1: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 16; [Epub ahead of print] 

Feasibility and outcome of automated kinetic perimetry in children.

Wilscher S, Wabbels B, Lorenz B.

Kreiskrankenhaus Erding, Affiliated Teaching Hospital of the Technical
University, Munich, Germany.

PURPOSE: Visual field testing in children is often performed using a Goldmann
perimeter. Because the technique is performed manually, it is difficult to
standardize, and stimuli are often presented too quickly. Automated kinetic
perimetry has been successfully established in adults, but to date no results
have been published in children. This paper describes the feasibility and
outcome of automated kinetic perimetry in children in a standard clinical
setting. METHODS: Fifty children aged 5-14 years were examined using a Twinfield
perimeter (Oculus Inc., Wetzlar, Germany), including healthy children, children
with unilateral pathologies (normal eye tested) and children with unilateral
strabismus (non-affected eye tested). Kinetic perimetry was performed using
stimuli III(4), I(4), I(2) and I(1) (Goldmann standard) with a test velocity of
2 degrees /s. Whenever possible, each test was performed twice. Automated and/or
manual re-testing was possible on the same device whenever indicated. RESULTS:
Automated kinetic perimetry took about 3.5 min per eye and could be completed
more quickly than manual Goldmann perimetry, despite the lower test velocity.
All children-with the exception of one 11 year old-were able to perform the test
at least once. There was no significant correlation between age and the isopters
or the area inside the isopters. No significant difference was found between
children with and without strabismus. CONCLUSION: In 49 out of 50 children (98%)
automatic kinetic perimetry was possible in a clinical setting using a
commercially available Twinfield perimeter in a session of clinically practical
duration. A major advantage is constant test velocity, independent of the
examiner. Test performance was not only dependent on age, but also on the
child's maturity and ability to concentrate. Older children tended to detect the
stimuli more peripherally. Older children got better results from the examiner
evaluation parameters attention and central fixation.

PMID: 20232076  [PubMed - as supplied by publisher]

2: Graefes Arch Clin Exp Ophthalmol. 2010 Apr;248(4):607; author reply 609-10. 

Intraocular pressure measured by dynamic contour tonometer and ocular response
analyzer in normal tension glaucoma.

Chen Z, Xu G.

Publication Types:
    Letter

PMID: 20229612  [PubMed - in process]

3: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 13; [Epub ahead of print] 

Thickness of photoreceptor layers in polypoidal choroidal vasculopathy and
central serous chorioretinopathy.

Ooto S, Tsujikawa A, Mori S, Tamura H, Yamashiro K, Yoshimura N.

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate
School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan,
ohoto@kuhp.kyoto-u.ac.jp.

BACKGROUND: To evaluate retinal thickness using spectral-domain optical
coherence tomography (SD-OCT) with reduced speckle noise in eyes with polypoidal
choroidal vasculopathy (PCV) compared to those with normal eyes and those with
central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed
cases of foveal serous retinal detachment in 36 eyes of 36 patients with active
CSC and 23 eyes of 23 patients with active PCV, and 44 eyes of 44 normal
subjects. Patients were examined using SD-OCT with reduced speckle noise, and
the thickness of the outer nuclear layer (ONL), photoreceptor inner segment
(IS), and photoreceptor outer segment (OS) were measured. RESULTS: The ONL and
IS were thicker in normal eyes than in eyes with CSC or PCV (P < 0.001). The OS
was significantly less thick in eyes with PCV than in normal eyes (P < 0.001),
whereas there was no significant difference between eyes with CSC and normal
eyes. The thickness of IS and OS in eyes with PCV was related to fibrin or
hemorrhage being present in the subretinal space. In eyes with PCV,
best-corrected visual acuity at baseline correlated with IS thickness (P =
0.023). CONCLUSIONS: Thinning of each photoreceptor layer was observed in the
eyes of PCV patients as compared to that observed in the case of normal
individuals. The differentiating factors between PCV and CSC, observed using
SD-OCT, include the thinning of the OS in eyes with PCV, which makes SD-OCT
helpful in differentiating PCV from CSC. More severe photoreceptor alterations
were seen in PCV, because fibrin and hemorrhage were present in the subretinal
space, which correlated with poorer vision.

PMID: 20229103  [PubMed - as supplied by publisher]

4: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 16; [Epub ahead of print] 

Contrast sensitivity after intravitreal antivascular endothelial growth factor
therapy for myopic choroidal neovascularization.

Moussa S, Ansari-Shahrezaei S, Smretschnig E, Hagen S, Steindl-Kuscher K, Krebs
I, Binder S.

The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery,
Vienna, Austria.

BACKGROUND: To evaluate contrast sensitivity (CS) using Pelli-Robson charts
after intravitreal ranibizumab (IVR) (Lucentis, Novartis, Basel, Switzerland) or
bevacizumab (IVB) (Avastin, Genentech, South San Francisco, California, USA) in
eyes with myopic choroidal neovascularization (mCNV). METHODS: A retrospective
review was performed of 17 consecutive patients treated with IVR (n = 10; 0.5
mg) or IVB (n = 7; 1.25 mg) for mCNV from July, 2006 with follow-ups through
September, 2009. Re-treatment was performed at monthly or longer intervals if
there was fluorescein leakage in fluorescein angiogram (FAG) and or apparent
subretinal fluid in optical coherence tomography (OCT) persisted. RESULTS: CS
improved by a mean of one letter at 1 month (n = 17; p = 0.32), four letters at
3 months (n = 17; p = 0.02), four letters at 6 months (n = 15; p = 0.01), five
letters at 9 months (n = 14; p = 0.04) and six letters at 12 months (n = 13; p =
0.03). The mean number of IVR/IVB was 1.6/1.6, 2.6/2.3, 3.1/3.2, 4.1/4.2 and
4.5/4.6 at 1 month, 3 months, 6 months, 9 months, and 12 months, respectively.
CONCLUSIONS: Improvements in Pelli-Robson CS scores were observed during the
first year after IVR/IVB in eyes with mCNV.

PMID: 20232077  [PubMed - as supplied by publisher]

5: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 16; [Epub ahead of print] 

Refractive lens exchange with distance-dominant diffractive bifocal intraocular
lens implantation.

Alfonso JF, Fernandez-Vega L, Orti S, Montes-Mico R.

Fernandez-Vega Ophthalmological Institute, Avda. Dres. Fernandez-Vega 34, 33012,
Oviedo, Spain, j.alfonso@fernandez-vega.com.

PURPOSE: To assess efficacy, safety and predictability after refractive lens
exchange (RLE) in patients who had bilateral implantation of a distance-dominant
diffractive bifocal intraocular lens (IOL). METHODS: Seventeen patients (34
eyes) were examined after RLE with bilateral implantation of a diffractive
bifocal 447D IOL. Eyes were divided into myopic and hyperopic groups. Monocular
uncorrected distance visual acuity, best-corrected distance visual acuity
(BCVA), uncorrected distance near visual acuity, and best distance-corrected
near visual acuity (BCNVA) were recorded preoperatively and 6 months after
surgery. RESULTS: Efficacy indexes were 1.10 for myopic and 0.98 for hyperopic
eyes, at 6 months postoperatively. No eye lost >/= 1 line of BCVA. For the
myopic group, four eyes gained 1 line, and six eyes gained >/= 2 lines; for the
hyperopic group, three eyes gained 1 line, and five eyes gained >/= 2 lines.
Safety indexes were 1.21 and 1.08 for myopic and hyperopic eyes respectively. No
eye lost >/= 1 line of BCNVA. Safety indexes at near were 1.02 for myopic and
1.01 for hyperopic eyes. Efficacy indexes at near were 1.02 for myopic and 1.00
for hyperopic eyes. CONCLUSIONS: Six-month results of bilateral implantation of
a distance-dominant diffractive bifocal IOL for RLE demonstrated efficacy,
safety, and predictability in correcting ametropia and presbyopia.

PMID: 20232075  [PubMed - as supplied by publisher]

6: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 13; [Epub ahead of print] 

Exogenous modulation of intrinsic optic nerve neuroprotective activity.

Grozdanic SD, Lazic T, Kuehn MH, Harper MM, Kardon RH, Kwon YH, Lavik EB,
Sakaguchi DS.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa
State University, Ames, IA, 50011, USA, sgrozdan@iastate.edu.

BACKGROUND: To characterize the molecular and functional status of the rat
retina and optic nerve after acute elevation of intraocular pressure (IOP).
METHODS: Retinal ischemia was induced in rats by increasing the IOP (110 mmHg/60
minutes). Microarray analysis, quantitative RT-PCR (qRT-PCR) and
immunohistochemistry were used to characterize retinal tissue. PLGA microspheres
containing neurotrophic factors (BDNF, GDNF, or CNTF) or empty microspheres were
injected into the vitreous of operated animals 1 day after elevation of IOP.
Pupil light reflex (PLR) parameters and electroretinograms (ERG) were monitored
at multiple time points during the 60-day postoperative recovery period.
RESULTS: Molecular analysis showed a significant intrinsic up-regulation of CNTF
at 10 and 25 days after induction of the acute ocular hypertension (p = 0.0067).
Molecular tissue analysis of GDNF and its receptors (GDNFR1, GDNFR2), and BDNF
and its receptor (trkB) showed no change in expression. Animals that received
CNTF microspheres had no significant functional recovery compared to animals
which received blank microspheres (p > 0.05). Animals that received GDNF or BDNF
microspheres showed significant PLR recovery (p < 0.05 and p < 0.001
respectively) compared to non-treated animals. CONCLUSIONS: Continuous release
of neurotrophic growth factors (NGFs) significantly protects optic nerve
function in the experimental model of retinal ischemia observed by PLR analysis.

PMID: 20229104  [PubMed - as supplied by publisher]

7: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 12; [Epub ahead of print] 

Early trabeculectomy bleb walls on anterior-segment optical coherence
tomography.

Nakano N, Hangai M, Nakanishi H, Inoue R, Unoki N, Hirose F, Ojima T, Yoshimura
N.

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate
School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.

BACKGROUND: To correlate the cross-sectional features of filtering blebs on
anterior-segment optical coherence tomography (AS-OCT) 2 weeks after
trabeculectomy with bleb function at 6 months. METHODS: Forty-eight eyes
followed for 6 months or more after trabeculectomy with mitomycin C were
included. Bleb wall reflectivity of developing blebs on AS-OCT 2 weeks
postoperatively was correlated with mature bleb function at 6-month
postoperative visit. RESULTS: Developing bleb walls at 2 weeks were classified
as uniform in 10/48 eyes (20.8%) and multiform in 38/48 eyes (79.2%). Blebs with
uniform reflectivity were significantly more likely to have worse function at 6
months (P < 0.001). Multiform bleb walls had hyporeflective areas seeming to
represent loosely-arranged connective tissue (multiple-layer structures),
subconjunctival separation, and microcysts. Blebs with multiple-layer structures
at 2 weeks were associated with better bleb function at 6 months (P = 0.025).
Intraocular pressure (IOP) of developing blebs at 2 weeks did not correlate with
bleb function at 6 months (P = 0.471). CONCLUSIONS: Bleb wall reflectivity on
AS-OCT 2 weeks after surgery may predict bleb function at 6 months, whereas IOP
of developing blebs may not.

PMID: 20224953  [PubMed - as supplied by publisher]

8: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 12; [Epub ahead of print] 

Two single descriptors of endothelial polymegethism and pleomorphism.

Gonzalez-Meijome JM, Jorge J, Queiros A, Peixoto-de-Matos SC, Parafita MA.

Clinical & Experimental Optometry Research Lab, Department of Physics
(Optometry), School of Sciences, University of Minho, Campus de Gualtar,
4710-057, Braga, Portugal, jgmeijome@fisica.uminho.pt.

PURPOSE: To compute two new quantitative parameters that directly reflect the
level of polymegethism and pleomorphism using data provided by a non-contact
specular microscope. METHODS: We examined right eyes of 306 voluntaries (102
males, 204 females) whose ages ranged from 6 to 82 years (mean +/- SD, 44 +/- 22
years). Endothelial cell density (ECD), average cell size (ACS), standard error
of cells surface (SEM), coefficient of variation in cell size (CV) and
hexagonality index (HI) were obtained. In addition, two new indices of
polymegethism (POLi) and pleomorphism (PLEi) were derived using weighted linear
combinations of data obtained from instrument classification of endothelial
cells based on the individual counts of cells by size and number of sides
respectively, as provided by the instrument. Values of POLi and PLEi were
compared between a group of diabetic patients and a group of age-matched
controls. RESULTS: Average values of POLi and PLEi were 10.47 +/- 3.94 and 8.36
+/- 1.21 respectively. POLi and PLEi display high correlation with SEM (r =
0.911, r = 0.664), ECD (r = -0.997, r = -0.585), ACS (r = 0.997, r = 0.441), ACS
(SD) (r = 0.883, r = 0.682), CV (r = 0.301, r = 0.712) and HI (r = -0.437, r =
-0.991); all these correlations were highly significant (p < 0.001). POLi and
PLEi also showed significant positive correlations with age (r = 0.765, p <
0.001 and r = 0.428, p < 0.001 respectively). POLi was significantly higher in a
group of diabetic patients when compared with another group of age-matched
controls (p = 0.001). CONCLUSIONS: Two single quantitative parameters of
endothelial polymegethism and pleomorphism (POLi and PLEi respectively) have
been derived from the data obtained with a commercial non-contact specular
microscope. These parameters have been demonstrated to identify differences
between the corneal endothelium of diabetic and non-diabetic patients.

PMID: 20224952  [PubMed - as supplied by publisher]

9: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 10; [Epub ahead of print] 

Intravitreal bevacizumab to treat myopic choroidal neovascularization: 2-year
outcome.

Ruiz-Moreno JM, Montero JA.

Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain,
josemaria.ruiz@uclm.es.

BACKGROUND: Myopic maculopathy is the leading cause of subfoveal choroidal
neovascularization (CNV) among patients under 50 years of age. New
antiangiogenic drugs are being used off-label to treat myopic CNV and the
short-term outcome of these therapies has been reported. The aim of this study
is to report the changes in best-corrected visual acuity (BCVA) and optical
coherence tomography (OCT) in highly myopic CNV treated by intravitreal
bevacizumab at 2 years. METHODS: Prospective non-randomized, interventional case
series study of 19 highly myopic eyes from 18 patients with subfoveal and
juxtafoveal CNV treated by three monthly intravitreal injections of 1.25 mg
bevacizumab. Patients were evaluated for BCVA and OCT at baseline and then
monthly for 2 years. RESULTS: Eleven eyes were naive for treatment and eight
eyes had been previously treated by photodynamic therapy. LogMAR BCVA averaged
0.54 (SD 0.25, range 0.2-1.0; Snellen 20/69) at baseline; 0.40 (SD 0.35, range
0.0-1.2; Snellen 20/50) at 1 year; and 0.47 (SD 0.31, range 0.0-1.0; Snellen
20/59) at 2 years (p = 0.04 and p = 0.20, respectively, Student's t test paired
data). Re-treatment was performed in four eyes during the first year: three eyes
at month six and one eye at month 12. Four eyes required one re-injection during
the second year at months 14, 18, 20, and 24. Neither ocular nor systemic
adverse reactions were detected. CONCLUSIONS: Intravitreal bevacizumab seems to
be effective for subfoveal and juxtafoveal CNV in highly myopic eyes. BCVA gain
decreases and is no longer significant by the end of the second year.

PMID: 20221624  [PubMed - as supplied by publisher]

10: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 10; [Epub ahead of print] 

Photodynamic therapy alone versus combined with intravitreal bevacizumab for
neovascular age-related macular degeneration without polypoidal choroidal
vasculopathy in Japanese patients.

Hara R, Kawaji T, Inomata Y, Tahara J, Sagara N, Fukushima M, Tanihara H.

Department of Ophthalmology and Visual Science, Graduate School of Medical
Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.

BACKGROUND: To compare 12-month results of two single initial
treatments-photodynamic therapy with verteporfin alone (PDT group), and this
therapy combined with intravitreal bevacizumab (IVB) (COMB group)-for
neovascular age-related macular degeneration (AMD), not including patients with
polypoidal choroidal vasculopathy (PCV) who were presumed to have AMD. METHODS:
This retrospective study evaluated 23 eyes in the PDT group and 22 eyes in the
COMB group. IVB (1.25 mg) was administered within 2 weeks after PDT. Main
outcome measures were best-corrected visual acuity (VA), central foveal
thickness by optical coherence tomography, and number of treatments. RESULTS: At
month 12, the PDT group had gained 0.7 letter mean VA and the COMB group, 8.8
letters (P = 0.04). Ten eyes (43%) in the PDT group and 19 eyes (86%) in the
COMB group received only one treatment, and significant difference was found (P
= 0.005). No severe ocular or systemic safety concerns were discovered.
CONCLUSIONS: Our 12-month results of PDT combined with IVB for Japanese patients
with AMD without PCV appeared to be more effective than those of PDT alone with
fewer treatments.

PMID: 20221623  [PubMed - as supplied by publisher]

11: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 6; [Epub ahead of print] 

IL-2 and IFN-gamma in the retina of diabetic rats.

Johnsen-Soriano S, Sancho-Tello M, Arnal E, Navea A, Cervera E, Bosch-Morell F,
Miranda M, Javier Romero F.

Fundacion Oftalmologica del Mediterraneo (FOM), Bifurcacion Pio Baroja-General
Aviles, s/n 46015, Valencia, Spain.

BACKGROUND: The pathophysiology of the early events leading to diabetic
retinopathy is not fully understood. It has been suggested that Inflammatory
processes are involved in the development of the disease; however, the
concentrations of tissue retinal inflammatory mediators and their possible
alteration in diabetic retinopathy have not been described. The aim of this work
was to study T-helper cell cytokine and chemokine profiles, and tyrosine
nitration in retinal tissue of diabetic rats. METHODS: Cytokines (interleukin
IL-1a, IL-1b, IL-2, IL-4, IL-6, IL-10, TNFa, GM-CSF, IFN-g), chemokines (MIP-1a,
MIP-2, MIP-3a, MCP-1, GRO/KC, RANTES, Fractalkine), and tyrosine nitration were
measured in retinal homogenate obtained from Long-Evans rats after 5 months of
experimental diabetes. RESULTS: The T-helper type 1 cytokines IL-2 and
INF-gamma, in addition to NO production (measured as nitrotyrosine), were found
to be significantly elevated in diabetic rat retina homogenates. None of the
other cytokines and chemokines studied were affected by the diabetic condition.
CONCLUSIONS: Immunoregulatory cytokines belonging to the Th-1 group (IL-2 and
IFN-gamma) were increased in the retina of experimental diabetic rats. Moreover,
the nitrotyrosine formation (as an expression of increased NO production) was
significantly elevated in the diabetic retina, supporting the concept of an
inflammatory element in the development of diabetic retinopathy.

PMID: 20213480  [PubMed - as supplied by publisher]

12: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 6; [Epub ahead of print] 

Comparison of optic nerve head topography findings in eyes with non-arteritic
anterior ischemic optic neuropathy and eyes with glaucoma.

Horowitz J, Fishelzon-Arev T, Rath EZ, Segev E, Geyer O.

Department of Ophthalmology, Carmel Medical Center, affiliated to the Bruce
Rappaport Medical School, The Technion, Michal 7 St., Haifa, Israel,
horowitz1@012.net.il.

BACKGROUND: To compare the peripapillary retinal nerve fiber layer (RNFL)
thickness in eyes affected by non-arteritic ischemic optic neuropathy (NAION) or
glaucoma as determined by optical coherence tomography (OCT). METHODS: This
cross-sectional institutional study included 18 eyes with NAION (at least 6
months since the acute event) and 29 eyes with glaucoma, both having localized
visual field (VF) defects confined to one hemifield. Twenty-nine normal subjects
served as controls. The fast RNFL thickness protocol (3.4) of the Stratus OCT
(Carl Zeiss Meditec, Dublin, CA, USA) was used. The RNFL thickness and inferior
maximum/temporal average (Imax/Tavg) and superior maximum/temporal average
(Smax/Tavg) data corresponding to the hemifield with and without visual
sensitivity loss were compared between NAION and glaucomatous eyes and with
corresponding quadrants in normal eyes. The area under the receiver operating
characteristic curve (AUC), sensitivities, and specificities were used to
determine the OCT parameters that differ most in the two groups. RESULTS: The
mean RNFL thickness in the quadrants corresponding to the affected hemifield in
the NAION and glaucomatous eyes was not significantly different (P > 0.9), but
the values for both were decreased compared to the control eyes (P < 0.0001).
The mean RNFL thickness in the quadrant corresponding to the unaffected
hemifield was significantly lower in the glaucomatous eyes (73.8 +/- 20.04
micro) than in the NAION eyes (96.6 +/- 23.32 micro, P = 0.023), and in both
study groups compared to the controls (117.2 +/- 13.44 micro, P < 0.0001 for
glaucomatous vs control eyes, and P < 0.025 for NAION vs control eyes).
Smax/Tavg and Imax/Tavg of the quadrant corresponding to the unaffected
hemifield had the strongest power to differentiate the two diseases (an AUC of
0.92). CONCLUSIONS: Stratus OCT detected significant quantitative differences in
RNFL thickness between glaucomatous and NAION eyes, both conditions with
hemifield defects. These differences might hold a clue in understanding the
processes involved in optic nerve injury.

PMID: 20213479  [PubMed - as supplied by publisher]

13: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 6; [Epub ahead of print] 

Polypoidal choroidal vasculopathy in a patient with angioid streaks secondary to
pseudoxanthoma elasticum.

Baillif-Gostoli S, Quaranta-El Maftouhi M, Mauget-Faysse M.

Saint Roch University Hospital, Nice, France, baillif-gostoli.s@chu-nice.fr.

PMID: 20213478  [PubMed - as supplied by publisher]

14: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 7; [Epub ahead of print] 

Foveal cone photoreceptor involvement in primary open-angle glaucoma.

Kanis MJ, Lemij HG, Berendschot TT, van de Kraats J, van Norren D.

Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The
Netherlands.

BACKGROUND: To test whether foveal cone photoreceptors are impaired in primary
open-angle glaucoma (POAG). METHODS: Nineteen POAG eyes with central
glaucomatous visual field defects, and 34 age-matched control eyes were
included. Fundus reflectometry, together with a model fit procedure, provided
information on a set of parameters: lens optical density, macular pigment
optical density, melanin, blood, the directional cone reflectance (Rd), a
measure for foveal cone photoreceptor integrity, and RILM, the reflectance at
the inner limiting membrane. Optical coherence tomography (OCT) was performed to
assess macular thickness. A Kolmogorov-Smirnov Z-test was used to compare
parameters between the two groups. RESULTS: Median age (range) was 55.1
(24.7-73.3) years in the control subjects, and 60.1 (20.7-77.0) years in the
POAG patients (P = 0.24). Of all eight model parameters, only Rd and RILM were
significantly lower in POAG. Median Rd (range) was 2.21 (0.64-4.93) % in the
control subjects and 1.19 (0.08-3.60) % in the POAG patients (P = 0.003). Median
RILM (range) was 0.15 (0.00-1.08) % in the control subjects, and 0.08
(0.01-0.29) % in the POAG patients (P < 0.001). Rd showed no linear relationship
with central retinal sensitivity on Visual Field test in POAG patients. Retinal
thickness of the inner 1-3 mm ring and the outer 3-6 mm ring on OCT, centered on
the fovea, was significantly lower in POAG patients than in control subjects.
CONCLUSIONS: The integrity of the foveal cone outer segments, and the
reflectance of the central ILM were impaired in POAG with advanced central
visual field defects.

PMID: 20213477  [PubMed - as supplied by publisher]

15: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 7; [Epub ahead of print] 

Videokeratoscopic indices in relation to epidemiological exposure to
keratoconus.

Mato JL, Lema I, Diez-Feijoo E.

E.U. Optica e Optometria. Campus Sur, Universidade de Santiago de Compostela,
Santiago de Compostela, 15705 (A Coruna), Spain, jlmato@victormato.com.

BACKGROUND: To establish the relationship between videokeratoscopic indices and
the degree of epidemiological exposure to keratoconus in three groups of
clinically normal subjects. METHODS: Cross-sectional study in which 75 subjects
lacking clinical signs of keratoconus were divided into three groups according
to epidemiological exposure to the condition: 25 fellow eyes of subjects with
clinical signs on the contralateral eye only (the "fellow eye" group), to be
compared to 25 first-degree relatives of patients with keratoconus (the
"relatives" group) and 25 controls without a family history of the disease (the
"control" group). Qualitative patterns and quantitative parameters describing
curvature (central curvature), irregularity (root mean square of the
higher-order corneal wavefront aberration), and asymmetry (inferior-superior
dioptric asymmetry, Zernike vertical coma) obtained from videokeratoscopy were
used for comparison between groups. RESULTS: Members of the fellow eye group
featured a greater number of asymmetric curvature patterns and increased values
in indices describing asymmetry and irregularity than subjects included in both
control and relatives groups. Control and relatives groups were not
significantly different. Despite significant differences in the distribution of
values between the groups, no single index was able to effectively discriminate
between groups using ROC curve analysis. CONCLUSIONS: A prior threefold
classification of clinically normal subjects according to epidemiological
exposure to keratoconus was not sustained by significant differences in
videokeratoscopic indices when comparing between groups.

PMID: 20213476  [PubMed - as supplied by publisher]

16: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 9; [Epub ahead of print] 

Risk factors for subject withdrawals in clinical trials evaluating glaucoma
medications.

Stewart WC, Demos CM, Turner MK, Stewart JA.

PRN Pharmaceutical Research Network, LLC, Charleston, SC, USA, info@prnorb.com.

BACKGROUND: To evaluate risk factors for subject withdrawals from multicenter
clinical trials evaluating glaucoma medications. METHODS: An analysis of
prospective, randomized, multicenter, parallel, active-controlled clinical
trials with 70 subjects/treatment arm published from 1996-2008. RESULTS: We
analyzed 36 glaucoma studies including 17,511 subjects at 1,294 clinical sites.
There were 2,060 (12%) subject withdrawals with 669 (32%) for administrative
errors, 945 (46%) for adverse events (AEs), 197 (10%) for inadequate intraocular
pressure (IOP) control and 249 (12%) for unknown reasons. By multilinear
regression analysis, no positive risk factors for early subject withdrawals were
observed following a Bonferroni correction (p >/= 0.01). A positive correlation
was observed for medication errors and protocol violations to withdrawals due to
ocular AEs and total administrative errors (p < 0.0001). Protocol violations
alone were correlated to subject withdrawals for any AE (total/month) and
systemic AEs (p < 0.0001). Females and Caucasians were correlated to medication
errors (p < 0 .0001). Among medical therapies, alpha-agonists, beta-blockers,
the carbonic anhydrase inhibitor/beta-blocker fixed combination and
prostaglandins were correlated with systemic AEs (p PMID: 20213475  [PubMed - as supplied by publisher]

17: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 4; [Epub ahead of print] 

Treatment of neovascular age-related macular degeneration with a variable
ranibizumab dosing regimen and one-time reduced-fluence photodynamic therapy:
the TORPEDO trial at 2 years.

Spielberg L, Leys A.

Department of Ophthalmology, University Hospital Leuven, Kapucijnenvoer 33,
3000, Leuven, Belgium, spielz01@hotmail.com.

BACKGROUND: The combination of verteporfin photodynamic therapy (PDT) and
anti-angiogenics has been shown to be safe and efficacious in the treatment of
choroidal neovascularization (CNV) secondary to age-related macular degeneration
(AMD). The purpose of this study is to demonstrate long-term prevention of
vision loss and improvement in best-corrected visual acuity (BCVA) after
treatment with one-time reduced-fluence-rate PDT followed by administration of
ranibizumab on a variable dosing regimen over 24 months in patients with
neovascular AMD. Secondary outcome measures included the change in central
macular thickness (CMT), reinjection frequency, and safety. METHODS: This
prospective, nonrandomized, open-label, single-center study enrolled 27
consecutive patients (27 eyes) presenting at the Leuven University Eye Hospital
with previously untreated, active neovascular AMD between September 2006 and
January 2007. All patients were treated with one-time, reduced-fluence-rate
verteporfin PDT, followed by intravitreal ranibizumab 0.5 mg on the same day. A
second and third ranibizumab injection were given at weeks 4 and 8,
respectively, after which patients were followed up monthly for 24 months.
Additional treatment with ranibizumab was administered to eyes with active
neovascularization as indicated clinically and on imaging studies. Retreatment
was based on the following criteria: (1) presence of subretinal fluid (SRF),
intraretinal edema or sub-retinal pigment epithelial fluid, as seen on OCT; (2)
increase of CMT by >100 mm on OCT; (3) signs of active CNV leakage on
fluorescein angiography; (4) new sub- or intraretinal hemorrhage; and (5) BCVA
decreased of >/=5 letters on the Early Treatment of Diabetic Retinopathy Study
(ETDRS) chart. If any single criterion for reinjection was fulfilled,
retreatment with ranibizumab was administered. RESULTS: Twenty-five patients
completed the 2-year study. Occult CNV was present in 64% and retinal
angiomatous proliferative (RAP) lesions were present in 24% of the study eyes.
The remaining three eyes had lesions classified as classic (one eye) or
predominantly classic (two eyes) CNV. Month 24 data are available for 25 eyes
(25 patients; age 55-86 years; mean 77; standard deviation (SD) = 7.2). Mean
baseline VA was 58.6 letters (range: 35-70; SD = 8.4); 24-month VA was 66.2
letters (35-82; 12.7), not including one warfarin-treated patient who suffered
vitreous hemorrhage. The mean visual acuity improved by 7.2 letters (p < 0.05)
and the mean CMT decreased by 146 mum. VA improved >3 lines (15 letters) in 16%;
improved 1-3 lines in 20%; remained within one line of baseline in 32%,
decreased 1-3 lines in 16%, and decreased >3 lines in 16%. Losses of >3 lines
were due to vitreous hemorrhage, geographic atrophy, fibrosis, and growth of an
initially small CNV lesion. An average of 5.1 injections (range: 3-9) were
administered during the first 12 months, and 7.1 injections (3-13) over 24
months. A total of 178 injections were performed; no systemic side-effects,
uveitis, or choroidal collateral vascular damage were observed. Two patients
were lost to follow-up. CONCLUSION: Combined PDT and ranibizumab injection the
same day was well tolerated in all patients. Eighty-four percent of patients had
stable or improved vision at month 24.

PMID: 20204659  [PubMed - as supplied by publisher]

18: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 5; [Epub ahead of print] 

Retinal re-detachment after scleral buckling procedure.

Jonas JB, Mangler B, Decker A, Schlichtenbrede FC.

Department of Ophthalmology, Medical Faculty Mannheim of the
Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany,
Jost.Jonas@augen.ma.uni-heidelberg.de.

PMID: 20204658  [PubMed - as supplied by publisher]

19: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 5; [Epub ahead of print] 

Genetic diversity and medicinal drug response in eye care.

Shastry BS.

Department of Biological Sciences, Oakland University, Rochester, MI, USA,
shastry@oakland.edu.

BACKGROUND: Individual variation in drug response and adverse drug reactions are
a serious problem in medicine. This inter-individual variation in drug response
could be due to multiple factors such as disease determinants, environmental and
genetic factors. Much has been published in the literature in recent years about
the potential of pharmacogenetic testing and individualized medicine. The
development of personalized medicine is truly an exciting area of research.
METHODS: This pharmacogenetic concept in ophthalmology has existed for more than
a century. Although substantial studies that link genetic variants to
inter-individual difference in drug response have been reported in several
diseases such as cancer and heart diseases, such studies are progressing slowly
in the eye field. In this short article, an attempt has been made to summarize
these results. RESULTS: Recently, there have been some small-scale studies that
seem to associate the drug response to the genotype of patients in two major eye
disorders, namely age-related macular degeneration (ARMD) and glaucoma.
CONCLUSION: These studies are still in their infancy, and do not suggest that a
pharmacogenetic basis of drug development is a credible concept and can become
reality in the future. This is because most drug responses involve a large
number of genes that have several polymorphisms and it is unlikely that any one
single gene dictates the drug response. Therefore, a polygenic approach, whole
genome single nucleotide polymorphism (SNP) analysis and a molecular
understanding of disease itself may provide a better insight in the future about
genetic predisposing factors for adverse drug reactions.

PMID: 20204657  [PubMed - as supplied by publisher]

20: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 5; [Epub ahead of print] 

Response to "Use of air in macular hole surgery"

Hasegawa Y, Hata Y, Mochizuki Y, Arita R, Kawahara S, Kita T, Noda Y, Ishibashi
T.

Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu
University, Fukuoka, Japan.

PMID: 20204656  [PubMed - as supplied by publisher]

21: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 3; [Epub ahead of print] 

Visualization and follow-up of acute macular neuroretinopathy with the
Spectralis((R)) HRA+OCT device.

Neuhann IM, Inhoffen W, Koerner S, Bartz-Schmidt KU, Gelisken F.

Tuebingen University Eye Hospital, Schleichstr. 12-16, 72076, Tuebingen,
Germany, irmi@neuhann.de.

BACKGROUND: Acute macular neuroretinopathy (AMNR) is a rare disease entity, the
diagnosis of which is frequently complicated by the subtlety of biomicroscopic
findings. METHODS: Two cases of AMNR are presented, in which the diagnosis and
follow-up was enabled using the Spectralis((R)) HRA+OCT in the absence of clear
biomicroscopic findings. RESULTS: The typical lesions were visualized by
hyporeflexion during infrared imaging and faded over time. With spectral domain
optical coherence tomography, changes in the outer retina in the affected
regions were documented, with no change over time. CONCLUSION: The broader
availability of this technology may enhance the diagnosis and follow-up of AMNR.

PMID: 20198487  [PubMed - as supplied by publisher]

22: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 2; [Epub ahead of print] 

Drainage of subretinal fluid in optic disc pit maculopathy using subretinal
42-gauge cannula: a new surgical approach.

Jalil A, Stavrakas P, Dhawahir-Scala FE, Patton N.

Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WH, United Kingdom.

BACKGROUND: Different surgical approaches have been used for the treatment of
optic disc pit associated maculopathy, with increasing emphasis on vitrectomy.
METHODS: Case report RESULTS: We report a case of optic disc pit maculopathy
where vitrectomy was combined with subretinal fluid drainage using a 42-gauge
subretinal cannula connected to a "back-flush" flute handle. No retinopexy was
performed at the site of drainage. This technique resulted in almost complete
resolution of subretinal fluid by 6 weeks, with visual acuity improving from
1.00 Log MAR preoperatively to 0.40 at 8 months after surgery. CONCLUSION: We
describe a novel technique for subretinal fluid drainage using a subretinal 42-G
cannula connected to a standard "back flush" flute in optic disc pit-associated
maculopathy.

PMID: 20195626  [PubMed - as supplied by publisher]

23: Graefes Arch Clin Exp Ophthalmol. 2010 Mar 2; [Epub ahead of print] 

Topographic and age-related changes of the retinal epithelium and Bruch's
membrane of rhesus monkeys.

Gouras P, Ivert L, Neuringer M, Mattison JA.

Department of Ophthalmology, Columbia University, New York, NY, 10032, USA,
pg10@columbia.edu.

PURPOSE: To examine structural differences in the retinal pigmented epithelium
(RPE) and Bruch's membrane of rhesus monkeys (Macaca mulatta) as a function of
topography and age. METHODS: The retinas of two old (24 and 26 years old) and
two young (1 and 6 years old) female monkeys were examined by light fluorescence
and electron microscopy at the macula, equator, and ora serrata. RESULTS: All
monkeys lacked fluorescence and lipofuscin granules in the RPE at the ora
serrata where photoreceptors are absent. The equator and macula showed intense
fluorescence and many lipofuscin granules in the RPE of the old but not the
young monkeys. At the ora, the RPE contained many dense round melanin granules
throughout the cell. At the equator and macula, melanin granules were more
apical, less frequent, and often elongated. Mitochondria were clustered at the
basal side of the RPE cell near infolds of the plasma membrane. Both
mitochondria and infolds tended to increase toward the macula. In all regions,
the basal lamina of the RPE did not penetrate the extracellular space adjacent
to infolds. The elastin layer of Bruch's membrane was wide at the ora and
equator and thinner at the macula. In the old monkeys, drusen were found at all
retinal regions between the basal lamina and the internal collagen layer of
Bruch's membrane. The drusen were often membrane-bound with a basal lamina and
contained material resembling structures in the RPE. CONCLUSIONS: Lack of
fluorescence and lipofuscin in the RPE at the ora serrata, where photoreceptors
are absent, confirms that RPE fluorescence occurs only where outer segments are
phagocytized. Mitochondrial clustering indicates that the basal side of the RPE
cell uses the most energy and this becomes maximal at the macula. The presence
of age-related degenerative changes and drusen at all retinal locations in the
older monkeys, even at the ora where RPE lipofuscin was absent, indicates that
these processes are not dependent on local lipofuscin accumulation. Therefore
lipofuscin toxicity may not be the sole cause of age-related RPE degeneration.

PMID: 20195625  [PubMed - as supplied by publisher]

24: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 27; [Epub ahead of print] 

Measurement of retinal nerve fiber layer thickness in optic atrophy eyes of
patients with optic neuritis using optical coherence tomography.

Wang XL, Yu T, Xia DZ, Zhang JS, Yan QC, Luo YH.

Department of Ophthalmology, the Forth Affiliated Hospital, China Medical
University, 11 Xinhua Road, Heping District, Shenyang, 110005, China,
wxinling@126.com.

OBJECTIVE: To measure the retinal nerve fiber layer (RNFL) thickness using
optical coherence tomography (OCT) in optic atrophy eyes of patients with optic
neuritis and investigate the correlation between the RNFL thickness and the
visual function. METHODS: To compare the RNFL thickness using StratusOCT, three
groups of the subjects were enrolled, including 72 patients with optic atrophy
with definite demyelinating optic neuritis history (the neuritis group), 47
patients with advanced POAG atrophic neuropathy (the POAG group), and 47 healthy
subjects (the control group). The correlation between the RNFL thickness and
visual function parameters were investigated in the neuritis group, including
the best-corrected visual acuity (BCVA), the visual field mean deviation (MD),
pattern standard deviation (PSD), and P(100) latency of visual evoked potentials
(VEP). RESULTS: The average RNFL thickness, superior, nasal and inferior
thicknesses were significantly thinner in both the neuritis group and the POAG
group than those in the control group (p < 0.05), while they were higher in the
neuritis group than the POAG group (p < 0.05). The significant correlations were
found both between the average RNFL thickness and BCVA (r = 0.35, p < 0.05), MD
(r = 0.43, p < 0.05), and PSD (r = 0.39, p < 0.05). CONCLUSION: In comparison to
the advanced POAG and normal eyes, the RNFL thickness was decreased moderately
in the optic atrophy eyes resulting from demyelinating optic neuritis and was
quantitatively correlated with the visual function parameters.

PMID: 20191363  [PubMed - as supplied by publisher]

25: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Recurrent disc hemorrhage does not increase the rate of visual field
progression.

de Beaufort HC, De Moraes CG, Teng CC, Prata TS, Tello C, Ritch R, Liebmann JM.

Ophthalmology, New York University School of Medicine, New York, NY, USA,
heatherdebeaufort@gmail.com.

AIMS: To determine whether recurrent disc hemorrhage (DH) accelerates
glaucomatous visual field (VF) loss compared to an isolated, single, detected
DH. METHODS: We evaluated the disc photographs of consecutive patients with >/=5
SITA-Standard fields for DH. Group A had patients with a single DH in one eye,
and group B had at least one recurrence in the same eye. Automated pointwise
linear regression analysis was used to calculate rates of progression. Logistic
regression was used to determine ocular or systemic variables associated with DH
recurrence after baseline assessment. RESULTS: One hundred and seventeen
patients were enrolled (group A = 72, group B = 45). The mean age was 67.1 +/-
10.8 years; most patients were women (65%) of European ancestry (92%) diagnosed
with primary open-angle glaucoma (47%). The mean number of VF after the initial
DH was 7.9 +/- 2.9, spanning a mean of 4.6 +/- 2.2 years. None of the ocular or
systemic characteristics revealed a significant difference between groups. The
mean global rate of progression (group A, -0.8 +/- 0.6 vs group B, -0.8 +/- 0.7
dB/year, p = 0.93) and number of eyes reaching a progression endpoint (group A,
70% vs group B, 73%, p = 0.80) did not differ between groups. Recurrent DH eyes
showed a tendency to be followed longer, with a greater number of disc
photographs, which was not significant in the multivariate analysis. The global
rates of progression between groups remained non-significant even after
adjusting to follow-up time and number of VF tests (p = 0.69). CONCLUSION:
Recurrent DH does not result in a faster rate of VF progression compared to a
single detected DH. Eyes with single or recurrent DH have similar risks for
future disease progression.

PMID: 20182885  [PubMed - as supplied by publisher]

26: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Conservative management of bilateral persistent pupillary membranes with 18
years of follow-up.

Meyer-Rusenberg B, Thill M, Vujancevic S, Meyer-Rusenberg HW.

Department of Ophthalmology, University Medical Center Hamburg-Eppendorf,
Martinistrasse 52, 20246, Hamburg, Germany, b.meyer-ruesenberg@uke.de.

PMID: 20182884  [PubMed - as supplied by publisher]

27: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

The effect of a preoperative subconjuntival injection of dexamethasone on
blood-retinal barrier breakdown following scleral buckling retinal detachment
surgery: a prospective randomized placebo-controlled double blind clinical
trial.

Bali E, Feron EJ, Peperkamp E, Veckeneer M, Mulder PG, van Meurs JC.

The Rotterdam Eye Hospital, Rotterdam, The Netherlands.

BACKGROUND: Blood-retinal barrier breakdown secondary to retinal detachment and
retinal detachment repair is a factor in the pathogenesis of proliferative
vitreoretinopathy (PVR). We wished to investigate whether an estimated 700 to
1000 ng/ml subretinal dexamethasone concentration at the time of surgery would
decrease the blood-retinal barrier breakdown postoperatively. METHODS:
Prospective, placebo-controlled, double blind clinical trial. In 34 patients
with rhegmatogenous retinal detachment scheduled for conventional scleral
buckling retinal detachment surgery, a subconjunctival injection of 0.5 ml
dexamethasone diphosphate (10 mg) or 0.5 ml placebo was given 5-6 hours before
surgery. Differences in laser flare photometry (KOWA) measurements taken 1, 3
and 6 weeks after randomisation between dexamethasone and placebo were analysed
using mixed model ANOVA, while correcting for the preoperative flare
measurement. RESULTS: Six patients did not complete the study, one because of
recurrent detachment within 1 week, and five because they missed their
postoperative laser flare visits. The use of dexamethasone resulted in a
statistically significant decrease in laser flare measurements at the 1-week
postoperative visit. CONCLUSION: The use of a preoperative subconjunctival
injection of dexamethasone decreased 1-week postoperative blood-retina barrier
breakdown in patients undergoing conventional scleral buckling retinal
detachment surgery. This steroid priming could be useful as a part of a
peri-operative regime that would aim at decreasing the incidence of PVR.

PMID: 20182883  [PubMed - as supplied by publisher]

28: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Intravitreal triamcinolone acetonide versus bevacizumab therapy for macular
edema associated with branch retinal vein occlusion.

Byun YJ, Roh MI, Lee SC, Koh HJ.

The Institute of Vision Research, Department of Ophthalmology, Yonsei University
College of Medicine, 134 Shinchon-dong, Sodaemoon-gu, Seoul, 120-752, Korea.

PURPOSE: To compare visual outcomes after intravitreal triamcinolone acetonide
(IVTA) injection and intravitreal bevacizumab (IVB) administration for treatment
of macular edema associated with branch retinal vein occlusion (BRVO). METHODS:
A retrospective comparative case series of 134 consecutive patients that were
treated with either IVTA or IVB for macular edema caused by BRVO. Visual acuity
at baseline and 1, 3, 6, 9, and 12 months, and central macular thickness
measured by OCT at baseline and 1, 3, 6, and 12 months. The time to recurrence
of macular edema after treatment was also analyzed. RESULTS: Visual acuity
(Snellen equivalent) improved significantly from 0.87 logMAR (0.14) to 0.49
logMAR (0.33) in the IVTA group, and from 0.91 logMAR (0.13) to 0.45 logMAR
(0.36) in the IVB group 12 months after injection (p < 0.001). Central macular
thickness decreased significantly from 491.0 mum to 255.8 mum in the IVTA group,
and from 477.4 mum to 218.9 mum in the IVB group 12 months after injection (p <
0.001). In between-group comparisons, neither visual acuity (p = 0.892) nor
macular thickness (p = 0.612) improvements were statistically significantly
different. In the IVTA-all group, recurrence of macular edema occurred in 7.6%
of patients at a mean of 12.6 months postoperatively, and the average number of
injections was 1.08. In the IVB-all group, 26.0% of patients suffered
recurrences at a mean of 5.3 months after treatment, and received a mean of 1.89
injections. Recurrence was more frequent in the IVB group compared to the IVTA
group (Kaplan-Meier survival analysis log-rank test, p < 0.0001). CONCLUSIONS:
IVTA and IVB injections were similarly effective for improving visual acuity in
patients with macular edema secondary to BRVO. However, the IVTA group showed
longer mean improvement duration and less disease recurrence, and required fewer
injections than the IVB group.

PMID: 20182882  [PubMed - as supplied by publisher]

29: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 25; [Epub ahead of print] 

Use of air in macular hole surgery.

Gupta D.

Norfolk and Norwich University Hospital, Norwich, UK, Dgupta_01@yahoo.com.

PMID: 20182881  [PubMed - as supplied by publisher]

30: Graefes Arch Clin Exp Ophthalmol. 2010 Feb 24; [Epub ahead of print] 

Comparison of full-thickness traumatic macular holes and idiopathic macular
holes by optical coherence tomography.

Huang J, Liu X, Wu Z, Sadda S.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen
University, 54 Xianlienan Road, Guangzhou, 510060, People's Republic of China.

BACKGROUND: The optical coherence tomography (OCT) and clinical characteristics
of traumatic macular holes (TMHs) can be compared to those of idiopathic macular
holes (IMHs) to gain insights into the pathogenesis of both. METHODS: The
demographic data and visual acuity of 73 consecutive patients with unilateral,
full-thickness TMHs and 182 consecutive patients with idiopathic IMHs were
recorded. All patients with TMH and 60 patients with IMH underwent OCT scanning
and quantitative measurements. The apical and basal diameters and marginal
retinal thicknesses were recorded for each hole. The hole areas and
eccentricities were calculated. These parameters were compared between the two
types of macular holes, and correlated with visual acuity. RESULTS: Compared to
IMHs, TMHs were generally thinner, larger at the base, less circular, and were
associated with worse vision. Vitreous detachment was more commonly associated
with IMHs than TMHs. Both IMHs and TMHs were wider horizontally than vertically.
Visual acuity was negatively correlated with the size of IMHs, but not with any
tomographic parameters in TMHs. CONCLUSION: The tomographic and clinical
findings associated with TMHs and IMHs provide useful insights into the
pathogenesis of these two types of macular holes.

PMID: 20180132  [PubMed - as supplied by publisher]