Journal Contents

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

Dehydroxymethylepoxyquinomicin, a novel nuclear factor-κB inhibitor, reduces
chemokines and adhesion molecule expression induced by IL-1β in human corneal

Inokawa S(1), Watanabe T, Keino H, Sato Y, Hirakata A, Okada AA, Fukuda K,
Fukushima A, Umezawa K.

Author information: 
(1)Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2
Shinkawa, Mitaka, Tokyo, 181-8611, Japan.

PURPOSE: Dehydroxymethylepoxyquinomicin (DHMEQ) is derived from the antibiotic,
epoxyquinomicin C, and is a novel low molecular weight nuclear factor-κB (NF-κB) 
inhibitor. We investigated the effects of DHMEQ on the expression of chemokines
and the intercellular adhesion molecule (ICAM)-1 induced by proinflammatory
cytokines in cultures of the human corneal fibroblasts (HCFs).
METHODS: The cytotoxicity of DHMEQ on cultured HCFs was evaluated by cell
proliferation assays. Cultures were exposed to interleukin (IL)-1β, and the
production of IL-8 and monocyte chemoattractant protein (MCP)-1 was assessed by
enzyme-linked immunosorbent assay. The degree of expression of ICAM-1 was
measured by flow cytometry. The translocation of NF-κB p65 into the nucleus of
HCFs was assessed by immunocytochemistry.
RESULTS: DHMEQ was not toxic to cultured HCFs at doses up to 10 μg/ml. DHMEQ
significantly suppressed the production of both IL-8 and MCP-1 in
IL-1β-stimulated HCFs. In addition, DHMEQ down-regulated ICAM-1 expression in
IL-1β-stimulated HCFs in a dose-dependent manner. DHMEQ inhibited the
IL-1β-induced nuclear accumulation of p65, a component of NF-κB, in HCFs.
CONCLUSIONS: The suppression of inflammatory chemokines IL-8 and MCP-1 and
inhibition of the expression of ICAM-1 in cultured HCFs by DHMEQ indicates that
DHMEQ may have a therapeutic potential for treating ICAM-1 and chemokine-mediated
corneal inflammatory disorders.

PMID: 25519802   [PubMed - as supplied by publisher]

2. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 16. [Epub ahead of print]

Flicker-defined form perimetry in glaucoma patients.

Horn FK(1), Kremers J, Mardin CY, Jünemann AG, Adler W, Tornow RP.

Author information: 
(1)Department of Ophthalmology and University Eye Hospital, Friedrich-Alexander
University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany,

PURPOSE: To assess the potential of flicker-defined form (FDF) perimetry to
detect functional loss in patient groups with beginning glaucoma, and to evaluate
the dynamic range of the FDF stimulus in individual patients and at individual
test positions.
METHODS: FDF perimetry and standard automated perimetry (SAP) were performed at
identical test locations (adapted G1 protocol) in 60 healthy subjects and 111
glaucoma patients. All patients showed glaucomatous optic disc appearance.
Grouping within the glaucoma cohort was based on SAP-performance: 33
"preperimetric" open-angle glaucoma (OAG) patients, 28 "borderline" OAG (focal
defects and SAP-mean defect (MD) <2 dB), 33 "early" OAG (SAP-MD < 5 dB), 17
"advanced" OAG. All participants were experienced in psychophysical and
perimetric tests. Defect values and the areas under receiver operating
characteristic curves (ROC) in patient groups were statistically compared.
RESULTS: The values of FDF-MD in the preperimetric, borderline, and early OAG
group were 2.7 ± 3.4 dB, 5.5 ± 2.6 dB, and 8.5 ± 3.4 dB respectively (all
significantly above normal). The percentage of patients exceeding normal FDF-MD
was 27.3 %, 60.7 %, and 87.9 % respectively. The age-adjusted FDF-mean defect
(MD) of the G1X-protocol was not significantly correlated with refractive error, 
lens opacity, pupil size, or gender. Occurrence of ceiling effects (inability to 
detect targets at highest contrast) showed a high correlation with visual field
losses (R = 0.72, p < 0.001). Local analysis indicates that SAP losses exceeding 
5 dB could not be distinguished with the FDF technique.
CONCLUSION: The FDF stimulus was able to detect beginning glaucoma damage.
Patients with SAP-MD values exceeding 5 dB should be monitored with conventional 
perimetry because of its larger dynamic range.

PMID: 25511293   [PubMed - as supplied by publisher]

3. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 14. [Epub ahead of print]

The role of electrical stimulation therapy in ophthalmic diseases.

Fu L(1), Lo AC, Lai JS, Shih KC.

Author information: 
(1)Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong
Kong, 301B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong, China.

INTRODUCTION: Electrical stimulation therapy (EST) involves the use of a
low-intensity electrical current in the treatment of neuromuscular conditions.
During the recent two decades, EST has emerged as a potential neuroprotective
strategy in certain ophthalmic diseases, aided by a lack of effective management 
for these conditions.
PURPOSE: The aim of this review is to summarize and discuss current available
evidence for the use of EST in ophthalmic diseases in the laboratory setting and 
in human trials.
METHODS: The compilation and review of published English-language reports on the 
use of EST in human ophthalmic disease and animal models of ophthalmic disease.
RESULTS: From published reports, research work on the use of EST in ophthalmic
diseases began in the last 20 years. Different methods of electrical stimulation 
have been devised, with varying levels of invasiveness. Results from human trials
have favored earlier and repeated treatment after insults to the optic nerve,
while EST has shown transient effectiveness in degenerative diseases of
photoreceptors. Patients also reported no serious adverse effects from EST in the
clinical trials. Results from animal studies have further confirmed survival
benefits of EST in retinal cell survival, with the underlying mechanism likely
multifactorial, but involving Müller cell modulation.
CONCLUSIONS: Results from human and animal studies have demonstrated the
relevance and potential effectiveness of EST in ophthalmic disease. However,
optimal disease and species-specific stimulation settings need to be defined.

PMID: 25501299   [PubMed - as supplied by publisher]

4. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 14. [Epub ahead of print]

Intravitreal bevacizumab monotherapy for type-1 prethreshold, threshold, and
aggressive posterior retinopathy of prematurity - 27 month follow-up results from

Yetik H(1), Gunay M, Sirop S, Salihoglu Z.

Author information: 
(1)Cerrahpasa School of Medicine, Istanbul University, Fatih, Istanbul, Turkey,

PURPOSE: To study the efficacy of intravitreal bevacizumab (IVB) injection as a
single treatment for retinopathy of prematurity (ROP).
METHODS: This was a prospective interventional case series study performed in a
clinical practice setting; a total of 122 patients including prethreshold (type
1) (n  = 79, 152 eyes, six unilateral), threshold (n = 12, 24 eyes), and
aggressive posterior (APROP) (n = 31, 62 eyes); cases were included without any
randomization or masking. A total of 253 IVB injections, 238 in the first
session, 11 in the second session, and four in the third session were performed, 
and followed up for a mean of 89.155 ± 4.277 (range 82 to 105) weeks of
postmenstrual age (PMA). Regression of ROP, maturation of the retina, and
associated complications were evaluated.
RESULTS: Total regression was achieved in 227/238 eyes (95.4 %) after the first
dose injection. The remaining 11 received a second injection, after which an
additional seven (234/238; 98.2 %) regressed; after the third injection, the
remaining 4 (238/238; 100 %) regressed. Complete retinal vascular maturation was 
achieved without any significant complications in all of the cases.
CONCLUSIONS: IVB injection as monotherapy seems to be a very effective treatment 
modality for ROP. Based on timely intervention, IVB as a single treatment
modality can salvage almost all ROP cases before stage 4.

PMID: 25501298   [PubMed - as supplied by publisher]

5. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 13. [Epub ahead of print]

A randomized trial of intravitreal bevacizumab vs. ranibizumab for myopic CNV.

Pece A(1), Milani P, Monteleone C, Trombetta CJ, De Crecchio G, Fasolino G,
Matranga D, Cillino S, Vadalà M.

Author information: 
(1)Unità operativa di Oftalmologia, Ospedale di Melegnano, via Pandina,
Melegnano, (MI), Italy,

AIMS: The aim was to compare the efficacy of intravitreal therapy with
bevacizumab and ranibizumab for choroidal neovascularization (CNV) in pathologic 
myopia (PM).
METHODS: This was a prospective multicenter randomized nonblinded trial.
RESULTS: In seven centers, 78 eyes were randomized 1:1 to treatment with
bevacizumab (group B, 40 eyes) or ranibizumab (group R, 38 eyes) given with an
"on demand" regimen (PRN). The mean follow-up was 19 months (SD 2, range 12-24). 
The mean BCVA at baseline was 0.60 logMAR (20/80 Snellen equivalent, Seq) and 50 
letter score (ls). Mean final BCVA was 0.51 LogMAR (20/63 Seq) and 57 ls
(p = 0.0009 and p = 0.0002, respectively). In group B, mean basal BCVA was 0.52
logMAR (20/63 Seq) and 54 ls, and final BCVA was 0.51 logMar (20/63 Seq) and 57
ls. In group R, mean basal BCVA was 0.62 logMAR (20/80 Seq) and 45 ls, and the
final values were 0.50 logMAR (20/63 Seq) and 58 ls. Statistical comparison of
the two groups showed no significant difference (logMAR p = 0.90 and letters
p = 0.78). Multivariate analysis showed no influence of age or previous
photodynamic treatment (PDT) on final visual changes. The mean number of
treatments in the first year was 2.7 in group B and 2.3 in group R (p = 0.09).
CONCLUSION: Myopic CNV equally benefits from on-demand intravitreal injection of 
either bevacizumab or ranibizumab; the therapeutic effect is independent of
previous PDT and age.

PMID: 25500986   [PubMed - as supplied by publisher]

6. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 12. [Epub ahead of print]

Ocular surface changes after strabismus surgery with different incisions.

Li Q(1), Fu T, Yang J, Wang QL, Li ZE.

Author information: 
(1)Department of Ophthalmology, The Second People's Hospital of Jinan, 148#,
Jingyi Road, Jinan, 250001, People's Republic of China,

OBJECTIVES: To compare ocular surface changes after strabismus surgery with
different incisions.
METHODS: One hundred and twenty eyes with exotropia were randomly assigned to
Group A (limbal incision) or Group B (fornix incision). Dry eye questionnaire,
corneal sensitivity, tear film breakup time (TFBUT), Schirmer I test (SIT), and
corneal fluorescein staining (CFS) were assessed at 1 day preoperatively and at
different postoperative times.
RESULTS: In the A group, dry eye questionnaire scores increased and TFBUT
decreased at postoperative weeks 1, 2, and 4. Corneal sensitivity decreased at
postoperative weeks 1 and 2. In the B group, dry eye questionnaire scores
increased and TFBUT decreased at postoperative weeks 1 and 2. Corneal sensitivity
did not change. Postoperative between-group differences were significant in dry
eye questionnaire scores (P = 0.0009, 1 week; P < 0.0001, 2 weeks; P = 0.0001,
4 weeks) and TFBUT (P = 0.004, 1 week; P = 0.0003, 2 weeks; P = 0.0001, 4 weeks).
Between-group differences in CFS were significant postoperatively (P = 0.045,
1 week; P = 0.020, 2 weeks).
CONCLUSION: Compared to fornix incision, limbal incision results in more serious 
dry eye symptoms and has a greater impact on corneal sensitivity and tear film

PMID: 25500985   [PubMed - as supplied by publisher]

7. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 12. [Epub ahead of print]

Three-dimensional optic nerve head images using optical coherence tomography with
a broad bandwidth, femtosecond, and mode-locked laser.

Shoji T(1), Kuroda H, Suzuki M, Baba M, Araie M, Yoneya S.

Author information: 
(1)Department of Ophthalmology, Saitama Medical University, 38 Morohongo
Moroyama-machi, Iruma, Saitama, 350-0495, Japan,

PURPOSE: The aim of this study was to demonstrate the fine laminar structure of
the optic nerve head (ONH), in vivo, using a broad wavelength, ultra-high
resolution, and optically coherent tomography (OCT) system.
METHODS: This high-resolution OCT system, based on a 200 nm bandwidth
spectrometer and an 8 femtosecond ultra-short, mode-locked, coherent laser light 
source, enabled in vivo cross-sectional ONH imaging with 2.0 μm axial resolution.
A total of 300 optic disc B-scans, which consisted of 300 × 2048 pixels, were
obtained in 10 μm steps. Three-dimensional images were rendered from these images
to obtain n face images of the optic disc. Fundus photography, scanning laser
ophthalmoscopy (SLO), and standard OCT were also performed for all subjects.
RESULTS: Thirty-six eyes of normal subjects and ten eyes of glaucoma patients
with mean age of 40.0 ± 10.0 years were enrolled in this study. Sequential en
face images, from the ONH surface to deeper layers, were reconstructed in 2.0 μm 
steps. Observation of the images indicated variations in the shape and
arrangement of the lamina pores at different depths. Clear lamina pores were
identified by this technique in 44 eyes, compared with the fundus camera
(identified in six eyes), SLO (identified in 14 eyes), and standard OCT
(identified in 24 eyes) (all comparisons, p < 0.001).
CONCLUSIONS: The fine structure of the ONH could be resolved in vivo using our
OCT, providing improved imaging that can be used in research and clinical
applications for a better characterization of the anatomical and pathological
features associated with glaucoma.

PMID: 25500984   [PubMed - as supplied by publisher]

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

Anti-interferon alpha antibodies and autoantibodies in patients with Behçet's
disease uveitis treated with recombinant human interferon alpha-2a.

Aydinoglu-Candan O(1), Araz-Erşan B, Gul A, Badur S, Tugal-Tutkun I.

Author information: 
(1)Istanbul Faculty of Medicine Department of Ophthalmology, Istanbul University,
Istanbul Tip Fakultesi, Goz Hastaliklari A.D. Capa, Istanbul, 34093, Turkey.

BACKGROUND: Recombinant human (rh) interferon alpha2a (IFN-α2a) therapy is
successfully used for the treatment of Behçet's disease (BD) uveitis refractory
to conventional immunosuppressive treatment.
PURPOSE: Our aim in this study was to investigate the frequency and clinical
significance of anti-IFN-α antibodies and autoantibodies during recombinant human
rhIFN-α2a therapy in patients with BD uveitis.
METHODS: This comparative, cross-sectional, serological screening study included 
30 BD patients treated with rhIFN-α2a (Group 1), 29 BD patients treated with
conventional immunosuppressive agents (Group 2), 29 BD patients who received only
colchicine (Group 3), and 30 healthy subjects (Group 4). Anti-IFN-α-binding
antibodies and autoantibodies, including anti-nuclear antibody, anti-thyroid
peroxidase antibody, and anti-cardiolipin antibody, were measured in serum
samples. Antibody seropositivity was compared between study groups. Retrospective
clinical data were compared between antibody-positive and antibody-negative
RESULTS: A significantly higher proportion of patients in Group 1 had
anti-interferon-α (26.6 %) and autoantibody (30 %) seropositivity compared to the
other groups. No correlation was found between seropositivity for
anti-interferon-α and other autoantibodies. No significant difference was found
in cumulative dose of IFN-α, duration of IFN-α therapy, time to first uveitis
attack, or attack rate between anti-interferon-α antibody-positive and
antibody-negative patients in Group 1. Uveitis attacks were observed in 22 % of
autoantibody-positive and 71 % of autoantibody-negative patients in Group 1
(p = 0.018).
CONCLUSIONS: Patients with BD uveitis develop anti-IFN-α-binding antibodies and
autoantibodies during treatment with rhIFN-α2a. While the clinical relevance of
anti-IFN-α-binding antibodies remains unclear in this study, induction of
autoimmunity was found to be associated with a tendency for better therapeutic

PMID: 25500983   [PubMed - as supplied by publisher]

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

Distribution of internal carotid artery plaque locations among patients with
central retinal artery occlusion in the Eagle study population.

Leisser C(1), Kaufmann TA, Feltgen N, Schumacher M, Schmoor C, Meckel S.

Author information: 
(1)Department of Ophthalmology, Heinrich-Collinstrasse 30, A-1140,
Hanuschkrankenhaus, Vienna,

PURPOSE: Arterial emboli in the internal carotid artery (ICA) mainly cause
cerebral ischemia; only 10 % of emboli reach the retinal arteries. Computational 
blood flow studies suggest that plaques situated in the ICA siphon may be a
source of embolism to the ophthalmic artery (OA). To validate these calculated
probabilities in patients with central retinal artery occlusion (CRAO), we
reanalyzed digital subtraction angiography (DSA) images from the Multicenter
Study of the European Assessment Group for Lysis in the Eye (EAGLE) study, a
multicenter randomized study in patients with nonarteritic CRAO.
METHODS: A reevaluation of 34 DSA studies was done from the interventional arm of
the EAGLE study with regards to distribution of arterial plaques at specific ICA 
siphon locations and ICA stenosis. A comparison was made of plaque distribution
to calculated probabilities for emboli reaching the OA from a computational fluid
dynamics (CFD) model of a patient-specific ICA siphon.
RESULTS: Most of the ICA plaques near the OA's origin were located in the
cavernous ICA portion (31.3%). Of these, 12.5 % had plaques in the curvature
opposite the OA origin, a location carrying the highest risk for embolization
into the OA (according to the CFD model 12.6-13.2 % probability of embolisation
into the OA). Also, 15.6 % had plaques in the paraclinoid ICA portion distal to
the OA origin.
CONCLUSIONS: There were 40.6% of the patients that had plaques in the cavernous
and clinoid ICA portions presenting possible sources for embolic material
generating RAO.

PMID: 25500982   [PubMed - as supplied by publisher]

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

Rate of vision loss in neovascular age-related macular degeneration explored.

Real JP(1), Granero GE, De Santis MO, Juarez CP, Palma SD, Kelly SP, Luna JD.

Author information: 
(1)Pharmacy Department of the Faculty of Chemical Sciences, National University
of Córdoba UNITEFA (CONICET), Cordoba, Argentina.

PURPOSE: To explore decline in visual acuity in patients with neovascular
age-related macular degeneration (n-AMD) awaiting intravitreal bevacizumab or
ranibizumab treatment following initial diagnosis and after disease reactivation.
METHODS: Retrospective analysis of 74 treatment-naïve patients (84 eyes) in two
centers in Córdoba, Argentina. The time between treatment indication and
intravitreal injection, and the changes in BCVA produced during this delay were
studied in both periods. A linear regression model to search the impact of time
on progression visual impairment was conducted.
RESULTS: In both periods, a significant reduction in vision occurred awaiting
intravitreal injection. The longer the delay, the greater the vision loss
(R2 = 0.55 p < 0.01) and the less improvement following treatment (Pearson
coefficient -0.26). The result of the model shows that the change in vision as a 
function of initial delay were best described by a polynomic model with a mean
loss of 5 letters in the first 3 weeks, a slowdown in the rate of change of VA,
and a dependence of visual acuity at the moment of diagnosis . The loss of visual
acuity after reactivation shows the same behavior as at the onset of the disease 
but independent of visual acuity prior to reactivation.
CONCLUSION: Visual loss awaiting injection intravitreal anti-VEGF is clinically
significant and with an asymptotic pattern, with early rapid loss of vision in
both the onset of the disease and the reactivation. Initiation of anti-VEGF
treatment must be undertaken urgently, as should retreatment of disease
activation to reduce visual loss.

PMID: 25491161   [PubMed - as supplied by publisher]

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

Asymmetric vitreomacular traction and symmetrical full thickness macular hole

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

Author information: 
(1)Department of Ophthalmology, St James' Hospital, Leeds, UK,

BACKGROUND: A Full Thickness Macular Hole (FTMH) is often associated with
vitreomacular traction, and this can be asymmetric with vitreomacular traction on
one side of the hole but not the other. In cross-section, the elevated retinal
rim around a developed FTMH is seen as a drawbridge elevation, and this
drawbridge elevation may be used as a measure of morphological change.
Examination of the drawbridge elevation of the retinal rim in FTMH with
asymmetric vitreomacular traction may help to clarify the role of vitreomacular
traction in the development of FTMH.
METHOD: Cases of FTMH were identified with an initial OCT scan showing
vitreomacular traction on one side of the hole only and that had a follow-up OCT 
scan showing progression of the hole. A tangent to the retinal surface at a
distance of 700 microns from the axis of the hole was used as a marker of the
drawbridge elevation of the retinal rim around the macular hole. Comparisons of
the drawbridge elevation and change in drawbridge elevation between the sides
with and without initial vitreomacular traction were made.
RESULTS: There was no significant difference between the drawbridge elevation, or
change in drawbridge elevation, on the side of the hole with initial
vitreomacular traction compared to the side without initial traction.
CONCLUSION: There is some intrinsic mechanism within the retina to link the
morphological changes on the two sides of a FTMH. A bistable hypothesis of FTMH
formation and closure is postulated to explain this linkage.

PMID: 25491160   [PubMed - as supplied by publisher]

12. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 11. [Epub ahead of print]

Histopathological comparison of eyes from patients with autosomal recessive
retinitis pigmentosa caused by novel EYS mutations.

Bonilha VL(1), Rayborn ME, Bell BA, Marino MJ, Pauer GJ, Beight CD, Chiang J,
Traboulsi EI, Hollyfield JG, Hagstrom SA.

Author information: 
(1)Ophthalmic Research - i31, Cleveland Clinic, Cole Eye Institute, 9500 Euclid
Avenue, Cleveland, OH, 44195, USA,

To evaluate the retinal histopathology in donor eyes from patients with autosomal
recessive retinitis pigmentosa (arRP) caused by EYS mutations. Eyes from a
72-year-old female (donor 1, family 1), a 91-year-old female (donor 2, family 2),
and her 97-year-old sister (donor 3, family 2) were evaluated with macroscopic,
scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT)
imaging. Age-similar normal eyes and an eye donated by donor 1's asymptomatic
mother (donor 4, family 1) were used as controls. The perifovea and peripheral
retina were processed for microscopy and immunocytochemistry with markers for
cone and rod photoreceptor cells. DNA analysis revealed EYS mutations
c.2259 + 1G > A and c.2620C > T (p.Q874X) in family 1, and c.4350_4356del
(p.I1451Pfs*3) and c.2739-?_3244 + ?del in family 2. Imaging studies revealed the
presence of bone spicule pigment in arRP donor retinas. Histology of all three
affected donor eyes showed very thin retinas with little evidence of stratified
nuclear layers in the periphery. In contrast, the perifovea displayed a prominent
inner nuclear layer. Immunocytochemistry analysis demonstrated advanced retinal
degenerative changes in all eyes, with near-total absence of rod photoreceptors. 
In addition, we found that the perifoveal cones were more preserved in retinas
from the donor with the midsize genomic rearrangement (c.4350_4356del
(p.I1451Pfs*3) and c.2739-?_3244 + ?del) than in retinas from the donors with the
truncating (c.2259 + 1G > A and c.2620C > T (p.Q874X) mutations. Advanced retinal
degenerative changes with near-total absence of rods and preservation of some
perifoveal cones are observed in arRP donor retinas with EYS mutations.

PMID: 25491159   [PubMed - as supplied by publisher]

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

Bimonthly injections of ranibizumab for age-related macular degeneration.

Ilhan A(1), Tas A, Yolcu U, Gundogan FC.

Author information: 
(1)Ophthalmology Department, Erzurum Military Hospital, Erzurum, Turkey,

PMID: 25488573   [PubMed - as supplied by publisher]

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

Repeatability of mesopic visual acuity measurements using high- and low-contrast 
ETDRS letter charts.

Barrio A(1), Antona B, Puell MC.

Author information: 
(1)Applied Vision Research Group, Faculty of Optics and Optometry, Complutense
University of Madrid, Av. Arcos de Jalón 118, 28037, Madrid, Spain,

PURPOSE: To determine the repeatability of mesopic high-contrast (HC) and
low-contrast (LC) visual acuity (VA) measurements made at distance and near in
healthy young individuals. While the repeatability of photopic VA is well-known, 
there is a lack of information with regard to the repeatability of VA measured
under low luminance conditions.
METHODS: In two different sessions 1 week apart, best-corrected monocular VA was 
determined using HC (96 %) and LC (10 %) ETDRS charts under mesopic luminance
conditions (0.75 cd/m(2)) at distance (HCD, LCD) and near (HCN, LCN) in 47
healthy subjects aged 22.9 ± 6.8 years. Repeatability was estimated by the Bland 
and Altman method, whereby the mean difference (MD) and the 95 % limits of
agreement were determined as the coefficient of repeatability (COR).
RESULTS: Mean logMAR VA values were HCD = 0.09, LCD = 0.44, HCN = 0.21, and LCN =
0.57. Mean differences in measurements between sessions 1 and 2 were not
significant, and low in clinical terms (≤1 letter). Repeatability was better for 
the distance measurements at both high and lowcontrast (COR HCD ±0.11 and COR LCD
±0.11 logMAR vs COR HCN ±0.15 and COR LCN ±0.16 logMAR), and MDs were also
slightly closer to zero for the distance measurements. Similar repeatability was 
observed between HC and LC VA, both at distance and near.
CONCLUSIONS: In mesopic conditions, ETDRS charts offer repeatable best-corrected 
monocular VA measurements. The criterion for a significant change in logMAR VA
was 1 line at distance and 1.5 lines at near.

PMID: 25488572   [PubMed - as supplied by publisher]

15. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 9. [Epub ahead of print]

Evaluation of filtering blebs exhibiting transconjunctival oozing using anterior 
segment optical coherence tomography.

Nakashima KI(1), Inoue T, Fukushima A, Hirakawa S, Kojima S, Tanihara H.

Author information: 
(1)Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University,
1-1-1 Honjo, Kumamoto, 860-8556, Japan.

PURPOSE: To explore the features of filtering blebs exhibiting transconjunctival 
oozing via three-dimensional anterior segment optical coherence tomography (3D
METHODS: In this cross-sectional study, 131 eyes of 131 patients exhibiting
filtering blebs were examined. Of those, 20 eyes were excluded as flat-shaped,
non-functioning bleb. Transconjunctival oozing was defined as transconjunctival
aqueous egress evident on the bleb surface, in the absence of any point leak
observable using a slit-lamp, as confirmed by application of digital pressure.
Total bleb height, the height of the fluid-filled cavity, and bleb wall thickness
and density were measured using 3D AS-OCT. Patient age, the etiology of glaucoma,
postoperative follow-up period, number of glaucoma medication classes prescribed,
intraocular pressure (IOP), grade of bleb vascularity, and bleb parameters were
compared in eyes with and without bleb oozing.
RESULTS: Sixty (54.0 %) of 111 eyes excluding non-functioning flat blebs
exhibited oozing; mean IOP value (11.7 ± 4.5 vs. 14.8 ± 4.0 mmHg) and bleb
vascularity grade (1.5 ± 0.7 vs. 2.4 ± 1.0) were lower than those of eyes without
oozing. Total bleb height (1.1 ± 0.4 vs. 0.9 ± 0.4 mm), bleb wall thickness
(0.7 ± 0.4 vs. 0.5 ± 0.3 mm), and bleb wall density (131.3 ± 45.7 vs.
180.9 ± 39.8 optical density units) differed significantly between the two groups
(oozing vs. non-oozing).
CONCLUSION: Transconjunctival oozing after trabeculectomy with MMC was associated
with a low IOP, low-level bleb vascularity, an elevated total bleb height, a
thicker bleb wall, and low bleb wall density.

PMID: 25488571   [PubMed - as supplied by publisher]

16. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 9. [Epub ahead of print]

Accommodative changes produced in response to overnight orthokeratology.

Felipe-Marquez G(1), Nombela-Palomo M, Cacho I, Nieto-Bona A.

Author information: 
(1)Department of Optics II (Optometry & Vision) Faculty of Optics & Optometry,
Complutense University of Madrid, Madrid, Spain,

BACKGROUND: To evaluate short-term (3 months) and long-term (3 years)
accommodative changes produced by overnight orthokeratology (OK).
METHODS: A prospective, longitudinal study on young adult subjects with low to
moderate myopia was carried out. A total of 93 patients took part in the study.
Out of these, 72 were enrolled into the short-term follow-up: 21 were on a
control group, 26 on a Paragon CRT contact lenses group, and 25 on a Seefree
contact lenses group. The other 21 patients were old CRT wearers on long-term
follow-up. Accommodative function was assessed by means of negative and positive 
relative accommodation (NRA / PRA), monocular accommodative amplitude (MAA),
accommodative lag, and monocular accommodative facility (MAF). These values were 
compared among the three short-term groups at the follow-up visit. The long- and 
short-term follow-up data was compared among the CRT groups.
RESULTS: Subjective accommodative results did not suffer any statistically
significant changes in any of the accommodative tests for any of the short-term
groups when compared to baseline. There were no statistically significant
differences between the three short-term groups at the follow-up visit. When
comparing the short- and long-term groups, only the NRA showed a significant
difference (p = 0.0006) among all the accommodation tests.
CONCLUSIONS: OK does not induce changes in the ocular accommodative function for 
either short-term or long-term periods.

PMID: 25488570   [PubMed - as supplied by publisher]

17. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 6. [Epub ahead of print]

Reply to the letter to the editor: bimonthly injections of ranibizumab for
age-related macular degeneration.

Sawada T(1), Ohji M.

Author information: 
(1)Department of Ophthalmology, Shiga University of Medical Science, Seta
Tsukinowacho, Otsu, Shiga, 520-2192, Japan,

PMID: 25480718   [PubMed - as supplied by publisher]

18. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 4. [Epub ahead of print]

Refractive and visual outcomes after combined cataract and trabectome surgery : A
report on the possible influences of combining cataract and trabectome surgery on
refractive and visual outcomes.

Luebke J(1), Boehringer D, Neuburger M, Anton A, Wecker T, Cakir B, Reinhard T,
Jordan JF.

Author information: 
(1)Eye Center, University of Freiburg im Breisgau, Killianstraße 5, 79106,
Freiburg, Germany,

PURPOSE: To compare combined trabectome-cataract surgery with cataract-alone
surgery regarding their refractive and visual outcomes and complications.
METHODS: In 137 eyes that underwent combined trabectome-cataract surgery, the
postoperative refraction error and best visual acuity after at least 2 months
postoperatively were compared to those of an in-house control group of 1,704 eyes
that underwent outpatient cataract surgery.
RESULTS: Combined trabectome-cataract surgery showed no significant differences
regarding the biometry prediction error (BPE, mean 0.53 D vs. 0.48 D, p = 0.24)
or visual outcome (BCVA, 0.81 vs. 0.78, p = 0.06). The rate of postoperative
cystoid macular edema was slightly higher in the combined surgery group (2.2 %
vs. 1.9 %).
CONCLUSIONS: Refractive and visual outcomes were similar in both groups. Despite 
the slightly higher rate of postoperative macula edema, we were able to observe
that the combination of these two procedures is a feasible method in glaucoma and
cataract surgeries.

PMID: 25471021   [PubMed - as supplied by publisher]

19. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 5. [Epub ahead of print]

EGFR inhibitor Gefitinib attenuates posterior capsule opacification in vitro and 
in the ex vivo human capsular bag model.

Wertheimer C(1), Siedlecki J, Kook D, Mayer WJ, Wolf A, Klingenstein A, Kampik A,
Eibl-Lindner K.

Author information: 
(1)Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrasse
8, 80336, Munich, Germany,

PURPOSE: Posterior capsule opacification (PCO) occurs as a common complication
after cataract surgery. Gefitinib is a selective inhibitor of the epidermal
growth factor receptor (EGFR) which represents a potential pharmacological target
for PCO prevention. In this in vitro study, we assessed the effect and
biocompatibility of Gefitinib in PCO prophylaxis.
METHODS: The effect of Gefitinib on the key pathological features of PCO was
assessed in vitro. We determined growth in the human capsular bag model, prepared
from sixteen cadaver eyes that underwent sham cataract surgery. Furthermore, two 
lens epithelial cell lines, HLE-B3 and FHL-124, were used to determine
concentration-based effects on cell proliferation. In addition, cell-migration,
matrix-contraction, and cell spreading were investigated. To exclude toxic
concentrations, Gefitinib was assessed for its biocompatibility on six different 
human ocular cell types from the anterior and posterior segment of the eye.
RESULTS: Gefitinib significantly increased the time until confluence of the
capsular bag compared to controls (p < 0.001)). In both human lens epithelial
cell lines (HLE-B3 and FHL-124), proliferation decreased significantly and as
equally strong after incubation with Gefitinib (p < 0.001), as did chemotactic
migration (p = 0.004), matrix contraction (p = 0.001), and cell-spreading
(p = 0.001). At the IC50 concentration, Gefitinib was well tolerated by six
different human ocular cell types of the anterior and posterior segment.
CONCLUSION: The specific EGFR inhibitor Gefitinib might become of clinical
relevance in PCO prophylaxis as it attenuated cellular growth and other
pathological PCO factors in the ex vivo human capsular bag model and in two human
lens epithelial cell lines, while showing good biocompatibility in vitro.

PMID: 25471020   [PubMed - as supplied by publisher]

20. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 4. [Epub ahead of print]

BAG3 protects against hyperthermic stress by modulating NF-κB and ERK activities 
in human retinoblastoma cells.

Yunoki T(1), Tabuchi Y, Hayashi A, Kondo T.

Author information: 
(1)Department of Radiological Sciences, Graduate School of Medicine and
Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194,

PURPOSE: BCL2-associated athanogene 3 (BAG3), a co-chaperone of HSP70, is a
cytoprotective and anti-apoptotic protein that acts against various stresses,
including heat stress. Here, we examined the effect of BAG3 on the sensitivity of
human retinoblastoma cells to hyperthermia (HT).
METHODS: We examined the effects of BAG3 knockdown on the sensitivity of Y79 and 
WERI-Rb-1cells to HT (44 °C, 1 h) by evaluating apoptosis and cell proliferation 
using western blotting, real-time quantitative PCR (qPCR), flow cytometry, and a 
WST-8 assay kit. Furthermore, we examined the effects of activating nuclear
factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK) using
western blotting and real time qPCR.
RESULTS: HT induced considerable apoptosis along with the activation of caspase-3
and chromatin condensation. The sensitivity of Y79 and WERI-Rb-1 cells to HT was 
significantly enhanced by BAG3 knockdown. Compared to HT alone, the combination
of BAG3 knockdown and HT reduced phosphorylation of the inhibitors of kappa B α
(IκBα) and p65, a subunit of NF-κB, and degraded IκB kinase γ (IKKγ) during the
recovery period after HT. Furthermore, BAG3 knockdown increased the HT-induced
phosphorylation of ERK after HT treatment, and the ERK inhibitor U0126
significantly improved the viability of the cells treated with a combination of
BAG3 knockdown and HT.
CONCLUSIONS: The silencing of BAG3 seems to enhance the effects of HT, at least
in part, by maintaining HT-induced inactivity of NF-κB and the phosphorylation of
ERK. These findings indicate that BAG3 may be a potential molecular target for
modifying the outcomes of HT in retinoblastoma.

PMID: 25471019   [PubMed - as supplied by publisher]

21. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 4. [Epub ahead of print]

It is time to bring retinopathy of prematurity monitoring into the 21st century.

Trese MT(1).

Author information: 
(1), 3535 W. 13 Mile Road, Suite 344, Royal Oak, MI, 48073, USA,

PMID: 25471018   [PubMed - as supplied by publisher]

22. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 3. [Epub ahead of print]

Evaluation of the retinal, choroidal, and nerve fiber layer thickness changes in 
patients with toxic anterior segment syndrome.

Sorkin N(1), Goldenberg D, Rosenblatt A, Shemesh G.

Author information: 
(1)Department of Ophthalmology, Tel Aviv Medical Center and the Sackler Faculty
of Medicine, Tel Aviv University, 6 Weizmann Street, Tel Aviv, 6423906, Israel,

PURPOSE: To evaluate changes in choroidal, retinal, and nerve fiber layer (NFL)
thickness following toxic anterior segment syndrome (TASS).
METHODS: Macular and peripapillary choroidal thickness was measured using
enhanced depth imaging (EDI) optical coherence tomography (OCT) on the day of the
diagnosis and on three follow-up exams (months 1 to 4). A similar OCT analysis of
central retinal and NFL thickness was performed.
RESULTS: Thirteen TASS patients were included. Average age was 72.8 ± 8.7 years. 
Macular choroidal thickness in the superior, subfoveal, and nasal macula in the
study eye was larger than the control eye and decreased at months 2-4. This was
statistically significant only for the superior macula (p = 0.004). Peripapillary
choroidal thickness was larger in the study eye at baseline compared with the
control eye-significantly so in the nasal (p = 0.026) and inferior (p = 0.033)
locations. Peripapillary choroidal thickness peaked at the baseline or 1st month 
exam and decreased thereafter. Retinal thickness increased significantly with
time, peaking at the 2nd month and decreasing thereafter. No changes were found
in the NFL.
CONCLUSIONS: TASS may have a transient effect on the choroid. Changes in retinal 
thickness are probably a normal transient postoperative response and not a result
of TASS.

PMID: 25467759   [PubMed - as supplied by publisher]

23. Graefes Arch Clin Exp Ophthalmol. 2014 Dec 3. [Epub ahead of print]

Identification and biometry of horizontal extraocular muscle tendons using
optical coherence tomography.

Salcedo-Villanueva G(1), Paciuc-Beja M, Harasawa M, Velez-Montoya R, Olson JL,
Oliver SC, Mandava N, Quiroz-Mercado H.

Author information: 
(1)Denver Health Medical Center, 777 Bannock Street, Denver, CO, 80204, USA,

PURPOSE: To purpose if this study was to determine whether the horizontal rectus 
muscle tendons (HRMTs) can be observed using anterior segment optical coherence
tomography (AS-OCT) and to determine the repeatability of its measurements. Also,
this study aimed to observe and measure the different external ocular structures 
at the level of the horizontal rectus muscle (HRM) insertion.
METHODS: This was a retrospective, observational, descriptive and comparative
study. Images were obtained utilizing the RTVue 100 CAM system. Eyes were
analyzed at the three and nine o'clock position. Scans were performed for three
different locations: the limbus, the ciliary body and the equator. All scans were
analyzed by two graders, separately and blinded. Measurements were performed for:
HRMT length; HRM thickness; conjunctival epithelium thickness; conjunctiva and
Tenon's capsule thickness; scleral thickness; and external ocular thickness.
RESULTS: Results were obtained from twenty eyes of ten volunteers. The
conjunctival epithelium thickness was 52.33 μm, the total conjunctiva/Tenon's
capsule thickness was 313.54 μm, the medial rectus (MR) thickness was 136.63 μm
and the lateral rectus (LR) thickness was 181.65 μm. The MR tendon length was
1,426.88 μm, the LR tendon length was 1,433.65 μm, the scleral thickness was
489.91 μm and the total external ocular structure thickness was 785.17 μm.
Intra-observer reproducibility (intraclass correlation coefficient [ICC]) for
tendon length was 0.993 for grader #1, 0.989 for grader #2; the muscle thickness 
ICC was 0.990 for grader #1 and 0.981 for grader #2. The inter-observer
reproducibility ICC for tendon length was 0.557; the ICC for muscle thickness was
CONCLUSIONS: It is possible to visualize and measure HRMTs using AS-OCT.
Measurements of the HRM, as well as the surrounding external ocular tissues, can 
be achieved.

PMID: 25467758   [PubMed - as supplied by publisher]

24. Graefes Arch Clin Exp Ophthalmol. 2014 Nov 30. [Epub ahead of print]

Statins in rhegmatogenous retinal detachment are associated with low intravitreal
angiopoietin-2, VEGF and MMP-2 levels, and improved visual acuity gain in
vitrectomized patients.

Tuuminen R(1), Haukka J, Loukovaara S.

Author information: 
(1)Department of Ophthalmology, Helsinki University Central Hospital,
Haartmaninkatu 4 C, FI-00290, Helsinki, Finland.

PURPOSE: In rhegmatogenous retinal detachment (RRD), intravitreal growth factors 
and cytokines may compromise post-vitrectomy outcomes. Here, we analysed
perioperative intravitreal protein levels of potent vasoactive, pro-inflammatory,
and extracellular matrix-remodelling factors in RRD eyes of patients treated with
statins and evaluated post-vitrectomy outcome in the same study eyes.
METHODS: Institutional, retrospective, observational study of 14 patients
operated on for RRD while on statins compared to patients without statin
medication (n = 82). Vitreous samples were subjected to protein measurements of
angiopoietin (ANGPT)-1 and -2, transforming growth factor-β1, and vascular
endothelial growth factor (VEGF) by ELISA, and of matrix metalloproteinase
(MMP)-2 and -9 by gelatin zymography. A 1-month best-corrected visual acuity
(BCVA) gain was modelled by Student's T-test and multivariate linear regression
with concomitant perioperative medication. Cumulative 12-month revitrectomy
frequency was modelled by Kaplan-Meier log-rank test.
RESULTS: Intravitreal levels of ANGPT-2 (49.2 ± 33.1 vs. 112.8 ± 134.1 pg/ml,
mean ± SD, p < 0.001), VEGF (2.3 ± 2.4 vs. 17.7 ± 57.8 pg/ml, p = 0.021), and
MMP-2 (1107.1 ± 884.6 vs 1976.4 ± 970.1 AU/ml, p = 0.005) in RRD eyes of patients
treated with statins were lower than in non-statin-treated controls. Patients on 
statins had better 1-month BCVA improvement than did those not on statins
(p = 0.022), with no difference in 1-year re-vitrectomy rates.
CONCLUSIONS: Intravitreal levels of ANGPT-2, VEGF, factors involved in vascular
permeability and inflammation, and activity of MMP-2, the factor connected with
breakdown of basement membrane and fibroproliferation, were lower in RRD eyes of 
patients with statin treatment. At 1-month, postoperative BCVA gain was improved 
in statin-treated RRD eyes, suggesting that statin administration may be
effective in preventing inflammation-related PVR formation.

PMID: 25432094   [PubMed - as supplied by publisher]

25. Graefes Arch Clin Exp Ophthalmol. 2014 Nov 30. [Epub ahead of print]

Visual field changes following implantation of the Argus II retinal prosthesis.

Rizzo S(1), Belting C, Cinelli L, Allegrini L.

Author information: 
(1)Unità Operativa Chirurgia Oftalmica, Azienda Ospedaliero-Universitaria Pisana,
Via Paradisa 2, 56124, Pisa, Italy,

PMID: 25432093   [PubMed - as supplied by publisher]

26. Graefes Arch Clin Exp Ophthalmol. 2014 Nov 25. [Epub ahead of print]

Erratum to: The clinical characteristics of alcohol-related ocular rupture.

Jian-Wei L(1), Zhen-Bo H, Shu-Na W, Yu-Guang Z, Ai-Jun D.

Author information: 
(1)Department of Ophthalmology, Affiliated Hospital of Weifang Medical
University, Yu-He Street 2428, Weifang, 261031, Shandong Province, China,

PMID: 25418037   [PubMed - as supplied by publisher]

27. Graefes Arch Clin Exp Ophthalmol. 2014 Nov 25. [Epub ahead of print]

Quantifying silicone oil emulsification in patients: are we only seeing the tip
of the iceberg?

Chan YK(1), Cheung N, Chan WS, Wong D.

Author information: 
(1)Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of
Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam,
Hong Kong.

PURPOSE: Emulsification of silicone oil in the eye is a difficult problem. In an 
effort to find an objective way to quantify emulsification, we used the Coulter
principle to measure silicone oil emulsified droplets from the washings of a
series of patients.
METHODS: Aqueous washouts after silicone oil removal were obtained from nine
patients (nine eyes). We used the Coulter counter Multisizer® 4 to obtain the
size distribution of the oil droplets.
RESULTS: Over 65 % of the emulsified silicone oil droplets in the clinical
samples had a diameter smaller than is detectable by light microscopy (2 μm). The
median size of the droplets was between 1.1 and 1.9 μm. Based on the Spearman's
correlation coefficient (r), there was a strong correlation between the number of
the droplets that cannot be seen (between 1 and 2 μm) and those that can be seen 
(7-30 μm) (r = 0.817, p = 0.007).
CONCLUSION: Once emulsification was detected clinically in the anterior chamber, 
extensive emulsification would have already occurred in the posterior chamber,
with most of the emulsified droplets that were too small in size to be seen on
clinical examination. Ostwald ripening might explain why there were so many small
droplets. The predominance of small droplets might account for some of the
clinical complications associated with silicone oil use.

PMID: 25418036   [PubMed - as supplied by publisher]

28. Graefes Arch Clin Exp Ophthalmol. 2014 Nov 25. [Epub ahead of print]

A pilot study on total, corneal, and internal aberrations in insulin-dependent
and non-insulin-dependent diabetes mellitus patients.

Calvo-Maroto AM(1), Pérez-Cambrodí RJ, García-Lázaro S, Albarrán-Diego C, Cerviño

Author information: 
(1)Optometry Research Group, Department of Optics, University of Valencia, Dr.
Moliner 50, 46100, Burjassot, Valencia, Spain.

PURPOSE: To explore the distribution of total, corneal, and internal higher-order
aberrations (HOAs) in both insulin-dependent (IDDM) and non-insulin-dependent
(NIDDM) diabetic patients.
METHODS: Pilot study including seven patients with IDDM (14 eyes) and 11 patients
with NIDDM (22 eyes). Ocular HOAs were examined using ray tracing aberrometry
(i-Trace, Tracey Technologies Corp., Houston, TX) and the measurements of
anterior segment using Scheimpflug imaging (Pentacam, Oculus Inc. Germany).
RESULTS: Total HOAs was slightly higher in IDDM (0.634 ± 0.228 μm, 95%
IC ± 0.131) than in NIDDM patients (0.527 ± 0.245 μm, 95% IC ± 0.108)
(p = 0.267). The greatest contributor for total ocular HOAs was internal vertical
coma (Z3 (- 1)) for both diabetic groups. In NIDDM, age and central corneal
thickness (CCT) were correlated with total HOAs (p < 0.001, p = 0.0180
respectively); however, anterior chamber volume (ACV) was inversely correlated
with total HOAs (p = 0.019). In IDDM, total HOAs were correlated with posterior
asphericity (Q) (p = 0.002) and inversely correlated with ageing (p = 0.013).
CONCLUSIONS: Diabetic patients showed high values of total and internal vertical 
coma (Z3 (- 1)). There might be a role for optical quality measurements in
monitoring changes due to DM.

PMID: 25418035   [PubMed - as supplied by publisher]

29. Graefes Arch Clin Exp Ophthalmol. 2014 Nov 25. [Epub ahead of print]

Subretinal injection of recombinant tissue plasminogen activator for submacular
hemorrhage associated with ruptured retinal arterial macroaneurysm.

Inoue M(1), Shiraga F, Shirakata Y, Morizane Y, Kimura S, Hirakata A.

Author information: 
(1)Kryorin Eye Center, Kryorin University School of Medicine, 6-20-2 Shinkawa,
Mitaka, Tokyo, 181-8611, Japan,

PURPOSE: To evaluate the surgical outcomes of small-gauge vitrectomy with
subretinal injection of recombinant tissue plasminogen activator (rt-PA) for a
submacular hemorrhage caused by a ruptured retinal arterial macroaneurysm (RAM).
METHODS: Non-comparative, consecutive case-series performed at two
ophthalmological institutions. We examined 22 eyes of 22 patients with a
submacular hemorrhage associated with a RAM but without a preretinal or
sub-internal limiting membrane hemorrhage at the fovea. During 25-gauge
vitrectomy, approximately 4000-8000 IU of rt-PA was injected subretinally,
followed by the injection of air or 10 % sulfur hexafluoride as a tamponade. The 
patients maintained an upright position for 1 hour, then turned to a facedown
position for 1 to 3 days. The best-corrected visual acuity (BCVA) and
postoperative complications were evaluated.
RESULTS: The average interval from the onset of symptoms to surgery was
8.4 ± 7.6 days, and the average size of the subretinal hemorrhage was 3.4 ± 1.0
disc diameters. The submacular hemorrhage was displaced from the foveal area in
all eyes after 1 week. The mean baseline BCVA was 1.41 ± 0.41 logMAR units, and
it improved to 0.91 ± 0.43 at 1 month and to 0.64 ± 0.45 at the final visit
(P = 0.0001, P < 0.0001 respectively). A macular hole was detected
intraoperatively in two eyes and postoperatively in two eyes, and both were
closed by internal limiting membrane peeling or a second vitrectomy.
CONCLUSIONS: Small-gauge vitrectomy with subretinal rt-PA injection and gas
tamponade were effective in displacing a submacular hemorrhage associated with a 

PMID: 25418034   [PubMed - as supplied by publisher]

30. Graefes Arch Clin Exp Ophthalmol. 2014 Nov 21. [Epub ahead of print]

Aggressive posterior retinopathy of prematurity: a pilot study of quantitative
analysis of vascular features.

Woo R(1), Chan RV, Vinekar A, Chiang MF.

Author information: 
(1)Department of Ophthalmology, Jules Stein Eye Institute, University of
California, Los Angeles, Los Angeles, CA, USA.

PURPOSE: To evaluate aggressive posterior retinopathy of prematurity (AP-ROP)
with regard to inter-expert diagnostic agreement and quantitative vascular
METHODS: Eight ROP experts interpreted 15 retinal images for AP-ROP and plus
disease. Inter-expert agreement was calculated by absolute agreement for AP-ROP
and plus, and kappa statistic for each expert was compared with others. Retinal
vessels were analyzed by a computer-based system to calculate diameter and
integrated curvature (IC). Consensus reference standards for images were
developed, and quantitative parameters for arterioles and venules were compared
among images with AP-ROP vs. not AP-ROP, plus vs. not plus, and AP-ROP vs. plus.
RESULTS: Mean kappa for each expert in AP-ROP diagnosis ranged from -0.15 (no
agreement) to 0.42 (moderate agreement). Nine (30 %) of 30 total AP-ROP diagnoses
were also classified as not plus disease. Analysis of images with AP-ROP vs. plus
showed that images with AP-ROP had higher venular IC (p = 0.04). Arteriolar IC
was statistically significant between images with AP-ROP vs. not AP-ROP
(p = 0.01) and plus vs. not plus (p = 0.00003). There were no statistically
significant differences in diameter between image groups.
CONCLUSIONS: Inter-expert agreement with regard to AP-ROP diagnosis is imperfect.
Venular curvature may be a distinguishing characteristic between AP-ROP and plus.
Future studies involving quantitative features of AP-ROP will have benefits for
clinical diagnosis and management.

PMID: 25413261   [PubMed - as supplied by publisher]