vein
occlusion after intravitreal injections of dexamethasone implants (DEX) and
METHODS: One hundred two patients (64 in the anti-VEGF group, 38 in the DEX
group) without previous treatment were included in this multi-center
retrospective study and evaluated at baseline and 1, 3, 6, and 12 months after
the onset of treatment. Patients were defined as "good responders" if central
macular thickness (CMT) was less than or equal to 250 μm in TD-OCT or 300 μm in
SD-OCT after the injections.
RESULTS: At month 3 (n = 102), BCVA had increased significantly, by 0.1 ± 0.3
logMAR in the anti-VEGF group (p = 0.04) and 0.4 ± 0.4 logMAR in the DEX group
(p < 0.001); the difference between the two groups was statistically significant 
(p = 0.007). CMT decreased significantly, by 138 ± 201 μm (-19 %, p < 0.001) in
the anti-VEGF group and 163 ± 243 μm (-21 %, p < 0.001) in the DEX group. After
3 months, five patients (13 %) in the DEX group and 20 (31 %) in the anti-VEGF
group (p < 0.001) changed treatment. Among the 77 patients who did not switch
from their initial treatment, no significant functional or anatomical difference 
between the two groups was observed at months 6 and 12. Elevation of intraocular 
pressure > 21 mmHg was more frequent in the DEX group (21 %) than in the
anti-VEGF group (3 %, p = 0.008).
CONCLUSIONS: Visual acuity recovery was better in the DEX group than in the
anti-VEGF group at month 3, but with no difference in CMT. In patients who did
not change treatment, the long-term anatomical and visual outcome was similar
between the DEX and anti-VEGF groups.

PMID: 25673251   [PubMed - as supplied by publisher]

21. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 12. [Epub ahead of print]

Refractive errors, visual impairment, and the use of low-vision devices in
albinism in Malawi.

Schulze Schwering M(1), Kumar N, Bohrmann D, Msukwa G, Kalua K, Kayange P,
Spitzer MS.

Author information: 
(1)c/o College of Medicine, University of Malawi, P Bag 360, Blantyre 3,
Blantyre, Malawi,

BACKGROUND: This study focuses on the refractive implications of albinism in
Malawi, which is mostly associated with the burden of visual impairment. The main
goal was to describe the refractive errors and to analyze whether patients with
albinism in Malawi, Sub-Saharan Africa, benefit from refraction.
METHODS: Age, sex, refractive data, uncorrected and best-corrected visual acuity 
(UCVA, BCVA), colour vision, contrast sensitivity, and the prescription of
sunglasses and low vision devices were collected for a group of 120 albino
individuals with oculocutaneous albinism (OCA). Refractive errors were evaluated 
objectively and subjectively by retinoscopy, and followed by cycloplegic
refraction to reconfirm the results. Best-corrected visual acuity (BCVA) was also
assessed binocularly.
RESULTS: One hundred and twenty albino subjects were examined, ranging in age
from 4 to 25 years (median 12 years), 71 (59 %) boys and 49 (41 %) girls. All
exhibited horizontal pendular nystagmus. Mean visual acuity improved from 0.98
(0.33) logMAR to 0.77 (0.15) logMAR after refraction (p < 0.001). The best
improvement of VA was achieved in patients with mild to moderate myopia. Patients
with albinism who were hyperopic more than +1.5 D hardly improved from
refraction. With the rule (WTR) astigmatism was more present (37.5 %) than
against the rule (ATR) astigmatism (3.8 %). Patients with astigmatism less than
1.5 D improved in 15/32 of cases (47 %) by 2 lines or more. Patients with
astigmatism equal to or more than 1.5 D in any axis improved in 26/54 of cases
(48 %) by 2 lines or more.
CONCLUSIONS: Refraction improves visual acuity of children with oculocutaneous
albinism in a Sub-Saharan African population in Malawi. The mean improvement was 
2 logMAR units.

PMID: 25673250   [PubMed - as supplied by publisher]

22. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 10. [Epub ahead of print]

αA-crystallin gene CpG islands hypermethylation in nuclear cataract after pars
plana vitrectomy.

Zhu XJ(1), Zhang KK, Zhou P, Jiang CH, Lu Y.

Author information: 
(1)Department of Ophthalmology, Eye and ENT Hospital, Fudan University, 83
Fenyang Road, Shanghai, 200031, People's Republic of China.

PURPOSE: To investigate the DNA methylation status of αA-crystallin gene in
cataract secondary to pars plana vitrectomy.
METHODS: Anterior capsular membranes of 40 eyes of 40 patients with cataract
secondary to vitrectomy were collected. Another 20 eyes of 20 patients who
received pars plana vitrectomy and phacoemulsification in the primary procedure, 
were recruited as control. Methylation status of the CpG islands of αA-crystallin
gene was analyzed by pyrosequencing. Expression of αA-crystallin was evaluated by
real-time polymerase chain reaction and western blot.
RESULTS: In the post vitrectomy group, five patients with posterior subcapsular
opacity and four patients with cortical opacity were excluded from further
analysis. The remaining 31 patients with nuclear cataract were assigned into two 
groups according to tamponade types: 19 of octafluoropropane (C3F8) and 12 of
silicone oil (SiO). The average nuclear color grading was elevated both in C3F8
and SiO groups after vitrectomy. Compared to the control group, hypermethylation 
of the CpG islands in the αA-crystallin gene promoter was found in both post
vitrectomy groups, accompanied by significantly reduced αA-crystallin expression.
No statistically significant differences were found between the C3F8 and SiO
groups either for DNA methylation status or αA-crystallin expression.
CONCLUSIONS: CpG islands hypermethylation of αA-crystallin gene may be involved
in nuclear cataract formation after pars plana vitrectomy.

PMID: 25663476   [PubMed - as supplied by publisher]

23. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 10. [Epub ahead of print]

Analysis of choroidal folds in acute Vogt-Koyanagi-Harada disease using
high-penetration optical coherence tomography.

Tsuboi K(1), Nakai K, Iwahashi C, Gomi F, Ikuno Y, Nishida K.

Author information: 
(1)Department of Ophthalmology E7, Osaka University Medical School, 2-2
Yamada-oka Suita, 565-0871, Osaka, Japan.

PURPOSE: To characterize patients with Vogt-Koyanagi-Harada (VKH) disease with
choroidal folds (CFs) and determine how the foveal choroidal thickness changes
after initial treatment using high-penetration optical coherence tomography
METHODS: In this retrospective observational study, we analyzed 42 eyes of 21
patients with new-onset VKH disease to determine the demographic and clinical
differences between patients with and without CFs.
RESULTS: Twenty-four eyes (57.1 %) of 13 patients with VKH disease had CFs. The
mean age (p = 0.0009) of patients with CFs was significantly higher than that of 
those without CFs (49.1 vs 39.4 years respectively). The frequency of disc
swelling (p = 0.0001) was significantly higher in eyes with CFs than in those
without CFs (95.8 % vs 38.9 %). The choroidal thickness at the first visit
(p = 0.0011) was significantly greater in eyes with CFs than in those without CFs
(794 ± 144 μm vs 649 ± 113 μm). The choroid 6 months after the initial treatment 
(p = 0.0118) was significantly thinner in eyes with CFs than in those without CFs
(270 ± 92 μm vs 340 ± 80 μm). The frequency of sunset glow fundus at 6 months
(p = 0.0334) in eyes with CFs was significantly higher than in those without CFs 
(62.5 % vs 27.8 %).
CONCLUSION: The development of CFs in patients with VKH disease was significantly
correlated with age, disc swelling, and choroidal thickness. The eyes with CFs
frequently developed a sunset glow fundus. The findings suggested that patients
with CFs might have severe and longstanding inflammation of the choroidal

PMID: 25663475   [PubMed - as supplied by publisher]

24. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 7. [Epub ahead of print]

New Miyake-Apple view using a nasal endoscope.

Hwang HS(1), Paik JS, Kim MS, Yang SW.

Author information: 
(1)Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym
University, Chuncheon, South Korea.

PMID: 25663438   [PubMed - as supplied by publisher]

25. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 8. [Epub ahead of print]

Binding of VEGF-A is sufficient to abrogate the disturbing effects of VEGF-B
together with VEGF-A on retinal endothelial cells.

Deissler HL(1), Lang GK, Lang GE.

Author information: 
(1)Department of Ophthalmology, University of Ulm, Prittwitzstrasse 43, 89075,
Ulm, Germany,

PURPOSE: Inhibition of vascular endothelial growth factor (VEGF) is a promising
strategy to treat retinal complications of diabetes. In contrast to VEGF-A
binding ranibizumab, aflibercept also binds to other members of the VEGF family
including VEGF-B, but potential effects of this factor on permeability and
angiogenic processes are unclear. Therefore, we studied how VEGF-B variants as
single agents or together with VEGF-A165 might affect proliferation, migration,
or barrier function of retinal endothelial cells (REC). Also investigated was the
normalization of REC properties with both VEGF-inhibitors to explore if
additional targeting of VEGF-B is relevant.
METHODS: Stimulation of proliferation or migration of immortalized bovine REC
(iBREC) and disturbance of their barrier by exposure to VEGF-B variants (as
single factors or together with VEGF-A165) was determined with or without
VEGF-binding proteins being added. Permeability of iBREC was assessed by
measuring their transendothelial resistance (TER) and expression of the tight
junction protein claudin-1.
RESULTS: VEGF-B167 and VEGF-B186 enhanced proliferation of iBREC but these
isoforms did not affect cell migration. Interestingly, ranibizumab completely
blocked both migration and proliferation induced by VEGF-A plus VEGF-B. Both
VEGF-B variants did also not affect barrier function or claudin-1 expression in a
normal or high-glucose environment. Accordingly, binding VEGF-A was enough to
normalize a reduced TER and reinstate claudin-1 lost during treatment with this
factor in combination with VEGF-B.
CONCLUSIONS: Important properties and functions of REC seem not to be affected by
any VEGF-B variant and targeting the key factor VEGF-A is sufficient to normalize
growth factor-disturbed cells of this type.

PMID: 25663437   [PubMed - as supplied by publisher]

26. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 6. [Epub ahead of print]

Postoperative refractive error after phacovitrectomy for epiretinal membrane with
and without macular oedema.

Frings A(1), Dulz S, Skevas C, Stemplewitz B, Linke SJ, Richard G, Wagenfeld L.

Author information: 
(1)Department of Ophthalmology, University Medical Center Hamburg-Eppendorf
(UKE), Martinistraße 52, 20246, Hamburg, Germany,

PURPOSE: This study was initiated to investigate whether the presence of macular 
oedema influenced intraocular lens (IOL) power calculation in eyes with
epiretinal membrane.
METHODS: The files of patients undergoing combined phacoemulsification were
retrospectively reviewed. Two groups were defined according to presence of
macular oedema. The main outcome measure was the IOL power prediction error (PE).
Secondary outcome measures were the correlation between preoperative macular
thickness, absolute change of macular thickness and dioptric shift. The mean
postoperative PE achieved with the Haigis formula was compared with the PE that
would have been obtained had the SRKII and HofferQ formulas been used.
RESULTS: We investigated 47 eyes of 47 consecutive patients. Regardless of the
IOL formula used, the PE was on average higher in eyes without macula oedema
(group 1). The myopic dioptric shift was dependent on preoperative macular
thickness and absolute change of macular thickness. This association was more
markedly pronounced in group 1.
CONCLUSIONS: Increased retinal thickness is the main cause for underestimation of
the cornea-photoreceptor layer distance, and therefore could contribute to
inaccuracy in IOL power calculations. The current results show that a myopic
shift tends to be less pronounced in cases where a macula oedema is present. Eyes
with pure traction have less predictable refractive results in terms of higher PE
and dioptric shift.

PMID: 25655649   [PubMed - as supplied by publisher]

27. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 5. [Epub ahead of print]

The outer choroidoscleral boundary in full-thickness macular holes before and
after surgery-a swept-source OCT study.

Michalewska Z(1), Michalewski J, Nawrocka Z, Dulczewska-Cichecka K, Nawrocki J.

Author information: 
(1)Ophthalmic Clinic "Jasne Blonia", ul. Rojna 90, Lodz, 91-162, Poland,

PURPOSE: To report on choroidal thickness and the morphology of the outer
choroidoscleral boundary in swept-source OCT in patients with full-thickness
macular holes (FTMH) before and after surgery.
METHODS: Single center matched case-control study of 32 patients with FTMH (group
1), fellow eyes (group 2), and 32 eyes of 32 healthy controls (group 3). All eyes
from group 1 had vitrectomy with a minimum follow-up of 3 months. Main outcome
measures were the visibility and regularity of the outer choroidoscleral boundary
(CSB), and additionally the eventual visibility of the suprachoroidal layer
RESULTS: Choroidal thickness was indifferent between groups. Choroidal thickness 
did not change after surgery (p = 0.1). CSB was visible in all cases. CSB was
irregular in 59 % of eyes in group 1, in 40 % of eyes in group 2, and in any eye 
in group 3. SCL was visible in 34 % of eyes in group 1, and remained visible
after surgery. In group 2, SCL was observed in 44 % of eyes, and in group 3 in
one eye.
CONCLUSIONS: Choroidal thickness does not differ between eyes with FTMH and their
fellow eyes and healthy controls. CSB is more often irregular and SCL is more
often visible in eyes with FTMH and their fellow eyes than in healthy controls.
In fellow eyes of FTMH, the visibility of SCL was observed more often in eyes
with partial vitreous detachment (p = 0.0). Three months after surgery, choroidal
thickness does not change, the irregularities of CSB and SCL remain visible. More
frequent changes of the outer choroidoscleral boundary in FTMH, and especially in
their fellow eyes, may suggest a role of the choroid in the pathogenesis of FTMH.

PMID: 25652163   [PubMed - as supplied by publisher]

28. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 3. [Epub ahead of print]

Cocaine snorting may induce ocular surface damage through corneal sensitivity

Mantelli F(1), Lambiase A, Sacchetti M, Orlandi V, Rosa A, Casella P, Bonini S.

Author information: 
(1)IRCCS Fondazione GB Bietti, Via Livenza, 3, 00198, Rome, Italy,

PURPOSE: Cocaine abuse may cause severe ischemic and necrotic tissue damage in
several organs, including the eye. However, the cornea is an avascular tissue
relying on sensitive nerves for its trophic support, and the pathogenesis of
cocaine-induced corneal lesions is unclear. In this study, we aimed to
investigate if corneal sensitivity, ocular surface, and tear function are damaged
by habitual cocaine snorting.
METHODS: Ocular examination, corneal sensitivity, and tear function testing were 
carried out in 48 cocaine addicts, and in 22 heroin addicts and 30 drug-free
age/sex-matched individuals who served as controls. We also performed corneal
confocal microscopy, conjunctival impression cytology, and tear sample collection
to evaluate corneal and conjunctival morphology, and the presence of cocaine in
tears. Statistical analysis was performed to compare groups and to correlate
clinical findings with anamnestic data on cocaine use.
RESULTS: We observed decreased corneal sensitivity in 26 cocaine addicts, and
neurotrophic keratitis in six of them, with corneal damage, absence of symptoms, 
reduced tear production, and prolonged interblink-time. No significant changes in
ocular surface parameters including corneal sensitivity were observed in heroin
addicts. The major risk factors for developing cocaine-induced neurotrophic
keratitis appeared to be duration and frequency of drug abuse.
CONCLUSIONS: A complete ophthalmic evaluation including corneal sensitivity
testing should be planned for an optimal management of cocaine addicts, even in
the absence of ocular symptoms, to reduce the risk of corneal lesions and
consequent vision impairment. Sensory nerve damage should also be evaluated in
cocaine-induced lesions of other organs.

PMID: 25644620   [PubMed - as supplied by publisher]

29. Graefes Arch Clin Exp Ophthalmol. 2015 Feb 3. [Epub ahead of print]

Anatomical effects of clear lens extraction by phacoemulsification versus
trabeculectomy on anterior chamber drainage angle in primary angle-closure
glaucoma (PACG) patients.

Man X(1), Chan NC, Baig N, Kwong YY, Leung DY, Li FC, Tham CC.

Author information: 
(1)Department of Ophthalmology & Visual Sciences, The Chinese University of Hong 
Kong, Hong Kong SAR, People's Republic of China.

PURPOSE: To document the anatomical effects of clear lens extraction by
phacoemulsification versus trabeculectomy on anterior chamber angle in patients
with primary angle-closure glaucoma (PACG).
METHODS: Gonioscopy and ultrasound biomicroscopy (UBM) were performed
pre-operatively, and at 1 year after clear lens extraction or trabeculectomy in
PACG eyes.
RESULTS: Fifty PACG eyes of 50 patients were included. Twenty-six eyes had clear 
lens extraction by phacoemulsification, while 24 eyes underwent trabeculectomy.
The mean extent of synechial angle closure was significantly reduced from
272.3° ± 57.3° to 253.3° ± 70.5° (p = 0.007) by phacoemulsification, but it was
only reduced from 285.0° ± 64.6° to 283.1° ± 55.5° (p = 0.32) by trabeculectomy. 
The mean angle-opening distance at 500 microns from sclera spur (AOD500) measured
by UBM was significantly increased from 220.3 ± 93.8 microns to 388.9 ± 134.1
microns (p < 0.001) by clear lens extraction, but decreased from 220.9 ± 79.8
microns to 214.5 ± 70.2 microns (p = 0.11) by trabeculectomy. The mean anterior
chamber depth (ACD) measured by UBM was significantly increased from
1,983.8 ± 176.8 microns to 3335.0 ± 174.2 microns (p < 0.001) by clear lens
extraction, but decreased from 2,000.2 ± 214.5 microns to 1975.8 ± 218.2 microns 
(p = 0.001) by trabeculectomy.
CONCLUSION: Compared to trabeculectomy, clear lens extraction resulted in a
significant reduction in synechial angle closure, and an increase in anterior
chamber angle width and anterior chamber depth in PACG eyes without cataract.

PMID: 25644619   [PubMed - as supplied by publisher]