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 Oct 15. [Epub ahead of print]

Evolution of vitreomacular adhesion to acute vitreofoveal separation with special
emphasis on a traction-induced foveal pathology. A prospective study of
spectral-domain optical coherence tomography.

Theodossiadis GP(1), Chatziralli IP, Sergentanis TN, Datseris I, Theodossiadis

Author information: 
(1)2nd Department of Ophthalmology, Henry Dunant Hospital, 13 Lykiou street, 10674, 
Athens, Greece,

PURPOSE: To investigate the evolution of vitreomacular adhesion (VMA) to acute
vitreofoveal separation with particular emphasis on cases involving the
underlying fovea.
METHODS: In this observational case series, of 192 cases in the VMA stage, 51
progressed to acute vitreofoveal separation; this subgroup was divided into those
with normal separation (Group I) and those with co-existing macular findings
(Group II). All patients were examined using spectral domain-optical coherence
tomography (SD-OCT) at regular three-month intervals. We recorded the
best-corrected visual acuity (BCVA), the vitreomacular angle of the VMA (nasally 
and temporally), the horizontal diameter of the VMA, the macular thickness, the
integrity of the photoreceptor layer and of the external limiting membrane. The
Amsler grid test was used in the intermediate examinations in cases where
patients developed symptoms.
RESULTS: Out of the 51 cases in the VMA stage, 45 (88.2%) progressed to normal
spontaneous vitreofoveal separation, while six (11.8%) developed findings of the 
fovea, such as macular thinning (two cases), an anomalous foveal contour (two
cases), a macular tissue defect (one case) and vitreous separation from only the 
temporal side of the VMA in one case. Foveal findings were the same during the
follow-up period in all but one case in which improvement was noted. Differences 
in BCVA between baseline measurements, those made immediately after vitreofoveal 
separation, and those made during final examination were not statistically
significant. For the whole sample of our study (51 cases), the mean observation
time at the VMA stage was 21.8 ±10.6 months, while the mean follow-up time after 
vitreofoveal separation was 9.7 ±4.9 months. In cases that developed incidents
from the fovea, the mean observation time from the baseline to the last
examination before vitreofoveal separation was 16.5 ±11.2 months and the mean
follow-up time from the diagnosis of vitreofoveal separation to the final
examination was 8.5 ±4.4 months.
CONCLUSIONS: VMA, excepting its progression to vitreomacular traction or
spontaneous release, in a subset of patients can also cause findings associated
with the fovea, concomitantly with vitreofoveal separation. Vitreofoveal
separation can induce unilateral anatomic distortion of the fovea accompanied by 
symptoms, such as metamorphopsia or micropsia.

PMID: 25315850   [PubMed - as supplied by publisher]

2. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 15. [Epub ahead of print]

Late surgical complications to endophthalmitis after cataract surgery in the
post-EVS era.

Solborg Bjerrum S(1), Kiilgaard JF, La Cour M.

Author information: 
(1)Department of Ophthalmology, Glostrup University Hospital, Nordre Ringvej 57,
2600, Glostrup, Denmark,

BACKGROUND: To compare the risk of surgical complications after primary surgical 
intervention for postoperative endophthalmitis after cataract surgery (PE) in
cases that underwent a pars plana vitrectomy (PPV) or a vitreous tap (VT) in
Denmark in the calendar period 1 January 2000 to 30 June 2011.
METHODS: Retrospective, register- and chart-based study.
RESULTS: A total of 121 PE cases were identified and followed up to 12.8 years.
The overall risk of surgical complications in PE cases that underwent a PPV and a
VT was 24.2 and 36.7 %, respectively. This difference was non-statistically
significant (p = 0.18). In all, 9.9 % of the PE cases had more than one surgical 
complication, and 97 % of the primary surgical complications occurred within the 
first 5 months. There was no statistically significant difference in the risk of 
retinal detachment (p = 0.45), surgery for PE (p = 0.22), intraocular lens
removal (p = 0.19), or removal of the eye (p = 0.69) between the two groups. PE
cases that underwent a VT had a statistically significantly higher risk of
surgery for vitreous opacities (p = 0.047) compared to a PPV.
CONCLUSIONS: In all, 27.3 % of all cases developed a surgical complication after 
primary surgical intervention for PE. If a PE case did not have a surgical
complication within the first 5 months, it was highly unlikely that a new
surgical complication would occur. A VT was not associated with a statistically
significantly higher overall risk of surgical complications compared to a PPV.

PMID: 25315849   [PubMed - as supplied by publisher]

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

Concurrent presentation of corneal dystrophy and tilted disc syndrome: report of 
two cases.

Choi SY(1), Yum HR, Lee YC, Park SH.

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

PMID: 25311655   [PubMed - as supplied by publisher]

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

Determinants of anterior chamber angle narrowing after mydriasis in the patients 
with cataract.

Arimura S(1), Takamura Y, Takihara Y, Matsumura T, Tomomatsu T, Inatani M.

Author information: 
(1)Department of Ophthalmology, Faculty of Medical Science, University of Fukui,
23-3, Shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan.

PURPOSE: To identify the determinants of anterior chamber angle narrowing after
mydriasis by quantitative assessment of the anterior chamber components using
anterior segment optical coherence tomography (AS-OCT).
METHODS: In this intervention study, anterior chamber angle analysis was
performed using AS-OCT in patients with cataract before pharmacological pupillary
dilation and 30 min afterwards. Angle narrowing was quantified by the change of
angle opening distance 500 after mydriasis (ΔAOD500). Multivariate linear
regression and stepwise selection regression were used to identify which
parameters in AS-OCT significantly determined ΔAOD500.
RESULTS: One hundred and two Japanese patients (age, mean ± standard deviation,
71.9 ± 11.2 years) were enrolled. Multivariate analysis indicated that smaller
ΔAOD500 were significantly associated with larger lens vault (LV; P < 0.001),
larger iris area (IA; P = 0.003), and posterior corneal arch distance (PCAL;
P = 0.01). Stepwise linear regression analysis revealed that smaller ΔAOD500 was 
independently associated with larger LV (partial R (2) = 0.232, P < 0.001),
larger IA (partial R (2) = 0.080, P = 0.001), and smaller PCAL (partial R
(2) = 0.066, P = 0.002) before mydriasis. These three factors explained 37.7 % of
the decrease in ΔAOD500.
CONCLUSION: Larger LV, larger IA, and smaller PCAL contribute considerably to
anterior chamber angle narrowing after mydriasis in patients with cataract.

PMID: 25311654   [PubMed - as supplied by publisher]

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

Level of vitreous alpha-B crystallin in eyes with rhegmatogenous retinal

Baba T(1), Oshitari T, Yamamoto S.

Author information: 
(1)Department of Ophthalmology and Visual Science, Chiba University Graduate School 
of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-0856, Japan,

PURPOSE: Alpha-B crystallin (αB-crystallin) is a molecular chaperone, and one of 
the small heat shock proteins (sHSPs). αB-crystallin has been shown to have
neuroprotective properties. The purpose of this study was to determine the level 
of αB-crystallin in eyes with a rhegmatogenous retinal detachment (RRD).
METHODS: Vitreous samples were collected before vitrectomy from 32 eyes of 32
consecutive patients with RRD. The concentration of αB-crystallin was measured by
enzyme-linked immunosorbent assay (ELISA). Vitreous samples were also collected
before vitrectomy from 16 patients with an idiopathic macular hole and epiretinal
membrane, and used as controls.
RESULTS: The mean age was 56 years (range, 31-67 years) in the RRD cases and
66 years (range, 49-77 years) in the controls. The mean level of αB-crystallin
was significantly higher in the RRD cases (36.7 ± 37.4 ng/ml) than that in
controls (8.5 ± 12.2 ng/ml; P = 0.0028).
CONCLUSIONS: The increased level of αB-crystallin suggests that αB-crystallin may
play a neuroprotective role by lessening retinal cell death after a retinal

PMID: 25311653   [PubMed - as supplied by publisher]

6. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 14. [Epub ahead of print]

Aging and corneal layers: an in vivo corneal confocal microscopy study.

Gambato C(1), Longhin E, Catania AG, Lazzarini D, Parrozzani R, Midena E.

Author information: 
(1)Department of Ophthalmology, University of Padova, via Giustiniani 2, Padova,
35128, Italy.

PURPOSE: To describe age-related changes of different corneal layers using a
quantitative analysis of in vivo corneal confocal microscopy.
DESIGN: Descriptive observational cross-sectional study.
METHODS: A total of 108 healthy corneas of 108 subjects, distributed in four age 
categories, underwent in vivo corneal confocal microscopy. The effect of aging on
the main features of corneal epithelium, sub-basal nerve plexus, stroma, and
endothelium was investigated.
RESULTS: Mean diameter of superficial epithelial cells increases with age
(0.05 μm per year; p < 0.0001). Mean cell density of basal epithelium does not
change with age (p = 0.37). The sub-basal nerve plexus fiber number, density, and
the number of beadings do not statistically change with age (p = 0.14, p = 0.10
and p = 0.17, respectively). Keratocyte density significantly reduces with age in
each stromal layer (p < 0.0001). Endothelial cell count decreases by 10.92
cells/mm(2) per year (p < 0.0001). Endothelial polymegathism index and
pleomorphism index do not change with age (p = 0.79 and p = 0.39, respectively).
CONCLUSIONS: Corneal confocal microscopy allows a non-invasive examination of the
living cornea, analyzing the microstructure of each corneal layer. Aging
significantly influences the corneal confocal microscopy parameters of individual
corneal layers, except sub-basal nerve plexus and basal epithelium.

PMID: 25311652   [PubMed - as supplied by publisher]

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

Macular response to supplementation with differing xanthophyll formulations in
subjects with and without age-related macular degeneration.

Thurnham DI(1), Nolan JM, Howard AN, Beatty S.

Author information: 
(1)Northern Ireland Centre for Food and Health (NICHE), University of Ulster,
Coleraine, UK,

PURPOSE: Our aim was to investigate the macular response to three different
supplements containing lutein (L), zeaxanthin (Z) and meso-zeaxanthin (MZ) in
normal subjects and those with age-related macular degeneration (AMD).
MATERIALS AND METHODS: Macular pigment optical density (MPOD) and serum
xanthophyll concentrations were measured in normal (n = 31) and AMD subjects
(n = 32), randomly assigned to: group 1 (20 mg L, 2 mg Z, 0.3 mg MZ), group 2
(10 mg L, 2 mg Z, 10 mg MZ) or group 3 (3 mg L, 2 mg Z, 17 mg MZ). MPOD was
measured at baseline, 2, 4, 6 and 8 weeks and at 0.25°, 0.5°, 1.0° and 1.75° of
eccentricity using customised heterochromatic flicker photometry and serum
xanthophylls by HPLC.
RESULTS: MPOD increased significantly at all eccentricities in each group
(p < 0.05), except at 1.75° in group 3 (p = 0.242). There was no difference in
MPOD measurements between AMD and normal subjects, except for group 2, where AMD 
subjects exhibited a greater response at 1.75° (p = 0.012). Final serum
concentrations of MZ were positively and significantly related to final MPOD
values at each eccentricity in all subjects. Targeted analysis of those subjects 
receiving the MZ-containing supplements exhibited stronger relationships between 
serum MZ concentrations and MPOD at 0.25° in group 3 than group 2; in group 2 all
associations were positive, but only significant at 1.75°.
CONCLUSIONS: Serum concentrations of MZ were strongly correlated with MPOD after 
8 weeks of supplementation with the group 3 formulation, but the inclusion of L
in the group 2 formulation may result in greater MPOD augmentation across the
spatial profile.

PMID: 25311651   [PubMed - as supplied by publisher]

8. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 14. [Epub ahead of print]

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,

PURPOSE: To evaluate the characteristics and outcomes of drunken patients treated
for ocular rupture, and to compare these results to patients injured without
alcohol consumption.
DESIGN AND METHODS: The medical records of 182 patients with or without alcohol
consumption before injury who were treated and followed up because of ocular
rupture at the Affiliated Hospital of Weifang Medical University from October
2007 to October 2011 were evaluated retrospectively. The characteristics and
outcomes of 45 alcohol-related injury patients were compared with the rest in the
cohort. The clinical data included in this study were: anatomic sites and length 
of the wound, involvement of ocular adnexa injuries, evisceration rate, and final
mean visual acuity.
RESULTS: Wound locations were significantly different between the alcohol-related
group and the non-alcohol-related one. Compared with the non-alcohol-related
ocular rupture population, the anatomic sites of the drunken patients were more
likely to be located at zone I and zone II (60.0 vs 40.1 %; χ2 = 5.39,P < 0.05). 
The difference of wound length between the alcohol-related group and the
non-alcohol-related one was significant. The alcohol-related patients had a
longer wound length (Z = -8.590,P < 0.05). Compared with the non-alcohol
population, the alcohol-consuming patients were more likely to suffer adnexa
injuries (84.4 vs 59.8 %; χ2 = 5.86,P < 0.05), and had worse final visual
acuities (Z = -7.195,P < 0.05). The evisceration rate of the alcohol-related
patients was significantly higher than the non-alcohol patients (24.4 vs 9.4 %;
χ2 = 6.62,P < 0.05).
CONCLUSIONS: Drinking more easily leads to injury of the front part of eyes.
Moreover, the drunken patients had a worse visual acuity outcome, longer wound
length, higher evisceration rate, and were more prone to endure adnexa injuries. 
The importance of prevention and education to recognize the hazards of drinking
cannot be overemphasized.

PMID: 25311650   [PubMed - as supplied by publisher]

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

Short-term fluctuation of intraocular pressure is higher in patients with
pseudoexfoliation syndrome despite similar mean intraocular pressure: a
retrospective case-control study.

Huchzermeyer C(1), Horn F, Lämmer R, Mardin CY, Jünemann AG.

Author information: 
(1)Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nuremberg,
Schwabachanlage 6, Erlangen, 91054, Germany,

PURPOSE: Higher levels of short-term fluctuation of intraocular pressure (IOP)
are characteristic of pseudoexfoliation syndrome (PEX). However, it is not known 
whether they are just a side effect of the higher mean intraocular pressure (IOP)
or an independent feature. The purpose of this study was to compare short-term
fluctuation of IOP between eyes with PEX and control eyes that were matched as
closely as possible for mean IOP.
METHODS: In this retrospective case-control study, all patients with confirmed
PEX were identified from the database of the Erlangen Glaucoma Registry. From the
same database, matched control eyes with similar treatment, age, glaucoma stage, 
and mean IOP were identified. For each patient, data from multiple extended
diurnal IOP profiles were available.
RESULTS: Seventy-eight eyes were included in the study (39 with PEX and 39
matched control eyes). Although a very close match was achieved, a small but
statistically significant difference in mean IOP was still present, but this did 
not seem to explain the differences in IOP fluctuation levels. Eyes with PEX had 
significantly higher short-term IOP fluctuations (SD of IOP and range of IOP).
CONCLUSIONS: The higher levels of short-term fluctuation in IOP appear to be an
independent feature of PEX and not merely a secondary effect of the higher mean
IOP. We suggest that this may have practical implications, even if IOP
fluctuation levels should not prove to be an independent risk factor for
development/progression of glaucoma, because more frequent measurements are
needed in these patients to obtain good estimates of mean IOP and changes in IOP 
under treatment.

PMID: 25308782   [PubMed - as supplied by publisher]

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

Diagnosis of subretinal neovascularization associated with idiopathic juxtafoveal
retinal telangiectasia - fluorescein angiography versus spectral-domain optical
coherence tomography - can we choose?

Singh S(1), Agarwal M, Venkatesh R, Mayor R.

Author information: 
(1)Dr Shroff's Charity Eye Hospital, Vitreo-Retina services, 5027, Kedarnath Road,
Daryaganj, New Delhi, 110002, India,

PMID: 25308781   [PubMed - as supplied by publisher]

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

Twin-twin transfusion syndrome as a possible risk factor for the development of
retinopathy of prematurity.

Gschließer A(1), Stifter E, Neumayer T, Moser E, Papp A, Dorner G,
Schmidt-Erfurth U.

Author information: 
(1)Department of Ophthalmology, Medical University of Vienna, Währinger Gürtel
18-20, 1090, Vienna, Austria.

PURPOSE: The objective of this study was to evaluate the correlation between
twin-twin transfusion syndrome (TTTS) and the development of retinopathy of
prematurity (ROP) in premature infants.
METHODS: Fifty-one infants who were less than 32 postmenstrual gestational weeks 
at birth or with a birth weight less than 1,501grams were included in this
longitudinal observational study. The infants were matched by gestational age and
birth weight, and divided into three groups: multiples with TTTS, multiples
without TTTS, and singletons. The primary outcome variable was the incidence of
ROP in infants affected by TTTS versus infants not affected by TTTS. Secondary
outcome variables were multiple pregnancy, gestational age, and birth weight.
RESULTS: Infants affected by TTTS showed a significantly higher incidence of ROP 
than infants not affected by TTTS (p < 0.01). TTTS donors and TTTS recipients
were both at greater risk of developing ROP. ROP occurred in infants with TTTS
whose gestational age at birth was significantly higher than that of infants with
ROP who were not affected by TTTS (p = 0.01). Multiple pregnancy itself was not a
risk factor for ROP disease.
CONCLUSIONS: Infants affected by TTTS during pregnancy are at high risk of
developing ROP, even if they were born at an older gestational age. Special
awareness in ROP screening is necessary for these infants.

PMID: 25303884   [PubMed - as supplied by publisher]

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

Long-term outcomes of needle revision of failing deep sclerectomy blebs.

Koukkoulli A(1), Musa F, Anand N.

Author information: 
(1)Department of Ophthalmology, FRCOphth, Royal Free Hospital, Pond Street, NW3 2QG,
London, UK,

PURPOSE: To report on long-term outcomes of mitomycin C (MMC)-augmented needle
revision of failing deep sclerectomy (DS) blebs.
METHODS: Retrospective database search of all needle revisions with MMC for DS
blebs between 2002 and 2008 was conducted. Sixty-six eyes of 66 patients were
included in the study. Subconjunctival MMC 0.01-0.02 mg was injected 15 min
before needle revision. Complete success was defined as intraocular
pressure ≤ 18 mmHg or 20 % decrease from baseline with no glaucoma medications or
further surgical procedures. Partial success was based on the same criteria, but 
with medications.
RESULTS: Mean follow-up after index needle revision was 67.8 ± 24.8 months (range
1-10 years). The mean number of needle revisions was 1.6 ± 0.8 (range 1-4). Two
or more procedures were done in 31 eyes (47.0 %). Mean preoperative intraocular
pressure was 23.2 ± 6.9 mmHg. Complete and partial success rates were 64 % and
71 % at 1 year, 57 % and 68 % at 3 years, and 40 % and 58 % at 5 years after
surgery, respectively. Early needle revision, within 6 months of index surgery,
was significantly associated with failure, both on uni- and multivariate tests.
Significant complications included delayed hypotony in five eyes (7.6 %), delayed
bleb leak in two eyes (3.0 %), endophthalmitis in one eye (1.5 %), and corneal
oedema in two eyes (3.0 %).
CONCLUSIONS: Needle revision with subconjunctival MMC may successfully lower the 
intraocular pressure in eyes with a failing DS bleb in the long term.
Complications known to be associated with trabeculectomy and MMC were anticipated
and observed in our DS group.

PMID: 25303883   [PubMed - as supplied by publisher]

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

Effects of antioxidant gene therapy on the development of diabetic retinopathy
and the metabolic memory phenomenon.

Zhang L(1), Xia H, Han Q, Chen B.

Author information: 
(1)Department of Ophthalmology, The Second Xiangya Hospital, Central South
University, Changsha Hunan Province, People's Republic of China.

PURPOSE: The purpose of this study was to determine the therapeutic effect and
mechanism of AAV-MnSOD by intravitreal injection on diabetic retinopathy (DRP)
and the metabolic memory phenomenon.
METHODS: The effect of hyperglycemia and metabolic memory on the thickness of
basement membrane, ratio of pericyte area and cross-sectional area of capillary
vessels in the nerve fiber layer and outer plexiform layer; retinal capillary
cell apoptosis; number of acellular capillaries and activities of retinal MnSOD
and catalase were examined and compared with intravitreal injection of AAV-MnSOD 
by transmission electron microscopy, TUNEL assay, ELISA, and
RESULTS: Hyperglycemia increased the thickness of capillary basement membranes in
the nerve fiber layer and outer plexiform layer, decreased the ratio of pericyte 
area and cross-sectional area of capillary vessels, increased numbers of
acellular capillaries and apoptosis of retinal capillary cells, and decreased
activities of retinal MnSOD and catalase. Termination of hyperglycemia cannot
reverse pathological changes listed above. Intra-vitreal injection of AAV-MnSOD
dramatically elevated the level and activities of retinal MnSOD and catalase, and
effectively prevented the progression of DRP and the metabolic memory phenomenon.
CONCLUSIONS: Increasing reactive oxygen species concentration and continuous
decreasing of antioxidant enzyme activity play important roles in DRP and the
metabolic memory phenomenon. AAV-MnSOD gene therapy provides a promising strategy
to inhibit this blinding disease.

PMID: 25301398   [PubMed - as supplied by publisher]

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

The role of rarebit perimetry in evaluation of functional outcome after
successful macular hole and epiretinal membrane surgery.

Dujmović L(1), Benčić G, Vatavuk Z.

Author information: 
(1)University Department of Ophthalmology, University Clinical Centre "Sestre
Milosrdnice", Vinogradska cesta 29, Zagreb, Croatia,

PMID: 25301397   [PubMed - as supplied by publisher]

15. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 10. [Epub ahead of print]

Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic
anterior ischaemic optic neuropathy.

Zhu W(1), Liao R, Chen Y, Liu L, Zhang Y.

Author information: 
(1)Department of Ophthalmology, The First Affiliated Hospital of Sun Yat-sen
University, Guangzhou, 510080, China.

PURPOSE: The purpose is to study the effect of Enhanced Extracorporeal
Counterpulsation (EECP) in patients with non-arteritic anterior ischaemic optic
neuropathy (NAION).
METHODS: EECP is a noninvasive, mechanical, and circulatory support therapy.
Sixteen patients with unilateral NAION were treated with EECP (twelve 1-h daily
treatment sessions for each patient). Color Doppler imaging (CDI) was applied to 
measure the mean flow velocity (MFV), peak-systolic velocity (PSV), end-diastolic
velocity (EDV) of the ophthalmic artery (OA) and central retinal artery (CRA).
Intraocular pressure (IOP) was measured by Goldmann applanation tonometry.
Measurements were collected before and immediately after the first and the last
sessions of EECP in both eyes, and they were compared with the baseline
measurement before EECP. The measurements were also compared between the NAION
eyes and the normal fellow eyes. Visual acuity (VA) and visual field (VF) were
assessed before EECP and after the last EECP.
RESULTS: EECP progressively increased blood flow velocities of the OA and CRA and
progressively decreased IOP in both eyes (P < 0.05). After the first session of
EECP, there was a 16 ± 5.3 % increase in EDV and a 13.9 ± 9.5 % increase in MFV
of the OA, and a 17.1 ± 2.5 % increase in PSV, a 21.2 ± 9.3 % increase, in EDV
and a 16.5 ± 3.3 % increase in MFV of the CRA in NAION eyes. After the last EECP 
treatment, there was a 16.8 ± 6.7 % increase in EDV and a 14.0 ± 5.1 % increase
in MFV of the OA, and a 17.7 ± 12.3 % increase in PSV, a 23.1 ± 6.3 % increase in
DSV, and a 21.1 ± 8.4 % increase in MFV of the CRA in NAION eyes (P < 0.05). The 
change of the PSV, EDV, and MFV in the CRA were more significant in NAION eyes
than that of their fellow eyes (P < 0.05). VA was improved and VF mean deviation 
was decreased in NAION eyes after the last EECP treatment (P = 0.003 and 0.049,
respectively), and VA improvement was correlated positively with the blood flow
CONCLUSIONS: EECP could be a clinically effective and safe treatment for NAION.

PMID: 25301396   [PubMed - as supplied by publisher]

16. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 10. [Epub ahead of print]

Heat shock protein 47 is up-regulated in conjunctival bleb scarring after
filtration surgery in rats.

Wang W(1), Zhao J, Yang G, Cheng G, Yang X.

Author information: 
(1)Department of Ophthalmology, Xi'an No. 4 Hospital, School of Medicine, Xi'an Jiao
Tong University, Xi'an, Shaanxi Province, China, 710004.

BACKGROUND: Heat shock protein 47 (HSP47), a collagen-specific molecular
chaperone, is involved in the biosynthesis and secretion of procollagen. Recent
studies have shown a close association between increased HSP47 and excessive
accumulation of collagens in various fibrotic diseases. This study was conducted 
to evaluate whether HSP47 plays a role in conjunctival bleb scarring after
filtration surgery in rats.
METHODS: Trabeculectomy of the right eye was performed in Sprague-Dawley (SD)
rats. Eight rats were euthanized at 2, 5, 8 and 11 days after surgery. Four rats 
were used to extract mRNA and the other four were used to extract protein. Blebs 
and normal control conjunctival tissues were collected. Real-time PCR (RT-PCR)
and Western blot methods were used to evaluate alterations in HSP47 levels and
type I and type III collagen.
RESULTS: Bleb formation was observed in all eyes. Both the expression of HSP47
mRNA and protein in conjunctival blebs increased at 2, 5, 8 and 11 days
postoperatively compared with that in normal control conjunctival tissues. The
differences of both the mean mRNA and protein levels of HSP47 in blebs at each
time point and in the normal control conjunctiva were statistically significant
(mRNA level: F = 175.811, p < 0.001; protein level: F = 68.356, p < 0.001). Type 
I and type III collagen levels in blebs were raised at different time points both
at mRNA and at protein levels. The differences between mean mRNA and protein
levels of both type I and type III collagen in blebs at 2, 5, 8 and 11 days after
surgery and in the normal control conjunctiva were statistically significant
(mRNA level: FI = 182.210, p I < 0.001; FIII = 125.490, p III < 0.001; protein
level: FI = 160.092, p I < 0.001; FIII = 62.374, p III < 0.001 ). The amount of
HSP47 in bleb positively correlated with that of both type I and type III
collagens (mRNA level: rsI = 0.688, p I = 0.003; rsIII = 0.900, p III < 0.001;
protein level: rsI = 0.688, p I = 0.003; rsIII = 0.832, p III < 0.001).
CONCLUSIONS: HSP47 is likely to be involved in the pathogenesis of conjunctival
bleb scarring and may play a role in the process of conjunctival bleb fibrosis.

PMID: 25301395   [PubMed - as supplied by publisher]

17. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 9. [Epub ahead of print]

Effect of age and other factors on macular pigment optical density measured with 
resonance Raman spectroscopy.

Obana A(1), Gohto Y, Tanito M, Okazaki S, Gellermann W, Bernstein PS, Ohira A.

Author information: 
(1)Department of Ophthalmology, Seirei Hamamatsu General Hospital, Sumiyoshi,
2-12-12, Naka-ku, Hamamatus City, Sizuoka, 430-8558, Japan,

PMID: 25298005   [PubMed - as supplied by publisher]

18. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 8. [Epub ahead of print]

Evaluation of proliferating cell abundance and phenotypes in proliferative
diabetic retinopathy.

Feist RM Jr(1), King JL, Feist RM Sr, Mason JO 3rd, Morris RE, Guidry C.

Author information: 
(1)Department of Ophthalmology, University of Alabama School of Medicine,
Birmingham, AL, 35294, USA.

BACKGROUND: The aim of this work is to evaluate the abundance, origins, and
phenotypes of actively proliferating cells in proliferative diabetic retinopathy 
METHODS: Eleven epiretinal membranes from patients undergoing surgery for PDR
were evaluated by indirect immunofluorescence for evidence of cell proliferation 
using the nuclear cell proliferation marker Ki67 and for cell identities using
glial fibrillary acidic protein (GFAP), glutamine synthetase, and α-smooth muscle
actin (αSMA).
RESULTS: Ki67 positivity was consistently rare in PDR epiretinal membranes at
3.02 ± 1.42 % of the total cell population. The majority of the Ki67-positive
cells were also positive for GFAP (74.0 %) with lower proportions positive for
αSMA (30.7 %) and glutamine synthetase (1.5 %). Co-localization studies using
glial and myoid markers revealed that virtually all (92 %) of the αSMA-positive
cells are also GFAP positive and thus derive from glia.
CONCLUSIONS: Entry into cell cycle and thus cell proliferation appears to be a
rare phenomenon in PDR involving only a small percentage of the total cell
population. Glia and/or glial-derived myofibroblasts appear to be the predominate
cell types in epiretinal scar tissues and also account for the majority of the
actively proliferating cells.

PMID: 25294353   [PubMed - as supplied by publisher]

19. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 7. [Epub ahead of print]

Graefe's archive for clinical and experimental ophthalmology-instant glue for
retinal detachment surgery?

Cheung N(1), Wong D.

Author information: 
(1)The Eye Institute, Department of Ophthalmology, University of Hong Kong,
Pokfulam, Hong Kong, China.

PMID: 25283771   [PubMed - as supplied by publisher]

20. Graefes Arch Clin Exp Ophthalmol. 2014 Oct 3. [Epub ahead of print]

Anticoagulant therapy is not a risk factor for choroidal haemorrhage.

Grzybowski A(1), Prasad S.

Author information: 
(1)Department of Ophthalmology, Poznan City Hospital, ul. Szwajcarska 3, 61-285,
Poznań, Poland,

PMID: 25277171   [PubMed - as supplied by publisher]

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

Ameliorative effects of SkQ1 eye drops on cataractogenesis in
senescence-accelerated OXYS rats.

Rumyantseva YV(1), Ryabchikova EI, Fursova AZ, Kolosova NG.

Author information: 
(1)Institute of Cytology and Genetics, Siberian Branch of Russian Academy of
Sciences, 630090, Acad. Lavrentjev 10, Novosibirsk, Russia,

BACKGROUND: Antioxidant supplements have been suggested as a strategy to decrease
the risk of age-related cataract, but there is no evidence that antioxidants can 
reduce the signs of the disease. Recently, we showed that the mitochondrial
antioxidant SkQ1 can partially reverse cataract signs in senescence-accelerated
OXYS rats. The aim of the present study was the histomorphological examination of
the influence of SkQ1 eye drops on the cataract development in OXYS rats.
METHODS: OXYS rats received SkQ1 eye drops (250 nM) from 9 to 12 months of age.
Ophthalmoscopic examination was carried out before and after treatment. Light and
electron microscopy were used for histomorphological examination. Expression of
the Cryaa and Cryab genes was determined using real-time PCR. αB-crystallin
expression was detected using Western blotting.
RESULTS: SkQ1 completely prevented the cataract development in OXYS rats, and in 
some of the animals diminished the signs of the disease. Light and electron
microscopy showed that SkQ1 attenuated the (typical for cataract) alterations in 
the lens capsule and epithelial cells, ameliorated disturbances of the hexagonal 
packing geometry of lens fibers, and improved ultrastructure of the epithelial
cells. The levels of mRNA of α-crystallins genes which encode small heat shock
proteins αA- and αB-crystallin that play a central role in maintaining lens
transparency were significantly lower in the OXYS rats' lenses than in Wistar
rats (control). SkQ1 normalized the level of mRNA of Cryaa, and significantly
increased the level of Cryab mRNA as well as αB-crystallin protein in the lens of
OXYS rats to the level of the control Wistar rats.
CONCLUSION: SkQ1 eye drops hold promise as a treatment of cataract.

PMID: 25267419   [PubMed - as supplied by publisher]

22. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 30. [Epub ahead of print]

Refractory subretinal fluid in patients with neovascular age-related macular
degeneration treated with intravitreal ranibizumab: visual acuity outcome.

Jang L(1), Gianniou C, Ambresin A, Mantel I.

Author information: 
(1)Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland.

PURPOSE: To investigate the functional outcome of eyes with neovascular AMD
(nAMD) and subretinal fluid (SRF) refractory to treatment with ranibizumab.
METHODS: Retrospective chart review of consecutive treatment-refractory SRF in
nAMD despite monthly ranibizumab injections during 12 months or more. Data were
evaluated for baseline characteristics, location of the refractory SRF, mean
visual acuity (VA) change, number of injections, and timepoint of first complete 
disappearance of SRF.
RESULTS: Forty-five eyes in 44 patients (mean age of 76 years) were included. The
mean follow-up was 32.4 months (range 12-73 months). The mean number of
injections was 11.6 in the first year and 27.5 over follow-up. The refractory SRF
was located subfoveally in 66.7 %. In 12 eyes (26.7 %), complete absorption of
SRF was found after a mean of 22.6 months (range, 13-41 months). Mean VA
increased by 10.4, 8.2, and 8.6 letters by month 12, 24, and 36, respectively.
CONCLUSIONS: Neovascular AMD with SRF refractory to monthly retreatment with
ranibizumab may still allow good and maintained visual improvement, even if the
fluid is located subfoveally. SRF may progressively absorb under continuous
monthly treatment. The necessity to treat refractory SRF with monthly injections 
could be questioned and would need future investigations.

PMID: 25267418   [PubMed - as supplied by publisher]

23. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 26. [Epub ahead of print]

Associations of macular thickness in spectral-domain OCT with ocular and systemic
cardiovascular parameters - The MIPH Eye & Health Study.

Schuster AK(1), Fischer JE, Vossmerbaeumer U.

Author information: 
(1)Mannheim Institute of Public Health (MIPH), Social and Preventive Medicine,
Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

PURPOSE: Beyond in-vivo histological analysis of retinal tissue, optical
coherence tomography (OCT) allows quantitative image analysis. This study
evaluates associations of macular retinal thickness measured with spectral-domain
OCT (SD-OCT) and ocular and systemic cardiovascular parameters in adult subjects.
METHODS: An epidemiological cross-sectional study was performed in the staff of a
European high-tech company. Examination of known cardiovascular risk factors
including biochemical blood analysis was performed, and ocular parameters such as
refraction, tonometry, SD-OCT imaging of the macula and cornea, and fundus
photography were evaluated. Retinal thickness measurements were evaluated
according to the ETDRS grid. Associations of macular retinal thickness and
systemic cardiovascular and ocular parameters were calculated by multivariate
analysis using SPSS software.
RESULTS: Four hundred and twenty-four probands were included. Macular thickness
measurement were significantly associated with gender and refraction. Female
persons had thinner retinal thickness in all zones. Macular thickness decreased
with increasing myopia in all perifoveal measurements. Outer perifoveal
measurements were associated with keratometry; a flatter corneal radius was
linked to a thinner retina. Tonometry and systemic cardiovascular risk factors
were not associated with macular retinal thickness in multivariate analysis
(p > 0.05).
CONCLUSIONS: Macular retinal thickness is associated with refraction and gender; 
cardiovascular risk factors or tonometry do not influence macular retinal
thickness measurements. Keratometry might influence outer zone measurements. Our 
findings provide a dataset for quantitative evaluation of SD-OCT, and evaluate
influencing factors.

PMID: 25252606   [PubMed - as supplied by publisher]

24. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 23. [Epub ahead of print]

Factors affecting macular pigment optical density.

Kawada T.

Author information: 
Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi,
Bunkyo-Ku, Tokyo, 113-8602, Japan,

PMID: 25241648   [PubMed - as supplied by publisher]

25. Graefes Arch Clin Exp Ophthalmol. 2014 Sep 20. [Epub ahead of print]

Attitudes toward postmortem cornea donation in Germany: a multicenter survey.

Uhlig CE(1), Koch R, Promesberger J, Hirschfeld G, Schmidt H, Seitz B, Reinhard
T, Böhringer D.

Author information: 
(1)Department of Ophthalmology, University Medical Center, Münster, Germany,

PURPOSE: To analyse the willingness for postmortem cornea donation in Germany.
METHODS: Employees in two cities (UKM, UKS), and university hospitals (STM, STE),
members of the German Ophthalmological Society (DOG), and employees of an
automobile company (BO) participated in a questionnaire about postmortem cornea
donation attitudes. The questionnaire consisted of demographic items, motives
concerning postmortem cornea donation, general attitudes toward donation, and
questions concerning the perceived needs for information about donation. The
statistical analyses included logistic regression with the target parameter of
'willingness to donate cornea postmortem'.
RESULTS: Of the participants, 67.7 % (UKM, UKS), 70.9 % (STM, STE), 70.8 % (BO), 
and 79.4 % (DOG) declared their intention to donate their corneas postmortem.
Younger age (p < 0.001), poorer general health (p < 0.05), faith in an eternal
life (p < 0.05), disagreement with brain death diagnostics (p < 0.001), fear of
receiving worse medical treatment (p < 0.001), and fear of the commercialization 
of organs (p < 0.001) were found to be risk factors for a negative attitude
toward postmortem cornea. The majority of participants (57.4 %) indicated that
additional information about donation would be appreciated, and the internet
(69.9 %) was considered the most appropriate means for conveying this
CONCLUSIONS: Emotional items were revealed to be the most relevant factors
influencing the willingness to donate cornea postmortem, which may be
counteracted by means of public education. The relatively low willingness among
the medical staff contrasts with previous observations in a professional
ophthalmologic society.

PMID: 25236759   [PubMed - as supplied by publisher]