Journal Contents

Acta Ophthalmol Scand
Am Jour Ophthalmol
Arch Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Curr Eye Res
Eur J Ophthalmol
J Glaucoma
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. 2013 Jul 3. [Epub ahead of print]

Perioperative complications and clinical outcomes of intraocular lens exchange in
patients with opacified lenses.

Fernández-Buenaga R, Alió JL, Pinilla-Cortés L, Barraquer RI.

Vissum Corporation, Avda de Denia s/n, Edificio Vissum, 03016, Alicante, Spain.

BACKGROUND: To evaluate the perioperative complications and the outcomes of
intraocular lens (IOL) exchange in patients with opacified lenses.
METHODS: Retrospective multicentrical consecutive series of cases that comprised 
22 eyes from 21 patients who had previous phacoemulsification with implantation
of an IOL in the capsular bag and developed severe late opacification of the IOL.
All patients had loss of vision and reported light disturbances. The IOLs were
explanted and replaced with new IOLs. The perioperative complications were
evaluated. The best spectacle-corrected visual acuity (BSCVA) before and after
the surgery was compared.
RESULTS: The mean time lapsed between the original cataract surgery and the IOL
exchange surgery was 89.1 ± 33.6 [48-216] months. The IOL exchange was uneventful
in 14 eyes (63.6 %). Anterior vitrectomy was needed in seven cases (31.8 %).
Other complications included zonular dehiscence in one case (4.5 %). In most of
the cases, 14 eyes (63.6 %), the IOL was implanted in the sulcus. The most
explanted IOL was the Hydroview H60M (Bausch & Lomb). The mean BSCVA (LogMAR)
before and after the surgery were 0.57 ± 0.69 (0.10-3) and 0.18 ± 0.22 (0.0-1.10)
respectively (t paired test, p < 0.001). After the operation, 20 eyes (90.9 %)
achieved a BSCVA ≤ 0.3. No eye lost 1 or more lines of corrected vision after the
CONCLUSIONS: IOL exchange surgery, although associated with a high incidence of
complications, restores and significantly improves the visual acuity of patients 
with opacified IOLs.

PMID: 23821121   [PubMed - as supplied by publisher]

2. Graefes Arch Clin Exp Ophthalmol. 2013 Jul 3. [Epub ahead of print]

Effect of suppression during tropia and phoria on phoria maintenance in
intermittent exotropia.

Wakayama A, Nakada K, Abe K, Matsumoto C, Shimomura Y.

Department of Ophthalmology, Kinki University Faculty of Medicine, 377-2
Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan,

BACKGROUND: Treatment for intermittent exotropia X(T) aims to keep the eye in a
phoric position and to maintain the phoria. However, maintenance of phoria is
difficult even after treatment, and the cause is unclear. The aim of this study
was to investigate the presence of suppression during tropia and/or phoria in
X(T), and to determine how the suppression affected patient's ability to maintain
METHODS: Medical records of 89 children with X(T) (mean age, 9.8 ± 2.7 years)
were reviewed retrospectively. According to their previous treatment for X(T),
the patients were divided into four groups and compared: untreated and under
observation only (28 patients), surgical treatment (32 patients), orthoptic
training (eight patients) and a combined treatment of surgery and orthoptic
training (21 patients). Suppression during phoria was evaluated by a physiologic 
diplopia test, and suppression during tropia was evaluated by a convergence test 
or a cover test when fusion broke. Phoria maintenance was achieved if a phoric
condition was maintained even when the fusion broke at both near and far.
Furthermore, the Bagolini's red filter bar was used to quantitatively assess
patient's ability to maintain phoria at near and far distances.
RESULTS: No subject only suppressed during phoria. Patients who suppressed under 
both conditions could not maintain phoria. Suppression under both conditions
significantly correlated with phoria maintenance and the ability to maintain
phoria (P < 0.01, Fisher's exact probability test). All the patients with a
strong ability to maintain phoria did not suppress under either condition. As
compared to the surgical treatment group, the combined treatment group had a
higher percentage of patients who did not suppress under either condition and
could maintain the phoria. Suppression under both conditions also significantly
correlated the treatment methods (P < 0.01, Chi-square for the independence
CONCLUSIONS: Suppression under both tropic and phoric conditions significantly
relates to the outcome of patients' phoria maintenance and their ability to
maintain a phoric position. Suppression under both conditions is an important
indication of whether X(T) shifts to constant exotropia.

PMID: 23821120   [PubMed - as supplied by publisher]

3. Graefes Arch Clin Exp Ophthalmol. 2013 Jul 3. [Epub ahead of print]

Conjunctival hamartoma with eosinophilia-a novel lesion in a child with PTEN
hamartoma syndrome.

Mudhar HS, Rogers NK.

National Specialist Ophthalmic Pathology Service (NSOPS), E-Floor, Royal
Hallamshire Hospital, Glossop Road , S10 2JF, Sheffield, UK,

PMID: 23821119   [PubMed - as supplied by publisher]

4. Graefes Arch Clin Exp Ophthalmol. 2013 Jul 3. [Epub ahead of print]

Ischemic optic neuropathies - where are we now?

Hayreh SS.

Department of Ophthalmology and Visual Sciences, College of Medicine, University 
of Iowa, Iowa City, IA, USA,

Ischemic optic neuropathy is of two types: anterior and posterior. Non-arteritic 
anterior ischemic optic neuropathy (NA-AION) is the most common type of ischemic 
optic neuropathy. There are three major misconceptions about NA-AION: (1) that
its pathogenesis is not known, (2) that NA-AION and ischemic cerebral stroke are 
similar in nature, pathogenetically and in management, and (3) that there is no
treatment. All these misconceptions are based on lack of in-depth knowledge of
the subject. They are discussed in the light of our current scientific knowledge.
The pathogenesis of NA-AION is known but is highly complex. NA-AION and ischemic 
cerebral stroke are very different clinical entities, pathogenetically and in
management. Aspirin has no beneficial effect. Corticosteroid therapy during the
initial stages can be beneficial. To reduce the risk of development of NA-AION in
the other eye or of further visual loss in the same eye, it is essential to
reduce as many risk factors as possible. Management of arteritic anterior
ischemic optic neuropathy and of posterior ischemic optic neuropathy is

PMID: 23821118   [PubMed - as supplied by publisher]

5. Graefes Arch Clin Exp Ophthalmol. 2013 Jul 3. [Epub ahead of print]

The glaucoma detection capability of spectral-domain OCT and GDx-VCC deviation
maps in early glaucoma patients with localized visual field defects.

Na JH, Lee KS, Lee JR, Lee Y, Kook MS.

Department of Ophthalmology, University of Ulsan, College of Medicine, Asan
Medical Center, 388-1 Pungnap-2-dong, Songpa-gu, Seoul, Korea, 138-736.

PURPOSE: To evaluate and compare the glaucoma detection capabilities afforded by 
retinal nerve fiber layer (RNFL) thickness and deviation maps obtained using
Cirrus spectral domain optical coherence tomography (Cirrus OCT), and GDx
employing variable corneal compensation (GDx-VCC) in glaucoma patients with
early, localized visual field (VF) loss.
METHODS: This prospective controlled, comparative study was performed on 42 eyes 
with localized VF defects, and 42 age/refractive error-matched healthy eyes. All 
participants were imaged by both imaging devices at the same visit. The area of
the RNFL defect in each deviation map, corresponding to a VF defect, was analyzed
by direct counting of color-coded superpixels in each device. Receiver operating 
characteristic (ROC) curves were constructed and compared between Cirrus OCT and 
RESULTS: The areas under the ROCs (AUCs) of RNFL quadrant thicknesses in
hemifields with visual field (VF) defects did not differ significantly (Cirrus
OCT; 0.961, GDx-VCC; 0.919, P = 0.07). However, Cirrus OCT afforded a better
diagnostic ability, by deviation map analysis, than did GDx-VCC (0.972 vs 0.887, 
P = 0.02).
CONCLUSIONS: The RNFL thicknesses assessed by either Cirrus OCT or GDx-VCC were
comparable in terms of early glaucoma diagnostic capability. However, when areas 
containing RNFL defects were analyzed via deviation mapping, Cirrus OCT was
better than GDx-VCC.

PMID: 23818227   [PubMed - as supplied by publisher]

6. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 30. [Epub ahead of print]

Combined clear cornea phacoemulsification in the treatment of pseudoexfoliative
glaucoma associated with cataract: significance of trabecular aspiration and ab
interno trabeculectomy.

Klamann MK, Gonnermann J, Maier AK, Ruokonen PC, Torun N, Joussen AM, Bertelmann 

Department of Ophthalmology, Charité, University Medicine Berlin, Augustenburger 
Platz 1, 13353, Berlin, Germany,

BACKGROUND: In the present study, the effectiveness of combined cataract surgery 
and ab interno trabeculectomy (Trabectome) in exfoliation glaucoma (PEX) was
compared with combined cataract surgery and trabecular aspiration.
METHODS: In this retrospective comparative cohort outcome study, 27 consecutive
patients (mean age 73.41 years ± 10.78) in group 1 suffering from visually
significant cataract and PEX glaucoma (mean preoperative IOP 23.41 mmHg ± 5.86)
were treated with phacoemulsification combined with Trabectome; and 28
consecutive patients (73.83 years ± 8.94) were treated with phacoemulsification
combined with trabecular aspiration (mean preoperative IOP 22.22 mmHg ± 6.33).
The intraocular pressure (IOP) and the number of antiglaucoma eyedrops before and
after surgery were evaluated.
RESULTS: Examinations were performed prior to surgery, 1 day, 6 weeks, 3 months, 
6 months, and 1 year after surgery. In both groups there was a statistically
significant decrease in postoperative IOP during the whole follow-up period.
Comparing the two groups, there was a statistically significant lower IOP in the 
Trabectome group 1 day (p = 0.019), 6 months (p = 0.025), and 1 year (p = 0.019) 
after surgery. Between the two groups, there was no statistically significant
difference in the number of antiglaucoma eyedrops at any time.
CONCLUSIONS: Both procedures have the ability to significantly lower the
postoperative IOP during the first year. However, clear cornea
phacoemulsification combined with Trabectome seems to be more effective in IOP
reduction in cases of PEX glaucoma associated with cataract.

PMID: 23812010   [PubMed - as supplied by publisher]

7. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 29. [Epub ahead of print]

A modified Hartmann-Shack aberrometer for measuring stray light in the anterior
segment of the human eye.

Schramm S, Seifert BU, Schikowski P, Prehl J, Kunert KS, Blum M, Kaeding A,
Haueisen J.

Institute of Biomedical Engineering and Informatics, Faculty of Computer Sciences
and Automation, Technical University of Ilmenau, Ilmenau, Germany,

PURPOSE: To examine the use of a modified Hartmann-Shack wave front aberrometer
(WASCA; Carl Zeiss Meditec AG, Germany) to measure objective stray light caused
by forward light scatter from the anterior segment of the human eye.
SETTING: HELIOS Klinikum Erfurt/Institute of Biomedical Engineering and
Informatics, Ilmenau University of Technology, Germany.
METHOD: Scatter parameters, including the Michelson contrast and cross-sectional 
area at half height (CAHM) were examined in Hartmann-Shack images from ten
subjects with a cataract in one eye and an intraocular lens (IOL) in the other.
The parameters were compared between each eye. Light scatter was then measured in
40 healthy subjects (age range, 23-75 years) with spherical ametropia ranging
from -0.25 to 0.25 diopters. The subjects were divided into three age groups;
23-35, 36-50, and 51-75 years. Light scatter was also measured using four
alternative methods.
RESULTS: CAHM and contrast were significantly different between the eyes with the
cataract and the IOL (P = 0.007 and P = 0.004, respectively). CAHM (r = 0.557,
P < 0.001) and contrast (r = -0.467, P < 0.001) were both significantly
correlated with age. There were significant differences in CAHM and contrast
between the age groups.
CONCLUSION: The modified wave front aberrometer can be used to measure stray
light, although its diagnostic sensitivity in individual patients must be

PMID: 23811991   [PubMed - as supplied by publisher]

8. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 26. [Epub ahead of print]

Resolution of diabetic papillopathy with a single intravitreal injection of
bevacizumab combined with triamcinolone acetonide.

Feng J, Qu JF, Jiang YR.

Department of Ophthalmology, People's Hospital, Peking University, 11 Xizhimen
South Street, Xicheng District, 100044, Beijing, China.

PMID: 23801191   [PubMed - as supplied by publisher]

9. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 25. [Epub ahead of print]

Effects of vertical muscle surgery on differences in the orientation of Listing's
plane in patients with superior oblique palsy.

Miyata M, Shira Y, Kono R, Furuse T, Hamasaki I, Hasebe S, Ohtsuki H.

Department of Ophthalmology, Okayama University, Graduate School of Medicine,
Dentistry, and Pharmaceutical Sciences, 2-5-2 Shikata-cho, Kita-ku, Okayama,
700-8558, Japan,

BACKGROUND: Although scleral search coils are widely and accurately used for the 
measurement of Listing's plane in both eyes, they require specialized equipment
and are invasive. In this study, we describe a convenient and less invasive
method that uses a synoptometer to analyze the differences in orientation of
Listing's plane (difLP), and the effects of vertical muscle surgery on the difLP 
tilt in patients with superior oblique palsy (SOP).
METHODS: Seventeen patients with unilateral congenital SOP (CSOP) and four
patients with unilateral acquired SOP (ASOP) who had not undergone any strabismus
surgeries were examined. Cyclodeviations of 13 vertical and horizontal gaze
points within 30° were measured with a synoptometer, and the difLP tilts in the
yaw and pitch planes were analyzed before and after vertical muscle surgery.
RESULTS: The difLP tilt in the CSOP patients was significantly tilted nasally
(p = 0.02) and forward on the lower side (p = 0.001), whereas that in ASOP
patients tended to tilt temporally (p = 0.15). Ipsilateral inferior oblique
recession (IOR) performed in seven CSOP patients tended to improve the difLP tilt
in both the yaw (p = 0.07) and pitch (p = 0.09) planes, whereas contralateral
inferior rectus recession (IRR) performed in three CSOP patients significantly
improved the difLP tilt in the pitch plane (p = 0.015). The mean
excyclodeviations in the 13 gaze points were significantly improved with both
procedures (p < 0.0001 for both).
CONCLUSIONS: The difLP tilt in the SOP patients could be analyzed with a
convenient and less invasive method using a synoptometer, and dissimilar difLP
tilts were confirmed in the ASOP and CSOP patients. The results of this study
suggest that both IOR and IRR are reasonable treatments for improving the difLP
tilt in CSOP patients. IOR should be selected for patients with a steep
preoperative difLP tilt to the nasal side, whereas IRR should be selected for
patients with a gentle preoperative difLP tilt.

PMID: 23797172   [PubMed - as supplied by publisher]

10. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 23. [Epub ahead of print]

Simultaneous correction of post-traumatic aphakia and aniridia with the use of
artificial iris and IOL implantation.

Forlini C, Forlini M, Cavallini GM.

Department of Ophthalmology, Santa Maria delle Croci Hospital, Viale V. Randi 5
n. 43, 48121, Ravenna, Italy,

PMID: 23793912   [PubMed - as supplied by publisher]

11. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 23. [Epub ahead of print]

Combined foldable artificial iris with foldable IOL implantation through 5-mm
incisions-still to be verified in practice.

Grzybowski A, Beiko G.

Department of Ophthalmology, Poznań City Hospital, ul. Szwajcarska 3, 61-285,
Poznań, Poland,

PMID: 23793911   [PubMed - as supplied by publisher]

12. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 22. [Epub ahead of print]

Subbasal nerve morphology, corneal sensation, and tear film evaluation after
refractive femtosecond laser lenticule extraction.

Vestergaard AH, Grønbech KT, Grauslund J, Ivarsen AR, Hjortdal JO.

Department of Ophthalmology, Odense University Hospital, Sdr. Boulevard 29, 5000,
Odense C, Denmark,

BACKGROUND: The purpose of this study was to compare corneal subbasal nerve
morphology, corneal sensation, and tear film parameters after femtosecond
lenticule extraction (FLEX) and small-incision lenticule extraction (SMILE).
METHODS: A prospective, randomized, single-masked, paired-eye design clinical
trial of 35 patients treated for moderate to high myopia with FLEX in one eye and
SMILE in the other. In both techniques, an intrastromal lenticule was cut by a
femtosecond laser and manually extracted. In FLEX, a LASIK-like flap allowed
removal of the lenticule, whereas in SMILE, it was removed through a small
incision. In-vivo confocal microscopy was used to acquire images of the central
corneal subbasal nerve plexus, from which nerve density, total nerve number, and 
nerve tortuosity were analyzed. Corneal sensation was measured using
Cochet-Bonnet esthesiometry. A visual analog scale, tear osmolarity, non-invasive
tear film break-up time (keratograph) tear meniscus height (anterior segment
OCT), Schirmer's test, and fluorescein tear film break-up time were used to
evaluate tear film and ocular surface symptoms. Patients were examined before and
6 months after surgery.
RESULTS: There were no statistically significant differences in baseline
parameters between FLEX and SMILE (p > 0.050). With regard to changes from before
to 6 months after surgery, mean reduction in subbasal nerve density was
14.22 ± 6.24 mm/mm(2) in FLEX eyes, and 9.21 ± 7.80 mm/mm(2) in SMILE eyes
(p < 0.05). The total number of nerves decreased more in FLEX eyes than in SMILE 
eyes (p < 0.05). No change was found when comparing tortuosity (p > 0.05).
Corneal sensation was reduced with 0.38 ± 0.49 cm in FLEX eyes, and
0.10 ± 0.34 cm in SMILE eyes (p < 0.01). No differences were found between FLEX
and SMILE in tear film evaluation tests (p > 0.05). Significantly more patients
felt postoperative foreign body sensation in the FLEX eye within the first days
after surgery, as compared to the SMILE eye.
CONCLUSIONS: Six months after surgery, the less invasive SMILE technique seemed
better at sparing the central corneal nerves as compared to FLEX. Corneal
sensation was only significantly reduced in FLEX eyes. There were no differences 
between FLEX and SMILE when comparing tear film evaluation tests 6 months after

PMID: 23793872   [PubMed - as supplied by publisher]

13. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 13. [Epub ahead of print]

Peripheral optical quality and myopia progression in children.

Yamaguchi T, Ohnuma K, Konomi K, Satake Y, Shimazaki J, Negishi K.

Department of Ophthalmology, Tokyo Dental College, 5-11-13 Sugano, Ichikawa,
Chiba, Japan, 272-8513,

BACKGROUND: To investigate the peripheral optical quality and its relationship
with axial elongation, myopic progression in Japanese children. METHODS:
Twenty-nine Japanese children, ages 10 to 12 years old, with baseline refraction 
from +0.75D to -5.5 D, were included and followed for 9 months. The central and
peripheral point spread functions (PSFs; 0°, 10°, 20°, 30° nasally) were obtained
at 0.25 D steps around ±2.5 D of best-focus PSF (BF-PSF) using double-pass PSF
system. Modulation transfer function (MTF) area of the BF-PSF was calculated from
BF-PSF to represent the peripheral optical quality. Relative peripheral defocus
(RPD), the refraction of anterior/posterior focal lines, MTF area, and their
correlations with myopia progression were analyzed. RESULTS: The average
refractive change in 9 months was -0.5 ± 0.8 D. The change in axial length was
significantly positively correlated with the amount of myopic progression
(P = 0.0058) and RPD (P = 0.0007, 0.0036 and 0.0040, at 10°, 20°, 30°
respectively) at the initial visit, but did not correlate with the peripheral MTF
area. Myopic progression of more than 0.5 D with axial elongation was observed in
seven children (MP group). The RPDs at 20° and 30° in the MP group were
significantly more hyperopic than in the non-MP group (P = 0.002 and 0.007),
whereas there was no significant difference in axial length, and central and
peripheral MTF area between the MP and non-MP groups. MP group had more hyperopic
focal lines compared with non-MP group at 20°and 30°. CONCLUSION: These results
suggest that the progression of axial myopia in children is associated with
hyperopic RPD and refraction of focal lines, not with peripheral optical quality.

PMID: 23760671   [PubMed - as supplied by publisher]

14. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 13. [Epub ahead of print]

Ranibizumab efficiently blocks migration but not proliferation induced by growth 
factor combinations including VEGF in retinal endothelial cells.

Deissler HL, Deissler H, Lang GK, Lang GE.

Department of Ophthalmology, University of Ulm, Prittwitzstrasse 43, 89075, Ulm, 

BACKGROUND: Proliferation and migration of retinal endothelial cells (REC) are
associated with the development of proliferative diabetic retinopathy. REC
proliferation is stimulated by isoforms of vascular endothelial growth factor-A
(i.e., VEGF121 and VEGF165), basic fibroblast growth factor (bFGF), and
insulin-like growth factor (IGF-1) of which VEGF165 also enhances migration of
REC. Effects induced by VEGF-A can be blocked with ranibizumab, a VEGF-binding
Fab fragment used in therapy of diabetic macular edema. In this study, we
investigated potential angiogenic effects of placental growth factors (PlGF-1,
PlGF-2) as other members of the VEGF family and whether the primary action of
VEGF165 is modulated in the presence of bFGF, IGF-1 and PlGF-1/-2. We also
studied how effects of growth factor combinations can be attenuated with
ranibizumab. METHODS: Effects of single growth factors or their combinations on
proliferation and migration of immortalized bovine retinal endothelial cells
(iBREC) were studied with or without ranibizumab or the inhibitor of VEGF
receptors KRN951. RESULTS: Proliferation of iBREC was significantly stimulated by
1-100 ng/ml PlGF-1 or PlGF-2, but additive effects were not observed with various
combinations of the tested growth factors. Ranibizumab neutralized VEGF's effect 
on proliferation but was not effective when the other growth factors were used in
combination with VEGF. bFGF and IGF-1 but not PlGF-1 or PlGF-2 stimulated iBREC
migration as single agents, and they further enhanced VEGF-induced migration. The
effects of such growth factor combinations including VEGF on migration were
efficiently blocked by targeting only VEGF with ranibizumab. Migration induced by
VEGF plus bFGF and IGF-1 was also almost completely inhibited by KRN951
interfering with VEGF receptor signalling. CONCLUSIONS: Migration but not
proliferation of iBREC induced by combinations of bFGF, IGF-1, PlGF-1 or PlGF-2
together with VEGF is efficiently suppressed by ranibizumab. VEGF-mediated
signalling through VEGFR2 seems to control REC migration dominantly in the
presence of other growth factors.

PMID: 23760670   [PubMed - as supplied by publisher]

15. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 12. [Epub ahead of print]

Nemorosone and its emerging anti-neoplastic effects.

Kapoor S.

, 74 Crossing Place, Mechanicsville, VA, USA,

PMID: 23760655   [PubMed - as supplied by publisher]

16. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 8. [Epub ahead of print]

Serum dehydroepiandrosterone sulphate, total antioxidant capacity, and total
oxidant status in central serous chorioretinopathy.

Türkcü FM, Yüksel H, Yüksel H, Sahin A, Cinar Y, Cingü AK, Sahin M, Caça I.

Faculty of Medicine, Department of Ophthalmology, Dicle University, Diyarbakir,

BACKGROUND: The objective of this work is to evaluate plasma total antioxidant
capacity (TAC), total oxidant status (TOS), and dehydroepiandrosterone sulphate
(DHEA-S) levels in patients diagnosed with acute central serous chorioretinopathy
(CSCR) and control samples. METHODS: The TAC, TOS, and DHEA-S levels were
assessed in the plasma of 46 CSCR patients and compared with 40 control samples. 
RESULTS: The TAC level was 1.16 ± 0.08 and 1.20 ± 0.09 mmol Trolox eq./l; TOS
level was 28.77 ± 33.33 and 19.95 ± 10.42 μmol H202/l; DHEA-S level was
203.79 ± 84.75 μg/dl and 249.36 ± 122.93 μg/dl in the CSCR group and in the
control group, respectively. The plasma TAC and DHEA-S values were significantly 
lower in the CSCR group than in the control group (p = 0.027 and p = 0.046,
respectively). There was no significant difference between the CSCR and the
control groups in terms of age, gender, and TOS levels (p > 0.05). CONCLUSIONS:
We demonstrated that the levels of plasma DHEA-S and antioxidative parameters
were reduced in CSCR. Our results suggest that the antioxidant defense system may
be inadequate or corrupted in CSCR. Reduced DHEA-S level is one of the factors
that trigger this insufficiency.

PMID: 23749383   [PubMed - as supplied by publisher]

17. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 7. [Epub ahead of print]

The effect of reactive oxygen species on the myogenic tone of rat ophthalmic
arteries with and without endothelium.

Wagenfeld L, von Domarus F, Weiss S, Klemm M, Richard G, Zeitz O.

Department of Ophthalmology, University Medical-Center Hamburg-Eppendorf,
Martinistr. 52, 20246, Hamburg, Germany,

BACKGROUND: Reactive oxygen species (ROS) play an important role in the
pathogenesis of various ocular diseases. ROS can induce vasodilation or
vasoconstriction depending on the species, the tested vessel bed, and the
condition of the vessel. This study investigates the effect of different dosages 
of ROS on the tone of rat ophthalmic arteries. METHODS: Freshly dissected rat
ophthalmic arteries were pressurized in a perfusion setup in steps of 10 mmHg to 
180 mmHg in three consecutive cycles. The first cycle was run under mostly
physiological conditions, the second cycle was run after ROS treatment, and the
third cycle as passive dilation after all Ca(2+) was removed from the solution.
ROS-induced dilation or constriction was calculated in relation to the passive
dilation. All experiments were performed with or without endothelium. RESULTS:
For vessels with endothelium, dilation in control experiments was 20.0 ± 0.1 %;
after 5 s of ROS dilation was 74.4 ± 0.6 %, and after 20 s 87.4 ± 0.3 %. ANOVA
revealed significant differences between these groups (P = 0.048). For vessels
without endothelium, a slight dilation was seen in control experiments
(14.5 ± 0.4 %), which was also present after 5 s of ROS treatment (15.4 ± 0.4 %).
Treatment with ROS for 20 s led to a constriction of the vessel preparations
(-16.6 ± 0.5 %; P = 0.831). CONCLUSIONS: ROS led to a vasodilation in vessels
with endothelium that was not seen in vessels without endothelium. Endothelial
function seems to determine the effect of ROS on the vessel tone in isolated rat 
ophthalmic arteries.

PMID: 23744487   [PubMed - as supplied by publisher]

18. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 6. [Epub ahead of print]

Outcomes of phacoemulsification in eyes with congenital choroidal coloboma.

Khokhar S, Gupta S, Kusumesh R, Kumar G.

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of
Medical Sciences, New Delhi, 110029, India.

PMID: 23740521   [PubMed - as supplied by publisher]

19. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 6. [Epub ahead of print]

Anti-angiogenic effect of KH902 on retinal neovascularization.

Wang F, Bai Y, Yu W, Han N, Huang L, Zhao M, Zhou A, Zhao M, Li X.

Key Laboratory of Vision Loss and Restoration, Ministry of Education, Department 
of Ophthalmology, Peking University People's Hospital, Xizhimen South Street 11, 
Xi Cheng District, 100044, Beijing, China.

PURPOSE: KH902 is a fusion protein derived from the extracellular domains of
vascular endothelial growth factor (VEGF) receptors 1 and 2 and the Fc portion of
immunoglobulin G1 (IgG1). Retinopathy of prematurity (ROP) is an eye disease that
affects premature babies who have received intensive neonatal care, and the
disorganization of retinal blood vessels may result in scarring and retinal
detachment. This study was designed to examine the inhibitory effects of KH902 on
mice with oxygen-induced retinopathy (OIR), one of the animal models of ROP.
METHODS: Human umbilical vein endothelial cells (HUVECs) were used for an in
vitro study, and the C57BL/6 J OIR mouse model was used for an in vivo study.
HUVECs were incubated with KH902 or a VEGF- and KH902-containing medium. Cell
proliferation, migration, apoptosis, and tube formation were measured with BrdU
incorporation, Transwell, flow cytometry, and Matrigel assays. C57BL/6 J mice
were exposed to 75 % oxygen from postnatal day 7 (P7) to P12, after which the
mice were brought to room air and intravitreously injected with KH902. At P18,
the mice were perfused with fluorescein isothiocyanate (FITC)-dextran and Evans
Blue, and flat-mounted retinas were used to measure the non-perfused and leakage 
areas. The data were analyzed with GraphPad Prism 5.0 software. RESULTS: In
vitro, KH902 dose-dependently inhibited HUVEC proliferation in general culture
medium and in VEGF165-containing medium at different time points. Moreover, KH902
inhibited HUVEC migration and tube formation and induced HUVEC apoptosis. In
vivo, an intravitreous injection of KH902 reduced the retinal non-perfused area
from 34 % in the control group to 19 % in the treatment group and significantly
reduced the retinal leakage area from 18 % to 9 %. CONCLUSION: KH902 had marked
inhibitory effects on angiogenesis both in vitro and in vivo. These data suggest 
that KH902 could serve as an innovative pharmaceutical agent to prevent retinal
neovascularization (NV) and as a strategy for the treatment of ROP.

PMID: 23740520   [PubMed - as supplied by publisher]

20. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 6. [Epub ahead of print]

Enzymes of urea synthesis are expressed at the ocular surface, and decreased urea
in the tear fluid is associated with dry-eye syndrome.

Jäger K, Kielstein H, Dunse M, Nass N, Paulsen F, Sel S.

Department of Anatomy and Cell Biology, Martin Luther University of
Halle-Wittenberg, Große Steinstraße, Halle/Saale, Germany,

PURPOSE: The present study aims at determining whether enzymes of urea synthesis 
are expressed in the human lacrimal gland and in tissues of ocular surface
(conjunctiva, cornea), to give evidence for the hypothesis that urea can be
locally formed from ocular tissues and is important for the composition of the
tear fluid. METHODS: The presences of enzymes (arginase 1, 2 and agmatinase) that
directly contribute to the formation of urea were investigated in the lacrimal
gland and tissues of ocular surface by RT-PCR and immunohistochemistry. We
collected tear fluid, aqueous humour, and blood samples from a total of 38
subjects, and tear fluid samples from a total of 78 subjects, with and without
dry-eye syndrome (DES, keratoconjunctivitis sicca), and determined the urea
concentration. RESULTS: The enzymes arginase 1, 2 and agmatinase were expressed
in all tissues examined except for arginase 1, which was not expressed in the
cornea. There was no correlation of urea concentration in tear fluid with aqueous
humour and blood plasma (r = 0.13, p = 0.58 and r = 0.45, p = 0.05 respectively).
However, correlation of urea concentration between aqueous humour and blood
plasma was highly significant (r = 0.7, p = 0.0001). The concentration of urea in
the tear fluid of patients with DES compared to healthy control group was
significantly reduced (p < 0.0001). CONCLUSION: Enzymes that are directly
involved in the formation of urea are expressed in ocular tissues. This may imply
that in the ocular surface is a well-coordinated system of enzymes that can
produce urea which might be independent of external urea supply.

PMID: 23740519   [PubMed - as supplied by publisher]

21. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 6. [Epub ahead of print]

Response to: position-dependent accommodative shift of retropupillary fixated
iris-claw lenses.

Sekundo W.

Klinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort
Marburg, Baldingerstr., 35043, Marburg, Germany,

PMID: 23740518   [PubMed - as supplied by publisher]

22. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 6. [Epub ahead of print]

Preliminary study of retinal pathological features in preterm birth pups exposed 
to an animal model of oxygen-induced retinopathy in mice.

Chu ZJ, Dou GR, Wang YS, Qu XJ, Zhang Y.

Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University,
No.169 West Changle Road, Xi'an, 710032, Shaanxi, China.

BACKGROUND: The main risk factors of retinopathy of prematurity (ROP) are low
gestational age and low birth weight, which are mainly caused by preterm birth.
Currently, the animal model of oxygen-induced retinopathy (OIR) in mice is the
most widely used model in ROP-associated studies. However, the experimental mice 
are normal-term pups, and may not mimic the pathogenic status of human ROP
patients. In this study, we investigated the retinal pathological features in
preterm birth pups exposed to an animal model of oxygen-induced retinopathy in
mice. METHODS: Preterm-birth mice were obtained from pregnant C57BL/6J mice that 
were induced by an intraperitoneal injection of lipopolysaccharide (LPS). The
preterm and control mice were treated with high oxygen (75 %) from postnatal day 
7 (P7) to P12. The mice were perfused with high-molecular-weight FITC-dextran on 
P12, P15 and P17, and the retinas were whole-mounted and imaged. Vascular
endothelial growth factor (VEGF) mRNA was also detected. Cross-sections of the
retina were stained with hematoxylin and eosin (H&E) to identify preretinal
neovascular tufts. For general observation, whole retinal images were also
obtained using a microscope. RESULTS: Leakage of the retinal blood vessels was
aggravated in the preterm mice, particularly on P12 and P15. The non-perfused
areas of the retina (pixel value, 183,673 ± 28,148 vs 132,110 ± 23,732,
P = 0.009) and the number of preretinal endothelial cell nuclei were smaller
(30.17 ± 8.33 vs 22.17 ± 6.74, P < 0.0001) on P17. The VEGF mRNA levels in the
retinas were higher on P12 and P15 but lower on P17, compared with the control
mice. Retinal hemorrhage was observed in the preterm mouse group (five out of six
examined eyes). CONCLUSIONS: Preterm-birth mice that were subject to OIR
exhibited several pathological features, such as retinal hemorrhage, severe
retinal leakage and moderate retinal neovascularization, which were similar to
the clinical manifestations in ROP patients.

PMID: 23740517   [PubMed - as supplied by publisher]

23. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 5. [Epub ahead of print]

Correlation of optical coherence tomography parameters with clinical and
radiological progression in patients with symptomatic optic pathway gliomas.

Fard MA, Fakhree S, Eshraghi B.

Farabi Eye Research Center, Department of Ophthalmology, Tehran University of
Medical Sciences, Tehran, Iran,

PURPOSE: To study the optical coherence tomography (OCT) characteristics in
children with optic pathway glioma (OPG) to determine if OCT changes occur
alongside clinical/radiological changes at diagnosis and during the second-year
follow-up. METHODS: Twenty-three patients (38 eyes) diagnosed with symptomatic
OPG in a single institution were enrolled in this longitudinal observational
cohort study. Complete ophthalmologic evaluation, including determination of
visual acuity, visual fields, retinal nerve fiber layer ,and posterior pole
retinal thickness scanning with spectral-domain optical coherence tomography, and
neuroimaging was performed at the time of diagnosis and 6 months and 1 and
2 years after presentation. Patients who experienced visual decline or
radioagraphic tumor enlargement of the OPG were classified as progressors. OCT
data were compared between progressors and nonprogressors. RESULTS: The average
age at diagnosis was 5.8 years. All patients were followed up for 24 months. Five
patients (21 %) (eight eyes) had clinical or radiological progression of their
OPG during follow-up and were classified as progressors. Mean changes in average 
nerve fiber layer and posterior pole retinal thickness were significantly higher 
for progressors compared with nonprogressors (P < 0.001). The area under the
receiver operator characteristic curves comparing average nerve fiber layer and
posterior pole retinal thinning between the progressors and nonprogressors were
0.94 and 0.95 respectively. CONCLUSIONS: Optical coherence tomography of average 
nerve fiber layer and posterior pole retinal thickness may be helpful in
monitoring OPG.

PMID: 23736991   [PubMed - as supplied by publisher]

24. Graefes Arch Clin Exp Ophthalmol. 2013 Jul;251(7):1663-6. doi:

Stephen j. Ryan.

Wiedemann P.

Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig,
Liebigstr. 10-14, 04103, Leipzig, Germany,

PMID: 23736990   [PubMed - in process]

25. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 4. [Epub ahead of print]

The effects of bupivacaine injection and oral nitric oxide on extraocular muscle 
in the rabbit.

Bilgin B, Gursoy H, Basmak H, Ozkurt M, Tuncel N, Canaz F, Isiksoy S, Colak E.

Department of Ophthalmology, Eskisehir Osmangazi University Medical Faculty,
Eskişehir, Turkey.

AIM: Nitric oxide (NO) plays a key role in muscle regeneration, which is the
primary response, observed during bupivacaine-induced extraocular muscle (EOM)
hypertrophy. Our aims were to investigate the effects of bupivacaine injection
into the rabbit EOM and the interaction with NO. MATERIALS AND METHODS: Superior 
rectus (SR) muscles of 24 New Zealand albino rabbits were studied. Single muscle 
twitch tension (SMTT) and tetanic muscle tensions at 50, 75, and 100 Hz were
recorded using a 15 V stimuli. The rabbits were equally allocated into three
groups. Measurements were performed without any drug treatments in group 1. In
groups 2 and 3, bupivacaine, 0.5 ml of a 0.50 % solution, was injected into the
EOM, and after 21 days, measurements were performed. Oral isosorbide dinitrate
(NO donor) at 20 mg/day was given each day prior to measurements in group 3.
RESULTS: SMTTs were 69.9 (66.7-77.6), 187.7 (114.9-252.1) and 204.2 (135.3-311.6)
mg in groups 1, 2, and 3 respectively. SMTTs for both groups 2 and 3 were
significantly higher than that for group 1 (p < 0.05). Compared with group 1,
group 2 exhibited a 3.8-11.7 % increase in the tetanic tensions at 50, 75, and
100 Hz, but none of these differences were statistically significant. The
increase was 47.5-137.5 % in group 3 relative to group 2, and the differences
were statistically significant except at 100 Hz. The enlargement of the muscle
fibers after bupivacaine injection was shown histopathologically. CONCLUSION:
Bupivacaine injection increased the EOM tension in rabbits to some extent. NO
augmented the effect of bupivacaine.

PMID: 23733036   [PubMed - as supplied by publisher]

26. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 4. [Epub ahead of print]

Aphakic retropupillary iris-claw intraocular lens (IOL) pseudophakic

Galvis V, Tello A, Carreño NI, Revelo ML.

Centro Oftalmológico Virgilio Galvis, FOSCAL, Floridablanca, Colombia.

PMID: 23733035   [PubMed - as supplied by publisher]

27. Graefes Arch Clin Exp Ophthalmol. 2013 Jun 4. [Epub ahead of print]

Visual field defects due to optic disk drusen in children.

Noval S, Visa J, Contreras I.

Pediatric Ophthalmology Department, La Paz University Hospital, Paseo de la
Castellana 261, 28046, Madrid, Spain,

BACKGROUND: Optic nerve head drusen (ONHD) are deposits due to abnormalities in
axonal metabolism and degeneration. Studies so far have focused on adults. Our
aim was to study the effect of ONHD on visual function as well as optic nerve
head structure using optical coherence tomography (OCT) in children. METHODS:
Subjects younger than 18 years of age with ONHD and who had a reliable visual
field defect in at least one eye due to ONHD were considered for inclusion. All
subjects underwent an extensive ophthalmic examination including best-corrected
visual acuity (BCVA), funduscopy, and SITA 24-2 standard automated perimetry. OCT
scanning was performed using Cirrus-HD Model 4000. Retinal nerve fiber layer
(RNFL) thickness data were compared with a group of age-matched healthy children.
RESULTS: Fifteen children were included, with a mean age of 13 years (range 7 to 
17 years). BCVA was 1.0 in all eyes, except in a child with concomitant
esotropia. ONHD were bilateral in 13 children. Among the 28 eyes with ONHD, 12
(43 %) were classified as type 1 (buried), eight (29 %) as type 2 (ringed) and
eight (29 %) as type 3 (superficial). All children had a visual field defect in
at least one eye, according to the inclusion criteria; however, two eyes (7 %)
had no defect in spite of the presence of ONHD. Five eyes showed an isolated
enlarged blind spot (18 %), 15 cases showed a nasal defect (54 %), and six eyes
showed a constricted visual field (21 %). RNFL thickness was higher in type 1 and
2 ONHD than in the control group, although these differences were only
significant for the average, superior, and inferior quadrant thicknesses in type 
1 and the inferior quadrant in type 2. RNFL thickness was lower in type 3 ONHD
than in the control group, although these differences were only significant for
the average, superior, and nasal quadrant thicknesses. CONCLUSIONS: ONHD may lead
to the development of visual field defects, even in children. In initial stages, 
ONHD produce an increase in RNFL thickness as measured with OCT. As drusen
develop and become superficial, the RNFL thickness decreases. The temporal
quadrant is often undamaged, probably reflecting the preservation of central
visual acuity.

PMID: 23733034   [PubMed - as supplied by publisher]