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Publisher: John Wiley and Sons   (Total: 1583 journals)

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Showing 1 - 200 of 1583 Journals sorted alphabetically
Abacus     Hybrid Journal   (Followers: 12, SJR: 0.48, h-index: 22)
About Campus     Hybrid Journal   (Followers: 5)
Academic Emergency Medicine     Hybrid Journal   (Followers: 54, SJR: 1.385, h-index: 91)
Accounting & Finance     Hybrid Journal   (Followers: 44, SJR: 0.547, h-index: 30)
ACEP NOW     Free  
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 50, SJR: 1.02, h-index: 88)
Acta Archaeologica     Hybrid Journal   (Followers: 142, SJR: 0.101, h-index: 9)
Acta Geologica Sinica (English Edition)     Hybrid Journal   (Followers: 3, SJR: 0.552, h-index: 41)
Acta Neurologica Scandinavica     Hybrid Journal   (Followers: 5, SJR: 1.203, h-index: 74)
Acta Obstetricia et Gynecologica Scandinavica     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 81)
Acta Ophthalmologica     Hybrid Journal   (Followers: 5, SJR: 0.112, h-index: 1)
Acta Paediatrica     Hybrid Journal   (Followers: 54, SJR: 0.794, h-index: 88)
Acta Physiologica     Hybrid Journal   (Followers: 7, SJR: 1.69, h-index: 88)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Acta Psychiatrica Scandinavica     Hybrid Journal   (Followers: 35, SJR: 2.518, h-index: 113)
Acta Zoologica     Hybrid Journal   (Followers: 5, SJR: 0.459, h-index: 29)
Acute Medicine & Surgery     Hybrid Journal   (Followers: 2)
Addiction     Hybrid Journal   (Followers: 31, SJR: 2.086, h-index: 143)
Addiction Biology     Hybrid Journal   (Followers: 11, SJR: 2.091, h-index: 57)
Adultspan J.     Hybrid Journal   (SJR: 0.127, h-index: 4)
Advanced Energy Materials     Hybrid Journal   (Followers: 24, SJR: 6.411, h-index: 86)
Advanced Engineering Materials     Hybrid Journal   (Followers: 25, SJR: 0.81, h-index: 81)
Advanced Functional Materials     Hybrid Journal   (Followers: 49, SJR: 5.21, h-index: 203)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 13, SJR: 0.232, h-index: 7)
Advanced Materials     Hybrid Journal   (Followers: 251, SJR: 9.021, h-index: 345)
Advanced Materials Interfaces     Hybrid Journal   (Followers: 6, SJR: 1.177, h-index: 10)
Advanced Optical Materials     Hybrid Journal   (Followers: 5, SJR: 2.488, h-index: 21)
Advanced Science     Open Access   (Followers: 4)
Advanced Synthesis & Catalysis     Hybrid Journal   (Followers: 17, SJR: 2.729, h-index: 121)
Advances in Polymer Technology     Hybrid Journal   (Followers: 13, SJR: 0.344, h-index: 31)
Africa Confidential     Hybrid Journal   (Followers: 19)
Africa Research Bulletin: Economic, Financial and Technical Series     Hybrid Journal   (Followers: 12)
Africa Research Bulletin: Political, Social and Cultural Series     Hybrid Journal   (Followers: 9)
African Development Review     Hybrid Journal   (Followers: 33, SJR: 0.275, h-index: 17)
African J. of Ecology     Hybrid Journal   (Followers: 14, SJR: 0.477, h-index: 39)
Aggressive Behavior     Hybrid Journal   (Followers: 15, SJR: 1.391, h-index: 66)
Aging Cell     Open Access   (Followers: 9, SJR: 4.374, h-index: 95)
Agribusiness : an Intl. J.     Hybrid Journal   (Followers: 6, SJR: 0.627, h-index: 14)
Agricultural and Forest Entomology     Hybrid Journal   (Followers: 14, SJR: 0.925, h-index: 43)
Agricultural Economics     Hybrid Journal   (Followers: 44, SJR: 1.099, h-index: 51)
AIChE J.     Hybrid Journal   (Followers: 29, SJR: 1.122, h-index: 120)
Alcoholism and Drug Abuse Weekly     Hybrid Journal   (Followers: 7)
Alcoholism Clinical and Experimental Research     Hybrid Journal   (Followers: 7, SJR: 1.416, h-index: 125)
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 34, SJR: 2.833, h-index: 138)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 3)
Allergy     Hybrid Journal   (Followers: 49, SJR: 3.048, h-index: 129)
Alternatives to the High Cost of Litigation     Hybrid Journal   (Followers: 3)
American Anthropologist     Hybrid Journal   (Followers: 128, SJR: 0.951, h-index: 61)
American Business Law J.     Hybrid Journal   (Followers: 24, SJR: 0.205, h-index: 17)
American Ethnologist     Hybrid Journal   (Followers: 90, SJR: 2.325, h-index: 51)
American J. of Economics and Sociology     Hybrid Journal   (Followers: 28, SJR: 0.211, h-index: 26)
American J. of Hematology     Hybrid Journal   (Followers: 31, SJR: 1.761, h-index: 77)
American J. of Human Biology     Hybrid Journal   (Followers: 12, SJR: 1.018, h-index: 58)
American J. of Industrial Medicine     Hybrid Journal   (Followers: 16, SJR: 0.993, h-index: 85)
American J. of Medical Genetics Part A     Hybrid Journal   (Followers: 15, SJR: 1.115, h-index: 61)
American J. of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 3, SJR: 1.771, h-index: 107)
American J. of Medical Genetics Part C: Seminars in Medical Genetics     Partially Free   (Followers: 5, SJR: 2.315, h-index: 79)
American J. of Orthopsychiatry     Hybrid Journal   (Followers: 4, SJR: 0.756, h-index: 69)
American J. of Physical Anthropology     Hybrid Journal   (Followers: 36, SJR: 1.41, h-index: 88)
American J. of Political Science     Hybrid Journal   (Followers: 249, SJR: 5.101, h-index: 114)
American J. of Primatology     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 63)
American J. of Reproductive Immunology     Hybrid Journal   (Followers: 3, SJR: 1.347, h-index: 75)
American J. of Transplantation     Hybrid Journal   (Followers: 15, SJR: 2.792, h-index: 140)
American J. on Addictions     Hybrid Journal   (Followers: 9, SJR: 0.843, h-index: 57)
Anaesthesia     Hybrid Journal   (Followers: 116, SJR: 1.404, h-index: 88)
Analyses of Social Issues and Public Policy     Hybrid Journal   (Followers: 11, SJR: 0.397, h-index: 18)
Analytic Philosophy     Hybrid Journal   (Followers: 16)
Anatomia, Histologia, Embryologia: J. of Veterinary Medicine Series C     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 27)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1, SJR: 0.633, h-index: 24)
Andrologia     Hybrid Journal   (Followers: 2, SJR: 0.528, h-index: 45)
Andrology     Hybrid Journal   (Followers: 2, SJR: 0.979, h-index: 14)
Angewandte Chemie     Hybrid Journal   (Followers: 155)
Angewandte Chemie Intl. Edition     Hybrid Journal   (Followers: 211, SJR: 6.229, h-index: 397)
Animal Conservation     Hybrid Journal   (Followers: 34, SJR: 1.576, h-index: 62)
Animal Genetics     Hybrid Journal   (Followers: 8, SJR: 0.957, h-index: 67)
Animal Science J.     Hybrid Journal   (Followers: 6, SJR: 0.569, h-index: 24)
Annalen der Physik     Hybrid Journal   (Followers: 5, SJR: 1.46, h-index: 40)
Annals of Anthropological Practice     Partially Free   (Followers: 2, SJR: 0.187, h-index: 5)
Annals of Applied Biology     Hybrid Journal   (Followers: 8, SJR: 0.816, h-index: 56)
Annals of Clinical and Translational Neurology     Open Access   (Followers: 1)
Annals of Human Genetics     Hybrid Journal   (Followers: 9, SJR: 1.191, h-index: 67)
Annals of Neurology     Hybrid Journal   (Followers: 43, SJR: 5.584, h-index: 241)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 2, SJR: 0.531, h-index: 38)
Annals of Public and Cooperative Economics     Hybrid Journal   (Followers: 9, SJR: 0.336, h-index: 23)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5, SJR: 2.389, h-index: 189)
Annual Bulletin of Historical Literature     Hybrid Journal   (Followers: 12)
Annual Review of Information Science and Technology     Hybrid Journal   (Followers: 14)
Anthropology & Education Quarterly     Hybrid Journal   (Followers: 24, SJR: 0.72, h-index: 31)
Anthropology & Humanism     Hybrid Journal   (Followers: 16, SJR: 0.137, h-index: 3)
Anthropology News     Hybrid Journal   (Followers: 14)
Anthropology of Consciousness     Hybrid Journal   (Followers: 11, SJR: 0.172, h-index: 5)
Anthropology of Work Review     Hybrid Journal   (Followers: 11, SJR: 0.256, h-index: 5)
Anthropology Today     Hybrid Journal   (Followers: 93, SJR: 0.545, h-index: 15)
Antipode     Hybrid Journal   (Followers: 44, SJR: 2.212, h-index: 69)
Anz J. of Surgery     Hybrid Journal   (Followers: 6, SJR: 0.432, h-index: 59)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apmis     Hybrid Journal   (Followers: 1, SJR: 0.855, h-index: 73)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 67, SJR: 0.754, h-index: 69)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 7, SJR: 0.632, h-index: 58)
Applied Psychology     Hybrid Journal   (Followers: 138, SJR: 1.023, h-index: 64)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 48, SJR: 0.868, h-index: 13)
Applied Stochastic Models in Business and Industry     Hybrid Journal   (Followers: 5, SJR: 0.613, h-index: 24)
Aquaculture Nutrition     Hybrid Journal   (Followers: 13, SJR: 1.025, h-index: 55)
Aquaculture Research     Hybrid Journal   (Followers: 31, SJR: 0.807, h-index: 60)
Aquatic Conservation Marine and Freshwater Ecosystems     Hybrid Journal   (Followers: 34, SJR: 1.047, h-index: 57)
Arabian Archaeology and Epigraphy     Hybrid Journal   (Followers: 11, SJR: 0.453, h-index: 11)
Archaeological Prospection     Hybrid Journal   (Followers: 12, SJR: 0.922, h-index: 21)
Archaeology in Oceania     Hybrid Journal   (Followers: 13, SJR: 0.745, h-index: 18)
Archaeometry     Hybrid Journal   (Followers: 27, SJR: 0.809, h-index: 48)
Archeological Papers of The American Anthropological Association     Hybrid Journal   (Followers: 14, SJR: 0.156, h-index: 2)
Architectural Design     Hybrid Journal   (Followers: 25, SJR: 0.261, h-index: 9)
Archiv der Pharmazie     Hybrid Journal   (Followers: 4, SJR: 0.628, h-index: 43)
Archives of Drug Information     Hybrid Journal   (Followers: 4)
Archives of Insect Biochemistry and Physiology     Hybrid Journal   (SJR: 0.768, h-index: 54)
Area     Hybrid Journal   (Followers: 12, SJR: 0.938, h-index: 57)
Art History     Hybrid Journal   (Followers: 215, SJR: 0.153, h-index: 13)
Arthritis & Rheumatology     Hybrid Journal   (Followers: 49, SJR: 1.984, h-index: 20)
Arthritis Care & Research     Hybrid Journal   (Followers: 28, SJR: 2.256, h-index: 114)
Artificial Organs     Hybrid Journal   (Followers: 1, SJR: 0.872, h-index: 60)
ASHE Higher Education Reports     Hybrid Journal   (Followers: 14)
Asia & the Pacific Policy Studies     Open Access   (Followers: 14)
Asia Pacific J. of Human Resources     Hybrid Journal   (Followers: 312, SJR: 0.494, h-index: 19)
Asia Pacific Viewpoint     Hybrid Journal   (SJR: 0.616, h-index: 26)
Asia-Pacific J. of Chemical Engineering     Hybrid Journal   (Followers: 7, SJR: 0.345, h-index: 20)
Asia-pacific J. of Clinical Oncology     Hybrid Journal   (Followers: 6, SJR: 0.554, h-index: 14)
Asia-Pacific J. of Financial Studies     Hybrid Journal   (SJR: 0.241, h-index: 7)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 3, SJR: 0.377, h-index: 7)
Asian Economic J.     Hybrid Journal   (Followers: 8, SJR: 0.234, h-index: 21)
Asian Economic Policy Review     Hybrid Journal   (Followers: 3, SJR: 0.196, h-index: 12)
Asian J. of Control     Hybrid Journal   (SJR: 0.862, h-index: 34)
Asian J. of Endoscopic Surgery     Hybrid Journal   (SJR: 0.394, h-index: 7)
Asian J. of Organic Chemistry     Hybrid Journal   (Followers: 4, SJR: 1.443, h-index: 19)
Asian J. of Social Psychology     Hybrid Journal   (Followers: 5, SJR: 0.665, h-index: 37)
Asian Politics and Policy     Hybrid Journal   (Followers: 13, SJR: 0.207, h-index: 7)
Asian Social Work and Policy Review     Hybrid Journal   (Followers: 5, SJR: 0.318, h-index: 5)
Asian-pacific Economic Literature     Hybrid Journal   (Followers: 5, SJR: 0.168, h-index: 15)
Assessment Update     Hybrid Journal   (Followers: 4)
Astronomische Nachrichten     Hybrid Journal   (Followers: 2, SJR: 0.701, h-index: 40)
Atmospheric Science Letters     Open Access   (Followers: 29, SJR: 1.332, h-index: 27)
Austral Ecology     Hybrid Journal   (Followers: 12, SJR: 1.095, h-index: 66)
Austral Entomology     Hybrid Journal   (Followers: 10, SJR: 0.524, h-index: 28)
Australasian J. of Dermatology     Hybrid Journal   (Followers: 8, SJR: 0.714, h-index: 40)
Australasian J. On Ageing     Hybrid Journal   (Followers: 7, SJR: 0.39, h-index: 22)
Australian & New Zealand J. of Statistics     Hybrid Journal   (Followers: 13, SJR: 0.275, h-index: 28)
Australian Accounting Review     Hybrid Journal   (Followers: 4, SJR: 0.709, h-index: 14)
Australian and New Zealand J. of Family Therapy (ANZJFT)     Hybrid Journal   (Followers: 3, SJR: 0.382, h-index: 12)
Australian and New Zealand J. of Obstetrics and Gynaecology     Hybrid Journal   (Followers: 43, SJR: 0.814, h-index: 49)
Australian and New Zealand J. of Public Health     Hybrid Journal   (Followers: 11, SJR: 0.82, h-index: 62)
Australian Dental J.     Hybrid Journal   (Followers: 6, SJR: 0.482, h-index: 46)
Australian Economic History Review     Hybrid Journal   (Followers: 4, SJR: 0.171, h-index: 12)
Australian Economic Papers     Hybrid Journal   (Followers: 22, SJR: 0.23, h-index: 9)
Australian Economic Review     Hybrid Journal   (Followers: 6, SJR: 0.357, h-index: 21)
Australian Endodontic J.     Hybrid Journal   (Followers: 3, SJR: 0.513, h-index: 24)
Australian J. of Agricultural and Resource Economics     Hybrid Journal   (Followers: 3, SJR: 0.765, h-index: 36)
Australian J. of Grape and Wine Research     Hybrid Journal   (Followers: 5, SJR: 0.879, h-index: 56)
Australian J. of Politics & History     Hybrid Journal   (Followers: 13, SJR: 0.203, h-index: 14)
Australian J. of Psychology     Hybrid Journal   (Followers: 17, SJR: 0.384, h-index: 30)
Australian J. of Public Administration     Hybrid Journal   (Followers: 385, SJR: 0.418, h-index: 29)
Australian J. of Rural Health     Hybrid Journal   (Followers: 4, SJR: 0.43, h-index: 34)
Australian Occupational Therapy J.     Hybrid Journal   (Followers: 66, SJR: 0.59, h-index: 29)
Australian Psychologist     Hybrid Journal   (Followers: 11, SJR: 0.331, h-index: 31)
Australian Veterinary J.     Hybrid Journal   (Followers: 19, SJR: 0.459, h-index: 45)
Autism Research     Hybrid Journal   (Followers: 31, SJR: 2.126, h-index: 39)
Autonomic & Autacoid Pharmacology     Hybrid Journal   (SJR: 0.371, h-index: 29)
Banks in Insurance Report     Hybrid Journal   (Followers: 1)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 10, SJR: 0.539, h-index: 70)
Basic and Applied Pathology     Open Access   (Followers: 2, SJR: 0.113, h-index: 4)
Basin Research     Hybrid Journal   (Followers: 3, SJR: 1.54, h-index: 60)
Bauphysik     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 5)
Bauregelliste A, Bauregelliste B Und Liste C     Hybrid Journal  
Bautechnik     Hybrid Journal   (Followers: 1, SJR: 0.321, h-index: 11)
Behavioral Interventions     Hybrid Journal   (Followers: 8, SJR: 0.297, h-index: 23)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 23, SJR: 0.736, h-index: 57)
Berichte Zur Wissenschaftsgeschichte     Hybrid Journal   (Followers: 9, SJR: 0.11, h-index: 5)
Beton- und Stahlbetonbau     Hybrid Journal   (Followers: 2, SJR: 0.493, h-index: 14)
Biochemistry and Molecular Biology Education     Hybrid Journal   (Followers: 6, SJR: 0.311, h-index: 26)
Bioelectromagnetics     Hybrid Journal   (Followers: 1, SJR: 0.568, h-index: 64)
Bioengineering & Translational Medicine     Open Access  
BioEssays     Hybrid Journal   (Followers: 10, SJR: 3.104, h-index: 155)
Bioethics     Hybrid Journal   (Followers: 14, SJR: 0.686, h-index: 39)
Biofuels, Bioproducts and Biorefining     Hybrid Journal   (Followers: 1, SJR: 1.725, h-index: 56)
Biological J. of the Linnean Society     Hybrid Journal   (Followers: 14, SJR: 1.172, h-index: 90)
Biological Reviews     Hybrid Journal   (Followers: 3, SJR: 6.469, h-index: 114)
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 42, SJR: 0.12, h-index: 1)
Biology of the Cell     Full-text available via subscription   (Followers: 9, SJR: 1.812, h-index: 69)
Biomedical Chromatography     Hybrid Journal   (Followers: 6, SJR: 0.572, h-index: 49)
Biometrical J.     Hybrid Journal   (Followers: 5, SJR: 0.784, h-index: 44)
Biometrics     Hybrid Journal   (Followers: 36, SJR: 1.906, h-index: 96)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 10, SJR: 0.715, h-index: 44)
Biopolymers     Hybrid Journal   (Followers: 18, SJR: 1.199, h-index: 104)
Biotechnology and Applied Biochemistry     Hybrid Journal   (Followers: 45, SJR: 0.415, h-index: 55)
Biotechnology and Bioengineering     Hybrid Journal   (Followers: 137, SJR: 1.633, h-index: 146)
Biotechnology J.     Hybrid Journal   (Followers: 13, SJR: 1.185, h-index: 51)
Biotechnology Progress     Hybrid Journal   (Followers: 39, SJR: 0.736, h-index: 101)
Biotropica     Hybrid Journal   (Followers: 18, SJR: 1.374, h-index: 71)
Bipolar Disorders     Hybrid Journal   (Followers: 10, SJR: 2.592, h-index: 100)
Birth     Hybrid Journal   (Followers: 34, SJR: 0.763, h-index: 64)
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 2, SJR: 0.727, h-index: 77)
Birth Defects Research Part B: Developmental and Reproductive Toxicology     Hybrid Journal   (Followers: 5, SJR: 0.468, h-index: 47)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal   (SJR: 1.513, h-index: 55)

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Journal Cover Acta Ophthalmologica
  [SJR: 1.473]   [H-I: 38]   [5 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1755-375X - ISSN (Online) 1755-3768
   Published by John Wiley and Sons Homepage  [1583 journals]
  • Characteristics of corneal biomechanical responses detected by a
           non-contact scheimpflug-based tonometer in eyes with glaucoma
    • Authors: Younhea Jung; Hae-Young L. Park, Hee Jung Yang, Chan Kee Park
      Abstract: PurposeTo determine the corneal biomechanical properties in eyes with glaucoma using a non-contact Scheimpflug-based tonometer.MethodsCorneal biomechanical responses were examined using a non-contact Scheimpflug-based tonometer. The tonometer parameters of the normal control group (n = 75) were compared with those of the glaucoma group (n = 136), including an analysis of glaucoma subgroups categorized by visual field loss.ResultsAfter adjusting for potential confounding factors, including the intraocular pressure (IOP), central corneal thickness (CCT), age and axial length, the deformation amplitude was smaller in the glaucoma group (1.09 ± 0.02 mm) than in the normal control group (1.12 ± 0.02 mm; p value = 0.031). The deformation amplitude and the deflection amplitude of the severe glaucoma group (1.12 ± 0.02 mm and 0.92 ± 0.01 mm) were significantly greater than that of the early glaucoma group (1.07 ± 0.01 mm and 0.88 ± 0.11 mm, p = 0.006 and p = 0.031), whereas that of the moderate glaucoma group (1.09 ± 0.02 mm and 0.90 ± 0.02 mm) was greater than that of the early glaucoma group, but this difference was not statistically significant. The deformation amplitude showed a negative correlation with the CCT in the normal control group (r = −0.235), with a weaker negative relationship observed in the early glaucoma group (r = −0.099). However, in the moderate and severe glaucoma groups, the deformation amplitude showed a positive relationship with the CCT, showing an inverse relationship. The duration and number of antiglaucomatous eyedrops used had negative correlations with the CCT in eyes with moderate and severe glaucoma.ConclusionOverall, the glaucoma group showed significantly less deformable corneas than did the normal controls, even after adjusting for the IOP, CCT, age and axial length. However, there were also differences according to the severity of glaucoma, where the corneal deformation amplitude was greater in the severe glaucoma group compared to the early glaucoma group. The combined effects of stiffening due to glaucoma and increased viscoelastic properties caused by the chronic use of antiglaucomatous eyedrops may have resulted in the present findings.
      PubDate: 2017-06-21T05:25:23.917571-05:
      DOI: 10.1111/aos.13466
  • A novel double nucleotide variant in the ferritin-L iron-responsive
           element in a Finnish patient with hereditary hyperferritinaemia-cataract
    • Authors: Roosa-Maria Mattila; Annele Sainio, Marketta Järveläinen, Juha Pursiheimo, Hannu Järveläinen
      Abstract: PurposeTo present a novel Finnish double nucleotide variant in the iron-responsive element (IRE) of the ferritin L-chain gene (FTL) leading to hyperferritinaemia-cataract syndrome (HHCS).MethodsGenomic DNA extracted from peripheral blood leucocytes and synthetized with three different primers flanking the IRE in the FTL 5′-untranslated region of the FTL was used in polymerase chain reaction (PCR). Thereafter, Sanger sequencing was performed on the 487-bp and 602-bp PCR amplification products with specific primers to reveal FTL IRE mutations.ResultsA 58-year-old female patient with elevated serum ferritin level (1339 μg/l) was diagnosed with HHCS after extensive workup. Genetic testing identified a novel double point mutation g.48965355G>C (chr19, hg19) and g.48965356G>T (chr19, hg19) in the lower stem region of the IRE canonical structure of the FTL.ConclusionAfter excluding other causes, elevated serum ferritin level in a person with early onset cataract is indicative for HHCS, a genetic disorder caused by mutation in the IRE of the FTL.
      PubDate: 2017-06-21T05:16:03.554016-05:
      DOI: 10.1111/aos.13492
  • Retinal vascular injuries and intravitreal human embryonic stem
           cell-derived haemangioblasts
    • Authors: Jin-Da Wang; Ying An, Jing-Shang Zhang, Xiu-Hua Wan, Wei Zhang, Robert Lanza, Shi-Jiang Lu, Jost B. Jonas, Liang Xu
      Abstract: ObjectiveTo investigate whether intravitreally applied haemangioblasts (HB) derived from human embryonic stem cells (hESCs) are helpful for the repair of vascular damage caused in animals by an oxygen-induced retinopathy (OIR), by an induced diabetic retinopathy (DR) or by an induced retinal ischaemia with subsequent reperfusion.MethodsHuman embryonic stem cell-derived HBs were transplanted intravitreally into C57BL/6J mice (OIR model), into male Wistar rats with an induced DR and into male Wistar rats undergoing induced retinal ischaemia with subsequent reperfusion. Control groups of animals received an intravitreal injection of endothelial cells (ECs) or phosphate-buffered saline (PBS). We examined the vasculature integrity in the mice with OIR, the blood–retina barrier in the rats with induced DR, and retinal thickness and retinal ganglion cell density in retina flat mounts of the rats with the retinal ischaemic–reperfusion retinopathy.ResultsIn the OIR model, the study group versus control groups showed a significantly (p 
      PubDate: 2017-06-21T05:05:55.290801-05:
      DOI: 10.1111/aos.13477
  • Recombinant human serum albumin for corneal preservation
    • Authors: Mohit Parekh; Hossein Elbadawy, Gianni Salvalaio, Marie-Claude Amoureux, Enzo Di Iorio, Denis Fortier, Diego Ponzin, Stefano Ferrari, Alessandro Ruzza
      Abstract: PurposeTo study the performance of a completely synthetic organ culture (OC) preservation system containing recombinant human serum albumin (rHSA) for preservation of human donor corneas.MethodsTwenty-four paired donor corneas were randomly collected, and one cornea from each donor was preserved in synthetic (experimental) and serum-based media (control). The tissues were assessed at day 0; after 6 days of preservation at room temperature (RT) in Cornea Trans® and Cornea Prep II®; after 28 days at 31°C in Cornea Syn® [with rHSA] and Cornea Max® [with foetal calf serum (FCS)] and; 4-day post deswelling in Cornea Trans® and Cornea Jet®. Thickness was determined with optical coherence tomography (OCT) and transparency with a validated, custom device. Morphology, endothelial cell density (ECD) and mortality were observed after treating the tissues with Trypan blue and sucrose. Glucose uptake by the cells was analysed. Data were compared using non-parametric paired Wilcoxon tests with p 
      PubDate: 2017-06-21T04:56:26.246336-05:
      DOI: 10.1111/aos.13498
  • Optical coherence tomography angiography in choroidal haemangioma: small
           case series
    • Authors: Giuseppe Lo Giudice; Anton Giulio Catania, Alessandro Galan
      PubDate: 2017-06-21T04:45:56.454516-05:
      DOI: 10.1111/aos.13512
  • Bilateral diffuse uveal melanocytic proliferation: Case report and
           literature review
    • Authors: Kristian Klemp; Jens Folke Kiilgaard, Steffen Heegaard, Tove Nørgaard, Mette Klarskov Andersen, Jan Ulrik Prause
      Abstract: Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic intraocular disease that causes progressive visual loss in patients driven by an IgG factor associated with an underlying malignancy. Characteristic ocular findings include exudative retinal detachment, rapid cataract formation and uveal melanocytic tumours. The awareness and documentation of BDUMP has increased during the past decade, and the increasing amount of data collected demonstrates the effect of treatment with plasmapheresis and the value of diagnostic tools in BDUMP such as genetic and immunologic investigations. The literature of BDUMP has not been reviewed since 2003, and there is a growing need for an updated review on diagnosis and management of BDUMP. We review the literature and report a case of BDUMP with a white ciliary body tumour, iris rubeosis, increased iris pigmentation and cataract.
      PubDate: 2017-06-21T04:36:57.550013-05:
      DOI: 10.1111/aos.13481
  • Efficacy of aflibercept for polypoidal choroidal vasculopathy in
    • Authors: Sanaz Shoja Gharehbagh; Yousif Subhi, Torben Lykke Sørensen
      PubDate: 2017-06-21T04:26:50.619529-05:
      DOI: 10.1111/aos.13461
  • Selective laser trabeculoplasty as replacement therapy in medically
           controlled glaucoma patients
    • Authors: Myrjam De Keyser; Maya De Belder, Jonas De Belder, Veva De Groot
      Abstract: PurposeWe examined selective laser trabeculoplasty (SLT) as a replacement therapy for medically controlled open-angle glaucoma (OAG) or ocular hypertensive patients.MethodsA prospective randomized interventional clinical trial on 143 glaucoma patients. Patients were randomized to either receiving SLT or to the control group that continued on pressure lowering medication. Data were recorded 1 hr, 1 week, 1, 3, 6, 12 and 18 months after SLT. Primary outcome was number of medications at 12 and 18 months while maintaining a predetermined target intraocular pressure (IOP).ResultsSelective laser trabeculoplasty (SLT) reduced number of medications from a mean of 1.5 at baseline, to 0.35 after 12 months and 0.29 after 18 months. Meanwhile, SLT achieved more than 20% IOP lowering in 95% of eyes and more than 30% IOP lowering in 86% of eyes after 18 months. Seventy-seven per cent of our eyes no longer needed any medication after SLT at 18 months.ConclusionSelective laser trabeculoplasty (SLT) enabled a reduction in number of medications while maintaining good IOP control. Selective laser trabeculoplasty (SLT) was able to completely replace medical therapy in 77% of eyes after 18 months. Selective laser trabeculoplasty (SLT) as replacement therapy may reduce local and systemic side-effects and prevent adherence issues.
      PubDate: 2017-06-21T04:15:36.560524-05:
      DOI: 10.1111/aos.13509
  • C-Reactive protein and progression of vision loss in retinitis pigmentosa
    • Authors: Yusuke Murakami; Yasuhiro Ikeda, Shunji Nakatake, Kohta Fujiwara, Takashi Tachibana, Noriko Yoshida, Shoji Notomi, Toshio Hisatomi, Shigeo Yoshida, Tatsuro Ishibashi, Koh-Hei Sonoda
      Abstract: PurposeChronic inflammation is involved in retinitis pigmentosa (RP). We demonstrated previously that intraocular inflammatory levels, as measured by slit-lamp ophthalmoscopy or laser flare photometry, are inversely correlated with central visual function in patients with RP. Here, we investigated the relationship between serum high-sensitivity C-reactive protein (hs-CRP) and visual parameters in RP.MethodsWe studied 58 consecutive typical patients with RP
      PubDate: 2017-06-21T04:10:40.315583-05:
      DOI: 10.1111/aos.13502
  • Microstructural changes in the fovea following autologous internal
           limiting membrane transplantation surgery for large macular holes
    • Authors: Seung Min Lee; Han Jo Kwon, Sung Who Park, Ji Eun Lee, Ik Soo Byon
      PubDate: 2017-06-21T04:00:29.349679-05:
      DOI: 10.1111/aos.13504
  • Venous loops: a benign feature of diabetic retinopathy or cause for
    • Authors: Thomas Lee Torp; Tunde Peto, Jakob Grauslund, Søren Leer Blindbæk
      PubDate: 2017-06-21T02:25:24.771725-05:
      DOI: 10.1111/aos.13507
  • Internal cyclopexy for complicated traumatic cyclodialysis cleft
    • Authors: Cong Wang; Xiao-Yan Peng, Qi-Sheng You, Yi Liu, Xiu-Qin Pang, Peng-Fei Zheng, Jost B. Jonas
      Abstract: PurposeTo assess the surgical and functional outcome of internal direct cyclopexy as therapy of complicated traumatic cyclodialysis.MethodsThe single-centre interventional case-series study included eyes with traumatic cyclodialysis who had consecutively been treated. Internal cyclopexy was performed using double-armed sutures introduced into the eye through the pars plana opposite to the cyclodialysis cleft and which were laid parallel to limbus. Additional procedures included cataract surgery, and pars plana vitrectomy. The cyclodialysis was documented upon ultrasound biomicroscopy and gonioscopy.ResultsThe study included 44 patients (44 eyes). The cyclodialysis extended over 4.8 ± 3.2 clock hours of scleral spur circumference (range 1–12 hr, median 4 hr), involving>180° of the scleral spur circumference in 16 eyes (37%) and 360° in 3 eyes (7%). Besides cyclodialysis, additional trauma-related complications included hyphema, iridodialysis, lens dislocation, cataract, vitreous haemorrhage, retinal detachment, suprachoroidal haemorrhage and endophthalmitis. The surgery performed on average at 64 days after the trauma included a mean number of 4.6 ± 1.9 sutures (range: 2–9), with 1.2 sutures per 30° width of cyclodialysis. Mean follow-up was 32 ± 8 weeks (range: 6–51 weeks). Closure of the cyclodialysis was achieved in all 44 eyes, and intraocular pressure (IOP) increased from 8.0 ± 3.4 mmHg (range: 3 21 mmHg) to 14.4 ± 4.0 mmHg (range: 11–21 mmHg). Mean visual acuity (VA) improved from 2.3 ± 1.1 logMAR (range: 0.22–4.0) to 1.2 ± 0.8 logMAR (range 0.3–4.0 logMAR).ConclusionIn conclusion, internal direct cyclopexy is a novel and relatively little invasive surgery technique for the repair of traumatic cyclodialysis.
      PubDate: 2017-06-20T02:35:25.282063-05:
      DOI: 10.1111/aos.13463
  • Two-years results of small-incision lenticule extraction and
           wavefront-guided laser in situ keratomileusis for Myopia
    • Authors: Hidenaga Kobashi; Kazutaka Kamiya, Akihito Igarashi, Masahide Takahashi, Kimiya Shimizu
      Abstract: PurposeTo compare the 2-years visual and refractive outcomes between small-incision lenticule extraction (SMILE) and wavefront-guided laser in situ keratomileusis (LASIK) in eyes with myopia and myopic astigmatism.MethodsOur retrospective case–control study examined 30 eyes of 30 patients with the manifest refraction spherical equivalent (MRSE) of −3.71 ± 1.83 dioptres (D) who underwent SMILE and 30 eyes of 30 patients with MRSE of −3.81 ± 1.40 D who underwent wavefront-guided LASIK. We assessed the 2-years clinical outcomes.ResultsLogarithm of the minimal angle of resolution (LogMAR)-corrected distance visual acuity (CDVA) was −0.23 ± 0.07 in the SMILE group and −0.24 ± 0.07 in the wavefront-guided LASIK group 2 years postoperatively (p = 0.82). Logarithm of the minimal angle of resolution-uncorrected distance visual acuity (UDVA) was −0.18 ± 0.09 and −0.15 ± 0.11 (p = 0.30, respectively). In the SMILE and wavefront-guided LASIK groups 2 years postoperatively, 100% and 73% of eyes, respectively, were within 0.5 D of the prompted MRSE correction (p = 0.005). Changes in the MRSE of −0.10 ± 0.30 D and −0.23 ± 0.51 D occurred from 3 months to 2 years (p = 0.40, respectively). We found a significant correlation between myopic regression and the changes in the keratometric readings from 3 months to 2 years after wavefront-guided LASIK (r = −0.48, p = 0.002), but not after SMILE (r = −0.004, p = 0.90).ConclusionSmall-incision lenticule extraction offers better refractive outcomes than wavefront-guided LASIK during a 2-years follow-up for the correction of myopia and myopic astigmatism.
      PubDate: 2017-06-20T02:28:31.070254-05:
      DOI: 10.1111/aos.13470
  • Aqueous humour concentrations of TGF-β, PLGF and FGF-1 and total retinal
           blood flow in patients with early non-proliferative diabetic retinopathy
    • Authors: Shaolin Du; Lanli Ju, Wenkai Zheng
      PubDate: 2017-06-20T02:25:25.943947-05:
      DOI: 10.1111/aos.13426
  • Comparison of subconjunctival scarring after microincision vitrectomy
           surgery using 20-, 23-, 25- and 27-gauge systems in rabbits
    • Authors: Makoto Gozawa; Yoshihiro Takamura, Seiji Miyake, Kentaro Iwasaki, Shogo Arimura, Yuji Takihara, Masaru Inatani
      Abstract: PurposeTo compare subconjunctival scarring after vitrectomy in rabbit eyes using different gauge systems by analysing anterior segment optical coherence tomography (AS-OCT) images and histological sections.MethodsVitrectomy using 20-, 23-, 25- and 27-gauge systems was performed for rabbits. Anterior segment optical coherence tomography (AS-OCT) images of the incision sites were obtained before and at day 1, 7 and 1 month after surgery. We measured the thickness of conjunctival epithelium, stroma, Tenon's capsule and total conjunctiva of these three layers, then determined the preservation rates of the borderlines between each layer. Surgical invasion was estimated by histological observation.ResultsThe thickness of total conjunctiva, or the thickness of both conjunctival stroma and Tenon's capsule in the 20-gauge group was significantly thicker than that in the 27-gauge group at day 1 and day 7 after surgery. Preservation rates of the conjunctival stroma/Tenon's capsule borderline were significantly lower in the 20-gauge group than in the 25- and 27-gauge groups at day 1, day 7 and 1 month. Preservation rates of the Tenon's capsule/sclera borderline were significantly lower in the 20-gauge group than in the 25- and 27-gauge groups at 1 month. In the 27-gauge group, the number of α-smooth muscle actin-positive fibroblasts was significantly smaller than in the 20-gauge group at day 7.ConclusionBased on the finding of AS-OCT and histology, micro incision vitreous surgery, especially using 27-gauge, contributed to less subconjunctival scarring postoperatively. Therefore, the 27-gauge pars plana vitrectomy (PPV) may be a more effective technique for preserving the structure of conjunctiva.
      PubDate: 2017-06-19T02:07:09.295705-05:
      DOI: 10.1111/aos.13459
  • A perfluorobutylpentane (F4H5)-based solution for the removal of residual
           emulsified silicone oil
    • Authors: Yau Kei Chan; Ho Ching Cheng, Jing Wu, Yuk Heng Matthew Tang, San To Chan, David Wong, Ho Cheung Shum
      Abstract: PurposeThe emulsification of silicone oil (SO) is associated with many complications. In this study, we investigate a new SO solvent, perfluorobutylpentane (F4H5) with 1% by volume of perfluorinated polyethers–polyethylene glycol–perfluorinated polyethers (PFPE-PEG-PFPE) triblock copolymer, for removing emulsified droplets.MethodsAn in vitro 3D printed model eye chamber was used to evaluate the efficiency of the three test liquids in removing SO droplets, namely saline, F4H5 and F4H5 with surfactant PFPE-PEG-PFPE. The numbers of SO droplets were quantified using a Coulter Counter. The stability of double emulsion formed was tested with a fluidic device based on electro-coalescence. Two retinal cell lines were used to test the biocompatibility of the liquids.ResultsThe mean number of droplets remaining in the eye chamber after rinsing with a solution of F4H5 with surfactant was 13 315 ± 4620/ml compared to saline (23 460 ± 7595/ml; p 
      PubDate: 2017-06-14T20:15:10.625008-05:
      DOI: 10.1111/aos.13465
  • High-resolution transbulbar ultrasonography helping differentiate
           intracranial hypertension in bilateral optic disc oedema patients
    • Authors: Qian Chen; Weimin Chen, Min Wang, Xinghuai Sun, Yan Sha, Zhenxin Li, Guohong Tian
      Abstract: PurposeThe enlargement of optic nerve sheath diameter (ONSD) has been proven to be related with raised intracranial pressure (ICP). No prospective study has been focused on utilizing retrobulbar ultrasonography in optic disc oedema patient presented to ophthalmologist.MethodsHigh-resolution transbulbar ultrasonography was performed in a cohort of patient presented with bilateral optic disc oedema. The subarachnoid space of optic nerve (SAS), ONSD and optic nerve diameter (OND) was measured prior to other ancillaries including lumbar puncture. Subjects were classified into increased intracranial pressure (IIP) and normal intracranial pressure (NIP) group according to the open cerebrospinal fluid pressure more than 200 mm H20. The SAS, ONSD and OND were compared between groups and with normal control. The sensitivity of SAS or ONSD change for predicating intracranial hypertension was assessed.ResultsA total of 20 IIP, 25 NIP patients and 25 normal controls were evaluated. The mean SAS and ONSD measured in idiopathic intracranial hypertension group was significantly increased than that of NIP and controls (p 
      PubDate: 2017-06-14T20:10:11.115324-05:
      DOI: 10.1111/aos.13473
  • The Paediatric Cataract Register (PECARE): an overview of operated
           childhood cataract in Sweden and Denmark
    • Authors: Gunilla Magnusson; Birgitte Haargaard, Saima Basit, Anna Lundvall, Alf Nyström, Annika Rosensvärd, Kristina Tornqvist
      Abstract: AimTo report basic epidemiological data concerning surgically treated childhood cataract in Sweden and Denmark.MethodsData were derived from the Paediatric Cataract Register (PECARE), a binational, web-based surgical register representing Sweden and Denmark. All children operated before 8 years of age between 1 January 2007 and 31 December 2013 were included. Age-specific prevalence per 100 000 population was calculated.ResultsA total 574 operations in 213 boys (51.7%) and 199 girls (48.3%), altogether 412 children, were registered, the vast majority (n = 395/412; 95.9%) being individuals with congenital/infantile cataract. Of these 412, a total of 294 (147 boys and 147 girls) were Swedish and 118 (66 boys and 52 girls) were Danish. The age-specific prevalence of operated cataract in Sweden was 31/100 000 and in Denmark 28/100 000. In 454 of 574 eyes (79.1%), the cataract was dense. Altogether, 266 of 574 (46.3%) were operated during the first year of life, 193 during the first 12 weeks representing 33.6% of all operations. A primary intraocular lens (IOL) implantation was done in altogether 411 of 574 eyes (71,6%). In total, 210 unilateral cataract operations (210/574; 36.6%) were performed. Persistent fetal vasculature (PFV) was present in 64 of 193 (33.1%) of those with a congenital unilateral cataract. In 84 individuals (84/395; 21.3%) with congenital or infantile cataract, a coexisting disorder was found.ConclusionThe age-specific binational prevalence of operated congenital/infantile cataract in Sweden and Denmark is 30/100 000. About half of the operations are performed within the first year of life, one-third within the first 3 months. In our study population, a primary IOL was implanted in the majority of cases.
      PubDate: 2017-06-14T06:40:20.582276-05:
      DOI: 10.1111/aos.13497
  • Feasibility study on robot-assisted retinal vascular bypass surgery in an
           ex vivo porcine model
    • Authors: Yi Qi Chen; Ji Wei Tao, Liang Li, Jian Bo Mao, Chen Ting Zhu, Ji Meng Lao, Yang Yang, Li-Jun Shen
      Abstract: PurposeTo describe a new robot-assisted surgical system for retinal vascular bypass surgery (RVBS) and to compare the success rate with freehand RVBS.MethodsA robot-assisted system for retinal microsurgery was constructed to include two independent robotic arms. A 23-gauge light probe and an intraocular forceps were affixed to the arm end effectors to perform the intraocular manipulation. Harvested porcine eyes were introduced to be established animal models of closed-sky eyeballs after that pars plana vitrectomy using temporary keratoprosthesis was performed by a skilful surgeon. Retinal vascular bypass surgery (RVBS) was performed by an inexperienced ophthalmologist to test the ease of use. A stainless steel wire (45-μm pipe diameter) was used as an artificial vessel. Before RVBS, the wires were prepositioned at the retinal surface of the eyes. The Control group (n = 20) underwent freehand RVBS, and the Experimental group (n = 20) underwent robot-assisted RVBS. To create the simulated bypass, the distal end of the wire was inserted into the selected vessel and advanced ~4 mm away from the optic disc. If successful, then the proximal wire end was inserted and advanced ~2 mm towards the optic disc. The difference in the success rate for the freehand and robot-assisted procedures was analysed by the chi-square test.ResultsThe success rate for the freehand RVBS was 5% (1/20 eyes). In contrast, the robot-assisted success rate was 35% (7/20) of eyes (p 
      PubDate: 2017-06-09T02:10:25.212304-05:
      DOI: 10.1111/aos.13457
  • Endothelial alterations in 712 keratoconus patients
    • Authors: Susanne Goebels; Timo Eppig, Berthold Seitz, Nòra Szentmàry, Alan Cayless, Achim Langenbucher
      Abstract: PurposeTo investigate the effect of the severity of keratoconus on the corneal endothelium using specular microscopy.MethodsSeven hundred and twelve eyes from the Homburg Keratoconus Center (HKC) database were included in this retrospective study. Corneal endothelium was evaluated using the Tomey EM-3000 specular microscope. Keratoconus-related topographic and tomographic data were obtained from Scheimpflug-based tomography (Oculus Pentacam® HR). Eyes were classified into stages 0 (healthy) to 4 (severe keratoconus) according to the Topographic Keratoconus Classification (TKC). Subgroups were analysed based on contact lens (CL) type (none/rigid/soft).ResultsThe frequencies of keratoconus stages 0/1/2/3/4 according to TKC were 169/94/206/166/77. The endothelial cell density (ECD) for the endothelial cell area for TKC 0/1/2/3/4 was 2611/2624/2557/2487/2401 cells per mm² and the coefficient of variation (CV) was 40.9/40.0/41.6/46.2/49.0%, respectively. The more severe the keratoconus stage, the lower the endothelial cell count (p 
      PubDate: 2017-06-09T01:50:39.457729-05:
      DOI: 10.1111/aos.13471
  • Can the retina be used to diagnose and plot the progression of Alzheimer's
    • Authors: Deepti Mahajan; Marcela Votruba
      Abstract: Alzheimer's disease (AD) is a neurodegenerative disease and the most common cause of senile dementia. It impairs the quality of life of a person and their family, posing a serious economic and social threat in developed countries. The fact that the diagnosis can only be definitively made post-mortem, or when the disease is fairly advanced, presents a serious problem if novel therapeutic interventions are to be devised and used early in the course of the disease. There is therefore a pressing need for more sensitive and specific diagnostic tests with which we can detect AD in the preclinical stage. The tau proteins and beta-amyloid proteins start to accumulate 20 years before the symptoms begin to manifest. Detecting them in the preclinical stage would be a potential breakthrough in the management of AD. A high degree of clinical suspicion is needed to correlate problems in cognition with the changes in the eye, particularly the retina, pupil and ocular movements, so that the disease can be detected early and managed in the prodromal phase. In this systematic review, we ask the question whether the retina can be used to make a specific and early diagnosis of AD.
      PubDate: 2017-06-09T01:40:59.633058-05:
      DOI: 10.1111/aos.13472
  • Refractive outcome after pars plana vitrectomy for macular hole in
           pseudophakic eyes
    • Authors: Hassan Hamoudi; Ulrik Correll Christensen, Birgit Sander, Michael Larsen, Morten la Cour
      PubDate: 2017-06-09T01:20:57.984137-05:
      DOI: 10.1111/aos.13476
  • Association of risk genotypes of ARMS2/LOC387715 A69S and CFH Y402H with
           age-related macular degeneration with and without reticular pseudodrusen:
           a meta-analysis
    • Authors: Mohammad Hossein Jabbarpoor Bonyadi; Mehdi Yaseri, Homayoun Nikkhah, Mortaza Bonyadi, Masoud Soheilian
      Abstract: To pool the results of published data regarding association of ARMS2/LOC387715 A69S, CFH Y402H and CFH I62V genotypes with age-related macular degeneration (AMD) with and without reticular pseudodrusen (RPD). The results of this pooled data used to estimate the contribution of each of these genes in the pathogenesis of RPD. Heterogeneity of studies was evaluated using Cochran Q-test and I2 index. To modify the heterogeneity in the variables, we used the random effects model. Meta-analysis was performed using STATA. Odds ratio (OR) of genotypes in each study was calculated. Six studies of AMD with RPD and AMD without RPD cases included in this analysis. Analysis of pooled data showed that risk genotypes frequency of ARMS2 A69S was significantly different between AMD with RPD and AMD without RPD [OR = 1.82, 95% confidence interval (CI): 1.26–2.63 for GT versus GG ARMS2 A69S; OR = 2.40, 95% CI: 1.50–3.84 for TT versus GG ARMS2 A69S]. Further analysis also showed that the risk genotype frequency of CFH Y402H was not significantly different between these two groups (OR = 1.02, 95% CI: 0.69–1.50 for CT versus TT CFH Y402H; OR = 1.09, 95% CI: 0.74–1.60 for CC versus TT CFH Y402H). Comparison of above-mentioned ORs revealed statistically higher values for GT and TT genotypes of ARMS2 A69S compared with CFH Y402H genotypes (p = 0.011, p = 0.014, respectively).Our analysis showed stronger contribution of ARMS2 in AMD with RPD group versus AMD without RPD group, in comparison with CFH genotypes.
      PubDate: 2017-06-08T02:20:24.219822-05:
      DOI: 10.1111/aos.13494
  • Acute concomitant esotropia in children
    • Authors: Marlene Schörkhuber; Domagoj Ivastinovic, Wilfried Glatz, Mona-Regina Schneider, Susanne Lindner, Andrea Langmann
      PubDate: 2017-06-02T07:05:35.540126-05:
      DOI: 10.1111/aos.13490
  • Optical coherence tomography angiography of the macular microvasculature
           changes in retinitis pigmentosa
    • Authors: Yoshito Koyanagi; Yusuke Murakami, Jun Funatsu, Masato Akiyama, Shunji Nakatake, Kohta Fujiwara, Takashi Tachibana, Shintaro Nakao, Toshio Hisatomi, Shigeo Yoshida, Tatsuro Ishibashi, Koh-Hei Sonoda, Yasuhiro Ikeda
      Abstract: PurposeTo investigate the macular microvasculature changes by optical coherence tomography angiography (OCTA) and analyse the correlation between these changes and central visual function in patients with retinitis pigmentosa (RP).MethodsWe measured the area of the foveal avascular zone (FAZ) and the foveal and parafoveal flow density (FFD and PFD, respectively) in the superficial (S) and deep (D) retinal plexus by OCTA (AngioVue) and compared these values between 73 RP patients and 36 healthy controls. We analysed the relationships between these microvasculature measurements and central visual functions such as visual acuity (VA) and the values of static perimetry tests (Humphrey Field Analyzer, the central 10–2 program) in the RP patients.ResultsThe FFD-S, PFD-S and PFD-D were significantly decreased in the RP patients compared to the controls (all p  0.05). A subgroup analysis showed that the RP patients with VA
      PubDate: 2017-05-31T04:05:44.558636-05:
      DOI: 10.1111/aos.13475
  • Evaluation of clinical validity of the Rabin cone contrast test in normal
           phakic or pseudophakic eyes and severely dichromatic eyes
    • Authors: Masato Fujikawa; Sanae Muraki, Yuichi Niwa, Masahito Ohji
      Abstract: PurposeTo evaluate the clinical validity of the Rabin cone contrast test (RCCT; Innova Systems, Inc.) in patients with normal phakic/pseudophakic eyes and severe dichromatic colour vision deficiency (CVD).MethodsWe evaluated age-related changes in the RCCT scores in 166 phakic eyes and 34 pseudophakic eyes and the RCCT sensitivity and specificity in 28 men with severe dichromatic CVD (10 with protanopia, 18 with deutanopia) and nine age-matched controls. All participants had 20/20 or better Snellen best-corrected visual acuity (BCVA). The RCCT was used to measure the L, M and S-CCT scores (range, 0–100).ResultsIn normal phakic eyes, the mean L, M and S-CCT scores decreased gradually with ageing, with normal levels in patients in the second to seventh decades of life and some below normal in the eighth and ninth decades of life. In normal pseudophakic eyes, the mean L, M and S-CCT scores were normal in patients in the seventh to ninth decades of life. In eyes with severe CVD, the mean L, M and S-CCT scores were, respectively, 31.5 ± 18.3, 86.0 ± 12.6 and 98.0 ± 6.3 in patients with protanopia; 92.8 ± 10.5, 50.8 ± 19.6 and 97.8 ± 5.2 in patients with deutanopia; and 99.4 ± 1.7, 98.3 ± 5.0 and 99.4 ± 1.7 in controls. The RCCT sensitivity and specificity were 100% for diagnosing the CVD type.ConclusionThe RCCT can be used in non-visually impaired patients up to the seventh decade of life and after cataract surgery in elderly patients. The RCCT is available for CVD screening and typing and the score has a wide distribution range even in patients with severe CVD.
      PubDate: 2017-05-29T06:16:11.934352-05:
      DOI: 10.1111/aos.13495
  • Two-year functional and anatomical results after converting treatment
           resistant eyes with exudative age-related macular degeneration to
           aflibercept in accordance with a treat and extend protocol
    • Authors: Øystein Kalsnes Jørstad; Rowan Thomas Faber, Morten Carstens Moe
      Abstract: PurposeTo study the effects of converting to aflibercept in accordance with a treat and extend (T&E) strategy in eyes with treatment resistant exudative age-related macular degeneration (AMD).MethodsTwo-year prospective study of eyes with exudative AMD and persistent macular fluid despite monthly treatment with ranibizumab or bevacizumab. Eyes were converted to 2.0 mg aflibercept in accordance with a T&E protocol.ResultsFifty eyes from 47 patients were included. At baseline, the mean central retinal thickness (CRT) was 273 μm and mean best-corrected visual acuity (BCVA) 0.25 logarithm of the minimal angle of resolution (logMAR). The mean number of aflibercept injections the first year was 9.2. After 1 year, there was a reduction in mean CRT to 228 μm (p 
      PubDate: 2017-05-29T00:40:26.235415-05:
      DOI: 10.1111/aos.13480
  • Impact of postoperative positioning on the outcome of pars plana
           vitrectomy with gas tamponade for primary rhegmatogenous retinal
           detachment: comparison between supine and prone positioning
    • Authors: Keiko Otsuka; Hisanori Imai, Akiko Miki, Makoto Nakamura
      Abstract: PurposeTo compare the postoperative anatomic success rates and the frequency of complications between prone or supine postoperative positioning after transconjunctival sutureless vitrectomy (TSV) for rhegmatogenous retinal detachment (RRD).MethodsAll patients underwent primary 27-gauge TSV for the treatment of primary RRD. Patients were divided into two groups as follows: group A was patients instructed to keep strict postoperative prone positioning for a minimum of 8 days. Group B was patients instructed to keep the prone positioning on the day of the surgery followed by supine positioning for minimum of 7 days from the day after surgery.ResultSixty-two eyes were enrolled (group A: 32, group B: 30). There was no significant difference in baseline data between two groups. The initial and final anatomical success rates were 93.8% and 100% in group A and 93.3% and 100% in group B, respectively (p = 1, p = 1, respectively). Posterior synechia of the iris occurred in one eye in group A and in two eyes in group B (p = 0.61). Macular pucker and retinal fold did not occur in either group. Preoperative intraocular pressure (IOP; mmHg) was 14.5 ± 2.9 in group A and 14.5 ± 2.6 in group B (p = 0.92). Intraocular pressure (IOP) was not statistically different between the groups during the follow-up period (p = 0.36, p = 0.07, respectively).ConclusionSupine positioning may be an option as a postoperative positioning after TSV and gas tamponade for the treatment of RRD.
      PubDate: 2017-05-27T01:10:25.387263-05:
      DOI: 10.1111/aos.13482
  • Association of the expression level of the neurodegeneration-related
           proteins with the risk of development and progression of primary
           open-angle glaucoma
    • Authors: Alicja Nowak; Wioletta Rozpędek, Magda Cuchra, Radosław Wojtczak, Mateusz Siwak, Katarzyna Szymanek, Marta Szaflik, Jerzy Szaflik, Jacek Szaflik, Ireneusz Majsterek
      PubDate: 2017-05-27T00:50:25.590802-05:
      DOI: 10.1111/aos.13479
  • Comparison of circumferential peripheral angle closure using
           iridotrabecular contact index after laser iridotomy versus combined laser
           iridotomy and iridoplasty
    • Authors: Hyun-kyung Cho; Changwon Kee, Heon Yang, Hyoun Do Huh, Su Jin Kim, Young Min Park, Jong Moon Park
      Abstract: PurposeTo compare the quantitative changes of peripheral angle after laser iridotomy (LI) alone (group A) or combined LI and Iridoplasty (group B) using iridotrabecular contact (ITC) index by swept-source anterior segment optical coherence tomography (AS-OCT).MethodsIn this prospective comparative observational study, OCT images were obtained before and after the procedure. In each image frame, scleral spur (SS) and the ITC end point (EP) were marked and ITC index was calculated as a percentage of the angle closure from 360°. Age, gender, diagnosis and initial ITC index in Group B were matched with group A. Changes in ITC index, anterior chamber angle parameters, and intraocular pressure (IOP) were inspected.ResultsThirty-three eyes (20 patients) with shallow anterior chamber were included in each group. Initial ITC index and initial IOP were not significantly different between the two groups (both p > 0.05). However, ITC index and IOP after the procedure were significantly lower in group B than those in group A (ITC index: 31.3 ± 23.2 in group A, 19.0 ± 21.3 in group B, p = 0.011, IOP: p = 0.004). All anterior chamber angle parameters in group B and all parameters in group A except nasal trabecular-iris angles (TIA) were significantly increased after the laser procedure (all p 
      PubDate: 2017-05-27T00:40:25.738101-05:
      DOI: 10.1111/aos.13450
  • Ophthalmic nepafenac use in the Netherlands and Denmark
    • Authors: Andrea V Margulis; Eline Houben, Jesper Hallas, Jetty A Overbeek, Anton Pottegård, Tobias Torp-Pedersen, Susana Perez-Gutthann, Alejandro Arana
      Abstract: PurposeTo describe nepafenac use in the Netherlands and Denmark with reference to its approved indications. For context, we also describe the use of ketorolac and diclofenac.MethodsWe identified users in the PHARMO Database Network (the Netherlands, 2008–2013) and the Danish national health registers (Denmark, 1994–2014). We described prevalence of cataract surgery and duration of use in patients with cataract surgery with and without diabetes.ResultsIn the Netherlands, 9530 nepafenac users (mean age, 71 years; 60% women) contributed 12 691 therapy episodes, of which 21% had a recently recorded cataract surgery. Of 2266 episodes in adult non-diabetic patients with cataract surgery, 60% had one bottle dispensed (treatment duration ≤21 days). Of 441 episodes in adult diabetic patients with cataract surgery, 90% had up to two bottles dispensed (≤60 days).Denmark had 60 403 nepafenac users (mean age, 72 years; 58% women) and 73 648 episodes (41% had recorded cataract surgery). Of 26 649 nepafenac episodes in adult non-diabetic patients with cataract surgery, 92% had one bottle dispensed. Of 3801 episodes in adult diabetic patients with cataract surgery, 99.8% had up to two bottles dispensed.Use patterns of nepafenac, ketorolac and diclofenac were roughly similar in the Netherlands, but not in Denmark.ConclusionLess than half of therapy episodes were related to cataract surgery; around 90% of episodes with surgery were within the approved duration. Underrecording of ophthalmic conditions and procedures was a challenge in this study.
      PubDate: 2017-05-10T23:30:26.963776-05:
      DOI: 10.1111/aos.13468
  • Anisometropia of spherical equivalent and astigmatism among myopes: a
           23-year follow-up study of prevalence and changes from childhood to
    • Authors: Olavi Pärssinen; Markku Kauppinen
      Abstract: PurposeTo study anisometropia of spherical equivalent and astigmatism from the onset of myopia at school age to adulthood.MethodsA total of 240 myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983–1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Examinations with subjective cyclopedic refraction were repeated 3 years later (follow-up 1) for 238 subjects and thereafter at the mean ages of 23.2 (follow-up 2) and 33.9 years (follow-up 3) for 178 and 134 subjects. After exclusions, the 102 subjects who attended all three follow-ups were included in the analyses. Corneal refractive power and astigmatism and anterior chamber depth was measured with Pentacam topography and axial length with IOL master at study end. Prevalence and changes in anisometropia of spherical equivalent (AnisoSE) and astigmatism (AnisoAST) and their relationships with refractive and axial measures were studied.ResultsMean (±SD) of spherical equivalent (SE), AnisoSE and AnisoAST increased from baseline to follow-up end from −1.44 ± 0.57 D to −5.11 ± 2.23 D, from 0.28 ± 0.30 D to 0.68 ± 0.69 D and from 0.14 ± 0.18 D to 0.37 ± 0.36 D, respectively. Prevalence of AnioSE, ≥1 D, increased from 5% to 22.6% throughout follow-up. Higher AnisoSE was associated with SE in the less myopic eye at baseline and at follow-up 1, and with SE in the more myopic eye in follow-ups 2 and 3 in adulthood. At study end, AnisoSE was associated with the interocular difference in axial length (AL) (r = 0.612, p 
      PubDate: 2017-05-08T07:25:30.473219-05:
      DOI: 10.1111/aos.13405
  • Corneal endothelial cell loss and corneal biomechanical characteristics
           after two-step sequential or combined phaco-vitrectomy surgery for
           idiopathic epiretinal membrane
    • Authors: Hassan Hamoudi; Ulrik Correll Christensen, Morten La Cour
      Abstract: PurposeTo assess the impact of sequential and combined surgery [cataract surgery and 23-gauge pars plana vitrectomy (PPV) with peeling] on corneal endothelium cell density (CED) and corneal biomechanical characteristics.MethodsPhakic eyes with epiretinal membrane (ERM) were prospectively allocated to (i) cataract surgery and subsequent PPV (CAT group), (ii) PPV and subsequent cataract surgery (VIT group) or (iii) phacovitrectomy (COMBI group). Eyes were examined at baseline, 1 month after each surgery, and at 3 and 12 months follow-up. Corneal endothelium cell density (CED) was assessed with non-contact specular microscopy. Pachymetry [central cornea thickness (CCT)], keratometry and cornea volume (CV) were measured with Pentacam Scheimpflug camera. Primary outcome was change in CED after 12 months; secondary outcomes were changes in CCT and CV after 12 months.ResultsSixty-two eyes were enrolled and allocated to the three groups. The mean preoperative CED was 2776, 2794 and 2653 cells/mm2, which decreased significantly at 12 months by 15.3, 20.0 and 19.3% in the CAT, VIT and COMBI group. There was no significant difference in percentage cell loss between the groups at final follow-up. The CED decreased significantly after cataract surgery, but was unaffected by PPV. Central cornea thickness (CCT) increased by 10 μm (p = 0.005) and CV by 1.38 mm3 (2.3%, p 
      PubDate: 2017-05-08T07:00:37.696685-05:
      DOI: 10.1111/aos.13474
  • Optical coherence tomography morphology and evolution in cblC
           disease-related maculopathy in a case series of very young patients
    • Authors: Giacomo M. Bacci; Maria A. Donati, Elisabetta Pasquini, Francis Munier, Catia Cavicchi, Amelia Morrone, Andrea Sodi, Vittoria Murro, Nuria Garcia Segarra, Claudio Defilippi, Leonardo Bussolin, Roberto Caputo
      Abstract: PurposeTo describe the retinal structure of a group of patients affected by methylmalonic aciduria with homocystinuria cblC type, caused by mutations in the MMACHC gene, using spectral domain optical coherence tomography (SD-OCT).MethodsYoung patients (n = 11, age 0–74 months) with cblC disease, detected by newborn screening or clinically diagnosed within 40 days of life, underwent molecular analysis and complete ophthalmic examination, including fundus photography and SD-OCT. In one case, we also performed fluorescein angiography (FA) and standard electroretinography (ERG).ResultsMolecular analysis of the MMACHC gene fully confirmed cblC disease in nine of 11 patients. Two patients harboured only a single heterozygous pathogenic MMACHC mutation and large unbalanced rearrangements were excluded by array-CGH analysis in both. All patients except two showed a bilateral maculopathy. In general, retinal changes were first observed before one year of age and progressed to a well-established maculopathy. Measurable visual acuities ranged from normal vision, in keeping with age, to bilateral, severe impairment of central vision. Nystagmus was present in six patients. Spectral domain optical coherence tomography (SD-OCT) showed macular thinning with severe alterations in outer, and partial sparing of inner, retinal layers.ConclusionPatients affected by cblC disease may frequently show an early onset maculopathy with variable ophthalmoscopic appearance. Spectral domain optical coherence tomography (SD-OCT) broadens the knowledge of subtle retinal alterations during the disease's progression and helps to shed light on the pathological mechanism of maculopathy development.
      PubDate: 2017-05-08T06:45:41.326963-05:
      DOI: 10.1111/aos.13441
  • Dynamics of big bubble formation in deep anterior lamellar keratoplasty by
           the big bubble technique: in vitro studies
    • Authors: Harminder S Dua; Lana A Faraj, Mohamed B Kenawy, Saief AlTaan, Mohamed S Elalfy, Tarek Katamish, Dalia G Said
      Abstract: PurposeTo examine the movement of air injected in the cornea in simulated deep anterior lamellar keratoplasty (DALK), from the needle tip to the formation of different types of big bubbles (BB) and to ascertain how air travels through the stroma and pre-Descemet's layer [Dua's layer (PDL)] to create a type-1 (air between PDL and deep stroma) and type-2BB (air between PDL and Descemet's membrane).MethodsAir was injected in 57 sclerocorneal discs and the passage recorded. Leaking points and sites of commencement of type-1 and type-2BB were examined by scanning electron microscopy. Stromal distribution of air pockets was studied by light microscopy. Uninjected corneas served as controls.ResultsInjected air followed a consistent pattern, initially as radial tracks to the limbus, then as circumferential bands along the limbus and finally centripetally to create predominantly a type-1BB. Type-2BB started at the periphery, by air emerging through clusters of tiny fenestrations discovered in the periphery of PDL. Fifteen to 20 such clusters were also seen in control samples on either side of the Descemet's attachment. Type-1BB was formed by air emerging through wide spaces between lamellae of deep stroma. Histologically, the circumferential band revealed an aggregation of air pockets in the mid-stroma.ConclusionThe consistent pattern of passage of air is indicative of the architecture and microanatomy of the corneal stroma where collagen lamellae are orthogonally arranged centrally and as a circular annulus at the periphery. The novel peripheral fenestrations explain the peripheral commencement of a type-2BB and the escape of air into the anterior chamber during DALK.
      PubDate: 2017-05-08T06:25:45.499897-05:
      DOI: 10.1111/aos.13460
  • Influence of scanning area on choroidal vascularity index measurement
           using optical coherence tomography
    • Authors: Rupesh Agrawal; Xin Wei, Abhilash Goud, Kiran Kumar Vupparaboina, Soumya Jana, Jay Chhablani
      Abstract: PurposeRecently, choroidal vascularity index (CVI) is proposed as a novel tool to evaluate the choroidal vasculature. In this study, we investigate the impact of scanning area on CVI measurement using spectral-domain optical coherence tomography (SD-OCT).MethodsSpectral-domain optical coherence tomography (SD-OCT) using enhanced depth imaging mode was performed in 30 eyes from 15 normal subjects. Three scanning areas were compared: dingle foveal scan; central macular scans [scan passing through central 1000 microns circle on Early Treatment Diabetic Retinopathy Study (ETDRS) grid, inner circle]; and total macular cube scans. Binarization of OCT B-scans and segmentation of the binarized choroid layer were achieved using a previously reported validated automated software. Choroidal vascularity index (CVI) percentage was calculated. Degree of agreement among foveal, central macular and total macular CVI was assessed using intraclass correlation coefficient (ICC) and was plotted using Bland–Altman plot.ResultsThe mean CVI in subfoveal, central macular and total macular scans was 49.95 ± 4.84%, 50.00 ± 4.68% and 51.10 ± 4.63%, respectively. Intraclass correlation coefficient (ICC) was more than 0.8 for all three comparisons [subfoveal versus central macular CVI, ICC = 0.92 (95% CI: 0.84–0.96); central macular versus total macular CVI, ICC = 0.90 (95% CI: 0.82–0.96); subfoveal versus total macular CVI, ICC = 0.92 (95% CI: 0.85–0.95)]. No significant differences in variance (all p > 0.05) were noted among CVI measured from the three scanning areas.ConclusionChoroidal vascularity index (CVI) measurements were highly reproducible using subfoveal, central and total macular scans in healthy individuals. Single foveal scan choroidal vascularity represents total macular choroidal vascularity in healthy population.
      PubDate: 2017-05-04T02:35:26.734447-05:
      DOI: 10.1111/aos.13442
  • Systemic intravenous abciximab: a novel treatment for acute central
           retinal artery occlusion'
    • Authors: José Ferreira Mendes; José Amorim, Gil Calvão-Santos
      PubDate: 2017-05-04T02:20:24.422142-05:
      DOI: 10.1111/aos.13446
  • Visual outcomes of polypoidal choroidal vasculopathy treated with
           intravitreal ranibizumab with or without photodynamic therapy
    • Authors: Colin S. Tan; Wei Kiong Ngo, Louis W. Lim
      PubDate: 2017-04-29T04:39:53.654973-05:
      DOI: 10.1111/aos.13467
  • The effect of canaloplasty with suprachoroidal drainage combined with
           cataract surgery – 1-year results
    • Authors: Anna-Maria Seuthe; Kai Januschowski, Siegfried Mariacher, Martina Ebner, Natalia Opitz, Peter Szurman, Karl Boden
      Abstract: PurposeThe purpose of this study was to investigate the safety and efficacy of phacocanaloplasty with suprachoroidal drainage (PCscD) and to compare its intraocular pressure (IOP)-lowering and drug-sparing effect to canaloplasty with suprachoroidal drainage (CscD).MethodsThe study retrospective interventional study included patients with open-angle glaucoma or secondary forms of glaucoma who underwent either CscD or PCscD between the year 2011 and 2014 in Knappschaft Eye Clinic Sulzbach. Primary end-points were IOP reduction and the number of IOP-lowering medication after 12 months. Secondary end-points were intraoperative and postoperative complications.ResultsA total of 328 eyes were included, 193 were treated with CscD and 135 underwent PCscD. Canaloplasty with scD achieved an IOP reduction of 37.0% (from 20.9 ± 3.6 mmHg to 13.2 ± 2.6 mmHg) after 1 year, whereas PCscD showed a significant higher reduction of 47.4% (from 23.2 ± 5.1 mmHg to 12.2 ± 1.7 mmHg). Reduction in IOP-lowering medication was higher after PCscD (from 3.6 ± 0.6 to 0.2 ± 0.5) than after CscD (from 3.5 ± 0.8 to 0.7 ± 1.0). Twelve months after surgery 55.5% in the CscD group and 80.2% in the PCscD group were free of IOP-lowering medication. In both groups, no severe or sight-threatening complications occurred.ConclusionCombining cataract surgery and CscD achieves a higher IOP reduction, and patients postoperatively need less IOP-lowering medication than after CscD alone.
      PubDate: 2017-04-27T11:37:42.658616-05:
      DOI: 10.1111/aos.13393
  • Antiretinal antibodies in central serous chorioretinopathy: prevalence and
           clinical implications
    • Authors: Josianne C. E. M. Berge; Elon H. C. Dijk, Marco W. J. Schreurs, Jacolien Vermeer, Camiel J. F. Boon, Aniki Rothova
      Abstract: PurposeTo investigate the possible role of autoimmune reactions directed against retinal tissue in central serous chorioretinopathy (CSC), by analysing the presence of serum antiretinal antibodies (ARAs) and establishing their clinical relevance.MethodsSixty-three patients with CSC were included, and clinical characteristics were collected. Serum samples of all patients with CSC, 101 uveitis patients and 60 healthy donors were analysed for the presence of ARAs by indirect immunofluorescence. Furthermore, all CSC serum samples were analysed on Western blot. Correlations between laboratory findings and clinical features of CSC were determined by logistic regression.ResultsAntiretinal antibodies (ARAs) were present in 54% of the patients with CSC, in 46% of uveitis patients (p = 0.153) and in 17% of healthy controls (p 
      PubDate: 2017-04-26T06:25:30.536892-05:
      DOI: 10.1111/aos.13445
  • Intraocular pressure following intrastromal corneal ring segments
    • Authors: Paula Arribas-Pardo; Carmen Mendez-Hernandez, Ricardo Cuiña-Sardiña, Jose Manuel Benitez-del-Castillo, Julian Garcia-Feijoo
      PubDate: 2017-04-26T06:10:30.828355-05:
      DOI: 10.1111/aos.13454
  • Optical coherence tomography evaluation of patients with macula-off
           retinal detachment after different postoperative posturing: a randomized
           pilot study
    • Authors: Enrico Peiretti; Francesco Nasini, Elisa Buschini, Giulia Caminiti, Sarit Y. Lesnik Oberstein, Alissa Willig, Heico M. Bijl, Marco Mura
      Abstract: PurposeTo assess the presence of outer and inner retinal folds (RFs) and drop-out of the ellipsoid zone (EZ) occurring after surgical repair of macula-off rhegmatogenous retinal detachment (RRD) with different postoperative posture and preoperative use of adjuvant perfluorocarbon liquid (PFCO).MethodsIn this prospective study, 56 eyes of 56 consecutive patients affected by RRD were subjected to 23- or 25-gauge pars plana vitrectomy (PPV). The patients were randomized in four groups (14 prone 5 hr without PFCO, 14 supine 5 hr without PFCO, 14 prone 5 hr with PFCO and 14 supine 5 hr with PFCO) and followed up with spectral domain optical coherence tomography (SD-OCT).ResultsSpectral domain optical coherence tomography (SD-OCT) was recorded before surgery, at days 30 and 90 to detect the presence of outer RFs, inner RFs and drop-out of EZ and to follow their variation over time. No statistical significance was found in our groups for outer RFs, inner RFs, drop-out of EZ formation and evolution. The postoperative best-corrected visual acuity (BCVA) improved in all groups (mean preoperative BCVA 1.47 logMar ± 0.19, mean postoperative BCVA 0.27 logMar ± 0.11, p 
      PubDate: 2017-04-26T06:02:17.446092-05:
      DOI: 10.1111/aos.13397
  • Prognostic impact of chromosomal aberrations and GNAQ, GNA11 and BAP1
           mutations in uveal melanoma
    • Authors: Kjersti M. Staby; Karsten Gravdal, Sverre J. Mørk, Steffen Heegaard, Olav K. Vintermyr, Jørgen Krohn
      Abstract: PurposeTo evaluate clinico-pathological and molecular prognostic factors in a well-defined series of posterior uveal melanoma (UM) with focus on chromosomal aberrations and mutations in the GNAQ, GNA11 and BRCA1-associated protein 1 (BAP1) genes.MethodsFormalin-fixed paraffin-embedded (FFPE) tissue samples were obtained from 50 consecutive eyes enucleated for UM between 1993 and 2005. The material was tested for loss of chromosome 3 and gain of chromosome 8q gene signatures by selective molecular gene markers using multiplex ligation-dependent probe amplification (MLPA), and for DNA mutations in the GNAQ, GNA11 and BAP1 genes.ResultsAfter a mean follow-up of 83 months (range, 8–205 months), 21 patients had died of metastatic UM and 16 patients of other causes. Tumour diameter, ciliary body involvement, mixed/epithelioid cell types, mitotic index, Ki-67 proliferation index, loss of chromosome 3 and gain of chromosome 8q showed statistically significant associations with metastatic disease. There were no significant differences in the prevalence of GNAQ and GNA11 mutations between patients with or without metastatic disease. Mutational analysis of the BAP1 gene was performed in 32 primary UM and in five UM liver metastases. Nine different BAP1 missense mutations were identified. BAP1 mutations were not more common in metastasizing than in nonmetastasizing UM.ConclusionThe molecular gene markers showing loss of chromosome 3 and gain of 8q gene signatures were associated with an increased risk of metastatic disease. BRCA1-associated protein 1 (BAP1) gene mutation status had no prognostic significance. The frequency and spectrum of BAP1 mutations in UM may be more dependent on ethnicity and demographic variables than hitherto considered.
      PubDate: 2017-04-26T03:35:58.26382-05:0
      DOI: 10.1111/aos.13452
  • Prevalence and risk factors for diabetic retinopathy in 17 152 patients
           from the island of Funen, Denmark
    • Authors: Morten B. Larsen; Jan Erik Henriksen, Jakob Grauslund, Tunde Peto
      Abstract: PurposeThis study aims to estimate the prevalence and risk factors of diabetic retinopathy (DR) in patients enrolled in a large Danish quality-assuring database for diabetes: the Funen Diabetes Database (FDDB).MethodsAll patients with type 1 (T1DM) and type 2 DM (T2DM) diabetes mellitus (DM) were included in a cross-sectional study. The level of DR per patient was determined based on the eye with highest level of DR. All ocular and non-ocular data were extracted at the latest examination that corresponded to the most recent DR-grading data.ResultsData from 17 152 patients were analysed; 83.1% had T2DM. Prevalence of DR was 23.8% (T1DM: 54.3%, T2DM: 21.2%). T1/T2DM patients were statistically significantly different regarding age, duration of diabetes, BMI, systolic blood pressure (BP), cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, s-creatinine and u-albumin (p 
      PubDate: 2017-04-26T02:16:44.250352-05:
      DOI: 10.1111/aos.13449
  • A comparison between patients with epiphora and cataract of the activity
           limitations they experience in daily life due to their visual disability
    • Authors: Elin Bohman; Maria Wyon, Mats Lundström, Eva Dafgård Kopp
      Abstract: PurposeThe objective of this study was to compare patients with epiphora and cataract in terms of the activity limitations they experience in daily life due to their visual disability and to validate the use of the Catquest-9SF questionnaire for epiphora patients.MethodsSeventy-two consecutively encountered adult patients with confirmed lacrimal obstruction and listed for dacryocystorhinostomy (DCR) or lacrimal intubation at the St. Erik Eye Hospital, Stockholm, Sweden, completed the Catquest-9SF questionnaire, which measures activity limitations in daily life due to visual disability. The psychometric qualities of the Catquest-9SF results obtained from this group of patients were evaluated by Rasch analysis. Rasch analysis was further employed to convert the ordinal raw data to a Rasch score for comparison with the preoperative scores of patients registered in the Swedish National Cataract Register (NCR) during March 2013.ResultsThe Catquest-9SF exhibited good psychometric qualities when investigating epiphora patients, with the exception of a misfit for Item 4, the item regarding facial recognition. On the Rasch scale (−5.43 = no activity limitations to +5.01 = severe activity limitations), the mean score for epiphora patients was −0.82 while for patients listed for 1st eye and 2nd eye cataract surgery it was −0.17 and −0.76, respectively. An equivalence test confirmed that the reported visual disability of epiphora patients was not significantly different from visual disability reported by patients waiting for 2nd eye cataract surgery.ConclusionThe Catquest-9SF is a valid measure of visual disability in patients with epiphora. Epiphora patients experience visual disability to the same degree as patients awaiting 2nd eye cataract surgery.
      PubDate: 2017-04-26T01:50:48.543682-05:
      DOI: 10.1111/aos.13447
  • Topical antibiotics and intravitreal injections
    • Authors: Alex P. Hunyor; Rohan Merani, Archie Darbar, Jean-François Korobelnik, Paolo Lanzetta, Annabelle A. Okada
      Abstract: There is increasing evidence that topical antibiotics, given before and/or after intravitreal injections, are ineffective in preventing endophthalmitis and are possibly harmful. In addition to the lack of efficacy and increased development of resistant organisms, the use of topical antibiotics adds significantly to the cost of delivering intravitreal therapy. Despite this, in many countries, it is still common practice to use pre- and/or postinjection topical antibiotics. This review outlines the general principles of effective antibiotic prophylaxis, and the evidence regarding topical antibiotic use as a prophylactic measure for endophthalmitis following intravitreal injections. A key distinguishing feature of intravitreal injections from most other invasive procedures is the fact that they are often repeated on multiple occasions to the same eye. Given the lack of evidence to support topical antibiotics as an effective method of prophylaxis for postinjection endophthalmitis, it appears that more widespread education of ophthalmologists is required to avoid continued inappropriate use. Revision of drug labels in some jurisdictions, and amendment of local/professional society guidelines, may be required to assist in achieving this goal. Emphasis should be placed on antisepsis and aseptic technique, which are the major proven methods of endophthalmitis prevention, rather than antibiotics.
      PubDate: 2017-04-25T04:46:37.759621-05:
      DOI: 10.1111/aos.13417
  • Imaging collector channel entrance with a new intraocular micro-probe
           swept-source optical coherence tomography
    • Authors: Chen Xin; Xiaoya Chen, Meng Li, Yan Shi, Huaizhou Wang, Ruikang Wang, Ningli Wang
      Abstract: PurposeTo describe the use of a newly developed side-viewing catheter probe to provide the cross-sectional images of collector channel entrance (CCE), achieved by swept-source optical coherence tomography (SS-OCT).MethodsA side-viewing SS-OCT catheter probe was developed that has a core probe diameter of 0.15 mm and an outer diameter of 0.25 mm, for the purpose of imaging CCEs within eye globe. Cadaver eyes harvested from swine and human were used to demonstrate its feasibility. For porcine eyes, the probe imaged the CCE by accessing the region of the aqueous plexus (AP) as well as along the inner wall (IW) of the trabecular meshwork (TM). For human eyes, the CCE images were captured by placing the probe within the lumen of the Schlemm's canal (SC) and along its IW.ResultsWith the optical coherence tomography (OCT) catheter probe, the CCE is well delineated as optically empty areas within the highly scattering sclera. In porcine eyes, images captured in the region of the AP demonstrate a large cavity with delicate tissue strands around the probe. The CCE can be identified at the outer margin of the AP. When imaged along the IW, the TM is discernable but difficult to be distinguished from the AP. In the human limbal regions, when placed within the lumen of the SC, the catheter probe fully occupies the potential space. TM is highly compact. The CCE can be identified at the outer wall of the SC. When imaged along the IW of TM, the SC and CCE can be identified.ConclusionThe intraocular SS-OCT catheter probe is feasible to provide the CCE images, indicating useful clinical applications to assist glaucoma surgery.
      PubDate: 2017-04-25T04:37:50.59274-05:0
      DOI: 10.1111/aos.13415
  • Can the SENSIMED Triggerfish® lens data be used as an accurate measure of
           intraocular pressure?
    • Authors: Parveen Vitish-Sharma; Austin G. Acheson, Richard Stead, John Sharp, Ali Abbas, Marta Hovan, Charles Maxwell-Armstrong, Boliang Guo, Anthony J. King
      Abstract: PurposeThe SENSIMED Triggerfish® contact lens sensor (CLS) has an embedded micro-sensor that captures spontaneous circumferential changes at the corneoscleral junction and transmits them via an antenna to a device where these measurements are stored. During laparoscopic colorectal surgery, patients are placed in Trendelenburg position which has been shown to increase intraocular pressure (IOP). Laparoscopic colorectal surgery requires both pneumoperitoneum and Trendelenburg positioning; therefore, IOP can vary significantly. We aimed to assess whether circumferential changes in the corneoscleral area can be correlated to IOP changes measured using Tono-pen® XL applanation tonometer during laparoscopic colorectal surgery.MethodPatients undergoing laparoscopic colorectal resections were included. On the day of surgery, baseline IOP was taken and the SENSIMED Triggerfish® CLS was then set up in one eye of the patient. During surgery (whilst under general anaesthetic), IOP measurements were taken in the contralateral eye using a Tono-pen® XL applanation tonometer every hour and any time the table was moved to record the fluctuations of IOP during surgery and any association with position change. The timings of these readings were documented.ResultsTwenty patients were included in this study (six males, 14 females). Average age was 64.6 years (SD = 16.3). The fluctuation in IOP measured in the reference eye ranged between 6.3 and 46.7 mmHg. The mean correlation coefficient between CLS output measurements and these IOP measurements was r = 0.291 (95% CI).ConclusionOur results showed a weak correlation between the SENSIMED Triggerfish® CLS data output and IOP measurements taken using the Tono-pen® XL applanation tonometer.
      PubDate: 2017-04-09T02:10:27.91942-05:0
      DOI: 10.1111/aos.13456
  • The aetiology of uveitis in Suriname
    • Authors: Sayad Bhikhie; Janna Minderhoud, Anne-Marie T. Bueno de Mesquita-Voigt, Aniki Rothova, Anjo Riemens
      PubDate: 2017-04-09T01:55:26.253923-05:
      DOI: 10.1111/aos.13455
  • Fundus imaging in newborn children with wide-field scanning laser
    • Authors: Vigdis Magnusdottir; Wouter B. Vehmeijer, Thorunn S. Eliasdottir, Sveinn H. Hardarson, Nicoline E. Schalij-Delfos, Einar Stefánsson
      Abstract: PurposeCurrent fundus imaging in newborn babies requires mydriatics, eye specula and corneal contact. We propose that a scanning laser ophthalmoscope (SLO) allows ultra wide-field imaging with reduced stress for the child.MethodsThis prospective observational single centre study was conducted in Landspítali, University Hospital, Reykjavik, Iceland. In this study, a noncontact wide-field SLO (Optomap 200Tx) was used to image the retina in healthy full-term newborns without the use of mydriatics or eye specula. The child was held by one of the parents, while one of the researchers supported the child's head in front of the SLO camera for alignment and opened the eye with either a finger or a cotton tip.ResultsFifty-nine participants were recruited (34 females). The mean age was 16 days, and the mean gestational age was 40 ± 1 weeks at the time of imaging. Ultra-wide-field (200°) images were obtained of 44 participants. Twenty-seven participants (61%) had at least one ultra wide-field image with the optic disc and vessel segments in all quadrants of the fundus visible and in focus. No retinal pathology was found in the participants with the exception of one participant with small retinal haemorrhages.ConclusionScanning laser ophthalmoscope (SLO) ultra-wide-field fundus imaging is feasible in healthy full-term newborns without corneal contact, eye speculum or mydriatics. This approach could be an improvement for retinal imaging in newborn infants. Eye movement of the infant, whether asleep or awake, influenced which part of the fundus was captured, but focus and image quality were generally good.
      PubDate: 2017-04-09T01:45:36.497041-05:
      DOI: 10.1111/aos.13453
  • Differential expression and localization of human tissue inhibitors of
           metalloproteinases in proliferative diabetic retinopathy
    • Authors: Ahmed M. Abu El-Asrar; Ajmal Ahmad, Emilie Bittoun, Mohammad Mairaj Siddiquei, Ghulam Mohammad, Ahmed Mousa, Gert De Hertogh, Ghislain Opdenakker
      Abstract: PurposeTissue inhibitors of metalloproteinases (TIMPs) block the catalysis by matrix metalloproteinases (MMPs) and have additional biologic activities, including regulation of cell growth and differentiation, apoptosis, angiogenesis and oncogenesis. We investigated the expression levels of all the four human TIMPs and correlated these levels with those of MMP-9 and vascular endothelial growth factor (VEGF) in proliferative diabetic retinopathy (PDR).MethodsVitreous samples from 38 PDR and 21 nondiabetic control patients and epiretinal membranes from 14 patients with PDR and 10 patients with proliferative vitreoretinopathy (PVR) were studied by enzyme-linked immunosorbent assay, Western blot analysis and immunohistochemistry.ResultsTissue inhibitor of metalloproteinases-1, TIMP-4, MMP-9 and VEGF levels were significantly higher in vitreous samples from PDR patients than in nondiabetic controls (p 
      PubDate: 2017-04-09T01:35:44.82652-05:0
      DOI: 10.1111/aos.13451
  • Preliminary study of a controllable device for subtenon drug infusion in a
           rabbit model
    • Authors: Yiqin Duan; Yezhen Yang, Xuetao Huang, Ding Lin
      Abstract: Background and objectiveConventional methods to treat intraocular diseases are invasive or associated with adverse effects. A minimally invasive means of sustained-release drug delivery to the vitreous is required. This study evaluated a novel device for subtenon drug delivery to the vitreous, relative to a single subconjunctival injection.MethodsSixty adult New Zealand White rabbits were randomly assigned to receive demethylvancomycin (DMV) by continuous subtenon delivery with the flow rate of 0.1 ml/hr for 24 hr, or as a single 0.3 ml subconjunctival injection in the right eyes. Rabbits were killed in subgroups of six at 1, 3, 6, 12 and 24 hr. The DMV concentration of the vitreous humour of the right eye was analysed by high-performance liquid chromatography.ResultsOverall, the vitreous DMV concentration of the subtenon group was significantly higher than that of the subconjunctival group (F = 25.928, p = 0.001). The DMV concentration of the subtenon group was also significantly higher than that of the subconjunctival group at 3, 6, 12 and 24 hr (t = 2.457, 5.064, 3.085, 4.207; p = 0.04, 0.01, 0.018, 0.004, respectively). In the subtenon group, the DMV concentration reached maximum (2.41 ± 0.67 μg/ml) at 6 hr, and at 24 hr was 2.37 ± 1.23 μg/ml. In the subconjunctival group, the DMV concentration reached maximum (0.48 ± 0.27 μg/ml) at 1 hr and declined to 0.09 ± 0.05 μg/ml at 24 hr.ConclusionSubtenon application with this novel minimally invasive design is an effective method for delivering an appropriate drug to the vitreous in a sustained and controllable amount.
      PubDate: 2017-04-09T01:20:36.742799-05:
      DOI: 10.1111/aos.13448
  • Factors affecting signal strength in spectral-domain optical coherence
    • Authors: Ryan Lee; Yih-Chung Tham, Carol Y. Cheung, Elizabeth Sidhartha, Rosalynn Grace Siantar, Sing-Hui Lim, Tien Yin Wong, Ching-Yu Cheng
      Abstract: PurposeTo identify ocular factors that affect signal strength in spectral-domain optical coherence tomography (SD-OCT).MethodsData from 1312 participants of the population-based Singapore Malay Eye Study-2 (SiMES-2) were included in the analysis. All participants underwent standardized ophthalmic examination, including measurements of best-corrected visual acuity (BCVA), refractive error, axial length, corneal curvature and presence of cataracts. Optic disc and macular cube scans were acquired using the Cirrus HD-OCT (software version 6.0, Carl Zeiss Meditec, Dublin, CA, USA). Signal strength of the optical coherence tomography (OCT) scan was recorded for each study eye. Multivariable linear regression analyses were performed to evaluate the associations between ocular factors and signal strength of the OCT scans.Results: The mean (±SD) age of our study participants was 61 ± 9 years, and 44.6% were male. Mean optic disc scan signal strength was 7.90 ± 1.25, range = 0–10, while mean macular scan signal strength was 8.80 ± 1.27, range = 0–10. In multivariable regression analyses, poorer signal strength in optic disc and macular cube scans was each associated with older age (per decade, β = −0.373, p 
      PubDate: 2017-04-09T01:00:25.695588-05:
      DOI: 10.1111/aos.13443
  • Topographic analysis of eyelid position using digital image processing
    • Authors: Yeoun Sook Chun; Hong Hyun Park, In Ki Park, Nam Ju Moon, Sang Joon Park, Jeong Kyu Lee
      Abstract: PurposeTo propose a novel analysis technique for objective quantification of topographic eyelid position with an algorithmatically calculated scheme and to determine its feasibility.MethodsOne hundred normal eyelids from 100 patients were segmented using a graph cut algorithm, and 11 shape features of eyelids were semi-automatically quantified using in-house software. To evaluate the intra- and inter-examiner reliability of this software, intra-class correlation coefficients (ICCs) were used. To evaluate the diagnostic value of this scheme, the correlations between semi-automatic and manual measurements of margin reflex distance 1 (MRD1) and margin reflex distance 2 (MRD2) were analysed using a Bland–Altman analysis. To determine the degree of agreement according to manual MRD length, the relationship between the variance of semi-automatic measurements and the manual measurements was evaluated using linear regression.ResultsIntra- and inter-examiner reliability were excellent, with ICCs ranging from 0.913 to 0.980 in 11 shape features including MRD1, MRD2, palpebral fissure, lid perimeter, upper and lower lid lengths, roundness, total area, and medial, central, and lateral areas. The correlations between semi-automatic and manual MRDs were also excellent, with better correlation in MRD1 than in MRD2 (R = 0.893 and 0.823, respectively). In addition, significant positive relationships were observed between the variance and the length of MRD1 and 2; the longer the MRD length, the more the variance.ConclusionThe proposed novel optimized integrative scheme, which is shown to have high repeatability and reproducibility, is useful for topographic analysis of eyelid position.
      PubDate: 2017-04-09T00:35:30.254519-05:
      DOI: 10.1111/aos.13437
  • Choroidal vascular changes in age-related macular degeneration
    • Authors: Lilian Hui Li Koh; Rupesh Agrawal, Neha Khandelwal, Labishetty Sai Charan, Jay Chhablani
      Abstract: PurposeTo assess the choroidal vascular changes using choroidal vascularity index (CVI) in patients with age-related macular degeneration (AMD) compared to controls.MethodsEnhanced depth imaging (EDI) optical coherence tomography (OCT) scans of 64 patients with unilateral or bilateral AMD were obtained. Images with a poorly demarcated choroidal–scleral interface (CSI) were excluded from the analysis. Foveal scans of 63 AMD eyes and 35 ‘normal fellow’ eyes were analysed. Images of 30 eyes from 18 age-matched healthy subjects were included as controls. Choroidal vascularity index (CVI) was derived from binarization of EDI OCT images, using fiji software.ResultsThe mean age was 56.50 ± 5.50 years for AMD patients and 52.25 ± 6.75 years for controls. All patients were treatment naïve. Subfoveal choroidal thickness (SFCT) in AMD, ‘normal fellow’ eyes and controls was 314.02 ± 78.80 μm, 300.88 ± 53.85 μm and 278.5 ± 65.31 μm, respectively. Choroidal vascularity index (CVI) in AMD, ‘normal fellow’ eyes and controls was 64.04 ± 2.43%, 64.66 ± 2.25% and 66.07 ± 1.72%, respectively. Choroidal vascularity index (CVI) of both AMD and ‘normal fellow’ eyes was significantly lower compared to controls (p 
      PubDate: 2017-04-09T00:20:32.712506-05:
      DOI: 10.1111/aos.13399
  • Nitric oxide in the pathophysiology of retinopathy: evidences from
           preclinical and clinical researches
    • Authors: Radka Opatrilova; Peter Kubatka, Martin Caprnda, Dietrich Büsselberg, Vladimir Krasnik, Pavol Vesely, Sandeep Saxena, Surabhi Ruia, Ioana Mozos, Luis Rodrigo, Peter Kruzliak, Katia Goncalves Santos
      Abstract: Retinopathy is the leading cause of blindness and visual disability in working-aged people. The pathogenesis of retinopathy is an actual and still open query. Alterations contributing to oxidative and nitrosative stress, including elevated nitric oxide and superoxide production, changes in the expression of different isoforms of nitric oxide synthase or endogenous antioxidant system, have been implicated in the mechanisms how this ocular disease develops. In addition, it was documented that renin–angiotensin system has been implicated in the progression of retinopathy. Based on comprehensive preclinical and clinical researches in this area, the role of above-mentioned factors in the pathogenesis of diabetic retinopathy, hypertensive retinopathy and ischaemic proliferative retinopathy is reviewed in this study. Moreover, the genetic susceptibility factors involved in the development of the retinopathy and possible strategies that utilize antioxidants as additive therapy are also highlighted here.
      PubDate: 2017-04-08T23:40:31.284243-05:
      DOI: 10.1111/aos.13384
  • Clinical impact of inflammation in dry eye disease: proceedings of the
           ODISSEY group meeting
    • Authors: Christophe Baudouin; Murat Irkeç, Elisabeth M. Messmer, José M. Benítez-del-Castillo, Stefano Bonini, Francisco C. Figueiredo, Gerd Geerling, Marc Labetoulle, Michael Lemp, Maurizio Rolando, Gysbert Van Setten, Pasquale Aragona,
      Abstract: Dry eye disease (DED) is a common, multifactorial ocular condition with major impact on vision and quality of life. It is now well recognized that the pathophysiology of chronic DED can include a cycle of inflammation involving both innate and adaptive immune responses. Recently, in vitro/in vivo models have been used to obtain a better understanding of DED-related inflammatory processes at molecular/cellular levels although they do not truly reproduce the complex and chronic hallmarks of human DED. In clinical DED research, advanced techniques such as impression cytology, conjunctival biopsy, in vivo confocal microscopy and multiplex tear analyses have allowed an improved assessment of inflammation in DED patients. This was supported by the identification of reliable inflammatory markers including matrix metalloproteinase-9, human leucocyte antigen-DR or intercellular adhesion molecule-1 in tears and impression cytology samples. One of the current therapeutic strategies focuses on breaking the inflammatory cycle perpetuating the ocular surface disease, and preclinical/clinical research has led to the development of promising anti-inflammatory compounds. For instance, cyclosporine, already approved in the United States, has recently been authorized in Europe to treat DED associated with severe keratitis. In addition, other agents such as corticosteroids, doxycycline and essential fatty acids, through their anti-inflammatory properties, show encouraging results. We now have a clearer understanding of the inflammatory processes involved in DED, and there is hope that the still emerging preclinical/clinical findings will be translated into new and highly effective therapies for patients in the near future.
      PubDate: 2017-04-08T02:56:19.240983-05:
      DOI: 10.1111/aos.13436
  • Incidence of secondary glaucoma after treatment of uveal melanoma with
           robotic radiosurgery versus brachytherapy
    • Authors: Jakob Siedlecki; Veronika Reiterer, Simon Leicht, Paul Foerster, Karsten Kortüm, Ulrich Schaller, Siegfried Priglinger, Christoph Fuerweger, Alexander Muacevic, Kirsten Eibl-Lindner
      Abstract: PurposeDifferent modalities of radiation therapy nowadays allow for effective treatment of uveal melanoma combined with the advantage of eye preservation. However, this advantage can secondarily be impaired by radiation-related side effects. After local recurrence, secondary glaucoma (SG) has been described as second most frequent complication leading to need of enucleation. This study compares the incidence of SG after conventional Ruthenium (Ru)-106 brachytherapy (BT) versus CyberKnife robotic radiosurgery (RRS) which has been gaining importance lately as an efficient treatment option offering improved patient comfort.MethodsMedical records of all patients diagnosed with uveal melanoma in the Eye Clinic of the Ludwig-Maximilians-University Munich between 2007 and 2013 were reviewed. A total of 268 eyes of 268 patients treated with Ru-106 BT or CyberKnife-RRS as monotherapy were entered in this retrospective cohort study. Incidence of SG was correlated with treatment modality and baseline tumour characteristics.ResultsFifty-three patients (19.8%) developed SG. At 5 years, SG was significantly more frequent after RRS (46.7%) than BT (11.1%); however, tumour thickness (maximum apical height) as a marker of tumour progress was more pronounced in the RRS group. Subgroup analysis of 178 patients for tumours amenable to both BT and RRS (thickness ≤6 mm) revealed comparable results at 3 years (RRS: 13.8 versus BT: 11.2%), but a trend towards increased incidence after RRS beyond year three. However, this difference was not significant at 5 years (28.2% versus 11.2%, p = 0.138). Tumour thickness was significantly associated with incidence of SG.ConclusionIn tumours ≤6 mm thickness, RRS and BT seem to offer a comparable safety profile in terms of SG. Beyond year three, SG was tendentially, but not significantly more frequent after RRS. Increasing tumour thickness is associated with risk of SG.
      PubDate: 2017-04-07T05:13:27.756852-05:
      DOI: 10.1111/aos.13418
  • Cytoarchitecture of epithelial inflammatory infiltration indicates the
           aetiology of infectious keratitis
    • Authors: Adrian Smedowski; Dorota Tarnawska, Michal Orski, Ewa Wroblewska-Czajka, Kai Kaarniranta, Pasquale Aragona, Edward Wylegala
      Abstract: PurposeTo analyse cytological features of corneal epithelium in infectious keratitis.MethodsOne hundred and eighteen patients (53 males and 65 females) diagnosed with acute stage of infectious keratitis (45 viral, 40 bacterial, 23 fungal, 10 Acanthamoeba keratitis) were included in study. We performed retrospective analysis of bright and blue-light slit-lamp photographs and in vivo corneal confocal microscopy scans of the corneal epithelium from five corneal regions (superior, inferior, temporal, nasal and central). Density, morphology of inflammatory cells and their relation to epithelial structures, as well as density of nerve fibres, were evaluated in relation to the keratitis aetiology.ResultsWe characterized five morphological types of inflammatory cells forming infiltration. Cell and nerve fibre densities showed significant differences between groups, and the most intense inflammatory infiltration was associated with fungal then bacterial, viral and Acanthamoeba keratitis. Additionally, differences in aetiology-specific ratio of round/non-round inflammatory cells were observed.ConclusionConfocal microscopy analysis in infectious keratitis of various aetiologies revealed quantitative and qualitative differences in inflammatory cell infiltration expressed in different ratio of round/non-round inflammatory cells. In vivo microscopic analysis of both the corneal epithelial layer cytopathology and the cytology of inflammatory infiltration provides a fast and specific differentiation of keratitis aetiology that may increase the accuracy in the selection of the initial treatment.
      PubDate: 2017-04-03T00:40:31.101654-05:
      DOI: 10.1111/aos.13363
  • Additive effects and safety of fixed combination therapy with 1%
           brinzolamide and 0.5% timolol versus 1% dorzolamide and 0.5% timolol in
           prostaglandin-treated glaucoma patients
    • Authors: Makoto Aihara; Misato Adachi, Hiroshi Matsuo, Tetsuya Togano, Takeo Fukuchi, Noriyuki Sasaki,
      Abstract: PurposeTo compare the additive effects and safety of 1% brinzolamide/0.5% timolol fixed combination (BTFC) versus the low-dose regimen of 1% dorzolamide/0.5% timolol fixed combination (DTFC) in patients with open-angle glaucoma and ocular hypertension (OAG/OH) following treatment with prostaglandin analogues (PGAs).MethodsA prospective, randomized, double-masked, multicentre, parallel-group and active-controlled study included 201 Japanese OAG/OH patients who had been treated with PGA. Efficacy was assessed as the change in intra-ocular pressure (IOP) from baseline after weeks 4 and 8. Safety was assessed with adverse event rates, ocular discomfort score, blur scale, blood pressure and heart rates, best-corrected visual acuity (BCVA) and slit lamp examinations.ResultsIntra-ocular pressure (IOP) change from baseline at 9 AM/11 AM pooled over the 8 weeks was −3.3/−3.3 mmHg in the BTFC group and −2.9/−3.4 mmHg in the DTFC group, demonstrating non-inferiority of BTFC to DTFC. Ocular irritation was frequently seen in DTFC group. Although blurred vision was frequently seen in BTFC group, it was transient and blurring became the equivalent 3 min after instillation between two groups. No noteworthy issue was observed in other safety outcome.ConclusionNon-inferiority of BTFC to DTFC in IOP reduction was demonstrated after adding onto PGA therapy in Japanese OAG/OH patients. Although the score of blurred vision was transiently higher in BTFC than DTFC, treatment difference decreased and disappeared with time. Thus, BTFC can be considered as a safe and effective agent for glaucoma treatment.
      PubDate: 2017-04-03T00:05:24.557264-05:
      DOI: 10.1111/aos.13401
  • Dexamethasone implant with fixed or individualized regimen in the
           treatment of diabetic macular oedema: six-month outcomes of the UDBASA
    • Authors: Valentina Sarao; Daniele Veritti, Claudio Furino, Ermete Giancipoli, Giovanni Alessio, Francesco Boscia, Paolo Lanzetta
      Abstract: PurposeTo evaluate a pro re nata administration of Ozurdex® implant versus a single administration for treating diabetic macular oedema (DME).MethodsThis exploratory study is designed as a comparative, multicentre, randomized study with a follow-up of 6 months. Patients with DME were assigned to treatment at baseline either with a single Ozurdex® implant during the entire six-month follow-up (fixed group) or Ozurdex® implant followed by retreatment on an individualized basis (PRN group). Patients were scheduled for monthly evaluation based on assessment of best-corrected visual acuity (BCVA) and optical coherence tomography.ResultsTwenty eyes were enrolled to the PRN group, and 22 were included in the fixed group. Following an equally steady, initial gain up to month 1, and maintenance up to month 3, vision started to decline in the fixed regimen group. At 6 months, a difference of 0.11 logMAR in BCVA was observed in favour of the PRN group. Compared to baseline, a significant reduction in retinal thickness was achieved up to month 2, when the fixed regimen group had begun to revert to pretreatment level. At 4 and 5 months, the difference in thickness between the two groups was statistically significant (p 
      PubDate: 2017-01-31T04:17:01.372738-05:
      DOI: 10.1111/aos.13395
  • New parameters in assessment of human donor corneal stroma
    • Authors: Marie Borderie; Kate Grieve, Kristina Irsch, Djida Ghoubay, Cristina Georgeon, Celine De Sousa, Laurent Laroche, Vincent M. Borderie
      Abstract: PurposeTo provide quantitative parameters for assessment of human donor corneal stroma by imaging stromal features of diseased and normal human corneas with full-field optical coherence microscopy (FFOCM), using confocal microscopy (CM) and histology as reference techniques.MethodsBowman's layer (BL) thickness and keratocyte density were assessed ex vivo in 23 human donor corneas and 27 human pathological corneas (keratoconus and other corneal disorders) with FFOCM, CM and histology. Stromal backscattering was assessed with FFOCM. Additionally, 10 normal human corneas were assessed in vivo with CM.ResultsIn FFOCM, the logarithm of the normalized stromal reflectivity was a linear function of stromal depth (R2 = 0.95) in human donor corneas. Compared with keratoconus corneas, human donor corneas featured higher BL thickness (p = 0.0014) with lower coefficient of variation (BL-COV; p = 0.0002), and linear logarithmic stromal reflectivity with depth (higher R2, p = 0.0001). Compared with other corneal disorders, human donor corneas featured lower BL-COV (p = 0.012) and higher R2 (p = 0.0001). Using the 95% confidence limits of the human donor cornea group, BL thickness  18.6% (79%; 100%) and R2 
      PubDate: 2017-01-30T00:35:58.019376-05:
      DOI: 10.1111/aos.13351
  • Higher vitreous concentrations of dabigatran after repeated oral
    • Authors: Verena C. Mulder; Cornelis Kluft, Peter G. Etten, Ellen C. La Heij, Jan C. Meurs
      PubDate: 2017-01-27T05:30:29.780868-05:
      DOI: 10.1111/aos.13348
  • Differentiation between optic disc drusen and optic disc oedema using
           fundus photography
    • Authors: Kyoung Min Lee; Se Joon Woo, Jeong-Min Hwang
      Abstract: PurposeTo describe a funduscopic sign that can be used to differentiate between optic disc drusen (ODD) and optic disc oedema (ODE).MethodsA total of 73 eyes from 73 consecutive subjects with disc margin blurring who had been evaluated using spectral-domain optical coherence tomography (SD-OCT) were included. Final diagnosis was made by SD-OCT; ODD was defined by direct visualization of ODD, while ODE was defined by documentation of retinal nerve fibre layer oedema (nasal retinal nerve fibre layer thickness>78.0 μm). Peripapillary retina was selected as a two-disc-diameter-sized square image from the fundus photograph. Using MATLAB software, colour photographs were converted to indexed image of eight colours. Presence of a smooth contour strip between the nasal disc margin and juxtapapillary retina was defined as a halo. Whether the halo could predict the ODD was analysed retrospectively.ResultsThe halo sign was detected in 45 eyes (100%) with ODD including one eye with both ODD and ODE. No eyes with ODE alone showed the halo sign. The halo sign implied the presence of ODD (Cohen's kappa = 1.000, p 
      PubDate: 2017-01-13T02:51:29.972981-05:
      DOI: 10.1111/aos.13338
  • Issue Information
    • Pages: 327 - 330
      PubDate: 2017-06-12T01:28:51.64859-05:0
      DOI: 10.1111/aos.13263
  • This issue of ACTA
    • Authors: Einar Stefánsson
      Pages: 333 - 334
      PubDate: 2017-06-12T01:28:55.77748-05:0
      DOI: 10.1111/aos.13496
  • Erratum
    • Pages: 334 - 334
      PubDate: 2017-06-12T01:28:52.244213-05:
      DOI: 10.1111/aos.13499
  • The Nobel Prized cellular target autophagy in eye diseases
    • Authors: Kai Kaarniranta; Goran Petrovski, Anu Kauppinen
      Pages: 335 - 336
      PubDate: 2017-06-12T01:28:58.340995-05:
      DOI: 10.1111/aos.13344
  • Multifocal visual evoked potentials for quantifying optic nerve
           dysfunction in patients with optic disc drusen
    • Authors: Lasse Malmqvist; Luis Santiago, Luciano Boquete, Steffen Hamann
      Pages: 357 - 362
      Abstract: PurposeTo explore the applicability of multifocal visual evoked potentials (mfVEPs) for research and clinical diagnosis in patients with optic disc drusen (ODD). This is the first assessment of mfVEP amplitude in patients with ODD.MethodsMfVEP amplitude and latency from 33 patients with ODD and 22 control subjects were examined. Mean amplitude, mean inner ring (IR) amplitude (0.87–5.67° of visual field) and mean outer ring amplitude (5.68–24° of visual field) were calculated using signal-to-noise ratio (SNR) and peak-to-peak analysis. Monocular latency was calculated using second peak analysis, while latency asymmetry was calculated using cross-correlation analysis.ResultsCompared to normals, significantly decreased mean overall amplitude (p 
      PubDate: 2017-01-31T05:35:38.06854-05:0
      DOI: 10.1111/aos.13347
  • The physical properties of generic latanoprost ophthalmic solutions are
           not identical
    • Authors: Miriam Kolko; Peter Koch Jensen
      Pages: 370 - 373
      Abstract: PurposeTo compare various characteristics of Xalatan® and five generic latanoprost ophthalmic solutions.MethodsDrop size, volume, pH values, buffer capacity, viscosity, hardness of bottles and costs were determined. Drop sizes were measured in triplicates by micropipettes, and the number of drops counted in three separate bottles of each generic product was determined. pH values were measured in triplicates by a calibrated pH meter. Buffer capacity was exploited by titrating known quantities of strong base into 2.5 ml of each brand and interpolated to neutral pH. Kinematic viscosity was determined by linear regression of timed gravity flow from a vertical syringe through a 21-G cannula. The hardness of the bottles was evaluated by gradually increasing tension on a hook placed around each bottle until a drop was expelled reading the tension on an attached spring scale.ResultsDrop sizes and the number of drops in the bottles varied significantly between the generic drugs. The control value of pH in the brand version (Xalatan®) was markedly lower compared to the generic latanoprost products. Titration of Xalatan® to neutrality required substantially more NaOH compared to the generic latanoprost products. Finally, the viscosity revealed a significant variability between brands. Remarkable differences were found in bottle shapes, bottle hardness and costs of the latanoprost generics.ConclusionGeneric latanoprost eye drops should not be considered identical to the original brand version as regards to drop size, volumes, pH values, buffer capacity, viscosity, hardness of bottles and costs. It is likely that these issues affect compliance and intraocular pressure (IOP)-lowering effect. Therefore, re-evaluation of the requirements for introducing generic eye drops seems reasonable.
      PubDate: 2017-02-22T22:05:23.11151-05:0
      DOI: 10.1111/aos.13355
  • Effect of selective laser trabeculoplasty on ocular haemodynamics in
           primary open-angle glaucoma
    • Authors: Karin R. Pillunat; Eberhard Spoerl, Naim Terai, Lutz E. Pillunat
      Pages: 374 - 377
      Abstract: PurposeSelective laser trabeculoplasty (SLT) is known to reduce intraocular pressure (IOP) effectively. The aim of this study, however, was to evaluate the effect of SLT on ocular haemodynamics.MethodsA total of 69 eyes of 69 patients (age 67.8 ± 9.9 years) with already treated primary open-angle glaucoma who were assigned for SLT for further IOP reduction were consecutively enrolled in this prospective interventional case series. Intraocular pressure, the ocular pulse amplitude (OPA), ocular pulse volume (OPV) and pulsatile ocular blood flow (pOBF) were assessed with the Ocular Blood Flow Analyzer prior to and 3 months after SLT.ResultsIntraocular pressure was statistically significantly reduced from 16.0 ± 5.4 mmHg to 12.8 ± 4.0 mmHg (p = 0.001). The OPA did not change (p = 0.783) after IOP reduction following SLT. OPV and pOBF increased statistically significantly. OPV increased from 7.33 ± 3.05 to 8.59 ± 3.35 μl (17.2%; p = 0.001) and pOBF from 17.11 ± 5.42 to 19.74 ± 6.59 μl/s (15.4%; p = 0.002).ConclusionSelective laser trabeculoplasty probably does not induce any pharmacological changes effecting systemic blood pressure or ocular blood flow as topical IOP-lowering medication might do, nor does it change biomechanical properties of the eye as surgery could. Therefore, an increase in ocular blood flow following SLT can only be explained by the reduction in IOP and might be a sign of dysfunctional autoregulation in glaucoma patients.
      PubDate: 2017-01-31T00:30:39.796542-05:
      DOI: 10.1111/aos.13360
  • Oxidized low-density lipoprotein, lipid and calcium aggregates reveal
    • Authors: Minna Helin-Toiviainen; Seppo Rönkkö, Kai Kaarniranta, Tuomo Puustjärvi, Petri Rekonen, Minna Ollikainen, Hannu Uusitalo
      Pages: 378 - 385
      Abstract: PurposeConjunctival specimens from primary open-angle glaucoma (POAG), exfoliation glaucoma (ExG) patients and controls were histologically analysed for oxidized low-density lipoprotein (ox-LDL), lipid and calcium aggregates. Our goal was to use them as biomarkers of oxidative stress and inflammation and to evaluate their correlation with glaucoma and impact on surgical outcome.MethodsConjunctival samples were obtained from POAG (n = 14) and ExG (n = 17) patients and from control subjects (n = 11) operated for macular hole, retinal detachment or strabismus. Immunohistochemistry was performed using the antibody against ox-LDL. Lipids and calcium were analysed by histochemical stainings with Nile red and Alizarin red S, respectively.ResultsImmunoreaction for ox-LDL was significantly increased in POAG (p = 0.049) and the number of lipid aggregates was significantly higher in ExG (p = 0.009) when compared to control. When POAG and ExG patients were grouped according to the outcome of deep sclerectomy (DS) surgery, the number of lipid (p 
      PubDate: 2017-01-31T04:57:09.305423-05:
      DOI: 10.1111/aos.13380
  • Objective and subjective outcomes of strabismus surgery in Graves'
           orbitopathy: a prospective multicentre study
    • Authors: Hinke Marijke Jellema; Peerooz Saeed, Ilse Mombaerts, Peter J. Dolman, Jim Garrity, Mike Kazim, Elona Dhrami-Gavazi, Christopher Lyons, Pythia Nieuwkerk, Maarten P. Mourits
      Pages: 386 - 391
      Abstract: PurposeTo assess the change and interrelationship of the field of binocular single vision (BSV) and the quality of life (QoL), tested with two different tools, after one or two strabismus surgeries in patients with Graves' orbitopathy (GO).MethodsProspectively, consecutive patients with GO who were scheduled for their first strabismus surgery were recruited from five centres specialized in the treatment of GO. One week preoperatively and 3 months after the last operation, a full ophthalmic and orthoptic examination was performed. Change in field of BSV, GO-QoL and thyroid eye disease-QoL (TED-QoL) was recorded.ResultsA total of 59 met all the eligibility criteria of whom 15 underwent two strabismus operations. The median (interquartile range) preoperative score of the field of BSV was 0 (0–0), which improved to 73 (53–85) after the correction(s) (p 
      PubDate: 2017-01-30T03:17:38.926788-05:
      DOI: 10.1111/aos.13367
  • Identification and clinical role of choroidal neovascularization
           characteristics based on optical coherence tomography angiography
    • Authors: Florian Sulzbacher; Andreas Pollreisz, Alexandra Kaider, Stefan Kickinger, Stefan Sacu, Ursula Schmidt-Erfurth,
      Pages: 414 - 420
      Abstract: PurposeTo suggest a novel classification of neovascular age-related macular degeneration (AMD) based on optical coherence tomography angiography (OCTA) and to correlate morphological characteristics based on optical coherence tomography (OCT)/OCTA with clinical criteria of disease activity.MethodsA total of 88 eyes with neovascular AMD (14 treatment-naïve, 74 eyes following anti-vascular endothelial growth factor treatment (VEGF)) were examined using the AngioVue OCTA system (Optovue, Inc., Fremont, CA, USA) and evaluated based on vascular morphology. Choroidal neovascularization (CNV)-vessel morphology based on OCTA and associations with retinal layers were described and correlated with clinical markers of disease activity.ResultsIn treatment-naïve CNV, CNV-vessel morphology based on OCTA showed a dense-net configuration (DN) in 12 of 14 eyes, a loose-net configuration (LN) in one of 14 eyes and an unidentifiable CNV pattern in one of 14 eyes, whereas in treated CNV, DN was registered in 43.2% (32/74), LN in 27% (20/74), DN with additional LN (mixed type) in 14.9% (11/74) and an unidentifiable CNV pattern in 14.9% (11/74). Clinical correlations revealed a significantly longer disease duration for LN with a median value of 4.3 years compared to DN with 2.0 years (p = 0.009) and for CNV involving the outer retina with 3.1 years compared to CNV not involving the outer retina with 1.9 years (p = 0.051).ConclusionOptical coherence tomography angiography (OCTA) allows identification of distinct CNV-specific vascular patterns at the level of the outer retinal layer and choriocapillaris. Correlation with clinical and functional parameters may be useful to better understand pathophysiological mechanisms and guide efficient therapeutic strategies.
      PubDate: 2017-01-30T01:10:54.074053-05:
      DOI: 10.1111/aos.13364
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