1: Graefes Arch Clin Exp Ophthalmol. 2012 Feb 3; [Epub ahead of print] 

GM-CSF protects rat photoreceptors from death by activating the SRC-dependent
signalling and elevating anti-apoptotic factors and neurotrophins.

Schallenberg M, Charalambous P, Thanos S.

Department of Experimental Ophthalmology, School of Medicine, University Eye
Hospital Munster and Interdisciplinary Centre for Clinical Research (IZKF),
Domagkstrasse 15, 48149, Munster, Germany, maurice.schallenberg@uk-essen.de.

BACKGROUND:                       The term retinitis pigmentosa (RP) comprises a
heterogeneous group of hereditary and sporadic human retinal degenerative
diseases. The molecular and cellular events still remain obscure, thus hiding
effective therapies. Granulocyte-macrophage colony-stimulating factor (GM-CSF)
is a hematopoietic factor which plays a crucial role in protecting neuronal
cells. Binding of GM-CSF to its receptor induces several intracellular signaling
pathways and kinases. Here we examined whether GM-CSF has a neuroprotective
effect on photoreceptor degeneration in Royal College of Surgeons (RCS) rats.   
                                     METHODS:                       GM-CSF was
injected into the vitreous body of RCS rats either once at the onset of
photoreceptor degeneration at day 21, or twice at day 21 and day 42. At day 84,
when photoreceptor degeneration is completed, the rats were sacrificed, their
eyes enucleated and processed for histological staining and counting the
surviving photoreceptor nuclei. The expression of apoptosis-related factors,
such as BAD, APAF1 and BCL-2 was examined by Western blot analysis. The
expression of neurotrophins such as ciliary neurotrophic factor (CNTF),
brain-derived neurotrophic factor (BDNF), and glia-derived neurotrophic actor
(GDNF), as well as glial fibrillary acidic protein (GFAP) was analysed by
Western blots and immunohistochemistry. The expression of JAK/STAT, ERK1/2 and
SRC pathway proteins was assessed by Western blot analysis.                     
                   RESULTS:                       GM-CSF protects significantly
against photoreceptor degeneration in comparison to control group. After a
single injection of GM-CSF at P21, a 4-fold increase of photoreceptors was
observed, whereas eyes which received a repeated injection of GM-CSF at P42
showed a 10-fold increase of photoreceptors. Western blot analysis revealed a
decreased BAD and an increased pBAD and BCL-2 expression, indicating changed
expression profiles of apoptosis-related proteins. Neurotrophic factors examined
are up-regulated, whereas GFAP was also modulated. At cell signalling levels,
GM-CSF activates SRC-dependent STAT3 which is independent of JAK2, while
proteins of the ERK1/2 pathway are not affected.                                
        CONCLUSIONS:                       The data suggest that GM-CSF is a
potent therapeutic agent in photoreceptor degeneration caused by mutation of the
receptor tyrosine kinase gene (Mertk), and may be also effective in other
photoreceptor degeneration.

PMID: 22297538  [PubMed - as supplied by publisher]

2: Graefes Arch Clin Exp Ophthalmol. 2012 Feb 3; [Epub ahead of print] 

Long-term follow-up of invasive ocular surface squamous cell carcinoma treated
with excision, cryotherapy, and topical mitomycin C.

Kashkouli MB, Heirati A, Pakdel F, Kiavash V, Naseripour M, Aghamohammadi F.

Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical
Sciences, Sattarkhan-Niayesh Street, Tehran, 14455-364, Iran,
bahmanik@yahoo.com.

BACKGROUND:                       To evaluate the efficacy of surgical excision,
cryotherapy and topical Mitomycin C (MMC) for ocular surface squamous cell
carcinoma (SCC) with at least 24 months follow-up.                              
          METHODS:                       Seventeen patients with primary and
recurrent invasive SCC of ocular surface underwent surgical excision and map
biopsy of the margins, and double freeze-thaw cryotherapy of the bed and
margins. Topical MMC (0.04%, 4 times daily) was commenced 7-10 days after
operation. It was delivered in cycles that consisted of medication 4 times daily
for 7 consecutive days followed by 7 consecutive days of no medication. Patients
with primary SCC received two cycles (protocol 1) and those with recurrent SCC
received three cycles (protocol 2). Patients with intra-ocular and or orbital
extension or those with less than 24 months of follow-up were excluded. The
frequency of tumor recurrence and complications associated with treatment were
measured.                                         RESULTS:                      
Mean age was 70.7 years (SD = 10, range: 48-80). Mean follow-up time was 48
months (SD = 21, range: 24-89). There were 12 patients with primary SCC and five
with recurrent SCC. Mean largest diameter was 9.7 mm (3-20). Surgical margins
were free in 12 cases. One patient with recurrent SCC who received protocol 2
treatment developed recurrence 9 months after excision, and remained free of
recurrence 24 months after second treatment. Complications comprised transient
mild punctate corneal epithelial erosion (eight), irritation and conjunctival
hyperemia (11), corneal scar (six), and scleral thinning (three). All except one
responded well to conservative management. One scleral thinning required scleral
patch graft 1 year after treatment.                                        
CONCLUSION:                       The combination of surgical excision,
cryotherapy, and post-operative topical mitomycin-C was effective treatment for
ocular surface invasive SCC in long-term follow-up.

PMID: 22297537  [PubMed - as supplied by publisher]

3: Graefes Arch Clin Exp Ophthalmol. 2012 Feb 3; [Epub ahead of print] 

Persistent bloody tears as the initial manifestation of conjunctival chloroma
associated with chronic myelogenous leukemia.

Shah SB, Reichstein DA, Lally SE, Shields CL.

Department of Ophthalmology (SBS) and Ocular Oncology Service (DAR, SEL, CLS),
Wills Eye Institute, 840 Walnut Street, Philadelphia, PA, 19107, USA.

PMID: 22297536  [PubMed - as supplied by publisher]

4: Graefes Arch Clin Exp Ophthalmol. 2012 Feb 3; [Epub ahead of print] 

Evaluation of the Icare-ONE rebound tonometer as a self-measuring intraocular
pressure device in normal subjects.

Halkiadakis I, Stratos A, Stergiopoulos G, Patsea E, Skouriotis S, Mitropoulos
P, Papaconstantinou D, Georgopoulos G.

Ophthalmiatrion Athinon, Athens Eye Hospital, Konstadinoupoleos 17 Marousi,
15124, Athens, Greece, ihalkia@gmail.com.

PURPOSE:                       To compare Icare ONE rebound self-tonometer
(ICRBT) measurements with Goldman applanation tonometry (GAT).                  
                      METHODS:                       A trained examiner
instructed each of 60 normal subjects on use of the ICRBT. Each subject then
took two measurements of his/her own pressure using the ICRBT. Finally, a
different examiner, who was masked to the earlier readings, measured IOP by GAT.
Bland-Altman limits of agreement (LOA), intraclass correlation coefficients
(ICCs), Kappa values, and paired t-test were used to assess the agreement
between the two methods. Pearson's correlation coefficient was used for
correlation analysis.                                         RESULTS:          
            All of the subjects were able to obtain correct measurements with
ICRBT after three attempts. The mean intraocular pressure with ICRBT and GAT
measurements were 16.0 +/- 3.3 mmHg and 13.7 +/- 2.5 mmHg respectively. The mean
difference between patient's ICRBT and technician's GAT measurements was 2.3
mmHg (p < 0.001). In 63 % (38/60) of the cases the IOP difference (ICRBT - GAT)
was within +/- 3 mmHg. The weighted Kappa for the IOP measurements of the two
methods was 0.49 (95% CI: 0.30-0.68, p < 0.001), indicating acceptable
agreement. A significantly positive correlation was found between ICRBT IOP
measurements and central corneal thickness (CCT) (r = 0.48, p < 0.001). In
addition, the difference in IOP measurements (ICRBT - GAT) between the two
methods was positively correlated with CCT (r = 0.31, p = 0.015), indicating
that greater thickness is associated with greater differences between the two
methods.                                         CONCLUSION:                    
  The ICRBT was reliable in the hands of normal subjects, and may be used for
self-monitoring of IOP. ICRBT measurements generally overestimated GAT
measurements.

PMID: 22297535  [PubMed - as supplied by publisher]

5: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 31; [Epub ahead of print] 

Pupil dynamics in Chinese subjects with angle closure.

Zheng C, Cheung CY, Narayanaswamy A, Ong SH, Perera SA, Baskaran M, Chew PT,
Friedman DS, Aung T.

Singapore Eye Research Institute, Singapore & Singapore National Eye Centre,
Singapore, Singapore.

OBJECTIVE:                       To evaluate the speed of pupil constriction
(SPC) in response to a standardized change in illumination from dark to light
using anterior segment optical coherence tomography (AS-OCT) in eyes with closed
angles, compared to those with open angles.                                     
   METHODS:                       This was a prospective, comparative,
observational study. Study subjects with primary angle-closure glaucoma (PACG)
and/or primary angle-closure (PAC) were recruited along with a group of normal
as controls. Videos of iris and anterior segment changes in response to
illumination were captured with real-time video recording from AS-OCT and
analysed frame by frame, beginning from a dilated to a constricted pupil.
Customized software was used to measure speed of iris constriction, anterior
chamber depth (ACD), anterior chamber width (ACW), iris thickness, and pupil
diameter (PD). SPC was defined as the rate of pupil diameter change in response
to illumination.                                         RESULTS:               
       One hundred and sixty three Chinese subjects were recruited in this
study. A total of 137 of 163 eligible videos (82.5%) were available for
analysis, comprising 87 subjects with closed angles (all had undergone laser
peripheral iridotomies before) and 50 with open angles. SPC was less in eyes
with closed angles (1.22 mm/sec vs 1.56 mm/sec, p < 0.001), after adjusting for
age and ACW, and was positively correlated with axial length, ACD, anterior
chamber angle status, PD in the dark, and iris thickness in the dark, (all r >
0.2, all p < 0.05). In multivariate analysis, SPC was independently associated
with anterior chamber angle status (closed angle vs open angle) (beta = 0.276, p
= 0.016) and PD in dark (beta = 0.129, p = 0.009), after adjusting for age, ACW,
ACD, iris thickness and vertical cup-to-disc ratio.                             
           CONCLUSIONS:                       Compared to those with open
angles, eyes with closed angles in Chinese subjects have slower speed of pupil
constriction in response to dark-light change, even after adjusting for
biometric factors associated with angle closure. The results suggest that
differences in irido-pupillary dynamics may play a role in the pathogenesis of
angle closure.

PMID: 22290071  [PubMed - as supplied by publisher]

6: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 31; [Epub ahead of print] 

Relationship between retinal morphological findings and visual function in
age-related macular degeneration.

Akagi-Kurashige Y, Tsujikawa A, Oishi A, Ooto S, Yamashiro K, Tamura H, Nakata
I, Ueda-Arakawa N, Yoshimura N.

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate
School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan.

BACKGROUND:                       We aimed to study the retinal morphological
findings associated with exudative age-related macular degeneration (AMD) and
their association with visual prognosis.                                        
METHODS:                       We retrospectively reviewed the medical records
of 96 consecutive patients (96 eyes) with exudative AMD. Retinal structural
changes were examined using optical coherence tomography (OCT).                 
                       RESULTS:                       Initial OCT examination
showed cystoid macular edema in 18 eyes (18.8%), fibrin exudate in 56 eyes
(58.3%), and hyperreflective foci within the neurosensory retina in 78 eyes
(81.3%). Upon initial examination, an external limiting membrane (ELM) line was
detected under the fovea in 64 eyes (66.7%). Using Pearson's correlation
analyses, final visual acuity (VA) was correlated with initial VA (r = 0.61, p <
0.001), age (r = 0.34, p < 0.001), initial total foveal thickness (r = 0.41, p <
0.001), presence of hyperreflective foci (r = 0.40, p < 0.001), and detection of
a foveal ELM line (r = 0.55, p < 0.001). After multiple regression analysis,
final VA correlated with initial VA (r = 0.48, p < 0.001), initial presence of
hyperreflective foci (r = 0.23, p = 0.054), and detection of a foveal ELM line
(r = 0.36, p = 0.008).                                         CONCLUSIONS:     
                 In eyes with exudative AMD, final VA was most correlated with
initial VA. In addition, the initial integrity of the foveal outer retina was
partially correlated with the visual prognosis. The initial ELM condition was
associated with good final VA, while the initial presence of hyperreflective
foci in the foveal neurosensory retina was associated with poor final VA.

PMID: 22290070  [PubMed - as supplied by publisher]

7: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 31; [Epub ahead of print] 

Cone-rod dystrophy can be a manifestation of Danon disease.

Thiadens AA, Slingerland NW, Florijn RJ, Visser GH, Riemslag FC, Klaver CC.

Department of Ophthalmology, Erasmus Medical Center, P.O. Box 2040, NL-3000 CA,
Rotterdam, Netherlands, thiadens@hotmail.com.

BACKGROUND:                       Danon disease is a neuromuscular disorder with
variable expression in the eye. We describe a family with Danon disease and
cone-rod dystrophy (CRD).                                         METHODS:      
                Affected males of one family with Danon were invited for an
extensive ophthalmologic examination, including color vision testing, fundus
photography, Goldmann perimetry, full-field electroretinogram (ERG), and SD-OCT.
Previous ophthalmologic data were retrieved from medical charts. The LAMP2 and
RPGR gene were analyzed by direct sequencing.                                   
     RESULTS:                       Two siblings had no ocular phenotype. The
third sibling and a cousin developed CRD leading to legal blindness. Visual
acuity deteriorated progressively over time, color vision was severely
disturbed, and ERG showed reduced photopic and scotopic responses. SD-OCT
revealed thinning of the photoreceptor and RPE layer. Visual fields demonstrated
central scotoma. The causal mutation was p.Gly384Arg in LAMP2; no mutations were
found in RPGR.                                         CONCLUSIONS:             
         This is the first description of CRD in Danon disease. The retinal
phenotype was a late onset but severe dystrophy characterized by loss of
photoreceptors and RPE cells. With this report, we highlight the importance of a
comprehensive ophthalmologic examination in the clinical work-up of Danon
disease.

PMID: 22290069  [PubMed - as supplied by publisher]

8: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 28; [Epub ahead of print] 

Prevalence of macular holes in rural central India. The Central India Eye and
Medical Study.

Nangia V, Jonas JB, Khare A, Lambat S.

Suraj Eye Institute, Nagpur, Maharashtra, India.

PMID: 22286711  [PubMed - as supplied by publisher]

9: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 28; [Epub ahead of print] 

Surgical outcome of Descemet's stripping automated endothelial keratoplasty for
bullous keratopathy secondary to argon laser iridotomy.

Hirayama M, Yamaguchi T, Satake Y, Shimazaki J.

Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College,
5-11-13, Sugano, Ichikawa, Chiba, 272-8513, Japan, mar.hirayama@gmail.com.

BACKGROUND:                       To report the 6-month clinical outcome of
Descemet's stripping automated endothelial keratoplasty (DSAEK) for bullous
keratopathy (BK) secondary to argon laser iridotomy (ALI), and compare the
results with those of DSAEK for pseudophakic bullous keratopathy (PBK) or Fuchs'
endothelial dystrophy (FED).                                         METHODS:   
                   A total of 103 patients (54 with ALI, 28 with PBK, 21 with
FED) undergoing DSAEK were retrospectively analyzed. Simultaneous cataract
surgery was performed in 37 patients with ALI and 13 with FED. Preoperative
ocular conditions, best spectacle-corrected visual acuity (BSCVA), spherical
equivalent refraction (SE), induced astigmatism, keratometric value, endothelial
cell density (ECD), and complications were determined over 6 months
postoperatively.                                         RESULTS:               
       Mean axial length in the ALI group (21.8 +/- 0.8 mm) was significantly
shorter than that in the FED (P = 0.02) or PBK groups (P = 0.003). Severe
corneal stromal edema (n = 6), advanced cataract (n = 10), posterior synechia (n
= 3), poor mydriasis (n = 5), and Zinn zonule weakness (n = 1) were found only
in the ALI group. A significant improvement was observed in postoperative BSCVA
in all groups. No significant difference was observed in BSCVA, SE, induced
astigmatism, keratometric value, ECD, or complications among the three groups.  
                                      CONCLUSIONS:                      
Descemet's stripping automated endothelial keratoplasty for BK secondary to ALI
showed rapid postoperative visual improvement, with similar efficacy and safety
to that observed in DSAEK for PBK or FED.

PMID: 22286710  [PubMed - as supplied by publisher]

10: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 27; [Epub ahead of print] 

Paracentral retinal holes occurring after macular surgery: incidence, clinical
features, and evolution.

Sandali O, El Sanharawi M, Basli E, Lecuen N, Bonnel S, Borderie V, Laroche L,
Monin C.

Centre Hospitalier National d'Ophtalmologie des XV-XX, 28 rue de Charenton,
75571, Paris, France, sanotman1@yahoo.fr.

AIM:                       To describe the incidence, clinical features, and
evolution of paracentral retinal holes occurring after macular surgery.         
                               METHODS:                       A retrospective
non-randomized study of 909 patients operated on for either a macular hole (MH,
n = 400 patients) or an epiretinal membrane (ERM, n = 509 patients) between 2004
and 2009. Six patients (0.6%) developed a paracentral macular hole after
surgery. Their clinical, auto-fluorescence, and optical coherence tomography
(OCT) characteristics as well as their visual outcomes were studied.            
                            RESULTS:                       The mean age of
patients was 70 years. Paracentral holes occurred approximately 5 weeks after
surgery (with a range of 2-12 weeks). All patients were asymptomatic. Five
patients underwent ILM peeling during initial surgery. Paracentral retinal holes
were located superiorly to the fovea in three cases and temporally in the other
three cases. Mean pre-operative BCVA was 20/200 and mean post-operative BCVA was
20/40. The eye where the eccentric MHs were closest to the fovea (inferior to 1
optic disc area) had the poorest final visual acuity. Autofluorescence imaging
showed a bright fluorescence in paramacular holes. On OCT images, they were
shown to be flat full-thickness holes. No treatment was attempted. No
rhegmatogenous complications or choroidal neovascularization occurred in any of
the patients. Mean follow-up was 2 years.                                       
 CONCLUSIONS:                       In summary, paracentral MHs are uncommon
complications which can occur at the site where ILM peeling has been initiated
or completed. Except for the closest holes to fovea, they have good visual
prognosis and do not require any treatment underlining the importance of
initiating the ILM peeling as far as possible from the fovea.

PMID: 22282218  [PubMed - as supplied by publisher]

11: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 27; [Epub ahead of print] 

Electrical stimulation - a therapeutic strategy for retinal and optic nerve
disease?

Gekeler F, Bartz-Schmidt KU.

Centre for Ophthalmology, Eberhard Karls University, Schleichstr, 12, D-72076,
Tubingen, Germany, gekeler@uni-tuebingen.de.

PMID: 22282217  [PubMed - as supplied by publisher]

12: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 27; [Epub ahead of print] 

Comparison of moxifloxacin and levofloxacin in an epithelial disorder model
using cultured rabbit corneal epithelial cell sheets.

Miyake T, Ito N, Tajima K, Goto H, Furukawa T.

Department of Ophthalmology, Tokyo Medical University, MD, 6-7-1 Nishi-shinjuku,
Shinjyuku-ku, Tokyo, 160-0023, Japan.

BACKGROUND:                       When ophthalmic drug solutions are developed
and clinically applied, their influence on corneal epithelium is an important
issue. In the past, cells obtained by monolayer culture in vitro were used for
evaluation of such influence. We recently created an experimental model of cell
damage repair closer to the live body than conventional models by using layered
sheets of cultured corneal epithelium. The present study was undertaken to
evaluate the influence of ophthalmic moxifloxacin hydrochloride (MFLX) solution
in comparison to that of ophthalmic levofloxacin (LVFX) solution using this
model.                                         METHODS:                      
Corneal epithelium cells were collected from corneal tissue specimens of white
rabbits and subjected to air-lift culture to induce layering. Epithelial cell
defects were created by a sponge soaked in 1 N aqueous sodium hydroxide. After
removal of the sponge, either ophthalmic MFLX solution or ophthalmic LVFX
solution was dropped onto the specimens three times daily (washed 1 min after
each dose, followed by continuation of air-lifting culture). The percentage of
the defective area repaired (percent defect repair) was evaluated. Each of the
ophthalmic MFLX solution and the ophthalmic LVFX solution was used after the
stock solution was diluted fourfold (1:4). Drug-free culture medium served as
the negative control. Benzalconium chloride solution (BAC) 0.01% served as the
positive control.                                         RESULTS:              
        In the negative control group, complete repair of the defect with
epithelial cells was seen 4 days after the start of treatment. In the positive
control group, repair was suppressed. In the MFLX group and the LVFX group, the
defect was repaired at each drug concentration, showing no significant
difference from the negative control group. Thus, in this study using layered
sheets of cultured corneal epithelium (a model closer to the living body than
conventional models), the corneal epithelial defect was repaired in the
ophthalmic MFLX solution treatment group and the ophthalmic LVFX solution
treatment group to a degree similar to that in the negative control group.      
                                  CONCLUSIONS:                       These
results suggest that neither MLFX nor LVFX suppresses repair of corneal
epithelial damage.

PMID: 22282216  [PubMed - as supplied by publisher]

13: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 25; [Epub ahead of print] 

Comparison of global indices and test duration between two visual field
analyzers: Octopus 300 and Topcon SBP-3000.

Garcia-Medina JJ, Garcia-Medina M, Zanon-Moreno V, Garcia-Maturana C,
Cruz-Espinosa FJ, Pinazo-Duran MD.

Department of Ophthalmology, Huercal Overa Hospital, Almeria, Spain,
josegarciam@yahoo.com.

PURPOSE:                       To compare the global indices and test duration
as measured by Octopus 300 and Topcon SBP-3000 perimeters. To our knowledge,
this is the first study performed in this way.                                  
      METHODS:                       Eighty eyes of 40 glaucomatous and ocular
hypertensive patients with previous perimetric experience had visual field tests
with Octopus 300 (TOP strategy) and TOPCON SBP-3000. All pairs of tests were
performed randomly on separate days, but within 1 month of each other. Taking
into account reliability factors of both perimetric examinations, 54 eyes of
thirty patients were eligible. Only one eye from each patient was considered.
Mean sensitivity (MS), mean defect (MD), loss of variance (sLV-Octopus- and LV
-Topcon-) and test duration times were considered.                              
          RESULTS:                       A significant difference was found
between the global indices and duration times of the Octopus and the Topcon
perimeters (p < 0.05; Wilcoxon test). Moderate degrees of correlation were
obtained for MS (Spearman s rho = 0.635; p < 0.001) and MD (Spearman s rho =
0.592; p = 0.001) measurements. There was no correlation between sLV and LV
(Spearman s rho = 0.181; p = 0.337). Agreements between pairs of global indices
were low as measured by concordance correlation coefficient.                    
                    CONCLUSION:                       Global indices measured by
the Octopus and Topcon perimeters are significantly different, so direct
comparison of the measured values is not reliable. Because of the poor
association and agreement between values obtained by these two perimeters,
indirect comparison is also inadvisable.

PMID: 22270219  [PubMed - as supplied by publisher]

14: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 25; [Epub ahead of print] 

23-gauge transconjunctival sutureless vitrectomy in treatment of post-operative
endophthalmitis.

Almanjoumi AM, Combey A, Romanet JP, Chiquet C.

Department of Ophthalmology, CHU de Grenoble, University Hospital, University
Joseph Fourier, 38043, Grenoble Cedex 09, France.

PURPOSE:                       To report the safety and efficacy of 23-gauge
(23-G) transconjunctival vitrectomy (TSV) in the surgical management of
postoperative endophthalmitis.                                         MATERIALS
AND METHODS:                       Ten consecutive patients underwent a 23-G TSV
in 2008-2010 after cataract surgery (n = 5) or filtrating surgery (n = 5), and
were prospectively studied with a minimum follow-up of 6 months. TSV was
performed within a median delay of 1 day after the diagnosis, after one or two
injections of intravitreal antibiotics (vancomycin, ceftazidime). Conventional
cultures (brain heart infusion media) and/or panbacterial PCR were performed on
aqueous humor and/or vitreous samples.                                        
RESULTS:                       Initial visual acuity was less than or equal to
hand motion in all cases, and clinical findings included hypopyon (80%),
pupillary fibrin membrane (80%), and dense vitreitis (4+, 100%). The bacteria
identified were Gram-positive cocci in 60% of the cases (coagulase-negative
staphylococci, 20%; streptococcus, 40%) and Gram-negative bacilli in 10%
(moraxella lacunata). All patients had central and peripheral vitrectomy (mean
duration, 58.6 +/- 16 min). No intraoperative complications were noted. Two
patients developed retinal detachment postoperatively and were reoperated. The
final visual vision was 20/400 for two patients and 20/50 or better for the
other patients.                                         CONCLUSION:             
         23-G TSV allows the surgeon to meet the same objectives as the 20-G
technique for the treatment of endophthalmitis.

PMID: 22270218  [PubMed - as supplied by publisher]

15: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 22; [Epub ahead of print] 

Factors associated with enlargement of chorioretinal atrophy after intravitreal
bevacizumab for myopic choroidal neovascularization.

Uemoto R, Nakasato-Sonn H, Kawagoe T, Akira M, Okada E, Mizuki N.

Department of Ophthalmology, Yokohama City University School of Medicine, 3-9
Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan,
minami111@nyc.odn.ne.jp.

PURPOSE:                       To determine the factors significantly associated
with an enlargement of the area of a chorioretinal atrophy (ChRA) after
intravitreal bevacizumab (IVB) to treat myopic choroidal neovascularization
(mCNV).                                         METHODS:                      
The medical charts of 27 eyes with a mCNV that had received IVB were reviewed.
The ophthalmic examinations included measurements of the best-corrected visual
acuity, visual fields with the Humphrey 10-2 Field Analyzer, fluorescein
angiography, and indocyanine green angiography. The area of the mCNV and the
chorioretinal atrophy (ChRA) were measured on the FA images.                    
                    RESULTS:                       Eyes with an enlargement of
the ChRA had significantly larger mCNVs at the baseline, a greater reduction in
the size of the mCNV, a higher incidence of subretinal hemorrhage, longer
duration of follow-up, received more injections of IVB, and had a greater
decrease of retinal sensitivity (P PMID: 22270217  [PubMed - as supplied by publisher]

16: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 21; [Epub ahead of print] 

Systemic corticosteroids reduce the risk of cellophane membranes after retinal
detachment surgery: a prospective randomized placebo-controlled double-blind
clinical trial.

Koerner F, Koerner-Stiefbold U, Garweg JG.

Klinik Siloah, CH-3073, Guemligen, Bern, Switzerland, fritz.koerner@bbox.ch.

BACKGROUND:                       Cellophane membranes are an early stage of
proliferative vitreoretinopathy (PVR) complicating retinal detachment surgery.
Our aim was to assess whether a prolonged administration of systemic
corticosteroids would attenuate early stages of PVR such as cellophane
membranes.                                         DESIGN:                      
Prospective randomized placebo-controlled double-blind clinical trial.          
                              PATIENTS AND METHODS:                       A
total of 220 consecutive eyes (220 patients) were operated for primary
rhegmatogenous retinal detachment (RD), mainly by scleral buckling procedures.
Patients were randomized into two groups: 110 patients (steroid group) received
prednisone for 15 days starting with 100 mg at the day of surgery and being
tapered to 12.5 mg. The control group of 110 patients received placebo in a
comparable manner. Follow-up examinations were performed at 1, 3 and 6 months
postoperatively, and included visual acuity and assessment of retinal findings. 
                                       RESULTS:                       Cellophane
membranes occurred in 41.8%, 46.9%, and 39.1% in the placebo group and 26.7%,
23.6%, and 19.8% in the steroid group at 1, 3 and 6 months postoperatively (p <
0.05, = 0.0005, and <0.005 respectively). The application of five or more
cryocoagulation spots was associated with more cases developing cellophane
membranes in the placebo than the steroid group (p < 0.05). A complete
reattachment of the retina was achieved in 95% steroid and 89% placebo group
eyes, and a reattachment of the macula in 98% of both groups. There was no
significant difference of the final visual outcome in both groups.              
                          CONCLUSION:                       Early stages of PVR
such as cellophane membranes after retinal detachment surgery can be reduced
with corticosteroids in oral doses.

PMID: 22270216  [PubMed - as supplied by publisher]

17: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 20; [Epub ahead of print] 

Resolution of photoreceptor outer segment damage in a patient with unilateral
acute idiopathic maculopathy observed using spectral-domain optical coherence
tomography.

Matsushita E, Fukuda K, Nakahira A, Kishi S, Fukushima A.

Department of Ophthalmology and Visual Science, Kochi Medical School, Kohasu,
Oko-cho, 783-8505, Nankoku-city, Kochi, Japan, matsu-eri@kochi-u.ac.jp.

PMID: 22261750  [PubMed - as supplied by publisher]

18: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 19; [Epub ahead of print] 

Use of hydroxychloroquine in corticodependent and recurrent scleritis.

Maschi C, Tieulie N, Gastaud P, Baillif S.

Service Ophtalmologie, Hopital Saint Roch, CHU-Nice, 5, rue Pierre Devoluy,
Nice, 06000, France, maschi.c@chu-nice.fr.

PMID: 22258547  [PubMed - as supplied by publisher]

19: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 18; [Epub ahead of print] 

Matrix metalloproteinase-9 expression in the Seoul-type keratoprosthesis
implanted corneas with concurrent cultivated autologous oral mucosal epithelial
cell tranplantation.

Lee SM, Kim MK, Shin MS, Wee WR.

Department of Ophthalmology, Seoul National University College of Medicine, 103
Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.

PMID: 22252113  [PubMed - as supplied by publisher]

20: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 17; [Epub ahead of print] 

Superior oblique tendon lengthening and medial rectus transposition in the
bilateral aplasia of the inferior rectus muscle : SO lengthening in the
bilateral aplasia of IR.

Kim US.

Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research
Institute, Konyang University College of Medicine, Youngdeungpo 4th 156,
Youngdeungpo gu, Seoul, 150-034, Korea, ungsookim@kimeye.com.

PMID: 22249318  [PubMed - as supplied by publisher]

21: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 17; [Epub ahead of print] 

Surveillance of late-onset bleb leak, blebitis and bleb-related endophthalmitis
- a UK incidence study.

Alwitry A, King AJ.

Department of Ophthalmology, Royal Derby Hospital, Uttoxeter Road, Derby, DE22
3NE, UK, Amar.Alwitry@nhs.net.

AIMS:                       To determine the incidence of late-onset bleb leak
(BL), blebitis (B) and bleb-related endophthalmitis (BRE) after trabeculectomy
surgery, and report the management approaches employed by UK ophthalmologists.  
                                      METHODS:                       Prospective
case ascertainment study reporting of incident cases fulfilling the study
definitions of BL, B and BRE through the reporting mechanism provided by the
British Ophthalmic Surveillance Unit (BOSU; United Kingdom) for the period July
2007 to August 2008 (13 months). Two questionnaires completed at initial
reporting and 6 months later were used to collect clinical details related to
presentation, early and late management and outcome.                            
            RESULTS:                       Ninety-eight cases were reported to
the British Ophthalmic Surveillance Unit during the study period. Seventy-one
first questionnaires were returned (response rate 72.4%). Of these, 11 were
erroneous/duplicated. Sixty second questionnaires were sent out, and of these 37
fully completed questionnaires were returned. Analysis was, therefore, based
upon 60 initial and 37 follow-up questionnaires. Overall incidences were
estimated for isolated bleb leak (0.22%), blebitis without bleb leak (0.1%),
blebitis with bleb leak (0.11%), and BRE with or without bleb leak (0.17%).
Visual outcome in the BL group was good; however, in the BRE group half the
patients ended with visions of perception of light or worse. There was a great
variance in the initial and late management of these conditions. Surgical
intervention for bleb leak seemed to result in the best chance of leak closure. 
                                       CONCLUSIONS:                       These
complications of trabeculectomy surgery are relatively low but potentially
visually devastating. This study updates the knowledge of the incidence of these
complications, and suggests that no consistent management approach to any of the
reported conditions was practised. In view of the potentially catastrophic
consequences of these complications, formal guidance as to best practice would
be beneficial, and further research to establish this is required.

PMID: 22249317  [PubMed - as supplied by publisher]

22: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 17; [Epub ahead of print] 

Methylglyoxal induces hyperpermeability of the blood-retinal barrier via the
loss of tight junction proteins and the activation of matrix metalloproteinases.

Kim J, Kim CS, Lee YM, Jo K, Shin SD, Kim JS.

Diabetic Complications Research Center, Division of Traditional Korean Medicine
(TKM) Integrated Research, Korea Institute of Oriental Medicine, Daejeon, South
Korea.

BACKGROUND:                       One of the early signs of diabetic retinopathy
is the alteration of the blood-retinal barrier (BRB), which may involve the
breakdown of endothelial cell tight junctions. Methylglyoxal (MGO) is a
cytotoxic metabolite that is produced from glycolysis in vivo. Elevated levels
of MGO are observed in a number of pathological conditions, including
neurodegenerative disorders and diabetic complications. Herein, we hypothesize
that increased levels of MGO disrupt the tight junction protein known as
occludin protein by matrix metalloproteinases (MMPs), leading to breakage of the
BRB.                                         METHODS:                       MGO
was intravitreally injected into eyes of rats. BRB leakage, MMPs activity, and
occludin were investigated in intravitreally MGO-injected eyes.                 
                       RESULTS:                       When normoglycemic rats
were intravitreally injected with 400 muM MGO, there was widespread leakage of
fluorescein isothiocyanate-bovine serum albumin (FITC-BSA) from the retinal
vasculature when compared to control retinas. In addition, MGO-injected retinas
demonstrated increases of both activity and expression of MMP-2 and MMP-9, and
the degradation of occludin was found in the MGO-injected retinas.              
                          CONCLUSIONS:                       The results suggest
that the activation of MMPs by elevated levels of MGO in the retina may
facilitate an increase in vascular permeability by a mechanism involving
proteolytic degradation of occludin. These findings may have implications for
the role of MGO in the pathogenesis of diabetic retinopathy.

PMID: 22249316  [PubMed - as supplied by publisher]

23: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 17; [Epub ahead of print] 

Linear scleroderma en coup de sabre affecting the upper eyelid and lashes.

Mears KA, Servat JJ, Black EH.

Department of Ophthalmology, Kresge Eye Institute, Wayne State University, 4717
St Antoine, Detroit, MI, 48201, USA, kmears@med.wayne.edu.

PMID: 22249315  [PubMed - as supplied by publisher]

24: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 14; [Epub ahead of print] 

Pediatric eye injuries presenting to United States emergency departments:
2001-2007.

Armstrong GW, Kim JG, Linakis JG, Mello MJ, Greenberg PB.

Division of Ophthalmology, Warren Alpert Medical School of Brown University,
Providence, RI, USA.

BACKGROUND:                       The epidemiology of pediatric eye injuries is
not well-documented. This study describes the characteristics of non-fatal eye
injuries in pediatric patients (<18 years of age) presenting to United States
(US) emergency departments (EDs).                                        
METHODS:                       Retrospective cohort study utilizing the National
Electronic Injury Surveillance System All Injury Program (NEISS-AIP) from 2001
to 2007 to perform a descriptive analysis of eye injury case information for
patients <18 years of age, including demographic variables, locales, diagnoses,
causes, and hospital disposition.                                        
RESULTS:                       In 2001-2007, an estimated 1,048,500 (95%
confidence interval [CI] 878,198-1,218,801) ED visits for eye injury occurred
among children less than 18 years of age, representing a rate of 14.31 per 1,000
children. Males accounted for 61.75% (CI 541,971-752,839) of visits. The rate of
eye injury was highest in the 15-17 year old age group (18.74 per 1,000
children; CI 199,224-267,132). The most common diagnosis was contusion/abrasion
(53.68%; CI 468,035-657,638). The most frequent cause of eye injury was being
struck by or against an object (56.63%; CI 491,760-695,758). The majority of
injuries occurred at home (65.84%; CI 382,443-588,416) and took place during the
spring and summer (39.26%; CI 343,535-479,888).                                 
       CONCLUSION:                       This study suggests that the risk for
pediatric eye injuries is highest for adolescents 15-17 years of age and at
home. Further research is needed to determine risk and protective factors
associated with injuries in this age group and location to design appropriate
prevention strategies.

PMID: 22245950  [PubMed - as supplied by publisher]

25: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 13; [Epub ahead of print] 

Choroidal observations in Vogt-Koyanagi-Harada disease using high-penetration
optical coherence tomography.

Nakai K, Gomi F, Ikuno Y, Yasuno Y, Nouchi T, Ohguro N, Nishida K.

Department of Ophthalmology E7, Osaka University Medical School, 2-2 Yamada-oka
Suita, 565-0871, Osaka, Japan, kei.nakai@ophthal.med.osaka-u.ac.jp.

BACKGROUND:                       The aim of this work was to investigate the
choroidal morphologic changes of Vogt-Koyanagi-Harada (VKH) disease in vivo
using high-penetration optical coherence tomography (HP-OCT) with a
long-wavelength light source (1,060 nm).                                        
METHODS:                       Fourteen patients with VKH disease were included
in this study: 12 eyes of six patients with treatment-naive acute VKH in the
first 6-12 months after diagnosis and 16 eyes of eight patients in the
convalescent phase with a sunset glow fundus appearance. A prototype HP-OCT
instrument was used to observe the deep choroid and sclera. The choroidal
thickness was measured for more than 6 months in eyes with acute disease. The
choroidal thickness in patients with a sunset glow fundus appearance for 2-9
years after the onset was also examined.                                        
RESULTS:                       In 12 eyes with acute VKH disease, the baseline
choroidal thickness was significantly (p < 0.0001) greater than in controls.
After treatment, the choroidal thickness decreased over time. However, the
choroidal thickness increased markedly again in four eyes with recurrent
disease. The mean thickness at 12 months was significantly less than the normal
value (p < 0.0001). In 16 eyes with a sunset glow fundus appearance, the
choroidal thickness was significantly (p < 0.0001) thinner compared to the
controls.                                         CONCLUSIONS:                  
    Significant choroidal thickness changes underlie VKH disease, which progress
over time. Objective measurement of the choroidal thickness using HP-OCT may be
useful for longitudinal evaluation of VKH activity.

PMID: 22240936  [PubMed - as supplied by publisher]

26: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 13; [Epub ahead of print] 

Restoration of the photoreceptor layer and improvement of visual acuity in
successfully treated optic disc pit maculopathy: a long follow-up study by
optical coherence tomography.

Theodossiadis GP, Grigoropoulos VG, Liarakos VS, Rouvas A, Emfietzoglou I,
Theodossiadis PG.

2nd Department of Ophthalmology, Henry Dunant Hospital, 13 Lykiou street, 10674,
Athens, Greece, theodossiadisg@ath.forthnet.gr.

PURPOSE:                       To investigate by optical coherence tomography
(OCT) the evolution of the photoreceptor layer and its association with
best-corrected visual acuity (BCVA) in optic disc pit (ODP) maculopathy after
successful surgical treatment.                                         METHODS: 
                     Fourteen eyes of 14 patients were included in this study,
and followed up from 36 to 95 months (mean 57.36 +/- 18.32 months). The
follow-up period started at the time of complete subretinal fluid absorption.
Examination was performed by time-domain OCT before and after treatment.
Spectral-domain OCT was used after treatment. Parameters assessed were type of
elevation, central foveal thickness, time elapsed from onset to treatment, type
of treatment, BCVA, and inner segment outer segment (IS/OS) junction line. The
IS/OS junction was characterized after treatment as intact, interrupted, or
absent (not distinguishable).                                         RESULTS:  
                    Significant restoration of the IS/OS junction line was first
noticed between 6 and 12 months after fluid absorption (p = 0.02; Wilcoxon
signed rank test). Restoration was continuous up to the 24th month of
postoperative examination after fluid absorption (p = 0.14; Wilcoxon signed rank
test). BCVA was 0.99 +/- 0.38 logMar before treatment, 0.81 +/- 0.26 logMar (p =
0.011; paired t-test) immediately after fluid absorption and 0.61 +/- 0.33
logMar (p = 0.026; one-way ANOVA) 24 months after fluid resolution. BCVA was
significantly positively correlated with the integrity of the IS/OS junction
line during follow-up (Pearson r = 0.775; p < 0.001).                           
             CONCLUSIONS:                       The IS/OS junction restoration
cannot be detected immediately after fluid resolution in the majority of cases.
It became evident 6-12 months later and was completed 24 months after fluid
absorption. Improvement in BCVA was noticed only during the first 2 years of
follow-up. No significant changes were noticed in BCVA or the IS/OS line after 2
years. Among the studied variables, the final photoreceptor layer condition and
BCVA immediately after fluid absorption are the main factors predicting final
BCVA after successful surgical treatment of ODP maculopathy.

PMID: 22237839  [PubMed - as supplied by publisher]

27: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 12; [Epub ahead of print] 

Radial intrastromal femtosecond laser incisions for myopia correction.

Zhang ZY, Hoffman MR, Zhang XR.

Department of Ophthalmology, Putuo Hospital, Shanghai Chinese Traditional
Medicine University, Shanghai, China, zzyly818@sina.com.

PMID: 22237838  [PubMed - as supplied by publisher]

28: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 11; [Epub ahead of print] 

Correlation between elevation of serum antinuclear antibody titer and decreased
therapeutic efficacy in the treatment of Behcet's disease with infliximab.

Iwata D, Namba K, Mizuuchi K, Kitaichi N, Kase S, Takemoto Y, Ohno S, Ishida S.

Department of Ophthalmology, Hokkaido University Graduate School of Medicine,
Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.

BACKGROUND:                       Infliximab, an anti-TNF-alpha monoclonal
antibody, administered to Behcet's disease (BD) patients in Japan with
refractory intraocular inflammation, has shown excellent clinical results.
However, some patients demonstrate a decreased response to infliximab during the
course of the treatment. In the present study, we investigated the correlation
between this reduced therapeutic effect and elevation of the serum antinuclear
antibody (ANA) titers in patients with BD who were undergoing infliximab
therapy.                                         METHODS:                      
Seventeen patients (14 males and three females) with uveitis in BD who were
undergoing treatment with infliximab for 2 years or longer were enrolled. Their
blood test results and clinical histories were obtained from medical records.   
                                     RESULTS:                       One patient
(5.9%) was ANA-positive prior to the initiation of infliximab, and 11 patients
(64.7%) developed positive ANA during the therapy. The appearance of ANA was
observed 6 months after the initiation of the infliximab therapy, and its titers
gradually increased. None of the patients showed lupus symptoms. Five patients
(29.4%) have suffered from ocular inflammatory attacks since the sixth month
from the initiation of infliximab treatment and all of them were ANA-positive.
In contrast, four patients (23.5%) who were ANA-negative experienced no ocular
attacks during the follow-up period.                                        
CONCLUSIONS:                       Here we report the positive conversion and
subsequent elevation of serum ANA titers in some patients with BD after the
initiation of infliximab therapy. Since all recurrences of uveitis were shown
only in the ANA-positive patients, serum ANA titer may be a helpful biomarker
for predicting the recurrence of ocular attacks in BD patients treated with
anti-TNF-alpha antibody therapies.

PMID: 22234352  [PubMed - as supplied by publisher]

29: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 11; [Epub ahead of print] 

Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment:
hypothesis and review.

Veckeneer M, Derycke L, Lindstedt EW, van Meurs J, Cornelissen M, Bracke M, Van
Aken E.

Rotterdam Eye Hospital, Vitreoretinal Surgery, Schiedamse vest 180, 3000LM,
Rotterdam, the Netherlands.

BACKGROUND:                       Persistent subretinal fluid after
rhegmatogenous retinal detachment (RRD) surgery is responsible for delayed
recovery, and may affect the final visual outcome. Cause, consequences, and
treatment remain elusive.                                         DESIGN:       
               Literature review and case series.                               
         METHODS:                       We reviewed the pathophysiological
principles and therapeutic options from the literature, and we report the
results from a subretinal fluid cytology study. Nine eyes from nine patients
with macula-involving RRD underwent surgical repair. The cellular content of
subretinal fluid (SRF) was studied by electron microscopy and anti-rhodopsin
immunostaining. All eyes were assessed postoperatively with optical coherence
tomography for the detection of persistent submacular fluid (PSF) (Ethics
Committee Ghent University Hospital, registration number B6702006169).          
                              RESULTS:                       Certain patient
characteristics as well as surgical methods were implicated. PSF appears to
occur more frequently in patients with longstanding detachments treated with
buckling surgery. Several therapeutic options have been suggested but safety and
efficacy remain unclear. We found PSF in three eyes on postoperative OCT scans,
which corresponded to the three cell-rich subretinal samples.                   
                     CONCLUSIONS:                       PSF after successful RRD
repair seems to be related to fluid composition. We hypothesize, in the absence
of an effective treatment, that a modified surgical drainage, including a
washout of the subretinal space, could evacuate the subretinal fluid more
completely, and may prevent this complication.

PMID: 22234351  [PubMed - as supplied by publisher]

30: Graefes Arch Clin Exp Ophthalmol. 2012 Jan 8; [Epub ahead of print] 

IL-12 concentrations in the aqueous humor and serum of diabetic retinopathy
patients.

Gverovic Antunica A, Karaman K, Znaor L, Sapunar A, Busko V, Puzovic V.

Department of Ophthalmology, General Hospital Dubrovnik, Roka Misetica bb, 20
000, Dubrovnik, Croatia, agantonela@net.hr.

BACKGROUND:                       Previous studies suggest that inflammation
plays an important part in the pathogenesis of diabetes. Cytokines may have a
role in both positive and negative control of immunological reactions. Among
many cytokines, interleukin 12 (IL-12) is known to be a strong pro-inflammatory
cytokine.                                         METHODS:                      
A total of 76 participants were enrolled in this study and classified into four
groups: 23 diabetic patients with non-treated retinopathy, 17 diabetic patients
with treated retinopathy, 12 diabetic patients without retinopathy, and 24
healthy control patients. Serum and aqueous humor samples were taken for the
analysis of IL-12 concentration.                                        
RESULTS:                       The aqueous humor IL-12 concentration was
significantly elevated in the patients with non-treated diabetic retinopathy
(chi(2)(3, n = 76) = 27.137; p < 0.001).                      No significant
differences in IL-12 serum concentrations between the groups were found (F =
0.405, p = 0.750). Correlation analysis of IL-12 concentrations in the serum and
aqueous humor showed a linear association between the two variables only in
non-diabetic patients (p = 0.003).                                        
CONCLUSIONS:                       This is the first study to show a
significantly higher concentration of pro-inflammatory cytokine IL-12 in the
aqueous humor of non-treated diabetic retinopathy patients in comparison with
diabetic patients treated for retinopathy, without retinopathy, or with healthy
individuals. Because the serum levels of IL-12 did not differ considerably
between the studied groups, it is plausible that this is due to its local
production and secretion.

PMID: 22227739  [PubMed - as supplied by publisher]