Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Cornea
Curr Eye Res
Eur J Ophthalmol
Eye
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
JPOS
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Ophthalmologica
Ophthalmology
Retina
Surv Ophthalmol
Ophthalmology Review Journal
Graefes Arch Clin Exp Ophthalmol[JOUR] Established 1995
1. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 28. [Epub ahead of print]

Recessive Stargardt disease phenocopying hydroxychloroquine retinopathy.

Nõupuu K(1), Lee W, Zernant J, Greenstein VC, Tsang S, Allikmets R.

Author information: 
(1)Department of Ophthalmology, Columbia University, Eye Research Annex Rm 202,
160 Ft Washington Ave, New York, NY, 10032, USA.

PURPOSE: To describe a series of patients with Stargardt disease (STGD1)
exhibiting a phenotype usually associated with hydroxychloroquine (HCQ)
retinopathy on spectral domain-optical coherence tomography (SD-OCT).
METHODS: Observational case series from Columbia University Medical Center
involving eight patients with genetically-confirmed STGD1. Patients selected for 
the study presented no history of HCQ use. Horizontal macular SD-OCT scans and
accompanying 488-nm autofluorescence (AF) images, color fundus photographs, and
full-field electroretinograms were analyzed.
RESULTS: All study patients exhibited an abrupt thinning of the parafoveal region
or disruption of the outer retinal layers on SD-OCT resembling the transient HCQ 
retinopathy phenotype. Funduscopy and AF imaging revealed variations of bull's
eye maculopathy (BEM). Five patients exhibited local fleck-like deposits around
the lesion. Genetic screening confirmed two disease-causing ABCA4 mutations in
five patients and one mutation in three patients.
CONCLUSIONS: A transient SD-OCT phenotype ascribed to patients with HCQ
retinopathy is associated with an early subtype of STGD1. This finding may also
present with HCQ retinopathy-like BEM lesions on AF imaging and funduscopy. A
possible phenotypic overlap is unsurprising, given certain shared mechanistic
disease processes between the two conditions. A thorough work-up, including
screening of genes that are causal in retinal dystrophies associated with foveal 
sparing, may prevent misdiagnosis of more ambiguous cases.

PMID: 26311262   [PubMed - as supplied by publisher]


2. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 27. [Epub ahead of print]

Long-term efficacy of abatacept in pediatric patients with idiopathic uveitis: a 
case series.

Marrani E(1), Paganelli V, de Libero C, Cimaz R, Simonini G.

Author information: 
(1)Pediatric Rheumatology, Anna Meyer Children Hospital, Florence, Italy,
edoardo.marrani@gmail.com.

BACKGROUND: Non-infectious uveitis represents one of the most common causes of
blindness, even at pediatric age; in particular, idiopathic chronic uveitis can
pose significant difficulties during treatment, due to a partial response to
TNF-α antagonists. To date, very few case series exist describing the treatment
of idiopathic uveitis not adequately controlled by TNF-α antagonists. The aim of 
our study is to describe the role of abatacept in achieving remission in patients
with idiopathic uveitis previously treated with TNF-α antagonists, and to assess 
how long abatacept efficacy is maintained during follow-up. The treatment's
safety profile and tolerability were also specifically investigated.
METHODS: Three patients affected with chronic idiopathic uveitis, who have been
treated with abatacept due to loss of efficacy of TNF-α antagonists, were
reviewed. Details of the demographic and clinical characteristics were recorded, 
and a summary of the medical history was obtained. Patients were regularly
reviewed in the ophthalmology and rheumatology clinics. Assessment of their
ocular condition was characterized according to the Standardization of Uveitis
Nomenclature (SUN) group.
RESULTS: In our patients, abatacept was able to induce remission and to
discontinue systemic corticosteroids after a mean of 30 weeks; the drug
maintained its efficacy through a long follow-up period (42, 33, and 18 months
respectively), with an excellent safety profile.
CONCLUSION: Our small case series seems to suggest abatacept to be a promising
therapy in children affected with chronic idiopathic uveitis not adequately
controlled by TNF-α antagonists.

PMID: 26311261   [PubMed - as supplied by publisher]


3. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 27. [Epub ahead of print]

Reliability of a new modified tear breakup time method: introduction of dry tear 
breakup time.

Kim KT(1), Kim JH.

Author information: 
(1)Department of Ophthalmology, Chungbuk National University College of Medicine,
776 1st Sunhwan-Ro, Gaesin-dong, Heungduk-ku, Cheongju, 361-711, South Korea.

PMID: 26311260   [PubMed - as supplied by publisher]


4. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 28. [Epub ahead of print]

Reliability of a new modified tear breakup time method: methodological and
statistical issues.

Sabour S(1).

Author information: 
(1)Safety Promotion and Injury Prevention Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, s.sabour@sbmu.ac.ir.

PMID: 26311259   [PubMed - as supplied by publisher]


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

Dark adaptation-induced changes in rod, cone and intrinsically photosensitive
retinal ganglion cell (ipRGC) sensitivity differentially affect the pupil light
response (PLR).

Wang B(1), Shen C, Zhang L, Qi L, Yao L, Chen J, Yang G, Chen T, Zhang Z.

Author information: 
(1)Department of Aerospace Medicine, the Forth Military Medical University,
Xi'an, Shaanxi, China, 710032.

PURPOSE: Our purpose was to explore pupil light response (PLR) with respect to
the change in sensitivity of photoreceptors during various dark adaptation phases
and to determine the optimal duration of dark adaptation time before the PLR.
METHODS: The PLR was recorded in 15 healthy subjects and three patients with
neural or retinal vision loss after 1-sec blue and red light stimuli of 1, 10,
and 100 cd/m(2). The PLR was repeated nine times at different checkpoints during 
the 40-minute dark adaptation. The transient contraction amplitude, sustained
contraction amplitude, and relative sustained contraction ratio of the PLR were
analyzed.
RESULTS: The increase in the transient contraction amplitude during the entire
dark adaptation process was significant (changing up to 45.1 %) in the initial
phase of dark adaptation under different stimulus conditions. The changes in the 
sustained contraction amplitude and the relative sustained contraction ratio were
substantial (changing up to 71.0 % and 37.2 % from 1 to 20 minutes of dark
adaptation, respectively) under high-intensity blue illumination. The inflection 
point of the contraction curves in the dark adaptation was 15 or 20 minutes. The 
patients' PLR results changed in a similar manner.
CONCLUSIONS: The changes in the sensitivity of different photoreceptors occurred 
at different rates, and the contraction amplitude of the PLR was significantly
affected by the dark adaptation duration. So 20 minutes of dark adaptation before
PLR testing was suggested to achieve a consistent and stable pupil response. The 
dark adaptation effect should be put into consideration when comparing the
results from different phases of the PLR test.

PMID: 26311258   [PubMed - as supplied by publisher]


6. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 27. [Epub ahead of print]

Epiretinal proliferation in lamellar macular holes and full-thickness macular
holes: clinical and surgical findings.

Lai TT(1), Chen SN, Yang CM.

Author information: 
(1)Department of Ophthalmology, National Taiwan University Hospital, Taipei,
Taiwan.

PURPOSE: To report the clinical findings and surgical outcomes of lamellar
macular holes (LMH) with or without lamellar hole-associated epiretinal
proliferation (LHEP), and those of full-thickness macular holes (FTMH) presenting
with LHEP.
METHODS: From 2009 to 2013, consecutive cases of surgically treated LMH, and all 
FTMH cases with LHEP were reviewed, given a follow-up time over 1 year.
RESULTS: In the LMH group (43 cases), those with LHEP (19 cases) had
significantly thinner bases and larger openings than those without (24 cases).
The rate of disrupted IS/OS line was higher in the LHEP subgroup preoperatively
(68.4 % vs 37.5 %), but similar between subgroups postoperatively (36.8 % and
33.3 %). The preoperative and postoperative visual acuity showed no significant
difference between two subgroups. In the FTMH group (13 cases), the average hole 
size was 219.2 ± 92.1 μm. Permanent or transient spontaneous hole closure was
noted in 69.2 % of cases. An intact IS-OS line was found in only 23 % of cases at
the final follow-up.
CONCLUSION: In the LMH group, LHEP was associated with a more severe defect but
didn't affect surgical outcomes. In the FTMH group, spontaneous hole closure was 
frequently noted. Despite small holes, disruption of IS-OS line was common after 
hole closure.

PMID: 26311257   [PubMed - as supplied by publisher]


7. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 21. [Epub ahead of print]

Measurement of early changes in anterior chamber morphology after cataract
extraction measured by anterior segment optical coherence tomography.

Kasai K(1), Takahashi G, Kumegawa K, Dogru M.

Author information: 
(1)Department of Ophthalmology, Jikei University School of Medicine, Katsushika
Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan,
kozue_message@yahoo.co.jp.

OBJECTIVE: To evaluate the serial changes in anterior chamber depth (ACD) and
angle parameters early after cataract surgery using anterior segment optical
coherence tomography (ASOCT).
METHODS: This was a retrospective chart review, case-control study; 150 eyes of
106 patients who underwent cataract surgery. Based on ACD and angle findings, the
eyes were classified into two groups, open-angle eyes (87 eyes) and narrow-angle 
eyes (63 eyes). ASOCT was used to measure ACD and angle parameters (angle opening
distance, angle recess area, trabecular iris space area, and trabecular iris
angle (TIA [1]). Serial changes in each group were measured before and 1 day, 1
week, and 1 month after cataract surgery, and the differences between the two
groups were compared.
RESULTS: ACD and all angle parameters in both groups at each examination time
after cataract surgery were significantly different from the preoperative values 
(p < 0.01). In addition, all angle parameters significantly differed between the 
two groups at each examination time after cataract surgery (p < 0.001). However, 
ACD after surgery was not significantly different, irrespective of ACD before
surgery. ACD and TIA500 both showed significantly greater changes from before
surgery to 1 day after surgery in narrow-angle eyes compared to open-angle eyes
(p < 0.001).
CONCLUSIONS: Cataract surgery increases ACD and all angle parameters early after 
the surgery. However, the degree of angle widening in narrow-angle eyes was not
as much as that in open-angle eyes, suggesting that factors other than the lens
influence the angle closure.

PMID: 26292955   [PubMed - as supplied by publisher]


8. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 20. [Epub ahead of print]

Spatial and temporal analyses of posture in strabismic children.

Ezane MD(1), Lions C, Bui Quoc E, Milleret C, Bucci MP.

Author information: 
(1)UMR 1141, INSERM - Université Paris 7, Hôpital Robert Debré, 48 boulevard
Sérurier, Paris, France.

PURPOSE: To analyse postural performances of strabismic children, both in the
spatial and the temporal domains, by wavelet transformation, comparing both
stable and unstable situations.
METHODS: Twenty-six strabismic children aged from 4 to 11 years old and 26
age-matched normal children participated in the study. Postural performances were
evaluated using the Framiral® platform. Posture was recorded in the following
conditions: eyes open fixating a target and eyes closed on stable and unstable
platforms.
RESULTS: For both strabismic and non-strabismic children, the surface and the
mean velocity of the center of pressure (CoP) were significantly larger in the
eyes closed on unstable platform condition, but this was much more pronounced in 
case of strabismus. Spectral power index and cancelling time were also found to
be altered in strabismic children compared to non-strabismic children.
CONCLUSIONS: This data demonstrates poor postural stability for both groups on an
unstable platform with the eyes closed. However, strabismic children had
significantly worse performance than non-strabismic children. Strabismic children
also engage more energy to stabilize their posture by using visuo-vestibular
sensory inputs to compensate their altered vision due to strabismus, in
comparison to non-strabismic children.

PMID: 26287266   [PubMed - as supplied by publisher]


9. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 20. [Epub ahead of print]

Factors that influence the suitability of human organ-cultured corneas.

Röck T(1), Hofmann J, Thaler S, Bramkamp M, Bartz-Schmidt KU, Yoeruek E, Röck D.

Author information: 
(1)Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076,
Tübingen, Germany, tobias.roeck@med.uni-tuebingen.de.

PURPOSE: The purpose was to assess the influence of donor and storage factors on 
the suitability of organ-cultured corneas for transplantation.
METHODS: Data from 1340 donor corneas stored between 2009 and 2015 were analyzed 
retrospectively. Logistic regression analysis was used to assess the influence of
different factors on the suitability of grafts for transplantation.
RESULTS: Forty-one percent (553/1340) of corneas were discarded. The leading
causes were medical contraindication (20.2 %) and poor endothelial quality
(19.3 %). Donor age influenced suitability for transplantation significantly.
Corneas from donors aged 80 years and older were more likely to be discarded
because of endothelial insufficiency (P < 0.0001). The cause of donor death
including infection and multiple organ dsyfunction syndrom (MODS) increased the
risk of bacterial or fungal contamination during organ culture (P = 0.007 and
P = 0.014, respectively). Prolonged time between death and enucleation was
associated with an increased risk of unsuitability for transplantation
(P < 0.0001). The amount of time between death and corneoscleral disc excision
and duration of storage influenced the suitability for transplantation
(P = 0.0007 and P < 0.0001, respectively).
CONCLUSION: Donor age, cause of death, storage time, death to enucleation and
death to disc excision times influenced transplantation suitability. The
percentage of discarded corneas may be reduced by shortening storage time, death 
to enucleation, and death to corneoscleral disc excision times. Setting a maximum
donor age could reduce the percentage of discarded corneas. However, as long as
there is a lack of donor corneas, we do not recommend any donor age limit.

PMID: 26287265   [PubMed - as supplied by publisher]


10. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 18. [Epub ahead of print]

Swedish Interactive Threshold Algorithm for central visual field defects
unrelated to nerve fiber layer.

Hirasawa K(1), Shoji N.

Author information: 
(1)Orthoptics and Visual Science, Department of Rehabilitation, School of Allied 
Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara,
Kanagawa, 252-0374, Japan, hirasawa@kitasato-u.ac.jp.

PURPOSE: To evaluate the characteristic appearance of induced central visual
field defects unrelated to the nerve fiber layer on standard automated perimetry 
using the Swedish Interactive Threshold Algorithm (SITA), and to compare the
findings to the appearance on existing Full Threshold (FT) and FASTPAC (FP)
algorithms.
METHODS: Thirty right eyes of 30 healthy young participants were examined using
four Humphrey 24-2 program algorithms: FT, FP, SITA-Standard (SS), and SITA-Fast 
(SF). Central visual field defects were induced using a high-density white
opacity filter centered on a plano lens. The test duration, fovea threshold, mean
sensitivity (MS), mean deviation (MD), pattern standard deviation (PSD), visual
field index (VFI), and defect size and depth were compared among all algorithms.
RESULTS: The mean test duration was 21 % to 71 % shorter (p < 0.01), the fovea
threshold 0.9 to 2.6 dB higher (p < 0.05), MS 1.1 to 1.7 dB higher (p < 0.05), MD
0.84 to 1.48 dB higher, PSD 0.33 to 0.60 lower, and VFI 2 % higher (p < 0.05) on 
SS and SF than on FT and FP. The defect size was approximately four points larger
and the defect depth 127 to 156 dB shallower on SS and SF than on FT and FP
(p < 0.01).
CONCLUSIONS: Central visual field defects unrelated to the nerve fiber layer were
wider and shallower and global indices were higher on SITA than on conventional
FT and FP. These findings indicate that careful attention is required when
converting from FT and FP to SITA.

PMID: 26279004   [PubMed - as supplied by publisher]


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

Elevated vitreous body glial fibrillary acidic protein in retinal diseases.

Jünemann AG(1), Rejdak R, Huchzermeyer C, Maciejewski R, Grieb P, Kruse FE,
Zrenner E, Rejdak K, Petzold A.

Author information: 
(1)Department of Ophthalmology, University of Erlangen-Nurnberg, Erlangen,
Germany.

PURPOSE: Increased expression of glial fibrillary acidic protein (GFAP) is a
characteristic of gliotic activation (Müller cells and astrocytes) in the retina.
This study assessed vitreous body GFAP levels in various forms of retinal
pathology.
METHODS: This prospective study included 82 patients who underwent vitrectomy (46
retinal detachments (RDs), 13 macular hole (MHs), 15 epiretinal glioses (EGs), 8 
organ donors). An established enzyme-linked immunosorbent assay (ELISA, SMI26)
was used for quantification of GFAP.
RESULTS: The highest concentration of vitreous body GFAP in organ donors was
20 pg/mL and it was used as the cutoff. A significant proportion of patients
suffering from RD (65 %) to EG (53 %) had vitreous body GFAP levels above this
cutoff when compared to organ donors (0 %, p < 0.0001, p = 0.0194, respectively, 
Fisher's exact test) and MH (8 %, p < 0.0001, p = 0.0157, respectively). In RD
and EG, vitreous body GFAP levels were correlated with axial length (R = 0.69,
R = 0.52, p < 0.05 for both).
CONCLUSIONS: The data suggest that human vitreous body GFAP is a protein
biomarker for glial activation in response to retinal pathologies. Vitreous body 
GFAP levels may be of interest as a surrogate outcome for experimental treatment 
strategies in translational studies.

PMID: 26279003   [PubMed - as supplied by publisher]


12. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 14. [Epub ahead of print]

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

Cheong KX(1), Tan CS.

Author information: 
(1)Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore.

PMID: 26271304   [PubMed - as supplied by publisher]


13. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 14. [Epub ahead of print]

Comparison of refractive outcomes in three corneal transplantation techniques for
keratoconus.

Huang T(1), Hu Y, Gui M, Hou C, Zhang H.

Author information: 
(1)State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun
Yat-sen University, Guangzhou, 510060, China, hc8877summer@163.com.

BACKGROUND: Deep anterior lamellar keratoplasty (DALK) has a much lower incidence
of immunologic reactions than penetrating keratoplasty (PK) for patients with
keratoconus. However, it is unclear whether DALK is better on refractive outcomes
than PK, due to its high postoperative myopia.
METHODS: We retrospectively studied the clinical records of keratoconus patients 
who underwent PK, DALK, or predescemetic DALK (pre-DALK, DALK with residual
stroma) between June 2004 and September 2008. The main outcome measures included 
refractive sphere, manifest cylinder, corneal power, keratometric astigmatism,
and best-corrected visual acuity (BCVA) at the latest visit and the methods of
visual correction. Postoperative manifest refractions and topography data were
compared at postoperative 3, 5, 7, and 9 years among the three groups.
Additionally, the final BCVA and the methods of vision correction were compared.
RESULTS: A total of 172 subjects (172 eyes) screened out of 207 keratoconus
patients underwent PK (79 eyes), DALK (68 eyes), or pre-DALK (25 eyes).
Postoperative myopic refractive sphere increased in all groups, but the most
obvious increase was noted in the pre-DALK group. At the 9-year follow-up, both
the pre-DALK group (-6.5 ± 1.7 D) and DALK group (-6.1 ± 1.8 D) had higher myopic
refractive sphere than the PK group (-5.0 ± 1.5 D, p < 0.05). Postoperative
myopic manifest astigmatism progressively increased in 5 years, but there were no
differences among the groups. The progressive increases in postoperative corneal 
power were recorded in all groups, with the highest one in the pre-DALK group and
the lowest in the PK group. At the 9-year follow-up, both the pre-DALK
(49.8 ± 2.7 D) and DALK (48.8 ± 2.1 D) groups had higher corneal power than the
PK group (47.3 ± 2.0 D); meanwhile, the corneal power was higher in the pre-DALK 
group than the DALK group (p < 0.05). No differences were noted with respect to
keratometric astigmatism among the groups. Mean LogMAR BCVA was 0.12 ± 0.12 in
the DALK group, 0.17 ± 0.10 in the pre-DALK group, and 0.1 ± 0.11 in the PK group
(p = 0.325) at 9 years after surgery. Moreover, the methods of achieving BCVA
seem to be similar among the treatment groups.
CONCLUSIONS: Although DALK has a slightly higher degree of myopic refraction than
PK, DALK and PK have comparable visual acuity outcomes and similar methods of
vision correction. DALK is recommended for the treatment of keratoconus.

PMID: 26271303   [PubMed - as supplied by publisher]


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

Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up.
(BERVOLT study: Bevacizumab for RVO long-term follow-up).

Kornhauser T(1), Schwartz R, Goldstein M, Neudorfer M, Loewenstein A, Barak A.

Author information: 
(1)Department of Ophthalmology, The Soroka University Medical Center, Ben Gurion 
University of the Negev, Beer Sheva, Israel, tomchook@gmail.com.

PURPOSE: To assess the efficacy and safety of intraocular injections of
bevacizumab in patients with macular edema (ME) following branch retinal vein
occlusion (BRVO) and central retinal vein occlusion (CRVO).
METHODS: Retrospective, non-comparative case series. Patients ≥18 years of age
with ME secondary to BRVO or CRVO who received a minimum of one intravitreal
injection of bevacizumab with a follow-up >3 months were included. Primary
endpoints were mean change in best corrected visual acuity (BCVA) from baseline
to 12 and 24 months, and mean change in central macular thickness (CMT) after 3
injections. Secondary endpoints were mean change in BCVA and CMT from baseline to
end of follow-up, number of injections, and ocular adverse events.
RESULTS: Eighty-seven eyes with BRVO and 65 eyes with CRVO were included. Mean
follow-up time was 24.4 and 26.1 months in the BRVO and CRVO groups,
respectively. The mean change in BCVA was 0.25 LogMAR in the BRVO group and
-0.118 LogMAR in the CRVO group.
CONCLUSION: Visual acuity outcomes in the CRVO group were poorer, especially in
patients with low baseline BCVA.

PMID: 26269374   [PubMed - as supplied by publisher]


15. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 13. [Epub ahead of print]

Lamina cribrosa depth according to the level of axial length in normal and
glaucomatous eyes.

Yun SC(1), Hahn IK, Sung KR, Yoon JY, Jeong D, Chung HS.

Author information: 
(1)Department of Clinical Epidemiology and Biostatistics, College of Medicine,
University of Ulsan, Asan Medical Center, Seoul, Korea.

PURPOSE: To compare the lamina cribrosa (LC) depth of the optic nerve head in
normal and glaucomatous eyes over a wide range of axial length (AXL).
METHODS: A total of 402 eyes, including 210 normal and 192 glaucomatous eyes,
were imaged by spectral domain optical coherence tomography. Normal and
glaucomatous eyes were each divided into three subgroups according to the level
of AXL; long (> 26 mm), mid-level (23-26 mm), and short (< 23 mm). Visual field
mean deviation (VF MD), LC thickness, and LC depth were compared between normal
and glaucomatous eyes in each of the AXL subgroups. These parameters were also
compared between normal and glaucomatous eyes in the three AXL subgroups. Factors
associated with LC depth in each AXL subgroup were evaluated by univariate and
multivariate regression analyses.
RESULTS: A comparison of the three AXL subgroups in normal eyes showed that the
LC was thinnest in the long AXL subgroup (short; 189.7 ± 24.1 μm, mid-level;
179.9 ± 34.3 μm, long; 149.2 ± 36.2 μm, p < 0.001), but LC depth did not differ
significantly in the three subgroups (short; 527.1 ± 144.4 μm, mid-level;
578.2 ± 163.5 μm, long; 594.4 ± 187.5 μm, p = 0.144). In glaucomatous eyes,
glaucoma severity assessed by VF MD did not differ significantly among the three 
AXL subgroups (short; -6.99 ± 8.50 dB, mid-level; -6.40 ± 7.64 dB, long;
-4.61 ± 5.22 dB, p = 0.168). However, LC depth was greater in the long than in
the short AXL subgroup (679.5 ± 192.7 μm and 555.9 ± 134.1 μm, respectively,
p = 0.004), although neither subgroup differed significantly in LC depth from the
mid-level AXL subgroup (611.8 ± 162.3 μm, p = 0.385, p = 0.090). LC thickness was
significantly different between normal and glaucomatous eyes (p < 0.001). LC
depth was not different between normal and glaucomatous eyes in both short and
mid-level AXL subgroups (p = 0.297, 0.222), but differed in the long AXL subgroup
(p = 0.022). The presence of glaucoma was associated with greater LC depth only
in the long AXL subgroup (p = 0.012).
CONCLUSIONS: LC depth may vary according to the level of AXL in glaucomatous eyes
with a similar level of glaucoma severity, with the greatest LC depth found in
eyes with long AXL. Those findings suggest that glaucomatous optic disc cupping
would manifest differently according to the level of AXL.

PMID: 26267752   [PubMed - as supplied by publisher]


16. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 13. [Epub ahead of print]

Age-dependency of ocular parameters: a cross sectional study of young and elderly
healthy subjects.

Jóhannesson G(1), Hallberg P, Ambarki K, Eklund A, Lindén C.

Author information: 
(1)Department of Clinical Science, Ophthalmology, Umeå University, SE-901 87,
Umeå, SWEDEN, gauti.johannesson@umu.se.

PURPOSE: To investigate the effect of aging on ocular parameters, including
intraocular pressure (IOP), measured with different tonometry methods in healthy 
young (HY) and healthy elderly (HE) subjects and to study the effect of corneal
parameters on tonometry methods.
METHODS: In this prospective, cross-sectional study, fifty eyes of 50 HY subjects
(28 females, 22-31 years of age) and 43 eyes of 43 HE subjects (22 females,
64-79) were included. IOP was measured with four tonometry methods in a
standardized order: ocular response analyser (ORA), dynamic contour tonometry
(DCT), applanation resonance tonometry (ART) and Goldmann applanation tonometry
(GAT). Other measurements included axial length (AL), central corneal thickness
(CCT), corneal curvature (CC), anterior chamber volume (ACV), corneal hysteresis 
(CH) and corneal resistance factor (CRF).
RESULTS: The mean IOP (HY/HE; mmHg ± standard deviation (SD)) was
12.2 ± 2.2/14.1 ± 3.5 with GAT. IOP was significantly higher
(difference ± standard error) in HE compared to HY measured with an ORA
(+3.1 mmHg ± 0.6), GAT (+1.9 ± 0.6) and DCT (+1.6 ± 0.6). No significant
difference was found in IOP measured with ART. CH and ACV were significantly
lower in HE compared to HY. There was no difference between the groups in CCT,
CC, AL or CRF. No tonometry method was dependant on CCT or CC.
CONCLUSIONS: IOP measured with an ORA and via DCT and GAT was higher in HE
compared to HY Swedish subjects, while IOP measured with ART did not differ
between the groups. In these homogeneous groups, tonometry methods were
independent of CCT and CC.

PMID: 26267751   [PubMed - as supplied by publisher]


17. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 13. [Epub ahead of print]

Measurement of retinal wall-to-lumen ratio by adaptive optics retinal camera: a
clinical research.

Meixner E(1), Michelson G.

Author information: 
(1)Department of Ophthalmology, University Hospital,
Friedrich-Alexander-University Erlangen-Nürnberg, Schwabachanlage 6, 91054,
Erlangen, Germany, Eva.Meixner@med.stud.uni-erlangen.de.

PURPOSE: To measure the wall-to-lumen ratio (WLR) and the cross-sectional area of
the vascular wall (WCSA) of retinal arterioles by an Adaptive Optics (AO) retinal
camera.
METHODS: Forty-seven human subjects were examined and their medical history was
explored. WLR and WCSA were measured on the basis of retinal arteriolar wall
thickness (VW), lumen diameter (LD) and vessel diameter (VD) assessed by rtx1
Adaptive Optics retinal camera. WLR was calculated by the formula [Formula: see
text]. Arterio-venous ratio (AVR) and microvascular abnormalities were attained
by quantitative and qualitative assessment of fundus photographs. Influence of
age, arterial hypertension, body mass index (BMI) and retinal microvascular
abnormalities on the WLR was examined. An age-adjusted WLR was created to test
influences on WLR independently of age. Considering WLR and WCSA, a distinction
between eutrophic and hypertrophic retinal remodeling processes was possible.
RESULTS: The intra-observer variability (IOV) was 6 % ± 0.9 for arteriolar wall
thickness and 2 % ± 0.2 for arteriolar wall thickness plus vessel lumen. WLR
depended significantly on the wall thickness (r = 0.715; p < 0.01) of retinal
arterioles, but was independent of the total vessel diameter (r = 0.052;
p = 0.728). WLR correlated significantly with age (r = 0.769; p < 0.01). Arterial
hypertension and a higher BMI were significantly associated with an increased
age-adjusted WLR. WLR correlated significantly with the stage of microvascular
abnormalities. 55 % of the hypertensive subjects and 11 % of the normotensive
subjects showed eutrophic remodeling, while hypertrophic remodeling was not
detectable. WLR correlated inversely with AVR. AVR was independent of the
arteriolar wall thickness, age and arterial hypertension.
CONCLUSIONS: The technique of AO retinal imaging allows a direct measurement of
the retinal vessel wall and lumen diameter with good intra-observer variability. 
Age, arterial hypertension and an elevated BMI level are significantly associated
with an increased WLR. The wall-to-lumen ratio measured by AO can be used to
detect structural retinal microvascular alterations in an early stage of
remodeling processes.

PMID: 26267750   [PubMed - as supplied by publisher]


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

Structural and functional changes in corneal innervation after laser in situ
keratomileusis and their relationship with dry eye.

Chao C(1), Stapleton F, Zhou X, Chen S, Zhou S, Golebiowski B.

Author information: 
(1)School of Optometry and Vision Science, University of New South Wales, Sydney,
New South Wales, 2052, Australia.

PURPOSE: The most likely etiology of post-LASIK dry eye is corneal nerve damage; 
however, no direct relationship between post-LASIK dry eye symptoms and nerve
damage has been established, and limited information is available about the
relationship between dry eye signs and corneal reinnervation after LASIK. Tear
neuropeptides (SP and CGRP) are important in the maintenance of corneal nerve
health, but the impact of LASIK has not yet been studied. This study evaluated
changes in nerve morphology, tear neuropeptide, and dry eye, so as to establish
the relationship between reinnervation and dry eye and to assess the role of tear
neuropeptides in reinnervation post-LASIK.
METHODS: Twenty non-dry eye volunteers who had undergone bilateral myopic-LASIK
completed this study. Corneal nerve morphology (density, width, interconnections,
and tortuosity), SP and CGRP concentration, and dry eye were monitored over time 
prior to, 1 day, 1 week, 1, 3, and 6 months post-LASIK.
RESULTS: Dry eye symptoms and tear function, except for osmolarity (P = 0.003),
remained unchanged post-LASIK. Corneal nerve morphology decreased immediately,
and did not return to preoperative levels by 6 months post-LASIK (P < 0.001).
Increased tear SP concentration was observed 3 months post-LASIK (P < 0.001).
Associations between reinnervation as measured by increased density and lower
tear SP (P = 0.03), and between increased density and decreased dry eye symptoms 
(P = 0.01) were found post-LASIK.
CONCLUSION: An inverse relationship between reinnervation post-LASIK and dry eye 
symptoms was found, confirming that post-LASIK dry eye is a neuropathic disease. 
This study is the first to demonstrate an association between tear SP and
post-LASIK reinnervation, suggesting that strategies for manipulating
neuropeptide concentration to improve reinnervation may improve ocular comfort
post-LASIK.

PMID: 26259635   [PubMed - as supplied by publisher]


19. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 11. [Epub ahead of print]

Interplay of proliferation and differentiation factors is revealed in the early
human eye development.

Matas A(1), Filipovic N, Znaor L, Mardesic S, Saraga-Babic M, Vukojevic K.

Author information: 
(1)Department of Ophthalmology, University Hospital Centre Split, Spinciceva 1,
21000, Split, Croatia.

BACKGROUND: Eye development is a consequence of numerous
epithelial-to-mesenchymal interactions between the prospective lens ectoderm,
outpocketings of the forebrain forming optic vesicles, and surrounding
mesenchyme. How different cell types forming eye structures differentiate from
their precursors, and which factors coordinate complex human eye development
remains largely unknown. Proper differentiation of photoreceptors is of special
interest because of their involvement in the appearance of degenerative retinal
diseases.
METHODS: Here we analyze the spatiotemporal expression of neuronal markers
nestin, protein gene product 9.5 (PGP9.5), and calcium binding protein (S100),
proliferation marker (Ki-67), markers for cilia (alpha-tubulin), and cell
stemness marker octamer-binding transcription factor 4 (Oct-4) in histological
sections of 5-12 -week human eyes using immunohistochemical and
immunofluorescence methods.
RESULTS: While during the investigated developmental period nestin shows strong
expression in all mesenchymal derivatives, lens, optic stalk and inner
neuroblastic layer, PGP9.5 and S100 expression characterizes only neural
derivatives (optic nerve and neural retina). PGP9.5 is co-localized with nestin
and S100 in the differentiating cells of the inner neuroblastic layer. Initially 
strong proliferation in all parts of the developing eye gradually ceases,
especially in the outer neuroblastic layer. Proliferating Ki-67 positive cells
co-localize with nestin in the retina, lens, and choroid. Strong Oct-4 and
alpha-tubulin immunoreactivity in the retina and optic nerve gradually decreases,
while they co-localize in outer neuroblastic and nerve fiber layers.
CONCLUSIONS: The described expression of investigated markers indicates their
importance in eye growth and morphogenesis, while their spatially and temporally 
restricted pattern coincides with differentiation of initially immature cells
into specific retinal cell lineages. Alterations in their spatiotemporal
interplay might lead to disturbances of visual function.

PMID: 26255818   [PubMed - as supplied by publisher]


20. Graefes Arch Clin Exp Ophthalmol. 2015 Sep;253(9):1557-64. doi:
10.1007/s00417-015-3095-y. Epub 2015 Aug 11.

Correlation between optic disc perfusion and glaucomatous severity in patients
with open-angle glaucoma: an optical coherence tomography angiography study.

Wang X(1), Jiang C, Ko T, Kong X, Yu X, Min W, Shi G, Sun X.

Author information: 
(1)Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat
Hospital, Shanghai Medical College of Fudan University, 83 Fenyang Road,
Shanghai, 200031, China.

PURPOSE: To explore how optic disc perfusion varies in patients with open-angle
glaucoma (OAG) and how this correlates with glaucoma severity.
METHODS: We performed a prospective and cross-sectional observational study that 
included 62 eyes from 62 patients with OAG, divided into three groups according
to their visual field (VF) results, and 20 eyes from 20 normal control subjects. 
Optic disc perfusion was studied using optical coherence tomography angiography
(angio-OCT), and flow index and vessel density were determined. The VF, mean
deviation (MD), pattern standard deviation (PSD), retinal nerve fiber layer
(RNFL) thickness, and ganglion cell complex (GCC) thickness were also recorded.
The potential associations between disc perfusion and VF defects or structural
loss were analyzed.
RESULTS: In OAG patients, the disc flow index and vessel density were
significantly lower than in normal controls (all p<0.001) and were correlated
with the severity of glaucoma. In OAG eyes, the flow index and vessel density
were significantly correlated with MD, RNFL, and GCC thickness (all p<0.01), but 
were not in the normal controls. The receiver operating characteristic (ROC)
curve analysis also revealed that disc flow index and vessel density had the
power to differentiate normal eyes from eyes with OAG (under the ROC curves: 0.82
and 0.80, respectively).
CONCLUSIONS: Angiograms demonstrated a reduced disc flow index and vessel density
in glaucoma, and this reduction was closely related to GCC thickness. This
indicated that measurement of disc perfusion by angio-OCT might be important for 
the monitoring of glaucoma.

PMID: 26255817   [PubMed - in process]


21. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 9. [Epub ahead of print]

Spontaneous globe luxation in iatrogenic Cushing syndrome.

Ortega-Evangelio L(1), Navarrete-Sanchis J, Williams BK Jr, Tomas-Torrent JM.

Author information: 
(1)Department of Ophthalmology of The Ribera Hospital, Ctra. Corbera, km 1,
46600, Alzira, Spain, Valencia, leticiaortegaevangelio@gmail.com.

PURPOSE: We report a rare case of spontaneous eyeball luxation associated with
exophthalmos due to iatrogenic Cushing syndrome (CS). The normalization of serum 
hormones led to the regression of the picture.
CASE: A 64-year-old man presented with spontaneous globe luxation of the left eye
after a 6-month history of bilateral, painless, and slowly progressive
exophthalmos. The patient had been receiving weekly infusions of methylprednisone
over the previous 6 months. His best-corrected visual acuity (BCVA) at
presentation was 20/40 in the right eye and 20/20 in the left eye. The patient
demonstrated full extraocular motility. The intraocular pressure (IOP) was
elevated in the right eye (24 mHg) and normal in the left eye (18 mmHg).
Exophthalmometry demonstrated bilateral proptosis with measurements of 27 mm in
the right eye and 28 mm in the left eye. Computed tomography scan of the brain
and orbits revealed increased orbital and cervical fat. Clinical, radiographic
and serologic findings ruled out potential diagnoses including orbital
metastasis, thyroid orbitopathy, carotid-cavernous fistula, and idiopathic
orbital pseudotumor. Clinical suspicion of iatrogenic CS was high, and additional
serologic testing confirmed the diagnosis.
CONCLUSION: Exophthalmos is an uncommon sign of CS, but to our knowledge, this is
the first reported case of spontaneous globe luxation secondary to CS. In our
case, normalization of cortisol was sufficient to resolve the clinical symptoms
and eliminated the need for surgical intervention such as orbital decompression
surgery.

PMID: 26255178   [PubMed - as supplied by publisher]


22. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 8. [Epub ahead of print]

A new method to predict anatomical outcome after idiopathic macular hole surgery.

Liu P(1), Sun Y, Dong C, Song D, Jiang Y, Liang J, Yin H, Li X, Zhao M.

Author information: 
(1)Department of Ophthalmology, Peking University People's Hospital, Xizhimen
South Street 11, Xi Cheng District, 100044, Beijing, China.

PURPOSE: To investigate whether a new macular hole closure index (MHCI) could
predict anatomic outcome of macular hole surgery.
METHODS: A vitrectomy with internal limiting membrane peeling, air-fluid
exchange, and gas tamponade were performed on all patients. The postoperative
anatomic status of the macular hole was defined by spectral-domain OCT. MHCI was 
calculated as (M+N)/BASE based on the preoperative OCT status. M and N were the
curve lengths of the detached photoreceptor arms, and BASE was the length of the 
retinal pigment epithelial layer (RPE layer) detaching from the photoreceptors.
Postoperative anatomical outcomes were divided into three grades: A (bridge-like 
closure), B (good closure), and C (poor closure or no closure). Correlation
analysis was performed between anatomical outcomes and MHCI. Receiver operating
characteristic (ROC) curves were derived for MHCI, indicating good model
discrimination. ROC curves were also assessed by the area under the curve, and
cut-offs were calculated. Other predictive parameters reported previously, which 
included the MH minimum, the MH height, the macular hole index (MHI), the
diameter hole index (DHI), and the tractional hole index (THI) had been compared 
as well.
RESULTS: MHCI correlated significantly with postoperative anatomical outcomes
(r = 0.543, p = 0.000), but other predictive parameters did not. The areas under 
the curves indicated that MHCI could be used as an effective predictor of
anatomical outcome. Cut-off values of 0.7 and 1.0 were obtained for MHCI from ROC
curve analysis. MHCI demonstrated a better predictive effect than other
parameters, both in the correlation analysis and ROC analysis.
CONCLUSIONS: MHCI could be an easily measured and accurate predictive index for
postoperative anatomical outcomes.

PMID: 26254111   [PubMed - as supplied by publisher]


23. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 9. [Epub ahead of print]

Detecting the effect of under-correcting myopia.

Medina A(1).

Author information: 
(1)Massachusetts Institute of Technology, Research Laboratory of Electronics,
Cambridge, Massachusetts, 02139, USA, puerta@alum.mit.edu.

PMID: 26254110   [PubMed - as supplied by publisher]


24. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 6. [Epub ahead of print]

Giant premacular bursa: a novel finding of the posterior vitreous in two patients
with Stickler syndrome type 1 revealed by swept-source optical coherence
tomography.

Chen KC(1), Jung JJ, Engelbert M.

Author information: 
(1)Department of Ophthalmology, New York University School of Medicine, New York,
NY, USA.

PMID: 26245341   [PubMed - as supplied by publisher]


25. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 7. [Epub ahead of print]

Static characteristics and dynamic functionality of retinal vessels in longer
eyes with or without pathologic myopia.

La Spina C(1), Corvi F, Bandello F, Querques G.

Author information: 
(1)Department of Ophthalmology, IRCCS San Raffaele Scientific Institute,
University Vita-Salute San Raffaele, Via Olgettina 60, Milan, 20132, Italy.

PURPOSE: To analyze major retinal vessels in eyes with high myopia by means of
the Dynamic Vessel Analyzer (DVA) in order to gather insight on retinal vascular 
functionality and better understand why these eyes are resistant to
diabetes-related changes.
METHODS: A total of 20 high-myopia eyes with pathologic myopia, 20 high-myopia
eyes without pathologic myopia and 20 age- and sex-matched control subjects
(without pathologic myopia) were included and compared.
RESULTS: Dynamic analysis showed mean arterial dilation of 2.44 ± 1.59 % in
high-myopia eyes with pathologic myopia, 2.67 ± 1.17 in high-myopia without
pathologic myopia eyes, and 3.28 ± 1.46 % in healthy eyes. Mean venous dilation
was 3.45 ± 1.82 %, 3.57 ± 1.72, and 4.45 ± 2.72 % respectively. Static analysis
in high myopia eyes with pathologic myopia showed a mean central retinal artery
equivalent (CRAE) of 171.6 ± 24.3, a mean central retinal vein equivalent (CRVE) 
of 199.5 ± 27.73, and a mean arteriovenous ratio (AVR) of 0.86 ± 0.01. In
patients with high myopia without pathologic myopia, we found a mean CRAE of
173 ± 21.6, a mean CRVE of 198.2 ± 18.8, and a mean AVR of 0.87 ± 0.1. In control
subjects, mean CRAE was 190.3 ± 11.93, mean was CRVE 215.7 ± 13.30, and mean AVR 
was 0.88 ± 0.04.
CONCLUSIONS: Static and dynamic tests revealed that in high-myopia eyes, the
vessels at the retinal posterior pole have reduced diameter, but are functionally
comparable to control subjects. This supports the hypothesis of reduced oxygen
consumption in high-myopia eyes.

PMID: 26245340   [PubMed - as supplied by publisher]


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

Polymorphisms in the CTSH gene may influence the progression of diabetic
retinopathy: a candidate-gene study in the Danish Cohort of Pediatric Diabetes
1987 (DCPD1987).

Thorsen SU(1), Sandahl K, Nielsen LB, Broe R, Rasmussen ML, Peto T, Grauslund J, 
Andersen ML, Mortensen HB, Pociot F, Olsen BS, Brorsson C.

Author information: 
(1)Department of Peadiatrics, Herlev Hospital, University of Copenhagen, Herlev
Ringvej 75, 2730, Herlev, Denmark.

BACKGROUND: The incidence of type 1 diabetes mellitus (T1DM) is increasing
globally, and as a consequence, more patients are affected by microvascular
complications such as diabetic retinopathy (DR). The aim of this study was to
elucidate possible associations between diabetes-related single-nucleotide
polymorphisms (SNP) and the development of DR.
METHODS: Three hundred and thirty-nine patients with T1DM from the Danish Cohort 
of Pediatric Diabetes 1987 (DCPD1987) went through an ophthalmic examination in
1995; 185 of these were reexamined in 2011. The development of DR was assessed by
comparison of overall DR level between baseline and follow-up in the worst eye at
baseline. Patients were graded on a modified version of the Early Treatment
Diabetic Retinopathy Study (ETDRS) scale, and 20 SNPs were genotyped in 130 of
the 185 patients.
RESULTS: We found the CTSH/rs3825932 variant (C > T) was associated with reduced 
risk of progression to proliferative diabetic retinopathy (PDR) (OR [95 %
CI] = 0.20 [0.07-0.56], p = 2.4 × 10(-3), padjust = 0.048) and ERBB3/rs2292239
variant (G > T) associated with increased risk of two-step progression (OR [95 % 
CI] = 2.76 [1.31-5.80], p = 7.5 × 10(-3), padjust = 0.15). The associations were 
independent of other known risk factors, such as HbA1c, sex, and diastolic blood 
pressure.
CONCLUSION: In conclusion, CTSH/rs3825932 and ERBB3/rs2292239 SNPs were
associated with reduced risk of progression to PDR and two-step progression of DR
on the ETDRS scale accordingly. The variant CTSH remained statistically
significant after adjusting for multiple testing. Our results suggest an overlap 
between genetic variants that confer risk of T1DM and progression of DR.

PMID: 26245339   [PubMed - as supplied by publisher]


27. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 6. [Epub ahead of print]

Distinct patterns of spontaneous brain activity between children and adults with 
anisometropic amblyopia: a resting-state fMRI study.

Liang M(1), Xie B, Yang H, Yu L, Yin X, Wei L, Wang J.

Author information: 
(1)Department of Radiology, Southwest Hospital, Third Military Medical
University, Chongqing, 400038, China.

PURPOSE: To detect the altered spontaneous brain activity patterns in children
and adults with anisometropic amblyopia using resting-state functional magnetic
resonance imaging (rs-fMRI) technique combined with the amplitude of
low-frequency fluctuation (ALFF) method.
METHODS: Thirty-two monocular anisometropic amblyopia and 34 normal-sight
controls were divided into child group and adult group. Rs-fMRI was performed in 
all participants and analysis of ALFF value within the whole brain was conducted 
in each subject. ALFF value differences between the patients and controls in the 
two groups were compared via an independent two-sample t test.
RESULTS: The amblyopic children mainly exhibited increased ALFF in part of the
bilateral calcarine (BA17), the left middle occipital gyrus (BA18/19), and the
left postcentral gyrus (BA2). By contrast, the amblyopic adults showed decreased 
ALFF in the bilateral precuneus cortex (part of BA7), and the standardized ALFF
value of bilateral precuneus were correlated with the amount of anisometropia of 
the amblyopic adults.
CONCLUSIONS: Rs-fMRI is an effective noninvasive technique for exploring brain
activity of the anisometropic amblyopia. Our findings demonstrated that brain
activity changed both in amblyopic children and adults under the resting state,
and revealed the differences in spontaneous activity patterns between the
amblyopic children and adults.

PMID: 26245338   [PubMed - as supplied by publisher]


28. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 6. [Epub ahead of print]

Abnormal traction of the vitreous detected by swept-source optical coherence
tomography is related to the maculopathy associated with optic disc pits.

Yokoi T(1), Nakayama Y, Nishina S, Azuma N.

Author information: 
(1)Department of Ophthalmology and Laboratory for Visual Science, National Center
for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535,
Japan.

BACKGROUND: Maculopathy associated with optic disc pits (ODP), which sometimes
causes severe visual loss, usually appears in late childhood or early adulthood. 
However, it has long been unclear how the disease begins to develop at these
ages. We evaluated the relationship between vitreous structure and maculopathy
associated with ODP.
METHODS: Six patients (seven eyes) with ODP were diagnosed between July 1990 and 
May 2013. Fundus photographs and swept-source optical coherence tomography
(SS-OCT) images were evaluated retrospectively, and the vitreous at the
vitreoretinal interface was visualized by reconstructing three-dimensional SS-OCT
images. Vitrectomy was performed in the eyes with maculopathy.
RESULTS: Among the six patients, five had ODP in one eye each and one patient had
bilateral ODP. The pits were mainly located in the temporal quadrant, and
maculopathy, including retinoschisis and retinal detachment, was detected in five
eyes associated only with the temporal pits. A flat retinal detachment was
observed in four eyes and identified within the vascular arcade except in one
eye. A posterior precortical vitreous pocket (PPVP) was observed in all eyes
except in one eye without maculopathy. Reconstructing images from SS-OCT showed
the vitreoretinal interface abnormalities around the optic disc and the macular
area in all eyes, which was completely different from the vitreoretinal interface
in the normal pediatric eye. Vitrectomy was performed in four eyes with retinal
detachment to resect the abnormal vitreous traction. Posterior vitreous
detachment was created in two eyes. Retinal reattachment was achieved in three
eyes, and subretinal fluid receded in one eye. The visual acuity improved in all 
four eyes.
CONCLUSIONS: Abnormal traction of the vitreous due to an abnormality of the
vitreoretinal interface, which may be strengthened by the development of a PPVP, 
generates the maculopathy associated with ODP.

PMID: 26245337   [PubMed - as supplied by publisher]


29. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 6. [Epub ahead of print]

Reply to letter to the editor: Comparison of retinal detachment surgery outcome
among patients undergoing pars plana vitrectomy with and without relaxing
retinotomy.

Barak A(1).

Author information: 
(1)Department of Ophthalmology, The Tel Aviv Medical Center, Tel Aviv University,
6 Waitzman Street, Tel Aviv, 45267, Israel, adielbarak@gmail.com.

PMID: 26245336   [PubMed - as supplied by publisher]


30. Graefes Arch Clin Exp Ophthalmol. 2015 Aug 5. [Epub ahead of print]

Response to letter regarding the publication "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,
nir_sorkin@yahoo.com.

PMID: 26242489   [PubMed - as supplied by publisher]