1: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 6; [Epub ahead of print] 

IL-2 and IFN-gamma in the retina of diabetic rats.

Johnsen-Soriano S, Sancho-Tello M, Arnal E, Navea A, Cervera E, Bosch-Morell F,
Miranda M, Javier Romero F.

Fundacion Oftalmologica del Mediterraneo (FOM), Bifurcacion Pio Baroja-General
Aviles, s/n 46015, Valencia, Spain.

BACKGROUND: The pathophysiology of the early events leading to diabetic
retinopathy is not fully understood. It has been suggested that Inflammatory
processes are involved in the development of the disease; however, the
concentrations of tissue retinal inflammatory mediators and their possible
alteration in diabetic retinopathy have not been described. The aim of this work
was to study T-helper cell cytokine and chemokine profiles, and tyrosine
nitration in retinal tissue of diabetic rats. METHODS: Cytokines (interleukin
IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-10, TNFa, GM-CSF, IFN-g), chemokines (MIP-1a,
MIP-2, MIP-3a, MCP-1, GRO/KC, RANTES, Fractalkine), and tyrosine nitration were
measured in retinal homogenate obtained from Long-Evans rats after 5 months of
experimental diabetes. RESULTS: The T-helper type 1 cytokines IL-2 and
INF-gamma, in addition to NO production (measured as nitrotyrosine), were found
to be significantly elevated in diabetic rat retina homogenates. None of the
other cytokines and chemokines studied were affected by the diabetic condition.
CONCLUSIONS: Immunoregulatory cytokines belonging to the Th-1 group (IL-2 and
IFN-gamma) were increased in the retina of experimental diabetic rats. Moreover,
the nitrotyrosine formation (as an expression of increased NO production) was
significantly elevated in the diabetic retina, supporting the concept of an
inflammatory element in the development of diabetic retinopathy.

PMID: 20213480  [PubMed - as supplied by publisher]

2: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 6; [Epub ahead of print] 

Comparison of optic nerve head topography findings in eyes with non-arteritic
anterior ischemic optic neuropathy and eyes with glaucoma.

Horowitz J, Fishelzon-Arev T, Rath EZ, Segev E, Geyer O.

Department of Ophthalmology, Carmel Medical Center, affiliated to the Bruce
Rappaport Medical School, The Technion, Michal 7 St., Haifa, Israel,
horowitz1@012.net.il.

BACKGROUND: To compare the peripapillary retinal nerve fiber layer (RNFL)
thickness in eyes affected by non-arteritic ischemic optic neuropathy (NAION) or
glaucoma as determined by optical coherence tomography (OCT). METHODS: This
cross-sectional institutional study included 18 eyes with NAION (at least 6
months since the acute event) and 29 eyes with glaucoma, both having localized
visual field (VF) defects confined to one hemifield. Twenty-nine normal subjects
served as controls. The fast RNFL thickness protocol (3.4) of the Stratus OCT
(Carl Zeiss Meditec, Dublin, CA, USA) was used. The RNFL thickness and inferior
maximum/temporal average (Imax/Tavg) and superior maximum/temporal average
(Smax/Tavg) data corresponding to the hemifield with and without visual
sensitivity loss were compared between NAION and glaucomatous eyes and with
corresponding quadrants in normal eyes. The area under the receiver operating
characteristic curve (AUC), sensitivities, and specificities were used to
determine the OCT parameters that differ most in the two groups. RESULTS: The
mean RNFL thickness in the quadrants corresponding to the affected hemifield in
the NAION and glaucomatous eyes was not significantly different (P > 0.9), but
the values for both were decreased compared to the control eyes (P < 0.0001).
The mean RNFL thickness in the quadrant corresponding to the unaffected
hemifield was significantly lower in the glaucomatous eyes (73.8 +/- 20.04
micro) than in the NAION eyes (96.6 +/- 23.32 micro, P = 0.023), and in both
study groups compared to the controls (117.2 +/- 13.44 micro, P < 0.0001 for
glaucomatous vs control eyes, and P < 0.025 for NAION vs control eyes).
Smax/Tavg and Imax/Tavg of the quadrant corresponding to the unaffected
hemifield had the strongest power to differentiate the two diseases (an AUC of
0.92). CONCLUSIONS: Stratus OCT detected significant quantitative differences in
RNFL thickness between glaucomatous and NAION eyes, both conditions with
hemifield defects. These differences might hold a clue in understanding the
processes involved in optic nerve injury.

PMID: 20213479  [PubMed - as supplied by publisher]

3: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 6; [Epub ahead of print] 

Polypoidal choroidal vasculopathy in a patient with angioid streaks secondary to
pseudoxanthoma elasticum.

Baillif-Gostoli S, Quaranta-El Maftouhi M, Mauget-Faysse M.

Saint Roch University Hospital, Nice, France, baillif-gostoli.s@chu-nice.fr.

PMID: 20213478  [PubMed - as supplied by publisher]

4: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 7; [Epub ahead of print] 

Foveal cone photoreceptor involvement in primary open-angle glaucoma.

Kanis MJ, Lemij HG, Berendschot TT, van de Kraats J, van Norren D.

Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The
Netherlands.

BACKGROUND: To test whether foveal cone photoreceptors are impaired in primary
open-angle glaucoma (POAG). METHODS: Nineteen POAG eyes with central
glaucomatous visual field defects, and 34 age-matched control eyes were
included. Fundus reflectometry, together with a model fit procedure, provided
information on a set of parameters: lens optical density, macular pigment
optical density, melanin, blood, the directional cone reflectance (Rd), a
measure for foveal cone photoreceptor integrity, and RILM, the reflectance at
the inner limiting membrane. Optical coherence tomography (OCT) was performed to
assess macular thickness. A Kolmogorov-Smirnov Z-test was used to compare
parameters between the two groups. RESULTS: Median age (range) was 55.1
(24.7-73.3) years in the control subjects, and 60.1 (20.7-77.0) years in the
POAG patients (P = 0.24). Of all eight model parameters, only Rd and RILM were
significantly lower in POAG. Median Rd (range) was 2.21 (0.64-4.93) % in the
control subjects and 1.19 (0.08-3.60) % in the POAG patients (P = 0.003). Median
RILM (range) was 0.15 (0.00-1.08) % in the control subjects, and 0.08
(0.01-0.29) % in the POAG patients (P < 0.001). Rd showed no linear relationship
with central retinal sensitivity on Visual Field test in POAG patients. Retinal
thickness of the inner 1-3 mm ring and the outer 3-6 mm ring on OCT, centered on
the fovea, was significantly lower in POAG patients than in control subjects.
CONCLUSIONS: The integrity of the foveal cone outer segments, and the
reflectance of the central ILM were impaired in POAG with advanced central
visual field defects.

PMID: 20213477  [PubMed - as supplied by publisher]

5: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 7; [Epub ahead of print] 

Videokeratoscopic indices in relation to epidemiological exposure to
keratoconus.

Mato JL, Lema I, Diez-Feijoo E.

E.U. Optica e Optometria. Campus Sur, Universidade de Santiago de Compostela,
Santiago de Compostela, 15705 (A Coruna), Spain, jlmato@victormato.com.

BACKGROUND: To establish the relationship between videokeratoscopic indices and
the degree of epidemiological exposure to keratoconus in three groups of
clinically normal subjects. METHODS: Cross-sectional study in which 75 subjects
lacking clinical signs of keratoconus were divided into three groups according
to epidemiological exposure to the condition: 25 fellow eyes of subjects with
clinical signs on the contralateral eye only (the "fellow eye" group), to be
compared to 25 first-degree relatives of patients with keratoconus (the
"relatives" group) and 25 controls without a family history of the disease (the
"control" group). Qualitative patterns and quantitative parameters describing
curvature (central curvature), irregularity (root mean square of the
higher-order corneal wavefront aberration), and asymmetry (inferior-superior
dioptric asymmetry, Zernike vertical coma) obtained from videokeratoscopy were
used for comparison between groups. RESULTS: Members of the fellow eye group
featured a greater number of asymmetric curvature patterns and increased values
in indices describing asymmetry and irregularity than subjects included in both
control and relatives groups. Control and relatives groups were not
significantly different. Despite significant differences in the distribution of
values between the groups, no single index was able to effectively discriminate
between groups using ROC curve analysis. CONCLUSIONS: A prior threefold
classification of clinically normal subjects according to epidemiological
exposure to keratoconus was not sustained by significant differences in
videokeratoscopic indices when comparing between groups.

PMID: 20213476  [PubMed - as supplied by publisher]

6: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 9; [Epub ahead of print] 

Risk factors for subject withdrawals in clinical trials evaluating glaucoma
medications.

Stewart WC, Demos CM, Turner MK, Stewart JA.

PRN Pharmaceutical Research Network, LLC, Charleston, SC, USA, info@prnorb.com.

BACKGROUND: To evaluate risk factors for subject withdrawals from multicenter
clinical trials evaluating glaucoma medications. METHODS: An analysis of
prospective, randomized, multicenter, parallel, active-controlled clinical
trials with 70 subjects/treatment arm published from 1996-2008. RESULTS: We
analyzed 36 glaucoma studies including 17,511 subjects at 1,294 clinical sites.
There were 2,060 (12%) subject withdrawals with 669 (32%) for administrative
errors, 945 (46%) for adverse events (AEs), 197 (10%) for inadequate intraocular
pressure (IOP) control and 249 (12%) for unknown reasons. By multilinear
regression analysis, no positive risk factors for early subject withdrawals were
observed following a Bonferroni correction (p >/= 0.01). A positive correlation
was observed for medication errors and protocol violations to withdrawals due to
ocular AEs and total administrative errors (p < 0.0001). Protocol violations
alone were correlated to subject withdrawals for any AE (total/month) and
systemic AEs (p < 0.0001). Females and Caucasians were correlated to medication
errors (p < 0 .0001). Among medical therapies, alpha-agonists, beta-blockers,
the carbonic anhydrase inhibitor/beta-blocker fixed combination and
prostaglandins were correlated with systemic AEs (p PMID: 20213475  [PubMed - as supplied by publisher]

7: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 4; [Epub ahead of print] 

Treatment of neovascular age-related macular degeneration with a variable
ranibizumab dosing regimen and one-time reduced-fluence photodynamic therapy:
the TORPEDO trial at 2 years.

Spielberg L, Leys A.

Department of Ophthalmology, University Hospital Leuven, Kapucijnenvoer 33,
3000, Leuven, Belgium, spielz01@hotmail.com.

BACKGROUND: The combination of verteporfin photodynamic therapy (PDT) and
anti-angiogenics has been shown to be safe and efficacious in the treatment of
choroidal neovascularization (CNV) secondary to age-related macular degeneration
(AMD). The purpose of this study is to demonstrate long-term prevention of
vision loss and improvement in best-corrected visual acuity (BCVA) after
treatment with one-time reduced-fluence-rate PDT followed by administration of
ranibizumab on a variable dosing regimen over 24 months in patients with
neovascular AMD. Secondary outcome measures included the change in central
macular thickness (CMT), reinjection frequency, and safety. METHODS: This
prospective, nonrandomized, open-label, single-center study enrolled 27
consecutive patients (27 eyes) presenting at the Leuven University Eye Hospital
with previously untreated, active neovascular AMD between September 2006 and
January 2007. All patients were treated with one-time, reduced-fluence-rate
verteporfin PDT, followed by intravitreal ranibizumab 0.5 mg on the same day. A
second and third ranibizumab injection were given at weeks 4 and 8,
respectively, after which patients were followed up monthly for 24 months.
Additional treatment with ranibizumab was administered to eyes with active
neovascularization as indicated clinically and on imaging studies. Retreatment
was based on the following criteria: (1) presence of subretinal fluid (SRF),
intraretinal edema or sub-retinal pigment epithelial fluid, as seen on OCT; (2)
increase of CMT by >100 mm on OCT; (3) signs of active CNV leakage on
fluorescein angiography; (4) new sub- or intraretinal hemorrhage; and (5) BCVA
decreased of >/=5 letters on the Early Treatment of Diabetic Retinopathy Study
(ETDRS) chart. If any single criterion for reinjection was fulfilled,
retreatment with ranibizumab was administered. RESULTS: Twenty-five patients
completed the 2-year study. Occult CNV was present in 64% and retinal
angiomatous proliferative (RAP) lesions were present in 24% of the study eyes.
The remaining three eyes had lesions classified as classic (one eye) or
predominantly classic (two eyes) CNV. Month 24 data are available for 25 eyes
(25 patients; age 55-86 years; mean 77; standard deviation (SD) = 7.2). Mean
baseline VA was 58.6 letters (range: 35-70; SD = 8.4); 24-month VA was 66.2
letters (35-82; 12.7), not including one warfarin-treated patient who suffered
vitreous hemorrhage. The mean visual acuity improved by 7.2 letters (p < 0.05)
and the mean CMT decreased by 146 mum. VA improved >3 lines (15 letters) in 16%;
improved 1-3 lines in 20%; remained within one line of baseline in 32%,
decreased 1-3 lines in 16%, and decreased >3 lines in 16%. Losses of >3 lines
were due to vitreous hemorrhage, geographic atrophy, fibrosis, and growth of an
initially small CNV lesion. An average of 5.1 injections (range: 3-9) were
administered during the first 12 months, and 7.1 injections (3-13) over 24
months. A total of 178 injections were performed; no systemic side-effects,
uveitis, or choroidal collateral vascular damage were observed. Two patients
were lost to follow-up. CONCLUSION: Combined PDT and ranibizumab injection the
same day was well tolerated in all patients. Eighty-four percent of patients had
stable or improved vision at month 24.

PMID: 20204659  [PubMed - as supplied by publisher]

8: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 5; [Epub ahead of print] 

Retinal re-detachment after scleral buckling procedure.

Jonas JB, Mangler B, Decker A, Schlichtenbrede FC.

Department of Ophthalmology, Medical Faculty Mannheim of the
Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany,
Jost.Jonas@augen.ma.uni-heidelberg.de.

PMID: 20204658  [PubMed - as supplied by publisher]

9: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 5; [Epub ahead of print] 

Genetic diversity and medicinal drug response in eye care.

Shastry BS.

Department of Biological Sciences, Oakland University, Rochester, MI, USA,
shastry@oakland.edu.

BACKGROUND: Individual variation in drug response and adverse drug reactions are
a serious problem in medicine. This inter-individual variation in drug response
could be due to multiple factors such as disease determinants, environmental and
genetic factors. Much has been published in the literature in recent years about
the potential of pharmacogenetic testing and individualized medicine. The
development of personalized medicine is truly an exciting area of research.
METHODS: This pharmacogenetic concept in ophthalmology has existed for more than
a century. Although substantial studies that link genetic variants to
inter-individual difference in drug response have been reported in several
diseases such as cancer and heart diseases, such studies are progressing slowly
in the eye field. In this short article, an attempt has been made to summarize
these results. RESULTS: Recently, there have been some small-scale studies that
seem to associate the drug response to the genotype of patients in two major eye
disorders, namely age-related macular degeneration (ARMD) and glaucoma.
CONCLUSION: These studies are still in their infancy, and do not suggest that a
pharmacogenetic basis of drug development is a credible concept and can become
reality in the future. This is because most drug responses involve a large
number of genes that have several polymorphisms and it is unlikely that any one
single gene dictates the drug response. Therefore, a polygenic approach, whole
genome single nucleotide polymorphism (SNP) analysis and a molecular
understanding of disease itself may provide a better insight in the future about
genetic predisposing factors for adverse drug reactions.

PMID: 20204657  [PubMed - as supplied by publisher]

10: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 5; [Epub ahead of print] 

Response to "Use of air in macular hole surgery"

Hasegawa Y, Hata Y, Mochizuki Y, Arita R, Kawahara S, Kita T, Noda Y, Ishibashi
T.

Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu
University, Fukuoka, Japan.

PMID: 20204656  [PubMed - as supplied by publisher]

11: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 3; [Epub ahead of print] 

Visualization and follow-up of acute macular neuroretinopathy with the
Spectralis((R)) HRA+OCT device.

Neuhann IM, Inhoffen W, Koerner S, Bartz-Schmidt KU, Gelisken F.

Tuebingen University Eye Hospital, Schleichstr. 12-16, 72076, Tuebingen,
Germany, irmi@neuhann.de.

BACKGROUND: Acute macular neuroretinopathy (AMNR) is a rare disease entity, the
diagnosis of which is frequently complicated by the subtlety of biomicroscopic
findings. METHODS: Two cases of AMNR are presented, in which the diagnosis and
follow-up was enabled using the Spectralis((R)) HRA+OCT in the absence of clear
biomicroscopic findings. RESULTS: The typical lesions were visualized by
hyporeflexion during infrared imaging and faded over time. With spectral domain
optical coherence tomography, changes in the outer retina in the affected
regions were documented, with no change over time. CONCLUSION: The broader
availability of this technology may enhance the diagnosis and follow-up of AMNR.

PMID: 20198487  [PubMed - as supplied by publisher]

12: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 2; [Epub ahead of print] 

Drainage of subretinal fluid in optic disc pit maculopathy using subretinal
42-gauge cannula: a new surgical approach.

Jalil A, Stavrakas P, Dhawahir-Scala FE, Patton N.

Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WH, United Kingdom.

BACKGROUND: Different surgical approaches have been used for the treatment of
optic disc pit associated maculopathy, with increasing emphasis on vitrectomy.
METHODS: Case report RESULTS: We report a case of optic disc pit maculopathy
where vitrectomy was combined with subretinal fluid drainage using a 42-gauge
subretinal cannula connected to a "back-flush" flute handle. No retinopexy was
performed at the site of drainage. This technique resulted in almost complete
resolution of subretinal fluid by 6 weeks, with visual acuity improving from
1.00 Log MAR preoperatively to 0.40 at 8 months after surgery. CONCLUSION: We
describe a novel technique for subretinal fluid drainage using a subretinal 42-G
cannula connected to a standard "back flush" flute in optic disc pit-associated
maculopathy.

PMID: 20195626  [PubMed - as supplied by publisher]

13: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 2; [Epub ahead of print] 

Topographic and age-related changes of the retinal epithelium and Bruch's
membrane of rhesus monkeys.

Gouras P, Ivert L, Neuringer M, Mattison JA.

Department of Ophthalmology, Columbia University, New York, NY, 10032, USA,
pg10@columbia.edu.

PURPOSE: To examine structural differences in the retinal pigmented epithelium
(RPE) and Bruch's membrane of rhesus monkeys (Macaca mulatta) as a function of
topography and age. METHODS: The retinas of two old (24 and 26 years old) and
two young (1 and 6 years old) female monkeys were examined by light fluorescence
and electron microscopy at the macula, equator, and ora serrata. RESULTS: All
monkeys lacked fluorescence and lipofuscin granules in the RPE at the ora
serrata where photoreceptors are absent. The equator and macula showed intense
fluorescence and many lipofuscin granules in the RPE of the old but not the
young monkeys. At the ora, the RPE contained many dense round melanin granules
throughout the cell. At the equator and macula, melanin granules were more
apical, less frequent, and often elongated. Mitochondria were clustered at the
basal side of the RPE cell near infolds of the plasma membrane. Both
mitochondria and infolds tended to increase toward the macula. In all regions,
the basal lamina of the RPE did not penetrate the extracellular space adjacent
to infolds. The elastin layer of Bruch's membrane was wide at the ora and
equator and thinner at the macula. In the old monkeys, drusen were found at all
retinal regions between the basal lamina and the internal collagen layer of
Bruch's membrane. The drusen were often membrane-bound with a basal lamina and
contained material resembling structures in the RPE. CONCLUSIONS: Lack of
fluorescence and lipofuscin in the RPE at the ora serrata, where photoreceptors
are absent, confirms that RPE fluorescence occurs only where outer segments are
phagocytized. Mitochondrial clustering indicates that the basal side of the RPE
cell uses the most energy and this becomes maximal at the macula. The presence
of age-related degenerative changes and drusen at all retinal locations in the
older monkeys, even at the ora where RPE lipofuscin was absent, indicates that
these processes are not dependent on local lipofuscin accumulation. Therefore
lipofuscin toxicity may not be the sole cause of age-related RPE degeneration.

PMID: 20195625  [PubMed - as supplied by publisher]

14: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 27; [Epub ahead of print] 

Measurement of retinal nerve fiber layer thickness in optic atrophy eyes of
patients with optic neuritis using optical coherence tomography.

Wang XL, Yu T, Xia DZ, Zhang JS, Yan QC, Luo YH.

Department of Ophthalmology, the Forth Affiliated Hospital, China Medical
University, 11 Xinhua Road, Heping District, Shenyang, 110005, China,
wxinling@126.com.

OBJECTIVE: To measure the retinal nerve fiber layer (RNFL) thickness using
optical coherence tomography (OCT) in optic atrophy eyes of patients with optic
neuritis and investigate the correlation between the RNFL thickness and the
visual function. METHODS: To compare the RNFL thickness using StratusOCT, three
groups of the subjects were enrolled, including 72 patients with optic atrophy
with definite demyelinating optic neuritis history (the neuritis group), 47
patients with advanced POAG atrophic neuropathy (the POAG group), and 47 healthy
subjects (the control group). The correlation between the RNFL thickness and
visual function parameters were investigated in the neuritis group, including
the best-corrected visual acuity (BCVA), the visual field mean deviation (MD),
pattern standard deviation (PSD), and P(100) latency of visual evoked potentials
(VEP). RESULTS: The average RNFL thickness, superior, nasal and inferior
thicknesses were significantly thinner in both the neuritis group and the POAG
group than those in the control group (p < 0.05), while they were higher in the
neuritis group than the POAG group (p < 0.05). The significant correlations were
found both between the average RNFL thickness and BCVA (r = 0.35, p < 0.05), MD
(r = 0.43, p < 0.05), and PSD (r = 0.39, p < 0.05). CONCLUSION: In comparison to
the advanced POAG and normal eyes, the RNFL thickness was decreased moderately
in the optic atrophy eyes resulting from demyelinating optic neuritis and was
quantitatively correlated with the visual function parameters.

PMID: 20191363  [PubMed - as supplied by publisher]

15: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Recurrent disc hemorrhage does not increase the rate of visual field
progression.

de Beaufort HC, De Moraes CG, Teng CC, Prata TS, Tello C, Ritch R, Liebmann JM.

Ophthalmology, New York University School of Medicine, New York, NY, USA,
heatherdebeaufort@gmail.com.

AIMS: To determine whether recurrent disc hemorrhage (DH) accelerates
glaucomatous visual field (VF) loss compared to an isolated, single, detected
DH. METHODS: We evaluated the disc photographs of consecutive patients with >/=5
SITA-Standard fields for DH. Group A had patients with a single DH in one eye,
and group B had at least one recurrence in the same eye. Automated pointwise
linear regression analysis was used to calculate rates of progression. Logistic
regression was used to determine ocular or systemic variables associated with DH
recurrence after baseline assessment. RESULTS: One hundred and seventeen
patients were enrolled (group A = 72, group B = 45). The mean age was 67.1 +/-
10.8 years; most patients were women (65%) of European ancestry (92%) diagnosed
with primary open-angle glaucoma (47%). The mean number of VF after the initial
DH was 7.9 +/- 2.9, spanning a mean of 4.6 +/- 2.2 years. None of the ocular or
systemic characteristics revealed a significant difference between groups. The
mean global rate of progression (group A, -0.8 +/- 0.6 vs group B, -0.8 +/- 0.7
dB/year, p = 0.93) and number of eyes reaching a progression endpoint (group A,
70% vs group B, 73%, p = 0.80) did not differ between groups. Recurrent DH eyes
showed a tendency to be followed longer, with a greater number of disc
photographs, which was not significant in the multivariate analysis. The global
rates of progression between groups remained non-significant even after
adjusting to follow-up time and number of VF tests (p = 0.69). CONCLUSION:
Recurrent DH does not result in a faster rate of VF progression compared to a
single detected DH. Eyes with single or recurrent DH have similar risks for
future disease progression.

PMID: 20182885  [PubMed - as supplied by publisher]

16: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Conservative management of bilateral persistent pupillary membranes with 18
years of follow-up.

Meyer-Rusenberg B, Thill M, Vujancevic S, Meyer-Rusenberg HW.

Department of Ophthalmology, University Medical Center Hamburg-Eppendorf,
Martinistrasse 52, 20246, Hamburg, Germany, b.meyer-ruesenberg@uke.de.

PMID: 20182884  [PubMed - as supplied by publisher]

17: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

The effect of a preoperative subconjuntival injection of dexamethasone on
blood-retinal barrier breakdown following scleral buckling retinal detachment
surgery: a prospective randomized placebo-controlled double blind clinical
trial.

Bali E, Feron EJ, Peperkamp E, Veckeneer M, Mulder PG, van Meurs JC.

The Rotterdam Eye Hospital, Rotterdam, The Netherlands.

BACKGROUND: Blood-retinal barrier breakdown secondary to retinal detachment and
retinal detachment repair is a factor in the pathogenesis of proliferative
vitreoretinopathy (PVR). We wished to investigate whether an estimated 700 to
1000 ng/ml subretinal dexamethasone concentration at the time of surgery would
decrease the blood-retinal barrier breakdown postoperatively. METHODS:
Prospective, placebo-controlled, double blind clinical trial. In 34 patients
with rhegmatogenous retinal detachment scheduled for conventional scleral
buckling retinal detachment surgery, a subconjunctival injection of 0.5 ml
dexamethasone diphosphate (10 mg) or 0.5 ml placebo was given 5-6 hours before
surgery. Differences in laser flare photometry (KOWA) measurements taken 1, 3
and 6 weeks after randomisation between dexamethasone and placebo were analysed
using mixed model ANOVA, while correcting for the preoperative flare
measurement. RESULTS: Six patients did not complete the study, one because of
recurrent detachment within 1 week, and five because they missed their
postoperative laser flare visits. The use of dexamethasone resulted in a
statistically significant decrease in laser flare measurements at the 1-week
postoperative visit. CONCLUSION: The use of a preoperative subconjunctival
injection of dexamethasone decreased 1-week postoperative blood-retina barrier
breakdown in patients undergoing conventional scleral buckling retinal
detachment surgery. This steroid priming could be useful as a part of a
peri-operative regime that would aim at decreasing the incidence of PVR.

PMID: 20182883  [PubMed - as supplied by publisher]

18: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Intravitreal triamcinolone acetonide versus bevacizumab therapy for macular
edema associated with branch retinal vein occlusion.

Byun YJ, Roh MI, Lee SC, Koh HJ.

The Institute of Vision Research, Department of Ophthalmology, Yonsei University
College of Medicine, 134 Shinchon-dong, Sodaemoon-gu, Seoul, 120-752, Korea.

PURPOSE: To compare visual outcomes after intravitreal triamcinolone acetonide
(IVTA) injection and intravitreal bevacizumab (IVB) administration for treatment
of macular edema associated with branch retinal vein occlusion (BRVO). METHODS:
A retrospective comparative case series of 134 consecutive patients that were
treated with either IVTA or IVB for macular edema caused by BRVO. Visual acuity
at baseline and 1, 3, 6, 9, and 12 months, and central macular thickness
measured by OCT at baseline and 1, 3, 6, and 12 months. The time to recurrence
of macular edema after treatment was also analyzed. RESULTS: Visual acuity
(Snellen equivalent) improved significantly from 0.87 logMAR (0.14) to 0.49
logMAR (0.33) in the IVTA group, and from 0.91 logMAR (0.13) to 0.45 logMAR
(0.36) in the IVB group 12 months after injection (p < 0.001). Central macular
thickness decreased significantly from 491.0 mum to 255.8 mum in the IVTA group,
and from 477.4 mum to 218.9 mum in the IVB group 12 months after injection (p <
0.001). In between-group comparisons, neither visual acuity (p = 0.892) nor
macular thickness (p = 0.612) improvements were statistically significantly
different. In the IVTA-all group, recurrence of macular edema occurred in 7.6%
of patients at a mean of 12.6 months postoperatively, and the average number of
injections was 1.08. In the IVB-all group, 26.0% of patients suffered
recurrences at a mean of 5.3 months after treatment, and received a mean of 1.89
injections. Recurrence was more frequent in the IVB group compared to the IVTA
group (Kaplan-Meier survival analysis log-rank test, p < 0.0001). CONCLUSIONS:
IVTA and IVB injections were similarly effective for improving visual acuity in
patients with macular edema secondary to BRVO. However, the IVTA group showed
longer mean improvement duration and less disease recurrence, and required fewer
injections than the IVB group.

PMID: 20182882  [PubMed - as supplied by publisher]

19: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Use of air in macular hole surgery.

Gupta D.

Norfolk and Norwich University Hospital, Norwich, UK, Dgupta_01@yahoo.com.

PMID: 20182881  [PubMed - as supplied by publisher]

20: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 24; [Epub ahead of print] 

Comparison of full-thickness traumatic macular holes and idiopathic macular
holes by optical coherence tomography.

Huang J, Liu X, Wu Z, Sadda S.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen
University, 54 Xianlienan Road, Guangzhou, 510060, People's Republic of China.

BACKGROUND: The optical coherence tomography (OCT) and clinical characteristics
of traumatic macular holes (TMHs) can be compared to those of idiopathic macular
holes (IMHs) to gain insights into the pathogenesis of both. METHODS: The
demographic data and visual acuity of 73 consecutive patients with unilateral,
full-thickness TMHs and 182 consecutive patients with idiopathic IMHs were
recorded. All patients with TMH and 60 patients with IMH underwent OCT scanning
and quantitative measurements. The apical and basal diameters and marginal
retinal thicknesses were recorded for each hole. The hole areas and
eccentricities were calculated. These parameters were compared between the two
types of macular holes, and correlated with visual acuity. RESULTS: Compared to
IMHs, TMHs were generally thinner, larger at the base, less circular, and were
associated with worse vision. Vitreous detachment was more commonly associated
with IMHs than TMHs. Both IMHs and TMHs were wider horizontally than vertically.
Visual acuity was negatively correlated with the size of IMHs, but not with any
tomographic parameters in TMHs. CONCLUSION: The tomographic and clinical
findings associated with TMHs and IMHs provide useful insights into the
pathogenesis of these two types of macular holes.

PMID: 20180132  [PubMed - as supplied by publisher]

21: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 24; [Epub ahead of print] 

Steroid eye drop treatment (difluprednate ophthalmic emulsion) is effective in
reducing refractory diabetic macular edema.

Nakano S, Yamamoto T, Kirii E, Abe S, Yamashita H.

Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of
Medicine, 2-2-2, Iidanishi, Yamagata, Yamagata, 9909585, Japan,
nakano-ygt@umin.ac.jp.

PURPOSE: To evaluate the efficacy of treatment of refractory diabetic macular
edema (DME) after vitrectomy with difluprednate ophthalmic emulsion 0.05%
(Durezol(TM)), and to compare this treatment with sub-Tenon's injection of
triamcinolone (STTA). METHODS: This study enrolled patients with refractory
diabetic macular edema that persisted despite pars plana vitrectomy in our
clinic. In all subjects, more than 3 months had passed since prior treatment.
Eleven eyes in ten subjects were treated with STTA (STTA group), and 11 eyes in
seven subjects were treated with difluprednate ophthalmic emulsion 0.05%
(Durezol(TM), Sirion Therapeutics Inc., USA) 4 times daily for the first month
and then twice daily for 2 months (eye drop group). RESULTS: In the eye drop
group, mean VA (+/- SD) was 0.67 +/- 0.35 logMAR and mean retinal thickness was
500.6 +/- 207.7 mum at baseline. After 3 months of treatment, mean VA was 0.67
+/- 0.29 and mean retinal thickness had decreased to 341.2 +/- 194.8 mum. The
mean minimum value of RT during the treatment period was 300.6 +/- 123.2 mum,
and significantly lower than that at baseline (Mann-Whitney U test: P = 0.003).
In the STTA group, mean VA (+/- SD) was 0.67 +/- 0.35 logMAR, and mean retinal
thickness was 543.3 +/- 132.6 mum at baseline. After 3 months of treatment, mean
VA was 0.49 +/- 0.67, and mean retinal thickness had decreased to 378.6 +/- 135
mum. The mean minimum value of RT during the treatment period was 349.9 +/-
113.8 mum, and significantly lower than at baseline (Mann-Whitney U test: P =
0.003). The rate of effective improvement in RT did not differ between the eye
drop group (73%) and STTA group (84%) (Fisher's exact test: P = 1). CONCLUSIONS:
Comparable improvements of retinal thickness were observed in the STTA and eye
drop groups. Instillation of difluprednate ophthalmic emulsion 0.05% is a safe
and effective treatment that does not require surgical intervention and does not
produce severe side-effects.

PMID: 20180131  [PubMed - as supplied by publisher]

22: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 20; [Epub ahead of print] 

A review of clinical trials of anti-VEGF agents for diabetic retinopathy.

Nicholson BP, Schachat AP.

Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195,
USA, nicholb2@ccf.org.

BACKGROUND: Diabetic retinopathy (DR) is a leading cause of vision loss in the
working-age population worldwide. Many observational and preclinical studies
have implicated vascular endothelial growth factor (VEGF) in the pathogenesis of
DR, and recent successes with anti-VEGF therapy for age-related macular
degeneration (AMD) have prompted research into the application of anti-VEGF
drugs to DR. Here we review the numerous early studies that suggest an important
potential role for anti-VEGF agents in the management of diabetic retinopathy.
CONCLUSIONS: For diabetic macular edema, phase II trials of intravitreal
pegaptanib and intravitreal ranibizumab have shown short-term benefit in visual
acuity. Intravitreal bevacizumab also has been shown to have beneficial
short-term effects on both visual acuity and retinal thickness. For
proliferative diabetic retinopathy (PDR), early studies suggest that
intravitreal bevacizumab temporarily decreases leakage from diabetic neovascular
lesions, but this treatment may be associated with tractional retinal detachment
(TRD). Furthermore, several studies indicate that bevacizumab is likely to prove
a helpful adjunct to diabetic pars plana vitrectomy (PPV) for TRD. Finally,
three small series suggest a potential beneficial effect of a single dose of
bevacizumab to prevent worsening of DME after cataract surgery. Use of anti-VEGF
medications for any of these indications is off-label. Despite promising early
reports on the safety of these medications, we eagerly await the results of
large, controlled trials to substantiate the safety and efficacy of anti-VEGF
drugs for diabetic retinopathy.

PMID: 20174816  [PubMed - as supplied by publisher]

23: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 19; [Epub ahead of print] 

A tissue-engineered approach towards retinal repair: Scaffolds for cell
transplantation to the subretinal space.

Hynes SR, Lavik EB.

Department of Biomedical Engineering, Yale University, New Haven, CT, 06520,
USA.

BACKGROUND: Several mechanisms of retina degeneration result in the
deterioration of the outer retina and can lead to blindness. Currently, with the
exception of anti-angiogenic treatments for wet age-related macular
degeneration, there are no treatments that can restore lost vision. There is
evidence that photoreceptors and embryonic retinal tissue, transplanted to the
subretinal space, can form new synapses with surviving host neurons. However,
these transplants have yet to result in a clinical treatment for retinal
degeneration. METHODS: This article reviews the current literature on the
transplantation of scaffolds with retinal and retinal pigmented epithelial (RPE)
cells to the subretinal space. We discuss the types of cells and materials that
have been investigated for transplantation to the subretinal space, summarize
the current findings, and present opportunities for future research and the next
generation of scaffolds for retinal repair. RESULTS: Challenges to cell
transplantation include limited survival upon implantation and the formation of
abnormal cell architectures in vivo. Scaffolds have been shown to enhance cell
survival and direct cell differentiation and organization in a number of models
of retinal degeneration. CONCLUSIONS: The transplantation of cells within a
scaffold represents a possible treatment to repair retinal degeneration and
restore vision in effected patients. Materials have been developed for the
delivery of retinal and RPE cells separately however, the development of a
combined tissue-engineered scaffold targeting both cell populations represents a
promising direction for retinal repair.

PMID: 20169358  [PubMed - as supplied by publisher]

24: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 19; [Epub ahead of print] 

Intravitreal injection of triamcinolone combined with bevacizumab for choroidal
neovascularization associated with large retinal pigment epithelial detachment
in age-related macular degeneration.

El Matri L, Chebil A, Kort F, Bouraoui R, Baklouti K, Mghaieth F.

Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Boulevard 9
avril 1006 Bab saadoun, Tunis, Tunisia, Leila.elmatri@rns.tn.

PURPOSE: To discuss the effect and outcome of a combined intravitreal
triamcinolone acetonide (IVTA) injection with intravitreal bevacizumab (IVB) in
treating choroidal neovascularization (CNV) associated with large retinal
pigment epithelial detachment (PED) in age-related macular degeneration (AMD).
DESIGN: Prospective, consecutive, observational case series. METHODS: Seven eyes
(five patients) with CNV associated with large PED in AMD were treated by IVTA
(4 mg/ 0.1 ml), followed by a IVB (1.25 mg/0.05 ml) 1 week later. Patients were
evaluated for best-corrected visual acuity (BCVA) and optical coherence
tomography (OCT) at baseline, at 1 week and every 6 weeks. Fluorescein
angiography (FA) and indocyanine green angiography (ICG) were performed at
baseline and every 3 months afterwards. Indications for retreatment by combined
injection were defined as persistent PED with subretinal and/or intraretinal
fluid on OCT. Patients with flattening of the PED and activity leakage
demonstrated by OCT underwent subsequent IVB. RESULTS: The mean duration of
follow-up was 11 months (range 9-14 months). BCVA at baseline averaged 20/125,
and 20/80 at the end of follow-up. FA showed no leakage from the lesion in four
eyes at the end of follow-up, and three eyes showed a decrease in leakage.
Average central foveal thickness was (CFT) 325.7 microns at baseline and 209.2
microns at the end. The average size of the PED was 2.34 disk diameters (range
1.33-3.25) at baseline, and the PED disappeared in four eyes, while it decreased
in size at the end in the remaining three. The subretinal fluid disappeared in
all patients at the end. The combined treatment (IVTA with IVB 1 week later) was
repeated in four eyes, and the number of IVB after combined injection ranged
from one to three. No RPE tear appeared during follow-up. Two eyes developed
glaucoma controlled by topical medication. There were no other ocular or
systemic complications CONCLUSION: Combined IVB and IVTA therapy seems to be an
effective and safe procedure to treat CNV associated with large PED in AMD.

PMID: 20169357  [PubMed - as supplied by publisher]

25: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 19; [Epub ahead of print] 

Intracellular bevacizumab reduces phagocytotic uptake in RPE cells.

Klettner A, Mohle F, Roider J.

Department of Ophthalmology, University of Kiel,, Arnold-Heller-Str. 3, Haus 25,
24105, Kiel, Germany, aklettner@auge.uni-kiel.de.

BACKGROUND: We have previously shown that bevacizumab, but not ranibizumab, is
taken up by porcine RPE cells. In this study, the effects of bevacizumab and
ranibizumab on proliferation, wound healing and phagocytosis of the RPE were
investigated. METHODS: Primary porcine RPE cell culture were prepared from fresh
eyes, cultivated and treated with clinically relevant concentrations of
bevacizumab or ranibizumab respectively. Proliferation was investigated in a
proliferation assay, wound healing in a wound scratch assay and phagocytosis was
investigated by feeding RPE cells photoreceptor outer segment-opsonized
FITC-labeled latex beads. RESULTS: Bevacizumab, and to a lesser extend
ranibizumab, impair the proliferation of RPE cells but do not affect wound
healing. Bevacizumab, but not ranibizumab, reduces the phagocytotic function of
RPE cells. CONCLUSIONS: The uptake of bevacizumab reduces phagocytosis in RPE
cells, which indicates possible long-term effects of repeated bevacizumab
treatment.

PMID: 20169356  [PubMed - as supplied by publisher]

26: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 17; [Epub ahead of print] 

Ultrasonic Doppler measurements of blood flow velocity of rabbit retinal vessels
using a 45-MHz needle transducer.

Matsuoka N, Paeng DG, Chen R, Ameri H, Abdallah W, Zhou Q, Fawzi A, Shung KK,
Humayun M.

Doheny Retina Institute, Los Angeles, CA, USA, naomat2@hotmail.com.

BACKGROUND: The purpose of this study is to measure blood flow velocity of
rabbit retinal vessels using a 45-MHz ultrasonic Doppler system with a needle
transducer. METHODS: A high-frequency pulsed Doppler system that utilizes a
45-MHz PMN-PT needle transducer was developed to measure retinal blood flow
velocity in situ. The pulsed Doppler allowed the differentiation of retinal from
choroidal blood flow velocity. The needle transducer was inserted into the
vitreous cavity through a 20-gauge incision port to access the retinal vessels.
The first phase of the experiment evaluated the reproducibility of the
measurements. The second phase measured velocities at four positions from the
optic disc edge to the distal part of each vessel in nine eyes for the temporal
and six eyes for the nasal portions. The angle between the transducer and the
retinal vessel at each site was measured in enucleated rabbit eyes to estimate
and compensate for measurement errors. RESULTS: In the first phase, the average
measurement error was 5.97 +/- 1.34%. There was no significant difference
comparing all eyes. In the second phase, the velocities gradually slowed from
the disc edge to the distal part, and temporal velocities were faster than nasal
velocities at all measurement sites. CONCLUSION: This study demonstrated the
feasibility of reliably measuring retinal blood flow velocity using a 45-MHz
ultrasonic Doppler system with a needle transducer.

PMID: 20162299  [PubMed - as supplied by publisher]

27: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 17; [Epub ahead of print] 

Verteporfin PDT for non-standard indications-a review of current literature.

Chan WM, Lim TH, Pece A, Silva R, Yoshimura N.

Department of Ophthalmology, HK Sanatorium Hospital, Happy Valley, Hong Kong.

BACKGROUND: Verteporfin photodynamic therapy (PDT) is approved for the treatment
of predominantly classic subfoveal choroidal neovascularization (CNV) due to
age-related macular degeneration (AMD), as well as for subfoveal CNV due to
pathologic myopia and ocular histoplasmosis syndrome. Verteporfin PDT addresses
the underlying pathology of ocular vascular disorders through its
angio-occlusive mechanism of action, which reduces both visual acuity loss and
the underlying leakage associated with lesions. Verteporfin PDT has also been
associated with encouraging treatment outcomes in case studies involving
patients with choroidal vascular disorders such as polypoidal choroidal
vasculopathy, central serous chorioretinopathy, choroidal haemangioma, angioid
streaks, and inflammatory CNV, i.e. conditions currently considered as
non-standard indications of verteporfin PDT. In many studies, outcomes were
better than expected based on the natural courses of each of these conditions.
Although the anti-vascular endothelial growth factor (VEGF) therapies,
ranibizumab and pegaptanib, have been approved for CNV due to AMD, their role in
these other choroidal vascular disorders remains to be established. We summarize
current literature that has documented the use of verteporfin PDT in these
conditions. CONCLUSIONS: The complex pathogenesis of CNV provides a rationale
for investigating combination approaches comprising verteporfin PDT and
anti-VEGF therapies. Randomized controlled studies are warranted to confirm the
preliminary results of verteporfin PDT as a monotherapy or in combination with
anti-VEGF therapies in the treatment of a variety of choroidal vascular
conditions.

PMID: 20162298  [PubMed - as supplied by publisher]

28: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 17; [Epub ahead of print] 

Thrombophilic risk factors in the pathogenesis of non-arteritic anterior
ischemic optic neuropathy patients.

Felekis T, Kolaitis NI, Kitsos G, Vartholomatos G, Bourantas KL, Asproudis I.

University Eye Clinic of Ioannina, Kosti Palama 1, Anatoli, Ioannina, 45500,
Greece.

BACKGROUND: Non-arteritic anterior ischemic optic neuropathy (N-AION) is caused
by acute ischemic infarction of the optic nerve head, supplied by the posterior
ciliary arteries. Thrombophilia is the tendency/predisposition to vascular
thromboses of arteries and veins, and the existence of thrombophilic risk
factors leads to blood hypercoagulability and potentially increased risk for
thromboses. OBJECTIVES: To investigate whether there is an association between
N-AION and a wide spectrum of thrombophilic risk factors. PATIENTS AND METHODS:
Seventy-seven consecutive cases of confirmed N-AION and 60 age- and sex-matched
consecutive controls constituted the study group. Fibrinogen levels, deficiency
of proteins C, S, ATIII, lupus anticoagulant, activated protein C resistance,
factor V Leiden, factor V H1299R, factor II G20210A, MTHFR C677T, MTHFR A1298C,
GPIIIa A1/A2, and ACE I/D polymorphisms were analysed. RESULTS: Statistical
analysis of the plasma proteins in our study demonstrated that the only
significant difference was the one concerning protein S levels. In particular,
the mean value for N-AION patients was 78.8% +/- 21.2, and for the control group
the mean value was 88% +/- 21.2 (p = 0.013). Despite the above-mentioned result,
there was not any statistical difference between the two subgroups regarding
actual protein S deficiency, as 9/77 (11.7%) patients and 4/60 (6.7%) controls
had protein S levels below 60% (p = 0.32). In our study sample, homozygosity for
MTHFR C677T polymorphism in the study group as a whole, and the presence of at
least one A2 allele of GPIIIa in the subgroup of male patients as compared to
healthy male controls, proved to be the most significant thrombophilic risk
factors, with odds ratios of 16.78 (95% C.I 0.96-294.42, p = 0.054) and 4.6 (95%
C.I 1.52-13.88, p = 0.007) respectively. CONCLUSION: Screening for these
polymorphisms would probably constitute a valuable procedure in N-AION patients,
as they may have an important contribution to the pathogenesis of the disease.

PMID: 20162297  [PubMed - as supplied by publisher]

29: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 17; [Epub ahead of print] 

Visual results and complications of primary intraocular lens implantation in
infants aged 6 to 12 months.

Lu Y, Ji YH, Luo Y, Jiang YX, Wang M, Chen X.

Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang
Road, Shanghai, 200031, China, luyi_eent@yahoo.com.cn.

BACKGROUND: To present the visual results and the complications of primary
intraocular lens (IOL) implantation in infants aged 6 to 12 months between
January 2002 and July 2007. METHODS: A total of 26 consecutive eyes, of 16
infants with cataract aged 6 to 12 months, were reviewed in the study. All
patients had cataract extraction with anterior and posterior capsulorrhexis
combined with anterior vitrectomy and primary hydrophobic acrylic IOL
implantation. Six infants (six eyes) had unilateral congenital cataract and ten
(20 eyes), bilateral cataract. Visual acuity and complications were recorded
throughout the 46.4-month mean follow-up (range 22 to 79 months). RESULTS: All
eyes had primary IOL implantation. The mean best-corrected visual acuity
(logMAR) was 0.98 +/- 0.18,0.50 +/- 0.14 and 0.61 +/- 0.25 for unilateral,
bilateral and all eyes respectively at the last follow-up. IOLs were implanted
in the capsular bag of 25 eyes (96.2%) and in the sulcus of the remaining one
eye (3.8%). Seven eyes (26.9%) developed visual axis opacification (VAO), and
four eyes required secondary pars plana vitrectomy (PPV). IOL opacification
occurred in one eye 54 months after implantation. Late onset open-angle glaucoma
developed in one eye, and required trabeculectomy surgery. The predictors of
good best-corrected visual acuity (BCVA) included partial cataract, bilateral
cataract, absence of strabismus or nystagmus, and good amblyopic treatment. The
greatest annual myopic change (5.15 +/- 2.08 D) was observed during the first 12
months after surgery. In unilateral cases, there was no significant difference
in the axial length between the cataractous eye and the fellow normal eye both
at the time of surgery (P = 0.891) and final follow-up (P = 0.693). CONCLUSIONS:
Primary IOL implantation was safe and effective for infantile cataract surgery.
Total or unilateral cataract, nystagmus or strabismus, and inadequate amblyopic
therapy were predictors of poor BCVA. Significant myopic shifts occurred
especially in infants in the first year of surgery. The pseudophakic eye had a
similar growth rate, as measured by axial length, to that of the fellow normal
eye, in unilateral cases.

PMID: 20162296  [PubMed - as supplied by publisher]

30: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 17; [Epub ahead of print] 

Lens epithelial cell apoptosis initiates diabetic cataractogenesis in the Zucker
diabetic fatty rat.

Kim J, Kim CS, Sohn E, Kim H, Jeong IH, Kim JS.

Diabetic Complications Research Center, Division of Traditional Korean Medicine
(TKM) Integrated Research, Korea Institute of Oriental Medicine, 483 Exporo,
Yuseong-gu, Daejeon, 305-811, South Korea.

BACKGROUND: It has been suggested that damage of lens epithelial cell (LEC) may
play an important role in cataract formation. Nitric oxide is involved in
cataract development. Here, we investigated the relationship between LEC damage
and iNOS expression in the Zucker diabetic fatty (ZDF) rat. METHODS: At 21 weeks
of age, the eyes were enucleated and the lens opacity was then examined.
Apoptosis were detected by TUNEL assay, and the expression of iNOS and NF-kappaB
activation were studied by immunohistochemistry and southwestern histochemistry
respectively. RESULTS: In 21-week-old male ZDF rats, cataract was developed,
TUNEL-positive LECs were markedly increased, and the expression levels of iNOS
mRNA and protein were significantly upregulated. The expression pattern of iNOS
was closely correlated with apoptotic change of LECs. In addition, advanced
glycation end products (AGEs) were accumulated in cytoplasm of LECs. Activated
NF-kappaB was mainly detected in nucleus of LECs. CONCLUSIONS: The higher
expressions of AGEs, NF-kappaB and iNOS in LECs of diabetic rats suggest that
these factors are involved in apoptosis of LEC alterations related to diabetic
cataract.

PMID: 20162295  [PubMed - as supplied by publisher]