Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Curr Eye Res
Eur J Ophthalmol
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Surv Ophthalmol
Ophthalmology Review Journal
Graefes Arch Clin Exp Ophthalmol[JOUR] Established 1995
1. Graefes Arch Clin Exp Ophthalmol. 2015 May 21. [Epub ahead of print]

Staging of development in Terrien's degeneration based on corneal curvatures
detected by optical coherence tomography.

Wang N(1), Wang CX, Lian XF, Duan SJ, Huang D, Zhou SY.

Author information: 
(1)Zhongshan Ophthalmic Center at SunYat-sen University, The State Key Laboratory
of Ophthalmology, 54 South Xianlie Road, Guangzhou, China, 510060.

PURPOSE: We aimed to explore a new classification system based on the change of
focal corneal curvatures and corneal thickness in Terrien's corneal degeneration 
with optical coherence tomography.
METHODS: This was a cross-sectional study. Ninety eyes of 59 patients with
Terrien's degeneration were examined with slit lamp biomicroscopy, Orbscan II
corneal tomography and the Visante OCT system, and were staged according to
Süveges's classification.
RESULTS: The ratio of female to male patients was 1.57:1. The ratio of bilateral 
to unilateral lesions was 1.27:1. The occurrence of bilateral lesion was higher
in males than in females (x(2) = 7.791, p = 0.005). There was no difference in
the mean age between female and male patients (t = 1.859, p = 0.068), or between 
patients with bilateral and unilateral lesions (t = 1.797, p = 0.078).The minimum
corneal thickness at the thinnest point (MinCT) and anterior curvature of the
peripheral cornea were almost normal in the initial stages of disease. The
anterior curvature was flattened when MinCT became less than 0.56 mm, returned to
normal when MinCT was no more than 0.24 mm, and bowed forward when MinCT was no
more than 0.13 mm. The posterior corneal curvatures were bowed forward from their
normal curvatures in 42 of 90 eyes when MinCT was no more than 0.41 mm. These
eyes' MinCT ranged from 0 to 0.41 mm. There was a strong correlation between
change of corneal curvatures and MinCT (r = -0.943, p < 0.01). A new
classification of six stages based on corneal curvatures is proposed for
evaluating the development of Terrien's degeneration. Statistically, there was a 
moderate correlation between either the Süveges staging or the new staging and
the width and circumference of corneal lesions, visual acuity, and simulated
keratometric value (all r < 0.6). The correlation of MinCT with the new
classification based on corneal curvatures was higher than that with Süveges's
classification (r 1 vs. r 2 , -0.943 vs. -0.801).
CONCLUSION: The proposed new classification based on focal corneal curvatures is 
closely associated with corneal thinning, is valuable for evaluating the
development of Terrien's degeneration and may enhance surgical planning.

PMID: 25994951   [PubMed - as supplied by publisher]

2. Graefes Arch Clin Exp Ophthalmol. 2015 May 19. [Epub ahead of print]

Bone augmentation of the osteo-odonto alveolar lamina in MOOKP-will it delay
laminar resorption?

Iyer G(1), Srinivasan B, Agarwal S, Rishi E, Rishi P, Rajan G, Shanmugasundaram

Author information: 
(1)CJ Shah Cornea Services/Dr G Sitalakshmi Memorial Clinic for Ocular Surface
Disorders, Medical Research Foundation, Sankara Nethralaya, 18 College Road,
Chennai, 600006, Tamil Nadu, India,

PURPOSE: We aimed to describe a new technique and analyse the early outcomes of
augmenting the canine tooth using a mandibular bone graft in an attempt to delay 
or retard the process of laminar resorption following the modified osteo odonto
keratoprosthesis (MOOKP) procedure.
DESIGN: This was a retrospective case series.
PATIENTS AND METHODS: Eyes that underwent the bone augmentation procedure between
December 2012 and February 2014 were retrospectively analysed. The procedure,
performed by the oromaxillofacial surgeon, involved securing a mandibular bone
graft beneath the periosteum on the labial aspect of the canine tooth chosen to
be harvested for the MOOKP procedure. This procedure was performed simultaneously
with the Stage 1 A of the MOOKP. Three months later, the tooth was harvested and 
fashioned into the osteo-odonto alveolar lamina similar to the method described
in the Rome-Vienna Protocol.
RESULTS: The bone augmentation procedure was performed in 11 eyes (five SJS/ six 
chemical injuries). The mean follow-up after Stage 2 of MOOKP procedure in these 
eyes was 7.45 months (2 to 20 months). Complications noted were peripheral
laminar exposure (three eyes-SJS) and bone graft exposure and necrosis in the
mouth (nine-SJS). No evidence of clinical laminar resorption was noted in any of 
the eyes.
CONCLUSION: Laminar resorption in MOOKP can lead to vision and globe threatening 
complications due to the consequent cylinder instability and chances of
extrusion. Augmenting the bone on the labial aspect of the canine tooth might
have a role to play in delaying or preventing laminar resorption.

PMID: 25981121   [PubMed - as supplied by publisher]

3. Graefes Arch Clin Exp Ophthalmol. 2015 May 17. [Epub ahead of print]

Birth-related retinal hemorrhages in healthy full-term newborns and their
relationship to maternal, obstetric, and neonatal risk factors.

Zhao Q(1), Zhang Y, Yang Y, Li Z, Lin Y, Liu R, Wei C, Ding X.

Author information: 
(1)Department of Ophthalmology, Zhongshan People's Hospital, Zhongshan Hospital, 
Sun Yat-San University, 2 Sunwen East Road, 528403, Zhongshan, China.

PURPOSE: The purpose was to explore underlying maternal, obstetric, and neonatal 
risk factors of retinal hemorrhages (RH) in healthy full-term newborns.
METHODS: A total of 1199 full-term infants, with gestational age more than
37 weeks and Apgar score of 7 or above, were included in this study. Infants with
severe systemic diseases or any other eye diseases were excluded. Eye
examinations with RetCamIII within 1 week of birth were performed in all infants.
Maternal, obstetric, and neonatal parameters were analyzed and compared between
newborns with RH and those without RH.
RESULTS: RH was seen in 294 of the 1199 infants (24.5 %) in this study. Among
factors examined in the study, spontaneous vaginal delivery (SVD) (odds ratio
[OR] =3.811 [95 % CI2.649-5.483], P < 0.001) and cephalhematoma (OR = 1.823 [95 %
CI1.009-3.296], P = 0.047) correlated positively with RH occurrence in newborns, 
while a history of cesarean delivery correlated negatively with RH occurrence
(OR = 0.296 [95 % CI0.139-0.630], P = 0.002). There was no statistical
correlation found between RH and the other risk factors examined in this study.
These factors included gender, gestational age, birth weight, maternal age,
volume, and turbidity of amniotic fluid, duration of the first or second stage of
labor, anemia, hypertensive disorders complicating pregnancy (HDCP), fetal
distress, intracranial hemorrhage, and neonatal hyperbilirubinemia.
CONCLUSIONS: RH is common in full-term newborns. A lower prevalence of newborn RH
was found in infants delivered by mothers with a history of cesarean delivery. In
contrast, SVD and cephalhematoma were found to be potential risk factors for the 
development of newborn RH in full-term infants. Infants with these risk factors
may, therefore, require greater attention in regard to RH development.

PMID: 25981120   [PubMed - as supplied by publisher]

4. Graefes Arch Clin Exp Ophthalmol. 2015 May 19. [Epub ahead of print]

Effects of mydriasis and miosis on kinetic perimetry findings in normal

Hirasawa K(1), Shoji N, Kobashi C, Yamanashi A.

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,

PURPOSE: To evaluate the effects of pharmacologically induced mydriasis and
miosis on kinetic perimetry findings in normal participants.
METHODS: Thirty-eight eyes of 38 healthy young participants underwent kinetic
perimetry (Octopus 900 perimeter) with III4e, I4e, I3e, I2e, and I1e stimuli. For
each participant, 24 predetermined meridians with 15° intervals were
automatically tested with a velocity of 3°/s under normal, mydriatic, and miotic 
conditions. Mydriasis and miosis were induced by one drop of 0.4 % tropicamide
and 2 % pilocarpine hydrochloride, respectively. The isopter area and kinetic
sensitivity were compared between the three pupil conditions.
RESULTS: The average pupil size in the normal condition was 5.6 ± 0.9 mm, and it 
significantly increased to 8.5 ± 0.7 mm after mydriasis (p < 0.01) and decreased 
to 3.4 ± 0.8 mm after miosis (p < 0.01). Compared to the normal pupil, the
isopter area of the dilated pupil was not significantly different under the III4e
stimulus; however, it significantly decreased under the I4e, I3e, I2e, and I1e
stimuli (p < 0.01). Compared to the normal pupil, the isopter area of the
constricted pupil significantly decreased (p < 0.01) with the III4e stimulus and 
significantly increased with the I3e and I2e stimuli (p < 0.05).
CONCLUSIONS: For both pupil conditions, kinetic sensitivity at each meridian
showed a similar trend to the isopter area under each stimulus. The isopter area 
of the dilated pupil generally decreased, whereas the isopter area of the
constricted pupil showed various findings. Therefore, careful attention should be
paid to changes in the isopter area associated with changes in the pupil size.

PMID: 25981119   [PubMed - as supplied by publisher]

5. Graefes Arch Clin Exp Ophthalmol. 2015 May 16. [Epub ahead of print]

Intravitreal inhibition of complement C5a reduces choroidal neovascularization in

Brockmann C(1), Brockmann T, Dege S, Busch C, Kociok N, Vater A, Klussmann S,
Strauß O, Joussen AM.

Author information: 
(1)Department of Ophthalmology, Charité - University Medicine Berlin,
Augustenburger Platz 1, 13353, Berlin, Germany,

PURPOSE: To investigate the influence of complement component C5a inhibition on
laser-induced choroidal neovascularization (CNV) in mice using a C5a specific
METHODS: In C57BL/6 J mice CNV was induced by argon-laser, C5a-inhibitor
(NOX-D20) was intravitreally injected in three concentrations: 0.3, 3.0, and
30 mg/ml. The unPEGylated derivate (NOX-D20001) was applied at 3.0 mg/ml; the
vehicle (5 % glucose) was injected in controls. Vascular leakage was evaluated
using fluorescence angiography, CNV area was examined immunohistochemically.
Activated immune cells surrounding the CNV lesion and potential cytotoxicity were
RESULTS: Compared to controls, CNV areas were significantly reduced after NOX-D20
injection at a concentration of 0.3 and 3.0 mg/ml (p = 0.042; p = 0.016).
NOX-D20001 significantly decreased CNV leakage but not the area (p = 0.007;
p = 0.276). At a concentration of 30 mg/ml, NOX-D20 did not reveal significant
effects on vascular leakage or CNV area (p = 0.624; p = 0.121). The amount of
CD11b positive cells was significantly reduced after treatment with 0.3 and
3.0 mg/ml NOX-D20 (p = 0.027; p = 0.002). No adverse glial cell proliferation or 
increased apoptosis were observed at effective dosages.
CONCLUSIONS: Our findings demonstrate that the targeted inhibition of complement 
component C5a reduces vascular leakage and neovascular area in laser-induced CNV 
in mice. NOX-D20 was proven to be an effective and safe agent that might be
considered as a therapeutic candidate for CNV treatment. The deficiency of
activated immune cells highlights promising new aspects in the pathology of
choroidal neovascularization, and warrants further investigations.

PMID: 25981118   [PubMed - as supplied by publisher]

6. Graefes Arch Clin Exp Ophthalmol. 2015 May 16. [Epub ahead of print]

Spatial characteristics of evoked potentials elicited by a MEMS microelectrode
array for suprachoroidal-transretinal stimulation in a rabbit.

Yan Y(1), Sui X, Liu W, Lu Y, Cao P, Ma Z, Chen Y, Chai X, Li L.

Author information: 
(1)School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai,
200240, China,

BACKGROUND: Suprachoroidal-transretinal stimulation (STS) can potentially restore
vision. This study investigated the spatial characteristics of cortical
electrical evoked potentials (EEPs) elicited by STS.
METHODS: A 4 × 4 thin-film platinum microelectrode stimulating array (200 μm
electrode diameter and 400 μm center-to-center distance) was fabricated by a
micro-electro-mechanical systems (MEMS) techniques and implanted into the
suprachoroidal space of albino rabbits.
RESULTS: The current threshold to elicit reliable EEPs by a single electrode was 
41.6 ± 12.6 μA, corresponding to a 66.2 ± 20.1 μC · cm(-2) charge density per
phase, which was lower than the reported safety limits. Spatially differentiated 
cortical responses could be evoked by STS through different rows or columns of
electrical stimulation; furthermore, shifts in the location of the maximum
cortical activities were consistent with cortical visuotopic maps; increasing the
number of simultaneously stimulating electrodes increased the response amplitudes
of EEPs and expanded the spatial spread as well. In addition, long-term
implantation and electrical stimulation of the MEMS electrode array in
suprachoroidal space are necessary to evaluate systematically the safety and
biocompatibility of this approach.
CONCLUSIONS: This study indicates that the STS approach by a MEMS-based platinum 
electrode array is a feasible alternative for visual restoration, and relatively 
high spatial discrimination may be achieved.

PMID: 25981117   [PubMed - as supplied by publisher]

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

Peripapillary choroidal thickness in patients with early age-related macular
degeneration and reticular pseudodrusen.

Yun C(1), Oh J, Ahn SE, Hwang SY, Kim SW, Huh K.

Author information: 
(1)Department of Ophthalmology, Korea University College of Medicine, 126-1
Anam-dong 5-ga, Sungbuk-gu, Seoul, 136-705, Korea.

PURPOSE: The purpose of this study was to investigate peripapillary and macular
choroidal thickness (CT) in patients with early age-related macular degeneration 
(AMD) with or without reticular pseudodrusen (RPD).
METHODS: We investigated the medical records of 89 patients (89 eyes) with early 
AMD. The eyes were grouped into three categories according to the extent of RPD: 
no RPD, localized RPD, and diffuse RPD. Peripapillary and macular CT were
measured with images obtained by spectral domain optical coherence tomography. CT
in the peripapillary and macular areas was compared among groups.
RESULTS: Both RPD groups exhibited an older subject age and a greater female
predominance compared to the non-RPD group (P = 0.007 and P = 0.030,
respectively). Macular and peripapillary CT were different among the three groups
(all, P < 0.001), and both RPD groups showed a thinner choroid in all areas
compared to the non-RPD group after adjusting for age and sex (all, P ≤ 0.016).
Temporal peripapillary and nasal macular CT at 500 μm and 1500 μm, respectively, 
from the fovea in eyes with diffuse RPD were significantly thinner than that in
eyes with localized RPD (P = 0.008, P = 0.016 and P < 0.001, respectively).
CONCLUSIONS: In addition to the macular area, the peripapillary CT, including the
area outside the macula, was thinner in eyes with RPD than in those without RPD. 
Significant differences in the papillomacular choroid were observed based on RPD 
distribution type, which suggests that variation in CT is based on the extent of 

PMID: 25971212   [PubMed - as supplied by publisher]

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

Determinants of patient satisfaction and function related to vision following
cataract surgery in eyes with no visually consequential ocular co-morbidity.

Kirwan C(1), Nolan JM, Stack J, Moore TC, Beatty S.

Author information: 
(1)Biomedical Science Research Institute, University of Ulster, Coleraine,
Northern Ireland, UK,

PURPOSE: To investigate subjectively reported outcomes following cataract surgery
and the relationships between such outcomes in the context of falling thresholds 
for cataract surgery.
SETTING: Large, private, non-refractive cataract practice, Institute of Eye
Surgery, Whitfield Clinic, Waterford, Ireland METHODS: Pre-operative,
intra-operative and post-operative data of 2552 eyes undergoing
phacoemulsification and implantation of the Tecnis(R) ZCB00 1-piece intraocular
lens (IOL) by a single surgeon between July 2009 and October 2013 was analysed.
Patients without visually consequential ocular co-morbidity completed two
validated questionnaires, designed to assess subjectively perceived visual
functioning and identify symptoms of dysphotopsia following cataract surgery.
RESULTS: 54.8 % of questionnaire respondents were entirely satisfied
(satisfaction 10/10) post-operatively, with 83.7 % reporting satisfaction of
≥7/10. Satisfaction was positively associated with patient age and negatively
associated with spectacle dependence, dysphotopsia, and function related to
vision (NEI VF-11) score. The mean (±standard deviation[SD]) dysphotopsia score
was 1.36 (±1.9; scale 0-10), with 40 % of respondents reporting no dysphotopsia
symptoms and 9.8 % reporting clinically meaningful dysphotopsia. The mean (±SD)
National Eye Institute visual function-11 (NEI VF-11) score was 0.33 (±0.53;
scale 0-4) and reduced function related to vision was associated with increasing 
severity of dysphotopsia symptoms. When linear regression was applied, 17.5 % of 
the variation in functionality was attributable to symptoms of dysphotopsia.
CONCLUSION: Dysphotopsia is an important determinant of a patient having
difficulty with vision-related tasks following cataract surgery, and patient
satisfaction is positively associated with patient age and negatively associated 
with spectacle in dependence, dysphotopsia and function related to the vision
(NEI VF-11) score.

PMID: 25968132   [PubMed - as supplied by publisher]

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

25-gauge pars plana vitrectomy with medium-term postoperative perfluoro-n-octane 
for the repair of giant retinal tears.

Randolph JC(1), Diaz RI, Sigler EJ, Calzada JI, Charles S.

Author information: 
(1)Department of Vitreoretinal Surgery, Charles Retina Institute, 6401 Poplar
Avenue, Suite 190, Memphis, TN, 38119, USA.

PURPOSE: The purpose of this study was to describe the treatment of giant retinal
tears (GRTs) with 25-gauge pars plana vitrectomy (PPV) and medium-term
postoperative perfluoro-n-octane (MT-PFO).
METHODS: The study was a retrospective interventional case series of consecutive 
patients with GRTs treated with 25-gauge PPV and postoperative MT-PFO for a
period of 2-3 weeks. A second, staged procedure was performed in all patients for
PFO removal.
RESULTS: Twenty-three eyes of 22 patients were studied, with a mean follow-up of 
33.04 ± 19.74 months. Successful reattachment was achieved in 91.3 % of eyes
(21/23) after MT-PFO. Retinal re-detachment occurred in five eyes, which was
caused by proliferative vitreoretinopathy. Additional complications included
cataract progression (n = 10), foreign body response (30.4 %, 7/23), and
transient intraocular pressure (IOP) elevation (8/23, 34.8 %). Transient IOP
elevation was associated with worse visual outcome (p = 0.01).
CONCLUSIONS: MT-PFO was found to be an effective and safe technique for operative
management of GRTs. In the majority of patients, retinas remained attached
without further surgical intervention. Cataract progression, intraocular
inflammation, and associated increased intraocular pressure are potential
complications of MT-PFO.

PMID: 25959143   [PubMed - as supplied by publisher]

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

Mean platelet volume in retinopathy of prematurity.

Tao Y(1), Dong Y, Lu CW, Yang W.

Author information: 
(1)Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical
University, Dalian, China,

PMID: 25957765   [PubMed - as supplied by publisher]

11. Graefes Arch Clin Exp Ophthalmol. 2015 May 10. [Epub ahead of print]

Serum and aqueous xanthine oxidase levels, and mRNA expression in anterior lens
epithelial cells in pseudoexfoliation.

Simavli H(1), Tosun M, Bucak YY, Erdurmus M, Ocak Z, Onder HI, Acar M.

Author information: 
(1)Department of Ophthalmology, Pamukkale University School of Medicine, Denizli,
20700, Turkey,

PURPOSE: The aim of this study was to determine serum and aqueous xanthine
oxidase (XO) levels, and mRNA expression in anterior lens epithelial cells in
pseudoexfoliation (PEX).
METHODS: In this prospective study, serum, aqueous and anterior lens capsules
were taken from 21 patients with PEX and 23 normal subjects who had undergone
routine cataract surgery. Serum and aqueous XO levels were analyzed using the
colorimetric method. mRNA expression of XO in anterior lens epithelial cells was 
evaluated using reverse transcription polymerase chain reaction analysis.
RESULTS: Serum XO levels (means ± standard deviations) were 207.0 ± 86.1 IU/mL
and 240.6 ± 114.1 IU/mL in the normal and PEX groups, respectively (p = 0.310).
Aqueous XO levels (means ± standard deviations) were 65.5 ± 54.3 IU/mL in the
normal group and 130.5 ± 117.4 IU/mL in the PEX group (p = 0.028). There was a
2.9 fold decrease in mRNA expression in anterior lens epithelial cells of PEX,
which is significantly lower than the normal group (p = 0.01).
CONCLUSIONS: Higher aqueous XO levels lacking associated different serum XO
suggests higher oxidative stress in the aqueous. Higher aqueous XO levels in PEX 
with decreased mRNA expression in anterior lens epithelial cells indicate
possible overexpression of XO in other structures related to the aqueous.

PMID: 25957764   [PubMed - as supplied by publisher]

12. Graefes Arch Clin Exp Ophthalmol. 2015 May 10. [Epub ahead of print]

An extraocular non-invasive transscleral LED-endoilluminator for eye speculum

Kölbl PS(1), Lindner C, Lingenfelder C, Deuchler S, Singh P, Koch F, Hessling M.

Author information: 
(1)Department of Mechatronics and Medical Engineering, Ulm University of Applied 
Sciences, Albert-Einstein-Allee 55, D-89081, Ulm, Germany.

PURPOSE: Conventional chandelier-endoilluminators used for pars-plana vitrectomy 
consist of a light-emitting tip attached to an optical fibre. The tip requires
introduction into the ocular space through an incision. To achieve complete
illumination of the intraocular space, the introduction of more than just one tip
is sometimes necessary. An extraocular vitreoretinal LED-endoilluminator
discussed in this paper represents a new approach to illuminate the intraocular
space. The light source is integrated into a speculum and firmly apposed to the
sclera. This approach offers the advantage of effectively illuminating the
interior of the eye even though the procedure is non-invasive. Furthermore, this 
approach significantly reduces the risk of damage to the retina by phototoxic
METHODS: A round white LED was used as a light source. By integrating the light
source into a speculum, the LED was firmly held against the sclera. Thus, the
ocular space was illuminated transsclerally. As a result, indirect uniform
illumination of the complete intraocular space was achieved. The prototype was
developed considering the relevant international standards. Porcine eyes were
used because their properties are similar to those of human eyes.
RESULTS: Porcine eyes could be acceptably illuminated with the selected LED. The 
LED-endoilluminator conforms with international standards for endoillumination.
Thus, possible photochemical and thermal risks are considered and reduced to a
CONCLUSIONS: A novel LED-endoilluminator which can be attached to a speculum was 
developed. The system does not need any connection to an external light source
and, consequently, also avoids usage of an optical fibre. Regular and uniform
illumination of the intraocular space was achieved by transmitted and scattered
visible irradiation, avoiding an incision. The duration of potential light
exposure, compared to existing illumination systems, can be significantly
increased. This is also true when the illuminator is not directly placed over the
pars-plana and the distance to the retina is reduced. Only a part of the light
reaches the retina and the fraction of short wavelength becomes very small.
Increased safety of the system results from now being able to increase the
exposure time and reduce phototoxic stress to the retina.

PMID: 25957763   [PubMed - as supplied by publisher]

13. Graefes Arch Clin Exp Ophthalmol. 2015 May 9. [Epub ahead of print]

Mean platelet volume in retinopathy of prematurity.

Şahin A(1), Uluca Ü, Türkcü FM.

Author information: 
(1)School of Medicine, Department of Ophthalmology, Dicle University, 21280,
Diyarbakır, Turkey,

PMID: 25957001   [PubMed - as supplied by publisher]

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

Retinal nerve fiber layer structure abnormalities in patients with Neuro-Behcet's

Ucar D(1), Uygunoglu U, Dikkaya F, Yıldırım Y, Yuksel-Elgin C, Saip S, Siva A,
Ozyazgan Y.

Author information: 
(1)Department of Ophthalmology, Cerrahpasa Medical School, University of
Istanbul, Istanbul, Turkey,

PURPOSE: Our aim was the evaluation of retinal nerve fiber layer (RNFL) and
central macular thickness (CMT) in patients with Neuro-Behcet's disease (NBD) and
to compare the results with healthy control subjects.
METHODS: We recruited 50 eyes of 25 patients with NBD and 42 eyes of 21
age-matched healthy control subjects. Patients and control subjects underwent a
thorough ophthalmic examination, including retinal nerve fiber layer and macular 
thickness measurements by optical coherence tomography.
RESULTS: No significant difference was found between groups for age, sex,
intra-ocular pressure and central corneal thickness measurements. The average
RNFL in patients with NBD was significantly lower than that of healthy controls
(86.92 ± 18.36 μm vs. 99.74 ± 8.73 μm; p = 0.00). There was significant thinning 
of the RNFL in three of four quadrants of the peripapillary area, superior
(107.22 ± 30.91 μm vs. 125.57 ± 20.97 μm; p = 0.00), inferior (110.36 ± 25.57 μm 
vs. 132.19 ± 12.71 μm; p = 0.00) and nasal (68.84 ± 18.47 μm vs.
74.98 ± 11.42 μm; p = 0.05), in patients with NBD. Average CMT was significantly 
lower in NBD patients than in control subjects (244.06 ± 26.25 μm vs.
261.69 ± 25.71 μm; p = 0.00).
CONCLUSIONS: There are significant differences in average RNFL and CMT between
the two groups. RNFL and CMT thicknesses are reduced in patients with NBD
compared with the healthy controls.

PMID: 25957000   [PubMed - as supplied by publisher]

15. Graefes Arch Clin Exp Ophthalmol. 2015 May 9. [Epub ahead of print]

Full-field ERG in diabetic retinopathy: a screening tool?

Tzekov R(1).

Author information: 
(1)Department of Ophthalmology, University of South Florida, Tampa, FL, 33612,

PMID: 25956999   [PubMed - as supplied by publisher]

16. Graefes Arch Clin Exp Ophthalmol. 2015 May 9. [Epub ahead of print]

Vascular endothelial growth factor levels in tears of patients with retinal vein 

Kasza M(1), Balogh Z, Biro L, Ujhelyi B, Damjanovich J, Csutak A, Várdai J, Berta
A, Nagy V.

Author information: 
(1)Medical Centre, Hungarian Defence Forces, 1134, Budapest, Róbert Károly krt.
44, Hungary,

PURPOSE: We measured vascular endothelial growth factor (VEGF) levels in tear
fluid and serum in patients with retinal vein occlusion (RVO).
PATIENTS AND METHODS: Eight patients with RVO due to secondary macular oedema
were examined. VEGF levels were measured by enzyme-linked immunosorbent assay.
All patients had a full ophthalmic examination (visual acuity, slit lamp
biomicroscopy, perimetry, and fluorescein angiography). Central retinal thickness
(CRT) was examined using optical coherence tomography (OCT). Tear and serum
samples were collected and examinations were performed at diagnosis and 1 and 4
weeks later.
RESULTS: VEGF levels in the tears of RVO eyes were significantly higher than in
fellow eyes at diagnosis and after both 1 and 4 weeks (paired t test, p1 = 0.01, 
p2 = 0.02, p3 = 0.006). We found a weak but significant positive correlation
between VEGF levels in tear fluid and serum of patients with RVO (r = 0.21),
while this correlation tended to be stronger between the fellow eyes and serum
levels (r = 0.33).
CONCLUSION: To the best of our knowledge, we are the first to report an increased
level of VEGF in the tear fluid of patients with RVO. Alterations of VEGF levels 
in tears may be useful for determining stages of RVO. This non-invasive and
objective method may also be helpful for estimating the severity of macular
oedema and efficacy of treatment.

PMID: 25956998   [PubMed - as supplied by publisher]

17. Graefes Arch Clin Exp Ophthalmol. 2015 May 8. [Epub ahead of print]

Retinal vessel oxygen saturation and vessel diameter in retinitis pigmentosa at
various ages.

Zong Y(1), Lin L, Yi C, Huang X, Fu Y, Dong Y, Qian X, Li Y, Gao Q.

Author information: 
(1)State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun
Yat-sen University,, 54 Xianlie Road, Guangzhou, Guangdong, 510060, China.

PURPOSE: This study was conducted to determine whether oxygen saturation and
retinal blood vessel diameter are affected by retinitis pigmentosa (RP) at
various ages.
METHODS: Relative oxygen saturation was measured in retinal blood vessels in 68
RP patients and 136 normal subjects using the Oxymap T1 retinal oximeter.
Subjects were divided into two age groups: Group A (20-40 years) and Group B (>
40 years). One randomly selected eye of each subject was used for statistical
analysis. Student's t tests were used to analyze the mean saturation and diameter
of retinal arterioles and venules and arteriovenous differences between RP and
normal subjects in the two age groups. A Spearman test was used to analyze the
correlation of mean saturation of retinal arterioles (AS) and arteriovenous
differences (AVS) with visual acuity, disease duration, and electroretinogram
(ERG) b-wave amplitude in patients with RP.
RESULTS: AS was significantly higher in patients with RP (105.5 ± 9.4 %) than in 
normal subjects (94.5 ± 4.4 %, p = 0.000) in Group A, while in Group B, AS was
significantly lower in RP patients (86.8 ± 10.3 %) than in healthy subjects
(96.0 ± 4.8 %, p = 0.000). Vessel diameter was smaller in RP patients than in
normal subjects. AS and AVS showed a negative correlation with disease duration
and a tendency toward positive correlation with ERG b-wave in patients with RP.
CONCLUSIONS: The shifting characteristics of retinal vessel oxygen saturation
suggest that the pathological mechanism of retinal oxygen metabolic disorder
differs by age in patients with RP.

PMID: 25952041   [PubMed - as supplied by publisher]

18. Graefes Arch Clin Exp Ophthalmol. 2015 May 8. [Epub ahead of print]

The long-term outcome of the refractive error in children with hypermetropia.

Mezer E(1), Meyer E, Wygnansi-Jaffe T, Haase W, Shauly Y, Biglan AW.

Author information: 
(1)Department of Ophthalmology, Rambam Health Care Campus, PO Box 9907, Haifa,
3109901, Israel,

PURPOSE: The purpose of this study was to investigate the long-term outcome of
high hypermetropic refractive errors in childhood.
METHODS: We retrospectively reviewed data from the clinical records of 164
children with spherical equivalent (SE) hypermetropic refractive errors in three 
medical centers collected over 29 years. Refractive errors between +1.00 and
+3.00 diopter (D) on initial examination were classified as mild hypermetropia
and those +5.00D or greater were classified as high hypermetropia. The four
variables studied were, age, refractive error, strabismus, and gender. The rate
of reduction in hypermetropic refractive error was calculated over time in years.
We identified subgroups according to age, gender, and initial refractive error.
RESULTS: Seventy-eight children with high hypermetropia and 86 children with mild
hypermetropia were studied. High hypermetropia was detected at a mean age of
3.3 years, while mild hypermetropia was detected at a mean 4 years of age. The
mean follow-up was 6.6 years for high hypermetropia and 6.4 years for mild
hypermetropia. Over the follow-up period, children in all subgroups tended to
reduce their refractive errors. The reduction in refraction power was small for
both mild and high hypermetropic refractive errors. Amblyopia in the high
hypermetropia group was more common and more refractory to treatment.
CONCLUSIONS: Most children with hypermetropia of less than +3.00D experience a
reduction in hyperopic refractive error over time and will outgrow any need for
corrective lenses. Children with hyperopia greater than +5.00D will not
experience a significant reduction in the power of the refractive error.

PMID: 25952040   [PubMed - as supplied by publisher]

19. Graefes Arch Clin Exp Ophthalmol. 2015 May 7. [Epub ahead of print]

Treatment of negative dysphotopsia with supplementary implantation of a
sulcus-fixated intraocular lens.

Makhotkina NY(1), Berendschot TT, Beckers HJ, Nuijts RM.

Author information: 
(1)University Eye Clinic, Maastricht University Medical Centre, P. Debyelaan 25, 
6202 AZ, Maastricht, The Netherlands,

PURPOSE: Our aim was to evaluate the resolution of negative dysphotopsia after
supplementary implantation of a sulcus-fixated intraocular lens (IOL).
METHODS: This was a retrospective case series. Patients with severe negative
dysphotopsia were treated with supplementary implantation of the Rayner Sulcoflex
Aspheric (653 L) IOL. Primary outcome measurements were subjectively reported
complaints of dysphotopsia, best corrected distance visual acuity (CDVA),
iris-IOL distance, anterior chamber depth (ACD) and volume (ACV), angle opening
distance and trabecular-iris space area at 500 and 750 μm.
RESULTS: A Rayner Sulcoflex IOL was implanted in seven patients (nine eyes) with 
negative dysphotopsias. Symptoms resolved completely in six eyes, partially in
one eye and remained unchanged in two eyes. We did not find any significant
changes in CDVA. Angle opening distance, ACD, ACV and iris-IOL distance reduced
significantly after Sulcoflex IOL implantation.
CONCLUSIONS: Supplementary implantation of a Sulcoflex IOL can successfully treat
negative dysphotopsia. The decrease in anterior segment dimensions in combination
with the displacement of light rays by the rounded edges of a Sulcoflex IOL may
contribute to the resolution of symptoms.

PMID: 25947640   [PubMed - as supplied by publisher]

20. Graefes Arch Clin Exp Ophthalmol. 2015 May 7. [Epub ahead of print]

A novel Cx50 (GJA8) p.H277Y mutation associated with autosomal dominant
congenital cataract identified with targeted next-generation sequencing.

Chen C(1), Sun Q, Gu M, Liu K, Sun Y, Xu X.

Author information: 
(1)Department of Ophthalmology, Shanghai First People's Hospital, School of
Medicine, Shanghai Jiao Tong University, Shanghai, China.

BACKGROUND: To unravel the molecular genetic background responsible for autosomal
dominant congenital pulverulent nuclear cataracts in a four-generation Chinese
METHODS: Family history data were collected, ophthalmological examinations were
performed, and genomic DNA was extracted from peripheral blood of the family
members. The candidate genes were captured and sequenced by targeted
next-generation sequencing, and the results were confirmed by Sanger sequencing. 
The structure modelling of the protein was displayed based on Swiss-Model Server,
and its possible changes in the secondary structure were predicted using
Antheprot 2000 software. The chemical dissimilarity and possible functional
impact of an amino acid substitution were performed with Grantham score,
PolyPhen-2, and SIFT predictions. Protein distributions were assessed by confocal
RESULTS: A novel heterozygous c.829C > T transition that led to the substitution 
of a highly conserved histidine by tyrosine at codon 277 (p.H277Y) in the coding 
region of connexin50 (Cx50, GJA8) was identified. Bioinformatics analysis showed 
that the mutation likely altered the secondary structure of the protein by
replacing the helix of the COOH-terminal portion with a turn. The mutation was
predicted to be moderately conservative by Grantham score and to be deleterious
by both PolyPhen-2 and SIFT with consistent results. In addition, when expressed 
in COS1 cells, the mutation led to protein accumulation and caused changes in
Cx 50 protein localization pattern.
CONCLUSIONS: This is a novel missense mutation [c.829C > T, (p.H277Y)] identified
in exon 2 of Cx50. Our findings expand the spectrum of Cx50 mutations that are
associated with autosomal dominant congenital pulverulent nuclear cataract.

PMID: 25947639   [PubMed - as supplied by publisher]

21. Graefes Arch Clin Exp Ophthalmol. 2015 May 6. [Epub ahead of print]

Sensitivity and specificity for detecting early glaucoma in eyes with high myopia
from normative database of macular ganglion cell complex thickness obtained from 
normal non-myopic or highly myopic Asian eyes.

Nakanishi H(1), Akagi T, Hangai M, Kimura Y, Suda K, Kumagai KK, Morooka S, Ikeda
HO, Yoshimura N.

Author information: 
(1)Department of Ophthalmology and Visual Sciences, Kyoto University Graduate
School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan,

PURPOSE: We aimed to determine the sensitivity and specificity of the normative
database of non-myopic and highly myopic eyes of the macular ganglion cell
complex (mGCC) thickness embedded in the NIDEK RS-3000 spectral-domain optical
coherence tomography (SD-OCT) for detecting early glaucoma in highly myopic eyes.
METHODS: Forty-seven highly myopic eyes (axial length ≥26.0 mm) of 47 subjects
were studied. The SD-OCT images were used to determine the mGCC thickness within 
a 9-mm diameter circle centered on the fovea. The sensitivity and specificity of 
the non-myopic database were compared to that of the highly myopic database for
distinguishing the early glaucomatous eyes from the non-glaucomatous eyes. The
mGCC scans were classified as abnormal if at least one of the eight sectors of
the significance map was < 1 % of the normative thickness.
RESULTS: Twenty-one eyes were diagnosed to be non-glaucomatous and 26 eyes to
have early glaucoma. . The average mGCC thickness was significantly thinner
(80.9 ± 8.5 μm) in the early glaucoma group than in the non-glaucomatous group
(91.2 ± 7.5 μm; p <1 × 10(-4)). The sensitivity was 96.2 % and specificity was
47.6 % when the non-myopic database was used, and the sensitivity was 92.3 % and 
the specificity was 90.5 % when the highly myopic database was used. The
difference in the specificity was significant (p < 0.01).
CONCLUSIONS: The significantly higher specificity of the myopic normative
database for detecting early glaucoma in highly myopic eyes will lead to fewer
false positive diagnoses. The database obtained from highly myopic eyes should be
used when evaluating the mGCC thickness of highly myopic eyes.

PMID: 25944452   [PubMed - as supplied by publisher]

22. Graefes Arch Clin Exp Ophthalmol. 2015 May 5. [Epub ahead of print]

The effect of prophylactic topical antibiotics on bacterial resistance patterns
in endophthalmitis following intravitreal injection.

Storey P(1), Dollin M, Rayess N, Pitcher J, Reddy S, Vander J, Hsu J, Garg S;
Post-Injection Endophthalmitis Study Team.

Author information: 
(1)Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Thomas
Jefferson University, 840 Walnut Street, Suite 1020, Philadelphia, PA, 19107,

PURPOSE: The purpose of this study was to evaluate the effect of prophylactic
topical antibiotics on bacterial resistance patterns in endophthalmitis following
intravitreal injection of anti-vascular endothelial growth factor (VEGF)
METHODS: In this retrospective case-control study, billing records and an
infection log were used to identify all cases of endophthalmitis following
intravitreal injection of ranibizumab, bevacizumab, or aflibercept between
January 1, 2009 and September 30, 2013 at a single retina practice. A 28-month
period when topical antibiotic drops were prescribed for use four times a day for
4 days following intravitreal injection was compared to a 21-month period when
topical antibiotics were not prescribed. Patients treated during an 8-month
transition period were excluded as prescription practices were changed.
RESULTS: During the study period, a total of 172,096 anti-VEGF injections were
performed. During the period when antibiotics were prescribed, 28 cases of
suspected infectious endophthalmitis occurred from a total of 57,654 injections, 
ten of which were culture-positive. During the period when antibiotics were not
used, 24 cases of suspected endophthalmitis occurred from a total of 89,825
injections, six of which were culture-positive. During the antibiotic period,
four of the ten (40 %) culture-positive cases grew bacteria resistant to the
prescribed prophylactic antibiotics. In contrast, none of the six
culture-positive cases grew bacteria resistant to those antibiotics during the
period when antibiotics were not used (odds ratio = 9.0; 95 % confidence
interval = 0.40-203.3; p = 0.17).
CONCLUSIONS: The use of prophylactic topical antibiotics following intravitreal
injection may lead to higher rates of antibiotic-resistant bacteria in
culture-positive endophthalmitis cases.

PMID: 25940556   [PubMed - as supplied by publisher]

23. Graefes Arch Clin Exp Ophthalmol. 2015 May 5. [Epub ahead of print]

Real-life experience after intravitreal ocriplasmin for vitreomacular traction
and macular hole: a spectral-domain optical coherence tomography prospective

Chatziralli I(1), Theodossiadis G, Parikakis E, Datseris I, Theodossiadis P.

Author information: 
(1)2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece.

PURPOSE: To evaluate prospectively the anatomical and functional results after
ocriplasmin injection in patients with vitreomacular traction (VMT), or macular
hole (MH) combined with VMT, providing the real-life experience of three centers,
using spectral domain-optical coherence tomography (SD-OCT).
METHODS: Twenty-four patients with VMT (17 with VMT alone and 7 with an MH
combined with VMT) were treated with a single ocriplasmin injection and
followed-up prospectively at baseline, day 1, 7, 28 and the last examination of
the follow-up for each patient (range: 30-127 days). Best-corrected visual acuity
(BCVA) and SD-OCT were performed for patient assessment, while various adverse
events were recorded and analysed. At baseline, univariate analysis was also
performed to examine the potential predictive factors for VMT release.
RESULTS: 66.7 % of patients presented VMT release at the end of the follow-up,
while 28.6 % exhibited MH closure. Baseline positive predictive factors for VMT
release were young age, being female, phakic lens status, increased vitreofoveal 
angle, V-shaped and loose vitreomacular adhesion, small adhesion area, thin
vitreous strands at the adhesion site and absence of an epiretinal membrane. Four
new cases of ellipsoid line changes and subretinal fluid development became
evident at day 7 compared to baseline. Lamellar macular hole (LMH) in four cases 
was first noticed at day 28 post injection. Formation of cystoid macular edema
(CME) was noticed in three new cases at day 28 compared to baseline.
CONCLUSIONS: Our study demonstrated a VMT release rate of 66.7 %. Apart from the 
known baseline factors that influence VMT release after ocriplasmin injection,
the size of the vitreofoveal angle, a V-shaped and loose vitreomacular adhesion, 
a small adhesion area, and thin vitreous strands at the adhesion site, could
additionally affect the outcome of VMT release. In addition, we studied when VMT 
release and concomitant events occur and for how long the induced complications

PMID: 25940555   [PubMed - as supplied by publisher]

24. Graefes Arch Clin Exp Ophthalmol. 2015 May 5. [Epub ahead of print]

Evaluating the long-term efficacy of short-duration 0.1 mg/ml and 0.2 mg/ml MMC
in primary trabeculectomy for primary adult glaucoma.

Sihota R(1), Angmo D, Chandra A, Gupta V, Sharma A, Pandey RM.

Author information: 
(1)Glaucoma Research Facility & Clinical Services, Dr Rajendra Prasad Centre for 
Ophthalmic Sciences, All India Institute of Medical Sciences, Room no.-495,
fourth floor, New Delhi, 110029, India,

OBJECTIVE: To evaluate safety and efficacy of 0.1 mg/ml versus 0.2 mg/ml
mitomycin-C (MMC), applied for 1 min subconjunctivally, during trabeculectomy for
primary adult glaucoma in previously un-operated eyes.
MATERIALS AND METHODS: This is a randomised controlled, non-inferior, clinical
trial consisting of 50 consecutive POAG or CPACG patients uncontrolled on maximal
hypotensive therapy, meeting all inclusion criteria. Patients were randomized
into two groups and underwent a standard limbus-based trabeculectomy with MMC:
Group I, 0.1 mg/ml and Group II, 0.2 mg/ml. The pre-operative and post-operative 
intraocular pressure (IOP), bleb morphology, and visual acuity were recorded
every 6 months for 2 years. Complete success (primary outcome) was defined as
IOP ≤ 15 mmHg without any additional medications at the end of 2 years.
RESULTS: The average age of patients was 62.6 ± 9.8 years and 61.2 ± 8.1 years in
Group 1 and 2, respectively; p = 0.57. The mean preoperative IOP was
22.5 ± 1.4 mmHg and 23.3 ± 1.8 mmHg; p = 0.10. The mean IOP at 2 years was
11.1 ± 1.6 mmHg and 10.8 ± 2.8 mmHg, a mean reduction in IOP of 50.6 ± 1.23 %,
and 53.7 ± 2.25 % in Group I and II, respectively. The complete success was
92.0 % and 91.7 % in the two groups, respectively (p = 0.99), and there was one
failure (Group II, post trauma). A wider bleb extent and larger areas of thin,
transparent conjunctiva over the bleb were seen with the 0.2 mg/ml MMC group
(p < 0.001) and in PACG eyes; p < 0.04.
CONCLUSION: A 1-min subconjunctival application of low dose 0.1 mg/ml MMC is
non-inferior to 0.2 mg/ml and is probably a safer alternative, as thinning of the
bleb is significantly less frequent in the long term.

PMID: 25940554   [PubMed - as supplied by publisher]

25. Graefes Arch Clin Exp Ophthalmol. 2015 May 5. [Epub ahead of print]

Retinal structure in young patients aged 10 years or less with Best vitelliform
macular dystrophy.

Schatz P(1), Sharon D, Al-Hamdani S, Andréasson S, Larsen M.

Author information: 
(1)Department of Ophthalmology, Clinical Sciences, Scane County University
Hospital, University of Lund, 22185, Lund, Sweden,

PURPOSE: Our aim was to analyze retinal structure in young patients with Best
disease with reference to future gene therapy.
METHODS: This was a retrospective observational spectral domain optical coherence
tomography study of four patients aged 10 years or less with Best disease.
RESULTS: Findings ranged from subtle thickening at the level of the retinal
pigment epithelium-photoreceptor interdigitation line, to subretinal fluid and
precipitate-like changes at the level of the photoreceptor outer segments, and
further to choroidal neovascularization. The photoreceptor inner segment
ellipsoid layer could be visualized seemingly undisturbed above the vitelliform
lesions, except in the case of choroidal neovascularization.
CONCLUSIONS: Clinical variability is evident even among young patients aged
10 years or less with Best disease. The earliest structural alterations seem to
occur at the level of the retinal pigment epithelium-photoreceptor
interdigitation line. The photoreceptor inner segment seems to be unaffected
unless choroidal neovascularization develops, which seems promising regarding
future gene therapy.

PMID: 25940553   [PubMed - as supplied by publisher]

26. Graefes Arch Clin Exp Ophthalmol. 2015 May 5. [Epub ahead of print]

The upregulation of zinc finger protein 670 and prostaglandin D2 synthase in
proliferative vitreoretinopathy.

Kuo HK(1), Chen YH, Huang F, Wu YC, Shiea J, Wu PC.

Author information: 
(1)Department of Ophthalmology, Kaohsiung Chang-Gung Memorial Hospital, 123 Dapi 
Road, Niaosong District, Kaohsiung, 83301, Taiwan.

PURPOSE: Proteins in the vitreous play an important role on the induction of
proliferative vitreoretinopathy (PVR) after retinal detachment. The aim of this
study was to investigate the variation of protein patterns in the vitreous of PVR
eyes and examine whether differentially expressed protein levels were expressed
in experimental PVR retina.
METHODS: Vitreous samples from PVR and macular hole patients were selected for
proteomic analysis. The vitreous protein samples were separated by
two-dimensional electrophoresis (2-DE). The differentially expressed protein
spots in the two groups were excised and subjected to in-gel digestion and
identification by electrospray ionization mass spectrometry (ESI-MS) analysis.
Two differentially expressed proteins, zinc finger protein 670 (ZFP 670) and
prostaglandin D2 synthase (PGD2S), were further validated by immunohistochemical 
staining and western blotting analysis in the retina of the experimental rabbit
PVR model.
RESULTS: In proteome analysis of human vitreous samples, five proteins had
increased expression in PVR, including zinc finger protein 670 (ZFP 670),
prostaglandin D2 synthase (PGD2S), IgG (Immunoglobulin G) light chain,
transthyretin precursor, and haptoglobin precursor. ZFP 670 and PGD2S levels were
expressed significantly higher in the experimental PVR retinas than in the
control group.
CONCLUSIONS: Levels of ZFP 670 and PGD2S were elevated in the vitreous fluid of
patients with PVR. In addition, there were higher expressions of ZFP 670 and
PGD2S in the experimental PVR retina. This result will expand our knowledge of
pathophysiologic characteristics of PVR, and might be helpful for further
developing possible treatment on this disorder.

PMID: 25940552   [PubMed - as supplied by publisher]

27. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 29. [Epub ahead of print]

Deficiency of aldose reductase attenuates inner retinal neuronal changes in a
mouse model of retinopathy of prematurity.

Fu Z(1), Nian S, Li SY, Wong D, Chung SK, Lo AC.

Author information: 
(1)Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University
of Hong Kong, Hong Kong, SAR, China.

Retinopathy of prematurity (ROP) is a leading cause of childhood blindness where 
vascular abnormality and retinal dysfunction are reported. We showed earlier that
genetic deletion of aldose reductase (AR), the rate-limiting enzyme in the polyol
pathway, reduced the neovascularization through attenuating oxidative stress
induction in the mouse oxygen-induced retinopathy (OIR) modeling ROP. In this
study, we further investigated the effects of AR deficiency on retinal neurons in
the mouse OIR. Seven-day-old wild-type and AR-deficient mice were exposed to 75 %
oxygen for 5 days and then returned to room air. Electroretinography was used to 
assess the neuronal function at postnatal day (P) 30. On P17 and P30, retinal
cytoarchitecture was examined by morphometric analysis and immunohistochemistry
for calbindin, protein kinase C alpha, calretinin, Tuj1, and glial fibrillary
acidic protein. In OIR, attenuated amplitudes and delayed implicit time of
a-wave, b-wave, and oscillatory potentials were observed in wild-type mice, but
they were not significantly changed in AR-deficient mice. The morphological
changes of horizontal, rod bipolar, and amacrine cells were shown in wild-type
mice and these changes were partly preserved with AR deficiency. AR deficiency
attenuated the Müller cell gliosis induced in OIR. Our observations demonstrated 
AR deficiency preserved retinal functions in OIR and AR deficiency could partly
reduce the extent of retinal neuronal histopathology. These findings suggested a 
therapeutic potential of AR inhibition in ROP treatment with beneficial effects
on the retinal neurons.

PMID: 25921391   [PubMed - as supplied by publisher]

28. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 29. [Epub ahead of print]

Marked dissociation of photopic and mesopic contrast sensitivity even in normal

Hertenstein H(1), Bach M, Gross NJ, Beisse F.

Author information: 
(1)Eye Center, University of Freiburg, Freiburg, Germany.

AIM: Although contrast vision is not routinely tested, it is important: for
instance, it predicts traffic incidents better than visual acuity. Mesopic
contrast sensitivity (CS) testing approximates low-lighting conditions but
entails dark adaptation, which can disrupt clinical routine. In receptor-specific
diseases, a dissociation of photopic and mesopic sensitivity would be expected,
but can photopic CS act as a surrogate measure for mesopic CS, at least for
screening purposes?
METHODS: Photopic and mesopic contrast sensitivities were studied in three
groups: 47 normal subjects, 23 subjects with glaucoma, and three subjects with
cataract. Twenty-eight of the normal subjects were additionally tested with
artificial blur. Photopic contrast sensitivity was assessed with both the
Freiburg Acuity and Contrast Test (FrACT) and the Mars Letter Contrast
Sensitivity Charts. Mesopic contrast sensitivity, without and with glare, was
measured with the Mesoptometer IIb. Coefficients of repeatability and limits of
agreement were calculated for all tests.
RESULTS: Test-retest limits of agreement were ± 0.17 logCS for Mars, ± 0.21 logCS
for FrACT, and ±0.20 logCS / ± 0.14 logCS for Mesoptometer IIb without and with
glare, respectively. In terms of inter-test comparison, Mars and FrACT largely
agreed, except for ceiling effects in the Mars test. While mesopic and photopic
contrast sensitivities correlate significantly (r  = 0.51, p < 0.01), only 27 %
of the variance is in common. In particular, subjects with high photopic results 
may be nearly as likely to have low as well as high mesopic results.
CONCLUSIONS: The photopic contrast sensitivity tests assessed here cannot serve
as surrogate measures for current mesopic contrast sensitivity tests. Low
photopic CS predicts low mesopic CS, but with normal photopic CS, mesopic CS can 
be normal or pathologic.

PMID: 25921390   [PubMed - as supplied by publisher]

29. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 26. [Epub ahead of print]

iStent inject in phakic open angle glaucoma.

Klamann MK(1), Gonnermann J, Pahlitzsch M, Maier AK, Joussen AM, Torun N,
Bertelmann E.

Author information: 
(1)Department of Ophthalmology, Charité - Universitätsmedizin Berlin,
Augustenburger Platz 1, 13353, Berlin, Germany,

BACKGROUND: The effectiveness and complication profile of the iStent inject
implantation among different open angle glaucoma subgroups were analyzed.
METHODS: In this retrospective cohort outcome study, 35 consecutive patients
suffering from glaucoma (primary open angle glaucoma (POAG) N = 17,
pseudoexfoliation glaucoma (PEX) N = 15, and pigmentary glaucoma (PG) N = 3) were
treated with the iStent inject. The intraocular pressure (IOP) and the number of 
antiglaucoma medications before and after surgery were evaluated.
RESULTS: In POAG, the mean IOP at 6 months measured 14.19 ± 1.38 mmHg with an
average decrease of 33 % from preoperative IOP (p < 0.001), and 15.33 ± 1.07 mmHg
with an average decrease of 35 % in PEX (p < 0.001), respectively. The number of 
antiglaucoma medications significantly decreased from 2.19 ± 0.91 to 0.88 ± 0.62 
in POAG (p < 0.001) and from 2.33 ± 1.23 to 1.04 ± 0.30 in PEX (p < 0.001) after 
6 months. In PG, IOP before surgery was 28.31 ± 3.21 mmHg and the number of
antiglaucoma medications was 3.66 ± 0.57. One day after surgery, IOP decreased
significantly to 12.33 mmHg ± 4.93 (p < 0.001). Within four weeks after surgery, 
IOP was raised above 30 mmHg in every patient. To exclude a steroid response,
topical steroids were stopped, but IOP did not decrease. To exclude blockage,
Nd:YAG - laser treatment of the visible opening of the iStents was performed.
Since the IOP stayed high and escalation of antiglaucoma medication was
insufficient to control IOP, trabeculectomy was performed.
CONCLUSIONS: In conclusion, implantation of the iStent inject has the ability to 
lower the postoperative IOP significantly in POAG and PEX after a short follow-up
of 6 months with a favorable risk profile. However, limitation of this surgical
procedure in phakic PG may exist and need to be investigated in further studies.

PMID: 25912085   [PubMed - as supplied by publisher]

30. Graefes Arch Clin Exp Ophthalmol. 2015 Apr 26. [Epub ahead of print]

An improved method for the isolation and culture of retinal pigment epithelial
cells from adult rats.

Langenfeld A(1), Julien S, Schraermeyer U.

Author information: 
(1)Section of Experimental Vitreoretinal Surgery, Centre for Ophthalmology,
Schleichstrasse 12/1, 72076, Tuebingen, Germany.

PURPOSE: Since adult rats are used in pre-clinical studies, and due to the
necessity of investigating the side-effects of drugs on RPE cells in vitro, there
is a great need for primary RPE cells from these animals. The aim of this study
was to develop a reproducible and quantifiable method of isolation, culture, and 
maintenance of adult rat RPE cells. Moreover, potential differences between RPE
cells from albino versus pigmented rats were also investigated.
METHODS: A total of 180 pigmented rats and 340 albino rats aged 6-14 weeks were
used. RPE cells were isolated and cultured for several weeks by using three
different methods: 1) growing directly on flat mounts, 2) after enzymatic
isolation, and 3) after they spontaneously detached from the flat mounts and
continued to grow on the plastic. Yield, cell survival, and morphological
characteristics were investigated using light and electron microscopy as well as 
RESULTS: After 0 weeks, the yield of the first method was 30,000 cells/eye; after
2 weeks 18,000 cells/eye; and after 4 weeks 11,000 cells/eye. The yield of RPE
cells was very low after enzymatic isolation in method 2 (0 weeks, 13.000
cells/eye; 2 weeks, 30,000 cells/eye; 4 weeks 38,000 cells/eye), whereas it was
higher when the RPE cells spontaneously detached from the flat mounts and then
continued to grow on the plastic in method three. (0 weeks, 30,000 cells/eye;
2 weeks, 314,000 cells/eye; 4 weeks, 659,000 cells/eye). The second method often 
showed contamination with fibroblasts, whereas the two other methods showed pure 
RPE cultures. The RPE cells were able to proliferate when using the second and
the third method, but not when they were cultivated directly on the flat mounts
(first method).
CONCLUSION: The qualitative and quantitative best method for isolating adult rat 
RPE cells is the culture of RPE cells which spontaneously detach from flat
mounts. No differences were observed between albino and pigmented RPE cells.

PMID: 25912084   [PubMed - as supplied by publisher]