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 Apr 16. [Epub ahead of print]

HIF-1α SUMOylation affects the stability and transcriptional activity of HIF-1α
in human lens epithelial cells.

Han X(1), Wang XL, Li Q, Dong XX, Zhang JS, Yan QC.

Author information: 
(1)Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical
University; Key Laboratory of Lens Research of Liaoning Province, Eye Hospital of
China Medical University, 11 Xinhua Road, Heping District, Shenyang, Liaoning
Province, 110005, People's Republic of China.

PURPOSE: High blood glucose can induce oxidative damage and result in diabetic
cataract. Oxidative stress induces various signal pathways including HIF-1α
transcriptional signal to attenuate the damage of lenses. Whether HIF-1α
SUMOylation can increase the activation of HIF-1α or if high glucose can affect
the SUMOylation of HIF-1α in cultured human lens epithelial cells (HLECs) is
still unknown, as well as the function of HIF-1α SUMOylation in oxidative damage 
induced by high glucose in HLECs. In the present study, we examined SUMO and SUMO
E3 (Cbx4 and PIASy) expression induced by high glucose, and investigated SUMO or 
SUMO E3 overexpression that enhanced HIF-1α SUMOylation in HLECs.
METHODS: SRA01/04 cells, one kind of human lens epithelial cell line, were
addressed in media with 5.5 mmol/l (normal control group), 25 mmol/l (high
glucose1 group) and 50 mmol/l (high glucose2 group) final glucose respectively.
Expression of SUMO1 ~ 4, Cbx4, PIASy, HIF-1α, GLUT1, and VEGFA were detected in
the mRNA and protein levels by RT-PCR and Western blot analysis. Protein
expression localization and co-localization were examined by immunofluorescence
and co-immunofluorescence. The effects of SUMO overexpression, SUMO E3
overexpression, and Proteasome inhibitor MG132 respectively on the stability and 
transcriptional activity of HIF-1α were analyzed by immunoblot.
RESULTS: High glucose treatment induced SUMO1-4 expression and enhanced the
expression of Cbx4 and PIASy. It also increased the expression of HIF-1α, GLUT1, 
and VEGFA. The co-localization of HIF-1α and SUMO was mainly in the nucleus
induced by high glucose. Further studies showed that SUMO overexpression or SUMO 
E3 overexpression could enhance HIF-1α stability and transcriptional activity in 
HLECs. Proteasome inhibitor MG132 protected the stability and transcriptional
activity of HIF-1α in the SRA01/04 cells.
CONCLUSIONS: HIF-1α SUMOylation affected the stability and transcriptional
activity of HIF-1α in cultured human lens epithelial cells; SUMO overexpression
or SUMO E3 overexpression enhanced the expression of HIF-1α, which is involved in
inhibiting cell apoptosis and protecting lens opacification, and presumably plays
a key role in protecting lenses from diabetic cataract.

PMID: 25877955   [PubMed - as supplied by publisher]


2. Graefes Arch Clin Exp Ophthalmol. 2015 Jan 21. [Epub ahead of print]

Combined silencing of TGF-β2 and Snail genes inhibit epithelial-mesenchymal
transition of retinal pigment epithelial cells under hypoxia.

Feng Z(1), Li R, Shi H, Bi W, Hou W, Zhang X.

Author information: 
(1)Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical
University, 23 Youzheng Street, Nangang district, Harbin, 150001, Heilongjiang,
Province, People's Reepublic of China.

BACKGROUND: The formation of scar-like fibrous tissue in age-related macular
degeneration (AMD) is associated with hypoxia. Under hypoxia, retinal pigment
epithelial (RPE) cells can secret more transforming growth factor-β2 (TGF-β2),
which is determined to induce epithelial-mesenchymal transition (EMT) at certain 
concentrations. Whether hypoxia can induce EMT by stimulating RPE cell line
secrets TGF-β2 or not remains unknown. To gain a better understanding of the
signaling mechanisms of fibrosis in AMD under hypoxic conditions, we investigated
EMT in retinal pigment epithelial (RPE) cells and the effect of TGF-β2 and Snail 
in this process.
METHODS: Human RPE cell line (ARPE-19) was incubated with 5 % O2 for different
periods of time. The expression of N-cadherin, α-smooth muscle actin (α-SMA),
TGF-β2 , and Snail were determined by Western blot and real-time PCR. Cell
proliferation was assessed by CCK8 kit. RNA interference was used for multi-gene 
silencing of TGF-β2 and Snail genes.
RESULTS: N-cadherin was decreased and mesenchymal cell marker α-SMA was increased
after the ARPE-19 cell line was incubated with 5 % O2. Meanwhile, the
proliferation capability of the cell line was increased. TGF-β2 and Snail
expression were increased in a time-dependent manner under hypoxia. After
multi-silencing TGF-β2 and Snail genes, N-cadherin was increased and α-SMA was
reduced. Meanwhile, the proliferation of the cell line was suppressed.
CONCLUSIONS: Under hypoxic conditions, RPE cells undergo EMT. Endogenic TGF-β2
and Snail are involved in this process. Furthermore, knockdown of both TGF-β2 and
Snail inhibited EMT to a greater extent than knockdown of either gene
individually.

PMID: 25875044   [PubMed - as supplied by publisher]


3. Graefes Arch Clin Exp Ophthalmol. 2015 Jan 21. [Epub ahead of print]

Multiple programmed cell death pathways are involved in
N-methyl-N-nitrosourea-induced photoreceptor degeneration.

Reisenhofer M(1), Balmer J, Zulliger R, Enzmann V.

Author information: 
(1)Department of Ophthalmology, Inselspital, University of Bern, Freiburgstrasse 
14, 3010, Bern, Switzerland.

PURPOSE: To identify programmed cell death (PCD) pathways involved in
N-methyl-N-nitrosourea (MNU)-induced photoreceptor (PR) degeneration.
METHODS: Adult C57BL/6 mice received a single MNU i.p. injection (60 mg/kg
bodyweight), and were observed over a period of 7 days. Degeneration was
visualized by H&E overview staining and electron microscopy. PR cell death was
measured by quantifying TUNEL-positive cells in the outer nuclear layer (ONL).
Activity measurements of key PCD enzymes (calpain, caspases) were used to
identify the involved cell death pathways. Furthermore, the expression level of
C/EBP homologous protein (CHOP) and glucose-regulated protein 78 (GRP78), key
players in endoplasmic reticulum (ER) stress-induced apoptosis, was analyzed
using quantitative real-time PCR.
RESULTS: A decrease in ONL thickness and the appearance of apoptotic PR nuclei
could be detected beginning 3 days post-injection (PI). This was accompanied by
an increase of TUNEL-positive cells. Significant upregulation of activated
caspases (3, 9, 12) was found at different time periods after MNU injection.
Additionally, several other players of nonconventional PCD pathways were also
upregulated. Consequently, calpain activity increased in the ONL, with a maximum 
on day 7 PI and an upregulation of CHOP and GRP78 expression beginning on day 1
PI was found.
CONCLUSIONS: The data indicate that regular apoptosis is the major cause of
MNU-induced PR cell death. However, alternative PCD pathways, including ER stress
and calpain activation, are also involved. Knowledge about the mechanisms
involved in this mouse model of PR degeneration could facilitate the design of
putative combinatory therapeutic approaches.

PMID: 25875043   [PubMed - as supplied by publisher]


4. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 12. [Epub ahead of print]

Effect of posterior vitreous detachment on aqueous humor level of vascular
endothelial growth factor in exudative age-related macular degeneration patients.

Nomura Y(1), Takahashi H, Tan X, Fujino Y, Kawashima H, Yanagi Y.

Author information: 
(1)Department of Ophthalmology, Graduate School of Medicine, The University of
Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, nomurayoko-tky@umin.ac.jp.

BACKGROUND: To investigate the association of posterior vitreous detachment (PVD)
with aqueous levels of vascular endothelial growth factor (VEGF) in eyes with
exudative age-related macular degeneration (AMD).
METHODS: This is a prospective comparative study. Subjects are 33 eyes with
exudative AMD. PVD was examined by B-mode ultrasonography and the subjects were
divided into a complete PVD group (PVD group) or a group with partial or no PVD
(without PVD group). At the beginning of intravitreal injection of ranibizumab,
aqueous humor was collected and the concentration of VEGF was measured using
ELISA. The concentration was compared between the two groups.
RESULTS: Complete PVD was observed in 13 (39 %) eyes. The mean concentration of
VEGF was 58 pg/ml in the PVD group and 91 pg/ml in the without PVD group.
Multiple regression analysis revealed that the concentration of VEGF was
significantly lower in the eyes with PVD than in those without PVD independent of
age and sex (P = 0.02).
CONCLUSIONS: Complete PVD is related to the lower concentration of aqueous VEDF
in AMD eyes.

PMID: 25863675   [PubMed - as supplied by publisher]


5. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 12. [Epub ahead of print]

Axonal protection by brimonidine with modulation of p62 expression in TNF-induced
optic nerve degeneration.

Kitaoka Y(1), Kojima K, Munemasa Y, Sase K, Takagi H.

Author information: 
(1)Department of Ophthalmology, St. Marianna University School of Medicine,
2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan,
kitaoka@marianna-u.ac.jp.

PURPOSE: The p62, also called sequestosome 1 (SQSTM1), plays a crucial role in
tumor necrosis factor (TNF)-induced optic nerve degeneration. Brimonidine has
been shown to have protective effects on retinal ganglion cell bodies, although
its role in their axons remains to be examined. We determined whether brimonidine
modulates axonal loss induced by TNF and affects the expression of p62 in the
optic nerve.
METHODS: Experiments were performed on adult male Wistar rats that received an
intravitreal injection of 10 ng TNF alone or simultaneous injection of TNF and 2,
20, or 200 pmol of brimonidine tartrate. The expression of p62 in the optic nerve
was examined by immunoblot analysis. The effects of brimonidine on axons were
evaluated by counting axon numbers 2 weeks after intravitreal injection.
RESULTS: Intravitreal injection of brimonidine exerted substantial axonal
protection against TNF-induced optic nerve degeneration. Immunoblot analysis
showed that p62 was upregulated in the optic nerve after intravitreal injection
of TNF, and that this increase was completely inhibited by brimonidine. Treatment
with brimonidine alone also significantly decreased p62 protein levels in the
optic nerve compared with the basal level.
CONCLUSIONS: These results suggest that the modulation of p62 levels in the optic
nerve by brimonidine may be involved partly in its axonal protection.

PMID: 25863674   [PubMed - as supplied by publisher]


6. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 12. [Epub ahead of print]

Analysis of the ganglion cell layer and photoreceptor layer using optical
coherence tomography after idiopathic epiretinal membrane surgery.

Park SW(1), Byon IS, Lee JE, Oum BS.

Author information: 
(1)Department of Ophthalmology, School of Medicine, Pusan National University,
Yangsan, Korea.

PMID: 25863673   [PubMed - as supplied by publisher]


7. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 12. [Epub ahead of print]

The effect of nifedipine on retinal venous pressure of glaucoma patients with the
Flammer-Syndrome.

Fang L(1), Turtschi S, Mozaffarieh M.

Author information: 
(1)Department of Ophthalmology, University of Basel, Mittlere Strasse 91, 4031,
Basel, Switzerland.

PURPOSE: The purpose was to measure the retinal venous pressure (RVP) in both
eyes of primary open-angle glaucoma (POAG) patients before and 3 weeks after
treatment with low-dosed Nifedipine.
METHODS: This retrospective study included 20 POAG patients who were treated with
Nifedipine (5 mg daily) and 20 untreated control POAG patients. In both the
treated and untreated control group, a distinction was made between those
patients who had the Flammer-Syndrome (FS) and those who did not. The RVP was
measured in all patients bilaterally at baseline and 3 weeks later by means of
contact lens ophthalmodynamometry and the RVP measurements of the treated POAG
patients were compared to the RVPs of the untreated POAG controls.
Ophthalmodynamometry is done by applying an increasing force on the eye via a
contact lens. The minimum force required to induce a venous pulsation is called
the ophthalmodynamometric force (ODF). The RVP is defined and calculated as the
sum of ODF and intraocular pressure (IOP) [RVP = ODF + IOP].
RESULTS: The RVP decreased significantly after 3 weeks in both eyes of patients
treated with low-dosed Nifedipine compared to the untreated group (mean decrease 
of 12.5 mmHg (SD 12.5), P < 0.001). A larger response to therapy was found in
patients with the FS compared to patients lacking the FS (mean decrease of 16.07 
vs. 7.28 mmHg, confidence Interval (CI): 5.2 to 9.3 vs. 12.3 to 19.7; P < 0.001).
No significant differences were accounted for in the IOP's of the patients after 
treatment. In the untreated control group, no significant differences were
accounted for either in the RVP or the IOP after 3 weeks.
CONCLUSIONS: Treatment with low-dosed Nifedipine decreases RVP in both eyes of
glaucoma patients, particularly in those with the Flammer-Syndrome. This effect
may be due to the partial inhibition of Endothelin-1 (ET-1) by Nifedipine.

PMID: 25863672   [PubMed - as supplied by publisher]


8. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 12. [Epub ahead of print]

Longitudinal analysis of the structural pattern of pseudophakic cystoid macular
edema using multimodal imaging.

Sigler EJ(1), Randolph JC, Kiernan DF.

Author information: 
(1)Division of Retina and Vitreous, Ophthalmic Consultants of Long Island, 2000
North Village Avenue, suite 402, Rockville Centre, NY, 11570, USA,
ejsigler@gmail.com.

PURPOSE: To describe the relationship between pseudophakic cystoid macular edema 
(CME) progression and retinal structural changes observed by spectral-domain
optical coherence tomography (SD-OCT) and fluorescein angiography.
METHODS: Retrospective, consecutive, longitudinal imaging analysis of patients
with acute pseudophakic cystoid macular edema. Two observers at two study centers
evaluated all images and categorized the macular structural features based on the
retinal layer involved with cystic changes and/or subretinal fluid. A time series
of the structural pattern and visual acuity was constructed for 1-month intervals
over a 6-month study period.
RESULTS: Thirty nine patients presented with CME. The mean time since cataract
extraction was 48 ±38 days (range 5-71). CME included inner nuclear layer (INL)
cystic changes, outer plexiform layer (OPL) cystic changes, and subretinal fluid.
Isolated INL changes were observed in four phakic fellow eyes. Isolated OPL
morphology was not observed, and additional inner layers remained uninvolved.
Resolution occurred rapidly following administration of periocular
glucocorticoids, and typically demonstrated a reverse structural pattern or
delayed subretinal fluid resolution. Isolated subretinal fluid or a combined INL 
and subretinal fluid structure indicated CME resolution.
CONCLUSION: Acute and recurrent pseudophakic CME involves a directional
progression of the retinal layer involved with cystic changes and a clinical
course. CME begins with INL cystic changes, progresses to combined INL and OPL
morphology, and may continue to involve subretinal fluid. The inner nuclear layer
is the most frequently involved layer, and isolated INL cysts may occur in phakic
fellow eyes. A three-layer structure, the presence of OPL morphology, or isolated
INL early in the postoperative period indicates disease activity.

PMID: 25863671   [PubMed - as supplied by publisher]


9. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 12. [Epub ahead of print]

The progression of corrected myopia.

Medina A(1).

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

PURPOSE: This study seeks to demonstrate the existence of a feedback loop
controlling myopia by comparing the prediction of a feedback model to the actual 
progression of corrected myopia. In addition to theoretical results, confirming
clinical data are presented.
METHODS: The refraction of 13 continuously corrected myopic eyes was collected
over a period of time ranging from 4 to 9 years from the time of their first
correction. Refractive data was collected in an optometry office from myopic
young subjects from the general population in Boston. Subjects were myopes, ages 
2 to 22 at the time of first correction selected randomly from a larger
population. All individuals were fully corrected with lenses; new lenses were
prescribed every time that their myopia increased by 0.25 diopters or more.
Subjects wore their spectacle lenses during the followed period.
RESULTS: Subjects exhibit a linear time course of myopia progression when
corrected with lenses. The observed rate of myopia increase is 0.2 to 1.0
diopters/year, with a mean correlation coefficient r  = -0.971, p < 0.005.
CONCLUSIONS: This report establishes that feedback control theory applies to the 
clinical phenomenon of progressive myopia. Continuous correction of myopia
results in a linear progression that increases myopia. The Laplace transformation
of temporal refractive data to the s-domain simplifies the study of myopia and
emmetropia. The feedback transfer function predicts that continuous correction of
myopia results in a linear progression because continuous correction opens the
feedback loop. This prediction is confirmed with all subjects.

PMID: 25863670   [PubMed - as supplied by publisher]


10. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 9. [Epub ahead of print]

Erratum to: Effect of gravity in long-term vitreous tamponade: in vivo
investigation using perfluorocarbon liquids and semi-fluorinated alkanes.

Mackiewicz J(1), Maaijwee K, Lüke C, Kociok N, Hiebl W, Meinert H, Joussen AM.

Author information: 
(1)Department of Vitreoretinal Surgery, Center for Ophthalmology, University of
Cologne, Kerpener Strasse 62, 50924, Cologne, Germany,
jerzy.mackiewicz@am.lublin.pl.

PMID: 25851864   [PubMed - as supplied by publisher]


11. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 9. [Epub ahead of print]

Comment on: Park SW, Byon IS, Kim HY, Lee JE, Oum BS (2015) Analysis of the
ganglion cell layer and photoreceptor layer using optical coherence tomography
after idiopathic epiretinal membrane surgery. Graefes Arch Clin Exp Ophthalmol
253:207-14.

Iuliano L(1), Bandello F, Pierro L.

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

PMID: 25851863   [PubMed - as supplied by publisher]


12. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 9. [Epub ahead of print]

Vascular endothelial growth factor plasma levels before and after treatment of
retinopathy of prematurity with ranibizumab.

Zhou Y(1), Jiang Y, Bai Y, Wen J, Chen L.

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

PURPOSE: To evaluate vascular endothelial growth factor (VEGF) plasma levels
before and after intravitreal injection of ranibizumab in patients with
retinopathy of prematurity (ROP).
METHODS: Case series study. Eleven infants with type 1 pre-threshold ROP were
treated with intravitreal ranibizumab 0.5 mg. Blood samples were collected before
intravitreal injection of ranibizumab and 1 day, 1 week, 2 weeks, and 4 weeks
after injection. Concentration of plasma VEGF was measured by enzyme-linked
immunosorbent assays (ELISA).
RESULTS: The mean ± standard deviation of plasma VEGF concentration of the
available samples before and 1 day, 1 week, 2 weeks, and 4 weeks after a total of
0.5 mg ranibizumab injection were 46.07 ± 9.40 pg/ml (n = 11), 10.59 ± 7.32 pg/ml
(n = 5), 45.76 ± 6.75 pg/ml (n = 5), 62.44 ± 15.51 pg/ml (n = 5), and
56.82 ± 12.78 pg/ml (n = 4) respectively. A significant reduction was found in
the plasma VEGF levels 1 day after intravitreal injection of ranibizumab
(P = 0.002). No significant differences were found between before and 1 week,
2 weeks, and 4 weeks after the injection.
CONCLUSIONS: Intravitreal ranibizumab reduced plasma VEGF levels 1 day after
injection in infants with ROP. This effect disappeared 1 week after the
injection. Intravitreal ranibizumab did not induce prolonged systemic VEGF
suppression.

PMID: 25851862   [PubMed - as supplied by publisher]


13. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 8. [Epub ahead of print]

Accurate evaluation of relationships among serum lipoprotein lipase mass,
visceral fat, and retinal nerve fiber layer thickness.

Shiba T(1), Takahashi M, Shiba C, Hori Y.

Author information: 
(1)Department of Ophthalmology, School of Medicine, Toho University, 6-11-1,
Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan, tomoaki-s@med.toho-u.ac.jp.

PMID: 25851861   [PubMed - as supplied by publisher]


14. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 9. [Epub ahead of print]

Accurate evaluation of relationships among serum lipoprotein lipase mass,
visceral fat and retinal nerve fiber layer thickness.

Ozgonul C(1), Sertoglu E, Gokce G, Ayyildiz O.

Author information: 
(1)Department of Ophthalmology, Van Military Hospital, Iskele Ave., Van, Turkey, 
cemozgonul@hotmail.com.

PMID: 25851860   [PubMed - as supplied by publisher]


15. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 7. [Epub ahead of print]

Medial rectus muscle elongation, a technique to treat very large-angle esotropia.

Ameri A(1), Akbari MR, Keshtkar Jaafari AR, Fard MA, Eshraghi B, Tavakoli V,
Mirmohammadsadeghi A.

Author information: 
(1)Farabi Eye Research Center, Tehran University of Medical Sciences, Tehran,
Iran.

PURPOSE: The purpose was to describe the medial rectus muscle elongation (MRE)
procedure to treat very large-angle esotropia (ET) with surgery on a lower number
of muscles.
METHODS: Twenty patients with very large-angle ET (more than 70 PD) underwent the
MRE procedure. In the MRE procedure, the muscle was split longitudinally into
three parts. The wider central part was sutured with 6/0 vicryl and disinserted. 
The distal end of the peripheral parts (still attached to the original
insertion), 7-9 mm away from the insertion, was sutured to the proximal end of
the central part. At the end of the procedure, the distance of the anastomosis
site from the insertion was named as the final elongation. The dose-response
effect of the final elongation was calculated in bilateral MRE cases. The mean of
the dose-response effect, obtained in the binocular surgery group, was used in
the monocular surgery group to calculate the resection effect of lateral rectus
(LR) muscle.
RESULTS: Eleven patients underwent bilateral MRE and nine patients underwent
unilateral MRE and LR muscle resection. The mean preoperative far and near
deviation was 94.10 ± 19.33 PD. The mean postoperative deviation was
14.60 ± 18.07 PD for far and 14.50 ± 18.23 PD for near deviation. In bilateral
MRE cases, the mean dose-response effect of the elongation was 5.53 ± 0.67 PD/mm 
for far and 5.58 ± 0.69 PD/mm for near deviation. The mean LR muscle resection
effect was 6.41 ± 1.99 PD/mm for far and 6.28 ± 1.93 PD/mm for near deviation.
CONCLUSION: The MRE procedure seems an acceptable method to treat very
large-angle ET with surgery on a lower number of muscles.

PMID: 25845955   [PubMed - as supplied by publisher]


16. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 1. [Epub ahead of print]

Long-term visual outcome and prognostic factors of Intravitreal anti-vascular
endothelial growth factor treatment for retinal angiomatous proliferation.

Cho HJ(1), Lee TG, Han SY, Kim HS, Kim JH, Han JI, Lew YJ, Kim JW.

Author information: 
(1)Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research
Institute, Konyang University College of Medicine, 156, 4ga, Yeoungdeungpo-dong, 
Yeoungdeungpo-gu, Seoul, South Korea.

PURPOSE: To evaluate the long-term visual outcomes and investigate the prognostic
factors of anti-vascular endothelial growth factor (VEGF) therapy for retinal
angiomatous proliferation (RAP).
METHODS: Thirty-eight treatment-naïve RAP eyes (38 patients) that received
intravitreal anti-VEGF (ranibizumab and/or bevacizumab) injections were included 
and analyzed in this retrospective case series. All patients were treated with an
initial series of three monthly intravitreal anti-VEGF injections, followed by
as-needed injections for a total of 36 months.
RESULTS: The mean number of anti-VEGF injections was 9.61 ± 3.1 during the
36-month follow-up. Mean baseline best-corrected visual acuity (BCVA) was
0.79 ± 0.56 logarithm of the minimum angle of resolution (logMAR; 20/123 Snellen 
equivalent), and 0.75 ± 0.41 logMAR (20/112 Snellen equivalent) at 36 months
(P = 0.55). Mean BCVA significantly improved at 3 months (P = 0.001), and the
significant improvement persisted until 18 months from baseline (P = 0.02).
However, the mean BCVA between 18 and 36 months showed no statistical in
comparison with baseline values. Geographic atrophy developed in 14 eyes (36.8 %)
during the entire 36-month follow-up period. Among baseline characteristics,
baseline BCVA, greatest lesion diameter (GLD), and lesion size were significantly
correlated with long-term visual outcome (P = 0.008, 0.02, and 0.002
respectively).
CONCLUSIONS: Intravitreal anti-VEGF injections for RAP showed a favorable visual 
outcome during the first year; however, the visual gains declined after the
second year from baseline. Better baseline BCVA, smaller lesion size, and smaller
baseline GLD are associated with better long-term visual outcomes in patients
with RAP.

PMID: 25825231   [PubMed - as supplied by publisher]


17. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 1. [Epub ahead of print]

Choroidal involvement in Rosai-Dorfman syndrome may be depicted and followed
using enhanced depth imaging optical coherence tomography (EDI-OCT).

Isaacs TW(1), Vermeulen TL, Spagnolo D, Amanuel B.

Author information: 
(1)Lions Eye Institute, 2 Verdun St, Nedlands, Western Australia, 6009,
tim@isaacs.net.au.

PMID: 25825230   [PubMed - as supplied by publisher]


18. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 29. [Epub ahead of print]

Strabismus in infants following congenital cataract surgery.

Demirkilinc Biler E(1), Bozbiyik DI, Uretmen O, Kose S.

Author information: 
(1)Faculty of Medicine, Department of Ophthalmology, Ege University, 35040,
Bornova, Izmir, Turkey, elif.dem@gmail.com.

PURPOSE: This study aimed to determine the incidence and characteristics of
strabismus following congenital cataract surgery in infants.
MATERIALS AND METHODS: Patients aged <12 months who underwent surgery for
congenital cataract and were followed-up for ≥1 years were included. Patients
that had strabismus prior to surgery were excluded. Data regarding gender,
cataract laterality, morphology, and density, age at the time of cataract
surgery, ocular motility post surgery, and the presence of nystagmus were
retrospectively obtained from the patients' records.
RESULTS: The study included 79 patients (48 male and 31 female). Unilateral
surgery was performed in 14 of the patients, versus bilateral surgery in 65.
Strabismus did not occur post surgery in 32 (40.5 %) of the patients (group 1),
whereas 47 (59.5 %) (group 2) developed strabismus following surgery. The
patients in group 1 were followed-up for a mean 50.7 ± 38.5 months, versus
50.3 ± 39 months in group 2. Mean age at the time of cataract surgery in groups 1
and 2 was 3.6 ± 1.9 years and 4.6 ± 3.2 months respectively. Mean duration of
time between cataract surgery and the development of strabismus was
13.3 ± 13 months (range: 1-60 months). Unilateral cases were more prone to
develop strabismus, which was statistically significant (p = 0.028). Age at the
time of cataract surgery, gender, cataract density, the occurrence of aphakic
glaucoma, the presence of nystagmus, and additional ocular surgery were not
significantly associated with the development of strabismus.
CONCLUSION: Strabismus develops more frequently in children undergoing cataract
surgery. In the present study strabismus occurred in more of the patients that
underwent unilateral surgery. Based on the present findings, we think that
long-term careful follow-up to monitor the development of strabismus is required 
in all infants undergoing cataract surgery, especially unilateral cases.

PMID: 25819919   [PubMed - as supplied by publisher]


19. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 28. [Epub ahead of print]

Vitreo-retinal relationship and post-operative outcome of macular hole repair in 
eyes with high myopia.

Wu LL(1), Ho TC, Yang CH, Yang CM.

Author information: 
(1)Department of Ophthalmology, National Taiwan University Hospital, No.7,
Zhongshan S. Rd. Zhongzheng Dist., Taipei City, 10002, Taiwan, Republic of China.

PURPOSE: To investigate the vitreoretinal relationship in eyes with
full-thickness macular hole (FTMH) without retinal schisis or detachment. Eyes
with and without high myopia were compared using slit-lamp biomicroscopy, optical
coherence tomography (OCT), and intraoperative observations.
METHODS: Clinical records of 34 consecutive cases of FTMH without schisis or
detachment in highly myopic eyes (refractive error larger than -6.0 diopters or
axial length >26 mm) were retrospectively reviewed. All eyes underwent pars plana
vitrectomy between 2006 and 2013. An additional 43 consecutive cases of FTMH in
eyes without high myopia were also reviewed to serve as controls. All control
patients underwent surgery during the same period. Ophthalmological, OCT, and
intraoperative findings, and vitreoretinal interface features were documented in 
both groups. Anatomical closure rate and final best-corrected visual acuity
(BCVA) were compared between groups.
RESULTS: Premacular tissue was identified during surgery in 21 of 34 high myopia 
patients (61.8 %) and three of 43 control patients (7.0 %). The high myopia group
showed two layers of premacular membranes. Two cases had a shiny, loose inner
membrane, 13 cases had a tightly adherent outer membrane, and six cases had both.
Only a tightly adherent membrane was found in controls. In the high myopia group,
11 of 21 eyes (52.4 %) did not have a preretinal membrane identified
preoperatively. Anatomical closure was achieved in 91.2 and 95.3 % of high myopia
and control patients respectively (p = 0.65). No significant intergroup
difference in final BCVA was observed.
CONCLUSION: Premacular tissue was found in 61.8 % of eyes with high myopia and
FTMH without retinal schisis or detachment. Anatomically successful surgical
closure in high myopia patients was achieved at a rate comparable to their
idiopathic counterparts.

PMID: 25812553   [PubMed - as supplied by publisher]


20. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 26. [Epub ahead of print]

Peripapillary retinal nerve fiber layer thickness in bipolar disorder.

Mehraban A(1), Samimi SM, Entezari M, Seifi MH, Nazari M, Yaseri M.

Author information: 
(1)Psychiatry Research Center, Department of Psychiatry, Imam Hossein Medical
Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

BACKGROUND: To compare peripapillary retinal nerve fiber layer thickness (RNFLT) 
between patients with bipolar disorder and a control group by optical coherence
tomography (OCT).
METHODS: This prospective comparative case series included 60 eyes of 30 patients
with bipolar disorder and 60 eyes of 30 age-matched healthy control subjects.
Using OCT, peripapillary RNFLT of the 4 quadrants and the mean of them was
compared between the two groups. Variables such as age of onset, duration,
smoking, psychosis, mania and depression episodes in the case group and their
relationships with RNFLT were evaluated by OCT.
RESULTS: Mean RNFLT was 99 ± 8 in the case group, significantly less than
the106 ± 8 mμ in the control group (p = 0.001). The inferior, superior, and nasal
quadrants in the case and control groups showed significant difference in RNFLT
(p < 0.001) (p = 0.040) (p = 0.005); however, the temporal quadrant was not
reduced significantly, compared to the control value (p = 0.907). Moreover, the
only variable showing significant relation with RNFLT was duration of bipolar
disorder (p = 0.040).
CONCLUSION: Reduction of peripapilary RNFLT occurs in patients with bipolar
disorder, and is related to the duration of disease. RNFLT can be a beneficial
value for studying neurodegenerative changes over time towards detecting the
severity and duration of disorder.

PMID: 25808660   [PubMed - as supplied by publisher]


21. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 25. [Epub ahead of print]

Applicability of the ISNT and IST rules on retinal nerve fiber layer measurement 
on spectral-domain optical coherence tomography in normal Indian children.

Dave P(1), Jethani J, Shah J.

Author information: 
(1)Dr. T V Patel Eye Institute, Vinoba Bhave Road, Salatwada, Vadodara, India,
390001, paaraj@gmail.com.

BACKGROUND: To determine the applicability of the ISNT
(inferior>superior>nasal>temporal) and IST (inferior>superior>temporal) rules on 
retinal nerve fiber layer (RNFL) measurement on spectral-domain optical coherence
tomography (SD-OCT) in normal children.
METHODS: A prospective, cross-sectional study including consecutive subjects
between the ages of 5-18 years who were born at term (≥37 weeks gestational age) 
and with a normal birth weight (≥2500 g) presenting to the out-patient department
for refractive error examination. RNFL measurement was done on Spectralis SD-OCT.
Exclusion criteria were best-corrected visual acuity less than 20/20, spherical
equivalent (SE) > ± 5 diopter (D), applanation IOP >21 mmHg, cup-to-disc (C/D)
ratio of >0.5, C/D ratio asymmetry of >0.2 between eyes and any retinal or optic 
disc anomaly as determined by mydriatic fundus examination. Subjects with
amblyopia, strabismus, or family history of optic nerve or retinal disease were
excluded. Poor cooperation for SDOCT imaging and lack of consent were other
exclusion criteria.
RESULTS: The ISNT rule on the RNFL was followed only by 30 eyes (23.8 %), while
the IST rule was followed by 66 eyes (52.4 %) (p < 0.001). The superior RNFL was 
thicker than the inferior in 57 eyes (45.2 %) while the temporal RNFL was thicker
than the nasal in 63 eyes (50 %). The age, gender, spherical equivalent, and disc
size did not predict the followability of the ISNT and IST rules (p > 0.05).
CONCLUSIONS: The ISNT and the IST rules for RNFL are not universally followed by 
all normal eyes in children. All deviations should therefore not be considered
pathological.

PMID: 25804995   [PubMed - as supplied by publisher]


22. Graefes Arch Clin Exp Ophthalmol. 2015 Apr;253(4):591-9. doi:
10.1007/s00417-015-2931-4. Epub 2015 Jan 21.

Canaloplasty versus non-penetrating deep sclerectomy - a prospective, randomised 
study of the safety and efficacy of combined cataract and glaucoma surgery;
12-month follow-up.

Rękas M(1), Byszewska A, Petz K, Wierzbowska J, Jünemann A.

Author information: 
(1)Department of Ophthalmology, Military Institute of Medicine, Szaserów 128
STR., 04-141, Warsaw, Poland, rekaspl@gmail.com.

PURPOSE: To compare outcomes of phaco-canaloplasty (PC) and phaco-non-penetrating
deep sclerectomy (PDS) with a viscoelastic compound.
METHODS: This study included 29 eyes after PC and 30 after PDS. Indications were 
uncontrolled primary open-angle glaucoma (POAG) and a cataract. Corrected
distance visual acuity (CDVA), intraocular pressure (IOP), and number of
medications were evaluated. Follow-up examinations were performed on days 1 and
7, and after 1, 3, 6, and 12 months. Complete and qualified success was an IOP ≤ 
18 mmHg.
RESULTS: At the 12-month follow-up, mean IOP decreased in the PC group from
19.0 ±6.9 mmHg to 12.6 ±2.7 mmHg, and in the PDS group, from 19.1 ±5.8 mmHg to
14.3 ±3.5 mmHg (P < 0.05). Both groups preoperatively and at 12 months showed no 
significant differences in IOP (P > 0.05). There was no statistically significant
difference between the number of medications used (P > 0.05). Complete and
qualified success rates for both groups were 79.0 % and 76.9 % (P = 0.701). The
most frequent postoperative PC complication was hyphema (58.0 %); for PDS, bleb
fibrosis was most frequent (26.7 %). No PC patients required postoperative
management. PDS patients required postoperative interventions 58.7 % of the time,
including a 5-fluorouracil (5-FU) injection (58.7 %), suture lysis (48.3 %), and 
needling (27.6 %).
CONCLUSIONS: Both PC and PDS lead to an effective decrease in IOP on a short-term
follow-up basis and demonstrate similar efficacy and safety profiles. PDS
patients required additional procedures including 5-FU injections, suture lysis, 
or needling. PC patients required no additional procedures.

PMID: 25795059   [PubMed - in process]


23. Graefes Arch Clin Exp Ophthalmol. 2015 Apr;253(4):583-9. doi:
10.1007/s00417-014-2895-9. Epub 2015 Jan 21.

Retinal vascular caliber between eyes with asymmetric glaucoma.

De Leon JM(1), Cheung CY, Wong TY, Li X, Hamzah H, Aung T, Su DH.

Author information: 
(1)Singapore Eye Research Institute, Singapore, Singapore.

PURPOSE: To compare differences in retinal arterial and venular caliber (RAC and 
RVC respectively) between fellow eyes with glaucoma of asymmetric severity.
METHODS: We included subjects with bilateral primary glaucoma that had vertical
cup-disc ratios (VCDR) >0.2 between both eyes, or visual field (VF) mean
deviation (MD) >6.0 decibels (dB) between both eyes.
RESULTS: Among 158 subjects, the average RAC in glaucoma eyes was 131.5 ± 17.8 μm
vs 141.6 ± 18.8 μm in fellow eyes with mild disease (p < 0.001). RVCs in glaucoma
eyes were 201.0 ± 21.4 μm vs 211.7 ± 25.3 μm in fellow eyes with mild disease
(p < 0.001). This relationship held in clustered linear regression models
adjusted for age, gender, vascular risk factors, visual acuity, axial length, and
intraocular pressure, with RVCs narrower in eyes with worse disease vs mild
disease. Eyes with worse disease had greater VCDR (0.9 ± 0.1 vs 0.7 ± 0.1,
p < 0.001), and worse VF MD (-18.5 ± 8.6 vs -6.6 ± 5.6, p < 0.001).
CONCLUSION: In glaucoma with asymmetric severity between fellow eyes, retinal
vascular caliber is less in the eye with more severe disease.

PMID: 25795058   [PubMed - in process]


24. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 21. [Epub ahead of print]

Oral Rifampin treatment for longstanding chronic central serous
chorioretinopathy.

Shulman S(1), Goldenberg D, Schwartz R, Habot-Wilner Z, Barak A, Ehrlich N,
Loewenstein A, Goldstein M.

Author information: 
(1)Department of Ophthalmology, Tel-Aviv Medical Center, 6 Weizman Street, Tel
Aviv, 64239, Israel, shulmanshiri@gmail.com.

PURPOSE: To investigate the effect of oral Rifampin in patients with chronic
central serous chorioretinoapthy (CSCR).
METHODS: This was a prospective pilot study of patients with chronic CSCR with
persistent subretinal fluid (SRF) for at least 3 months, who were treated with
oral Rifampin 300 mg twice per day for 3 months and had 6 months of follow-up.
All patients underwent a complete ocular examination and a spectral domain
optical coherence tomography (SD-OCT) scan monthly from baseline until month 4,
and then at month 6. Fluorescein angiography (FA) was performed at baseline and
at the end of the study.
RESULTS: Fourteen eyes of 12 patients were included in the study, nine men and
three women. Mean age was 58.5 years (range 32-80). Mean duration of SRF prior to
study entry was 28.4 months. Forty-two percent of eyes were treated previously
for CSR with thermal laser, PDT, or intravitreal bevacizumab. Mean best corrected
visual acuity (BCVA) at presentation was 20/60 and improved to a mean of 20/50 at
month 3 (P > 0.05). Retinal thickness was reduced by 25.3 %, 21.2 %, and 21 % on 
months 1, 2, 3, respectively (P < 0.05). Mean choroidal thickness at presentation
was 476 μ (SD 188 μ) decreasing to 427 μ (SD 125 μ) after 3 months of treatment
(P > 0.05). SRF was reduced in nine eyes (64 %) and completely resolved in six
eyes (42.8 %) at month 3 following 3 months of treatment, and four out of these
six eyes remained fluid free at month 6. Two patients stopped the treatment after
2 months due to adverse events.
CONCLUSIONS: Oral Rifampin may be a therapeutic option in patients with
longstanding chronic CSCR.

PMID: 25794988   [PubMed - as supplied by publisher]


25. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 21. [Epub ahead of print]

Treatment of stage 3 Coats' disease by endolaser photocoagulation via a two-port 
pars plana nonvitrectomy approach.

Cai X(1), Zhao P, Zhang Q, Jin H.

Author information: 
(1)Department of Ophthalmology, Xinhua Hospital affiliated to Shanghai Jiaotong
University School of Medicine, No. 1665, Kongjiang Road, Shanghai, China, 200092.

BACKGROUND: To evaluate the effectiveness of endolaser photocoagulation by a
two-port pars plana nonvitrectomy approach for treating Coats' disease with
shallow exudative retinal detachment.
METHODS: This study included 24 patients (23 boys with an age range of
2-17 years, and one girl, age 6 years) with stage 3 Coats' disease (25 eyes) from
December 2012 and May 2014 at a single center. All of the 25 eyes were
complicated with serous or total retinal detachment and received
none-vitrectomized endolaser: two (23- or 25-gauge) incisions were routinely made
3 mm posterior to the corneal limbus and a laser was applied directly on the
abnormal blood vessels. Additional treatments included subretinal fluid drainage 
(five eyes), intravitreal triamcinolone injection (seven eyes), and intravitreal 
anti-vascular endothelial growth factor (VEGF) injection (17 eyes).
Best-corrected visual acuity, intraocular pressure, and fundus and abnormal
vascular changes were recorded to determine therapeutic effects.
RESULTS: Twenty-four out of the 25 treated eyes (96 %) had retina reattached. The
number of treatment sessions differed case by case (1-5 sessions, average 1.96)
and the time to full treatment of retinal reattachment was 4 months in average.
One patient (4 %) presented with retinal redetachment. Five (20 %) eyes received 
further laser treatment with indirect ophthalmoscope and four eyes (16 %)
presented with total retinal detachment at their first visits received
consecutive treatments. At the end of the follow-up period (mean, 10.08 months), 
telangiectasias of 24 (96 %) eyes were resolved and no severe complications
occurred.
CONCLUSIONS: Endolaser photocoagulation by a two-port pars plana nonvitrectomy
approach is an effective treatment for advanced Coats' disease with serous
retinal detachment. The long-term safety of the approach needs further
investigation.

PMID: 25794987   [PubMed - as supplied by publisher]


26. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 22. [Epub ahead of print]

Correlation between depth and area of retinal nerve fiber layer defect as
measured by spectral domain optical coherence tomography.

Suh MH(1), Yoo BW, Park KH, Kim JY, Kim H, Kim HC.

Author information: 
(1)Department of Ophthalmology, Haeundae Paik Hospital, Inje University College
of Medicine, 1435 Jwa-dong, Haeundae-gu, Busan, 612-030, Korea,
crishuna0@hanmail.net.

BACKGROUND: To evaluate the correlation between the depth and area of retinal
nerve fiber layer (RNFL) defect, as measured on an RNFL map of spectral-domain
optical coherence tomography (SD-OCT).
METHODS: The RNFL of 472 glaucoma subjects and of 217 healthy subjects was imaged
by an SD-OCT. RNFL defect depth and area on the RNFL map were expressed as an
RNFL defect depth percentage index (RDPI) and an RNFL defect area index (RDAI),
respectively, according to the following two formulas: 100×[1-{summation of
thicknesses of RNFL defects/summation of thicknesses of upper 95th percentile
range of age-matched healthy subjects in areas corresponding to defects}];
100×[number of superpixels of RNFL defects/(46 × 46-superpixels inside optic disc
or β zone parapapillary atrophy)]. The best-fitting model describing the
relationship between the two parameters was derived by fractional polynomial
analysis.
RESULTS: Logarithmic fit was determined to be the best-fitting model in
describing the relationship of the RDPI against the RDAI (y = 53.4 + 3.7 ln(x)
and y = 50.9 + 5.9 ln(x) in superior and inferior hemifields, respectively). The 
expected RDAIs at the point where the RDPI and RDAI rates of change were the same
were 3.7 and 5.9 %; the corresponding upper 95 % confidence interval limits of
the RDPI 59.0 and 61.8 % in the superior and inferior hemifields, respectively.
CONCLUSIONS: The correlation between the RNFL defect depth and area, as derived
from the RNFL map, was best described by the logarithmic fit. Changes were more
marked in depth than in area, especially for mild localized defects.

PMID: 25794986   [PubMed - as supplied by publisher]


27. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 20. [Epub ahead of print]

Choroidal involvement in Rosai-Dorfman syndrome may be depicted and followed
using enhanced depth imaging optical coherence tomography (EDI-OCT).

Fassbender J(1), Schaal S.

Author information: 
(1)Department of Ophthalmology and Visual Sciences, University of Louisville, 301
E. Muhammad Ali Boulevard, Louisville, KY, 40202, USA.

PMID: 25791357   [PubMed - as supplied by publisher]


28. Graefes Arch Clin Exp Ophthalmol. 2015 Mar 20. [Epub ahead of print]

RhoA/mDia-1/profilin-1 signaling targets microvascular endothelial dysfunction in
diabetic retinopathy.

Lu Q(1), Lu L, Chen W, Chen H, Xu X, Zheng Z.

Author information: 
(1)Department of Ophthalmology, Shanghai First People's Hospital, School of
Medicine, Shanghai Jiaotong University, No.100 Haining Road, Shanghai, 200080,
China.

BACKGROUND: Diabetic retinopathy (DR) is a major cause of blindness in the
working-age populations of developed countries, and effective treatments and
prevention measures have long been the foci of study. Patients with DR invariably
demonstrate impairments of the retinal microvascular endothelium. Many
observational and preclinical studies have shown that angiogenesis and apoptosis 
play crucial roles in the pathogenesis of DR. Increasing evidence suggests that
in DR, the small guanosine-5'-triphosphate-binding protein RhoA activates its
downstream targets mammalian Diaphanous homolog 1 (mDia-1) and profilin-1, thus
affecting important cellular functions, including cell morphology, motility,
secretion, proliferation, and gene expression. However, the specific underlying
mechanism of disease remains unclear.
CONCLUSION: This review focuses on the RhoA/mDia-1/profilin-1 signaling pathway
that specifically triggers endothelial dysfunction in diabetic patients.
Recently, RhoA and profilin-1 signaling has attracted a great deal of attention
in the context of diabetes-related research. However, the precise molecular
mechanism by which the RhoA/mDia-1/profilin-1 pathway is involved in progression 
of microvascular endothelial dysfunction (MVED) during DR has not been
determined. This review briefly describes each feature of the cascade before
exploring the most recent findings on how the pathway may trigger endothelial
dysfunction in DR. When the underlying mechanisms are understood, novel therapies
seeking to restore the endothelial homeostasis comprised in DR will become
possible.

PMID: 25791356   [PubMed - as supplied by publisher]