1: Graefes Arch Clin Exp Ophthalmol. 2009 Apr 3; [Epub ahead of print] 

Drug reflux during posterior subtenon infusion of triamcinolone acetonide in
diffuse diabetic macular edema not only brings insufficient reduction but also
causes elevation of intraocular pressure.

Shimura M, Yasuda K, Nakazawa T, Shiono T, Sakamoto T, Nishida K.

Department of Ophthalmology, NTT East Japan Tohoku Hospital, 2-29-1, Yamato,
Wakabayashi, Sendai, Miyagi, 984-8560, Japan, masahiko@v101.vaio.ne.jp.

BACKGROUND: At the time of posterior subtenon infusion of triamcinolone
acetonide (STI-TA) in patients with diabetic macular edema (DME), drug reflux of
TA has sometimes been observed from the conjunctival incision site. We
investigated the influence of this reflux on regression of DME and postoperative
intraocular pressure (IOP). METHODS: STI-TA was performed on one hundred and
twenty-four eyes of 88 consecutive patients with DME. Eligible eyes were divided
into two groups: those with observed drug reflux of TA and those without
observed drug reflux of TA. Visual acuity (VA), foveal thickness (FT) and IOP
were monitored in each eye for up to 12 weeks after STI-TA. RESULTS: STI-TA with
drug reflux was observed in ten individual eyes of seven patients. These
patients were significantly younger than those patients without observed drug
reflux. After STI-TA, both improvement of VA and regression of FT in reflux(+)
eyes were less than in reflux(-) eyes. Postoperative IOP elevation in reflux(+)
eyes was much higher, and four of the ten eyes needed anti-glaucoma therapy.
This was in contrast to three of the 118 eyes without drug reflux that required
anti-glaucoma therapy. CONCLUSIONS: At the time of STI-TA in DME, drug reflux of
TA is a risk factor not only for insufficient reduction of edema, but also for
postoperative IOP elevation.

PMID: 19343359 [PubMed - as supplied by publisher]

2: Graefes Arch Clin Exp Ophthalmol. 2009 Apr 1; [Epub ahead of print] 

An epidemiological approach for the estimation of disease onset in Central
Europe in central and peripheral monogenic retinal dystrophies.

Prokofyeva E, Wilke R, Lotz G, Troeger E, Strasser T, Zrenner E.

Bioengineering Medical Laboratory, Institute for Ophthalmic Research, University
of Tuebingen, Paul-Ehrlich Str. 17, 72076, Tuebingen, Germany,
elena.prokofyeva@biomed-engineering.de.

PMID: 19337744 [PubMed - as supplied by publisher]

3: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 28; [Epub ahead of print] 

Fundus autofluorescence and fate of glycoxidized particles injected into
subretinal space in rabbit age-related macular degeneration model.

Hirata M, Yasukawa T, Wiedemann P, Kimura E, Kunou N, Eichler W, Takase A, Sato
R, Ogura Y.

Department of Ophthalmology and Visual Science, Nagoya City University Graduate
School of Medical Sciences, Mizuho-ku, Nagoya-shi, Aichi, 467-8601, Japan.

PURPOSE: Abnormal fundus autofluorescence (FAF) is associated with the incidence
or progression of dry and wet age-related macular degeneration (AMD). We
previously developed a rabbit AMD model with drusen and type-1 choroidal
neovascularization (CNV) that mimics the accumulation of lipofuscin using
artificial glycoxidized particles. The objective of the current study was to
investigate in vitro effects of glycoxidized particles on retinal pigment
epithelial (RPE) cells, and the FAF and fate of injected particles in this
model. METHODS: Glycoxidized particles were prepared by a 4-day incubation of
water-in-oil emulsions of serum albumin and glycolaldehyde to allow
glycoxidation and consequent cross-linking. After particles were added in the
culture medium of confluent human RPE cells, cell viability, adhesion activity,
and proliferation activity were assessed by cell counting. In anesthetized
rabbits, 250 microg of glycoxidized particles were injected into the subretinal
space to induce experimental AMD. FAF measurement and angiography with sodium
fluorescein and indocyanine green were performed periodically using the
Heidelberg Retina Angiograph 2 (HRA2). The eyes enucleated, and the lung and the
spleen, excised at week 4 or 12, were histologically evaluated by light and
fluorescence microscopy. RESULTS: Glycoxidized particles phagocytosed did not
impair the cell viability, adhesion, and proliferation of RPE cells, as compared
with RPE cells in controls. HRA2 showed different patterns of abnormal FAF in
the area with the implanted glycoxidized particles, similar to pathological FAF
patterns in aging human eyes with or without AMD. Histologic examination showed
accumulated glycoxidized particles and large lipofuscin granules with green
autofluorescence in and under the RPE and at the margins of or beneath drusen,
possibly associated with abnormal FAF. In addition, some particles were detected
in the lung and the spleen. CONCLUSIONS: Glycoxidized particles phagocytosed
might stay in RPE cells without any acute biological reaction. Our rabbit model
of AMD simulated abnormal FAF patterns observed in aging human eyes with or
without AMD. Glycoxidized particles phagocytosed by RPE cells could be deposited
on Bruch\'s membrane in rabbits, possibly excreted in part into choroidal
circulation. This model may be useful for understanding various patterns of
abnormal FAF histologically, and for elucidating the pathogenesis of AMD.

PMID: 19330346 [PubMed - as supplied by publisher]

4: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 28; [Epub ahead of print] 

Balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes in
the treatment of congenital nasolacrimal duct obstruction.

Huang YH, Liao SL, Lin LL.

Department of Ophthalmology, National Taiwan University Hospital, 7, Chung Shan
South Rd., Taipei, Taiwan.

PURPOSE: To report our experience with combined use of balloon dacryocystoplasty
and monocanalicular intubation with Monoka tubes for treating congenital
nasolacrimal duct obstruction. DESIGN: Retrospective consecutive interventional
case series. MATERIALS AND METHODS: This retrospective study consisted of 25
consecutive pediatric patients with congenital nasolacrimal duct obstruction who
underwent balloon dacryocystoplasty and monocanalicular intubation with Monoka
tubes between November 2003 and November 2006. Outcome evaluations included an
ophthalmologic examination and a dye appearance test postoperatively. Age,
history of a prior probing and complications related to the main outcome were
also analyzed. RESULTS: Thirty-three eyes of 25 patients aged 8 months to 9
years (3.5 +/- 2.4 years old) were included. Of the obstructed ducts treated,
97% (32/33) showed complete resolution of epiphoria. When analyzed by age
groups, patients more than 1 year of age had higher success rate (30 successes
in 30 patients) than patients less than 1 year of age (two successes in three
patients). Statistical analysis revealed no statistically significant difference
in success rate between both age groups (p = 0.09). The mean duration of
intubation was 5.7 +/- 2.2 months. No significant complication was noted, except
that early tube dislodgements occurred in six out of 31 Monoka intubations
(19%). CONCLUSIONS: The combined use of balloon dacryocystoplasty and
monocanalicular intubation with Monoka tubes is an effective procedure for
children with congenital nasolacrimal duct obstruction after failure of
conservative treatment or probing.

PMID: 19330345 [PubMed - as supplied by publisher]

5: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 28; [Epub ahead of print] 

Penetrating eye injury caused by eyelash curlers-a cause for concern?

Ramasamy B, Armstrong S.

St. Paul\'s Eye Unit, Royal Liverpool University Hospitals NHS Trust, Liverpool,
UK, anitharams@hotmail.co.uk.

PURPOSE: To report a case of open globe injury caused by eyelash curlers.
METHODS: Interventional case report. RESULTS: A 19-year-old female presented
with a history of accidentally poking herself in the left eye when her eyelash
curlers broke suddenly. Initial assessment revealed a laceration in the
infero-nasal cornea of the left eye. The patient was also noted to have
developed a traumatic cataract. Surgical exploration of the penetrating eye
injury also revealed damage to the posterior capsule of the lens. Lensectomy,
anterior vitrectomy, and implantation of an intraocular lens were performed. The
first day after the operation, the patient\'s visual acuity in the left eye
improved to 20/30 unaided. At 3-months follow-up, the sutures were removed and
visual acuity remains at 20/30 unaided. CONCLUSION: Our case represents an
unusual cause of serious ocular injury in a domestic setting wherein appropriate
and timely intervention resulted in a good clinical outcome.

PMID: 19330344 [PubMed - as supplied by publisher]

6: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 24; [Epub ahead of print] 

One-year results of combined photodynamic therapy and intravitreal bevacizumab
injection for retinal pigment epithelial detachment secondary to age-related
macular degeneration.

Shima C, Gomi F, Sawa M, Sakaguchi H, Tsujikawa M, Tano Y.

Department of Ophthalmology, Osaka University Medical School, 2-2 Yamada-oka,
Suita, Osaka, 565-0871, Japan.

BACKGROUND: To evaluate the efficacy of combined photodynamic therapy (PDT) and
intravitreal bevacizumab injection in eyes with a serous pigment epithelial
detachment (PED) associated with age-related macular degeneration (AMD).
METHODS: Twenty-two eyes with a serous PED exceeding two disc areas associated
with AMD with choroidal vascular abnormalities [choroidal neovascularization (n
= 10), polypoidal choroidal vasculopathy (n = 9), and retinal angiomatous
proliferation (n = 3)] received combined PDT and intravitreal bevacizumab, and
were followed about every 6 weeks for more than 1 year. Additional treatments
were given for residual or recurrent lesions. The main outcome measures were
changes in the PED height measured by optical coherence tomography, and the
best-corrected visual acuity. RESULTS: After one treatment, the PED resolved in
12 eyes (55%) and the PED decreased in ten eyes (45%). There was no recurrence
in eight (36%) eyes; however, PED recurred in 14 eyes. At 1 year, the average
PED height decreased to 413 microns from the baseline 751 microns (p < 0.001).
Twenty eyes (91%) had improved or stabilized vision; two eyes had decreased
vision due to a retinal pigment epithelial tear and subretinal hemorrhage.
CONCLUSIONS: Combined PDT and intravitreal bevacizumab may decrease the PED
height and stabilize visual acuity at 1 year.

PMID: 19308441 [PubMed - as supplied by publisher]

7: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 24; [Epub ahead of print] 

Presumed Vogt-Koyanagi-Harada disease with unilateral ocular involvement: report
of three cases.

Usui Y, Goto H, Sakai JI, Takeuchi M, Usui M, Rao NA.

Department of Ophthalmology, Tokyo Medical University Hospital, 6-7-1
Nishihinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan, usuyoshi@ff.iij4u.or.jp.

AIM: To report three cases of presumed Vogt-Koyanagi-Harada (VKH) disease with
unilateral ocular manifestations. METHODS: This retrospective study reviewed the
long-term follow-up observations of three patients who attended the uveitis
clinic at Tokyo Medical University Hospital. The patients were followed for 5-16
years with systemic clinical, ophthalmologic and laboratory examinations.
Ophthalmoscopic findings, extraocular manifestations, visual acuity, and
response to corticosteroid administration were evaluated. RESULTS: Three
patients had characteristic clinical features of VKH involving only one eye,
including diffuse choroiditis, serous retinal detachment, focal areas of delayed
choroidal perfusion, multifocal areas of pinpoint leakage, macular oedema, and
optic nerve staining. All patients received systemic corticosteroid therapy
during the acute phase of the disease. During the follow-up period (5-16 years),
all three patients developed sunset-glow fundus and nummular chorioretinal
depigmented scars in the affected eye only, as well as systemic complications of
deafness, vitiligo, and poliosis. CONCLUSION: The clinical and laboratory
features of all three patients were typical of VKH disease except for the
unilateral involvement. It is important for ophthalmologists to recognize
unilateral VKH disease, even though it is a rare clinical variant of the
disease.

PMID: 19308440 [PubMed - as supplied by publisher]

8: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 20; [Epub ahead of print] 

Suppression of retinal neovascularization by the iNOS inhibitor aminoguanidine
in mice of oxygen-induced retinopathy.

Zhang Q, Zhang J, Guan Y, Zhang S, Zhu C, Xu GT, Wang L.

Department of Ophthalmology, Ruijin Hospital Affiliated to Shanghai JiaoTong
University School of Medicine, No 197, Ruijin Er Road, Shanghai, 200025, China.

BACKGROUND: Retinal neovascularization (NV) is a major cause of blindness
associated with ischemic retinal disorders. Our study was focused on evaluating
the inhibitory effect of aminoguanidine (AG), an inhibitor of inducible nitric
oxide synthase (iNOS), on retinal NV in mice of oxygen-induced retinopathy
(OIR). METHODS: An OIR model was established with 7-day-old C57BL/6J mice. One
day before and 1 and 3 days after being returned to the room air, the right eyes
were injected intravitreally with bevacizumab, AG or bevacizumab+AG
respectively. The left eyes were injected with normal saline (NS) as control.
The mice were killed at postnatal day 17 (P17). The effects of AG or bevacizumab
on iNOS or VEGF expressions were evaluated by RT-PCR and immunohistochemistry.
Retinal NV was examined by fluorescein angiography, and was quantified
histologically by CD34 immnunostaining at P17. RESULTS: Compared with NS-treated
eyes, retinal VEGF and iNOS mRNA expressions were significantly reduced in AG-
and bevacizumab+AG-treated eyes; whereas in bevacizumab-treated eyes, retinal
VEGF mRNA expression increased and iNOS mRNA expression remained unchanged. The
above changes were confirmed by immunohistochemical study. The generalized
decrease in both VEGF and iNOS distributions in mice retina treated with AG or
bevacizumab+AG was demonstrated by immunohistochemistry. Retinal NV was
significantly reduced in all three groups treated with bevacizumab, AG or
bevacizumab+AG, when compared with NS-treated eyes. CONCLUSIONS: iNOS activation
plays a pathological role in retinal NV in a mouse model of ischemic
retinopathy. Administration of AG significantly suppressed retinal NV.
Therefore, AG appears to be a novel and effective therapeutic approach for
retinal NV.

PMID: 19301028 [PubMed - as supplied by publisher]

9: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 19; [Epub ahead of print] 

Evaluation of potential retinal toxicity of adalimumab (Humira).

Tsilimbaris M, Diakonis VF, Naoumidi I, Charisis S, Kritikos I, Chatzithanasis
G, Papadaki T, Plainis S.

Institute of Vision and Optics (IVO), School of Health Sciences, University of
Crete, 71003, Heraklion, Crete, Greece, tsilimb@med.uoc.gr.

PURPOSE: The purpose of this study is to evaluate the retinal toxicity of two
doses of adalimumab (Humira), a recombinant human IgG1 monoclonal antibody
specific for human tumor necrosis factor (TNF), when injected intravitreally in
rabbits. METHODS: Sixteen male pigmented rabbits (divided into two groups, eight
animals per group) were used for this study. Two concentrations of adalimumab
were tested: 0.5 mg/0.1 ml and 5 mg/0.1 ml. Each concentration was injected
intravitreally randomly in one eye (study group) of each rabbit (group I
received 0.5 mg/0.1 ml and group II received 5.0 mg/0.1 ml), while in the other
eye (control group) 0.1 ml of sterile balanced saline solution (BSS) was
injected. Slit-lamp and funduscopic examinations were performed every second day
for 2 weeks for signs of infection, inflammation and toxicity. A baseline
electroretinogram (ERG) was performed before the experiment and at the last
follow-up day (day 14). ERG examination followed ISCEV standards. At the last
follow-up day, the animals were sacrificed and the enucleated eyes were prepared
for histological evaluation of retinal toxicity. RESULTS: No differences in ERG
responses at photopic and scotopic conditions were observed in eyes injected
with either concentration of adalimumab or BSS. Furthermore, histologic
examination of the retina in the enucleated eyes (in all groups) did not
demonstrate any evidence of drug toxicity. CONCLUSIONS: Intravitreal adalimumab
did not appear toxic to the retina in this experimental model at concentrations
of 0.5 and 5 mg. If found safe in additional studies, intravitreally injected
adalimumab could be evaluated for efficacy in the treatment of inflammatory eye
conditions.

PMID: 19296122 [PubMed - as supplied by publisher]

10: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 18; [Epub ahead of print] 

Effect of vitrectomy on macular microcirculation in patients with diffuse
diabetic macular edema.

Park JH, Woo SJ, Ha YJ, Yu HG.

Department of Ophthalmology, Seoul National University Hospital, #28
Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.

PURPOSE: To determine whether retinal microcirculatory changes occur after
vitrectomy in eyes with diffuse diabetic macular edema (DME), and whether
changes in blood flow are associated with visual outcome and the resolution of
macular edema. METHODS: Thirty-three eyes of 30 consecutive diabetic patients
who underwent pars plana vitrectomy for diffuse DME, and 16 eyes of 16 diabetic
patients without macular edema, were included. Mean macular blood flows were
measured using a Heidelberg Retinal Flowmeter, and central macular thicknesses
(CMTs) were determined by optical coherence tomography. Visual outcomes, CMTs,
and macular blood flow were evaluated before and 1, 4, 12 weeks after
vitrectomy, and compared between eyes with resolved macular edema and those with
persistent macular edema. RESULTS: Mean preoperative macular blood flow in eyes
with diffuse DME was higher than in controls (606.5+/-357.9 AU vs 407.1+/-265.9
AU, P=0.021). Mean macular blood flow (422.6+/-247.5 AU) at 12 weeks after
vitrectomy was significantly lower than preoperative blood flow (P=0.002), and
similar to that of controls (P=0.47). In 22 of the 33 (66.7%) DME eyes, macular
edema was resolved at 12 weeks after vitrectomy. The mean ratio of macular blood
flow at 12 weeks postoperatively versus the preoperative level was significantly
lower in eyes with resolved macular edema than in eyes with persistent macular
edema (0.65 vs 1.08, P<0.001). CONCLUSIONS: Increased macular blood flow in
diabetic macular edema was normalized after vitrectomy in eyes with resolved
macular edema. Changes of macular blood flow may be associated with the
resolution of macular edema in diabetic eyes.

PMID: 19294405 [PubMed - as supplied by publisher]

11: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 17; [Epub ahead of print] 

Effect of epigallocatechin-gallate on inner retinal function in ocular
hypertension and glaucoma: A short-term study by pattern electroretinogram.

Falsini B, Marangoni D, Salgarello T, Stifano G, Montrone L, Di Landro S,
Guccione L, Balestrazzi E, Colotto A.

Institute of Ophthalmology, Catholic University, Largo Francesco Vito 1, 00168,
Rome, Italy, md0571@mclink.it.

BACKGROUND: Epigallocatechin-gallate (EGCG) is a powerful antioxidant with
suggested neuroprotective action. The aim of this study was to evaluate the
effect of short-term supplementation of EGCG on inner retinal function in ocular
hypertension (OHT) and open-angle glaucoma (OAG). METHODS: Eighteen OHT and 18
OAG patients (perimetric mean deviation: >-10 dB) were randomly assigned to
assume oral placebo or EGCG over a 3-month period in a randomized,
placebo-controlled, double-blind, cross-over design clinical trial
(clinicaltrials.gov identifier: NCT00476138). Pattern-evoked electroretinograms
(PERGs) to 1.6 cycles/degree square-wave gratings, counterphased at 16
reversals/second, and standard automated perimetry (Humphrey 30-2) were assessed
at the study entry (baseline), and after 3 months of placebo or EGCG. RESULTS:
After EGCG, PERGs of OAG, but not OHT patients were increased in amplitude,
compared either to baseline values (mean amplitude change: 0.06 log muV, p <
0.05) or to PERG amplitude values found in the same patients after placebo
administration (mean change: -0.02 log muV, p not significant; difference
between EGCG and placebo: 0.08 log muV, p < 0.05). In both OHT and OAG patients,
standard automated perimetry did not show significant changes after either EGCG
or placebo. In individual OAG patients, the magnitude of PERG amplitude
increment after EGCG was inversely related (r = -0.8, p < 0.01) to corresponding
baseline amplitudes. CONCLUSIONS: Although this study cannot provide evidence
for long-term benefit of EGCG supplementation in OAG, and the observed effect is
small, the results suggest that EGCG might favourably influence inner retinal
function in eyes with early to moderately advanced glaucomatous damage.

PMID: 19290537 [PubMed - as supplied by publisher]

12: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 12; [Epub ahead of print] 

Evaluation of Pseudomonas aeruginosa staphylolysin (LasA protease) in the
treatment of methicillin-resistant Staphylococcus aureus endophthalmitis in a
rat model.

Barequet IS, Habot-Wilner Z, Mann O, Safrin M, Ohman DE, Kessler E, Rosner M.

Maurice and Gabriela Goldschleger Eye Research Institute, Sackler Faculty of
Medicine, Tel Aviv University, Sheba Medical Center, Tel Hashomer, Israel,
ibarequet@hotmail.com.

BACKGROUND: Therapy of S. aureus ocular infections is increasingly challenging
due to emerging resistant strains. Staphylolysin (also called LasA protease) is
a staphylolytic endopeptidase secreted by Pseudomonas aeruginosa. The purpose of
this study was to evaluate the efficacy of staphylolysin as a therapy for
experimental methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis,
focusing on its bactericidal activity. METHODS: Endophthalmitis was induced in
the right eyes of 46 rats by an intravitreal injection of 50-160 MRSA cells. Two
therapeutic regimens were evaluated: (i) an intravitreal injection of
staphylolysin at 6 hours post-infection; (ii) two successive intravitreal
injections of staphylolysin given at 6 and 30 hours post-infection. Control eyes
were injected with vehicle alone at the same times. The rats were sacrificed 48
hours after infection, and the vitreous was withdrawn for determination of
colony forming units (CFU). Potential adverse effects of intravitreal
staphylolysin injection were assessed histopathologically in four uninfected
eyes, enucleated from rats sacrificed 1 month after intravitreal staphylolysin
injection. RESULTS: In eyes treated by the single-injection regimen,
staphylolysin reduced the mean CFU value per vitreous threefold as compared to
control (2,055 +/- 3,144 and 6,432 +/- 6,389 CFU/vitreous, respectively; P =
0.02). The repeated injection protocol was more effective, reducing the mean CFU
value per vitreous by two orders of magnitude as compared to control (1,148 +/-
3,096 and 143,519 +/- 151,358 CFU/vitreous, respectively; P = 0.0005).
Histopathological analysis showed no structural damage in eyes injected
intravitreally with staphylolysin. CONCLUSIONS: Staphylolysin is effective in
the treatment of experimental MRSA-induced endophthalmitis in rats, and causes
no morphological adverse effects to ocular tissues. Staphylolysin may be
beneficial in the treatment of S. aureus endophthalmitis in humans.

PMID: 19280208 [PubMed - as supplied by publisher]

13: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 12; [Epub ahead of print] 

Incidence of endophthalmitis in a large series of 23-gauge and 20-gauge
transconjunctival pars plana vitrectomy.

Parolini B, Romanelli F, Prigione G, Pertile G.

Ospedale Sacro Cuore, Negrar-Verona, 37024, Italy,
barbara.parolini@sacrocuore.it.

BACKGROUND: To study the incidence of endophthalmitis after 23-gauge pars plana
vitrectomy and to compare it with the endophthalmitis rate after 20-gauge pars
plana vitrectomy performed in the same ophthalmology department. METHODS: The
charts of 4,021 consecutive 20-gauge or 23-gauge pars plana vitrectomies
performed at a single institution, between August 1 2003 and April 1 2008, were
reviewed to search for the occurrence of postoperative endophthalmitis. This is
a retrospective, interventional, comparative cohort study. RESULTS:
Endophthalmitis developed in one of 3,078 eyes after 20-gauge vitrectomy (0.03%)
and in none of 943 eyes after 23-gauge vitrectomy. CONCLUSIONS: We did not find
an increased risk of endophthalmitis after 23-gauge sutureless vitrectomy.

PMID: 19280207 [PubMed - as supplied by publisher]

14: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 11; [Epub ahead of print] 

Comparison of contrast sensitivity, depth of field and ocular wavefront
aberrations in eyes with an IOL with zero versus positive spherical aberration.

Pepose JS, Qazi MA, Edwards KH, Sanderson JP, Sarver EJ.

Pepose Vision Institute, 1815 Clarkson Road, Chesterfield, MO, 63107, USA,
jpepose@peposevision.co.

PURPOSE: To compare the clinical performance of the zero spherical aberration
(SA) SofPort LI61AO (AO, Bausch & Lomb) intraocular lens (IOL) to the AcrySof
SA60AT (AT, Alcon), which has positive spherical aberration. METHODS: Patients
underwent uneventful phacoemulsification with implantation of either an aspheric
(AO, n = 19) or spherical (AT, n = 20) IOL. Postoperatively, a 5 mm artificial
pupil was positioned in trial frames with the cycloplegic refraction during
monocular, mesopic contrast sensitivity (CSF) and low-contrast visual acuity
(LCVA) testing with glare. Ocular and corneal wavefront error was determined at
5 mm diameters. RESULTS: Mean CSF scores were better at all frequencies tested
for the AO than for the AT group, and achieved statistical significance at 1.5
cpd (p = 0.038) and 6 cpd (p = 0.017). With glare, AO eyes read 30.9 +/- 5.0
low-contrast letters versus 25.2 +/- 6.8 for AT eyes (p = 0.005) (mean
DeltaLogMAR = -0.10), while high-contrast acuity and refraction were similar.
Eyes implanted with the SA60AT had 43% greater positive spherical aberration at
a 5 mm wavefront diameter, with no significant difference in corneal SA between
groups. A through-focus analysis demonstrated a similar depth of field, yet a
comparatively higher visual Strehl ratio for the aspheric IOL at emmetropia (p =
0.038). CONCLUSION: Eyes with the SofPort Advance Optics neutral aberration IOL
demonstrated less spherical aberration and better low-contrast acuity compared
to eyes with a spherical IOL, without sacrificing tolerance to defocus. The
aspheric IOL showed superior optical and clinical performance, which is most
likely due to its surface design.

PMID: 19277694 [PubMed - as supplied by publisher]

15: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 11; [Epub ahead of print] 

An epidemiological approach for the estimation of disease onset in Central
Europe in central and peripheral monogenic retinal dystrophies.

Prokofyeva E, Wilke R, Lotz G, Troeger E, Strasser T, Zrenner E.

Bioengineering Medical Laboratory, Institute for Ophthalmic Research, University
of Tuebingen, Paul-Ehrlich Str. 17, 72076, Tuebingen, Germany,
elena.prokofyeva@biomed-engineering.de.

PURPOSE: To study clinical patterns of disease onset in monogenic retinal
dystrophies (MRD), using an epidemiological approach. METHODS: Records of
patients with MRD, seen at the University Eye Hospital Tuebingen from 1994 to
1999, were selected from a database and retrospectively reviewed. For analysis,
patients were divided into 2 groups by predominant part of visual field (VF)
involvement: group 1 (predominantly central involvement) included Stargardt
disease (ST), macular dystrophy (MD), and central areolar choroidal dystrophy
(CACD), and group 2 (predominantly peripheral involvement) included Bardet-Biedl
syndrome (BBD), Usher syndrome (USH) I and II, and choroideremia (CHD). Age,
sex, age of first diagnosis, age of visual acuity (VA) decrease and VF
emergence, night blindness and photophobia onset, types of VF defects and age of
its onset, color discrimination defects and best corrected VA were analyzed.
RESULTS: Records of 259 patients were studied. Men were more prevalent than
women. Mean age of the patients was 47.2 (SD = 15.6) years old. Forty-five
patients in the first group and 40 in the second were first diagnosed between 21
and 30 years of age. Ninety-four patients in the first group had VA decrease
before 30 years of age; in the second group, 68 patients had VA decrease onset
between 21 and 40 years of age. Forty-four patients in the first group noticed
VF at an age between 21 and 30 years, and 74 patients between 11 and 30 years in
the second group. Central scotoma was typical for the first group, and was
detected in 115 patients. Concentric constriction was typical for the second
group, and was found in 81 patients. Half of patients in both groups preserved
best-corrected VA in the better eye at a level of 20/40 or better; 7% in the
first group and 6% in the second group were registered as legally blind
according to WHO criteria, having VA <1/50 or VF <5 degrees . Diagnosis
frequency was USH I and II-34%, ST-31%, MD-18%, CHD-14%, BBD-5%. CONCLUSIONS: An
epidemiological approach to the estimation of the disease onset of various
subtypes of monogenic retinal degenerations will be useful for detection of
disease duration, its prognosis, rehabilitation and the researching of future
treatment possibilities.

PMID: 19277693 [PubMed - as supplied by publisher]

16: Graefes Arch Clin Exp Ophthalmol. 2009 Mar 7; [Epub ahead of print] 

Amyloid precursor protein processing and retinal pathology in mouse models of
Alzheimer\'s disease.

Dutescu RM, Li QX, Crowston J, Masters CL, Baird PN, Culvenor JG.

Department of Pathology and Centre for Neuroscience, The University of
Melbourne, Parkville, Victoria, 3010, Australia, michael.dutescu@charite.de.

BACKGROUND: Retinal ganglion cell loss is considered to be a cause of visual
impairment in Alzheimer;s patients. Alterations in amyloid precursor protein
(APP) processing and amyloid-beta (Abeta) accumulation, key molecules associated
with Alzheimer;s disease pathogenesis, may therefore contribute to retinal
damage. We therefore investigated retinal APP processing and eye morphology in
Alzheimer;s transgenic mouse models. METHODS: Eyes and brain samples of 2- to
18-month-old transgenic mice expressing human APP with the double Swedish
mutation (APPswe) (APP K595N/M596L)(Tg2576) were compared with eyes and brain
tissue from wild-type background C57BL6xSJL controls. In addition, 6- to
12-month-old double transgenic mice over-expressing human APPswe and mutant
presenilin 1 with exon 9 deletion (APPswe/PS1-dE9) were compared with background
controls of C57BL6xC3H strain. Tissue samples were fixed in formalin for
immunohistochemistry, and dissected retinal and cerebellar extracts were frozen
for Western blotting and enzyme-linked immunosorbent assay (ELISA). Monoclonal
antibodies 1E8 and WO2 were used for immunohistochemical detection of APP and
Abeta, whereas Abeta 42/40 levels were assayed by ELISA. APP and processed
fragments were detected biochemically by Western blotting with domain-specific
antibodies, using antibody WO2 (Abeta) and rabbit antibody 369 to the C-terminal
domain of APP. RESULTS: Immunocytochemistry revealed strong cytoplasmic
expression of APP and possibly Abeta in retinal ganglion cells and inner nuclear
layer cells, and in lens and corneal epithelia for APP transgenic mice. Retinas
from the APP transgenic mouse strains contained 18 to 70 kDa APP proteolytic
products that were not detected in the cerebellum. We found a higher proportion
of APP alpha-secretase generated C-terminal fragments in transgenic retinal
tissues than beta-secretase-generated C-terminal fragments. Very low level Abeta
was detected in transgenic retinas by ELISA; retinal Abeta 42 was 75 times less
than for transgenic brain. Abeta was not detected in mouse retina by Western
blotting in our study, indicating much less generation of Abeta in retina than
brain tissue. CONCLUSIONS: Alzheimer\'s mouse model retinas present with
different APP proteolytic products and have a significantly lower production of
amyloidogenic Abeta than found in brain.

PMID: 19271231 [PubMed - as supplied by publisher]