The Dynamic Sclera: Extracellular Matrix Remodeling in Normal Ocular Growth and Myopia Development

PubMed Central

Harper, Angelica R.; Summers, Jody A.

2014-01-01

Myopia is a common ocular condition, characterized by excessive elongation of the ocular globe. The prevalence of myopia continues to increase, particularly among highly educated groups, now exceeding 80% in some groups. In parallel with the increased prevalence of myopia, are increases in associated blinding ocular conditions including glaucoma, retinal detachment and macular degeneration, making myopia a significant global health concern. The elongation of the eye is closely related to the biomechanical properties of the sclera, which in turn are largely dependent on the composition of the scleral extracellular matrix. Therefore an understanding of the cellular and extracellular events involved in the regulation of scleral growth and remodeling during childhood and young adulthood will provide future avenues for the treatment of myopia and its associated ocular complications. PMID:25819458

Test systems for measuring ocular parameters and visual function in mice.

PubMed

Schaeffel, Frank

2008-05-01

New techniques are described to measure refractive state, pupil responses, corneal curvature, ocular dimensions and spatial vision in mice. These variables are important for studies on myopia development in mice, but they are also valuable for phenotyping mouse mutants and for pharmacological studies.

Eye-Hand Synergy and Intermittent Behaviors during Target-Directed Tracking with Visual and Non-visual Information

PubMed Central

Huang, Chien-Ting; Hwang, Ing-Shiou

2012-01-01

Visual feedback and non-visual information play different roles in tracking of an external target. This study explored the respective roles of the visual and non-visual information in eleven healthy volunteers who coupled the manual cursor to a rhythmically moving target of 0.5 Hz under three sensorimotor conditions: eye-alone tracking (EA), eye-hand tracking with visual feedback of manual outputs (EH tracking), and the same tracking without such feedback (EHM tracking). Tracking error, kinematic variables, and movement intermittency (saccade and speed pulse) were contrasted among tracking conditions. The results showed that EHM tracking exhibited larger pursuit gain, less tracking error, and less movement intermittency for the ocular plant than EA tracking. With the vision of manual cursor, EH tracking achieved superior tracking congruency of the ocular and manual effectors with smaller movement intermittency than EHM tracking, except that the rate precision of manual action was similar for both types of tracking. The present study demonstrated that visibility of manual consequences altered mutual relationships between movement intermittency and tracking error. The speed pulse metrics of manual output were linked to ocular tracking error, and saccade events were time-locked to the positional error of manual tracking during EH tracking. In conclusion, peripheral non-visual information is critical to smooth pursuit characteristics and rate control of rhythmic manual tracking. Visual information adds to eye-hand synchrony, underlying improved amplitude control and elaborate error interpretation during oculo-manual tracking. PMID:23236498

Duane retraction syndrome: causes, effects and management strategies

PubMed Central

Kekunnaya, Ramesh; Negalur, Mithila

2017-01-01

Duane retraction syndrome (DRS) is a congenital eye movement anomaly characterized by variable horizontal duction deficits, with narrowing of the palpebral fissure and globe retraction on attempted adduction, occasionally accompanied by upshoot or down-shoot. The etiopathogenesis of this condition can be explained by a spectrum of mechanical, innervational, neurologic and genetic abnormalities occurring independently or which influence each other giving rise to patterns of clinical presentations along with a complex set of ocular and systemic anomalies. Huber type I DRS is the most common form of DRS with an earlier presentation, while Huber type II is the least common presentation. Usually, patients with unilateral type I Duane syndrome have esotropia more frequently than exotropia, those with type II have exotropia and those with type III have esotropia and exotropia occurring equally common. Cases of bilateral DRS may have variable presentation depending upon the type of presentation in each eye. As regards its management, DRS classification based on primary position deviation as esotropic, exotropic or orthotropic is more relevant than Huber’s classification before planning surgery. Surgical approach to these patients is challenging and must be individualized based on the amount of ocular deviation, abnormal head position, associated globe retraction and overshoots. PMID:29133973

A mass and solute balance model for tear volume and osmolarity in the normal and the dry eye.

PubMed

Gaffney, E A; Tiffany, J M; Yokoi, N; Bron, A J

2010-01-01

Tear hyperosmolarity is thought to play a key role in the mechanism of dry eye, a common symptomatic condition accompanied by visual disturbance, tear film instability, inflammation and damage to the ocular surface. We have constructed a model for the mass and solute balance of the tears, with parameter estimation based on extensive data from the literature which permits the influence of tear evaporation, lacrimal flux and blink rate on tear osmolarity to be explored. In particular the nature of compensatory events has been estimated in aqueous-deficient (ADDE) and evaporative (EDE) dry eye. The model reproduces observed osmolarities of the tear meniscus for the healthy eye and predicts a higher concentration in the tear film than meniscus in normal and dry eye states. The differential is small in the normal eye, but is significantly increased in dry eye, especially for the simultaneous presence of high meniscus concentration and low meniscus radius. This may influence the interpretation of osmolarity values obtained from meniscus samples since they need not fully reflect potential damage to the ocular surface caused by tear film hyperosmolarity. Interrogation of the model suggests that increases in blink rate may play a limited role in compensating for a rise in tear osmolarity in ADDE but that an increase in lacrimal flux, together with an increase in blink rate, may delay the development of hyperosmolarity in EDE. Nonetheless, it is predicted that tear osmolarity may rise to much higher levels in EDE than ADDE before the onset of tear film breakup, in the absence of events at the ocular surface which would independently compromise tear film stability. Differences in the predicted responses of the pre-ocular tears in ADDE compared to EDE or hybrid disease to defined conditions suggest that no single, empirically-accessible variable can act as a surrogate for tear film concentration and the potential for ocular surface damage. This emphasises the need to measure and integrate multiple diagnostic indicators to determine outcomes and prognosis. Modelling predictions in addition show that further studies concerning the possibility of a high lacrimal flux phenotype in EDE are likely to be profitable.

Ocular hemodynamic effects of nitrovasodilators in healthy subjects.

PubMed

Schmidl, D; Polska, E; Kiss, B; Sacu, S; Garhofer, G; Schmetterer, L

2010-01-01

Nitric oxide (NO) plays a key role in the regulation of ocular blood flow and may be an interesting therapeutic target in ocular ischemic disease. In the present study, we hypothesized that NO-releasing drugs may increase blood flow to the head of the optic nerve and also in the choroid. The study employed a randomized, placebo-controlled, double blind, four-way crossover design. On separate study days, 12 healthy subjects received infusions of nitroglycerin, isosorbide dinitrate, sodium nitroprusside, or placebo. All three study drugs reduced the mean arterial pressure (MAP) and ocular perfusion pressure (OPP) (P < 0.001). None of the administered drugs increased the ocular hemodynamic variables. By contrast, vascular resistance decreased dose dependently during administration of the study drugs (P < 0.001). These results indicate that systemic administration of NO-donor drugs is associated with a decrease in vascular resistance in the ocular vasculature. However, because these drugs also reduce blood pressure, they do not improve perfusion to the posterior eye pole.

The natural history of Stevens–Johnson syndrome: patterns of chronic ocular disease and the role of systemic immunosuppressive therapy

PubMed Central

De Rojas, M Victoria; Dart, John K G; Saw, Valerie P J

2007-01-01

Objective To characterize patterns of chronic ocular disease in patients with Stevens–Johnson syndrome (SJS) and its variant toxic epidermal necrolysis (TEN), and to describe their response to treatment. Methods Retrospective case series. A review of hospital records of 30 patients (60 eyes) with ocular manifestations of SJS or TEN was carried out. The principal outcome measure was to identify and classify the patterns of chronic ocular disease in SJS and TEN. The secondary outcome measure was the response to treatment. Results Patterns of chronic ocular disease observed after the acute episode included: mild/moderate SJS, severe SJS, ocular surface failure (SJS‐OSF), recurrent episodic inflammation (SJS‐RI), scleritis (SJS‐S) and progressive conjunctival cicatrisation resembling mucous membrane pemphigoid (SJS‐MMP). The median follow‐up was 5 years (range 0–29). 19 patients (29 eyes (48%)) developed SJS‐OSF, SJS‐RI, SJS‐S or SJS‐MMP during follow‐up. SJS‐OSF was present in 12 patients (18 eyes (30%)). In 5 patients (eight eyes) this developed 1 year after the acute illness, without any further inflammatory episodes; it was associated with SJS‐RI in 1 patient (2 eyes), with SJS‐RI and SJS‐S in 1 patient (1 eye), with SJS‐S in 1 patient (1 eye) and with SJS‐MMP in 4 patients (6 eyes). Episodes of SJS‐RI occurred in 4 patients (7 eyes (12%)). The median time from acute disease to the first episode of SJS‐RI was 8.5 years (range 5–63). SJS‐S developed in 2 patients (4 eyes (7%)), of which 2 eyes subsequently developed SJS‐OSF. SJS‐MMP developed in 5 patients (10 eyes (16.6%)). The median duration from the acute stage to the diagnosis of SJS‐MMP was 2 years (range 1–14). Immunosuppressive therapy successfully controlled inflammation in 10/10 patients with SJS‐MMP, SJS‐RI or SJS‐S. Conclusion Ocular disease in SJS/TEN is not limited solely to the sequelae of the acute phase illness. Patients and physicians need to know that ocular disease progression, due to surface failure and/or acute inflammatory conditions, may occur at variable periods following the acute disease episode. Recognition of this, and prompt access to specialist services, may optimise management of these uncommon patterns of disease in SJS. PMID:17314145

Infection and Replication of Influenza Virus at the Ocular Surface.

PubMed

Creager, Hannah M; Kumar, Amrita; Zeng, Hui; Maines, Taronna R; Tumpey, Terrence M; Belser, Jessica A

2018-04-01

Although influenza viruses typically cause respiratory tract disease, some viruses, particularly those with an H7 hemagglutinin, have been isolated from the eyes of conjunctivitis cases. Previous work has shown that isolates of multiple subtypes from both ocular and respiratory infections are capable of replication in human ex vivo ocular tissues and corneal or conjunctival cell monolayers, leaving the determinants of ocular tropism unclear. Here, we evaluated the effect of several variables on tropism for ocular cells cultured in vitro and examined the potential effect of the tear film on viral infectivity. All viruses tested were able to replicate in primary human corneal epithelial cell monolayers subjected to aerosol inoculation. The temperature at which cells were cultured postinoculation minimally affected infectivity. Replication efficiency, in contrast, was reduced at 33°C relative to that at 37°C, and this effect was slightly greater for the conjunctivitis isolates than for the respiratory ones. With the exception of a seasonal H3N2 virus, the subset of viruses studied in multilayer corneal tissue constructs also replicated productively after either aerosol or liquid inoculation. Human tears significantly inhibited the hemagglutination of both ocular and nonocular isolates, but the effect on viral infectivity was more variable, with tears reducing the infectivity of nonocular isolates more than ocular isolates. These data suggest that most influenza viruses may be capable of establishing infection if they reach the surface of ocular cells but that this is more likely for ocular-tropic viruses, as they are better able to maintain their infectivity during passage through the tear film. IMPORTANCE The potential spread of zoonotic influenza viruses to humans represents an important threat to public health. Unfortunately, despite the importance of cellular and tissue tropism to pathogenesis, determinants of influenza virus tropism have yet to be fully elucidated. Here, we sought to identify factors that limit the ability of most influenza viruses to cause ocular infection. Although ocular symptoms in humans caused by avian influenza viruses tend to be relatively mild, these infections are concerning due to the potential of the ocular surface to serve as a portal of entry for viruses that go on to establish respiratory infections. Furthermore, a better understanding of the factors that influence infection and replication in this noncanonical site may point toward novel determinants of tropism in the respiratory tract. This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply.

Genotype-phenotype variability of retinal manifestation in primary hyperoxaluria type 1.

PubMed

Dulz, S; Bigdon, E; Atiskova, Y; Schuettauf, F; Cerkauskiene, R; Oh, J; Brinkert, F

2018-04-01

Primary hyperoxaluria type 1 (PH1) is a rare congenital metabolic disorder of the glyoxylate pathway, which manifests with nephrocalcinosis, urolithiasis, and end-stage renal failure (ESRD) as well as deposition of oxalate crystals within ocular tissues. This report demonstrates classical ocular features of PH1 of the posterior pole and furthermore highlights the ocular genotype-phenotype variability among siblings with identical compound heterozygous alanine-glyoxylate aminotransferase (AGXT) mutations. Two siblings, an 8-year-old boy and an 18-year-old girl, with genetically confirmed AGXT mutation (c.364C>T (p.R122X) and c.33dupC), but different renal phenotype underwent an ophthalmic examination, including slit-lamp examination and funduscopy as well as optical coherence tomography (OCT), near-infrared autofluorescence (NIA), and microperimetry examination. The 8-year-old boy presented with a best-corrected visual acuity (BCVA) of 20/630. Fundus examination revealed bilateral, whitish oxalate deposits and prominent fibrotic macular scars. OCT imaging illustrated hyperdense deposits in all retinal layers and the choroid and the vitreous body along with a prominent dome-shaped macular fibrosis. NIA imaging outlined macular retinal pigment epithelium (RPE) atrophy with panretinal hyperreflective material. Bilateral symptomatic epiphora was putatively due to bilateral depositions of palpable nodular oxalate deposits at the level of the lacrimal sac. In contrary, the 18-year-old sister presented without any signs of ocular oxalate deposition and a BCVA of 20/20. PH1 is potentially accompanied with a considerable decline in visual acuity due to macular scaring and fibrosis, whereas a profound variability of ocular manifestations can be observed in PH1 patients with identical genotypes.

Ocular dimensions in relation to auxological data in a sample of Swedish children aged 4-15 years.

PubMed

Raffa, Lina H; Hellström, Ann; Aring, Eva; Andersson, Susann; Grönlund, Marita Andersson

2014-11-01

The purpose was to characterize normal growth patterns of ocular and optical components and to relate them to auxological data in a sample of Swedish children aged 4-15 years. A prospective cross-sectional study was carried out in 143 Swedish children with a mean age of 9.8 years. Variables including gestational age (GA), weight, length and head circumference (HCF) at birth and at the time of assessment were registered. Visual acuity (VA), cycloplegic refraction and biometric measures were obtained. Palpebral fissure length and inner canthal distance were measured. Optic disc morphology as seen on fundus photographs was analysed. Children born more mature, with male predilection, were found to have deeper anterior and vitreous chamber depths, longer axial lengths and thinner crystalline lens thickness. No correlations were found between ocular biometric measurements and VA or refraction after adjustment for confounding variables. Inner canthal distance was significantly correlated with birth length (p = 0.03), height, weight, BMI and HCF (p = 0.0008, p = 0.0007, p = 0.037, and p = 0.04, respectively) at time of assessment. Total axial length was found to be significantly correlated with GA (p = 0.0226) and length at assessment in girls (p = 0.0084). Right optic disc and rim areas decreased with increasing age (p = 0.0078 and p = 0.0107, respectively); however, optic disc parameters were not dependent on any other variable. These normative values may serve as a basis for the ocular findings and their relationship to auxological data in Caucasian children aged 4-15 years, as well as for future comparison in patients with paediatric ocular pathologies. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Heritability of refractive error and ocular biometrics: the Genes in Myopia (GEM) twin study.

PubMed

Dirani, Mohamed; Chamberlain, Matthew; Shekar, Sri N; Islam, Amirul F M; Garoufalis, Pam; Chen, Christine Y; Guymer, Robyn H; Baird, Paul N

2006-11-01

A classic twin study was undertaken to assess the contribution of genes and environment to the development of refractive errors and ocular biometrics in a twin population. A total of 1224 twins (345 monozygotic [MZ] and 267 dizygotic [DZ] twin pairs) aged between 18 and 88 years were examined. All twins completed a questionnaire consisting of a medical history, education, and zygosity. Objective refraction was measured in all twins, and biometric measurements were obtained using partial coherence interferometry. Intrapair correlations for spherical equivalent and ocular biometrics were significantly higher in the MZ than in the DZ twin pairs (P < 0.05), when refraction was considered as a continuous variable. A significant gender difference in the variation of spherical equivalent and ocular biometrics was found (P < 0.05). A genetic model specifying an additive, dominant, and unique environmental factor that was sex limited was the best fit for all measured variables. Heritability of spherical equivalents of 88% and 75% were found in the men and women, respectively, whereas, that of axial length was 94% and 92%, respectively. Additive genetic effects accounted for a greater proportion of the variance in spherical equivalent, whereas the variance in ocular biometrics, particularly axial length was explained mostly by dominant genetic effects. Genetic factors, both additive and dominant, play a significant role in refractive error (myopia and hypermetropia) as well as in ocular biometrics, particularly axial length. The sex limitation ADE model (additive genetic, nonadditive genetic, and environmental components) provided the best-fit genetic model for all parameters.

Determinants of ocular deviation in esotropic subjects under general anesthesia.

PubMed

Daien, Vincent; Turpin, Chloé; Lignereux, François; Belghobsi, Riadh; Le Meur, Guylene; Lebranchu, Pierre; Pechereau, Alain

2013-01-01

The authors attempted to identify the determinants of ocular deviation in a population of patients with esotropia under general anesthesia. Forty-one patients with esotropia were included. Horizontal ocular deviation was evaluated by the photographic Hirschberg test both in the awakened state and under general anesthesia before surgery. Changes in ocular deviation were measured and a multivariate analysis was used to assess its clinical determinants. The mean age (± standard deviation [SD]) of study subjects was 13 ± 11 years and 51% were females. The mean spherical equivalent refraction of the right eye was 2.44 ± 2.50 diopters (D), with no significant difference between eyes (P = .26). The mean ocular deviation changed significantly, from 33.5 ± 12.5 prism diopters (PD) at preoperative examination to 8.8 ± 11.4 PD under general anesthesia (P = .0001). The changes in ocular deviation positively correlated with the pre-operative ocular deviation (correlation coefficient r = 0.59, P = .0001) and negatively correlated with patient age (correlation coefficient r = -0.53, P = .0001). These two determinants remained significant after multivariate adjustment of the following variables: preoperative ocular deviation; age; gender; spherical equivalent refraction; and number of previous strabismus surgeries (model r(2) = 0.49, P = .0001). The ocular position under general anesthesia was reported as a key factor in the surgical treatment of subjects with esotropia; therefore, its clinical determinants were assessed. The authors observed that preoperative ocular deviation and patient age were the main factors that influenced the ocular position under general anesthesia. Copyright 2013, SLACK Incorporated.

An Ocular Protein Triad Can Classify Four Complex Retinal Diseases

NASA Astrophysics Data System (ADS)

Kuiper, J. J. W.; Beretta, L.; Nierkens, S.; van Leeuwen, R.; Ten Dam-van Loon, N. H.; Ossewaarde-van Norel, J.; Bartels, M. C.; de Groot-Mijnes, J. D. F.; Schellekens, P.; de Boer, J. H.; Radstake, T. R. D. J.

2017-01-01

Retinal diseases generally are vision-threatening conditions that warrant appropriate clinical decision-making which currently solely dependents upon extensive clinical screening by specialized ophthalmologists. In the era where molecular assessment has improved dramatically, we aimed at the identification of biomarkers in 175 ocular fluids to classify four archetypical ocular conditions affecting the retina (age-related macular degeneration, idiopathic non-infectious uveitis, primary vitreoretinal lymphoma, and rhegmatogenous retinal detachment) with one single test. Unsupervised clustering of ocular proteins revealed a classification strikingly similar to the clinical phenotypes of each disease group studied. We developed and independently validated a parsimonious model based merely on three proteins; interleukin (IL)-10, IL-21, and angiotensin converting enzyme (ACE) that could correctly classify patients with an overall accuracy, sensitivity and specificity of respectively, 86.7%, 79.4% and 92.5%. Here, we provide proof-of-concept for molecular profiling as a diagnostic aid for ophthalmologists in the care for patients with retinal conditions.

Ocular health assessment of cocoa farmers in a rural community in Ghana.

PubMed

Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Kumi-Kyereme, Akwasi; Mashige, Khathutshelo Percy; Awusabo-Asare, Kofi; Ocansey, Stephen; Kyei, Samuel

2014-01-01

Cocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.

Dorzolamide and Timolol Ophthalmic

MedlinePlus

... timolol is used to treat eye conditions, including glaucoma and ocular hypertension, in which increased pressure can ... by your doctor.Dorzolamide and timolol combination controls glaucoma and ocular hypertension but does not cure them. ...

Ocular disease and driving.

PubMed

Wood, Joanne M; Black, Alex A

2016-09-01

As the driving population ages, the number of drivers with visual impairment resulting from ocular disease will increase given the age-related prevalence of ocular disease. The increase in visual impairment in the driving population has a number of implications for driving outcomes. This review summarises current research regarding the impact of common ocular diseases on driving ability and safety, with particular focus on cataract, glaucoma, age-related macular degeneration, hemianopia and diabetic retinopathy. The evidence considered includes self-reported driving outcomes, driving performance (on-road and simulator-based) and various motor vehicle crash indices. Collectively, this review demonstrates that driving ability and safety are negatively affected by ocular disease; however, further research is needed in this area. Older drivers with ocular disease need to be aware of the negative consequences of their ocular condition and in the case where treatment options are available, encouraged to seek these earlier for optimum driving safety and quality of life benefits. © 2016 Optometry Australia.

Lenalidomide, an anti-tumor drug, regulates retinal endothelial cell function: Implication for treating ocular neovascular disorder

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dong, Ling-Feng; Yao, Jin; Wang, Xiao-Qun

Ocular angiogenesis is an important pathologic character of several ocular diseases, such as retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration (AMD). Inhibition of ocular angiogenesis has great therapeutic value for treating these dieses. Here we show that lenalidomide, an anti-tumor drug, has great anti-angiogenic potential in ocular diseases. Lenalidomide inhibits retinal endothelial cell viability in normal and pathological condition, and inhibits VEGF-induced endothelial cell migration and tube formation in vitro. Moreover, lenalidomide inhibits ocular angiogenesis in vivo through the reduction of angiogenesis- and inflammation-related protein expression. Collectively, lenalidomide is a promising drug for treating ocular angiogenesis through its anti-proliferative andmore » anti-inflammatory property. - Highlights: • Lenalidomide inhibits retinal endothelial cell viability in vitro. • Lenalidomide inhibits retinal endothelial cell migration and tube formation. • Lenalidomide inhibits pathological ocular angiogenesis in vivo. • Lenalidomide inhibits angiogenesis- and inflammation-related protein expression.« less

Three-dimensional vestibular eye and head reflexes of the chameleon: characteristics of gain and phase and effects of eye position on orientation of ocular rotation axes during stimulation in yaw direction.

PubMed

Haker, H; Misslisch, H; Ott, M; Frens, M A; Henn, V; Hess, K; Sándor, P S

2003-07-01

We investigated gaze-stabilizing reflexes in the chameleon using the three-dimensional search-coil technique. Animals were rotated sinusoidally around an earth-vertical axis under head-fixed and head-free conditions, in the dark and in the light. Gain, phase and the influence of eye position on vestibulo-ocular reflex rotation axes were studied. During head-restrained stimulation in the dark, vestibulo-ocular reflex gaze gains were low (0.1-0.3) and phase lead decreased with increasing frequencies (from 100 degrees at 0.04 Hz to < 30 degrees at 1 Hz). Gaze gains were larger during stimulation in the light (0.1-0.8) with a smaller phase lead (< 30 degrees) and were close to unity during the head-free conditions (around 0.6 in the dark, around 0.8 in the light) with small phase leads. These results confirm earlier findings that chameleons have a low vestibulo-ocular reflex gain during head-fixed conditions and stimulation in the dark and higher gains during head-free stimulation in the light. Vestibulo-ocular reflex eye rotation axes were roughly aligned with the head's rotation axis and did not systematically tilt when the animals were looking eccentrically, up- or downward (as predicted by Listing's Law). Therefore, vestibulo-ocular reflex responses in the chameleon follow a strategy, which optimally stabilizes the entire retinal images, a result previously found in non-human primates.

Accuracy of a technology-assisted eye exam in evaluation of referable diabetic retinopathy and concomitant ocular diseases.

PubMed

Conlin, Paul R; Asefzadeh, Baharak; Pasquale, Louis R; Selvin, Gerald; Lamkin, Rebecca; Cavallerano, Anthony A

2015-12-01

Digital retinal imaging using store-and-forward technology is used to screen for diabetic retinopathy (DR). Its usefulness in detecting non-diabetic eye diseases is uncertain. We determined the level of agreement between teleretinal imaging supplemented with visual acuity and intraocular pressure (IOP) measurements (ie, technology-assisted eye (TAE) exam) and a comprehensive eye exam in evaluation for DR and non-diabetic ocular conditions. We conducted a prospective, observational study with two parallel evaluations. Patients with diabetes (n=317) had a TAE exam and a comprehensive eye exam on the same day. A subset of participants with normal baseline exams (n=72) had follow-up exams 1 year later. We measured the level of agreement for referable ocular findings. Agreement for referable ocular findings was moderate (n=389, agreement: 77%; κ: 0.55), due in part to ungradable exams (22%). However, about half of the ungradable exams had findings that warranted referral. There was substantial agreement for follow-up exams (n=72, agreement: 93%; κ: 0.63). Among all gradable exams (n=303), the TAE exam had 86% sensitivity and 84% specificity for referable ocular findings, with high agreement (≥94%) for DR and other major ocular diagnoses. There was moderate-to-substantial agreement between a TAE exam and a comprehensive eye exam for referable ocular findings in patients with diabetes. Ungradable exams were a frequent marker of ocular pathology. Teleretinal imaging may be a useful evaluation for both diabetic and non-diabetic ocular conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Allergic conjunctivitis: a comprehensive review of the literature

PubMed Central

2013-01-01

Ocular allergy represents one of the most common conditions encountered by allergists and ophthalmologists. Allergic conjunctivitis is often underdiagnosed and consequently undertreated. Basic and clinical research has provided a better understanding of the cells, mediators, and immunologic events, which occur in ocular allergy. New pharmacological agents have improved the efficacy and safety of ocular allergy treatment. An understanding of the immunologic mechanisms, clinical features, differential diagnosis, and treatment of ocular allergy may be useful to all specialists who deal with these patients. The purpose of this review is to systematically review literature underlining all the forms classified as ocular allergy: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis, atopic keratocongiuntivitis, contact allergy, and giant papillary conjunctivitis. PMID:23497516

Functional and Morphologic Changes of Meibomian Glands in an Asymptomatic Adult Population.

PubMed

Yeotikar, Nisha S; Zhu, Hua; Markoulli, Maria; Nichols, Kelly K; Naduvilath, Thomas; Papas, Eric B

2016-08-01

The aim of the study was to understand natural changes of meibomian glands (MG) that occur with aging in the absence of any ocular pathology or ocular discomfort symptoms, to differentiate between "age normal" and pathologic or dysfunctional changes of the MG. A total of 185 subjects (109 females) with no pre-existing ocular and systemic abnormalities were recruited and divided into four age groups: 25 to 34, 35 to 44, 45 to 54, and 55 to 66 years. At a single visit, the following MG measures were collected: meibum quality (MQ) and MG expressibility (MGE) of the lower lid, and MG drop-out score (meiboscale) using infrared meibography of the upper and lower lids. Assessments of anterior eye, tear function variables, noninvasive and invasive tear breakup time (TBUT), corneal integrity, and lid wiper epitheliopathy were also performed during the visit. An Ocular Surface Disease Index (OSDI) questionnaire was used to record dry eye symptoms. Meibum lipids samples were collected and analyzed. A majority of the study population (61%) was asymptomatic. There was a significant worsening in the MQ (P< 0.048), MGE (P < 0.03), and meiboscale (P < 0.01) with increasing age. Significant increase was observed in anterior blepharitis (P < 0.001) and telangiectasia (P< 0.02) with aging. Interestingly, tear osmolarity decreased significantly (P < 0.001), while tear meniscus height (P < 0.001) and invasive TBUT (P = 0.02) increased with increase in age. There was no significant association between MG variables and sex, ocular discomfort symptoms, or meibum lipids classes. Progressive MG loss occurs normally with age accompanied by reduced quality and quantity of the meibum produced. However, clinical presentation of ocular discomfort symptoms is stalled without corresponding disruption to tear function.

BLINKER: Automated Extraction of Ocular Indices from EEG Enabling Large-Scale Analysis.

PubMed

Kleifges, Kelly; Bigdely-Shamlo, Nima; Kerick, Scott E; Robbins, Kay A

2017-01-01

Electroencephalography (EEG) offers a platform for studying the relationships between behavioral measures, such as blink rate and duration, with neural correlates of fatigue and attention, such as theta and alpha band power. Further, the existence of EEG studies covering a variety of subjects and tasks provides opportunities for the community to better characterize variability of these measures across tasks and subjects. We have implemented an automated pipeline (BLINKER) for extracting ocular indices such as blink rate, blink duration, and blink velocity-amplitude ratios from EEG channels, EOG channels, and/or independent components (ICs). To illustrate the use of our approach, we have applied the pipeline to a large corpus of EEG data (comprising more than 2000 datasets acquired at eight different laboratories) in order to characterize variability of certain ocular indicators across subjects. We also investigate dependence of ocular indices on task in a shooter study. We have implemented our algorithms in a freely available MATLAB toolbox called BLINKER. The toolbox, which is easy to use and can be applied to collections of data without user intervention, can automatically discover which channels or ICs capture blinks. The tools extract blinks, calculate common ocular indices, generate a report for each dataset, dump labeled images of the individual blinks, and provide summary statistics across collections. Users can run BLINKER as a script or as a plugin for EEGLAB. The toolbox is available at https://github.com/VisLab/EEG-Blinks. User documentation and examples appear at http://vislab.github.io/EEG-Blinks/.

Newer approaches for optimal bioavailability of ocularly delivered drugs: review.

PubMed

Kesavan, K; Balasubramaniam, J; Kant, S; Singh, P N; Pandit, J K

2011-03-01

Eye diseases can cause discomfort and anxiety in patients, with the ultimate fear of loss of vision and facial disfigurement. Many regions of the eye are relatively inaccessible to systemically administered drugs and, as a result, topical drug delivery remains the preferred route in most cases. Drugs may be delivered to treat the precorneal region for conjunctivitis and blepharitis, or to provide intraocular diseases such as glaucoma, uveitis, and cytomegalovirus retinitis. Most of the ophthalmic formulation strategies aim at maximizing ocular drug permeability through prolongation of the drug residence time in the cornea and conjunctival sac, as well as minimizing precorneal drug loss. The conventional topical ocular drug delivery systems show drawbacks such as increased precorneal elimination and high variability in efficacy. Attempts have been made to overcome these problems and enhance ocular bioavailability by the development of newer drug delivery systems. This review is concerned with classification, recent findings and applications and biocompatibility of newer drug delivery systems for the treatment of ocular diseases.

Evolving paradigm in the management of allergic rhinitis-associated ocular symptoms: role of intranasal corticosteroids.

PubMed

Blaiss, Michael S

2008-03-01

Along with nasal symptoms, ocular symptoms such as itching, tearing, and redness are common, bothersome components of the allergic rhinitis (AR) profile. Treatment of the patient with ocular allergy symptoms should take into account a variety of factors, including severity of symptoms, convenience/compliance issues, and patient preferences. To review from the primary care perspective the epidemiology, pathophysiology, and management of ocular symptoms associated with AR, and to evaluate the emerging role of intranasal corticosteroids (INSs). A search of the PubMed database identified clinical trials that assessed efficacy of agents in reducing ocular allergy symptoms. Internet searches identified further information including data on over-the-counter agents for treatment of ocular symptoms. Searches were conducted using search terms such as pathophysiology, epidemiology, ocular allergy, quality of life, drug class, and drug names. Primary care physicians are often the first point of contact for patients with seasonal AR (SAR) or perennial AR (PAR) symptoms. Ocular allergy associated with SAR and PAR (seasonal and perennial allergic conjunctivitis, respectively) is characterized by both early- and late-phase reactions, with symptoms often persisting long after allergen exposure. Non-pharmacologic measures such as allergen avoidance, use of artificial tears, and cool compresses are pertinent for all ocular allergy sufferers, but may not afford adequate symptom control. Pharmacotherapy options have traditionally included topical ophthalmic products for cases of isolated ocular symptoms, and oral antihistamines for patients with both nasal and ocular symptoms. However, this paradigm is changing with new evidence regarding the efficacy of INSs in reducing ocular symptoms. A number of meta-analyses and individual studies, most of which studied ocular symptoms as secondary variables, have demonstrated the ocular effects of INSs versus topical and oral antihistamines. Additional prospective studies on this topic are encouraged to provide further evidence for these findings. In light of their well-established efficacy in reducing nasal allergy symptoms, INSs offer a comprehensive treatment option in patients with nasal and ocular symptoms. Oral antihistamines and/or topical eye drops may also be necessary depending on symptom control.

Photochemical mechanisms of ocular photic injury (Abstract Only)

NASA Astrophysics Data System (ADS)

Stuck, Bruce E.; Lund, David J.; Zuclich, Joseph A.

2000-03-01

Mechanisms of photic injury to the eye can be categorized as photochemical, photothermal or photodistruptive. Exposure wavelength, exposure duration, ocular tissue characteristics and response criteria are key factors in the delineation of the ocular injury mechanisms. Depending on the exposure condition, one or all of the laser-tissue interaction mechanisms can be involved. Although photic injury to the eye was initially assumed to involve thermal mechanisms, more recent research has demonstrated that ocular effects can be produced by light exposure without a significant retinal temperature rise. Photochemical mechanisms are also implicated in UV photic injury to the cornea and lens. Exposure of the retina to short visible wavelengths for prolonged durations results in photochemical retinal damage with negligible localized retinal temperature elevation. For exposure conditions where photochemical mechanisms are dominate, the reciprocity of irradiance and exposure duration is apparent. The latency until observation of a photochemical lesion is often 24-48 hours whereas a thermal lesion is observed immediately or within a few hours after the exposure. Action spectra for photochemical injury to the eye are discussed in the context of ocular injury thresholds and current permissible exposure limits.

[Application of Ocular Trauma Score in Mechanical Ocular Injury in Forensic Medicine].

PubMed

Xiang, Jian; Guo, Zhao-ming; Wang, Xu; Yu, Li-li; Liu, Hui

2015-10-01

To evaluate the application value for the prognosis of mechanical ocular injury cases using ocular trauma score (OTS). Four hundred and eleven cases of mechanical ocular trauma were retrospectively reviewed. Of the 449 eyes, there were 317 closed globe injury and 132 open globe injury. OTS variables included numerical values as initial visual acuity, rupture, endophthalmitis, perforat- ing or penetrating injury, retinal detachment and relative afferent pupillary block. The differences be- tween the distribution of the final visual acuity and the probability of standard final visual acuity were compared to analyze the correlation between OTS category and final visual acuity. The different types of ocular trauma were compared. Compared with the distribution of final visual acuity in standard OTS score, the ratio in OTS-3 category was statistically different in present study, and no differences were found in other categories. Final visual acuity showed a great linear correlation with OTS category (r = 0.71) and total score (r = 0.73). Compared with closed globe injury, open globe injury was generally associated with lower total score and poorer prognosis. Rupture injury had poorer prognosis compared with penetrating injury. The use of OTS for the patients with ocular trauma can provide re- liable information for the evaluation of prognosis in forensic medicine.

The importance of vitamin D in systemic and ocular wellness

PubMed Central

Richer, Stuart P.; Pizzimenti, Joseph J.

2013-01-01

Vitamin D is good for bones and teeth. It may also have a role in preventing and treating diabetes, certain cancers, atherosclerosis, multiple sclerosis, hip fractures and ocular conditions such as age-related macular degeneration.

OCULAR SYPHILIS IN A KIDNEY TRANSPLANT RECIPIENT

PubMed Central

ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel

2016-01-01

We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748

Occurrence of Staphylococcal Ocular Infections of Food Producing Animals in Nsukka Southeast, Nigeria

PubMed Central

Udegbunam, Sunday Ositadinma; Udegbunam, Rita Ijeoma; Anyanwu, Madubuike Umunna

2014-01-01

Staphylococcal ocular infections of food animals have been somewhat under diagnosed probably due to the ubiquitous nature of staphylococcal organisms. This study was undertaken to determine the occurrence of staphylococcal ocular infections of food producing animals in Nsukka Southeast, Nigeria, and to determine the antibiogram of the isolated staphylococci. A total of 5,635 food producing animals were externally examined for signs of clinical ocular conditions. Animals that showed clinical eye lesions were further examined using pen light to assess the entire globe and the pupillary reflex. Blindness was assessed using menace blink reflex, palpebral reflex and obstacle methods. Isolation and identification of staphylococcal isolates from ocular swabs were done by standard methods. Antibiogram of the isolates was determined by disc diffusion method. Sixty-three (1.1%) of the examined animals showed signs of ocular condition. Thirty-one (49.2%) of the cultured swabs yielded Staphylococcus aureus (S. aureus). Isolation rates from different animal species were caprine (60%), ovine (33.3%), bovine (12.5%), and porcine (0%). Resistance of the isolates was 100% to ampicillin/cloxacillin, 90% to tetracycline, 80% to streptomycin, 71% to chloramphenicol, 20% to erythromycin, 16% to gentamicin, and 0% to ciprofloxacin and norfloxacin. Twenty-five (81%) of the isolates were multi-drug resistant. This study has shown that antibiotic-resistant staphylococci are associated with a sizeable percentage of ocular infections of food producing animals and should be considered during diagnosis and treatment. PMID:24693461

The prevalence and characteristics of chronic ocular itch: a cross-sectional survey.

PubMed

Stull, Carolyn; Valdes-Rodriguez, Rodrigo; Shafer, Brian M; Shevchenko, Alina; Nattkemper, Leigh A; Chan, Yiong-Huak; Tabaac, Sydney; Schardt, Martin J; Najjar, Dany M; Foster, William J; Yosipovitch, Gil

2017-03-01

In this cross-sectional study, we aimed to determine the prevalence and characteristics of chronic ocular itch in an outpatient ophthalmology and optometry clinic. Four hundred patients from an outpatient ophthalmology and optometry clinic were enrolled. The presence and characteristics of chronic ocular itch were assessed by a questionnaire. Data regarding ophthalmologic, dermatologic, and systemic conditions as well as current medications were extracted from medical records. Chronic ocular itch was present in 118 (29.5%) of 400 participants. Chronic ocular pruritus was significantly more prevalent in females [ P =0.015; odds ratio (OR)=1.8; 95% confidence interval (CI), 1.1-2.8] and was significantly associated with the presence of allergic conjunctivitis [51.8% (n=45); P <0.001; OR=5.0; 95% CI, 3.0-8.3], dry eye syndrome [40.1% (75); P <0.001; OR=2.6; 95% CI, 1.7-4.1], blepharitis [43.8% (n=21); P =0.021; OR=2.0; 95% CI, 1.1-3.8], and atopic dermatitis [50.0% (n=10); P =0.023; OR=2.6; 95% CI, 1.1-5.8]. Chronic ocular itch was not significantly associated with systemic conditions, or the use of prescribed ophthalmologic medications. Chronic ocular itch is common and may be related to ophthalmologic or dermatologic pathologies. The present findings highlight the importance of identifying and managing this uncomfortable symptom that may negatively impact the quality of life and sleep of affected patients.

Knowledge and awareness of ocular allergy among undergraduate students of public universities in Ghana.

PubMed

Kyei, Samuel; Tettey, Bernard; Asiedu, Kofi; Awuah, Agnes

2016-10-28

Ocular allergy is a growing public health problem that greatly impacts the day-to-day life of sufferers and their families. Other aspects of their activities of daily living such as schooling, professional, and social life are affected hence an increased awareness and knowledge of ocular allergies, their detection and treatment is paramount. This study was to assess the level of knowledge and awareness of ocular allergy among undergraduate students of public universities in Ghana. A descriptive cross sectional survey was conducted among 1000 students from three selected public universities in Ghana. Each respondent completed a questionnaire that had questions concerning awareness and knowledge of ocular allergy. Out of the 1000 students, 347 (34.7 %) were aware of ocular allergy. Of these 347 students, the level of knowledge of ocular allergy was generally low. Majority of the students had their source of information about ocular allergy from the media and the internet. There was statistical significant association among awareness of ocular allergy, sources of information and programme of study (p < 0.001). Level of awareness among university students is generally low. Students' programmes of study influenced their knowledge of ocular allergy. Public health measures are recommended to help educate students on the prevention and control of ocular allergy as well as the complications associated with this condition.

Iris concavity, corneal biomechanics, and their correlations with ocular biometry in a cohort of 10- to 12-year-old UK school boys: baseline data.

PubMed

Shah, Ameet; Low, Sancy; Garway-Heath, David F; Foster, Paul J; Barton, Keith

2014-04-17

Pigment dispersion syndrome is associated with iris concavity. This study investigated the prevalence of iris concavity, defined as a measurement of ≤-0.1 mm, in a cohort of 10- to 12-year-old boys, and explored the relationship between iris curvature and anterior segment biometry. Associations with corneal biomechanical parameters also were explored. A cohort of school boys (n = 96) was recruited from a local school. Anterior segment optical coherence tomography (AS-OCT) was performed under accommodative and nonaccommodative conditions, and iris curvature quantified. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with the ocular response analyzer (ORA). Noncontact axial biometry was performed using laser interferometry. The prevalence of iris concavity was 24% on distance fixation, increasing to 65% on accommodation. Variables significantly associated with nonaccommodating iris curvature were lens vault (P = 0.02) and mean keratometry (P = 0.02). For both variables acting jointly, R(2) = 0.30. Variables associated significantly with accommodating iris curvature were anterior chamber depth (P = 0.009), lens vault (P = 0.049), and mean scleral spur angle (P < 0.0001). For these three variables acting jointly, R(2) = 0.33. Significant association was found between CH and spur-to-spur distance (R(2) = 0.07, P = 0.025). Iris concavity was a common finding in this cohort and related to anterior segment biometric parameters. Further work is required to clarify whether anatomical differences exist between iris concavity seen in the adolescent eye and that found in adults with pigment dispersion syndrome. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Formulation Development, Optimization, and In vitro - In vivo Characterization of Natamycin Loaded PEGylated Nano-lipid Carriers for Ocular Applications.

PubMed

Patil, Akash; Lakhani, Prit; Taskar, Pranjal; Wu, Kai-Wei; Sweeney, Corinne; Avula, Bharathi; Wang, Yan-Hong; Khan, Ikhlas A; Majumdar, Soumyajit

2018-04-23

Current study aimed at formulating and optimizing natamycin (NT) loaded PEGylated NLCs (NT-PEG-NLCs) using Box-Behnken Design and investigating their potential in ocular applications. Response surface methodology (RSM) computations and plots for optimization were performed using Design Expert ® software, to obtain optimum values for response variables based on the criteria of desirability. Optimized NT-PEG-NLCs had predicted values for the dependent variables not significantly different from the experimental values. NT-PEG-NLCs were characterized for their physicochemical parameters; NT's rate of permeation and flux across rabbit cornea was evaluated, in vitro; ocular tissue distribution was assessed in rabbits, in vivo. NT-PEG-NLCs were found to have optimum particle size (< 300 nm) narrow PDI, high NT entrapment and NT content. In vitro transcorneal permeability and flux of NT from NT-PEG-NLCs was significantly higher than Natacyn ® . NT-PEG-NLC (0.3%) showed improved delivery of NT across the intact cornea and provided concentrations statistically similar to the marketed suspension (5%) in inner ocular tissues, in vivo, indicating that it could be a potential alternative to the conventional suspension during the course of fungal keratitis therapy. Copyright © 2018. Published by Elsevier Inc.

Clinical Profile and Visual Outcome of Ocular Bartonellosis in Malaysia

PubMed Central

Tan, Chai Lee; Fhun, Lai Chan; Abdul Gani, Nor Hasnida; Muhammed, Julieana; Tuan Jaafar, Tengku Norina

2017-01-01

Background. Ocular bartonellosis can present in various ways, with variable visual outcome. There is limited data on ocular bartonellosis in Malaysia. Objective. We aim to describe the clinical presentation and visual outcome of ocular bartonellosis in Malaysia. Materials and Methods. This was a retrospective review of patients treated for ocular bartonellosis in two ophthalmology centers in Malaysia between January 2013 and December 2015. The diagnosis was based on clinical features, supported by a positive Bartonella spp. serology. Results. Of the 19 patients in our series, females were predominant (63.2%). The mean age was 29.3 years. The majority (63.2%) had unilateral involvement. Five patients (26.3%) had a history of contact with cats. Neuroretinitis was the most common presentation (62.5%). Azithromycin was the antibiotic of choice (42.1%). Concurrent systemic corticosteroids were used in approximately 60% of cases. The presenting visual acuity was worse than 6/18 in approximately 60% of eyes; on final review, 76.9% of eyes had a visual acuity better than 6/18. Conclusion. Ocular bartonellosis tends to present with neuroretinitis. Azithromycin is a viable option for treatment. Systemic corticosteroids may be considered in those with poor visual acuity on presentation. PMID:28265290

BLINKER: Automated Extraction of Ocular Indices from EEG Enabling Large-Scale Analysis

PubMed Central

Kleifges, Kelly; Bigdely-Shamlo, Nima; Kerick, Scott E.; Robbins, Kay A.

2017-01-01

Electroencephalography (EEG) offers a platform for studying the relationships between behavioral measures, such as blink rate and duration, with neural correlates of fatigue and attention, such as theta and alpha band power. Further, the existence of EEG studies covering a variety of subjects and tasks provides opportunities for the community to better characterize variability of these measures across tasks and subjects. We have implemented an automated pipeline (BLINKER) for extracting ocular indices such as blink rate, blink duration, and blink velocity-amplitude ratios from EEG channels, EOG channels, and/or independent components (ICs). To illustrate the use of our approach, we have applied the pipeline to a large corpus of EEG data (comprising more than 2000 datasets acquired at eight different laboratories) in order to characterize variability of certain ocular indicators across subjects. We also investigate dependence of ocular indices on task in a shooter study. We have implemented our algorithms in a freely available MATLAB toolbox called BLINKER. The toolbox, which is easy to use and can be applied to collections of data without user intervention, can automatically discover which channels or ICs capture blinks. The tools extract blinks, calculate common ocular indices, generate a report for each dataset, dump labeled images of the individual blinks, and provide summary statistics across collections. Users can run BLINKER as a script or as a plugin for EEGLAB. The toolbox is available at https://github.com/VisLab/EEG-Blinks. User documentation and examples appear at http://vislab.github.io/EEG-Blinks/. PMID:28217081

Attention capture by eye of origin singletons even without awareness--a hallmark of a bottom-up saliency map in the primary visual cortex.

PubMed

Zhaoping, Li

2008-05-07

Human observers are typically unaware of the eye of origin of visual inputs. This study shows that an eye of origin or ocular singleton, e.g., an item in the left eye among background items in the right eye, can nevertheless attract attention automatically. Observers searched for a uniquely oriented bar, i.e., an orientation singleton, in a background of horizontal bars. Their reports of the tilt direction of the search target in a brief (200 ms) display were more accurate in a dichoptic congruent (DC) condition, when the target was also an ocular singleton, than in a monocular (M) condition, when all bars were presented to the same single eye, or a dichoptic incongruent (DI) condition, when an ocular singleton was a background bar. The better performance in DC did not depend on the ability of the observers to report the presence of an ocular singleton by making forced choices in the same stimuli (though without the orientation singleton). This suggests that the ocular singleton exogenously cued attention to its location, facilitating the identification of the tilt singleton in the DC condition. When the search display persisted without being masked, observers' reaction times (RTs) for reporting the location of the search target were shorter in the DC, and longer in the DI, than the M condition, regardless of whether the observers were aware that different conditions existed. In an analogous design, similar RT patterns were observed for the task of finding an orientation contrast texture border. These results suggest that in typical trials, attention was more quickly attracted to or initially distracted from the target in the DC or DI condition, respectively. Hence, an ocular singleton, though elusive to awareness, can effectively compete for attention with an orientation singleton (tilted 20 or 50 degrees from background bars in the current study). Similarly, it can also make a difficult visual search easier by diminishing the set size effect. Since monocular neurons with the eye of origin information are abundant in the primary visual cortex (V1) and scarce in other cortical areas, and since visual awareness is believed to be absent or weaker in V1 than in other cortical areas, our results provide a hallmark of the role of V1 in creating a bottom-up saliency map to guide attentional selection.

Space Flight-Associated Neuro-ocular Syndrome.

PubMed

Lee, Andrew G; Mader, Thomas H; Gibson, C Robert; Tarver, William

2017-09-01

New and unique physiologic and pathologic systemic and neuro-ocular responses have been documented in astronauts during and after long-duration space flight. Although the precise cause remains unknown, space flight-associated neuro-ocular syndrome (SANS) has been adopted as an appropriate descriptive term. The Space Medicine Operations Division of the US National Aeronautics and Space Administration (NASA) has documented the variable occurrence of SANS in astronauts returning from long-duration space flight on the International Space Station. These clinical findings have included unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and nerve fiber layer infarcts. The clinical findings of SANS have been correlated with structural changes on intraorbital and intracranial magnetic resonance imaging and in-flight and terrestrial ultrasonographic studies and ocular optical coherence tomography. Further study of SANS is ongoing for consideration of future manned missions to space, including a return trip to the moon or Mars.

Diagnostic categorization according to the First International Workshop on Ocular Sarcoidosis (FIWOS) criteria in a series of 11 patients.

PubMed

Meneses, Carlos F; Egües, César A; Uriarte, Miren; Errazquin, Nerea; Valero Jaimes, Alejandro; Maíz, Olga; Belzunegui, Joaquín; Blanco, Ana

Categorization of patients diagnosed with ocular sarcoidosis during the period 2009-2014. The medical records of patients with ocular sarcoidosis were reviewed and variables were collected to categorize the patients according to the criteria of the FIWOS. We found 11 patients, 7 women and 4 men, with sarcoid uveitis; the median age was 58 years. Bilateral panuveitis was the most common pattern (54.5%), followed by chronic anterior uveitis (27.2%). The diagnosis of sarcoidosis was definitive in 4 patients (36.3%), presumed in 5 (45.4%), probable in 1 (9%) and possible in 1 (9%). Ocular sarcoidosis was diagnosed in more than half of the patients who had no confirmatory biopsy. Bilateral panuveitis and chronic anterior uveitis were the patterns most frequently observed. Copyright © 2016. Publicado por Elsevier España, S.L.U.

Design and ocular tolerance of flurbiprofen loaded ultrasound-engineered NLC.

PubMed

Gonzalez-Mira, E; Egea, M A; Garcia, M L; Souto, E B

2010-12-01

Packaging small drug molecules, such as non-steroidal anti-inflammatory drugs (NSAIDs) into nanoparticulate systems has been reported as a promising approach to improve the drug's bioavailability, biocompatibility and safety profiles. In the last 20 years, lipid nanoparticles (lipid dispersions) entered the nanoparticulate library as novel carrier systems due to their great potential as an alternative to other systems such as polymeric nanoparticles and liposomes for several administration routes. For ocular instillation nanoparticulate carriers are required to have a low mean particle size, with the lowest polydispersity as possible. The purpose of this work was to study the combined influence of 2-level, 4-factor variables on the formulation of flurbiprofen (FB), a lipophilic NSAID, in lipid carriers currently named as nanostructured lipid carriers (NLC). NLC were produced with stearic acid (SA) and castor oil (CO) stabilized by Tween® 80 (non-ionic surfactant) in aqueous dispersion. A 2(4) full factorial design based on 4 independent variables was used to plan the experiments, namely, the percentage of SA with regard to the total lipid, the FB concentration, the stabilizer concentration, and the storage conditions (i.e., storage temperature). The effects of these parameters on the mean particle size, polydispersity index (PI) and zeta potential (ZP) were investigated as dependent variables. The optimization process was achieved and the best formulation corresponded to the NLC formulation composed of 0.05 (wt%) FB, 1.6 (wt%) Tween® 80 and a 50:50 ratio of SA to CO, with an average diameter of 288 nm, PI 0.245 of and ZP of -29 mV. This factorial design study has proven to be a useful tool in optimizing FB-loaded NLC formulations. Stability of the optimized NLC was predicted using a TurbiScanLab® and the ocular tolerance was assessed in vitro and in vivo by the Eytex® and Draize test, respectively. The developed systems were shown physico-chemically stable with high tolerance for eye instillation. Copyright © 2010 Elsevier B.V. All rights reserved.

Ocular emergencies presenting to Menelik II Hospital.

PubMed

Negussie, Dereje; Bejiga, Abebe

2011-01-01

Ocular conditions such as trauma, painful red eye of any cause, painless sudden visual loss and others are commonly seen as ocular emergencies, and can lead to ocular morbidity and visual loss. To determine types and causes of ocular emergencies seen at Menelik II hospital. A cross-sectional study was conducted from April to October, 2007. Consecutive patients who presented with ocular emergencies at any time of the day were prospectively evaluated and registered on a formatted questionnaire. Evaluation of the patients included history of presenting illness, visual acuity testing intraocular pressure measurement on non-perforated and non-infected eyes, and complete eye examination in order to arrive at the diagnosis. A total of 26,400 patients attended Menelik II hospital during the study period. Of these, 758 (3%) were persons with an ocular emergency. The majority of patients (n=551; 72.7%) were male, with a male to female ratio of 2.7:1. The age group of 16 to 30 years was the most affected (47.9%), followed by those aged 15 years or younger (27.3%). Ocular trauma and ocular infections accounted for 75.6% and 13.1% of cases, respectively. Of the total ocular emergencies, open globe injuries constituted 171 (22.6%), corneal foreign bodies and abrasion 125 (16.5%), and open adnexal injuries 119 (15.7%). Metal and wood were the commonest work-related causes of ocular injuries in adults, with both together accounting for 60% of all ocular injuries. Children, on the other hand, sustained ocular injury while playing with others in 128 (22.3%) of cases. This study was able to provide a more complete picture to improve understanding of the nature and circumstances of ocular emergencies in Ethiopia. Ocular emergencies were dominated by ocular trauma, particularly affecting males and working-age adults. Public education and use of protective safety measures are recommended to alleviate the problem.

Experimental support that ocular tremor in Parkinson's disease does not originate from head movement.

PubMed

Gitchel, George T; Wetzel, Paul A; Qutubuddin, Abu; Baron, Mark S

2014-07-01

Our recent report of ocular tremor in Parkinson's disease (PD) has raised considerable controversy as to the origin of the tremor. Using an infrared based eye tracker and a magnetic head tracker, we reported that ocular tremor was recordable in PD subjects with no apparent head tremor. However, other investigators suggest that the ocular tremor may represent either transmitted appendicular tremor or subclinical head tremor inducing the vestibulo-ocular reflex (VOR). The present study aimed to further investigate the origin of ocular tremor in PD. Eye movements were recorded in 8 PD subjects both head free, and with full head restraint by means of a head holding device and a dental impression bite plate. Head movements were recorded independently using both a high sensitivity tri-axial accelerometer and a magnetic tracking system, each synchronized to the eye tracker. Ocular tremor was observed in all 8 PD subjects and was not influenced by head free and head fixed conditions. Both magnetic tracking and accelerometer recordings supported that the ocular tremor was fully independent of head position. The present study findings support our initial findings that ocular tremor is a fundamental feature of PD unrelated to head movements. Although the utility of ocular tremor for diagnostic purposes requires validation, current findings in large cohorts of PD subjects suggest its potential as a reliable clinical biomarker. Published by Elsevier Ltd.

Characteristics of ocular pain complaints in patients with idiopathic dry eye symptoms

PubMed Central

Kalangara, Jerry P.; Galor, Anat; Levitt, Roy C.; Covington, Derek B.; McManus, Katherine T.; Sarantopoulos, Constantine D.; Felix, Elizabeth R.

2016-01-01

Objective The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms. Methods Subjects with clinically-relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared to similar measures from published data in other chronic pain populations. Results The study sample consisted of 154 subjects, of which 91% were male and ranged in age from 27 to 89 (mean age = 61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale (NRS) ≥ 4), with specific characteristics (i.e., “burning” spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57 to 0.66). Dry eye signs, however, did not generally correlate with ocular pain severity. Conclusions A significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with the majority endorsing descriptors commonly used by patients with non-ocular neuropathic pain conditions. Identifying sub-groups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye sub classification and better individualize treatment strategies. PMID:26925537

Effective melanin depigmentation of human and murine ocular tissues: an improved method for paraffin and frozen sections.

PubMed

Manicam, Caroline; Pitz, Susanne; Brochhausen, Christoph; Grus, Franz H; Pfeiffer, Norbert; Gericke, Adrian

2014-01-01

The removal of excessive melanin pigments that obscure ocular tissue morphology is important to address scientific questions and for differential diagnosis of ocular tumours based on histology. Thus, the goal of the present study was to establish an effective and fast melanin bleaching method for paraffin and frozen mouse and human ocular tissues. Paraffin-embedded and frozen ocular specimens from mice and human donors were subjected to bleaching employing two methods. The first employed potassium permanganate (KMnO4) with oxalic acid, and the second 10% hydrogen peroxide (H2O2). To determine optimal bleaching conditions, depigmentation was carried out at various incubation times. The effect of diluents used for 10% H2O2 was assessed using phosphate-buffered saline (PBS), and deionized water. Three different slide types and two fixatives, which were ice-cold acetone with 80% methanol, and 4% paraformaldehyde (PFA) were used to determine the optimal conditions for better tissue adherence during bleaching. All tissues were stained in hematoxylin and eosin for histological evaluation. Optimal bleaching was achieved using warm 10% H2O2 diluted in PBS at 65°C for 120 minutes. Chromium-gelatin-coated slides prevented tissue detachment. Adherence of cryosections was also improved with post-fixation using 4% PFA and overnight air-drying at RT after cryosectioning. Tissue morphology was preserved under these conditions. Conversely, tissues bleached in KMnO4/oxalic acid demonstrated poor depigmentation with extensive tissue damage. Warm dilute H2O2 at 65°C for 120 minutes rapidly and effectively bleached both cryo- and paraffin sections of murine and human ocular tissues.

Ocular complications in patients with lung transplants.

PubMed

Tarabishy, Ahmad B; Khatib, Omar F; Nocero, John R; Budev, Marie; Kaiser, Peter K

2011-09-01

To describe infectious and non-infectious ocular complications found in patients with lung transplants. 545 patients underwent lung transplantation from January 1998 to September 2008 at the Cleveland Clinic. Patients who underwent ophthalmic examination at the Cole Eye Institute after lung transplantation were included in the study. Diagnoses, treatments, surgeries, laboratory parameters of immune status and patient survival were examined. Of the 545 patients who received a lung transplant during the study period at the Cleveland Clinic, 46 (8.4%) patients underwent ophthalmology examination after a lung transplant. The most common ocular finding was posterior subcapsular cataract, found in 13/46 (28.3%) patients. Infectious ocular complications were present in 6/46 patients (13.0%) including fungal infections (rhino-orbital mucormycosis (n=1), disseminated Pseudallescheria boydii infection (n=2)), cytomegalovirus retinitis (n=1), varicella-zoster virus keratouveitis (n=1) and herpes zoster ophthalmicus (n=1). Five of six patients with infectious ocular complications died within 6 months of evaluation. Decreased absolute lymphocyte count was associated with infectious ocular complications (p=0.014). Many ocular conditions can occur in patients with lung transplants. Ocular infectious complications were uncommon but may be associated with increased mortality.

Significance of mucin on the ocular surface.

PubMed

Watanabe, Hitoshi

2002-03-01

To review the significance of mucin in the tear film and the ocular surface epithelium. Summary of the information on how mucin derived from the corneal and conjunctival epithelia and from goblet cells plays a role in the stability of the tear film over the ocular surface. The change in mucin expression derived from the ocular surface epithelium is also discussed with reference to ocular surface disease. The corneal and conjunctival epithelia produce transmembrane mucins such as MUC1, MUC2, and MUC4. In contrast, goblet cells produce the gel-forming secretory mucin, MUC5AC. The lacrimal gland produces MUC7. On the ocular surface, cooperation between transmembrane mucin and secretory mucin is necessary for the stability of the tear film. The expression of mucin from the ocular surface epithelium is coordinated from the time of eyelid opening and is altered in conditions such as squamous metaplasia and dry eye. This alteration may result in instability of the tear film. CONCLU SION: The induction of mucin from the ocular surface may facilitate the stability of the tear film, and increased knowledge may lead to the development of a new modality for the treatment of dry eye.

Local synthesis of sex hormones: are there consequences for the ocular surface and dry eye?

PubMed

Gibson, Emma J; Stapleton, Fiona; Wolffsohn, James S; Golebiowski, Blanka

2017-12-01

Sex hormones are associated with the physiology and pathophysiology of almost all organs in the body, as well as most diseases. Interest in the associations between sex hormones and ocular tissues has increased in recent years. Androgens may have a positive effect on dry eye, whereas the effects of oestrogen on ocular conditions remain unclear. Intracrinology, the local synthesis and metabolism of hormones that is unique to humans, is of relevance to the eye and may help to explain why studies of the relationship between oestrogens and dry eye signs and symptoms are inconclusive. Knowledge of the pathways of hormone formation and metabolism is crucial to understanding the pathogenesis of ocular disease including dry eye. This review examines the mechanisms of steroidal sex hormone biosynthesis and reviews the significance of locally produced sex hormones, with a focus on ocular surface tissues. Much of the current literature is based on animal studies, which may not be transferable to humans due to the absence of intracrine production in animals. A large proportion of the human studies investigate systemic hormone levels rather than local levels. There is subsequently a need for additional studies to provide a better understanding of the local production of sex hormones within the human eye and ocular surface and to clarify the relationships between ocular levels of sex hormones and conditions including dry eye. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Intrafamilial variability of the ocular phenotype in a Polish family with a missense mutation (A63D) in the Norrie disease gene.

PubMed

Zaremba, J; Feil, S; Juszko, J; Myga, W; van Duijnhoven, G; Berger, W

1998-09-01

To describe the phenotypic variability in a Polish Norrie disease (ND) family associated with the missense mutation A63D. A patient with spared vision from a Polish ND family underwent detailed ophthalmological examinations including slit-lamp biomicroscopy, ultrasound (USG), angiography, Goldmann kinetic visual field, and electroretinography (ERG). Mutation screening was carried out using the single-strand conformation polymorphism (SSCP) technique and subsequent DNA sequencing of the coding part of the ND gene. A mutation was detected (exon 3, A63D) in a large Polish family with 12 affected males, all but one presenting with classical ND symptoms. In one male, partially preserved vision was observed up to 40 years of age (distance acuity of the right eye 1/50 and left eye 2/50). Slit-lamp examination revealed remnants of a persistent primary vitreous and hyaloid artery. Upon angiography, the retina was vascularized within the posterior pole but not in the periphery. The ERG revealed pathological changes characteristic for chorioretinal degenerations. Within one family, individuals with identical sequence alterations in the ND gene can show remarkable phenotypic variability of the ocular symptoms. These findings indicate the involvement of additional factors (epigenetic or genetic) in ocular pathogenesis of ND.

Ocular Effects of Exposure to 40, 75, and 95 GHz Millimeter Waves

NASA Astrophysics Data System (ADS)

Kojima, Masami; Suzuki, Yukihisa; Sasaki, Kensuke; Taki, Masao; Wake, Kanako; Watanabe, Soichi; Mizuno, Maya; Tasaki, Takafumi; Sasaki, Hiroshi

2018-05-01

The objective of this study was to develop a model of ocular damage induced by 40, 75, and 95 GHz continuous millimeter waves (MMW), thereby allowing assessment of the clinical course of ocular damage resulting from exposure to thermal damage-inducing MMW. This study also examined the dependence of ocular damage on incident power density. Pigmented rabbit eyes were exposed to 40, 75, and 95 GHz MMW from a spot-focus-type lens antenna. Slight ocular damage was observed 10 min after MMW exposure, including reduced cornea thickness and reduced transparency. Diffuse fluorescein staining around the pupillary area indicated corneal epithelial injury. Slit-lamp examination 1 day after MMW exposure revealed a round area of opacity, accompanied by fluorescence staining, in the central pupillary zone. Corneal edema, indicative of corneal stromal damage, peaked 1 day after MMW exposure, with thickness gradually subsiding to normal. Three days after exposure, ocular conditions had almost normalized, though corneal thickness was slightly greater than that before exposure. The 50% probability of ocular damage (DD50) was in the order 40 > 95 ≈ 75 GHz at the same incident power densities.

Chlamydia psittaci is variably associated with ocular adnexal MALT lymphoma in different geographical regions.

PubMed

Chanudet, E; Zhou, Y; Bacon, C M; Wotherspoon, A C; Müller-Hermelink, H-K; Adam, P; Dong, H Y; de Jong, D; Li, Y; Wei, R; Gong, X; Wu, Q; Ranaldi, R; Goteri, G; Pileri, S A; Ye, H; Hamoudi, R A; Liu, H; Radford, J; Du, M-Q

2006-07-01

Infectious agents play a critical role in MALT lymphoma development. Studies from Italy showed Chlamydia psittaci infection in 87% of ocular adnexal MALT lymphomas and complete or partial regression of the lymphoma after C. psittaci eradication in four of nine cases. However, C. psittaci was not demonstrated in ocular adnexal MALT lymphomas from the USA. This study was thus designed to investigate further the role of C. psittaci, and other infectious agents commonly associated with chronic eye disease, in the development of ocular adnexal MALT lymphoma. The presence of C. psittaci, C. trachomatis, C. pneumoniae, herpes simplex virus 1 and 2 (HSV1, HSV2), and adenovirus 8 and 19 (ADV8, ADV19) was assessed separately by polymerase chain reaction in 142 ocular adnexal MALT lymphomas, 53 non-marginal zone lymphomas, and 51 ocular adnexal biopsies without a lymphoproliferative disorder (LPD), from six geographical regions. C. psittaci was detected at similar low frequencies in non-LPD and non-marginal zone lymphoma groups from different geographical regions (0-14%). Overall, the prevalence of C. psittaci was significantly higher in MALT lymphomas (22%) than in non-LPD (10%, p=0.042) and non-marginal zone lymphoma cases (9%, p=0.033). However, the prevalence of C. psittaci infection in MALT lymphoma showed marked variation among the six geographical regions examined, being most frequent in Germany (47%), followed by the East Coast of the USA (35%) and the Netherlands (29%), but relatively low in Italy (13%), the UK (12%), and Southern China (11%). No significant differences in the detection of C. pneumoniae, C. trachomatis, HSV1, HSV2, ADV8, and ADV19 were found between lymphomas and controls from different geographical regions. In conclusion, our results show that C. psittaci, but not C. pneumoniae, C. trachomatis, HSV1, HSV2, ADV8 or ADV19, is associated with ocular adnexal MALT lymphoma and that this association is variable in different geographical areas. Copyright (c) 2006 Pathological Society of Great Britain and Ireland.

Ocular manifestations of injection drug use.

PubMed

Kim, Rubin W; Juzych, Mark S; Eliott, Dean

2002-09-01

Injection drug use can result in a variety of severe ocular conditions. Hematogenous dissemination of various fungi and bacteria may produce endophthalmitis with resultant severe visual loss. Retinal arterial occlusive disease may result from talc and other particulate emboli. Most commonly, life-threatening systemic diseases such as endocarditis and HIV infection secondarily affect the eye. Because many of these conditions may result in blindness if untreated, accurate diagnosis and prompt initiation of therapy are essential.

Modification of Otolith-Ocular Reflexes, Motion Perception and Manual Control During Variable Radius Centrifugation Following Space Flight

NASA Technical Reports Server (NTRS)

Wood, Scott J.; Clarke, A. H.; Rupert, A. H.; Harm, D. L.; Clement, G. R.

2009-01-01

Two joint ESA-NASA studies are examining changes in otolith-ocular reflexes and motion perception following short duration space flights, and the operational implications of post-flight tilt-translation ambiguity for manual control performance. Vibrotactile feedback of tilt orientation is also being evaluated as a countermeasure to improve performance during a closed-loop nulling task. Data is currently being collected on astronaut subjects during 3 preflight sessions and during the first 8 days after Shuttle landings. Variable radius centrifugation is utilized to elicit otolith reflexes in the lateral plane without concordant roll canal cues. Unilateral centrifugation (400 deg/s, 3.5 cm radius) stimulates one otolith positioned off-axis while the opposite side is centered over the axis of rotation. During this paradigm, roll-tilt perception is measured using a subjective visual vertical task and ocular counter-rolling is obtained using binocular video-oculography. During a second paradigm (216 deg/s, less than 20 cm radius), the effects of stimulus frequency (0.15 - 0.6 Hz) are examined on eye movements and motion perception. A closed-loop nulling task is also performed with and without vibrotactile display feedback of chair radial position. Data collection is currently ongoing. Results to date suggest there is a trend for perceived tilt and translation amplitudes to be increased at the low and medium frequencies on landing day compared to pre-flight. Manual control performance is improved with vibrotactile feedback. One result of this study will be to characterize the variability (gain, asymmetry) in both otolith-ocular responses and motion perception during variable radius centrifugation, and measure the time course of post-flight recovery. This study will also address how adaptive changes in otolith-mediated reflexes correspond to one's ability to perform closed-loop nulling tasks following G-transitions, and whether manual control performance can be improved with vibrotactile feedback of orientation.

Safety parameters for avoiding acute ocular damage from the reflected CO2 (10.6 microns) laser beam.

PubMed

Friedman, N R; Saleeby, E R; Rubin, M G; Sandu, T; Krull, E A

1987-11-01

Reflections from instruments in the surgical field involving the CO2 laser beam present a serious ocular hazard. In addition to the use of plastic or glass protective eyewear, this hazard can be minimized by utilizing anodized instruments and recognizing the specific distances at which various reflections are no longer hazardous depending upon certain variables, including laser output wattage, emergent beam lengths, and surface characteristics of the reflecting instruments.

Factors associated with childhood ocular morbidity and blindness in three ecological regions of Nepal: Nepal pediatric ocular disease study.

PubMed

Adhikari, Srijana; Shrestha, Mohan Krishna; Adhikari, Kamala; Maharjan, Nhukesh; Shrestha, Ujjowala Devi

2014-10-23

Nepal Pediatric Ocular Diseases Study is a three year longitudinal population based study. Here we present the baseline survey report which aims to investigate various risk factors associated with childhood ocular morbidity and blindness in three ecological regions of Nepal. This baseline survey is a population based cross sectional study. The investigation was conducted in a district from each of the following regions: Terai, Hill and Mountain. The Village Development Committees (VDCs) from each district were selected by random sampling. Three Community health workers were given training on vision screening and identification of abnormal ocular signs in children. They conducted a house to house survey in their respected districts examining the children and gathering a standardized set of data variables. Children with abnormal vision or ocular signs were then further examined by pediatric ophthalmologists. A total of 10950 children aged 0-10 years (5403 from Terai, 3204 from the hills, 2343 from the mountains) were enrolled in the study. However 681 (6.2%) were non responders. The male to female ratio was 1.03. The overall prevalence of ocular morbidity was 3.7% (95% CI of 3.4%-4%) and blindness was 0.07% (95% CI of 0.02%-0.12%). Ocular morbidity was more prevalent in the mountain region whereas blindness was more prevalent in the Terai region.Children from the Terai region were more likely to suffer from congenital ocular anomalies compared to the other regions. Children whose mother smoked, drank alcohol, or was illiterate were significantly afflicted with ocular diseases (p < 0.05). In addition,a higher prevalence of ocular disease was related to children with past medical history of systemic illnesses, abnormal postnatal period or missing childhood vaccinations. Blindness was more prevalent in children who suffered from a systemic illness. Females and under-nourished children were more likely to have ocular morbidity and blindness. It was found that childhood blindness was more prevalent in the Terai region, the undernourished, females and in those with co-morbid systemic illnesses. This study strongly suggests that prevention of childhood blindness requires additional resources to address these disparity.

Dry eye disease: an immune-mediated ocular surface disorder

PubMed Central

Stevenson, William; Chauhan, Sunil K.; Dana, Reza

2013-01-01

Dry eye disease is a multifactorial disorder of the tears and ocular surface characterized by symptoms of dryness and irritation. Although the pathogenesis of dry eye disease is not fully understood, it is recognized that inflammation has a prominent role in the development and propagation of this debilitating condition. Factors that adversely affect tear film stability and osmolarity can induce ocular surface damage and initiate an inflammatory cascade that generates innate and adaptive immune responses. These immunoinflammatory responses lead to further ocular surface damage and the development of a self-perpetuating inflammatory cycle. Herein, we review the fundamental links between inflammation and dry eye disease and discuss the clinical implications of inflammation in disease management. PMID:22232476

Characteristics of Ocular Pain Complaints in Patients With Idiopathic Dry Eye Symptoms.

PubMed

Kalangara, Jerry P; Galor, Anat; Levitt, Roy C; Covington, Derek B; McManus, Katherine T; Sarantopoulos, Constantine D; Felix, Elizabeth R

2017-05-01

The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms. Subjects with clinically relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared with similar measures from published data in other chronic pain populations. The study sample consisted of 154 subjects, of which 91% were men and ranged in age from 27 to 89 (mean age=61). Fifty-three percent of participants reported an average ocular pain of at least moderate intensity (numerical rating scale≥4), with specific characteristics (i.e., "burning" spontaneous pain) reported at frequencies comparable to prevalent chronic neuropathic pain syndromes as reported in the literature. Significant correlations were found between ocular pain metrics and dry eye symptom severity scores (r=0.57-0.66). Dry eye signs, however, did not generally correlate with ocular pain severity. A significant proportion of subjects with idiopathic dry eye symptoms reported moderate or greater ocular pain intensity, with most endorsing descriptors commonly used by patients with nonocular neuropathic pain conditions. Identifying subgroups of dry eye patients based on the presence and characteristics of ocular pain complaints may improve dry eye subclassification and better individualize treatment strategies.

Correlation of Handheld Infrared Skin Thermometer and Infrared Videothermography Device for Measurement of Corneal Temperature.

PubMed

Oztas, Zafer; Barut Selver, Ozlem; Akkin, Cezmi; Canturk, Ecem; Afrashi, Filiz

2016-05-01

In our study, we aimed to investigate the correlation of handheld infrared skin thermometer and videothermography device for the measurement of corneal temperature. Forty healthy individuals (80 eyes) were enrolled to the study. Participants underwent a detailed ophthalmologic examination and medical history review for excluding any ocular and systemic diseases. The measurements of the central corneal temperature were performed in a room having constant temperature, humidity, and brightness levels. To avoid any variability, all the temperature measurements were performed in the same examination room by a single examiner. The temperature was measured with a handheld infrared skin thermometer (MEDISANA, FTN) from the corneal surface. The same instrument was also used to measure the subjects' body temperature. Moreover, the subjects underwent the corneal temperature measurement by a noncontact videothermography device (Optris PI 450; Optris GmbH). The male to female ratio was 19:21 among the subjects. The mean age was 25.1±4.7 years. The mean body temperature was 36.93±0.33°C. The mean corneal temperatures measured by the handheld infrared skin thermometer and the ocular videothermography device were 36.94±0.28°C and 35.61±0.61°C, respectively (P<0.01). The mean temperature difference was 1.34±0.57°C, with a 95% confidence interval. There was a moderate correlation between the corneal temperatures measured by the 2 devices in the right, the left eyes, and both eyes, respectively (P=0.450, 0.539, 0.490). Handheld infrared skin thermometers can be used for the evaluation of the corneal temperature. These devices may provide a simple, practical, and cheaper way to detect the corneal temperature, and the widely performed corneal temperature measurements may afford us to understand the temperature variability in numerous ocular conditions in a better way.

Clinical and laboratory characteristics of ocular syphilis: a new face in the era of HIV co-infection.

PubMed

Lee, Sun Young; Cheng, Vincent; Rodger, Damien; Rao, Narsing

2015-12-01

Ocular syphilis is reemerging as an important cause of uveitis in the new era of common co-infection with HIV. This study will reveal the clinical and laboratory characteristics in the group of individuals co-infected with ocular syphilis and HIV compared with HIV-negative individuals. In this retrospective observational case series, medical records of patients diagnosed with ocular syphilis with serologic support from 2008 to 2014 were reviewed. Ocular and systemic manifestation and laboratory profiles were reviewed. Twenty-nine eyes of 16 consecutive patients (10 HIV-positive and 6 HIV-negative) were included. All patients were males, and mean age of onset for ocular syphilis was 43 (mean 42.65 ± 13.13). In both HIV-positive and HIV-negative groups, ocular manifestations of syphilis were variable including anterior uveitis (4 eyes), posterior uveitis (8 eyes), panuveitis (13 eyes), and isolated papillitis (4 eyes). In HIV-positive patients, panuveitis was the most common feature (12/18 eyes, 67 %) and serum rapid plasma reagin (RPR) titers were significantly higher (range 1:64-1:16,348; mean 1:768; p = 0.018) than in HIV-negative patients. Upon the diagnosis of ocular syphilis in HIV-positive patients, HIV-1 viral load was high (median 206,887 copies/ml) and CD4 cell count ranged from 127 to 535 cells/ml (mean 237 ± 142; median 137). Regardless of HIV status, cerebrospinal fluid (CSF) exam was frequently abnormal: positive CSF fluorescent treponemal antibody absorption (FTA-ABS) or Venereal Disease Research Laboratory (VDRL) test results in seven patients or either elevated CSF WBC count or elevated CSF protein in six patients. Our results reveal that the patients with ocular syphilis with high serum RPR titers may have concomitant HIV infection requiring further testing for HIV status and ocular syphilis is likely associated with the central nervous system involvement and therefore needs to be managed according to the treatment recommendations for neurosyphilis.

Multifocal electroretinographical changes in monkeys with experimental ocular hypertension: a longitudinal study.

PubMed

Kremers, Jan; Doelemeyer, Arno; Polska, Elzbieta A; Moret, Fabrice; Lambert, Christian; Lambrou, George N

2008-07-01

To study the time course of changes in the multifocal electroretinograms (mfERG) in monkeys with experimental ocular hypertension (OHT). The mfERGs were recorded in 12 eyes out of 6 monkeys. Two baseline measurements were used to quantify the reproducibility, the inter-ocular and the inter-individual variability of the ERG signals. Thereafter, the trabeculum of one eye of each animal was laser-coagulated in one to three sessions to induce OHT. ERG measurements were repeated regularly in a period of 18 months and the changes in ERG waveforms were quantified. All animals displayed OHT (between 20 and 50 mmHg) in the laser-coagulated eyes. An ERG change was defined as the sum of differences during the first 90 ms between the laser-coagulated eye and the same eye before laser coagulation and between the laser-coagulated eye and the non-treated fellow eye. Three animals displayed significant changes for nearly all retinal areas and all stimulus conditions. The three remaining animals displayed significant changes only in one comparison, indicating very mild changes. The data indicate that a high stimulus contrast is more sensitive to detect changes, probably because of a better signal-to-noise ratio. Moreover, the comparisons with the fellow eye are more sensitive to detect changes than comparisons with the measurements before laser-coagulation. OHT does not always lead to ERG changes. Comparisons with fellow eyes using high contrast stimuli are more sensitive to detect changes related to OHT.

External ocular hyperemia: a quantifiable indicator of spacecraft air quality.

PubMed

Ogle, J W; Cohen, K L

1996-05-01

Eye irritation consistently ranks as a top astronaut complaint but is difficult to measure. Exposure to internal air pollution hypothetically disrupts the eye's tear film, thereby exposing the crewmembers' conjunctivae to the irritating effects of the recirculated, contaminant-laden atmosphere of the space vehicle. Causes elude engineers and toxicologists, who report that measured irritants remain below established Spacecraft Maximum Allowable Concentrations. Lack of objective ocular endpoints stymies efforts to identify etiologies. Computers offer a practical means of analyzing ocular hyperemia in space. We use computer analysis to quantify redness and blood vessels of digitized images of bulbar conjunctivae in near real time. Custom software masks artifacts, lids and lashes for each photographic or telemedicine ocular image, Algorithms then generate semi-independent measurements of hyperemia. Computed difference scores between 34 pairs of images were compared with subjective difference scores as voted on by a panel of ophthalmology residents. Objective data were reliably extracted from ocular images and significantly correlated (r = 0.583, p < 0.05) with subjective scores. This ground-based methodology generates accurate and reliable ocular endpoint data without mass, volume, or power penalty. To assist in identifying and eliminating onboard ocular irritants, these objective data can be regressed against independent variables such as mission elapsed time, subjective astronaut complaints, levels of chemical and electromagnetic contaminants, nephthelometric and barothermal data. As missions lengthen, sensitive tools such as hyperemia quantification will become increasingly important for assessing and optimizing spacecraft environments.

Ocular dominance stability and reading skill: a controversial relationship.

PubMed

Zeri, Fabrizio; De Luca, Maria; Spinelli, Donatella; Zoccolotti, Pierluigi

2011-11-01

Evidence is mixed concerning the relationship between stability of ocular dominance and reading deficits. Contrasting results may be due to the use of different tests of dominance, different samples of readers, and different scoring methods. The aim of this study was to investigate the relationship among ocular dominance, general visual abilities, and reading performance, and to evaluate the consistency and reliability of different tests of ocular dominance and the effects of different types of eye dominance scoring. In a group of young adults, we measured: (a) main optometric parameters; (b) reading time and accuracy; and (c) ocular dominance in two sighting and four motor tests. Dominance was determined using different scoring methods (relative, absolute, and binary scores). All dominance tests showed good levels of internal reliability. Sighting tests were consistent regardless of the scoring method, and all participants had stable dominance. Three of four motor tests were moderately consistent when dominance was measured with relative scores but not when it was measured with absolute or binary scores. No relationship was found between stability of dominance and reading performance, regardless of the type of test or scoring method. No systematic pattern of correlation was found between binocular vision variables and dominance measures. Choosing the type of motor test to measure ocular dominance is crucial, because the level of consistency among tests is low to moderate. Furthermore, motor tests were not correlated with reading performances. Present results suggest caution when trying to link reading difficulties with specific profiles of ocular dominance.

Uveitis as an initial manifestation of acquired immunodeficiency syndrome.

PubMed

Tsen, Chui-Lien; Chen, Shih-Chou; Chen, Yao-Shen; Sheu, Shwu-Jiuan

2017-10-01

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a multisystem disease that can involve the human eyes. Using ophthalmic examination records from January 2006 to November 2015, we retrospectively reviewed all patients who were diagnosed with HIV/AIDS in our hospital. The study was performed at a tertiary referral center in southern Taiwan. Data included age, gender, ophthalmic examinations, systemic conditions, CD4 cell counts, course, and treatment. Eleven patients were identified as having AIDS with uveitis as their presenting manifestation. All were men, with a mean age of 39.5 ± 11.4 years (range 24-56). The mean CD4 + T-cell counts were 91.7 ± 50.3 cells/μl (range 27-169). Ocular diagnoses included cytomegalovirus (CMV) retinitis in five patients, ocular syphilis in four patients, and ocular toxoplasmosis in two patients. Uveitis resolved in all patients after medical treatment. However, a retinal detachment developed in two eyes in CMV retinitis and one eye in ocular syphilis. Ocular manifestations are among the most common clinical features in patients with HIV/AIDS who have varying clinical presentations that affect almost all ocular structures. This study demonstrated that ocular findings could be an initial manifestation of an underlying disease. Awareness of ocular lesions in HIV/AIDS is important for early recognition and management.

Eye disorders in newborn infants (excluding retinopathy of prematurity).

PubMed

Wan, Michael J; VanderVeen, Deborah K

2015-05-01

A screening eye examination is an essential part of the newborn assessment. The detection of many ocular disorders in newborn infants can be achieved through careful observation of the infant's visual behaviour and the use of a direct ophthalmoscope to assess the ocular structures and check the red reflex. Early diagnosis and subspecialty referral can have a critical impact on the prognosis for many ocular conditions, including potentially blinding but treatable conditions such as congenital cataracts, life-threatening malignancies such as retinoblastoma and harbingers of disease elsewhere such as sporadic aniridia and its association with the development of Wilms tumour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Ocular static and dynamic light scattering: a noninvasive diagnostic tool for eye research and clinical practice

NASA Technical Reports Server (NTRS)

Ansari, Rafat R.

2004-01-01

The noninvasive techniques of static and dynamic light scattering are emerging as valuable diagnostic tools for the early detection of ocular and systemic diseases. These include corneal abnormalities, pigmentary dispersion syndrome, glaucoma, cataract, diabetic vitreopathy, and possibly macular degeneration. Systemic conditions such as diabetes and possibly Alzheimer's disease can potentially be detected early via ocular tissues. The current state of development of these techniques for application to ophthalmic research and ultimately clinical practice is reviewed. (c) 2004 Society of Photo-Optical Instrumentation Engineers.

Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms.

PubMed

Spierer, Oriel; Felix, Elizabeth R; McClellan, Allison L; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J; Sarantopoulos, Constantine D; Levitt, Roy C; Ehrmann, Klaus; Galor, Anat

2016-02-01

To examine associations between corneal mechanical thresholds and metrics of dry eye. This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P < 0.05), implying decreased corneal sensitivity with age. Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = -0.13 to -0.27, P < 0.05 for values between -0.18 and -0.27), suggesting increased corneal sensitivity in those with more severe ocular complaints. Ocular signs, on the other hand, correlated poorly and nonsignificantly with mechanical detection and pain thresholds on the cornea. A multivariable linear regression model found that both posttraumatic stress disorder (PTSD) score (β = 0.21, SE = 0.03) and corneal pain threshold (β = -0.03, SE = 0.01) were significantly associated with self-reported evoked eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints.

Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms

PubMed Central

Spierer, Oriel; Felix, Elizabeth R.; McClellan, Allison L.; Parel, Jean Marie; Gonzalez, Alex; Feuer, William J.; Sarantopoulos, Constantine D.; Levitt, Roy C.; Ehrmann, Klaus; Galor, Anat

2016-01-01

Purpose To examine associations between corneal mechanical thresholds and metrics of dry eye. Methods This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain. Results A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P < 0.05), implying decreased corneal sensitivity with age. Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = −0.13 to −0.27, P < 0.05 for values between −0.18 and −0.27), suggesting increased corneal sensitivity in those with more severe ocular complaints. Ocular signs, on the other hand, correlated poorly and nonsignificantly with mechanical detection and pain thresholds on the cornea. A multivariable linear regression model found that both posttraumatic stress disorder (PTSD) score (β = 0.21, SE = 0.03) and corneal pain threshold (β = −0.03, SE = 0.01) were significantly associated with self-reported evoked eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57). Conclusions Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints. PMID:26886896

Vision-Related Quality of Life in Patients with Ocular Graft-versus-Host Disease.

PubMed

Saboo, Ujwala S; Amparo, Francisco; Abud, Tulio B; Schaumberg, Debra A; Dana, Reza

2015-08-01

To assess the vision-related quality of life (QOL) in a cohort of patients with ocular graft-versus-host disease (GVHD). Prospective study. Eighty-four patients diagnosed with chronic ocular GVHD. We assessed the vision-related QOL with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). The symptoms of ocular GVHD were assessed using the Ocular Surface Disease Index (OSDI) and Symptom Assessment in Dry Eye (SANDE) questionnaires. We assessed vision-related QOL with the NEI-VFQ-25 and compared the scores obtained from patients with ocular GVHD with those from a healthy population. In the ocular GVHD population, we also evaluated the associations between the NEI-VFQ-25 and the dry eye symptoms measured by the OSDI and SANDE questionnaires, age, duration of disease, best-corrected visual acuity (BCVA), corneal fluorescein staining (CFS), tear break-up time, and Schirmer test. The mean composite NEI-VFQ-25 score in patients with ocular GVHD was 76.5±17. Compared with healthy subjects, patients with ocular GVHD reported reduced scores on all NEI-VFQ-25 subscales (each P < 0.001) with the exception of color vision (P = 0.11). The NEI-VFQ-25 composite scores significantly correlated with OSDI (R = -0.81, P < 0.001), SANDE (R = -0.56, P < 0.001), CFS (R = -0.36, P = 0.001), and BCVA (R = -0.30, P = 0.004). Patients with ocular GVHD experience measurable impairment of vision-related QOL. This study highlights the impact of ocular GVHD on the vision-related QOL, and thus the importance of comprehensive diagnosis and treatment of this condition. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Vision-Related Quality of Life in Patients with Ocular Graft-versus-host Disease

PubMed Central

Saboo, Ujwala S; Amparo, Francisco; Abud, Tulio B; Schaumberg, Debra A; Dana, Reza

2015-01-01

Objective To assess the vision-related quality of life in a cohort of patients with ocular graft-versus-host disease (GVHD). Design Prospective study. Participants Eighty-four patients diagnosed with chronic ocular GVHD Methods We assessed the vision-related quality of life with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). The symptoms of ocular GVHD were assessed using the Ocular Surface Disease Index (OSDI) and Symptom Assessment in Dry Eye (SANDE) questionnaires. Main outcome measures We assessed vision-related quality of life with NEI-VFQ-25 and compared the scores obtained from patients with ocular GVHD to those from a healthy population. In the ocular GVHD population, we also evaluated the associations between the NEI-VFQ-25 and dry eye symptoms measured by OSDI and SANDE questionnaires, age, duration of disease, best-corrected visual acuity, corneal fluorescein staining, tear break-up time, and Schirmer test. Results The mean composite NEI-VFQ-25 score in patients with ocular GVHD was 76.5 ± 17. Compared to healthy subjects, ocular GVHD patients reported reduced scores on all NEI-VFQ-25 subscales (each P < 0.001) with exception of color vision (P = 0.11). The NEI-VFQ-25 composite scores significantly correlated with OSDI (R = −0.81, P < 0.001), SANDE (R = −0.56, P < 0.001), corneal fluorescein staining (R = −0.36, P = 0.001) and best-corrected visual acuity (R = −0.30, P = 0.004). Conclusion Patients with ocular GVHD experience measurable impairment of vision-related quality of life. This study highlights the impact of ocular GVHD on the vision-related quality of life, and hence the importance of comprehensive diagnosis and treatment of this condition. PMID:26001816

Müller glia-derived PRSS56 is required to sustain ocular axial growth and prevent refractive error.

PubMed

Paylakhi, Seyyedhassan; Labelle-Dumais, Cassandre; Tolman, Nicholas G; Sellarole, Michael A; Seymens, Yusef; Saunders, Joseph; Lakosha, Hesham; deVries, Wilhelmine N; Orr, Andrew C; Topilko, Piotr; John, Simon Wm; Nair, K Saidas

2018-03-01

A mismatch between optical power and ocular axial length results in refractive errors. Uncorrected refractive errors constitute the most common cause of vision loss and second leading cause of blindness worldwide. Although the retina is known to play a critical role in regulating ocular growth and refractive development, the precise factors and mechanisms involved are poorly defined. We have previously identified a role for the secreted serine protease PRSS56 in ocular size determination and PRSS56 variants have been implicated in the etiology of both hyperopia and myopia, highlighting its importance in refractive development. Here, we use a combination of genetic mouse models to demonstrate that Prss56 mutations leading to reduced ocular size and hyperopia act via a loss of function mechanism. Using a conditional gene targeting strategy, we show that PRSS56 derived from Müller glia contributes to ocular growth, implicating a new retinal cell type in ocular size determination. Importantly, we demonstrate that persistent activity of PRSS56 is required during distinct developmental stages spanning the pre- and post-eye opening periods to ensure optimal ocular growth. Thus, our mouse data provide evidence for the existence of a molecule contributing to both the prenatal and postnatal stages of human ocular growth. Finally, we demonstrate that genetic inactivation of Prss56 rescues axial elongation in a mouse model of myopia caused by a null mutation in Egr1. Overall, our findings identify PRSS56 as a potential therapeutic target for modulating ocular growth aimed at preventing or slowing down myopia, which is reaching epidemic proportions.

Müller glia-derived PRSS56 is required to sustain ocular axial growth and prevent refractive error

PubMed Central

Tolman, Nicholas G; Sellarole, Michael A.; Saunders, Joseph; Lakosha, Hesham; Topilko, Piotr; John, Simon WM.

2018-01-01

A mismatch between optical power and ocular axial length results in refractive errors. Uncorrected refractive errors constitute the most common cause of vision loss and second leading cause of blindness worldwide. Although the retina is known to play a critical role in regulating ocular growth and refractive development, the precise factors and mechanisms involved are poorly defined. We have previously identified a role for the secreted serine protease PRSS56 in ocular size determination and PRSS56 variants have been implicated in the etiology of both hyperopia and myopia, highlighting its importance in refractive development. Here, we use a combination of genetic mouse models to demonstrate that Prss56 mutations leading to reduced ocular size and hyperopia act via a loss of function mechanism. Using a conditional gene targeting strategy, we show that PRSS56 derived from Müller glia contributes to ocular growth, implicating a new retinal cell type in ocular size determination. Importantly, we demonstrate that persistent activity of PRSS56 is required during distinct developmental stages spanning the pre- and post-eye opening periods to ensure optimal ocular growth. Thus, our mouse data provide evidence for the existence of a molecule contributing to both the prenatal and postnatal stages of human ocular growth. Finally, we demonstrate that genetic inactivation of Prss56 rescues axial elongation in a mouse model of myopia caused by a null mutation in Egr1. Overall, our findings identify PRSS56 as a potential therapeutic target for modulating ocular growth aimed at preventing or slowing down myopia, which is reaching epidemic proportions. PMID:29529029

Density of ocular components of the bovine eye.

PubMed

Su, Xiao; Vesco, Christina; Fleming, Jacquelyn; Choh, Vivian

2009-10-01

Density is essential for acoustic characterization of tissues and provides a basic input for ultrasound backscatter and absorption models. Despite the existence of extensive compilations of acoustic properties, neither unified data on ocular density nor comparisons of the densities between all ocular components can be found. This study was undertaken to determine the mass density of all the ocular components of the bovine eye. Liquid components were measured through mass/volume ratio, whereas solid tissues were measured with two different densitometry techniques based on Archimedes Principle. The first method determines the density by measuring dry and wet weight of the tissues. The second method consists of immersing the tissues in sucrose solutions of varying densities and observing their buoyancy. Although the mean densities for all tissues were found to be within 0.02 g/cm by both methods, only the sucrose solution method offered a consistent relative order for all measured ocular components, as well as a considerably smaller standard deviation (a maximum standard deviation of 0.004 g/cm for cornea). The lens was found to be the densest component, followed by the sclera, cornea, choroid, retina, aqueous, and vitreous humors. The consistent results of the sucrose solution tests suggest that the ocular mass density is a physical property that is more dependent on the compositional and structural characteristics of the tissue and than on population variability.

The relationship between demodex and ocular discomfort.

PubMed

Lee, Seok Hyun; Chun, Yeoun Sook; Kim, Jae Hoon; Kim, Eung Suk; Kim, Jae Chan

2010-06-01

To determine the correlative relationship between the prevalence of Demodex in eyelashes and the severity of ocular discomfort, by investigating the demographic epidemiology associated with Demodex. One hundred seventy patients underwent epilation of four eyelashes of each eye, and the number of Demodex was counted. The patients answered questionnaires about ocular surface discomfort and underwent ophthalmic examinations, including slit lamp, tear film breakup time (BUT), Schirmer test, and microbial culturing. The correlative relationship between the number of Demodex and these variable data was analyzed. Demodex was found in 120 (70%) of the 170 tested patients. Of 1360 eyelashes, 740 (54%) had Demodex. There was no significant difference in the prevalence of Demodex between males and females (P = 0.35). The number of Demodex showed significant positive correlations with increased age, ocular discomfort, and 1/BUT (P < 0.001), but not with the Schirmer scores. The number of Demodex was significantly higher in patients with conjunctival papillary hypertrophy than in those without (P = 0.003). The presence or distribution of bacteria on eyelashes was similar between eyelids with and without Demodex. However, methicillin-resistant Staphylococcus aureus (MRSA) was detected more often on eyelids with Demodex, but this difference was not statistically significant. There is a strong correlation between the number of Demodex and the severity of ocular discomfort, suggesting that Demodex plays a pathogenic role in the ocular discomfort linked with aging.

Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome: Capturing the Discrepancy.

PubMed

Bezzina, Oriana M; Gallagher, Peter; Mitchell, Sheryl; Bowman, Simon J; Griffiths, Bridget; Hindmarsh, Victoria; Hargreaves, Ben; Price, Elizabeth J; Pease, Colin T; Emery, Paul; Lanyon, Peter; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; Hunter, John; Gupta, Monica; McLaren, John; Cooper, Anne M; Regan, Marian; Giles, Ian P; Isenberg, David A; Saravanan, Vadivelu; Coady, David; Dasgupta, Bhaskar; McHugh, Neil J; Young-Min, Steven A; Moots, Robert J; Gendi, Nagui; Akil, Mohammed; MacKay, Kirsten; Ng, W Fai; Robinson, Lucy J

2017-11-01

To develop a novel method for capturing the discrepancy between objective tests and subjective dryness symptoms (a sensitivity scale) and to explore predictors of dryness sensitivity. Archive data from the UK Primary Sjögren's Syndrome Registry (n = 688) were used. Patients were classified on a scale from -5 (stoical) to +5 (sensitive) depending on the degree of discrepancy between their objective and subjective symptoms classes. Sensitivity scores were correlated with demographic variables, disease-related factors, and symptoms of pain, fatigue, anxiety, and depression. Patients were on average relatively stoical for both types of dryness symptoms (mean ± SD ocular dryness -0.42 ± 2.2 and -1.24 ± 1.6 oral dryness). Twenty-seven percent of patients were classified as sensitive to ocular dryness and 9% to oral dryness. Hierarchical regression analyses identified the strongest predictor of ocular dryness sensitivity to be self-reported pain and that of oral dryness sensitivity to be self-reported fatigue. Ocular and oral dryness sensitivity can be classified on a continuous scale. The 2 symptom types are predicted by different variables. A large number of factors remain to be explored that may impact symptom sensitivity in primary Sjögren's syndrome, and the proposed method could be used to identify relatively sensitive and stoical patients for future studies. © 2016, The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

The Gait Disorder in Downbeat Nystagmus Syndrome

PubMed Central

Schniepp, Roman; Wuehr, Max; Huth, Sabrina; Pradhan, Cauchy; Schlick, Cornelia; Brandt, Thomas; Jahn, Klaus

2014-01-01

Background Downbeat nystagmus (DBN) is a common form of acquired fixation nystagmus with key symptoms of oscillopsia and gait disturbance. Gait disturbance could be a result of impaired visual feedback due to the involuntary ocular oscillations. Alternatively, a malfunction of cerebellar locomotor control might be involved, since DBN is considered a vestibulocerebellar disorder. Methods Investigation of walking in 50 DBN patients (age 72±11 years, 23 females) and 50 healthy controls (HS) (age 70±11 years, 23 females) using a pressure sensitive carpet (GAITRite). The patient cohort comprised subjects with only ocular motor signs (DBN) and subjects with an additional limb ataxia (DBNCA). Gait investigation comprised different walking speeds and walking with eyes closed. Results In DBN, gait velocity was reduced (p<0.001) with a reduced stride length (p<0.001), increased base of support (p<0.050), and increased double support (p<0.001). Walking with eyes closed led to significant gait changes in both HS and DBN. These changes were more pronounced in DBN patients (p<0.001). Speed-dependency of gait variability revealed significant differences between the subgroups of DBN and DBNCA (p<0.050). Conclusions (I) Impaired visual control caused by involuntary ocular oscillations cannot sufficiently explain the gait disorder. (II) The gait of patients with DBN is impaired in a speed dependent manner. (III) Analysis of gait variability allows distinguishing DBN from DBNCA: Patients with pure DBN show a speed dependency of gait variability similar to that of patients with afferent vestibular deficits. In DBNCA, gait variability resembles the pattern found in cerebellar ataxia. PMID:25140517

The gait disorder in downbeat nystagmus syndrome.

PubMed

Schniepp, Roman; Wuehr, Max; Huth, Sabrina; Pradhan, Cauchy; Schlick, Cornelia; Brandt, Thomas; Jahn, Klaus

2014-01-01

Downbeat nystagmus (DBN) is a common form of acquired fixation nystagmus with key symptoms of oscillopsia and gait disturbance. Gait disturbance could be a result of impaired visual feedback due to the involuntary ocular oscillations. Alternatively, a malfunction of cerebellar locomotor control might be involved, since DBN is considered a vestibulocerebellar disorder. Investigation of walking in 50 DBN patients (age 72 ± 11 years, 23 females) and 50 healthy controls (HS) (age 70 ± 11 years, 23 females) using a pressure sensitive carpet (GAITRite). The patient cohort comprised subjects with only ocular motor signs (DBN) and subjects with an additional limb ataxia (DBNCA). Gait investigation comprised different walking speeds and walking with eyes closed. In DBN, gait velocity was reduced (p<0.001) with a reduced stride length (p<0.001), increased base of support (p<0.050), and increased double support (p<0.001). Walking with eyes closed led to significant gait changes in both HS and DBN. These changes were more pronounced in DBN patients (p<0.001). Speed-dependency of gait variability revealed significant differences between the subgroups of DBN and DBNCA (p<0.050). (I) Impaired visual control caused by involuntary ocular oscillations cannot sufficiently explain the gait disorder. (II) The gait of patients with DBN is impaired in a speed dependent manner. (III) Analysis of gait variability allows distinguishing DBN from DBNCA: Patients with pure DBN show a speed dependency of gait variability similar to that of patients with afferent vestibular deficits. In DBNCA, gait variability resembles the pattern found in cerebellar ataxia.

Influence of Ophthalmic Solutions on Tear Components.

PubMed

Shigeyasu, Chika; Yamada, Masakazu; Akune, Yoko

2016-11-01

Tear fluids are a mixture of secretions derived from lacrimal glands, accessory lacrimal glands, conjunctiva, and meibomian glands. Compositional changes to tears occur in the normal state and during ocular surface disease, such as dry eye conditions. We have investigated compositional changes to tears after topical application of ophthalmic solutions, with regard to tear-specific proteins (secretory immunoglobulin A, lactoferrin, lipocalin-1, and lysozyme) and ocular surface mucin in normal and dry eye conditions using high-performance liquid chromatography. After application of saline solution (0.9% sodium chloride) in normal subjects, transient but significant decreases in all tear components were observed. The recovery of protein concentrations took up to 30 minutes and lasted longer when the saline solution was applied more frequently. When applying ophthalmic solutions, a balance between washout and dilutional effects should be considered in addition to the therapeutic effect. Investigation of the effect of diquafosol solution (3%) in normal subjects revealed a significant increase in sialic acid concentration, a marker of ocular mucin, at 5 minutes after application, whereas a significant decrease was observed with saline. This result indicates the accelerated secretion of mucin from ocular tissues induced by diquafosol. A clinical study to determine the efficacy of diquafosol in patients with dry eye revealed improvements in tear breakup time, keratoconjunctival staining scores, and Schirmer test score, accompanied by an increase in sialic acid concentration in tears. Investigating normal and dry eye conditions through tear analysis may clarify the pathophysiology of dry eye conditions and support the efficacy of treatments.

Petroleum Jelly: A Novel Medium for Ocular Ultrasound.

PubMed

Engelbert, Patrick R; Palma, James K

2015-08-01

Ocular ultrasound is a useful emergency department imaging modality for evaluation of many conditions, such as retinal detachment, vitreous detachment, vitreous hemorrhage, and elevated intracranial pressure. Obtaining satisfactory ocular ultrasound images requires the use of a medium that eliminates the air interface between the patient's eye and the transducer. Ultrasound gel is most commonly used; however, the use of a transparent dressing applied to the closed eye prior to the application of gel has also been described as a suitable technique. Ocular ultrasound is performed with the high-frequency linear array transducer using a medium to eliminate the air interface between the eye and the transducer. Although ultrasound gel is most frequently used, it can cause minor eye irritation. Placing a transparent dressing over a closed eye prior to application of gel can eliminate the eye irritation. However, our experience in training >500 students in ocular ultrasound has shown that air is frequently introduced underneath the dressing, which leads to poor-quality images. This article introduces petroleum jelly as a medium for ocular ultrasound. By applying a layer of petroleum jelly over the closed eye and allowing it to warm via body heat for 30 to 45 s, this medium can both minimize patient discomfort and provide easily obtainable, high-quality ocular ultrasound images. This article introduces petroleum jelly as a safe, comfortable, and effective medium for ocular ultrasound examination. Published by Elsevier Inc.

Seasonal and diurnal variations of ocular pressure in ocular hypertensive subjects in Pakistan.

PubMed

Qureshi, I A; Xiao, R X; Yang, B H; Zhang, J; Xiang, D W; Hui, J L

1999-05-01

Studies have been shown that intraocular pressure (IOP) shows a diurnal variation in ocular hypertensive subjects, but the amount of change differs from study to study. In recent years it has been noted that intraocular pressure is a dynamic function and is subjected to many influences both acutely and over the long term. The variability in the results may be due to negligence of factors that can affect IOP. Moreover, seasonal variations in the ocular hypertensive subjects have never been described. After placing control on those factors that can affect IOP, this study investigated seasonal and diurnal variations in IOP of ocular hypertensive subjects. IOP was measured each month over the course of 12 months with the Goldmann applanation tonometer in 91 ocular hypertensive male subjects. To see the diurnal changes, subjects were asked to stay in the hospital for 24 hours. The average IOP in the winter months was higher than those in spring, summer, and autumn. The IOP difference between winter and summer was (mean +/- sem) 2.9 +/- 0.9 mmHg (p < 0.001). The peak of mean IOP in diurnal variation curve (25.7 +/- 1.2 mmHg) appeared in the morning when the subjects had just awaken. The mean diurnal variation was found to be 4.2 +/- 0.6 mmHg (p < 0.001). This study confirms that seasons influence IOP and it shows diurnal variations. As compared to other nations, diurnal variations in ocular hypertensive subjects seem to be somewhat less in Pakistan. Knowledge of the seasonal and diurnal variations in IOP may help glaucoma screeners.

Loss of Retinal Function and Pigment Epithelium Changes in a Patient with Common Variable Immunodeficiency

PubMed Central

Halborg, Jakob; Sørensen, Torben L.

2012-01-01

Common variable immunodeficiency (CVID) has only scarcely been associated with ocular symptoms and rarely with retinal disease. In this case we describe a patient with distinct morphological and functional alterations in the retina. The patient presents with characteristic changes in retinal pigment epithelium, autofluorescence, and electrophysiology. PMID:23056974

Visualizing microvascular flow variation in OCTA using variable interscan time analysis (VISTA) (Conference Presentation)

NASA Astrophysics Data System (ADS)

Moult, Eric M.; Ploner, Stefan A.; Choi, WooJhon; Lee, ByungKun; Husvogt, Lennart A.; Lu, Chen D.; Novais, Eduardo; Cole, Emily D.; Potsaid, Benjamin M.; Duker, Jay S.; Hornegger, Joachim; Meier, Andreas K.; Waheed, Nadia K.; Fujimoto, James G.

2017-02-01

OCT angiography (OCTA) has recently garnered immense interest in clinical ophthalmology, permitting ocular vasculature to be viewed in exquisite detail, in vivo, and without the injection of exogenous dyes. However, commercial OCTA systems provide little information about actual erythrocyte speeds; instead, OCTA is typically used to visualize the presence and/or absence of vasculature. This is an important limitation because in many ocular diseases, including diabetic retinopathy (DR) and age-related macular degeneration (AMD), alterations in blood flow, but not necessarily only the presence or absence of vasculature, are thought to be important in understanding pathogenesis. To address this limitation, we have developed an algorithm, variable interscan time analysis (VISTA), which is capable of resolving different erythrocyte speeds. VISTA works by acquiring >2 repeated B-scans, and then computing multiple OCTA signals corresponding to different effective interscan times. The OCTA signals corresponding to different effective interscan times contain independent information about erythrocyte speed. In this study we provide a theoretical overview of VISTA, and investigate the utility of VISTA in studying blood flow alterations in ocular disease. OCTA-VISTA images of eyes with choroidal neovascularization, geographic atrophy, and diabetic retinopathy are presented.

The ocular surface and tear film and their dysfunction in dry eye disease.

PubMed

Rolando, M; Zierhut, M

2001-03-01

The ocular surface, tear film, lacrimal glands, and eyelids act as a functional unit to preserve the quality of the refractive surface of the eye and to resist injury and protect the eye against changing bodily and environmental conditions. Events that disturb the homeostasis of this functional unit can result in a vicious cycle of ocular surface disease. The tear film is the most dynamic structure of the functional unit, and its production and turnover is essential to maintaining the health of the ocular surface. Classically, the tear film is reported to be composed of three layers: the mucin, aqueous, and lipid layers. The boundaries and real thickness of such layers is still under discussion. A dysfunction of any of these layers can result in dry eye disease.

New Objective Refraction Metric Based on Sphere Fitting to the Wavefront

PubMed Central

Martínez-Finkelshtein, Andreí

2017-01-01

Purpose To develop an objective refraction formula based on the ocular wavefront error (WFE) expressed in terms of Zernike coefficients and pupil radius, which would be an accurate predictor of subjective spherical equivalent (SE) for different pupil sizes. Methods A sphere is fitted to the ocular wavefront at the center and at a variable distance, t. The optimal fitting distance, topt, is obtained empirically from a dataset of 308 eyes as a function of objective refraction pupil radius, r0, and used to define the formula of a new wavefront refraction metric (MTR). The metric is tested in another, independent dataset of 200 eyes. Results For pupil radii r0 ≤ 2 mm, the new metric predicts the equivalent sphere with similar accuracy (<0.1D), however, for r0 > 2 mm, the mean error of traditional metrics can increase beyond 0.25D, and the MTR remains accurate. The proposed metric allows clinicians to obtain an accurate clinical spherical equivalent value without rescaling/refitting of the wavefront coefficients. It has the potential to be developed into a metric which will be able to predict full spherocylindrical refraction for the desired illumination conditions and corresponding pupil size. PMID:29104804

New Objective Refraction Metric Based on Sphere Fitting to the Wavefront.

PubMed

Jaskulski, Mateusz; Martínez-Finkelshtein, Andreí; López-Gil, Norberto

2017-01-01

To develop an objective refraction formula based on the ocular wavefront error (WFE) expressed in terms of Zernike coefficients and pupil radius, which would be an accurate predictor of subjective spherical equivalent (SE) for different pupil sizes. A sphere is fitted to the ocular wavefront at the center and at a variable distance, t . The optimal fitting distance, t opt , is obtained empirically from a dataset of 308 eyes as a function of objective refraction pupil radius, r 0 , and used to define the formula of a new wavefront refraction metric (MTR). The metric is tested in another, independent dataset of 200 eyes. For pupil radii r 0 ≤ 2 mm, the new metric predicts the equivalent sphere with similar accuracy (<0.1D), however, for r 0 > 2 mm, the mean error of traditional metrics can increase beyond 0.25D, and the MTR remains accurate. The proposed metric allows clinicians to obtain an accurate clinical spherical equivalent value without rescaling/refitting of the wavefront coefficients. It has the potential to be developed into a metric which will be able to predict full spherocylindrical refraction for the desired illumination conditions and corresponding pupil size.

Modeling of mouse eye and errors in ocular parameters affecting refractive state

NASA Astrophysics Data System (ADS)

Bawa, Gurinder

Rodents eye are particularly used to study refractive error state of an eye and development of refractive eye. Genetic organization of rodents is similar to that of humans, which makes them interesting candidates to be researched upon. From rodents family mice models are encouraged over rats because of availability of genetically engineered models. Despite of extensive work that has been performed on mice and rat models, still no one is able to quantify an optical model, due to variability in the reported ocular parameters. In this Dissertation, we have extracted ocular parameters and generated schematics of eye from the raw data from School of Medicine, Detroit. In order to see how the rays would travel through an eye and the defects associated with an eye; ray tracing has been performed using ocular parameters. Finally we have systematically evaluated the contribution of various ocular parameters, such as radii of curvature of ocular surfaces, thicknesses of ocular components, and refractive indices of ocular refractive media, using variational analysis and a computational model of the rodent eye. Variational analysis revealed that variation in all the ocular parameters does affect the refractive status of the eye, but depending upon the magnitude of the impact those parameters are listed as critical or non critical. Variation in the depth of the vitreous chamber, thickness of the lens, radius of the anterior surface of the cornea, radius of the anterior surface of the lens, as well as refractive indices for the lens and vitreous, appears to have the largest impact on the refractive error and thus are categorized as critical ocular parameters. The radii of the posterior surfaces of the cornea and lens have much smaller contributions to the refractive state, while the radii of the anterior and posterior surfaces of the retina have no effect on the refractive error. These data provide the framework for further refinement of the optical models of the rat and mouse eye and suggest that extra efforts should be directed towards increasing the linear resolution of the rodent eye biometry and obtaining more accurate data for the refractive indices of the lens and vitreous.

Immunomodulatory therapy for ocular inflammatory disease: a basic manual and review of the literature.

PubMed

Okada, Annabelle A

2005-01-01

Corticosteroids are used as first-line treatment for many ocular inflammatory conditions. The risk of adverse effects, however, necessitates conversion to steroid-sparing immunomodulatory therapy (IMT) for disease that is recurrent, chronic, or poorly responsive to treatment. Combination drug treatments with multiple agent 'recipes' are also considered. Immunomodulatory agents include the broad categories of antimetabolites (azathioprine, methotrexate, mycophenolate mofetil), alkylating agents (cyclophosphamide, chlorambucil), T-cell inhibitors (cyclosporine, tacrolimus), and cytokines (interferon alfa). This article reviews and summarizes the evidence for IMT agent use in the treatment of various forms of ocular inflammation.

"Johnny Poppers": a cause of serious ocular injury

PubMed Central

MacAndie, K.; Kyle, P.

1998-01-01

AIMS/BACKGROUND—The causes of blunt ocular trauma are many and diverse. We present two cases of ocular injury caused by an unusual form of weapon called a "Johnny Popper". There follows a theoretical and experimental evaluation of the velocity of the projectiles fired by this device.
METHODS—A Johnny Popper was constructed under expert guidance. The elastic properties of the device were measured and this allowed calculation of a theoretical exit velocity of the projectiles fired. The weapon was subsequently fired under test conditions which permitted the exit velocity of the projectiles fired to be measured directly.
RESULTS—The theoretical velocity of the projectiles was calculated as 80 ms-1 and the experimentally measured velocity was 57 ms-1.
CONCLUSIONS—Johnny Poppers are a previously undescribed and unique form of home made weapon. They are intended for playful mischief, but have the potential to cause serious ocular trauma.

 Keywords: ocular trauma; projectiles PMID:9924377

Vestibular-ocular accommodation reflex in man

NASA Technical Reports Server (NTRS)

Clark, B.; Randle, R. J.; Stewart, J. D.

1975-01-01

Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present paper studies a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 sec of rotating. Accommodation was recorded continuously on an infrared optometer for 110 sec under two conditions: while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

Vestibular-ocular accommodation reflex in man.

PubMed

Clark, B R; Randle, R J; Stewart, J D

1975-11-01

Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present study was designed to study a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 s of rotation. Accommodation was recorded continuously on an infrared optometer for 110 s under two conditions; while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

Corneal biomechanical properties in different ocular conditions and new measurement techniques.

PubMed

Garcia-Porta, Nery; Fernandes, Paulo; Queiros, Antonio; Salgado-Borges, Jose; Parafita-Mato, Manuel; González-Méijome, Jose Manuel

2014-01-01

Several refractive and therapeutic treatments as well as several ocular or systemic diseases might induce changes in the mechanical resistance of the cornea. Furthermore, intraocular pressure measurement, one of the most used clinical tools, is also highly dependent on this characteristic. Corneal biomechanical properties can be measured now in the clinical setting with different instruments. In the present work, we review the potential role of the biomechanical properties of the cornea in different fields of ophthalmology and visual science in light of the definitions of the fundamental properties of matter and the results obtained from the different instruments available. The body of literature published so far provides an insight into how the corneal mechanical properties change in different sight-threatening ocular conditions and after different surgical procedures. The future in this field is very promising with several new technologies being applied to the analysis of the corneal biomechanical properties.

Corneal Biomechanical Properties in Different Ocular Conditions and New Measurement Techniques

PubMed Central

Garcia-Porta, Nery; Salgado-Borges, Jose; Parafita-Mato, Manuel; González-Méijome, Jose Manuel

2014-01-01

Several refractive and therapeutic treatments as well as several ocular or systemic diseases might induce changes in the mechanical resistance of the cornea. Furthermore, intraocular pressure measurement, one of the most used clinical tools, is also highly dependent on this characteristic. Corneal biomechanical properties can be measured now in the clinical setting with different instruments. In the present work, we review the potential role of the biomechanical properties of the cornea in different fields of ophthalmology and visual science in light of the definitions of the fundamental properties of matter and the results obtained from the different instruments available. The body of literature published so far provides an insight into how the corneal mechanical properties change in different sight-threatening ocular conditions and after different surgical procedures. The future in this field is very promising with several new technologies being applied to the analysis of the corneal biomechanical properties. PMID:24729900

Intrinsic-Signal Optical Imaging Reveals Cryptic Ocular Dominance Columns in Primary Visual Cortex of New World Owl Monkeys

PubMed Central

Kaskan, Peter M.; Lu, Haidong D.; Dillenburger, Barbara C.; Roe, Anna W.; Kaas, Jon H.

2007-01-01

A significant concept in neuroscience is that sensory areas of the neocortex have evolved the remarkable ability to represent a number of stimulus features within the confines of a global map of the sensory periphery. Modularity, the term often used to describe the inhomogeneous nature of the neocortex, is without a doubt an important organizational principle of early sensory areas, such as the primary visual cortex (V1). Ocular dominance columns, one type of module in V1, are found in many primate species as well as in carnivores. Yet, their variable presence in some New World monkey species and complete absence in other species has been enigmatic. Here, we demonstrate that optical imaging reveals the presence of ocular dominance columns in the superficial layers of V1 of owl monkeys (Aotus trivirgatus), even though the geniculate inputs related to each eye are highly overlapping in layer 4. The ocular dominance columns in owl monkeys revealed by optical imaging are circular in appearance. The distance between left eye centers and right eye centers is approximately 650 μm. We find no relationship between ocular dominance centers and other modular organizational features such as orientation pinwheels or the centers of the cytochrome oxidase blobs. These results are significant because they suggest that functional columns may exist in the absence of obvious differences in the distributions of activating inputs and ocular dominance columns may be more widely distributed across mammalian taxa than commonly suggested. PMID:18974855

Immunologically mediated ocular disease in the horse.

PubMed

Hines, M T

1984-11-01

The continued study of immunology and its relationship to diseases of the eye will hopefully give some insight into the pathogenic mechanisms of certain ocular diseases of many species, including the horse. It may lead to a better understanding of equine recurrent uveitis, a disease that has remained an enigma for years and that now appears to be an immunologic hypersensitivity response to a number of varied antigens. The precise mechanism of the inflammation is still unclear, and the immunologic response may be variable or mixed depending upon the inciting antigen. Other ophthalmic diseases in the horse, such as conjunctivitis, chorioretinitis, and less well-defined entities such as superficial punctate keratitis, may also have an immunologic component in their pathogenesis. An appreciation of immunopathologic mechanisms may thus enhance the veterinarian's understanding of the pathophysiology and treatment of equine ocular disease.

Evaluation of Dry Eye and Meibomian Gland Dysfunction in Teenagers with Myopia through Noninvasive Keratograph

PubMed Central

Wang, Xiu; Lu, Xiaoxiao; Yang, Jun; Wei, Ruihua; Yang, Liyuan; Zhao, Shaozhen; Wang, Xilian

2016-01-01

Purpose. This study aims to evaluate dry eye and ocular surface conditions of myopic teenagers by using questionnaire and clinical examinations. Methods. A total of 496 eyes from 248 myopic teenagers (7–18 years old) were studied. We administered Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp examination, and Keratograph 5M. The patients were divided into 2 groups based on OSDI dry eye standard, and their ocular surfaces and meibomian gland conditions were evaluated. Results. The tear meniscus heights of the dry eye and normal groups were in normal range. Corneal fluorescein scores were significantly higher whereas noninvasive break-up time was dramatically shorter in the dry eye group than in the normal group. All three meibomian gland dysfunction parameters (i.e., meibomian gland orifice scores, meibomian gland secretion scores, and meibomian gland dropout scores) of the dry eye group were significantly higher than those of the normal group (P < 0.0001). Conclusions. The prevalence of dry eye in myopic teenagers is 18.95%. Meibomian gland dysfunction plays an important role in dry eye in myopic teenagers. The Keratograph 5M appears to provide an effective noninvasive method for assessing ocular surface situation of myopic teenagers. PMID:26881059

Polymicrobial and microsporidial keratitis in a patient using Boston scleral contact lens for Sjogren's syndrome and ocular cicatricial pemphigoid.

PubMed

Fernandes, Merle; Sharma, Savitri

2013-04-01

To report a rare case of microsporidial and polymicrobial keratitis in a patient with Sjogren's syndrome and ocular cicatricial pemphigoid. This is a descriptive case report. A 66-year-old lady diagnosed with Sjogren's syndrome (SS) and ocular cicatricial pemphigoid (OCP) presented to us with microbial keratitis after using a Boston sclera contact lens for a painful epithelial defect. After 9 days of medical treatment, she underwent therapeutic penetrating keratoplasty. 10% potassium hydroxide and calcofluor white wet mount revealed microsporidial spores. Gram positive cocci and Gram variable bacilli on Gram stain were identified as Staphylococcus epidermidis and Corynebacterium accolens in culture. Histopathological examination of the corneal tissue confirmed the presence of microsporidial spores. Microsporidal keratitis can occur in patients with severe ocular surface disease due to SS and OCP. Predisposing factors include dry eye, local and systemic immunosuppression and Boston scleral contact lens. Early surgical intervention may be needed to eradicate the infection. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Computed tear film and osmolarity dynamics on an eye-shaped domain

PubMed Central

Li, Longfei; Braun, Richard J.; Driscoll, Tobin A.; Henshaw, William D.; Banks, Jeffrey W.; King-Smith, P. Ewen

2016-01-01

The concentration of ions, or osmolarity, in the tear film is a key variable in understanding dry eye symptoms and disease. In this manuscript, we derive a mathematical model that couples osmolarity (treated as a single solute) and fluid dynamics within the tear film on a 2D eye-shaped domain. The model includes the physical effects of evaporation, surface tension, viscosity, ocular surface wettability, osmolarity, osmosis and tear fluid supply and drainage. The governing system of coupled non-linear partial differential equations is solved using the Overture computational framework, together with a hybrid time-stepping scheme, using a variable step backward differentiation formula and a Runge–Kutta–Chebyshev method that were added to the framework. The results of our numerical simulations provide new insight into the osmolarity distribution over the ocular surface during the interblink. PMID:25883248

Air bags and ocular injuries.

PubMed

Stein, J D; Jaeger, E A; Jeffers, J B

1999-01-01

This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries. Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury. Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm.

Anthropomorphic measurements and general and ocular parameters in adult Chinese: the Beijing Eye Study.

PubMed

Xu, Liang; Wang, Ya Xing; Zhang, Hai Tao; Jonas, Jost B

2011-08-01

To determine whether anthropomorphic measurements are associated with ocular and general parameters. The population-based Beijing Eye Study, which included 4439 participants (age > 40 years) out of 5324 individuals invited to be examined in 2001, was repeated in 2006 with 3251 (73.2% of 4439, or 61.1% of 5324) participants. The anthropomorphic measurements body height and weight, socioeconomic variables and ocular parameters were evaluated. Of the 3251 individuals included in the study, measurements of body height and weight were available for 3214 (98.9%) participants. In multivariate analysis, body height was significantly associated with the systemic parameters higher level of education (p = 0.004), higher income (p < 0.001), lower body mass index (p < 0.001), lower systolic blood pressure (p = 0.012), higher diastolic blood pressure (p < 0.001), male gender (p < 0.001), lower age (p < 0.001) and living in an urban region (p < 0.001), and with the ocular parameter of a deep anterior chamber (p < 0.001). The association between marked hyperopia and low body height was statistically marginal (p = 0.11). In adult Chinese, body height is associated with higher level of education, higher income, lower systolic blood pressure, higher diastolic blood pressure and lower body mass index, in addition to living in an urban region and being male. From an ophthalmic point of view, tall individuals had deeper anterior chambers. There was a tendency towards lower body height and marked hyperopia. Because the socioeconomic, systemic and ocular parameters examined influence the occurrence and therapy of ocular diseases, these data may be helpful in the assessment of risk factors and in the diagnosis and treatment of ocular diseases. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

Evaluation of response variables in computer-simulated virtual cataract surgery

NASA Astrophysics Data System (ADS)

Söderberg, Per G.; Laurell, Carl-Gustaf; Simawi, Wamidh; Nordqvist, Per; Skarman, Eva; Nordh, Leif

2006-02-01

We have developed a virtual reality (VR) simulator for phacoemulsification (phaco) surgery. The current work aimed at evaluating the precision in the estimation of response variables identified for measurement of the performance of VR phaco surgery. We identified 31 response variables measuring; the overall procedure, the foot pedal technique, the phacoemulsification technique, erroneous manipulation, and damage to ocular structures. Totally, 8 medical or optometry students with a good knowledge of ocular anatomy and physiology but naive to cataract surgery performed three sessions each of VR Phaco surgery. For measurement, the surgical procedure was divided into a sculpting phase and an evacuation phase. The 31 response variables were measured for each phase in all three sessions. The variance components for individuals and iterations of sessions within individuals were estimated with an analysis of variance assuming a hierarchal model. The consequences of estimated variabilities for sample size requirements were determined. It was found that generally there was more variability for iterated sessions within individuals for measurements of the sculpting phase than for measurements of the evacuation phase. This resulted in larger required sample sizes for detection of difference between independent groups or change within group, for the sculpting phase as compared to for the evacuation phase. It is concluded that several of the identified response variables can be measured with sufficient precision for evaluation of VR phaco surgery.

Latanoprostene Bunod Ophthalmic

MedlinePlus

Latanoprostene bunod ophthalmic is used to treat glaucoma (condition in which increased pressure in the eye can lead to gradual loss of vision) and ocular hypertension (condition which causes increased pressure ...

Biomarkers and Surrogate Endpoints in Drug Development: A European Regulatory View.

PubMed

Wickström, Kerstin; Moseley, Jane

2017-05-01

To give a European regulatory overview of the requirements on and the use of biomarkers or surrogate endpoints in the development of drugs for ocular disease. Definitions, methods to validate new markers, and circumstances where surrogate endpoints can be appropriate are summarized. The key endpoints that have been used in registration studies so far are based on visual acuity, signs, and symptoms, or on surrogate endpoints. In some ocular conditions, established outcome measures such as those based on visual acuity or visual field are not feasible (as with slowly progressing diseases), or lack relevance (e.g., when central visual acuity may be preserved even though the patient is legally blind owing to a severely restricted visual field, or vice versa). There are several ocular conditions for which there is an unmet medical need. In some of these conditions, surrogate endpoints as well as new clinical endpoints are needed to help speed up patient access to new medicines. Interaction with European regulators through the pathway specific for the development of biomarkers or novel methods is encouraged.

Ocular surface involvements in ectrodactyly-ectodermal dysplasia-cleft syndrome.

PubMed

Kennedy, David P; Chandler, John W; McCulley, James P

2015-06-01

To present the ocular manifestation of 2 cases of ectrodactyly-ectodermal dysplasia-cleft syndrome, a multiple congenital anomaly syndrome caused by a single point mutation of the p63 gene that controls epidermal development and homeostasis and to present treatment options. Patient 1 presented with mild signs and symptoms of dry eye and limbal stem cell deficiency with retention of 20/30 vision. Patient 2 presented with severe signs and symptoms of limbal stem cell deficiency with diffuse corneal scarring and counting fingers vision. This second patient's course was complicated by allergic conjunctivitis and advanced steroid-induced glaucoma. The cause of visual loss in ectrodactyly-ectodermal dysplasia-cleft syndrome appears to be multifactorial and likely includes inflammation of the ocular surface, tear film abnormalities, eyelid abnormalities, and limbal stem cell deficiency. Treatment modalities including lubrication, contact lenses, and limbal stem cell transplantation are reviewed. The ophthalmic conditions seen in ectrodactyly-ectodermal dysplasia-cleft syndrome frequently lead to vision loss. Early correct diagnosis and appropriate therapy are paramount because p63 gene mutations have a critical role in maintaining the integrity of the ocular surface in the setting of limbal stem cell deficiency, especially if there are other ocular surface insults such as lid disease, meibomian gland dysfunction and toxicity from topical medications. Patients should be monitored at regular, frequent intervals; and particular attention should be taken to avoid adverse secondary effects of these conditions and medications. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Human ocular torsion during parabolic flights: an analysis with scleral search coil

NASA Technical Reports Server (NTRS)

Cheung, B. S.; Money, K.; Howard, I.; Kirienko, N.; Johnson, W.; Lackner, J.; Dizio, P.; Evanoff, J.

1992-01-01

Rotation of the eyes about the visual axis is known as ocular torsion. A lateral inclination (a "roll") of the head induces ocular torsion in the opposite direction, a response known as ocular counterrolling. For six subjects, we recorded the static (head still) and dynamic (head in oscillatory roll motion) ocular torsion in normal 1 g condition and also during the microgravity and hypergravity periods of parabolic flight, using the electromagnetic scleral search coil technique. With the head still, the direction and magnitude of torsion that occurred in response to microgravity and hypergravity differed substantially from one individual to another, but there was a significant difference in torsional magnitude between the microgravity and hypergravity periods, for all static head positions including the upright position. Under normal 1 g conditions, counterrolling compensated for about 16% of (voluntary) static head roll, while dynamic counterroll was much larger, up to 36% of head roll at 0.55 Hz. With increasing frequency of head oscillation between 0.33 Hz and 0.55 Hz, the gain of counterrolling increased and there was no change in the phase relationship. The gain of dynamic counterroll (in response to voluntary head rolling) was not significantly less in hypogravity, suggesting that on the ground at these frequencies the contribution of gravity and gravity receptors to this reflex is redundant: this reflex is probably driven by the semicircular canals. In some subjects, the torsional displacement in microgravity is accompanied by micro-torsional oscillatory motion.

Ocular involvement in melioidosis: a 23-year retrospective review.

PubMed

Yaisawang, Sasi; Asawaphureekorn, Somkiat; Chetchotisakd, Ploenchan; Wongratanacheewin, Surasakdi; Pakdee, Peerapat

2018-03-27

Ocular involvement in melioidosis is rare and has devastating outcomes. Although there have been few reports on the condition, Khon Kaen, a city in northeast Thailand, has been called the "capital of melioidosis" due to the high prevalence of the condition in the region. We retrospectively reviewed all admitted cases of melioidosis with ocular involvement from the two largest hospitals in Khon Kaen. We reviewed cases from Srinagarind Hospital (a university hospital) of patients admitted between 1993 and 2016 and from Khon Kaen Hospital (a provincial hospital) of patients who presented from 2012 to 2016. We identified 16 cases of ocular involvement. Eight of these cases were proven from positive culture, and the remaining eight were implied from high melioidosis titer. The prevalence was estimated as being from 0.49 to 1.02%. Most patients had underlying diseases (14, 88%), of which diabetes mellitus was the most prevalent (12, 75%). Nine cases (56%) were part of disseminated septicemia. Patients suffered from blindness in 11 (73%) of the 15 cases in which visual acuity was recorded. Orbital cellulitis was the most common manifestation (7, 44%) followed by endophthalmitis (4, 25%). Interestingly, all patients with necrotizing fasciitis (100%) developed septic shock as a consequence. In most of the cases, patients underwent surgery (13, 81%) including incision and drainage, debridement, and pars plana vitrectomy. Despite appropriate management, the visual outcomes were disappointing (9, 64%). To summarize, ocular melioidosis is a highly destructive disease. Early detection and prompt surgical management may reduce morbidity and mortality from septic shock.

Development of a second-generation novel UVR sensor for the quantification of the light field at the anterior ocular surface

NASA Astrophysics Data System (ADS)

Fleming, David; Walsh, James E.; Moore, Linda; Bergmanson, Jan P. G.; McMahon, David

2005-06-01

Research has shown in recent years that acute and cumulative exposure to excessive ultraviolet radiation (UVR) can cause a range of degenerative ocular conditions such as pterygium, photokeratitis and pinguecula. The increase in natural solar UVR as a result of the depletion of the ozone layer has led to a greater awareness of the adverse effects of UVR on the anterior ocular surface tissues. The relevance of this lies in the fact that these tissues are not immune to photodamage and that there is selective absorption of UVR by conjunctival and corneal tissue in the anterior ocular surface. Therefore, there is a demand for more precise quantification and localisation of UVR incidence at the anterior ocular surface. A novel solar blind photodiode sensor array has been designed, constructed and tested for this purpose. The emphasis of the measurements made by this sensor system is the acquisition of real time, field based surveys of the ocular UVR light field in a broad range of insolation environments. These data will then provide a thorough database of UVR irradiances that can be related to induced damage of anterior ocular tissue. Results to date show the first measured, in-vivo, absolute UVR levels on the eye, the corresponding relative field across the eye and the presence of nasal-temporal biases that exist.

[Challenge and treatment strategy for ocular surface damage in patients with long term use of antiglaucoma drugs].

PubMed

He, Xiang-Ge

2011-02-01

Long term use of topical anti-glaucoma drugs has been shown to induce chronic conjunctivitis, superficial punctate keratitis (SPK) and dry eye symptom. Under these conditions, a loss of goblet cells in conjunctiva, epithelial squamous metaplasia and apoptosis were morphologically revealed. Benzalkonium Chloride (BKC), a most frequently used preservative in eye drops, has been found to be an important factor causing ocular surface damage. Furthermore, a big challenge for ophthalmologists is that toxic damage of medication to ocular surface tissues is mild, poor specificity, and delayed manifestation in patients, especially when coexisting with other ocular surface diseases. Impairment of ocular surface tissues greatly impacts the life quality of patients and subsequently influences compliance with glaucoma therapy. This paper emphasizes to take measures to prevent ocular surface tissue damage resulted from chronic use of topical anti-glaucoma drugs and further discusses the treatment strategy. Effective and long-lasting action drugs should always be selected for glaucomatous patients in order to decrease the frequency of topical instillation or at a more expensive medication, a fixed combination formula can be considered for glaucoma therapy. An early surgery or laser treatment is also proposed for the patients who require an IOP reduction with an existing ocular surface impairment. Future investigation and development of new medications with long-term efficacy and appropriate BKC are suggested and preservative-free or drugs with new preservative materials recommended.

Dubowitz syndrome: review of 141 cases including 36 previously unreported patients.

PubMed

Tsukahara, M; Opitz, J M

1996-05-03

We review clinical information on 141 individuals with Dubowitz syndrome, 105 reported since 1965, and 36 previously unreported. We define the Dubowitz syndrome phenotype on the basis of clinical descriptions. The facial appearance is characteristic and present in most patients with Dubowitz syndrome. The phenotypic spectrum is quite variable and ranges from normal growth and head circumference with mild psychomotor retardation and lack of eczema to a condition of severe growth retardation, mental retardation, microcephaly, and eczema. Overall, the condition may involve the cutaneous, ocular, dental, digestive, musculoskeletal, urogenital, cardiovascular, neurological, hematological, and immune systems. Characteristic behavior patterns which have not been cited previously are present in our cases; most patients are hyperactive, shy, hate crowds, and like music, rhythm, and vibrations from music speakers, tape recorders, or transmitted through floors. Dubowitz syndrome is an autosomal recessive disorder with possibly increased frequency of parental consanguinity. Heterogeneity cannot be excluded at this time.

Axenfeld-Rieger syndrome (ARS): A review and case report.

PubMed

Waldron, Jennie M; McNamara, Clare; Hewson, Antonia R; McNamara, C M

2010-01-01

Axenfeld-Rieger syndrome (ARS) is a rare, autosomal dominant condition characterized by ocular, craniofacial, dental, and periumbilical abnormalities. Relatively little information exists on this syndrome within the dental literature despite the fact that midface hypoplasia and maxillary hypodontia are classical presenting features of this syndrome. This is a case report of a 7-year-old Caucasian female with ARS who presented with significant ocular and dental anomalies. She was also found to have osteopenia. Her dental condition is described, her immediate treatment is shown, and her long-term treatment needs are discussed. ©2010 Special Care Dentistry Association and Wiley Periodicals, Inc.

Circumscribed choroidal hemangioma: A case report and literature review.

PubMed

Berry, Morgan; Lucas, Linda J H

Choroidal hemangioma is a rare congenital ocular tumor that can present as either circumscribed or diffuse. Circumscribed choroidal hemangioma (CCH) typically manifests as a red-orange mass within the posterior pole and appears similar to other ocular conditions, such as choroidal melanoma and choroidal metastasis. Proper diagnosis is crucial and is aided by the use of ancillary testing. CCH itself is benign but can cause secondary complications such as subretinal fluid accumulation and subsequent retinal detachment. If these conditions should arise, several treatment options are available. Published by Elsevier España, S.L.U.

Matrix metalloproteinases and educational attainment in refractive error: evidence of gene-environment interactions in the AREDS study

PubMed Central

Wojciechowski, Robert; Yee, Stephanie S.; Simpson, Claire L.; Bailey-Wilson, Joan E.; Stambolian, Dwight

2012-01-01

Purpose A previous study of Old Order Amish families has shown association of ocular refraction with markers proximal to matrix metalloproteinase (MMP) genes MMP1 and MMP10 and intragenic to MMP2. We conducted a candidate gene replication study of association between refraction and single nucleotide polymorphisms (SNPs) within these genomic regions. Design Candidate gene genetic association study. Participants 2,000 participants drawn from the Age Related Eye Disease Study (AREDS) were chosen for genotyping. After quality control filtering, 1912 individuals were available for analysis. Methods Microarray genotyping was performed using the HumanOmni 2.5 bead array. SNPs originally typed in the previous Amish association study were extracted for analysis. In addition, haplotype tagging SNPs were genotyped using TaqMan assays. Quantitative trait association analyses of mean spherical equivalent refraction (MSE) were performed on 30 markers using linear regression models and an additive genetic risk model, while adjusting for age, sex, education, and population substructure. Post-hoc analyses were performed after stratifying on a dichotomous education variable. Pointwise (P-emp) and multiple-test study-wise (P-multi) significance levels were calculated empirically through permutation. Main outcome measures MSE was used as a quantitative measure of ocular refraction. Results The mean age and ocular refraction were 68 years (SD=4.7) and +0.55 D (SD=2.14), respectively. Pointwise statistical significance was obtained for rs1939008 (P-emp=0.0326). No SNP attained statistical significance after correcting for multiple testing. In stratified analyses, multiple SNPs reached pointwise significance in the lower-education group: 2 of these were statistically significant after multiple testing correction. The two highest-ranking SNPs in Amish families (rs1939008 and rs9928731) showed pointwise P-emp<0.01 in the lower-education stratum of AREDS participants. Conclusions We show suggestive evidence of replication of an association signal for ocular refraction to a marker between MMP1 and MMP10. We also provide evidence of a gene-environment interaction between previously-reported markers and education on refractive error. Variants in MMP1- MMP10 and MMP2 regions appear to affect population variation in ocular refraction in environmental conditions less favorable for myopia development. PMID:23098370

Corneal endothelial dysfunction in Pearson syndrome.

PubMed

Kasbekar, Shivani A; Gonzalez-Martin, Jose A; Shafiq, Ayad E; Chandna, Arvind; Willoughby, Colin E

2013-01-01

Mitochondrial disorders are associated with well recognized ocular manifestations. Pearson syndrome is an often fatal, multisystem, mitochondrial disorder that causes variable bone marrow, hepatic, renal and pancreatic exocrine dysfunction. Phenotypic progression of ocular disease in a 12-year-old male with Pearson syndrome is described. This case illustrates phenotypic drift from Pearson syndrome to Kearns-Sayre syndrome given the patient's longevity. Persistent corneal endothelial failure was noted in addition to ptosis, chronic external ophthalmoplegia and mid-peripheral pigmentary retinopathy. We propose that corneal edema resulting from corneal endothelial metabolic pump failure occurs within a spectrum of mitochondrial disorders.

Application of Box-Behnken design for preparation of levofloxacin-loaded stearic acid solid lipid nanoparticles for ocular delivery: Optimization, in vitro release, ocular tolerance, and antibacterial activity.

PubMed

Baig, Mirza Salman; Ahad, Abdul; Aslam, Mohammed; Imam, Syed Sarim; Aqil, Mohd; Ali, Asgar

2016-04-01

The aim of the present study was to develop and optimize levofloxacin loaded solid lipid nanoparticles for the treatment of conjunctivitis. Box-Behnken experimental design was applied for optimization of solid lipid nanoparticles. The independent variables were stearic acid as lipid (X1), Tween 80 as surfactant (X2) and sodium deoxycholate as co-surfactant (X3) while particle size (Y1) and entrapment efficiency (Y2) were the dependent variables. Further in vitro release and antibacterial activity in vitro were also performed. The optimized formulation of levofloxacin provides particle size of 237.82 nm and showed 78.71% entrapment efficiency and achieved flux 0.2,493 μg/cm(2)/h across excised goat cornea. In vitro release study showed prolonged drug release from the optimized formulation following Korsmeyer-Peppas model. Antimicrobial study revealed that the developed formulation possesses antibacterial activity against Staphylococcus aureus, and Escherichia coli equivalent to marketed eye drops. HET-CAM test demonstrated that optimized formulation was found to be non-irritant and safe for topical ophthalmic use. Our results concluded that solid lipid nanoparticles are an efficient carrier for ocular delivery of levofloxacin and other drugs. Copyright © 2015 Elsevier B.V. All rights reserved.

Ex vivo rabbit cornea diffusion studies with a soluble insert of moxifloxacin.

PubMed

Sebastián-Morelló, María; Calatayud-Pascual, María Aracely; Rodilla, Vicent; Balaguer-Fernández, Cristina; López-Castellano, Alicia

2018-02-01

The objective of this research was to develop and evaluate an ocular insert for the controlled drug delivery of moxifloxacin which could perhaps be used in the treatment of corneal keratitis or even bacterial endophthalmitis. We have evaluated the ex vivo ocular diffusion of moxifloxacin through rabbit cornea, both fresh and preserved under different conditions. Histological studies were also carried out. Subsequently, drug matrix inserts were prepared using bioadhesive polymers. The inserts were evaluated for their physicochemical parameters. Ophthalmic ex vivo permeation of moxifloxacin was carried out with the most promising insert. The formulate insert was thin and provided higher ocular diffusion than commercial formulations. Ocular diffusion studies revealed significant differences between fresh and frozen corneas. Histological examinations also showed differences in the thickness of stroma between fresh and frozen corneas. The ophthalmic insert we have developed allows a larger quantity of moxifloxacin to permeate through the cornea than existing commercial formulations of the drug. Ocular delivery of moxifloxacin with this insert could be a new approach for the treatment of eye diseases.

Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review.

PubMed

Pinazo-Durán, María D; Zanón-Moreno, Vicente; García-Medina, José J; Arévalo, J Fernando; Gallego-Pinazo, Roberto; Nucci, Carlo

2016-01-01

Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairment and blindness. Because of this, it is essential not to overlook sight-threatening conditions such as the ocular comorbidities and/or the eye involvement in the context of systemic disorders. Moreover, the important role of the multidisciplinary cooperation to improve and sustain management of patients affected with eclectic ocular comorbidities and/or systemic disorders with eye repercussion is specifically addressed. This review intends to shed light on these topics to help in making opportune diagnosis and appropriately managing the affected patients.

Slit2 signaling through Robo1 and Robo2 is required for retinal neovascularization

PubMed Central

Rama, Nicolas; Dubrac, Alexandre; Mathivet, Thomas; Chárthaigh, Róisín-Ana Ní; Genet, Gael; Cristofaro, Brunella; Pibouin-Fragner, Laurence; Ma, Le; Eichmann, Anne; Chédotal, Alain

2016-01-01

Ocular neovascular diseases are a leading cause of blindness. Vascular endothelial growth factor (VEGF) blockade improves vision, but not all individuals respond to anti-VEGF treatment, making additional means to prevent neovascularization necessary. Slit-family proteins (Slits) are ligands of Roundabout (Robo) receptors that repel developing axons in the nervous system. Robo1 expression is altered in ocular neovascular diseases, and previous in vitro studies have reported both pro- and anti-angiogenic effects of Slits. However, genetic evidence supporting a role for Slits in ocular neovascularization is lacking. Here we generated conditional knockout mice deficient in various Slit and Robo proteins and found that Slit2 potently and selectively promoted angiogenesis via Robo1 and Robo2 in mouse postnatal retina and in a model of ocular neovascular disease. Mechanistically, Slit2 acting through Robo1 and Robo2 promoted the migration of endothelial cells. These receptors are required for both Slit2- and VEGF-induced Rac1 activation and lamellipodia formation. Thus, Slit2 blockade could potentially be used therapeutically to inhibit angiogenesis in individuals with ocular neovascular disease. PMID:25894826

Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review

PubMed Central

Zanón-Moreno, Vicente; García-Medina, José J.; Arévalo, J. Fernando; Gallego-Pinazo, Roberto; Nucci, Carlo

2016-01-01

Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairment and blindness. Because of this, it is essential not to overlook sight-threatening conditions such as the ocular comorbidities and/or the eye involvement in the context of systemic disorders. Moreover, the important role of the multidisciplinary cooperation to improve and sustain management of patients affected with eclectic ocular comorbidities and/or systemic disorders with eye repercussion is specifically addressed. This review intends to shed light on these topics to help in making opportune diagnosis and appropriately managing the affected patients. PMID:27051666

New nanomicelle curcumin formulation for ocular delivery: improved stability, solubility, and ocular anti-inflammatory treatment.

PubMed

Li, Mengshuang; Xin, Meng; Guo, Chuanlong; Lin, Guiming; Wu, Xianggen

2017-11-01

A stable topical ophthalmic curcumin formulation with high solubility, stability, and efficacy is needed for pharmaceutical use in clinics. The objective of this article was to describe a novel curcumin containing a nanomicelle formulation using a polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol (PVCL-PVA-PEG) graft copolymer. Nanomicelle curcumin was formulated and optimized and then further evaluated for in vitro cytotoxicity/in vivo ocular irritation, in vitro cellular uptake/in vivo corneal permeation, and in vitro antioxidant activity/in vivo anti-inflammatory efficacy. The solubility, chemical stability, and antioxidant activity were greatly improved after the encapsulation of the PVCL-PVA-PEG nanomicelles. The nanomicelle curcumin ophthalmic solution was simple to prepare and the nanomicelles are stable to the storage conditions, and it had good cellular tolerance. Nanomicelle curcumin also had excellent ocular tolerance in rabbits. The use of nanomicelles significantly improved in vitro cellular uptake and in vivo corneal permeation as well as improved anti-inflammatory efficacy when compared with a free curcumin solution. These findings indicate that nanomicelles could be promising topical delivery systems for the ocular administration of curcumin.

Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review.

PubMed

Alamanos, Christos; Raab, Philipp; Gamulescu, Andreea; Behr, Michael

2016-03-01

The aim of this review was to investigate the association between the occurrence of ocular adverse events and dental local anesthesia, the most plausible anatomic mechanisms, and the measures that offer patients a restitutio ad integrum. This systematic review adopted a structured protocol to access available publications and followed the PRISMA statement. Eighty-nine cases of patients experiencing ocular adverse events after administration of dental local anesthesia have been reported in the literature. Most of the complications manifested as double vision. Only 8% of the complications caused permanent functional damage, either as vision deficit or anisocoria. Complete permanent blindness was not reported. Ocular complications as a result of dental local anesthesia may be seen as rare occurrences with usually low intensity. However, visual function may become permanently impaired and serious medical conditions may obscure ocular dysfunction. Copyright © 2016. Published by Elsevier Inc.

[Anophthalmia and microphthalmia requires multidisciplinary care. Many of the children also have other medical problems].

PubMed

Jugård, Ylva; Odersjö, Marie; Topa, Alexandra; Lindgren, Gun; Andersson Grönlund, Marita

2015-07-13

Anophthalmia/microphthalmia (A/M) are rare congenital eye malformations. Early intervention with ocular prosthesis can stimulate orbital growth and prevent facial asymmetry. We reviewed medical records from 18 individuals with A/M (0.8-31 years) treated with ocular prosthesis at Sahlgrenska University Hospital between 2000 and 2012. A majority had other ocular findings. Seven had subnormal visual acuity in the fellow eye, one third were in contact with vision support services and half of the group wore glasses. Eleven individuals had extra-ocular findings such as cardiac defect, hearing impairment and neuropsychiatric disorders, possibly indicating syndromic conditions. We suggest that investigation of A/M children should include ultrasound of the eye, optionally visual evoked potential and magnetic resonance imaging of the CNS. The ophthalmologist should initiate treatment with prosthesis, pediatric assessment, hearing tests and genetic counseling, but should also monitor visual development of the fellow eye.

"Johnny Poppers": a cause of serious ocular injury.

PubMed

MacAndie, K; Kyle, P

1998-07-01

The causes of blunt ocular trauma are many and diverse. We present two cases of ocular injury caused by an unusual form of weapon called a "Johnny Popper". There follows a theoretical and experimental evaluation of the velocity of the projectiles fired by this device. A Johnny Popper was constructed under expert guidance. The elastic properties of the device were measured and this allowed calculation of a theoretical exit velocity of the projectiles fired. The weapon was subsequently fired under test conditions which permitted the exit velocity of the projectiles fired to be measured directly. The theoretical velocity of the projectiles was calculated as 80 ms-1 and the experimentally measured velocity was 57 ms-1. Johnny Poppers are a previously undescribed and unique form of home made weapon. They are intended for playful mischief, but have the potential to cause serious ocular trauma.

Cyclodialysis: an update.

PubMed

González-Martín-Moro, Julio; Contreras-Martín, Inés; Muñoz-Negrete, Francisco José; Gómez-Sanz, Fernando; Zarallo-Gallardo, Jesús

2017-04-01

Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an abnormal pathway for aqueous humor drainage that may lead to ocular hypotony. For many years cyclodialysis was considered a treatment option for glaucoma. However, today it usually occurs as a complication of blunt trauma or more rarely as a complication of anterior segment ocular surgery. Ocular hypotony can lead to cataract development, optic disk swelling, refractive changes, and several retinal complications, making accurate identification and timely intervention of the cleft mandatory. Traditionally gonioscopy was the only available technique to diagnose and localize the cleft. However, other tests such as optical coherence tomography, magnetic resonance imaging, transillumination, and specially ultrasound biomicroscopy are now available for the diagnosis of cyclodialysis. Multiple treatment options are also available for this condition. Although medical treatment can be effective to close small clefts, surgery is needed in most patients to restore ocular pressure.

Quality of life assessment in ocular toxoplasmosis in a Colombian population.

PubMed

de-la-Torre, Alejandra; González-López, Gilberto; Montoya-Gutiérrez, Johanna Milena; Marín-Arango, Viviana; Gómez-Marín, Jorge Enrique

2011-08-01

To assess the quality of life in patients with ocular toxoplasmosis. The participants were 29 otherwise healthy patients with retinochoroidal lesions consistent with Toxoplasma infection. The controls were 29 gender and age-matched people with normal visual function who came from the same socioeconomic and educational background as the participants. The authors used the version of the National Eye Institute 25-item visual function questionnaire (NEI VFQ25). Patients with ocular toxoplasmosis had statistically significant lower scores than controls for all the subscales, except for color vision. Patients with bilateral lesions were more affected in the mental health, difficulties role, and specific vision subscales. The median of the compound score for the participants was 79 (range 35-99) and for the controls was 95 (range 72-98). People with ocular toxoplasmosis have worse vision-related quality of life than people without the condition, especially if they have bilateral lesions and more recurrences.

Glycobiology of ocular angiogenesis

PubMed Central

Markowska, Anna I; Cao, Zhiyi; Panjwani, Noorjahan

2014-01-01

Ocular neovascularization can affect almost all the tissues of the eye: the cornea, the iris, the retina, and the choroid. Pathological neovascularization is the underlying cause of vision loss in common ocular conditions such as diabetic retinopathy, retinopathy of prematurity and age-related macular neovascularization. Glycosylation is the most common covalent posttranslational modification of proteins in mammalian cells. A growing body of evidence demonstrates that glycosylation influences the process of angiogenesis and impacts activation, proliferation, and migration of endothelial cells as well as the interaction of angiogenic endothelial cells with other cell types necessary to form blood vessels. Recent studies have provided evidence that members of the galectin class of β-galactoside-binding proteins modulate angiogenesis by novel carbohydrate-based recognition systems involving interactions between glycans of angiogenic cell surface receptors and galectins. This review discusses the significance of glycosylation and the role of galectins in the pathogenesis of ocular neovascularization. PMID:25108228

Coupling Osmolarity Dynamics within Human Tear Film on an Eye-Shaped Domain

NASA Astrophysics Data System (ADS)

Li, Longfei; Braun, R. J.; Driscoll, T. A.; Henshaw, W. D.; Banks, J. W.; King-Smith, P. E.

2013-11-01

The concentration of ions in the tear film (osmolarity) is a key variable in understanding dry eye symptoms and disease. We derived a mathematical model that couples osmolarity (treated as a single solute) and fluid dynamics within the tear film on a 2D eye-shaped domain. The model concerns the physical effects of evaporation, surface tension, viscosity, ocular surface wettability, osmolarity, osmosis and tear fluid supply and drainage. We solved the governing system of coupled nonlinear PDEs using the Overture computational framework developed at LLNL, together with a new hybrid time stepping scheme (using variable step BDF and RKC) that was added to the framework. Results of our numerical simulations show good agreement with existing 1D models (for both tear film and osmolarity dynamics) and provide new insight about the osmolarity distribution over the ocular surface during the interblink.

Relationship between refractive error and ocular biometrics in twin children: the Guangzhou Twin Eye Study.

PubMed

Wang, Decai; Liu, Bin; Huang, Shengsong; Huang, Wenyong; He, Mingguang

2014-09-01

A cross-sectional study was conducted to explore the relationship between refractive error and ocular biometrics in children from the Guangzhou twin eye study. Twin participants aged 7-15 years were selected from Guangzhou Twin Eye Study. Ocular examinations included visual acuity measurement, ocular motility evaluation, autorefraction under cycloplegia, and anterior segment, media, and fundus examination. Axial length (AL), anterior chamber depth (ACD), and corneal curvature radius were measured using partial coherence laser interferometry. A multivariate linear regression model was used for statistical analysis. Twin children from Guangzhou city showed a decreased spherical equivalent with age, whereas both AL and ACD were increased and corneal curvature radius remained unchanged. When adjusted by age and gender, the data from 77% of twins presenting with spherical equivalent changes indicated that these were caused by predictable variables (R2 = 0.77, P < 0.001). Primary factors affecting children's refraction included axial length (β = -0.97,P < 0.001), ACD (β = 0.33, P < 0.001), and curvature radius (β = 2.10, P < 0.001). Girls had a higher tendency for myopic status than did boys (β = -0.26, P < 0.001). Age exerted no effect upon the changes in refraction (β = -0.01, P = 0.25). Refraction is correlated with ocular biometrics. Refractive status is largely determined by axial length as the major factor.

The combination of vestibular impairment and congenital sensorineural hearing loss predisposes patients to ocular anomalies, including Usher syndrome.

PubMed

Kletke, S; Batmanabane, V; Dai, T; Vincent, A; Li, S; Gordon, K A; Papsin, B C; Cushing, S L; Héon, E

2017-07-01

The co-occurrence of hearing impairment and visual dysfunction is devastating. Most deaf-blind etiologies are genetically determined, the commonest being Usher syndrome (USH). While studies of the congenitally deaf population reveal a variable degree of visual problems, there are no effective ophthalmic screening guidelines. We hypothesized that children with congenital sensorineural hearing loss (SNHL) and vestibular impairment were at an increased risk of having USH. A retrospective chart review of 33 cochlear implants recipients for severe to profound SNHL and measured vestibular dysfunction was performed to determine the ocular phenotype. All the cases had undergone ocular examination and electroretinogram (ERG). Patients with an abnormal ERG underwent genetic testing for USH. We found an underlying ocular abnormality in 81.81% (27/33) of cases; of which 75% had refractive errors, and 50% of those patients showed visual improvement with refractive correction. A total of 14 cases (42.42%; 14/33) had generalized rod-cone dysfunction on ERG suggestive of Usher syndrome type 1, confirmed by mutational analysis. This work shows that adding vestibular impairment as a criterion for requesting an eye exam and adding the ERG to detect USH increases the chances of detecting ocular anomalies, when compared with previous literature focusing only on congenital SNHL. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The ocular complications of boxing.

PubMed

Giovinazzo, V J; Yannuzzi, L A; Sorenson, J A; Delrowe, D J; Cambell, E A

1987-06-01

In cooperation with the New York State Athletic Commission, 74 boxers applying for a new or yearly renewal license were sequentially referred over a 2-year period for a complete dilated ocular examination at the Sports Vision Institute of the Manhattan Eye, Ear and Throat Hospital. At least one ocular injury was found in 66% of boxers. Vision-threatening injuries, defined as significant damage to the angle, lens, macula, or peripheral retina occurred in 58% of boxers. Nineteen percent of boxers had angle abnormalities. Nineteen percent of boxers had pathologic cataracts, over 70% of these were posterior subcapsular. Six boxers had macular lesions. A total of 24% of boxers had retinal tears. Standardized photographs were used to distinguish pathologic cataracts from congenital opacities and pathologic retinal tears from atrophic holes. Attempts were made to identify risk factors in boxing that might be predictive for ocular injury. Variables included age, weight division, left- or right-handedness, total number of losses, and total number of bouts. Significant correlations were found between the total number of bouts and the total number of losses, and the presence of retinal tears. College varsity athletes were selected as controls. Significant differences were found between boxers and controls for the total number of injuries, total vision-threatening injuries, and the number of retinal tears. A series of recommendations are proposed to aide in the early detection and prevention of serious ocular injuries.

Intraobserver reproducibility of retinal nerve fiber layer measurements using scanning laser polarimetry and optical coherence tomography in normal and ocular hypertensive subjects.

PubMed

Lleó-Pérez, A; Ortuño-Soto, A; Rahhal, M S; Martínez-Soriano, F; Sanchis-Gimeno, J A

2004-01-01

To evaluate quantitatively the intraobserver reproducibility of measurements of the retinal nerve fiber layer (RNFL) in healthy subjects and an ocular hypertensive population using two nerve fiber analyzers. Sixty eyes of normal (n=30) and ocular hypertensive subjects (n=30) were consecutively recruited for this study and underwent a complete ophthalmologic examination and achromatic automated perimetry. RNFL were measured using scanning laser polarimeter (GDx-VCC) and optical coherence tomography (OCT Model 3000). Reproducibility of the RNFL measurements obtained with both nerve fiber analyzers were compared using the coefficient of variation. In both groups the authors found fair correlations between the two methods in all ratio and thickness parameters. The mean coefficient of variation for measurement of the variables ranged from 2.24% to 13.12% for GDx-VCC, and from 5.01% to 9.24% for OCT Model 3000. The authors could not detect any significant differences between healthy and ocular hypertensive eyes, although in normal eyes the correlations improved slightly. Nevertheless, the test-retest correlation was slightly better for GDx-VCC than for OCT Model 3000 (5.55% and 7.11%, respectively). Retinal mapping software of both nerve fiber analyzers allows reproducible measurement of RNFL in both healthy subjects and ocular hypertensive eyes, and shows fair correlations and good intraobserver reproducibility. However, in our study, GDx showed a better test-retest correlation.

[Ocular findings in Polish Armed Forces in Iraq and Afghanistan, a review of medical examinations by The Military Medical Commission in Łodz].

PubMed

Pastuszka, Mirosław; Goś, Roman; Jurowski, Piotr; Chrzaszcz, Agnieszka; Smigielski, Janusz; Nowak, Michał S

2013-01-01

To determine the prevalence of ocular disorders among Polish soldiers returning from Iraq and Afghanistan military campaigns. A retrospective review of medical records of the Military Medical Commission of Lodz, Poland was performed. Records of 296 randomly selected soldiers, including 98 who returned from Iraq in 2004 and in 198 who returned from Afghanistan in 2012, were assessed. All subjects underwent comprehensive ocular examinations according to the military regulations. We used statistical analysis to review the results. The incidence of ocular disorders in Iraq and Afghanistan groups was 17.3% and 15.1%, respectively. The study revealed that the most common disorders among soldiers were refractive errors affecting 6.8% subjects, followed by defective color vision (4.7%) and solar retinopathy (3.0%). Combat injuries were diagnosed in 3 subjects, including 2 cases of corneal injury and 1 case of retinal detachment due to blast exposure. Combat injuries occurred in 1% of soldiers returning from Iraq and Afghanistan military campaigns. There were no statistically significant differences between Iraq and Afghanistan groups in the incidence of ocular disorders. Solar retinopathy was the most common problem related to the long-term exposure to rough climate conditions in both groups. ocular findings, Iraq, Afghanistan.

Atypical Presentation of Ocular Toxoplasmosis: A Case Report of Exudative Retinal Detachment and Choroidal Ischemia.

PubMed

Al-Zahrani, Yahya A; Al-Dhibi, Hassan A; Al-Abdullah, Abdulelah A

2016-01-01

A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. Fundus examination indicated right exudative retinal detachment and choroidal ischemia. The patient responded well to anti-toxoplasmosis medications and steroids. Exudative retinal detachment and choroidal ischemia are atypical presentations of ocular toxoplasmosis. However, both conditions responded well to anti.parasitic therapy with steroid.

Studies of the vestibulo-ocular reflex on STS 4, 5 and 6

NASA Technical Reports Server (NTRS)

Thornton, William E.; Pool, Sam L.; Moore, Thomas P.; Uri, John J.

1988-01-01

The vestibulo-ocular reflex (VOR) may be altered by weightlessness. Since this reflex plays a large role in visual stabilization, it was important to document any changes caused by space flight. This is a report on findings on STS-4 through 6 and is part of a larger study of neurosensory adaptation done on STS-4 through 8. Voluntary horizontal head oscillations at 1/3 Hz with amplitude of 30 deg right and left of center were recorded by a potentiometer and compared to eye position recorded by electroculography under the following conditions: eyes open, head fixed, tracking horizontal targets switched 0, 15, and 30 degrees right and left (optokinetic reflex - OKR - and calibration); eyes open and fixed on static external target with oscillation, (vestibulo ocular reflex, eyes closed - VOR EC); eyes open and wearing opaque goggles with target fixed in imagination (vestibulo-ocular reflex, eyes shaded - VOR ES); and eyes open and fixed on a head synchronized target with head oscillation (VOR suppression). No significant changes were found in voluntary head oscillation frequency or amplitude in those with (n=5), and without (n=3), space motion sickness (SMS), with phase of flight or test condition. Variations in head oscillation were too small to have produced detectable changes in test results.

[Mason's lacing cord. Potential danger of severe open ocular injuries].

PubMed

Tost, F; Großjohann, R; Schikorr, W; Tesch, R; Ekkernkamp, A; Lange, J; Langner, S; Bockholdt, B; Frank, M

2014-02-01

Introduction of new working equipment or the modification of established working routines could induce new trauma mechanisms. In all of theses cases ophthalmologists are not only responsible for ocular treatment they also have to act as assessors. This might include legal aspects, e.g. to validate the circumstances of an accident. We present a new trauma mechanism caused by a mason's lacing cord which was fixed with nails. In addition to two case studies we collected experimental data (maximum tension and maximum elongation of various mason's lacing cords) about the triggering event using standard test conditions. A tensile force of 96.2 N was needed to achieve maximum elongation of mason's lacing cords. With a cord length of 5 m, an elongation of 0.09 m was enough to cause penetrating injuries (for 10 m cord length the critical elongation was 0.13 m). Under these conditions a nail could be accelerated to a velocity of 18 m/s. This may lead to open eyeball injuries with severe visual loss. Nails fixed to elastic mason's lacing cords are potential risk factors for occupational ocular injuries and severe loss of vision. Caution labels should be attached to the work equipment and proper eye protection should be used to prevent severe occupational ocular injuries.

Survey, Culture, and Genome Analysis of Ocular Chlamydia trachomatis in Tibetan Boarding Primary Schools in Qinghai Province, China

PubMed Central

Feng, Le; Lu, Xinxin; Yu, Yonghui; Wang, Tao; Luo, Shengdong; Sun, Zhihui; Duan, Qing; Wang, Ningli; Song, Lihua

2017-01-01

Trachoma, the leading infectious cause of blindness worldwide, is an ancient human disease. Its existence in China can be traced back to as early as the twenty-seventh century BC. In modern China, the overall prevalence of trachoma has dramatically reduced, but trachoma is still endemic in many areas of the country. Here, we report that 26 (8%) of 322 students from two rural boarding schools of Qinghai province, west China, were identified as having ocular C. trachomatis infection; and 15 ocular C. trachomatis strains were isolated from these trachoma patients. Chlamydiae in 37 clinical samples were genotyped as type B based on ompA gene analyses. Three ompA variants with one or two in-between SNP differences in the second or fourth variable domain were found. C. trachomatis strains QH111L and QH111R were from the same patient's left and right conjunctival swabs, respectively, but their ompA genes have a non-synonymous base difference in the second variable domain. Moreover, this SNP only exists in this single sample, suggesting QH111L is a newly emerged ompA variant. Interestingly, chromosomal phylogeny analysis found QH111L clusters between a branch of two type B strains and a branch of both A and C strains, but is significantly divergent from both branches. Comparative chromosome analysis found that compared to sequences of reference B/TZ1A828/OT strain, 12 of 22 QH111L's chromosomal genes exhibiting more than nine SNPs have the best homology with reciprocal genes of UGT strains while 9 of 22 genes are closest to those of type C strains. Consistent with findings of UGT-type genetic features in the chromosome, the QH111L plasmid appears to be intermediate between UGT and classical ocular plasmids due to the existence of UGT-type SNPs in the QH111L plasmid. Moreover, the QH111L strain has a unique evolutionarily older cytotoxin region compared to cytotoxin regions of other C. trachomatis strains. The genome analyses suggest that the QH111L strain is derived from recombinations between UGT and classical ocular ancestors. This is the first study of culture and characterization of ocular C. trachomatis in Qinghai Tibetan areas. PMID:28119858

Optical response of the cultured bovine lens; testing opaque or partially transparent semi-solid/solid common consumer hygiene products.

PubMed

Wong, W; Sivak, J G; Moran, K L

2003-01-01

This study determines the relative ocular lens irritancy of 16 common partially transparent or non-transparent consumer hygiene products. The irritancy was found by measuring the changes in the sharpness of focus [referred to as the back vertex distance (BVD) variability] of the cultured bovine lens using a scanning laser In Vitro Assay System. This method consists of a laser beam that scans across the lens, and a computer, which then analyses the average focal length (mm), the BVD variability (mm), and the intensity of the beam transmitted. Lenses were exposed to the 16 hygiene products and the lens' focusing ability was monitored over 192 h. The products are semi-solids or solids (e.g. gels, lotions, shampoos). They are categorized into six groups: shampoos, body washes, lotions, toothpastes, deodorant, and anti-perspirant. Damage (measured by > 1 mm BVD variability) occurred slower for the shampoos, especially in the case of baby shampoo. The results indicate that shampoos exhibit the lowest level of ocular lens toxicity (irritability) while the deodorant is the most damaging.

Biobehavioural analysis of the vestibular system and posture control in patients with cervicogenic dizziness. A cross-sectional study.

PubMed

Grande-Alonso, M; Moral Saiz, B; Mínguez Zuazo, A; Lerma Lara, S; La Touche, R

2018-03-01

Cervicogenic dizziness is a musculoskeletal disorder mainly characterised by dizziness and disequilibrium associated with neck pain. The pathophysiology is unclear and the neurophysiological basis remains to be ascertained. The aim of this study is to compare the vestibulo-ocular reflex and postural control between patients with cervicogenic dizziness and asymptomatic subjects, and to assess the association between debilitating dizziness and other psychosocial variables. A total of 20 patients and 22 asymptomatic subjects were selected. Vestibulo-ocular reflex was assessed by performing the head impulse test. Computerised dynamic posturography was used to evaluate the postural control by means of the sensory organisation test. In addition, subjects self-reported their degree of disability due to dizziness, cervical disability, kinesiophobia, and state of anxiety and depression. There were no differences in the vestibulo-ocular reflex (P>.05). However, we found differences with a medium-to-large effect size (d>0.60) in variables related to proprioception and visual information integration; the former variable set was related to disability due to dizziness. Disability due to dizziness presents strong-to-moderate associations with cervical disability, kinesiophobia, and anxiety. Our data rule out changes in the vestibular system in cervicogenic dizziness, but they do point to proprioceptive impairment. According to our results, the association between dizziness-related disability and other psychosocial factors in cervicogenic dizziness is very relevant for clinical medicine and for future research projects. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Factors affecting outcome in ocular myasthenia gravis.

PubMed

Mazzoli, Marco; Ariatti, Alessandra; Valzania, Franco; Kaleci, Shaniko; Tondelli, Manuela; Nichelli, Paolo F; Galassi, Giuliana

2018-01-01

50%-60% of patients with ocular myasthenia gravis (OMG) progress to generalized myasthenia gravis (GMG) within two years. The aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables. We reviewed a cohort of 168 Caucasian patients followed from September 2000 to January 2016. Several independent variables were considered as prognostic factors: gender, age of onset, results on electrophysiological tests, presence and level of antibodies against acetylcholine receptors (AChR Abs), treatments, thymic abnormalities. The primary outcome was the progression to GMG and/or the presence of bulbar symptoms. Secondary outcomes were either achievement of sustained minimal manifestation status or worsening in ocular quantitative MG subscore (O-QMGS) or worsening in total QMG score (T-QMGS), assessed by Myasthenia Gravis Foundation of America (MGFA) quantitative scores. Changes in mental and physical subscores of health-related quality of life (HRQoL) were assessed with SF-36 questionnaire. Variance analysis was used to interpret the differences between AChR Ab titers at different times of follow up among the generalized and non-generalized patients. Conversion to GMG occurred in 18.4% of patients; it was significantly associated with sex, later onset of disease and anti-AChR Ab positivity. Antibody titer above the mean value of 25.8 pmol/mL showed no significant effect on generalization. Sex and late onset of disease significantly affected T-QMGS worsening. None of the other independent variables significantly affected O-QMGS and HRQoL. Sex, later onset and anti-AChR Ab positivity were significantly associated with clinical worsening.

Dynamic characteristics of otolith ocular response during counter rotation about dual yaw axes in mice

PubMed Central

Shimizu, Naoki; Wood, Scott; Kushiro, Keisuke; Yanai, Shuichi; Perachio, Adrian; Makishima, Tomoko

2014-01-01

The central vestibular system plays an important role in higher neural functions such as self-motion perception and spatial orientation. Its ability to store head angular velocity is called velocity storage mechanism (VSM), which has been thoroughly investigated across a wide range of species. However, little is known about the mouse VSM, because the mouse lacks typical ocular responses such as optokinetic after nystagmus or a dominant time constant of vestibulo-ocular reflex for which the VSM is critical. Experiments were conducted to examine the otolith-driven eye movements related to the VSM and verify its characteristics in mice. We used a novel approach to generate a similar rotating vector as a traditional off-vertical axis rotation (OVAR) but with a larger resultant gravito-inertial force (>1 g) by using counter rotation centrifugation. Similar to results previously described in other animals during OVAR, two components of eye movements were induced, i.e. a sinusoidal modulatory eye movement (modulation component) on which a unidirectional nystagmaus (bias component) was superimposed. Each response is considered to derive from different mechanisms; modulations arise predominantly through linear vestibulo-ocular reflex, whereas for the bias, the VSM is responsible. Data indicate that the mouse also has a well-developed vestibular system through otoliths inputs, showing its highly conserved nature across mammalian species. On the other hand, to reach a plateau state of bias, a higher frequency rotation or a larger gravito-inertial force was considered to be necessary than other larger animals. Compared with modulation, the bias had a more variable profile, suggesting an inherent complexity of higher-order neural processes in the brain. Our data provides the basis for further study of the central vestibular system in mice, however, the underlying individual variability should be taken into consideration. PMID:25446357

Seasonal allergic conjunctivitis induced by Japanese pear pollen.

PubMed

Yanagisawa, S; Nagaki, Y; Hiraki, S; Kadoi, C; Hayasaka, S; Teranishi, H

1999-01-01

To evaluate the ocular findings in patients with Japanese pear (Pyrus pyrifolia Nakai) pollinosis. Twenty-two farmers working on artificial pollination in Japanese pear orchards were examined for ocular itching, conjunctival conditions, presence of eosinophils in the conjunctival specimen, and nasal symptoms. Serum IgE antibody to Japanese pear pollen was determined in 16 farmers. Of the 22 subjects, 3 (Nos. 3, 4, and 13) exhibited ocular itching, conjunctival hyperemia, eosinophils in the conjunctival specimen, and positive serum IgE antibodies to Japanese pear pollen. In these patients, the conjunctivitis disappeared after treatment with topical cromoglycate. The present study demonstrated that seasonal allergic conjunctivitis may be induced by Japanese pear pollen (entomophilous flower pollen).

Ultraviolet laser effects on the cornea

NASA Astrophysics Data System (ADS)

Zuclich, Joseph A.

1990-07-01

Ultraviolet radiation in the ambient environment or from artificial sources may pose both acute and chronic hazards to the skin and the ocular tissues. In general terrestrial conditions have evolved such that there are only narrow safety margins between ambient UV levels and exposure levels harmful to the human. Obvious examples of acute consequences ofUV overexposure are sunburn and snowblindness as well as analogous conditions induced by artificial sources such as the welder''s arc mercury vapor lamps and UV-emitting lasers. Further chronic UV exposure is strongly implicated as a causative agent in certain types of cataract and skin cancer. This presentation will summarize a number of specific cases where UV radiation affected the primate cornea. Data presented will include the action spectra for far- and near-UV induced ocular damage the pulsewidth and total energy dependencies of ocular thresholds studies of cumulative effects of repeated UV exposures and quantitative determinations of tissue repair or recovery rates. Depending on the exposure parameters utilized photochemical thermal or photoablative damage mechanisms may prevail. 1.

Psychosocial impact on anophthalmic patients wearing ocular prosthesis.

PubMed

Goiato, M C; dos Santos, D M; Bannwart, L C; Moreno, A; Pesqueira, A A; Haddad, M F; dos Santos, E G

2013-01-01

The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Pseudoexfoliation syndrome in Ethiopian glaucoma patients.

PubMed

Bedri, A; Alemu, B

1999-05-01

Pseudoexfoliation syndrome (PXS) has variable prevalence rates in the glaucoma population depending on geographic location and racial composition of the population studied. There is no data available on this subject in Ethiopia. To determine the prevalence of PXS among Ethiopian glaucoma clinic population. A prospective study. The Glaucoma Clinic of Menelik-II-Hospital, which is a tertiary eye care centre in Addis Ababa, Ethiopia. All new patients with glaucoma or ocular hypertension (ocular HPN) seen during the study period from 1st April to 30th September 1996 were included in the study. Our of the 432 new patients of glaucoma or ocular HPN seen during the study, 108 patients (25%) had PXS. The age of PXS cases ranged from 32 years to 86 years (mean 62.3 years). There were 80 males and 28 females. Of the PXS patients, 104 (96.3%) were cases of chronic open angle glaucoma, while angle closure glaucoma and ocular HPN were rare comprising only two patients (1.85%) each. The relatively high prevalence rate of PXS among Ethiopian glaucoma clinic population found in this study stresses the need for further community-based research in order to prevent blindness due to glaucoma associated with PXS.

A study on the characterization of Propionibacterium acnes isolated from ocular clinical specimens.

PubMed

Sowmiya, Murali; Malathi, Jambulingam; Swarnali, Sen; Priya, Jeyavel Padma; Therese, Kulandai Lily; Madhavan, Hajib N

2015-10-01

There are only a few reports available on characterization of Propionibacterium acnes isolated from various ocular clinical specimens. We undertook this study to evaluate the role of P. acnes in ocular infections and biofilm production, and also do the phylogenetic analysis of the bacilli. One hundred isolates of P. acnes collected prospectively from ocular clinical specimens at a tertiary care eye hospital between January 2010 and December 2011, were studied for their association with various ocular disease conditions. The isolates were also subjected to genotyping and phylogenetic analysis, and were also tested for their ability to produce biofilms. Among preoperative conjunctival swabs, P. acnes was a probably significant pathogen in one case; a possibly significant pathogen in two cases. In other clinical conditions, 13 per cent isolates were probably significant pathogens and 38 per cent as possibly significant pathogens. The analysis of 16S rRNA gene revealed four different phylogenies whereas analysis of recA gene showed two phylogenies confirming that recA gene was more reliable than 16S rRNA with less sequence variation. Results of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) had 100 per cent concordance with phylogenetic results. No association was seen between P. acnes subtypes and biofilm production. RecA gene phylogenetic studies revealed two different phylogenies. RFLP technique was found to be cost-effective with high sensitivity and specificity in phylogenetic analysis. No association between P. acnes subtypes and pathogenetic ability was observed. Biofilm producing isolates showed increased antibiotic resistance compared with non-biofilm producing isolates.

Dry Eye Disease: Prevalence, Assessment, and Management.

PubMed

Rouen, Patricia A; White, Mary L

Dry eye disease is a chronic condition of the corneal surface marked by persistent symptoms of irritation or burning that can cause inflammatory damage to the cornea and conjunctiva if untreated. Common risk factors for this syndrome include advancing age, female sex, low humidity environments, systemic medications, and autoimmune disorders. Treatments to relieve symptoms include tear replacement, humidification, improved nutrition, and anti-inflammatory ocular agents. Home healthcare nurses can identify signs and symptoms of dry eye syndrome and initiate strategies that range from warm compresses to physician referrals for more aggressive treatment. Consistent management of this condition improves quality of life and minimizes damage to the ocular surface.

Dysfunctional tear syndrome: dry eye disease and associated tear film disorders - new strategies for diagnosis and treatment.

PubMed

Milner, Mark S; Beckman, Kenneth A; Luchs, Jodi I; Allen, Quentin B; Awdeh, Richard M; Berdahl, John; Boland, Thomas S; Buznego, Carlos; Gira, Joseph P; Goldberg, Damien F; Goldman, David; Goyal, Raj K; Jackson, Mitchell A; Katz, James; Kim, Terry; Majmudar, Parag A; Malhotra, Ranjan P; McDonald, Marguerite B; Rajpal, Rajesh K; Raviv, Tal; Rowen, Sheri; Shamie, Neda; Solomon, Jonathan D; Stonecipher, Karl; Tauber, Shachar; Trattler, William; Walter, Keith A; Waring, George O; Weinstock, Robert J; Wiley, William F; Yeu, Elizabeth

2017-01-01

Dysfunctional tear syndrome (DTS) is a common and complex condition affecting the ocular surface. The health and normal functioning of the ocular surface is dependent on a stable and sufficient tear film. Clinician awareness of conditions affecting the ocular surface has increased in recent years because of expanded research and the publication of diagnosis and treatment guidelines pertaining to disorders resulting in DTS, including the Delphi panel treatment recommendations for DTS (2006), the International Dry Eye Workshop (DEWS) (2007), the Meibomian Gland Dysfunction (MGD) Workshop (2011), and the updated Preferred Practice Pattern guidelines from the American Academy of Ophthalmology pertaining to dry eye and blepharitis (2013). Since the publication of the existing guidelines, new diagnostic techniques and treatment options that provide an opportunity for better management of patients have become available. Clinicians are now able to access a wealth of information that can help them obtain a differential diagnosis and treatment approach for patients presenting with DTS. This review provides a practical and directed approach to the diagnosis and treatment of patients with DTS, emphasizing treatment that is tailored to the specific disease subtype as well as the severity of the condition.

Dysfunctional tear syndrome: dry eye disease and associated tear film disorders – new strategies for diagnosis and treatment

PubMed Central

Milner, Mark S.; Beckman, Kenneth A.; Luchs, Jodi I.; Allen, Quentin B.; Awdeh, Richard M.; Berdahl, John; Boland, Thomas S.; Buznego, Carlos; Gira, Joseph P.; Goldberg, Damien F.; Goldman, David; Goyal, Raj K.; Jackson, Mitchell A.; Katz, James; Kim, Terry; Majmudar, Parag A.; Malhotra, Ranjan P.; McDonald, Marguerite B.; Rajpal, Rajesh K.; Raviv, Tal; Rowen, Sheri; Shamie, Neda; Solomon, Jonathan D.; Stonecipher, Karl; Tauber, Shachar; Trattler, William; Walter, Keith A.; Waring, George O.; Weinstock, Robert J.; Wiley, William F.; Yeu, Elizabeth

2017-01-01

Dysfunctional tear syndrome (DTS) is a common and complex condition affecting the ocular surface. The health and normal functioning of the ocular surface is dependent on a stable and sufficient tear film. Clinician awareness of conditions affecting the ocular surface has increased in recent years because of expanded research and the publication of diagnosis and treatment guidelines pertaining to disorders resulting in DTS, including the Delphi panel treatment recommendations for DTS (2006), the International Dry Eye Workshop (DEWS) (2007), the Meibomian Gland Dysfunction (MGD) Workshop (2011), and the updated Preferred Practice Pattern guidelines from the American Academy of Ophthalmology pertaining to dry eye and blepharitis (2013). Since the publication of the existing guidelines, new diagnostic techniques and treatment options that provide an opportunity for better management of patients have become available. Clinicians are now able to access a wealth of information that can help them obtain a differential diagnosis and treatment approach for patients presenting with DTS. This review provides a practical and directed approach to the diagnosis and treatment of patients with DTS, emphasizing treatment that is tailored to the specific disease subtype as well as the severity of the condition. PMID:28099212

Does the probability of developing ocular trauma-related visual deficiency differ between genders?

PubMed

Blanco-Hernández, Dulce Milagros Razo; Valencia-Aguirre, Jessica Daniela; Lima-Gómez, Virgilio

2011-01-01

Ocular trauma affects males more often than females, but the impact of this condition regarding visual prognosis is unknown. We undertook this study to compare the probability of developing ocular trauma-related visual deficiency between genders, as estimated by the ocular trauma score (OTS). We designed an observational, retrospective, comparative, cross-sectional and open-label study. Female patients aged ≥6 years with ocular trauma were included and matched by age and ocular wall status with male patients at a 1:2 male/female ratio. Initial trauma features and the probability of developing visual deficiency (best corrected visual acuity <20/40) 6 months after the injury, as estimated by the OTS, were compared between genders. The proportion and 95% confidence intervals (95% CI) of visual deficiency 6 months after the injury were estimated. Ocular trauma features and the probability of developing visual deficiency were compared between genders (χ(2) and Fisher's exact test); p value <0.05 was considered significant. Included were 399 eyes (133 from females and 266 from males). Mean age of patients was 25.7 ± 14.6 years. Statistical differences existed in the proportion of zone III in closed globe trauma (p = 0.01) and types A (p = 0.04) and type B (p = 0.02) in open globe trauma. The distribution of the OTS categories was similar for both genders (category 5: p = 0.9); the probability of developing visual deficiency was 32.6% (95% CI = 24.6 to 40.5) in females and 33.2% (95% CI = 27.6 to 38.9) in males (p = 0.9). The probability of developing ocular trauma-related visual deficiency was similar for both genders. The same standard is required.

Evidence that dry eye is a comorbid pain condition in a U.S. veteran population

PubMed Central

Lee, Charity J.; Levitt, Roy C.; Felix, Elizabeth R.; Sarantopoulos, Constantine D.; Galor, Anat

2017-01-01

Abstract Introduction: Recent evidence suggests that dry eye (DE) may be comorbid with other chronic pain conditions. Objectives: To evaluate DE as a comorbid condition in the U.S. veteran population. Methods: Retrospective review of veterans seen in the Veterans Administration Healthcare System (Veteran Affairs) between January 1, 2010, and December 31, 2014. Dry eye and nonocular pain disorders were ascertained by International Classification of Diseases, Ninth Revision (ICD-9) codes. Dry eye was further separated into ICD-9 codes representing tear film dysfunction or ocular pain. χ2 and logistic regression analyses were used to examine frequency and risk of DE, ocular pain, and tear film dysfunction by pain disorders. Results: Of 3,265,894 veterans, 959,881 had a DE diagnosis (29.4%). Dry eye frequency increased with the number of pain conditions reported (P < 0.0005). Ocular pain was most strongly associated with headache (odds ratio [OR] 2.98; 95% confidence interval [CI] 2.95–3.01), tension headache (OR 2.64; 95% CI 2.58–2.71), migraine (OR 2.58; 95% CI 2.54–2.61), temporomandibular joint dysfunction (OR 2.39; 95% CI 2.34–2.44), pelvic pain (OR 2.30; 95% CI 2.24–2.37), central pain syndrome (OR 2.24; 95% CI 1.94–2.60), and fibromyalgia/muscle pain (OR 2.23; 95% CI 2.20–2.26), all P < 0.0005. Tear film dysfunction was most closely associated with osteoarthritis (OR 1.97; 95% CI 1.96–1.98) and postherpetic neuralgia (OR 1.95; 95% CI 1.90–2.00), both P < 0.0005. Conclusions: Dry eye, including both ocular pain and tear film dysfunction, is comorbid with pain conditions in this nationwide population, implying common mechanisms. PMID:29392243

Mucins in contact lens wear and dry eye conditions.

PubMed

Ramamoorthy, Padmapriya; Nichols, Jason J

2008-08-01

Ocular mucins are thought to play integral roles in ocular surface lubrication, anchoring of the aqueous, stabilizing the lipid components of the tear film, eliminating foreign bodies and pathogens, and with potential involvement in cell cycle mediation and apoptotic activity of ocular surface epithelia. Ocular mucins are of secreted and membrane-associated types. Secreted mucins may be of large gel-forming type or small soluble mucins (e.g., MUC5AC and MUC7). Membrane-associated mucins such as MUCs 1 and 4 are a major component of the glycocalyx. They are thought to render structural support to the microplicae and mediate epithelial cell cycle and apoptotic activity. The alterations in ocular mucins with contact lens wear are unclear. Recent work shows mucin expression may be up-regulated during the early years of contact lens wear, and with long-term lens wear, mucin expression may return to normal levels or sub-normal levels, although this is not well understood. Further, the polar nature of mucins may be associated with their affinity for contact lens surfaces making them a component of contact lens deposition. This has potential implications in the wettability and tolerability of contact lenses, and may be impacted by surface coatings, polymer characteristics, or care solutions. Conjunctival mucin gene expression and secretion may be deficient in several ocular surface disorders associated with dry eye. Deficiency and alterations in glycosylation characteristics of MUC5AC and MUC2 have been reported in both Sjögren and non-Sjögren dry eye types. Decreased binding of the membrane-associated mucin MUC16 to the conjunctival epithelium has been reported in Sjögren dry eye while MUC1 alterations have been reported in Sjögren and non-Sjögren dry eye states. In view of the mucin involvement in dry eye conditions, stimulation of mucus secretion pathways may hold promise in the pharmaceutical treatment of dry eye.

Investigation of Tear Biomarkers as an Indicator of Human Health

NASA Technical Reports Server (NTRS)

Morton, Stephen; Tucker, Bethany; Crucian, Brian; Steinberg, Susan; Hagan, Suzanne

2017-01-01

Scientific literature suggests that tear biomarkers can be used as a guide towards clinical diagnosis of human health (Hagan et al., 2016). This study will investigate whether tear biomarkers represents a research and clinical opportunity to assess human health prior to, during, and after exposure to the spaceflight environment. The focus of this study is to compare biomarkers previously identified as potentially relevant to both ocular and brain health against unique physiological outcomes of exposure to the space flight environment. Study subjects suffering from terrestrial conditions thought to be similar to Spaceflight Associated Neuro-ocular Syndrome (SANS: formerly VIIP), e.g. patients with idiopathic intracranial hypertension (IIH) and optic neuritis may be relevant to conditions associated with spaceflight. This study will review methodologies, tear biomarkers related to state of ocular and brain health, the strengths and weakness of using tear fluid biomarkers versus other body fluid samples, and will survey current tear fluid biomarker knowledge in research and clinical practice. A strength of using tear biomarkers is that sampling is non-invasive and used as a guide in understanding pathologies, including ocular and systemic inflammatory conditions (Cocho et al., 2016)., Salvisberg et al., 2014). Moreover, tear biomarkers may reflect diseases affecting the central nervous system (CNS) (Salvisberg et al., 2014). For example, in multiple sclerosis (MS), the concordance rate between tear biomarkers versus cerebrospinal fluid (CSF) is approximately 83%, indicating that, in the majority of cases, tears are at least as effective as CSF in potentially identifying novel MS biomarkers (Devos et al., 2001).

Air bags and ocular injuries.

PubMed Central

Stein, J D; Jaeger, E A; Jeffers, J B

1999-01-01

PURPOSE: This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. METHODS: Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries. RESULTS: Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury. CONCLUSION: Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm. Images FIGURE 1 FIGURE 2A FIGURE 2B FIGURE 2C FIGURE 2D FIGURE 3A FIGURE 3B FIGURE 4 FIGURE 5 FIGURE 7 FIGURE 8 PMID:10703118

Ex vivo enrichment of circulating anti-tumor T cells from both cutaneous and ocular melanoma patients: clinical implications for adoptive cell transfer therapy.

PubMed

Mazzarella, Tonia; Cambiaghi, Valeria; Rizzo, Nathalie; Pilla, Lorenzo; Parolini, Danilo; Orsenigo, Elena; Colucci, Annalisa; Modorati, Giulio; Doglioni, Claudio; Parmiani, Giorgio; Maccalli, Cristina

2012-08-01

Tumor-infiltrating lymphocytes (TILs) have been successfully used for adoptive cell transfer (ACT) immunotherapy; however, due to their scarce availability, this therapy is possible for a limited fraction of cutaneous melanoma patients. We assessed whether an effective protocol for ex vivo T-cell expansion from peripheral blood mononuclear cells (PBMCs), suitable for ACT of both cutaneous and ocular melanoma patients, could be identified. PBMCs from both cutaneous and ocular melanoma patients were stimulated in vitro with autologous, irradiated melanoma cells (mixed lymphocyte tumor cell culture; MLTCs) in the presence of IL-2 and IL-15 followed by the rapid expansion protocol (REP). The functional activity of these T lymphocytes was characterized and compared with that of TILs. In addition, the immune infiltration in vivo of ocular melanoma lesions was analyzed. An efficient in vitro MLTC expansion of melanoma reactive T cells was achieved from all PBMC's samples obtained in 7 cutaneous and ocular metastatic melanoma patients. Large numbers of melanoma-specific T cells could be obtained when the REP protocol was applied to these MLTCs. Most MLTCs were enriched in non-terminally differentiated T(EM) cells homogeneously expressing co-stimulatory molecules (e.g., NKG2D, CD28, CD134, CD137). A similar pattern of anti-tumor activity, in association with a more variable expression of co-stimulatory molecules, was detected on short-term in vitro cultured TILs isolated from the same patients. In these ocular melanoma patients, we observed an immune infiltrate with suppressive characteristics and a low rate of ex vivo growing TILs (28.5% of our cases). Our MLTC protocol overcomes this limitation, allowing the isolation of T lymphocytes with effector functions even in these patients. Thus, anti-tumor circulating PBMC-derived T cells could be efficiently isolated from melanoma patients by our novel ex vivo enrichment protocol. This protocol appears suitable for ACT studies of cutaneous and ocular melanoma patients.

Long-term medical outcomes in survivors of extra-ocular retinoblastoma: the Memorial Sloan-Kettering Cancer Center (MSKCC) experience.

PubMed

Friedman, Danielle Novetsky; Sklar, Charles A; Oeffinger, Kevin C; Kernan, Nancy A; Khakoo, Yasmin; Marr, Brian P; Wolden, Suzanne L; Abramson, David H; Dunkel, Ira J

2013-04-01

Data on long-term outcomes of survivors of extra-ocular retinoblastoma are lacking. The authors sought to provide the first report characterizing long-term outcomes among survivors of extra-ocular retinoblastoma. Retrospective analysis of long-term medical outcomes in 19 survivors of extra-ocular retinoblastoma treated between 1992 and 2009. Severity of outcomes was graded using Common Terminology Criteria for Adverse Events. All patients received intensive multimodality therapy for their extra-ocular disease after management of their primary intra-ocular disease, including conventional chemotherapy (n = 19, 100%), radiotherapy (n = 15, 69%), and/or high-dose chemotherapy with autologous stem cell transplant (n = 17, 89%). The median follow-up was 7.8 years from diagnosis of extra-ocular retinoblastoma (range 2-17.8 years). The most common long-term non-visual outcomes were hearing loss (n = 15, 79%), short stature (n = 7, 37%), and secondary malignancies [SMN] (n = 6, 31%). Sixty-eight percent of survivors exhibited ≥2 non-visual long-term outcomes of any grade. Except short stature, which was not graded for severity, Grade 3-4 outcomes were limited to: ototoxicity (n = 8; n = 4 require hearing aids), SMNs (n = 6), and unequal limb length (n = 1). Five patients who developed SMNs carried a known RB1 mutation. SMNs developed at a median of 11.1 years after initial diagnosis; two patients died of their SMN. Long-term cardiac, pulmonary, hepatobiliary, or renal conditions were not identified in any survivors. Long-term outcomes are commonly seen in extra-ocular retinoblastoma survivors but the majority are mild-moderate in their severity. Longer comprehensive follow-up is needed to fully assess treatment-related outcomes but the information collected to date may affect management decisions for children with extra-ocular disease. Copyright © 2012 Wiley Periodicals, Inc.

The impact of ocular trauma during the Nepal earthquake in 2015.

PubMed

Pradhan, E; Limbu, B; Thakali, S; Jain, N S; Gurung, R; Ruit, S

2017-03-28

Nepal was struck by a massive earthquake on the 25th April 2015 and major aftershock on the 12th of May 2015, resulting in widespread devastation with a death toll in the thousands. The burden of ocular trauma resulting from the recent earthquakes in Nepal has not been described thus far. The aim of this study was to determine the types of ocular injuries sustained in the earthquake in Nepal and its management in Tilganga Institute of Ophthalmology (TIO) in Gaushala, Kathmandu. This is a hospital-based retrospective study of patients presenting to TIO following repeated earthquake. Variables that were recorded included patients' presenting symptoms and time to presentation, visual acuities at presentation and at follow-up, diagnosis of ocular injury and surgery performed. There were 59 cases of earthquake victims visiting TIO, Gaushala, Kathmandu from April 2015 to July 2015, with 64 affected eyes due to 5 cases of bilateral involvement. The majority of patients were from the district Sindhupalchowk (14 cases, 23.7%), which was the epicenter of the main earthquake. The average duration between the earthquake and presentation was 13 · 9 days (range 1-120 days). Closed globe injury was most frequent (23 cases), followed by open globe injuries (8 cases). While 24 patients (38%) initially presented with a visual acuity <3/60 in their affected eye, 15 patients (23%) had a visual acuity of <3/60 on follow-up. A variety of surgical treatments were required including anterior and posterior segment repair. Immediate management of ocular trauma is critical in order to prevent blindness. Characterizing the burden of earthquake-related ocular trauma will facilitate planning for service provision in the event of a future earthquake in Nepal, or in countries, which are similarly at risk of having natural disasters.

The Effects of Increasing Ocular Surface Stimulation on Blinking and Tear Secretion

PubMed Central

Wu, Ziwei; Begley, Carolyn G.; Port, Nicholas; Bradley, Arthur; Braun, Richard; King-Smith, Ewen

2015-01-01

Purpose. To investigate the effect of varying levels of ocular surface stimulation on the timing and amplitude of the blink and tear secretion. Methods. Following instillation of fluorescein dye, increasing levels of air flow were directed toward the central corneas of 10 healthy subjects. Interblink interval (IBI), tear meniscus height (TMH), and fluorescence intensity were measured simultaneously. Because blinking can obscure changes in TMH, we developed novel measures of tear secretion by calculating tear meniscus fluorescein concentration (TMFC) from intensity using a mathematical model. The change of TMH and TMFC over trials and the slope of the TMFC within each IBI (IBI-TTR) were further calculated. Results. The mean IBI was decreased by 8.08 ± 8.54 seconds from baseline to maximum air stimulation. The TMH increase was highly variable (0.41 ± 0.39 mm) among subjects, compared to the fluorescence tear turnover metrics: decrease in TMFC of 2.84 ± 0.98 natural logarithm or ln(%) and IBI-TTR of 0.065 ± 0.032 ln(%)/sec. Ocular surface stimulation was highly correlated with the TMFC and IBI-TTR, but less so with TMH (Pearson's r = 0.71, 0.69, and 0.40, P < 0.01, respectively). Blinking and tearing were significantly correlated with each other (Pearson's r = 0.56, P < 0.01), but tearing lagged behind by an average of 6.54 ± 4.07 seconds. Conclusions. Blinking and tearing share a common origin with sensory stimulation at the ocular surface. Both showed a dose–response increase with surface stimulation and were correlated with each other. These methods can potentially be used to understand alterations in ocular surface sensory function and associated protective responses in dry eye and other disorders of the ocular surface. PMID:26132780

The Effects of Increasing Ocular Surface Stimulation on Blinking and Tear Secretion.

PubMed

Wu, Ziwei; Begley, Carolyn G; Port, Nicholas; Bradley, Arthur; Braun, Richard; King-Smith, Ewen

2015-07-01

To investigate the effect of varying levels of ocular surface stimulation on the timing and amplitude of the blink and tear secretion. Following instillation of fluorescein dye, increasing levels of air flow were directed toward the central corneas of 10 healthy subjects. Interblink interval (IBI), tear meniscus height (TMH), and fluorescence intensity were measured simultaneously. Because blinking can obscure changes in TMH, we developed novel measures of tear secretion by calculating tear meniscus fluorescein concentration (TMFC) from intensity using a mathematical model. The change of TMH and TMFC over trials and the slope of the TMFC within each IBI (IBI-TTR) were further calculated. The mean IBI was decreased by 8.08 ± 8.54 seconds from baseline to maximum air stimulation. The TMH increase was highly variable (0.41 ± 0.39 mm) among subjects, compared to the fluorescence tear turnover metrics: decrease in TMFC of 2.84 ± 0.98 natural logarithm or ln(%) and IBI-TTR of 0.065 ± 0.032 ln(%)/sec. Ocular surface stimulation was highly correlated with the TMFC and IBI-TTR, but less so with TMH (Pearson's r = 0.71, 0.69, and 0.40, P < 0.01, respectively). Blinking and tearing were significantly correlated with each other (Pearson's r = 0.56, P < 0.01), but tearing lagged behind by an average of 6.54 ± 4.07 seconds. Blinking and tearing share a common origin with sensory stimulation at the ocular surface. Both showed a dose-response increase with surface stimulation and were correlated with each other. These methods can potentially be used to understand alterations in ocular surface sensory function and associated protective responses in dry eye and other disorders of the ocular surface.

Survey of ocular irritation predictive capacity using Chorioallantoic Membrane Vascular Assay (CAMVA) and Bovine Corneal Opacity and Permeability (BCOP) test historical data for 319 personal care products over fourteen years.

PubMed

Donahue, D A; Kaufman, L E; Avalos, J; Simion, F A; Cerven, D R

2011-03-01

The Chorioallantoic Membrane Vascular Assay (CAMVA) and Bovine Corneal Opacity and Permeability (BCOP) test are widely used to predict ocular irritation potential for consumer-use products. These in vitro assays do not require live animals, produce reliable predictive data for defined applicability domains compared to the Draize rabbit eye test, and are rapid and inexpensive. Data from 304 CAMVA and/or BCOP studies (319 formulations) were surveyed to determine the feasibility of predicting ocular irritation potential for various formulations. Hair shampoos, skin cleansers, and ethanol-based hair styling sprays were repeatedly predicted to be ocular irritants (accuracy rate=0.90-1.00), with skin cleanser and hair shampoo irritation largely dependent on surfactant species and concentration. Conversely, skin lotions/moisturizers and hair styling gels/lotions were repeatedly predicted to be non-irritants (accuracy rate=0.92 and 0.82, respectively). For hair shampoos, ethanol-based hair stylers, skin cleansers, and skin lotions/moisturizers, future ocular irritation testing (i.e., CAMVA/BCOP) can be nearly eliminated if new formulations are systematically compared to those previously tested using a defined decision tree. For other tested product categories, new formulations should continue to be evaluated in CAMVA/BCOP for ocular irritation potential because either the historical data exhibit significant variability (hair conditioners and mousses) or the historical sample size is too small to permit definitive conclusions (deodorants, make-up removers, massage oils, facial masks, body sprays, and other hair styling products). All decision tree conclusions should be made within a conservative weight-of-evidence context, considering the reported limitations of the BCOP test for alcohols, ketones, and solids. Copyright © 2010 Elsevier Ltd. All rights reserved.

The eyes of lanternfishes (Myctophidae, Teleostei): novel ocular specializations for vision in dim light.

PubMed

de Busserolles, Fanny; Marshall, N Justin; Collin, Shaun P

2014-05-01

Lanternfishes are one of the most abundant groups of mesopelagic fishes in the world's oceans and play a critical role in biomass vertical turnover. Despite their importance, very little is known about their physiology or how they use their sensory systems to survive in the extreme conditions of the deep sea. In this study, we provide a comprehensive description of the general morphology of the myctophid eye, based on analysis of 53 different species, to understand better their visual capabilities. Results confirm that myctophids possess several visual adaptations for dim-light conditions, including enlarged eyes, an aphakic gap, a tapetum lucidum, and a pure rod retina with high densities of long photoreceptors. Two novel retinal specializations were also discovered. The first specialization is a fundal pigmentation in adult eyes, found within an isolated retinal region (typically central retina) composed of modified pigment epithelial cells, which we hypothesize to be the remnant of a more pronounced visual specialization important in larval stages. The second specialization is an aggregation of extracellular microtubular-like structures found within the sclerad region of the inner nuclear layer of the retina. We hypothesize that the marked interspecific differences in the hypertrophy of these microtubular-like structures may be related to inherent differences in visual function. A general interspecific variability in other parts of the eye is also revealed and examined in this study. The contribution of both ecology and phylogeny to the evolution of ocular specializations and vision in dim light are discussed. Copyright © 2013 Wiley Periodicals, Inc.

A retrospective analysis of eye conditions among children attending St. John Eye Hospital, Hebron, Palestine.

PubMed

Banayot, Riyad G

2016-04-05

Eye diseases are important causes of medical consultations, with the spectrum varying in different regions. This hospital-based descriptive study aimed to determine the profile of childhood eye conditions at St. John tertiary Eye hospital serving in Hebron, Palestine. Files of all new patients less than 16 years old who presented to St. John Eye Hospital-Hebron, Palestine between January 2013 and December 2013 were retrospectively reviewed. Age at presentation, sex, and clinical diagnosis were extracted from medical records. Data were stored and analyzed using Wizard data analysis version 1.6.0 by Evan Miller. The Chi square test was used to compare variables and a p value of less than 0.05 was considered statistically significant. We evaluated the records of 1102 patients, with a female: male ratio of 1:1.1. Patients aged 0-5 years old were the largest group (40.2%). Refractive errors were the most common ocular disorders seen (31.6%), followed by conjunctival diseases (23.7%) and strabismus and amblyopia (13.8%). Refractive errors were recorded more frequently and statistically significant (p < 0.001) among (11-15) age group. Within the conjunctival diseases category, conjunctivitis and dry eyes was more prominent and statistically significant (p < 0.001) among the 6-10 year old age group. Within the strabismus and amblyopia category, convergent strabismus was more common and statistically significant among the youngest age group (0-5 years old). The most common causes of ocular morbidity are largely treatable or preventable. These results suggest the need for awareness campaigns and early intervention programs.

Implementation Intentions as a Strategy to Increase the Notification Rate of Potential Ocular Tissue Donors by Nurses: A Clustered Randomized Trial in Hospital Settings

PubMed Central

2014-01-01

Aim. The purpose of this study is to evaluate the impact, among nurses in hospital settings, of a questionnaire-based implementation intentions intervention on notification of potential ocular tissue donors to donation stakeholders. Methods. This randomized intervention was clustered at the level of hospital departments with two study arms: questionnaire-based implementation intentions intervention and control. In the intervention group, nurses were asked to plan specific actions if faced with a number of barriers when reporting potential ocular donors. The primary outcome was the potential ocular tissue donors' notification rate before and after the intervention. Analysis was based on a generalized linear model with an identity link and a binomial distribution. Results. We compared outcomes in 26 departments from 5 hospitals, 13 departments per condition. The implementation intentions intervention did not significantly increase the notification rate of ocular tissue donors (intervention: 23.1% versus control: 21.1%; χ 2 = 1.14, 2; P = 0.56). Conclusion. A single and brief implementation intentions intervention among nurses did not modify the notification rate of potential ocular tissue donors to donation stakeholders. Low exposure to the intervention was a major challenge in this study. Further studies should carefully consider a multicomponent intervention to increase exposure to this type of intervention. PMID:25132990

Attention-deficit/hyperactivity disorder children exhibit an impaired accommodative response.

PubMed

Redondo, Beatriz; Vera, Jesús; Molina, Rubén; García, José Antonio; Ouadi, Miriam; Muñoz-Hoyos, Antonio; Jiménez, Raimundo

2018-05-01

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common paediatric neurobehavioural disorders causing multiple functional impairments in children. Based on the relationship between the neural system that controls attention and ocular dynamics, the present study compares the magnitude and variability of accommodation between a group of non-medicated ADHD children and an age-matched control group. The magnitude and variability of the accommodative response were objectively measured in 36 children using the WAM-5500 autorefractometer for 90 consecutive seconds at three static viewing distances (500, 40, and 20 cm). Participants were divided into ADHD (n = 18) or control (n = 18) groups based on clinically validated criteria. Children with ADHD exhibited higher lags of accommodation (p = 0.024), increasing at closer viewing distances, in comparison to the control group. Marginal statistical differences were found for the variability of accommodation (p = 0.066), with the ADHD group showing a trend towards higher variability. Our analysis showed that the magnitude and variability of accommodation did not vary over time between groups (p > 0.05). Our data suggest that children with ADHD have a less accurate accommodative response. These results provide a new ocular index that could help to clarify the relationship between accommodative response and attentional deficits, which could have a direct impact on the academic, cognitive, and visual performance of ADHD children.

Ocular manifestations of canine transmissible venereal tumour: a retrospective study of 25 cases in Greece.

PubMed

Komnenou, A Th; Thomas, A L N; Kyriazis, A P; Poutahidis, T; Papazoglou, L G

2015-05-16

Transmissible venereal tumour (TVT) is a sexually transmitted neoplasm that frequently affects dogs of either sex, in tropical and subtropical regions. TVT primarily involves the external genitalia, although extragenital sites have also been reported. This study describes the ocular manifestations of TVT in 25 naturally infected dogs and their response to treatment. Seventeen male and eight female dogs were included in the study. TVT ocular lesions were either unilateral (21 dogs) or bilateral (four dogs). Ocular lesions as the single manifestation of TVT were seen in 22 animals. One dog presented external genitalia involvement while two others were found to have tumours in the oral and nasal mucosa. Variably sized multilobular tumour masses with irregular surface were noticed on the bulbar conjunctiva of the nictitating membrane in 17 dogs, on the conjunctiva of the upper eyelid in five dogs and on the conjunctiva of the lower eyelid and adjacent skin in three dogs. Deep ulcerative keratitis was observed in eight animals. TVT diagnosis was based on cytology and histopathology. The large eye masses were surgically excised. All dogs were treated with a single chemotherapeutic agent (vincristine). After four weeks of treatment, complete remission of the tumours was evident in all but one animal. Extragenital primary ophthalmic TVT can be completely eliminated by vincristine chemotherapy, while any further ocular damage is prevented with the combination of the above treatment and surgical excision. British Veterinary Association.

Acquired color vision deficiency.

PubMed

Simunovic, Matthew P

2016-01-01

Acquired color vision deficiency occurs as the result of ocular, neurologic, or systemic disease. A wide array of conditions may affect color vision, ranging from diseases of the ocular media through to pathology of the visual cortex. Traditionally, acquired color vision deficiency is considered a separate entity from congenital color vision deficiency, although emerging clinical and molecular genetic data would suggest a degree of overlap. We review the pathophysiology of acquired color vision deficiency, the data on its prevalence, theories for the preponderance of acquired S-mechanism (or tritan) deficiency, and discuss tests of color vision. We also briefly review the types of color vision deficiencies encountered in ocular disease, with an emphasis placed on larger or more detailed clinical investigations. Copyright © 2016 Elsevier Inc. All rights reserved.

Anterior segment and external ocular disorders associated with HIV infections in the era of HAART in Chiang Mai University Hospital, a prospective descriptive cross sectional study.

PubMed

Singalavanija, Tassapol; Ausayakhun, Somsanguan; Tangmonkongvoragul, Chulaluck

2018-01-01

Human immunodeficiency virus (HIV) causes impairment to the human immune system which leads to immunocompromised conditions, including ocular complications. Several important HIV-associated disorders may involve the anterior segment, ocular surface, and adnexae organ such as dry eye, blepharitis which reduce quality of life of patients. In present, potent antiretroviral therapies HAART (highly active antiretroviral therapy) has improved the length and quality of life which may lead to an increased prevalence of anterior segment ocular disorders. Hence, this study has been undertaken to identify the prevalence and associated factors of anterior segment and external ocular disorder in HIV infected patients in the era of HAART. A prospective descriptive cross sectional study was carried out in HIV positive patients conducted at the Department of Ophthalmology, Chiang Mai University Hospital, from February 2014 to October 2015. Detail history and ocular examination was carried out to examine for anterior segment and external ocular disorders. A total number of 363 patients were included for this prospective cross-sectional study. From the total of 363 patients, 123 patients had an anterior segment and external ocular disorder which account as the prevalence of 33.9%. The most common anterior segment manifestations was dry eye seen in 36 patients (9.9%), followed by posterior blepharitis (Meibomian gland dysfunction) seen in 23 patients (6.3%) and anterior blepharitis seen in 12 patients (3.3%). Other ocular complications included microvasculopathy, immune recovery uveitis, conjunctivitis, papilloma, anterior uveitis, corneal ulcer, nevus, trichiasis, molluscum contangiosum, Kaposi sarcoma, interstitial keratitis, conjunctival lymphangiectasia, dacryocystitis, vernal keratoconjunctivitis and eyelid penicilosis. In this study, the prevalance of anterior segment disorders was higher than in the preHAART era. Dry eye, blepharitis and uveitis were the top three most common anterior segment disorders in the HAART era. The statistical analysis showed no association between age, sex, CD4 count, duration of infection or receiving HAART and anterior segment disorders. Anterior segment abnormalities reduce the quality of life of patients, so ophthalmologists have to be aware and complete ocular examination should be performed in all HIV infected patients.

Anterior segment and external ocular disorders associated with HIV infections in the era of HAART in Chiang Mai University Hospital, a prospective descriptive cross sectional study

PubMed Central

Ausayakhun, Somsanguan

2018-01-01

Human immunodeficiency virus (HIV) causes impairment to the human immune system which leads to immunocompromised conditions, including ocular complications. Several important HIV-associated disorders may involve the anterior segment, ocular surface, and adnexae organ such as dry eye, blepharitis which reduce quality of life of patients. In present, potent antiretroviral therapies HAART (highly active antiretroviral therapy) has improved the length and quality of life which may lead to an increased prevalence of anterior segment ocular disorders. Hence, this study has been undertaken to identify the prevalence and associated factors of anterior segment and external ocular disorder in HIV infected patients in the era of HAART. A prospective descriptive cross sectional study was carried out in HIV positive patients conducted at the Department of Ophthalmology, Chiang Mai University Hospital, from February 2014 to October 2015. Detail history and ocular examination was carried out to examine for anterior segment and external ocular disorders. A total number of 363 patients were included for this prospective cross-sectional study. From the total of 363 patients, 123 patients had an anterior segment and external ocular disorder which account as the prevalence of 33.9%. The most common anterior segment manifestations was dry eye seen in 36 patients (9.9%), followed by posterior blepharitis (Meibomian gland dysfunction) seen in 23 patients (6.3%) and anterior blepharitis seen in 12 patients (3.3%). Other ocular complications included microvasculopathy, immune recovery uveitis, conjunctivitis, papilloma, anterior uveitis, corneal ulcer, nevus, trichiasis, molluscum contangiosum, Kaposi sarcoma, interstitial keratitis, conjunctival lymphangiectasia, dacryocystitis, vernal keratoconjunctivitis and eyelid penicilosis. In this study, the prevalance of anterior segment disorders was higher than in the preHAART era. Dry eye, blepharitis and uveitis were the top three most common anterior segment disorders in the HAART era. The statistical analysis showed no association between age, sex, CD4 count, duration of infection or receiving HAART and anterior segment disorders. Anterior segment abnormalities reduce the quality of life of patients, so ophthalmologists have to be aware and complete ocular examination should be performed in all HIV infected patients. PMID:29466424

Wavelet Representation of the Corneal Pulse for Detecting Ocular Dicrotism

PubMed Central

Melcer, Tomasz; Danielewska, Monika E.; Iskander, D. Robert

2015-01-01

Purpose To develop a reliable and powerful method for detecting the ocular dicrotism from non-invasively acquired signals of corneal pulse without the knowledge of the underlying cardiopulmonary information present in signals of ocular blood pulse and the electrical heart activity. Methods Retrospective data from a study on glaucomatous and age-related changes in corneal pulsation [PLOS ONE 9(7),(2014):e102814] involving 261 subjects was used. Continuous wavelet representation of the signal derivative of the corneal pulse was considered with a complex Gaussian derivative function chosen as mother wavelet. Gray-level Co-occurrence Matrix has been applied to the image (heat-maps) of CWT to yield a set of parameters that can be used to devise the ocular dicrotic pulse detection schemes based on the Conditional Inference Tree and the Random Forest models. The detection scheme was first tested on synthetic signals resembling those of a dicrotic and a non-dicrotic ocular pulse before being used on all 261 real recordings. Results A detection scheme based on a single feature of the Continuous Wavelet Transform of the corneal pulse signal resulted in a low detection rate. Conglomeration of a set of features based on measures of texture (homogeneity, correlation, energy, and contrast) resulted in a high detection rate reaching 93%. Conclusion It is possible to reliably detect a dicrotic ocular pulse from the signals of corneal pulsation without the need of acquiring additional signals related to heart activity, which was the previous state-of-the-art. The proposed scheme can be applied to other non-stationary biomedical signals related to ocular dynamics. PMID:25906236

Dry eye syndrome: developments and lifitegrast in perspective

PubMed Central

Lollett, Ivonne V; Galor, Anat

2018-01-01

Dry eye (DE) is a chronic ocular condition with high prevalence and morbidity. It has a complex pathophysiology and is multifactorial in nature. Chronic ocular surface inflammation has emerged as a key component of DE that is capable of perpetuating ocular surface damage and leading to symptoms of ocular pain, discomfort, and visual phenomena. It begins with stress to the ocular surface leading to the production of proinflammatory mediators that induce maturation of resident antigen-presenting cells which then migrate to the lymph nodes to activate CD4 T cells. The specific antigen(s) targeted by these pathogenic CD4+ T cells remains unknown. Two emerging theories include self-antigens by autoreactive CD4 T cells or harmless exogenous antigens in the setting of mucosal immunotolerance loss. These CD4 T cells migrate to the ocular surface causing additional inflammation and damage. Lifitegrast is the second topical anti-inflammatory agent to be approved by the US Food and Drug Administration for the treatment of DE and the first to show improvement in DE symptoms. Lifitegrast works by blocking the interaction between intercellular adhesion molecule-1 and lymphocyte functional associated antigen-1, which has been shown to be critical for the migration of antigen-presenting cells to the lymph nodes as well as CD4+ T cell activation and migration to the ocular surface. In four large multicenter, randomized controlled trials, lifitegrast has proven to be effective in controlling both the signs and symptoms of DE with minimal side effects. Further research should include comparative and combination studies with other anti-inflammatory therapies used for DE. PMID:29391773

Clinical efficacy of Ayurvedic management in computer vision syndrome: A pilot study.

PubMed

Dhiman, Kartar Singh; Ahuja, Deepak Kumar; Sharma, Sanjeev Kumar

2012-07-01

Improper use of sense organs, violating the moral code of conduct, and the effect of the time are the three basic causative factors behind all the health problems. Computer, the knowledge bank of modern life, has emerged as a profession causing vision-related discomfort, ocular fatigue, and systemic effects. Computer Vision Syndrome (CVS) is the new nomenclature to the visual, ocular, and systemic symptoms arising due to the long time and improper working on the computer and is emerging as a pandemic in the 21(st) century. On critical analysis of the symptoms of CVS on Tridoshika theory of Ayurveda, as per the road map given by Acharya Charaka, it seems to be a Vata-Pittaja ocular cum systemic disease which needs systemic as well as topical treatment approach. Shatavaryaadi Churna (orally), Go-Ghrita Netra Tarpana (topically), and counseling regarding proper working conditions on computer were tried in 30 patients of CVS. In group I, where oral and local treatment was given, significant improvement in all the symptoms of CVS was observed, whereas in groups II and III, local treatment and counseling regarding proper working conditions, respectively, were given and showed insignificant results. The study verified the hypothesis that CVS in Ayurvedic perspective is a Vata-Pittaja disease affecting mainly eyes and body as a whole and needs a systemic intervention rather than topical ocular medication only.

Clinical efficacy of Ayurvedic management in computer vision syndrome: A pilot study

PubMed Central

Dhiman, Kartar Singh; Ahuja, Deepak Kumar; Sharma, Sanjeev Kumar

2012-01-01

Improper use of sense organs, violating the moral code of conduct, and the effect of the time are the three basic causative factors behind all the health problems. Computer, the knowledge bank of modern life, has emerged as a profession causing vision-related discomfort, ocular fatigue, and systemic effects. Computer Vision Syndrome (CVS) is the new nomenclature to the visual, ocular, and systemic symptoms arising due to the long time and improper working on the computer and is emerging as a pandemic in the 21st century. On critical analysis of the symptoms of CVS on Tridoshika theory of Ayurveda, as per the road map given by Acharya Charaka, it seems to be a Vata–Pittaja ocular cum systemic disease which needs systemic as well as topical treatment approach. Shatavaryaadi Churna (orally), Go-Ghrita Netra Tarpana (topically), and counseling regarding proper working conditions on computer were tried in 30 patients of CVS. In group I, where oral and local treatment was given, significant improvement in all the symptoms of CVS was observed, whereas in groups II and III, local treatment and counseling regarding proper working conditions, respectively, were given and showed insignificant results. The study verified the hypothesis that CVS in Ayurvedic perspective is a Vata–Pittaja disease affecting mainly eyes and body as a whole and needs a systemic intervention rather than topical ocular medication only. PMID:23723647

ZAG-Otolith: Modification of Otolith-Ocular Reflexes, Motion Perception and Manual Control during Variable Radius Centrifugation Following Space Flight

NASA Technical Reports Server (NTRS)

Wood, S. J.; Clarke, A. H.; Rupert, A. H.; Harm, D. L.; Clement, G. R.

2009-01-01

Two joint ESA-NASA studies are examining changes in otolith-ocular reflexes and motion perception following short duration space flights, and the operational implications of post-flight tilt-translation ambiguity for manual control performance. Vibrotactile feedback of tilt orientation is also being evaluated as a countermeasure to improve performance during a closed-loop nulling task. METHODS. Data is currently being collected on astronaut subjects during 3 preflight sessions and during the first 8 days after Shuttle landings. Variable radius centrifugation is utilized to elicit otolith reflexes in the lateral plane without concordant roll canal cues. Unilateral centrifugation (400 deg/s, 3.5 cm radius) stimulates one otolith positioned off-axis while the opposite side is centered over the axis of rotation. During this paradigm, roll-tilt perception is measured using a subjective visual vertical task and ocular counter-rolling is obtained using binocular video-oculography. During a second paradigm (216 deg/s, <20 cm radius), the effects of stimulus frequency (0.15 - 0.6 Hz) are examined on eye movements and motion perception. A closed-loop nulling task is also performed with and without vibrotactile display feedback of chair radial position. PRELIMINARY RESULTS. Data collection is currently ongoing. Results to date suggest there is a trend for perceived tilt and translation amplitudes to be increased at the low and medium frequencies on landing day compared to pre-flight. Manual control performance is improved with vibrotactile feedback. DISCUSSION. One result of this study will be to characterize the variability (gain, asymmetry) in both otolithocular responses and motion perception during variable radius centrifugation, and measure the time course of postflight recovery. This study will also address how adaptive changes in otolith-mediated reflexes correspond to one's ability to perform closed-loop nulling tasks following G-transitions, and whether manual control performance can be improved with vibrotactile feedback of orientation.

[Biomechanical condition of the cornea as a new indicator for pathological and structural changes].

PubMed

Spörl, E; Terai, N; Haustein, M; Böhm, A G; Raiskup-Wolf, F; Pillunat, L E

2009-06-01

Several methods permit the measurement of geometric parameters of the cornea, but until now biomechanical conditions of the cornea have been ignored (e.g. in refractive corneal surgery). Besides the geometric condition, biomechanical properties of the cornea have been shown to influence applanation measurement of intra-ocular pressure (IOP) and epidemiological studies have identified corneal thickness as an independent risk factor for the development and progression of glaucoma. The aim of this investigation was to characterize the biomechanical properties of the cornea using the ocular response analyzer (ORA). The ocular response analyzer (ORA) is a new method available for non-contact measurement of the biomechanical properties of the cornea. We evaluated the reproducibility of measurements, the difference between static and dynamic factors and the impact of independent factors (e.g. IOP, age, CCT, swelling of the cornea) on 2,500 measurements of corneal hysteresis (CH) and corneal resistance factor (CRF). In a large sample size we observed changes in CH and CRF after refractive surgery procedures (LASIK, UV-A cross-linking, keratoplasty) and in other corneal disorders (keratoconus, corneal dystrophies). CRF and CH changes may reflect structural changes of the cornea. Thus, the ORA provides valuable information for a better understanding and characterization of the biomechanical condition of the cornea, especially with regard to diseases such as keratoconus and glaucoma.

Impact of oral vitamin D supplementation on the ocular surface in people with dry eye and/or low serum vitamin D.

PubMed

Yang, Chih-Huang; Albietz, Julie; Harkin, Damien G; Kimlin, Michael G; Schmid, Katrina L

2018-02-01

To determine the possible association between serum vitamin D levels and dry eye symptoms, and the impact of an oral vitamin D supplement. Three linked studies were performed. (i) 29 older adult participants, (ii) 29 dry eyed participants, and (iii) 2-month vitamin D supplementation for 32 dry eyed/low serum vitamin D levelled participants. All participants were assessed by the Ocular Surface Diseases Index (OSDI) to determine dry eye symptoms, and the phenol red thread test (PRT) and/or Schirmer's tear test, tear meniscus height, non-invasive tear break up time, grading ocular surface redness and fluorescein staining of the cornea to detect the tear quality and ocular surface conditions. Blood samples were collected for serum vitamin D analysis and interleukin-6 (IL-6) levels. Among older adult participants, vitamin D levels were negatively correlated with dry eye symptoms, the severity of dry eye, and associated with tired eye symptom. Vitamin D levels of people with dry eye diagnosis were not correlated with OSDI scores and IL-6 levels; while IL-6 levels showed correlation with tear production. In supplement study, vitamin D levels increased by 29mol/l, while dry eye symptoms and grading of corneal staining appeared significant reductions. No significant changes in IL-6 levels. Low vitamin D levels (<50nmol/l) were associated with dry eye symptoms in older individuals but not those diagnosed with dry eye. Vitamin D supplement increased the vitamin D levels, and improved dry eye symptoms, the tear quality and ocular surface conditions. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Estimating plant biomass for undergrowth species of northeastern Minnesota forest communities.

Treesearch

Lewis F. Ohmann; David F. Grigal; Lynn L. Rogers

1981-01-01

Biomass prediction equations were developed for some common ground cover plants from forest communities of northeastern Minnesota. The allometric function was used to predict biomass (dry weight) with ocular estimates of percent ground cover of the plant as the independent variable.

[Difference and distance between the central and thinnest points of the cornea: impact of refractive state, age and ocular side].

PubMed

Steinberg, J; Kohl, C; Katz, T; Richard, G; Linke, S J

2014-04-01

The aim of the study was to quantify the difference in corneal thickness between the central and thinnest points (∆PachyZ-PachyD), the distance between the center of the cornea and its thinnest point (vector length PachyD) and to explore the impact of refractive state, age and ocular side. This was a multicenter, retrospective, cross-sectional study and medical records of 16,872 eyes were reviewed. The Orbscan® (Bausch and Lomb) procedure was used for pachymetry and keratometry. The results showed that ∆PachyZ-PachyD and vector length PachyD were higher in hyperopic eyes (∆PachyZ-PachyD: 11.99 ± 12.08 µm, vector length PachyD: 0.85 ± 0.44 mm) compared to myopic eyes (∆PachyZ-PachyD: 9.2 ± 7.86 µm, vector length PachyD: 0.7 ± 0.37 mm; p < 0.001). Refractive state, age and ocular side demonstrated an independent, statistically significant impact on ∆PachyZ-PachyD and vector length PachyD. As a result of the significant impact of refractive state, age and ocular side on ∆PachyZ-PachyD and vector length PachyD, these variables should be considered in a normative data collection.

Neural Regulation of Lacrimal Gland Secretory Processes: Relevance in Dry Eye Diseases

PubMed Central

Dartt, Darlene A.

2013-01-01

The lacrimal gland is the major contributor to the aqueous layer of the tear film which consists of water, electrolytes and proteins. The amount and composition of this layer is critical for the health, maintenance, and protection of the cells of the cornea and conjunctiva (the ocular surface). Small changes in the concentration of tear electrolytes have been correlated with dry eye syndrome. While the mechanisms of secretion of water, electrolytes and proteins from the lacrimal gland differ, all three are under tight neural control. This allows for a rapid response to meet the needs of the cells of the ocular surface in response to environmental conditions. The neural response consists of the activation of the afferent sensory nerves in the cornea and conjunctiva to stimulate efferent parasympathetic and sympathetic nerves that innervate the lacrimal gland. Neurotransmitters are released from the stimulated parasympathetic and sympathetic nerves that cause secretion of water, electrolytes, and proteins from the lacrimal gland and onto the ocular surface. This review focuses on the neural regulation of lacrimal gland secretion under normal and dry eye conditions. PMID:19376264

Inner and outer segment junction (IS/OS line) integrity in ocular Behçet's disease.

PubMed

Yüksel, Harun; Türkcü, Fatih M; Sahin, Muhammed; Cinar, Yasin; Cingü, Abdullah K; Ozkurt, Zeynep; Sahin, Alparslan; Ari, Seyhmus; Caça, Ihsan

2014-08-01

In this study, we examined the spectral domain optical coherence tomography (OCT) findings of ocular Behçet's disease (OB) in patients with inactive uveitis. Specifically, we analyzed the inner and outer segment junction (IS/OS line) integrity and the effect of disturbed IS/OS line integrity on visual acuity. Patient files and OCT images of OB patients who had been followed-up between January and June of the year 2013 at the Dicle University Eye Clinic were evaluated retrospectively. Sixty-six eyes of 39 patients were included the study. OCT examination of the patients with inactive OB revealed that approximately 25% of the patients had disturbed IS/OS and external limiting membrane (EML) line integrity, lower visual acuity (VA), and lower macular thickness than others. Linear regression analysis revealed that macular thickness was not an independent variable for VA. In contrast, the IS/OS line integrity was an independent variable for VA in inactive OB patients. In this study, we showed that the IS/OS line integrity was an independent variable for VA in inactive OB patients. Further prospective studies are needed to evaluate the integrity of the IS/OS line in OB patients.

Iris juvenile xanthogranuloma in an infant - spontaneous hyphema and secondary glaucoma.

PubMed

Pantalon, Anca; Ștefănache, Tudor; Danciu, Mihai; Zurac, Sabina; Chiseliță, Dorin

2017-01-01

Juvenile xanthogranuloma (JXG) is a benign histiocytic skin disorder mainly encountered during infancy and childhood. Although with multiple potential localizations, less than 1% of the cases exhibit ocular manifestations. Some of these might lead to serious complications, specifically, secondary glaucoma that can result in severe and blinding eye disease. The aim of the present case report was to demonstrate typical clinical features, emphasize the difficulties attributed when managing these patients and literature review. We present the case of 4 months old female baby with spontaneous hyphema and secondary unilateral glaucoma due to ocular JXG. The natural history and treatment of the condition were extremely difficult to handle due to multiple opinions in histopathology related to other severe conditions that resembled with the lesions detected in this case: myelomonocytic leukemia and Langerhans cell histiocytosis. Although a minority of patients with JXG have ocular involvement, recognition of this condition is important because a treatment delay can lead to serious complications, such as glaucoma and spontaneous hyphema, as in our case. A thorough differential diagnosis represents the key to a proper management plan in these patients, both on short and long term. "Triple disease" defined as JXG plus neurofibromatosis type 1 (NF-1) and juvenile chronic myelogenous leukemia (JCML) has been reported, but it was not confirmed in our patient.

Hazards To The Eye From UV

NASA Astrophysics Data System (ADS)

Zuclich, Joseph A.

1980-10-01

Ocular effects of ultraviolet radiation, 200-400 nm, are reviewed. Depending upon the exposure parameter involved, UV radiation may be harmful to the cornea, lens and/or retina. Ranges of exposure parameters (wavelength, exposure duration, etc.) for which each of the tissues is susceptible are specified and the nature of the tissue is described. Present understanding of the thermal and photochemical damage mechanism operative for various conditions of exposure are discussed Ocular damage thresholds for wide ranges of exposure parameters are summarized and compared to existing safety standards.

Multiple ocular colobomas in the snow leopard (Uncia uncia).

PubMed

Barnett, K C; Lewis, J C M

2002-09-01

Two singleton female snow leopard cubs are reported with bilateral central upper lid colobomas. In addition, one cub had a coloboma of the fundus in one eye extending from the lower optic disc region. Surgical treatment by wedge resection was successful in both cases. Details of ocular colobomas in other snow leopards reported in the literature are described and it is suggested that the exact etiology of the condition in this species may be discovered by further study of similar colobomas in the domestic cat.

Ocular Toxicity Secondary to Asclepias physocarpa: The Balloon Plant.

PubMed

Pina, Susana; Pedrosa, Catarina; Santos, Cristina; Feijóo, Bernardo; Pego, Peter; Vendrell, Cristina; Santos, Maria João; Prieto, Isabel

2014-01-01

We report a case of a 65-year-old woman with symptoms of blurred vision and ocular irritation a few hours after accidental contact of the right eye with Asclepias physocarpa milky latex. Observation showed a diffuse conjunctival hyperemia and stromal corneal edema with Descemet's membrane folds. Recovery was fast and apparently complete in less than one month. However, specular microscopy at 6-months follow-up showed an abnormal endothelial morphology as sequelae, suggesting this condition is not as innocuous as it has been suggested.

Molecular genetics of inherited eye disorders.

PubMed

MacDonald, I M; Sasi, R

1994-10-01

In the past 10 y, there have been considerable advances in the mapping, isolation, and characterization of many genes for important ocular conditions: retinitis pigmentosa, Norrie disease, Waardenburg syndrome, choroideremia, aniridia, retinoblastoma, and others. The candidate gene approach has now supplemented classical linkage studies and positional cloning in the investigation of ocular disorders. Developmentally expressed genes and animal models have provided insights as to the etiology of other disorders. With this knowledge at hand, genetic counselling for heritable eye diseases has been greatly improved.

Clinical characteristics and current treatment of glaucoma.

PubMed

Cohen, Laura P; Pasquale, Louis R

2014-06-02

Glaucoma is a neurodegenerative disorder in which degenerating retinal ganglion cells (RGC) produce significant visual disability. Clinically, glaucoma refers to an array of conditions associated with variably elevated intraocular pressure (IOP) that contributes to RGC loss via mechanical stress, vascular abnormalities, and other mechanisms, such as immune phenomena. The clinical diagnosis of glaucoma requires assessment of the ocular anterior segment with slit lamp biomicroscopy, which allows the clinician to recognize signs of conditions that can produce elevated IOP. After measurement of IOP, a specialized prismatic lens called a gonioscope is used to determine whether the angle is physically open or closed. The structural manifestation of RGC loss is optic nerve head atrophy and excavation of the neuroretinal rim tissue. Treatment is guided by addressing secondary causes for elevated IOP (such as inflammation, infection, and ischemia) whenever possible. Subsequently, a variety of medical, laser, and surgical options are used to achieve a target IOP. Copyright © 2014 Cold Spring Harbor Laboratory Press; all rights reserved.

Tumor-specific frequencies and ocular melanoma.

PubMed

Milham, Samuel; Stetzer, David

2017-01-01

Specific kilohertz frequencies in the environment from variable frequency drives on electric motors at a liquid natural gas compressor and storage station on a natural gas pipeline seem to be associated with the development of a very rare cancer, ocular melanoma, at a high school and in individuals living or working in a neighborhood near the plant. Primary neutral-to-earth oscilloscope voltage waveforms and spectra measured near the high school were nearly identical to the ground voltage 2.3 miles away at the gas pipeline. Peak frequencies of 7440 and 19,980 Hz were found at both places. The electric utility practice of using the earth as a conduit for return currents facilitated this exposure.

[Ocular toxoplasmosis: from pathophysiology to microbiological diagnosis].

PubMed

Sauer, A; Villard, O; Bourcier, T; Speeg-Schatz, C; Candolfi, E

2013-01-01

Toxoplasmosis is the most common cause of posterior uveitis in immunocompetent subjects: 30% of the world population may be affected, with wide variability. However, despite high seroprevalence, the incidence of ocular toxoplasmosis (OT) is limited to about 2% of infected patients; thus, about one million patients in France may be estimated to have active or cicatricial OT. Microbiological tools available to the clinician have considerably advanced over the last two decades, allowing the diagnosis of toxoplasmosis to be confirmed in the vast majority of suspected cases. Regardless of the route of infection (congenital or acquired), laboratory confirmation of OT plays a major role in the patient's management, particularly in atypical cases. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Nanocarriers in ocular drug delivery: an update review.

PubMed

Wadhwa, Sheetu; Paliwal, Rishi; Paliwal, Shivani Rai; Vyas, S P

2009-01-01

Controlled drug delivery to eye is one of the most challenging fields of pharmaceutical research. Low drug-contact time and poor ocular bioavailability due to drainage of solution, tear turnover and its dilution or lacrimation are the problems associated with conventional systems. In addition, anatomical barriers and physiological conditions of eye are also important parameters which control designing of drug delivery systems. Nanosized carriers like micro/nano-suspensions, liposome, niosome, dendrimer, nanoparticles, ocular inserts, implants, hydrogels and prodrug approaches have been developed for this purpose. These novel systems offer manifold advantages over conventional systems as they increase the efficiency of drug delivery by improving the release profile and also reduce drug toxicity. Conventional delivery systems get diluted with tear, washed away through the lacrimal gland and usually require administering at regular time intervals whereas nanocarriers release drug at constant rate for a prolonged period of time and thus enhance its absorption and site specific delivery. This review presents an overview of the various aspects of the ocular drug delivery, with special emphasis on nanocarrier based strategies, including structure of eye, its barriers, delivery routes and the challenges/limitations associated with development of novel nanocarriers. The recent progresses in therapy of ocular disease like gene therapy have also been included so that future options should also be considered from the delivery point of view. Recent progress in the delivery of proteins and peptides via ocular route has also been incorporated for reader benefit.

Occupational Ocular UV Exposure in Civilian Aircrew.

PubMed

Chorley, Adrian C; Baczynska, Katarzyna A; Benwell, Martin J; Evans, Bruce J W; Higlett, Michael P; Khazova, Marina; O'Hagan, John B

2016-01-01

Ultraviolet radiation (UVR) increases with altitude; however, there are a number of other factors which may influence ocular exposure during flight. The aim of this study was to assess ocular UVR exposure of pilots in airline and off-shore helicopter operations on different aircraft types and to compare with exposure in a typical office environment. In-flight data were captured on equipment including a CCD array spectroradiometer on five return sector European airline flights and one transatlantic flight from London Gatwick in addition to four helicopter flights from Aberdeen Dyce airport. Further data were collected in an office environment from three workstations during summer and winter months. A wide variation in ocular UVA dose was found during flights. The main factor influencing exposure was the UVR transmission of the windshield, which fell into two distinct profile types. In an aircraft with good UVA blocking properties, ocular exposure was found to be equivalent to office exposure and did not exceed international guideline limits regardless of external conditions or flight time. Most aircraft assessed had poor UVA blocking windshields which resulted in an ocular exposure to the unprotected eye in excess of international guideline limits (up to between 4.5 to 6.5 times greater during one flight). No significant UVB dose was found. Pilots should be warned of the potential high UVA exposure during flight and advised on the use of sunglasses. A windshield labeling system would allow the pilot to tailor their eye protection practices to that particular aircraft.

The role of sensory ocular dominance on through-focus visual performance in monovision presbyopia corrections

PubMed Central

Zheleznyak, Len; Alarcon, Aixa; Dieter, Kevin C.; Tadin, Duje; Yoon, Geunyoung

2015-01-01

Monovision presbyopia interventions exploit the binocular nature of the visual system by independently manipulating the optical properties of the two eyes. It is unclear, however, how individual variations in ocular dominance affect visual function in monovision corrections. Here, we examined the impact of sensory ocular dominance on visual performance in both traditional and modified monovision presbyopic corrections. We recently developed a binocular adaptive optics vision simulator to correct subjects' native aberrations and induce either modified monovision (1.5 D anisometropia, spherical aberration of +0.1 and −0.4 μm in distance and near eyes, respectively, over 4 mm pupils) or traditional monovision (1.5 D anisometropia). To quantify both the sign and the degree of ocular dominance, we utilized binocular rivalry to estimate stimulus contrast ratios that yield balanced dominance durations for the two eyes. Through-focus visual acuity and contrast sensitivity were measured under two conditions: (a) assigning dominant and nondominant eye to distance and near, respectively, and (b) vice versa. The results revealed that through-focus visual acuity was unaffected by ocular dominance. Contrast sensitivity, however, was significantly improved when the dominant eye coincided with superior optical quality. We hypothesize that a potential mechanism behind this observation is an interaction between ocular dominance and binocular contrast summation, and thus, assignment of the dominant eye to distance or near may be an important factor to optimize contrast threshold performance at different object distances in both modified and traditional monovision. PMID:26024464

Tear film and ocular surface assessment in psoriasis.

PubMed

Aragona, Emanuela; Rania, Laura; Postorino, Elisa Imelde; Interdonato, Alberto; Giuffrida, Roberta; Cannavò, Serafinella Patrizia; Puzzolo, Domenico; Aragona, Pasquale

2018-03-01

Psoriasis is a skin disease with also systemic involvement: its impact on the eye is not well established and often clinically underestimated. Aim of this study was to investigate the presence of ocular discomfort symptoms and of ocular surface changes in a population of patients with psoriasis. For this cross-sectional, comparative study, 66 patients with psoriasis were subdivided according to the presence of arthritis and to the use of biological therapy. All patients underwent clinical evaluation with the following tests: Ocular Surface Disease Index Questionnaire, Tearscope examination, meibometry, tear film breakup time, corneal and conjunctival fluorescein staining, Schirmer I test, corneal aesthesiometry, meibomian gland dysfunction (MGD) assessment and conjunctival impression cytology. 28 healthy subjects were also enrolled and treated with the same clinical tests. A statistical analysis of the results was performed. Patients with psoriasis showed a significant deterioration of the ocular surface tests, if compared with healthy subjects, demonstrated by tear film lipid layer alteration, tear film instability, corneal and conjunctival epithelial suffering and mild squamous metaplasia at impression cytology. No differences were found in ocular surface test results of the psoriatic group when patients were divided according to the presence of arthritis, whereas the anti-inflammatory treatment with biological drugs demonstrated a significant improvement of corneal stain and MGD. Our findings suggest that the ocular surface involvement in patients with psoriasis indicates the need of periodic ophthalmological examinations to diagnose the condition and allow a proper treatment, so contributing to the amelioration of patients' quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The impact of ocular hemodynamics and intracranial pressure on intraocular pressure during acute gravitational changes.

PubMed

Nelson, Emily S; Mulugeta, Lealem; Feola, Andrew; Raykin, Julia; Myers, Jerry G; Samuels, Brian C; Ethier, C Ross

2017-08-01

Exposure to microgravity causes a bulk fluid shift toward the head, with concomitant changes in blood volume/pressure, and intraocular pressure (IOP). These and other factors, such as intracranial pressure (ICP) changes, are suspected to be involved in the degradation of visual function and ocular anatomical changes exhibited by some astronauts. This is a significant health concern. Here, we describe a lumped-parameter numerical model to simulate volume/pressure alterations in the eye during gravitational changes. The model includes the effects of blood and aqueous humor dynamics, ICP, and IOP-dependent ocular compliance. It is formulated as a series of coupled differential equations and was validated against four existing data sets on parabolic flight, body inversion, and head-down tilt (HDT). The model accurately predicted acute IOP changes in parabolic flight and HDT, and was satisfactory for the more extreme case of inversion. The short-term response to the changing gravitational field was dominated by ocular blood pressures and compliance, while longer-term responses were more dependent on aqueous humor dynamics. ICP had a negligible effect on acute IOP changes. This relatively simple numerical model shows promising predictive capability. To extend the model to more chronic conditions, additional data on longer-term autoregulation of blood and aqueous humor dynamics are needed. NEW & NOTEWORTHY A significant percentage of astronauts present anatomical changes in the posterior eye tissues after spaceflight. Hypothesized increases in ocular blood volume and intracranial pressure (ICP) in space have been considered to be likely factors. In this work, we provide a novel numerical model of the eye that incorporates ocular hemodynamics, gravitational forces, and ICP changes. We find that changes in ocular hemodynamics govern the response of intraocular pressure during acute gravitational change. Copyright © 2017 the American Physiological Society.

Sporotrichosis in the Ocular Adnexa: 21 Cases in an Endemic Area in Peru and Review of the Literature.

PubMed

Ramírez Soto, Max Carlos

2016-02-01

To describe the clinical and epidemiologic characteristics of sporotrichosis in ocular adnexa and give an insight into factors associated with this condition. Retrospective case series and literature review. We retrospectively reviewed all cases of sporotrichosis in ocular adnexa between 2004 and 2014 in the Santa Teresa Clinic of Abancay, Peru and reviewed all case reports of sporotrichosis in ocular adnexa in the literature. We reviewed records of 21 patients with sporotrichosis in ocular adnexa; 12 (57.1%) of them were male and their median age surrounded 9 years. In our series, 19 patients had lesions in the eyelids and 2 in the eyebrows. The lymphocutaneous form occurred in 62% of them. Ten patients (47.6%) were cured with potassium iodide. Among 65 patients with sporotrichosis in ocular adnexa (our 21 patients and 44 from the literature), the average age was 9 years, and 78% were ≤15 years of age; 54% were male. The lesions were more frequent on the eyelids (n = 53 [82%]), followed by the lacrimal gland (n = 5), conjunctiva (n = 4), and eyebrows (n = 3). The lymphocutaneous clinical form (54%) was the most frequent. Fifty patients were cured: 31 of them with potassium iodide, 16 with itraconazole, and 3 with a combination including potassium iodide, itraconazole, and fluconazole. Twenty-nine patients (44.6%) resided in a hyperendemic region, and 5 patients reported contact with cats that had sporotrichosis. Sporotrichosis in ocular adnexa is associated with children ≤15 years of age, and in 82% of these cases the disease is limited to the eyelids. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding the Presence and Roles of Ap4A (Diadenosine Tetraphosphate) in the Eye.

PubMed

Crooke, Almudena; Guzman-Aranguez, Ana; Carracedo, Gonzalo; de Lara, Maria J Perez; Pintor, Jesus

Diadenosine tetraphosphate abbreviated Ap 4 A is a naturally occurring dinucleotide, which is present in most of the ocular fluids. Due to its intrinsic resistance to enzyme degradation compared to mononucleotides, this molecule can exhibit profound actions on ocular tissues, including the ocular surface, ciliary body, trabecular meshwork, and probably the retina. The actions of Ap 4 A are mostly carried out by P2Y 2 receptors, but the participation of P2X2 and P2Y 6 in processes such as the regulation of intraocular pressure (IOP), together with the P2Y 2 , is pivotal. Beyond the physiological role, this dinucleotide can present on the ocular surface keeping a right production of tear secretion or regulating IOP. It is important to note that exogenous application of Ap 4 A to cells or animal models can significantly modify pathophysiological conditions and thus is an attractive therapeutic molecule. The ocular location where Ap 4 A actions have not been fully elucidated is in the retina. Although some analogues show interesting actions on pathological situations such as retinal detachment, little is known about the real effect of this dinucleotide, this being one of the challenges that require pursuing in the near future.

Tear Osmolarity and Correlation With Ocular Surface Parameters in Patients With Dry Eye.

PubMed

Mathews, Priya M; Karakus, Sezen; Agrawal, Devika; Hindman, Holly B; Ramulu, Pradeep Y; Akpek, Esen K

2017-11-01

To analyze the distribution of tear film osmolarity in patients with dry eye and its association with other ocular surface parameters. Tear osmolarity and other quantitative dry eye parameters were obtained from patients with 1) clinically significant dry eye (significant symptoms and ocular surface staining, n = 131), 2) symptoms-only dry eye (significant symptoms but no significant ocular surface staining, n = 52), and 3) controls (no significant symptoms or staining, n = 42). Tear osmolarity varied significantly across groups (P = 0.01), with patients with clinically significant dry eye having the highest tear osmolarity (312.0 ± 16.9 mOsm/L), control patients having the lowest tear osmolarity (305.6 ± 9.7 mOsm/L), and patients with symptoms-only dry eye falling in between (307.4 ± 5.6 mOsm/L). Patients with clinically significant dry eye also tended to have a greater intereye difference in osmolarity (12.0 ± 13.4) than did the individuals with symptoms-only dry eye (9.1 ± 12.4) and controls (9.0 ± 7.4) (P = 0.06). In multivariable regression models, higher tear osmolarity was associated with higher Ocular Surface Disease Index, discomfort subscore (P = 0.02), and higher corneal and conjunctival staining scores (P < 0.01 for both). Worse eye tear osmolarity was not correlated with the corresponding tear film breakup time or Schirmer test (P > 0.05 for both). Individuals with symptomatic dry eye that is not yet clinically significant seem to have higher and more variable osmolarity measurements than controls, potentially indicating that changes in osmolarity precede clinical findings.

Analysis of Factors Associated With the Tear Film Lipid Layer Thickness in Normal Eyes and Patients With Dry Eye Syndrome.

PubMed

Jung, Ji Won; Park, Si Yoon; Kim, Jin Sun; Kim, Eung Kweon; Seo, Kyoung Yul; Kim, Tae-Im

2016-08-01

To determine the effects of clinical variables, including age, sex, history of refractive or cataract surgery, contact lens use, and ocular surface and meibomian gland parameters on the lipid layer thickness (LLT) in normal subjects and patients with dry eye syndrome (DES). A total of 64 normal subjects and 326 patients with DES were enrolled, and they underwent measurements of LLT with a LipiView interferometer and tear meniscus height using optical coherence tomography, tear film break-up time (TBUT) determination, ocular surface staining, Schirmer's test, examination of the lid margins and meibomian glands, and assessment using the Ocular Surface Disease Index (OSDI). In normal subjects, the median (range) LLT was 67 (33-100) nm, and age was the only factor that was significantly associated with LLT (β = 0.678, P = 0.028). In patients with DES, the median (range) LLT was 84 (20-100) nm, and 79.0% of the participants fulfilled the diagnostic criteria for meibomian gland dysfunction (MGD). In a multivariate analysis, increased age and female sex were significantly related to increased LLT (β = 0.282, P = 0.005 and β = 11.493, P < 0.001), and hypersecretory MGD and lid margin inflammation were independently associated with increased LLT (β = 11.299, P = 0.001 and β = 12.747, P = 0.001). Lipid layer thickness measurements using a new interferometer are significantly affected by demographic factors such as age, sex, ocular surgical history, and MGD type. Therefore, all of these factors must be considered in the diagnosis of ocular surface diseases.

Optimization of visual evoked potential (VEP) recording systems.

PubMed

Karanjia, Rustum; Brunet, Donald G; ten Hove, Martin W

2009-01-01

To explore the influence of environmental conditions on pattern visual evoked potential (VEP) recordings. Fourteen subjects with no known ocular pathology were recruited for the study. In an attempt to optimize the recording conditions, VEP recordings were performed in both the seated and recumbent positions. Comparisons were made between recordings using either LCD or CRT displays and recordings obtained in silence or with quiet background music. Paired recordings (in which only one variable was changed) were analyzed for changes in P100 latency, RMS noise, and variability. Baseline RMS noise demonstrated a significant decrease in the variability during the first 50msec accompanied by a 73% decrease in recording time for recumbent position when compared to the seated position (p<0.05). Visual evoked potentials recorded using LCD monitors demonstrated a significant increase in the P100 latency when compared to CRT recordings in the same subjects. The addition of background music did not affect the amount of RMS noise during the first 50msec of the recordings. This study demonstrates that the use of the recumbent position increases patient comfort and improves the signal to noise ratio. In contrast, the addition of background music to relax the patient did not improve the recording signal. Furthermore, the study illustrates the importance of avoiding low-contrast visual stimulation patterns obtained with LCD as they lead to higher latencies resulting in false positive recordings. These findings are important when establishing or modifying a pattern VEP recording protocol.

Childhood Eye Diseases and Conditions

MedlinePlus

Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

Association between Refractive Errors and Ocular Biometry in Iranian Adults

PubMed Central

Hashemi, Hassan; Khabazkhoob, Mehdi; Emamian, Mohammad Hassan; Shariati, Mohammad; Miraftab, Mohammad; Yekta, Abbasali; Ostadimoghaddam, Hadi; Fotouhi, Akbar

2015-01-01

Purpose: To investigate the association between ocular biometrics such as axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD) and corneal power (CP) with different refractive errors. Methods: In a cross-sectional study on the 40 to 64-year-old population of Shahroud, random cluster sampling was performed. Ocular biometrics were measured using the Allegro Biograph (WaveLight AG, Erlangen, Germany) for all participants. Refractive errors were determined using cycloplegic refraction. Results: In the first model, the strongest correlations were found between spherical equivalent with axial length and corneal power. Spherical equivalent was strongly correlated with axial length in high myopic and high hyperopic cases, and with corneal power in high hyperopic cases; 69.5% of variability in spherical equivalent was attributed to changes in these variables. In the second model, the correlations between vitreous chamber depth and corneal power with spherical equivalent were stronger in myopes than hyperopes, while the correlations between lens thickness and anterior chamber depth with spherical equivalent were stronger in hyperopic cases than myopic ones. In the third model, anterior chamber depth + lens thickness correlated with spherical equivalent only in moderate and severe cases of hyperopia, and this index was not correlated with spherical equivalent in moderate to severe myopia. Conclusion: In individuals aged 40-64 years, corneal power and axial length make the greatest contribution to spherical equivalent in high hyperopia and high myopia. Anterior segment biometric components have a more important role in hyperopia than myopia. PMID:26730304

Requirement of Smad4 from Ocular Surface Ectoderm for Retinal Development.

PubMed

Li, Jing; Wang, Shusheng; Anderson, Chastain; Zhao, Fangkun; Qin, Yu; Wu, Di; Wu, Xinwei; Liu, Jia; He, Xuefei; Zhao, Jiangyue; Zhang, Jinsong

2016-01-01

Microphthalmia is characterized by abnormally small eyes and usually retinal dysplasia, accounting for up to 11% of the blindness in children. Right now there is no effective treatment for the disease, and the underlying mechanisms, especially how retinal dysplasia develops from microphthalmia and whether it depends on the signals from lens ectoderm are still unclear. Mutations in genes of the TGF-β superfamily have been noted in patients with microphthalmia. Using conditional knockout mice, here we address the question that whether ocular surface ectoderm-derived Smad4 modulates retinal development. We found that loss of Smad4 specifically on surface lens ectoderm leads to microphthalmia and dysplasia of retina. Retinal dysplasia in the knockout mice is caused by the delayed or failed differentiation and apoptosis of retinal cells. Microarray analyses revealed that members of Hedgehog and Wnt signaling pathways are affected in the knockout retinas, suggesting that ocular surface ectoderm-derived Smad4 can regulate Hedgehog and Wnt signaling in the retina. Our studies suggest that defective of ocular surface ectoderm may affect retinal development.

Requirement of Smad4 from Ocular Surface Ectoderm for Retinal Development

PubMed Central

Li, Jing; Wang, Shusheng; Anderson, Chastain; Zhao, Fangkun; Qin, Yu; Wu, Di; Wu, Xinwei; Liu, Jia; He, Xuefei; Zhao, Jiangyue; Zhang, Jinsong

2016-01-01

Microphthalmia is characterized by abnormally small eyes and usually retinal dysplasia, accounting for up to 11% of the blindness in children. Right now there is no effective treatment for the disease, and the underlying mechanisms, especially how retinal dysplasia develops from microphthalmia and whether it depends on the signals from lens ectoderm are still unclear. Mutations in genes of the TGF-β superfamily have been noted in patients with microphthalmia. Using conditional knockout mice, here we address the question that whether ocular surface ectoderm-derived Smad4 modulates retinal development. We found that loss of Smad4 specifically on surface lens ectoderm leads to microphthalmia and dysplasia of retina. Retinal dysplasia in the knockout mice is caused by the delayed or failed differentiation and apoptosis of retinal cells. Microarray analyses revealed that members of Hedgehog and Wnt signaling pathways are affected in the knockout retinas, suggesting that ocular surface ectoderm-derived Smad4 can regulate Hedgehog and Wnt signaling in the retina. Our studies suggest that defective of ocular surface ectoderm may affect retinal development. PMID:27494603

[Ten years of destructive eyeball surgery in Lomé].

PubMed

Vonor, K; Amedome, K M; Dzidzinyo, K; Ayena, K D; Santos, M K A; Maneh, N; Tete, Y; Balo, K P

2015-01-01

Destructive surgery of the eyeball comprises radical procedures - evisceration, enucleation, and exenteration - with various indications. The purpose of this study was to determine the features of these procedures in Lomé. We conducted a retrospective study reviewing records for all patients undergoing these procedures in 3 ophthalmic centers in Lomé in the decade from 2002 through 2011. Of 6240 eye operations, 76 involved one of these three procedures, for a frequency of 1.2%. Patients' mean age was 40.1 ± 26.9 years (range: 1 day to 91 years). The sex ratio (of men to women) was 1.2. The principal indications were staphyloma (38%), ocular and orbital tumors (30%), and phthisis bulbi (24%). Retinoblastoma was the leading type of ocular/orbital tumor (52%). Local anesthesia was performed in 64% of cases, and general anesthesia in 36%. Evisceration was practiced in 67% of cases, enucleation in 24%, and exenteration in 9%. An ocular prosthesis was placed in 46%. Staphyloma was the leading indication for destructive surgery. Given the damage of this type of procedure, primary prevention is important, including early and adequate management of ocular conditions.

Injuries of the globe: what can the radiologist offer?

PubMed

Sung, Edward K; Nadgir, Rohini N; Fujita, Akifumi; Siegel, Cory; Ghafouri, Roya H; Traband, Anastasia; Sakai, Osamu

2014-01-01

Traumatic ocular injuries are a significant cause of blindness and visual deficits. In the setting of acute orbital trauma, urgent ophthalmologic evaluation and intervention are critical in preserving vision. However, in the acute trauma setting, clinical evaluation of the globe may be difficult in the presence of surrounding periorbital soft-tissue swelling and other associated injuries, and patient cooperation may be limited because of unresponsiveness, altered mentation, or sedation. Often, rapid access to imaging is part of the initial diagnostic evaluation, and radiologists may be the first to identify traumatic injuries of the globe. Because of this, radiologists should be familiar with normal orbital and globe anatomy at various imaging modalities and have a thorough understanding of the various patterns of ocular injury and their imaging appearances. Radiologists should also be familiar with the various mimics of ocular injury, including congenital and acquired conditions that may alter the shape of the globe, various types of ocular calcifications, and the different types of material used to treat retinal detachment. Such knowledge may help radiologists make accurate diagnoses, which facilitates prompt and appropriate patient care. RSNA, 2014

Downbeat nystagmus due to ranitidine in a pediatric patient.

PubMed

Butragueño Laiseca, Laura; Toledo Del Castillo, Blanca; Rodríguez Jimenez, Cristina; Manrique-Rodríguez, Silvia; Pérez Moreno, Jimena

2017-07-01

Ranitidine has not been considered as a potential cause of ocular movement conditions. However, it is known that the vestibular nucleus complex, that has a key role in gaze control and vestibule-ocular reflexes, receives hypothalamic histaminergic innervations. Some studies reported the effect of ranitidine blocking the excitatory responses of vestibular nuclei neurons to histamine. We report the first case of a downbeat nystagmus secondary to ranitidine in an infant. A 3-month-old female developed a downbeat gaze after starting treatment with ranitidine for a pediatric gastroesophageal reflux disease. Microbiological test were negative and neuroblastoma evaluation was normal. As ranitidine is widely prescribed in the pediatric population, clinicians should be aware of its potential to cause ocular movements disorders. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

RECURRENCE RATES OF OCULAR TOXOPLASMOSIS DURING PREGNANCY

PubMed Central

Braakenburg, Arthur M.D.; Crespi, Catherine M.; Holland, Gary N.; Wu, Sheng; Yu, Fei; Rothova, Aniki

2014-01-01

Purpose To investigate whether recurrence rates of ocular toxoplasmosis are higher during pregnancy among women of childbearing age. Design Retrospective longitudinal cohort study. Methods We reviewed medical records of all women seen at a university eye clinic (Utrecht, Netherlands) during episodes of active toxoplasmic retinochoroiditis that occurred while the women were of childbearing age (16–42 years). Each woman was sent a questionnaire requesting information regarding all pregnancies and episodes of ocular toxoplasmosis, whether or not episodes were observed at the eye clinic. Conditional fixed-effects Poisson regression was used to model incident rate ratios of recurrence during pregnant versus non-pregnant intervals, adjusted for potential confounders, including age at time of active toxoplasmic retinochoroiditis and interval since last episode of active disease, which are known to influence risk of recurrence. Results Questionnaires were returned by 50 (58%) of 86 women, 34 of whom had 69 pregnancies during 584 person-years of study. There were 128 episodes of ocular toxoplasmosis during the study period (6 during pregnancy). First episodes of ocular toxoplasmosis occurred between ages 9.6 and 38.5 years. Youngest age at pregnancy was 16.1 years; oldest age at childbirth was 40.9 years. Incident rate ratios for pregnant versus non-pregnant intervals were in the direction of lower recurrence rates during pregnancy, with point estimates of 0.54 and 0.75 under two different approaches, but ratios were not significantly different from the null value (p-values of 0.16 and 0.55). Conclusions Recurrence rates of ocular toxoplasmosis are likely not higher during pregnancy, in contrast to traditional beliefs. PMID:24412127

Recurrence rates of ocular toxoplasmosis during pregnancy.

PubMed

Braakenburg, Arthur M D; Crespi, Catherine M; Holland, Gary N; Wu, Sheng; Yu, Fei; Rothova, Aniki

2014-04-01

To investigate whether recurrence rates of ocular toxoplasmosis are higher during pregnancy in women of childbearing age. Retrospective longitudinal cohort study. We reviewed medical records of all women seen at a university eye clinic (Utrecht, Netherlands) during episodes of active toxoplasmic retinochoroiditis that occurred while the women were of childbearing age (16-42 years). Each woman was sent a questionnaire requesting information regarding all pregnancies and episodes of ocular toxoplasmosis, whether or not episodes were observed at the eye clinic. Conditional fixed-effects Poisson regression was used to model incidence rate ratios of recurrence during pregnant versus nonpregnant intervals, adjusted for potential confounders, including age at time of active toxoplasmic retinochoroiditis and interval since last episode of active disease, which are known to influence risk for recurrence. Questionnaires were returned by 50 (58%) of 86 women, 34 of whom had had 69 pregnancies during 584 person-years of study. There were 128 episodes of ocular toxoplasmosis during the study period (6 during pregnancy). First episodes of ocular toxoplasmosis occurred between ages 9.6 and 38.5 years. The youngest age at pregnancy was 16.1 years; the oldest age at childbirth was 40.9 years. The incidence-rate ratios for pregnant versus nonpregnant intervals were in the direction of lower recurrence rates during pregnancy, with point estimates of 0.54 and 0.75 under 2 different approaches, but the ratios were not significantly different from the null value (P values of 0.16 and 0.55). Recurrence rates of ocular toxoplasmosis are probably not higher during pregnancy, in contrast to traditional beliefs. Copyright © 2014 Elsevier Inc. All rights reserved.

New platforms for multi-functional ocular lenses: engineering double-sided functionalized nano-coatings.

PubMed

Mehta, Prina; Justo, Lucas; Walsh, Susannah; Arshad, Muhammad S; Wilson, Clive G; O'Sullivan, Ciara K; Moghimi, Seyed M; Vizirianakis, Ioannis S; Avgoustakis, Konstantinos; Fatouros, Dimitris G; Ahmad, Zeeshan

2015-05-01

A scalable platform to prepare multi-functional ocular lenses is demonstrated. Using rapidly dissolving polyvinylpyrrolidone (PVP) as the active stabilizing matrix, both sides of ocular lenses were coated using a modified scaled-up masking electrohydrodynamic atomization (EHDA) technique (flow rates variable between 5 and 10 µL/min, applied voltage 4-11 kV). Each side was coated (using a specially designed flip-able well) selectively with a pre-determined morphology and model drug substance. PVP nanoparticles (inner side, to be in contact with the cornea, mean size

Ocular Toxicity Secondary to Asclepias physocarpa: The Balloon Plant

PubMed Central

Pina, Susana; Pedrosa, Catarina; Santos, Cristina; Feijóo, Bernardo; Pego, Peter; Vendrell, Cristina; Santos, Maria João; Prieto, Isabel

2014-01-01

We report a case of a 65-year-old woman with symptoms of blurred vision and ocular irritation a few hours after accidental contact of the right eye with Asclepias physocarpa milky latex. Observation showed a diffuse conjunctival hyperemia and stromal corneal edema with Descemet's membrane folds. Recovery was fast and apparently complete in less than one month. However, specular microscopy at 6-months follow-up showed an abnormal endothelial morphology as sequelae, suggesting this condition is not as innocuous as it has been suggested. PMID:25105044

[Spasm of the near reflex. Treatment with botulinum toxin].

PubMed

Merino, P; Rojas, P; Gómez de Liaño, P; Franco Iglesias, G

2015-05-01

A 38-year old female with diplopia and esotropia, with limitation of ocular abduction in both eyes, with full abduction after doll's head rotation also being observed. She was diagnosed with spasm of the near reflex. Treatment with injections of botulinum toxin in both medial rectus has temporally resolved the convergence spasm. Near reflex spasm is characterized as miosis, pseudomyopia, and convergent strabismus that lead to diplopia, blurred vision, headache, and variable, progressive, and intermittent esotropia. As the spasm worsens there will be limited ocular versions and ductions simulating a sixth nerve palsy. Botulinum toxin may be effective in some cases. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Voluntary presetting of the vestibular ocular reflex permits gaze stabilization despite perturbation of fast head movements

NASA Technical Reports Server (NTRS)

Zangemeister, Wolfgang H.

1989-01-01

Normal subjects are able to change voluntarily and continuously their head-eye latency together with their compensatory eye movement gain. A continuous spectrum of intent-latency modes of the subject's coordinated gaze through verbal feedback could be demonstrated. It was also demonstrated that the intent to counteract any perturbation of head-eye movement, i.e., the mental set, permitted the subjects to manipulate consciously their vestibular ocular reflex (VOR) gain. From the data, it is inferred that the VOR is always on. It may be, however, variably suppressed by higher cortical control. With appropriate training, head-mounted displays should permit an easy VOR presetting that leads to image stabilization, perhaps together with a decrease of possible misjudgements.

Otolithic and extraocular muscle proprioceptive influences on the spatial organization of the vestibulo- and cervico-ocular quick phases.

PubMed

Pettorossi, V E; Manni, E; Errico, P; Ferraresi, A; Bortolami, R

1997-03-01

The cervico-ocular reflex (COR) was studied alone or in combination with the vestibulo-ocular reflex (VOR) in the rabbit. Step stimulations of the body with respect to the fixed head induced small slow compensatory responses followed by large compensatory quick phases (QP). These responses remained aligned with the horizon at different head pitch angles. The QP reorientation in space was due to the gravity influence on the otolithic receptors. The vestibular induced QPs exhibit a similar pattern. Because of this reorientation, the reduction of the amplitude of the vestibular induced QPs, due to the addition of the COR, was maintained even at different static head positions. The electrolytic lesion of the ophthalmic branch of the trigeminal nerve deeply affected the space orientation of the COR. In particular, the cervically induced compensatory QPs of the eye ipsilateral to the lesion showed a remarkable variability of their trajectories and they lost space reorientation. These findings suggest that the coordinate system controlling the QPs is influenced by signals originating from both head position in space and eye position in the orbit.

Validation of the ocular trauma score for intraocular foreign bodies in deadly weapon-related open-globe injuries.

PubMed

Unal, Melih H; Aydin, Ali; Sonmez, Murat; Ayata, Ali; Ersanli, Dilaver

2008-01-01

To evaluate the prognostic value of the Ocular Trauma Score (OTS) in cases of deadly weapon-related open-globe injuries with intraocular foreign bodies. A retrospective, interventional case series included 20 eyes of 20 patients who had deadly weapon-related open-globe injuries with intraocular foreign bodies. The OTS was calculated for each patient by adding the determined numbers of OTS variables at presentation (initial visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect). Patients were categorized based on their score (category 1 through 5). Final visual acuities in the OTS categories were calculated and compared to those in OTS study group. No statistically significant difference was found between the categorical distributions of the study patients and those in the OTS study group. No patient in the study was in category 5. The OTS, which was designed to predict visual outcomes of general ocular trauma, may also provide reliable information about the prognosis of deadly weapon-related open-globe injuries with intraocular foreign bodies.

[Cysteamine ophthalmic hydrogel for the treatment of ocular cystinosis].

PubMed

Fernández-Ferreiro, Anxo; Luaces-Rodríguez, Andrea; Díaz-Tomé, Victoria; Gil-Martínez, María; Rodríguez Ares, María Teresa; Touriño Peralba, Rosario; Blanco-Méndez, José; González-Barcia, Miguel; Otero-Espinar, Francisco Javier; Lamas, María Jesús

2017-11-01

Ocular cystinosis is a rare disease characterised by the deposit of cystine crystals on the corneal surface, which hinder patients' eyesight. Oral cysteamine is given as cysteamine; however, it does not reach the cornea due to the lack of corneal vascularization making necessary its  administration by the topical ocular route. The aim of the present study is to  determine the stability of an ophthalmic hydrogel of cysteamine, which can be  potentially prepared at hospital pharmacy departments, under different preservation conditions during a follow-up of 30 days. Different physical  and chemical parameters were evaluated: osmolality, pH and  cysteamine concentration, which has been measured by a method of ultra  performance liquid chromatography-tandem mass spectrometer (UPLC-MS/MS).  Descriptive assays were also performed, such as transparency measurement and  microbiological assays in order to verify its sterility. The obtained results  allow us to conclude that the cysteamine hydrogel is stable during 30 days,  being recommendable its preservation in refrigerated conditions. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Clinical evaluation of a nutraceutical diet as an adjuvant to pharmacological treatment in dogs affected by Keratoconjunctivitis sicca.

PubMed

Destefanis, Simona; Giretto, Daniela; Muscolo, Maria Cristina; Di Cerbo, Alessandro; Guidetti, Gianandrea; Canello, Sergio; Giovazzino, Angela; Centenaro, Sara; Terrazzano, Giuseppe

2016-09-22

Canine keratoconjunctivitis sicca (cKCS) is an inflammatory eye condition related to a deficiency in the tear aqueous fraction. Etiopathogenesis of such disease is substantially multifactorial, combining the individual genetic background with environmental factors that contribute to the process of immunological tolerance disruption and, as a consequence, to the emergence of autoimmunity disease. In this occurrence, it is of relevance the role of the physiological immune-dysregulation that results in immune-mediated processes at the basis of cKCS. Current therapies for this ocular disease rely on immunosuppressive treatments. Clinical response to treatment frequently varies from poor to good, depending on the clinical-pathological status of eyes at diagnosis and on individual response to therapy. In the light of the variability of clinical response to therapies, we evaluated the use of an anti-inflammatory/antioxidant nutraceutical diet with potential immune-modulating activity as a therapeutical adjuvant in cKCS pharmacological treatment. Such combination was administered to a cohort of dogs affected by cKCS in which the only immunosuppressive treatment resulted poorly responsive or ineffective in controlling the ocular symptoms. Fifty dogs of different breeds affected by immune-mediated cKCS were equally distributed and randomly assigned to receive either a standard diet (control, n = 25) or the nutraceutical diet (treatment group, n = 25) both combined with standard immunosuppressive therapy over a 60 days period. An overall significant improvement of all clinical parameters (tear production, conjunctival inflammation, corneal keratinization, corneal pigment density and mucus discharge) and the lack of food-related adverse reactions were observed in the treatment group (p < 0.0001). Our results showed that the association of traditional immune-suppressive therapy with the antioxidant/anti-inflammatory properties of the nutraceutical diet resulted in a significant amelioration of clinical signs and symptoms in cKCS. The beneficial effects, likely due to the presence of supplemented nutraceuticals in the diet, appeared to specifically reduce the immune-mediated ocular symptoms in those cKCS-affected dogs that were poorly responsive or unresponsive to classical immunosuppressive drugs. These data suggest that metabolic changes could affect the immune response orchestration in a model of immune-mediated ocular disease, as represented by cKCS.

Roll-Tilt Perception Using a Somatosensory Bar Task

NASA Technical Reports Server (NTRS)

Black, F. O.; Wade, S. W.; Arshi, A.

1999-01-01

Visual estimates of roll-tilt perception during static roll-tilt are confounded by an offset due to the ocular counterroll that simultaneously occurs. An alternative, non-visual ('somatosensory') measure of roll-tilt perception was developed which is not contaminated by this offset. The aims of this study were to determine: 1) inter-subject variability of somatosensory settings across test session in normal subjects and patients with unilateral or bilateral vestibular loss and 2) intra-subject variability of settings across test session in normal subjects.

Ocular findings in MELAS syndrome – a case report.

PubMed

Modrzejewska, Monika; Chrzanowska, Martyna; Modrzejewska, Anna; Romanowska, Hanna; Ostrowska, Iwona; Giżewska, Maria

We present a case of a child with MELAS syndrome (mitochondrial encephalo-myopathy with lactic acidosis and stroke-like episodes), discussing clinical manifestation, ocular findings and diagnostic challenges. Predominant ocular symptom was a transient complete visual loss, while the predominant ocular sign was a visual field defect. The diagnosia was based on clinical manifestation, laboratory tests, brain scans and genetic testing which confirmed the pathognomonic mutation in the MTTL1 gene encoding the mitochondrial tRNA for leucine 3243> G. Ocular examination demonstrated decreased visual acuity (with bilateral best corrected visual acuity of .1). Periodical, transient visual loss and visual field defects were clinically predominant. Specialist investigations were carried out, which demonstrated homonymous hemianopia (kinetic perimetry), bilateral partial optic nerve atrophy (RetCam). Funduscopy and electrophysiology mfERG study did not confirm features of retinitis pigmentosa. The brain scans revealed numerous small cortical ischemic lesions within the frontal, parietal and temporal lobes, post-stroke focal areas within the occipital lobes and diffuse calcifications of the basal ganglia. During several years of follow-up, visual field defects showed progressive concentric narrowing. The patient received a long-term treatment with arginine, coenzyme Q and vitamin D, both oral and intravenous, but no beneficial effect for the improvement of ophthalmic condition was observed. As it is the case in severe MELAS syndrome, the course of disease was fatal and the patientdied at the age of 14.

Efficacy of a New Ocular Surface Modulator in Restoring Epithelial Changes in an In Vitro Model of Dry Eye Syndrome.

PubMed

Barabino, Stefano; De Servi, Barbara; Aragona, Salvatore; Manenti, Demetrio; Meloni, Marisa

2017-03-01

So far tear substitutes have demonstrated a limited role in restoring ocular surface damage in dry eye syndrome (DES). The aim of this study was to assess the efficacy of a new ocular surface modulator in an in vitro model of human corneal epithelium (HCE) damaged by severe osmotic stress mirroring the features of dry eye conditions. A reconstructed HCE model challenged by the introduction of sorbitol in the culture medium for 16 h was used to induce an inflammatory pathway and to impair the tight junctions integrity determining a severe modification of the superficial layer ultrastructure. At the end of the overnight stress period in the treated HCE series, 30 μl of the ocular surface modulator (T-LysYal, Sildeha, Switzerland) and of hyaluronic acid (HA) in the control HCE series were applied for 24 h. The following parameters were quantified: scanning electron microscopy (SEM), trans-epithelial electrical resistance (TEER), immunofluorescence analysis of integrin β1 (ITG-β1), mRNA expression of Cyclin D-1 (CCND1), and ITG-β1. In the positive control after the osmotic stress the HCE surface damage was visible at the ultrastructural level with loss of cell-cell interconnections, intercellular matrix destruction, and TEER reduction. After 24 h of treatment with T-LysYal, HCE showed a significant improvement of the ultrastructural morphological organization and increased expression of ITG-β1 at the tissue level when compared to positive and control series. A significant increase of mRNA expression for ITG-β1 and CCND1 was shown in the HA-treated cells compared to T-LysYal. TEER measurement showed a significant reduction in all groups after 16 h without modifications after the treatment period. This study has shown the possibility of a new class of agents denominated ocular surface modulators to restore corneal cells damaged by dry eye conditions. Further in vivo studies are certainly necessary to confirm these results.

Mechanisms of phosphene generation in ocular proton therapy as related to space radiation exposure

NASA Astrophysics Data System (ADS)

Chuard, D.; Anthonipillai, V.; Dendale, R.; Nauraye, C.; Khan, E.; Mabit, C.; De Marzi, L.; Narici, L.

2016-08-01

Particle therapy provides an opportunity to study the human response to space radiation in ground-based facilities. On this basis, a study of light flashes analogous to astronauts' phosphenes reported by patients undergoing ocular proton therapy has been undertaken. The influence of treatment parameters on phosphene generation was investigated for 430 patients treated for a choroidal melanoma at the proton therapy centre of the Institut Curie (ICPO) in Orsay, France, between 2008 and 2011. 60% of them report light flashes, which are predominantly (74%) blue. An analysis of variables describing the patient's physiology, properties of the tumour and dose distribution shows that two groups of tumour and beam variables are correlated with phosphene occurrence. Physiology is found to have no influence on flash triggering. Detailed correlation study eventually suggests a possible twofold mechanism of phosphene generation based on (i) indirect Cerenkov light in the bulk of the eye due to nuclear interactions and radioactive decay and (ii) direct excitation of the nerve fibres in the back of the eye and/or radical excess near the retina.

Presumed Isotretinoin-Induced, Concomitant Autoimmune Thyroid Disease and Ocular Myasthenia Gravis: A Case Report

PubMed Central

Gursoy, Huseyin; Cakmak, Idil; Yildirim, Nilgun; Basmak, Hikmet

2012-01-01

Introduction There are many adverse effects that have been described for isotretinoin. To the best of our knowledge, this is the first report of a possible association of oral isotretinoin intake with autoimmune thyroiditis and ocular myasthenia gravis (OMG). Case Presentation A 19-year-old Caucasian male, who had used oral isotretinoin for severe acne disease for the previous six months, was referred to our clinic. He had a three-week history of diplopia and variable bilateral ptosis. Physical examination showed moderate periorbital edema and limitations of up- and down-gaze in the left eye. Laboratory findings and thyroid ultrasound were consistent with autoimmune thyroiditis. Antithyroid therapy did not relieve the clinical symptoms. Concomitant OMG was suspected. Variable ptosis and a positive response to oral prednisolone of 40 mg/day and pyridostigmine of 360 mg/day supported the diagnosis of concomitant autoimmune thyroiditis and OMG. Conclusion Autoimmune disorders may be triggered by oral isotretinoin treatment. Clinicians prescribing isotretinoin should be aware of the possible association between isotretinoin intake and concomitant autoimmune thyroiditis and OMG. PMID:23275770

Dealing with ocular artifacts on lateralized ERPs in studies of visual-spatial attention and memory: ICA correction versus epoch rejection.

PubMed

Drisdelle, Brandi Lee; Aubin, Sébrina; Jolicoeur, Pierre

2017-01-01

The objective of the present study was to assess the robustness and reliability of independent component analysis (ICA) as a method for ocular artifact correction in electrophysiological studies of visual-spatial attention and memory. The N2pc and sustained posterior contralateral negativity (SPCN), electrophysiological markers of visual-spatial attention and memory, respectively, are lateralized posterior ERPs typically observed following the presentation of lateral stimuli (targets and distractors) along with instructions to maintain fixation on the center of the visual search for the entire trial. Traditionally, trials in which subjects may have displaced their gaze are rejected based on a cutoff threshold, minimizing electrophysiological contamination by saccades. Given the loss of data resulting from rejection, we examined ocular correction by comparing results using standard fixation instructions against a condition where subjects were instructed to shift their gaze toward possible targets. Both conditions were analyzed using a rejection threshold and ICA correction for saccade activity management. Results demonstrate that ICA conserves data that would have otherwise been removed and leaves the underlying neural activity intact, as demonstrated by experimental manipulations previously shown to modulate the N2pc and the SPCN. Not only does ICA salvage and not distort data, but also large eye movements had only subtle effects. Overall, the findings provide convincing evidence for ICA correction for not only special cases (e.g., subjects did not follow fixation instruction) but also as a candidate for standard ocular artifact management in electrophysiological studies interested in visual-spatial attention and memory. © 2016 Society for Psychophysiological Research.

C-peptide does not affect ocular blood flow in patients with type 1 diabetes.

PubMed

Polska, Elzbieta; Kolodjaschna, Julia; Berisha, Fatmire; Malec, Maria M; Simader, Christian; Bayerle-Eder, Michaela; Roden, Michael; Schmetterer, Leopold

2006-09-01

The aim of the present study was to investigate the effect of intravenous C-peptide infusion on ocular blood flow in patients with type 1 diabetes under euglycemic conditions. The study was performed in a randomized, placebo-controlled, double-masked, two-way, crossover design in 10 type 1 diabetic patients. C-peptide was intravenously administered at two different dosages (dosage 1: 25 pmol . kg(-1) . min(-1) bolus followed by 5 pmol . kg(-1) . min(-1) continuous infusion; dosage 2: six times higher than dosage 1), each for 60 min. Physiologic saline solution was used as a control for C-peptide on a different study day. On both study days, euglycemic clamps were performed. To assess retinal blood flow, laser Doppler velocimetry (blood flow velocities) and retinal vessel analyzer (vessels diameters) measurements were performed. Laser interferometric measurements of fundus pulsation were used to assess pulsatile choroidal blood flow. Blood velocities in the ophthalmic artery were measured using color Doppler imaging. Eight patients (two female and six male) completed the study according to the protocol and without adverse events. One patient developed an anaphylactic reaction to C-peptide, which resolved without sequelae. The following results originate from the remaining eight subjects. Systemic hemodynamic parameters remained stable during both study days. Infusion of C-peptide did not affect any ocular hemodynamic parameter. The data of the present study indicate that exogenous C-peptide exerts no effect on ocular hemodynamic parameters in type 1 diabetic patients under euglycemic conditions. The maximum detectable change in these parameters was <25%.

Chorioretinitis sclopetaria from BB ex memoria.

PubMed

Otto, C S; Nixon, K L; Mazzoli, R A; Raymond, W R; Ainbinder, D J; Hansen, E A; Krolicki, T J

2001-01-01

Chorioretinitis sclopetaria presents a characteristic pattern of choroidal and retinal changes caused by a high velocity projectile passing into the orbit, in close proximity to the globe. While it is unlikely that a patient should completely forget the trauma causing such damage, preserved or compensated visual function may blur the patient's memory of these events over time. Characteristic physical findings help to clarify the antecedent history. Despite the lack of an acknowledged history of ocular trauma or surgery, in our case, the characteristic ocular findings discovered at presentation allowed for recognition of the underlying etiology. Because of good visual function, the patient had completely forgotten about the trauma that occurred 12 years earlier. Strabismus surgery was performed for treatment of the presenting symptomatic diplopia. The pathognomonic findings in chorioretinitis sclopetaria are invaluable in correctly diagnosing this condition, especially when a history of ocular trauma is unavailable.

Juvenile xanthogranuloma of the corneoscleral limbus: case report and review of the literature.

PubMed

Chaudhry, Imtiaz A; Al-Jishi, Zohair; Shamsi, Farrukh A; Riley, Fenwick

2004-01-01

Juvenile xanthogranuloma is a benign histiocytic cutaneous disorder mainly occurring in infants which may affect the eye. Ocular manifestations usually present in the form of iris lesions with secondary hyphema and glaucoma, but juvenile xanthogranuloma may also present as a corneoscleral limbal mass. We present the case of an 18-month-old female infant with ocular juvenile xanthogranuloma occurring as a corneoscleral limbal mass without associated cutaneous or systemic findings. The limbal mass lesion was excised by lamellar dissection and histopathological studies revealed histiocytes admixed with lymphocytes, plasma cells, and eosinophils; foreign body and Touton giant cells present throughout the specimen confirmed the diagnosis of juvenile xanthogranuloma. At 14-month follow-up, there was no recurrence of the limbal mass. The natural history of this uncommon ocular condition is discussed and the relevant literature reviewed. Juvenile xanthogranuloma should be considered in the differential diagnosis of any corneoscleral limbal mass lesion, particularly in children.

Revisiting the role of erythropoietin for treatment of ocular disorders

PubMed Central

Shirley Ding, S L; Leow, S N; Munisvaradass, R; Koh, E H; Bastion, M L C; Then, K Y; Kumar, S; Mok, P L

2016-01-01

Erythropoietin (EPO) is a glycoprotein hormone conventionally thought to be responsible only in producing red blood cells in our body. However, with the discovery of the presence of EPO and EPO receptors in the retinal layers, the EPO seems to have physiological roles in the eye. In this review, we revisit the role of EPO in the eye. We look into the biological role of EPO in the development of the eye and the physiologic roles that it has. Apart from that, we seek to understand the mechanisms and pathways of EPO that contributes to the therapeutic and pathological conditions of the various ocular disorders such as diabetic retinopathy, retinopathy of prematurity, glaucoma, age-related macular degeneration, optic neuritis, and retinal detachment. With these understandings, we discuss the clinical applications of EPO for treatment of ocular disorders, modes of administration, EPO formulations, current clinical trials, and its future directions. PMID:27285322

Risk calculation variability over time in ocular hypertensive subjects.

PubMed

Song, Christian; De Moraes, Carlos Gustavo; Forchheimer, Ilana; Prata, Tiago S; Ritch, Robert; Liebmann, Jeffrey M

2014-01-01

To investigate the longitudinal variability of glaucoma risk calculation in ocular hypertensive (OHT) subjects. We reviewed the charts of untreated OHT patients followed in a glaucoma referral practice for a minimum of 60 months. Clinical variables collected at baseline and during follow-up included age, central corneal thickness (CCT), intraocular pressure (IOP), vertical cup-to-disc ratio (VCDR), and visual field pattern standard deviation (VFPSD). These were used to calculate the 5-year risk of conversion to primary open-angle glaucoma (POAG) at each follow-up visit using the Ocular Hypertension Treatment Study and European Glaucoma Prevention Study calculator (http://ohts.wustl.edu/risk/calculator.html). We also calculated the risk of POAG conversion based on the fluctuation of measured variables over time assuming the worst case scenarios (final age, highest PSD, lowest CCT, highest IOP, and highest VCDR) and best case scenarios (baseline age, lowest PSD, highest CCT, lowest IOP, and lowest VCDR) for each patient. Risk probabilities (%) were plotted against follow-up time to generate slopes of risk change over time. We included 27 untreated OHT patients (54 eyes) followed for a mean of 98.3±18.5 months. Seven individuals (25.9%) converted to POAG during follow-up. The mean 5-year risk of conversion for all patients in the study group ranged from 2.9% to 52.3% during follow-up. The mean slope of risk change over time was 0.37±0.81% increase/y. The mean slope for patients who reached a POAG endpoint was significantly greater than for those who did not (1.3±0.78 vs. 0.042±0.52%/y, P<0.01). In each patient, the mean risk of POAG conversion increased almost 10-fold when comparing the best case scenario with the worst case scenario (5.0% vs. 45.7%, P<0.01). The estimated 5-year risk of conversion to POAG among untreated OHT patients varies significantly during follow-up, with a trend toward increasing over time. Within the same individual, the estimated risk can vary almost 10-fold based on the variability of IOP, CCT, VCDR, and VFPSD. Therefore, a single risk calculation measurement may not be sufficient for accurate risk assessment, informed decision-making by patients, and physician treatment recommendations.

Safety and Efficacy of an Artificial Tear Containing 0.3% Hyaluronic Acid in the Management of Moderate-to-Severe Dry Eye Disease.

PubMed

López-de la Rosa, Alberto; Pinto-Fraga, José; Blázquez Arauzo, Francisco; Urbano Rodríguez, Rubén; González-García, María J

2017-11-01

To evaluate the safety and efficacy of a new 0.3% hyaluronic acid artificial tear compared with 0.9% saline solution (0.9% NaCl) in moderate-to-severe dry eye patients after 1 month's use. A total of 16 patients with moderate-to-severe dry eye were included in this crossover study. After a 1-week washout period, patients used the experimental (Visaid 0.3%) or control solution (0.9% NaCl), selected randomly, applying three to eight drops daily for a month. After another washout period, patients used the other solution in the same way. Percentage of change (ΔY) was calculated and analyzed for (1) safety variables: visual acuity, intraocular pressure, and ophthalmoscopy evaluation; (2) efficacy variable: Ocular Surface Disease Index (OSDI) questionnaire; and (3) secondary variables: biomicroscopy findings, fluorescein corneal staining, lissamine green conjunctival staining, tear breakup time (TBUT), contrast sensitivity, Schirmer test, and subject satisfaction. There were no significant differences in the safety parameters for either solution. After using Visaid 0.3%, patients showed significant improvements in OSDI score (ΔY: -9.66%±10.90), tarsal hyperemia (ΔY: -16.67%±27.89), corneal staining extension (ΔY: -34.90%±42.41), TBUT (ΔY: 13.98%±26.19), and subjective satisfaction (ΔY: 38.06%±47.06). When using 0.9% NaCl, Schirmer test results were significantly worse (ΔY: -11.47%±19.27). A significant difference between the 2 solutions was found in TBUT (ΔY: 13.98%±26.19 vs. 10.15%±42.34, respectively; P=0.0214). Visaid 0.3% is a safe product with some benefits over 0.9% NaCl in reducing ocular symptoms and improving some ocular signs in patients with moderate-to-severe dry eye.

Efficacy of two-month treatment with Xiloial eyedrops for discomfort from disposable soft contact lenses.

PubMed

Versura, Piera; Profazio, Vincenzo; Balducci, Nicole; Campos, Emilio C

2010-09-20

To evaluate the efficacy and tolerability of Xiloial(®) monodose eyedrops in the treatment of patients suffering from subjective symptoms of discomfort related to disposable soft contact lens (dSCL) wear. Fifteen (12 female, three male, medium age 39 ± 9 years) dSCL wearers were enrolled. Inclusion criteria were Ocular Surface Disease Index (ODSI) symptom questionnaire score >12, tear film break-up time (TFBUT) <10 sec, Schirmer test I >10 mm over five minutes, mild punctuate keratopathy, and conjunctival staining (Oxford grading ≤4). Monodose Xiloial eyedrops were administered three times daily for a two-month period. Patients were evaluated at enrollment, after three days of washout (baseline), and after one and two months of treatment, by OSDI score, Schirmer test I, TFBUT, ferning test, ocular surface damage (Oxford grade), and serum albumin in tears (index of passive exudation related to serum leakage). At endpoint versus baseline, respectively, the mean ± standard deviation of all variables improved as follows: OSDI (8.5 ± 3 versus 20.2 ± 1.6); TFBUT (9.6 ± 1.1 versus 7.1 ± 1.0); Oxford grading (0.5 ± 0.1 versus 3.6 ± 0.8); ferning test (2 ± 1 versus 2.4 ± 0.5); and Schirmer test I (14.6 ± 1.1 versus 12 ± 2.1), with P < 0.05 for all variables (Friedman and Wilcoxon tests). Tolerability was high, with no adverse events noted. A two-month treatment with Xiloial showed good tolerance and appeared to reduce ocular surface damage and symptoms of discomfort.

Assessment of the number of eye symptoms and the impact of some confounding variables for office staff in non-air-conditioned buildings.

PubMed

Doughty, Michael J; Blades, Kenneth A; Ibrahim, Nassim

2002-03-01

The goal of this study was both to assess the frequency of self-reported eye symptoms for employees in a non-air-conditioned office building complex, and to specifically assess whether confounding variables (contact lens wear, medicines use, and provoking stimuli) had a discernible impact on the characteristics of this reporting. A questionnaire was distributed, in the winter months, to office employees in a building complex within a city-located University site, consisting of non-air-conditioned rooms with some mechanical ventilation. The questionnaire asked respondents to identify any eye symptoms experienced (foreign body sensation, soreness, dryness, grittiness, itchiness, stinging, intense burning), the frequency of their occurrence, details of any conditions provoking eye symptoms (such as changes in the microenvironment), their medication use and if they were contact lens wearers. The proportion of respondents for various categories was calculated, along with the total number of symptoms. If 'eye irritation' is considered as reporting any symptoms experienced at any time, then 63% of 292 respondents (median age 42.5 years) reported an average of 1.83 symptoms. However, the identification of contact lens wearers, medication use (especially for seasonal allergies) and provoking stimuli reduced this prevalence to just 29% (with the average number of symptoms being 1.51). If the frequency of experiencing symptoms was also taken into account (never, sometimes, often, and constantly), then only 12.3% of the respondents indicated symptoms often or constantly, i.e. could be considered to have significant symptoms. In all categories, men were more likely to report eye symptoms compared with women. The results confirm that office employees are likely to have some ocular symptoms, but that even a simple consideration of possible confounding variables can greatly change the reported prevalence of eye irritation that might be specifically associated with the workplace environment.

Freeze drying optimization of polymeric nanoparticles for ocular flurbiprofen delivery: effect of protectant agents and critical process parameters on long-term stability.

PubMed

Ramos Yacasi, Gladys Rosario; Calpena Campmany, Ana Cristina; Egea Gras, María Antonia; Espina García, Marta; García López, María Luisa

2017-04-01

The stabilization of flurbiprofen loaded poly-ɛ-caprolactone nanoparticles (FB-PɛCL-NPs) for ocular delivery under accurate freeze-drying (FD) process provides the basis for a large-scale production and its commercial development. Optimization of the FD to improve long-term stability of ocular administration's FB-PɛCL-NPs. FB-PɛCL-NPs were prepared by solvent displacement method with poloxamer 188 (P188) as stabilizer. Freezing and primary drying (PD) were studied and optimized through freeze-thawing test and FD microscopy. Design of experiments was used to accurate secondary drying (SD) conditions and components concentration. Formulations were selected according to desired physicochemical properties. Furthermore, differential scanning calorimetry (DSC) and X-ray diffraction (XRD) were used to study interactions components. Optimized FB-PɛCL-NPs, stabilized with 3.5% (w/w) P188 and protected with 8% (w/w) poly(ethylene glycol), was submitted to precooling at +10 °C for 1 h, freezing at -50 °C for 4 h, PD at +5 °C and 0.140 mbar for 24 h and a SD at +45 °C during 10 h. These conditions showed 188.4 ± 1.3 nm, 0.087 ± 0.014, 85.5 ± 1.4%, 0.61 ± 0.12%, -16.4 ± 0.1 mV and 325 ± 7 mOsm/kg of average size, polydispersity index, entrapment efficiency, residual moisture, surface charge and osmolality, respectively. It performed a long-term stability >12 months. DSC and XRD spectra confirmed adequate chemical interaction between formulation components and showed a semi-crystalline state after FD. An optimal freeze dried ocular formulation was achieved. Evidently, the successful design of this promising colloidal system resulted from rational cooperation between a good formulation and the right conditions in the FD process.

Ocular toxicity of authentic lunar dust

PubMed Central

2012-01-01

Background Dust exposure is a well-known occupational hazard for terrestrial workers and astronauts alike and will continue to be a concern as humankind pursues exploration and habitation of objects beyond Earth. Humankind’s limited exploration experience with the Apollo Program indicates that exposure to dust will be unavoidable. Therefore, NASA must assess potential toxicity and recommend appropriate mitigation measures to ensure that explorers are adequately protected. Visual acuity is critical during exploration activities and operations aboard spacecraft. Therefore, the present research was performed to ascertain the ocular toxicity of authentic lunar dust. Methods Small (mean particle diameter = 2.9 ± 1.0 μm), reactive lunar dust particles were produced by grinding bulk dust under ultrapure nitrogen conditions. Chemical reactivity and cytotoxicity testing were performed using the commercially available EpiOcularTM assay. Subsequent in vivo Draize testing utilized a larger size fraction of unground lunar dust that is more relevant to ocular exposures (particles <120 μm; median particle diameter = 50.9 ± 19.8 μm). Results In vitro testing indicated minimal irritancy potential based on the time required to reduce cell viability by 50% (ET50). Follow-up testing using the Draize standard protocol confirmed that the lunar dust was minimally irritating. Minor irritation of the upper eyelids was noted at the 1-hour observation point, but these effects resolved within 24 hours. In addition, no corneal scratching was observed using fluorescein stain. Conclusions Low-titanium mare lunar dust is minimally irritating to the eyes and is considered a nuisance dust for ocular exposure. No special precautions are recommended to protect against ocular exposures, but fully shielded goggles may be used if dust becomes a nuisance. PMID:22817808

Ocular toxicity of authentic lunar dust.

PubMed

Meyers, Valerie E; Garcìa, Hector D; Monds, Kathryn; Cooper, Bonnie L; James, John T

2012-07-20

Dust exposure is a well-known occupational hazard for terrestrial workers and astronauts alike and will continue to be a concern as humankind pursues exploration and habitation of objects beyond Earth. Humankind's limited exploration experience with the Apollo Program indicates that exposure to dust will be unavoidable. Therefore, NASA must assess potential toxicity and recommend appropriate mitigation measures to ensure that explorers are adequately protected. Visual acuity is critical during exploration activities and operations aboard spacecraft. Therefore, the present research was performed to ascertain the ocular toxicity of authentic lunar dust. Small (mean particle diameter = 2.9 ± 1.0 μm), reactive lunar dust particles were produced by grinding bulk dust under ultrapure nitrogen conditions. Chemical reactivity and cytotoxicity testing were performed using the commercially available EpiOcularTM assay. Subsequent in vivo Draize testing utilized a larger size fraction of unground lunar dust that is more relevant to ocular exposures (particles <120 μm; median particle diameter = 50.9 ± 19.8 μm). In vitro testing indicated minimal irritancy potential based on the time required to reduce cell viability by 50% (ET50). Follow-up testing using the Draize standard protocol confirmed that the lunar dust was minimally irritating. Minor irritation of the upper eyelids was noted at the 1-hour observation point, but these effects resolved within 24 hours. In addition, no corneal scratching was observed using fluorescein stain. Low-titanium mare lunar dust is minimally irritating to the eyes and is considered a nuisance dust for ocular exposure. No special precautions are recommended to protect against ocular exposures, but fully shielded goggles may be used if dust becomes a nuisance.

Vision Aspects of Space Flight

NASA Technical Reports Server (NTRS)

Manuel, Keith; Billica, Roger (Technical Monitor)

2000-01-01

Vision, being one of our most important senses, is critically important in the unique working environment of space flight. Critical evaluation of the astronauts visual system begins with pre-selection examinations resulting in an average of 65% of all medical disqualification's caused by ocular findings. With an average age of 42, approximately 60% of the astronaut corps requires vision correction. Further demands of the unique training and working environment of microgravity, variable lighting from very poor to extreme brightness of sunlight and exposure to extremes of electromagnetic energy results in unique eyewear and contact lens applications. This presentation will describe some of those unique eyewear and contact lens applications used in space flight and training environments. Additionally, ocular findings from 26 shuttle and 5 MIR mission post-flight examinations will be presented.

Inflammation in dry eye.

PubMed

Stern, Michael E; Pflugfelder, Stephen C

2004-04-01

Dry eye is a condition of altered tear composition that results from a diseased or dysfunctional lacrimal functional unit. Evidence suggests that inflammation causes structural alterations and/or functional paralysis of the tear-secreting glands. Changes in tear composition resulting from lacrimal dysfunction, increased evaporation and/or poor clearance have pro-inflammatory effects on the ocular surface. This inflammation is responsible in part for the irritation symptoms, ocular surface epithelial disease, and altered corneal epithelial barrier function in dry eye. Anti-inflammatory therapies for dry eye target one or more of the inflammatory mediators/pathways that have been identified in dry eye.

Whole exome analysis identifies dominant COL4A1 mutations in patients with complex ocular phenotypes involving microphthalmia.

PubMed

Deml, B; Reis, L M; Maheshwari, M; Griffis, C; Bick, D; Semina, E V

2014-11-01

Anophthalmia/microphthalmia (A/M) is a developmental ocular malformation defined as complete absence or reduction in size of the eye. A/M is a heterogenous disorder with numerous causative genes identified; however, about half the cases lack a molecular diagnosis. We undertook whole exome sequencing in an A/M family with two affected siblings, two unaffected siblings, and unaffected parents; the ocular phenotype was isolated with only mild developmental delay/learning difficulties reported and a normal brain magnetic resonance imaging (MRI) in the proband at 16 months. No pathogenic mutations were identified in 71 known A/M genes. Further analysis identified a shared heterozygous mutation in COL4A1, c.2317G>A, p.(Gly773Arg) that was not seen in the unaffected parents and siblings. Analysis of 24 unrelated A/M exomes identified a novel c.2122G>A, p.(Gly708Arg) mutation in an additional patient with unilateral microphthalmia, bilateral microcornea and Peters anomaly; the mutation was absent in the unaffected mother and the unaffected father was not available. Mutations in COL4A1 have been linked to a spectrum of human disorders; the most consistent feature is cerebrovascular disease with variable ocular anomalies, kidney and muscle defects. This study expands the spectrum of COL4A1 phenotypes and indicates screening in patients with A/M regardless of MRI findings or presumed inheritance pattern. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Clinical and ocular motor analysis of the infantile nystagmus syndrome in the first 6 months of life.

PubMed

Hertle, R W; Maldanado, V K; Maybodi, M; Yang, D

2002-06-01

The infantile nystagmus syndrome (INS) usually begins in infancy and may or may not be associated with visual sensory system abnormalities. Little is known about its specific waveforms in the first 6 months of life or their relation to the developing visual system. This study identifies the clinical and ocular motility characteristics of the INS and establishes the range of waveforms present in the first 6 months of life. 27 infants with involuntary ocular oscillations typical of INS are included in this analysis. They were evaluated both clinically and with motility recordings. Eye movement analysis was performed off line from computer analysis of digitised data. Variables analysed included age, sex, vision, ocular abnormalities, head position, and null zone, neutral zone characteristics, symmetry, conjugacy, waveforms, frequencies, and foveation times. Ages ranged from 3 to 6.5 months (average 4.9 months). 15 patients (56%) had abnormal vision for age, nine (33%) had strabismus, five (19%) had an anomalous head posture, 13 (48%) had oculographic null and neutral positions, nine (33%) had binocular asymmetry, and only two showed consistent dysconjugacy. Average binocular frequency was 3.3 Hz, monocular frequency 6.6 Hz. Average foveation periods were longer and more "jerk" wave forms were observed in those patients with normal vision. Common clinical characteristics and eye movement waveforms of INS begin in the first few months of infancy and waveform analysis at this time may help with both diagnosis and visual status.

[Use of data display screens and ocular hypertension in local public sector workers].

PubMed

Abellán Torró, Rosana; Merelles Tormo, Antoni

2014-01-01

The main objective of this study is to examine the association between work with data display screens (DDS) and ocular hypertension (OHT). A cross-sectional study among local public sector workers (Diputación Provincial de Valencia). Data from 620 people were collected over 25 months, from periodic medical examinations performed at an occupational health unit. Intraocular pressure (IOP) was obtained with a portable puff tonometer validated for screening, establishing the cut-off point for OHT at 22 mmHg. Both biological characteristics and other work-related variables were taken into account as covariates. Descriptive statistics of the data were obtained, together with nonparametric tests with a level of significance of 95% and logistic regression with p 〈0.1 as the level of significance of the likelihood test. The average age of the study population is 52.8 years. The prevalence of OHT was 3.5% (5.1% among men and 1.2% among women; p=0.012). No significant associations were found between hours of DDS-related work and OHT were found (p=0.395). Logistic regression corroborated the association between gender and OHT, with women less affected (OR = 0.234; 95%CI: 0.068 - 0.799; p=0.020). In our study, no associations were found between time of exposure to data display screens and ocular hypertension. Logistic regression points to a certain association between ocular hypertension and gender, with men being more predisposed. Copyright belongs to the Societat Catalana de Salut Laboral.

Tear Film Osmolarity in Subjects with Acute Allergic Rhinoconjunctivitis

PubMed Central

NITODA, EIRINI; LAVARIS, ANASTASIOS; LAIOS, KONSTANTINOS; ANDROUDI, SOPHIA; KALOGEROPOULOS, CHRIS D; TSATSOS, MICHAEL; DAMASKOS, CHRISTOS; GARMPIS, NIKOLAOS; MOSCHOS, MARILITA M

2018-01-01

Background/Aim: Acute allergic rhinoconjuctivitis is the most common form of ocular allergies. The pathogenetic mechanisms are based on an immunoglobulin E (IgE)-mediated hypersensitivity reaction. On the other hand, tear osmolarity has been suggested to be an index of ocular surface damage and inflammation. These data were the motive to investigate the levels of tear osmolarity in subjects with acute allergic rhinoconjuctivitis, before and after administration of artificial tears. Patients and Methods: Forty-five subjects with acute allergic rhinoconjuctivitis were randomly divided into three groups, based on the type of artificial tears that they received: Group A (Thera tears), Group B (Wet therapy) and Group C (Tears Naturale free). The eye drops were administered six times a day for 60 days and all subjects underwent grading of subjective symptoms and clinical examination at baseline and at the end of the treatment. Results: The diagnosis of severe eye disease, which was based on ocular surface disease index (OSDI; Allergan, Inc, Irvine, CA, USA) and tear osmolarity values, concerned all patients at baseline. Although the administration of artificial tears significantly ameliorated the symptoms and the ocular variables in all groups, the results were better in the first group. Tear osmolarity was strongly and negatively correlated with tear film breakup time (BUT) and Schirmer I test at 2 months. Contrariwise, symptoms were eliminated, when tear osmolarity was decreased. Conclusion: Acute allergic rhinoconjuctivitis is characterized by tear hyperosmolarity, which can be rehabilitated with the administration of hypotonic artificial tears. PMID:29475928

Topical ketorolac tromethamine 0.5% ophthalmic solution in ocular inflammation after cataract surgery.

PubMed

Solomon, K D; Cheetham, J K; DeGryse, R; Brint, S F; Rosenthal, A

2001-02-01

To compare the efficacy and safety of ketorolac 0.5% ophthalmic solution with its vehicle in the treatment of ocular inflammation after cataract surgery and intraocular lens implantation. Multicenter clinical study. One hundred four patients were prospectively randomized, 52 patients in treatment group, 52 patients in control group. Patients received either ketorolac or vehicle four times daily in the operated eye for 14 days starting the day after surgery in a prospective, double-masked, randomized, parallel group study. Only patients with moderate or greater postoperative inflammation the day after surgery were enrolled. The main outcome measures include inflammation (cell, flare, ciliary flush), intraocular pressure and visual acuity. Ketorolac was significantly more effective than vehicle in reducing the manifestations of postoperative ocular inflammation, including: anterior chamber cells (P: = 0.002) and flare (P: = 0.009), conjunctival erythema (P: = 0.010), ciliary flush (P: = 0.022), photophobia (P: = 0.027), and pain (P: = 0.043). Five times as many patients were dropped from the study for lack of efficacy from the vehicle group (22/52) than from the ketorolac group (4/52; P: = 0.001). Ketorolac was found to be equally as safe as vehicle in terms of adverse events, changes in visual acuity, intraocular pressure, and biomicroscopic and ophthalmoscopic variables. Ketorolac tromethamine 0.5% ophthalmic solution was significantly more effective than vehicle in the treatment of moderate or greater ocular inflammation following routine cataract surgery, while being as safe as vehicle.

Infections of the head and ocular structures in the horse.

PubMed

Gerard, Mathew P; Wotman, Kathryn L; Komáromy, András M

2006-08-01

Infectious conditions of the equine head are commonly encountered in clinical practice. Pathogenic bacterial, viral, and fungal organisms may localize in the extensive nasal passages, paranasal sinuses, and guttural pouches, creating a range of clinical signs and conditions that can be severe enough to lead to unexpected fatality. Renewed interest in equine dentistry has led to a greater recognition of dental disease that is associated with infection. This article focuses on bacterial and fungal infections of the main anatomic regions of the equine head, where advances in diagnosis and management have been made or consolidated in recent years. It also addresses recent advances made in the area of infectious equine corneal disease, including bacterial, viral, and fungal etiologies. Recent developments in equine recurrent uveitis as it relates to infectious diseases and ocular manifestations of systemic disease are also discussed.

Oculomotor biofeedback therapy for exotropia.

PubMed

Goldrich, S G

1982-04-01

Twelve exotropes of various types received oculomotor biofeedback therapy at State College of New York (SUNY) University Optometric Center. Feedback of a variable pitch tone which reflected changes in ocular vergence reinforced motor control of eye posture. Patients were trained to achieve and sustain alignment in a variety of viewing situations. The six intermittent exotropes in the study who did not have amblyopia or prior history of unsuccessful surgical or orthoptic therapy achieved the highest recovery rating after training. The amblyope and those who had orthoptic training learned to voluntarily correct their eye position, although they did not achieve as acute a sensitivity to loss of alignment as did the others. Therapy restored eye control at near in a young constant exotrope whose condition resulted from severe neurological dysfunction. A constant postsurgical exotrope who had no ability for sensory fusion made little progress. Advantages of oculomotor biofeedback therapy are shorter treatment time, elimination of lengthy home training exercises, and enhanced patient motivation.

[Ocular traumatism in children at Laquintinie Hospital, Douala (Cameroon)].

PubMed

Bella-Hiag, A L; Mvogo, C E

2000-01-01

Pediatric ophthalmology is poorly developed in Cameroon. However, efforts are being made to collect data essential for the development of national strategies to combat blindness. We relate our experience, within this framework, at a large public hospital in Cameroon. We carried out a retrospective study covering the period from June 1993 to May 1998, studying the medical files of children under the age of 15 years with ocular traumatism. Data were collected from 144 files. The frequency of ocular/orbital injury was 7.8% and was the third most common condition, after ametropia and kerato-conjunctivitis, in this population. The mean age of the children was 7 years and 3 months and more boys (64%) than girls were affected. Ocular lesions were due to contusion in 83.3% of cases. The principal causes of the trauma were children's games (40.2%), and punishment by parents or teachers (23.7%). The ocular lesions were similar to those described in previous studies. Infection was rare, because the interval from trauma to consultation was very short. The functional prognosis was severe, with 24.3% of patients having final vision less than 1/10. We recommend that children should be informed about the dangers of violent games and that parents and teachers should be made aware of the dangers associated with brutality towards children. Finally, ophthalmologists should ensure that the injured eye is treated rapidly and carefully so as to minimize functional sequelae.

Identification of biomechanical properties of the cornea: the ocular response analyzer.

PubMed

Terai, Naim; Raiskup, Frederik; Haustein, Michael; Pillunat, Lutz E; Spoerl, Eberhard

2012-07-01

Several methods have been devised for measuring geometric parameters of the cornea but, until now, the biomechanics of the cornea have been largely ignored. The relatively new Ocular Response Analyzer (ORA) provides such biomechanical information. In order to correctly interpret the underlying biomechanics of ORA data, we review reported ORA measurements and provide a compendium of factors influencing these measurements, with discussion of possible explanations for ORA measurement results. This review comprised a literature search using "ocular response analyzer" and "ocular response analyser" as keywords. We reviewed and compared reported results from recent ORA studies so obtained, with an eye to understanding corneal biomechanics. Several ORA biomechanical parameters of the cornea - corneal hysteresis (CH) and corneal resistant factor (CRF) - characterize the viscoelastic properties of the cornea, especially those of the ground substance. The impact on CH and CRF values of various independent factors, e.g. intraocular pressure (IOP), age, central corneal thickness (CCT), and corneal swelling, are discussed. The impact on CH and CRF of treatment-related structural changes of the cornea, i.e. those occurring after refractive surgical procedures, placement of intracorneal rings, and collagen crosslinking (CXL), as well as pathological changes of the cornea, e.g. those resulting from keratoconus, edema, and glaucoma, are discussed. Changes in CRF and CH may be reflective of structural changes in the ground substance of the cornea. Thus, ORA provides invaluable information for delineating biomechanical conditions pertaining to the cornea, with special regard to ocular diseases, e.g. keratoconus and glaucoma.

In vivo retinal and choroidal hypoxia imaging using a novel activatable hypoxia-selective near-infrared fluorescent probe.

PubMed

Fukuda, Shinichi; Okuda, Kensuke; Kishino, Genichiro; Hoshi, Sujin; Kawano, Itsuki; Fukuda, Masahiro; Yamashita, Toshiharu; Beheregaray, Simone; Nagano, Masumi; Ohneda, Osamu; Nagasawa, Hideko; Oshika, Tetsuro

2016-12-01

Retinal hypoxia plays a crucial role in ocular neovascular diseases, such as diabetic retinopathy, retinopathy of prematurity, and retinal vascular occlusion. Fluorescein angiography is useful for identifying the hypoxia extent by detecting non-perfusion areas or neovascularization, but its ability to detect early stages of hypoxia is limited. Recently, in vivo fluorescent probes for detecting hypoxia have been developed; however, these have not been extensively applied in ophthalmology. We evaluated whether a novel donor-excited photo-induced electron transfer (d-PeT) system based on an activatable hypoxia-selective near-infrared fluorescent (NIRF) probe (GPU-327) responds to both mild and severe hypoxia in various ocular ischemic diseases animal models. The ocular fundus examination offers unique opportunities for direct observation of the retina through the transparent cornea and lens. After injection of GPU-327 in various ocular hypoxic diseases of mouse and rabbit models, NIRF imaging in the ocular fundus can be performed noninvasively and easily by using commercially available fundus cameras. To investigate the safety of GPU-327, electroretinograms were also recorded after GPU-327 and PBS injection. Fluorescence of GPU-327 increased under mild hypoxic conditions in vitro. GPU-327 also yielded excellent signal-to-noise ratio without washing out in vivo experiments. By using near-infrared region, GPU-327 enables imaging of deeper ischemia, such as choroidal circulation. Additionally, from an electroretinogram, GPU-327 did not cause neurotoxicity. GPU-327 identified hypoxic area both in vivo and in vitro.

Development of a non-settling gel formulation of 0.5% loteprednol etabonate for anti-inflammatory use as an ophthalmic drop

PubMed Central

Coffey, Martin J; DeCory, Heleen H; Lane, Stephen S

2013-01-01

The eye has protective barriers (ie, the conjunctival and corneal membranes) and defense mechanisms (ie, reflex tearing, blinking, lacrimal drainage) which present challenges to topical drug delivery. Topical ocular corticosteroids are commonly used in the treatment of anterior segment diseases and inflammation associated with ocular surgery, and manufacturers continually strive to improve their characteristics. We describe the development of a novel ophthalmic gel formulation of loteprednol etabonate (LE), a C-20 ester-based corticosteroid with an established safety profile, in the treatment of ocular inflammatory conditions. The new LE gel formulation is non-settling, eliminating the need to shake the product to resuspend the drug, has a pH close to that of tears, and a low preservative concentration. The rheological characteristics of LE gel are such that the formulation is instilled as a drop and transitions to a fluid upon instillation in the eye, yet retains sufficient viscosity to prolong ocular surface retention. The new formulation provides consistent, uniform dosing as evidenced by dose extrusion studies, while pharmacokinetic studies in rabbits demonstrated rapid and sustained exposure to LE in ocular tissues following instillation of LE gel. Finally, results from two clinical studies of LE gel in the treatment of postoperative inflammation and pain following cataract surgery indicate that it was safe and effective. Most patients reported no unpleasant drop sensation upon instillation, and reports of blurred vision were rare. PMID:23430378

Dry powder dosing in liquid vehicles: ocular tolerance and scintigraphic evaluation of a perfluorocarbon suspension.

PubMed

Zhu, Y; Wilson, C G; Meadows, D; Olejnik, O; Frier, M; Washington, N; Musson, R

1999-11-30

The ocular tolerance and precorneal disposition of 99mTc-labelled sterile carbon-perfluorodecalin (PFD) and carbon-aqueous suspensions were examined in a cohort of healthy volunteers. Formulations were prepared in PFD or saline using charcoal particles, radiolabelled with [99mTc]diethylenetriaminepentaacetic acid (DTPA) under GMP conditions. Colloidal silicon dioxide was used as a suspending agent. Ocular tolerance was examined following the instillation of each formulation to the eyes of 12 volunteers. The precorneal distribution of both formulations in man was monitored using gamma scintigraphy. Dynamic and static data acquisitions were taken over a period of 150 min after dosing. Carbon particulates suspended in PFD did not show any irritation to the eye. Administration of PFD formulation in man produced a significant increase in ocular retention over a saline formulation (mean residence time (MRT)=157+/-42 and 0.29+/-0.08 min, respectively, P=0.0001). Distribution of the carbon in man followed the same pattern as in a previous reported study in animals. The carbon deposited uniformly along the lid margin in the case of the PFD vehicle, whereas it agglomerated following dosing in the saline vehicle and was ejected from the eye. The novel non-aqueous vehicle system is able to significantly improve the ocular retention of charcoal particles in man and provides a unique distribution of the particles in the eye, which suggests a potential for the PFD system for the treatment of periocular diseases.

Effect of Gabapentin/Memantine on the Infantile Nystagmus Syndrome in the Zebrafish Model: Implications for the Therapy of Ocular Motor Diseases.

PubMed

Bögli, Stefan Yu; Afthinos, Maresa; Huang, Melody Ying-Yu

2017-06-01

Infantile nystagmus syndrome (INS) is a disorder characterized by typical horizontal eye oscillations. Due to the uncertain etiology of INS, developing specific treatments remains difficult. Single reports demonstrated, on limited measures, alleviating effects of gabapentin and memantine. In the current study, we employed the zebrafish INS model belladonna (bel) to conduct an in-depth study of how gabapentin and memantine interventions alleviate INS signs, which may further restore visual conditions in affected subjects. Moreover, we described the influence of both medications on ocular motor functions in healthy zebrafish, evaluating possible iatrogenic effects. Ocular motor function and INS characteristics were assessed by eliciting optokinetic response, spontaneous nystagmus, and spontaneous saccades in light and in dark, in 5- to 6-day postfertilization bel larvae and heterozygous siblings. Single larvae were recorded before and after a 1-hour drug treatment (200 mM gabapentin/0.2 mM memantine). Both interventions significantly reduced nystagmus intensity (gabapentin: 59.98%, memantine: 39.59%). However, while the application of gabapentin affected all tested ocular motor functions, memantine specifically reduced nystagmus amplitude and intensity, and thus left controls completely unaffected. Finally, both drug treatments resulted in specific changes in nystagmus waveform and velocity. Our study provides deeper insight into gabapentin and memantine treatment effect in the zebrafish INS model. Moreover, this study should establish zebrafish as a pharmacologic animal model for treating nystagmus and ocular motor disease, serving as a basis for future large-scale drug screenings.

Red-green opponent channel mediation of control of human ocular accommodation.

PubMed Central

Kotulak, J C; Morse, S E; Billock, V A

1995-01-01

1. It has been hypothesized, but not verified empirically, that the control of human ocular accommodation is mediated by either the red-green or yellow-blue colour channels. Our goal was to determine experimentally whether the red-green channel by itself could influence the accommodative response. 2. To find out, we isolated the red-green channel through chromatic bandpass filtering and measured accommodation under dynamic and static conditions. The effect of this filtering was to modulate the red-green channel without disturbing either the yellow-blue or luminance channels. 3. Accommodative gain (ratio of response to stimulus amplitude) declined monotonically with decreasing bandwidth under dynamic conditions. Because the outputs of both the luminance and yellow-blue colour channels did not vary with bandwidth, the only explanation is that the red-green opponent process was responsible for the effect. 4. Under static conditions, however, accommodation was independent of bandwidth. This may be attributable to the decreased sensitivity to chromatic contrast that occurs at low temporal frequencies. PMID:7738858

Modulating release of ranibizumab and aflibercept from thiolated chitosan-based hydrogels for potential treatment of ocular neovascularization.

PubMed

Moreno, Miguel; Pow, Poh Yih; Tabitha, Tan Su Teng; Nirmal, Sonali; Larsson, Andreas; Radhakrishnan, Krishna; Nirmal, Jayabalan; Quah, Soo Tng; Geifman Shochat, Susana; Agrawal, Rupesh; Venkatraman, Subbu

2017-08-01

This paper describes the synthesis of thiolated chitosan-based hydrogels with varying degrees of crosslinking that has been utilized to modulate release kinetics of two clinically relevant FDA-approved anti-VEGF protein drugs, ranibizumab and aflibercept. These hydrogels have been fabricated into disc shaped structures for potential use as patches on ocular surface. Protein conformational changes and aggregation after loading and release was evaluated by circular dichroism (CD), steady-state tryptophan fluorescence spectroscopy, electrophoresis and size-exclusion chromatography (SEC). Finally, the capacity of both released proteins to bind to VEGF was tested by ELISA and surface plasmon resonance (SPR) technology. The study demonstrates the versatility of thiolated chitosan-based hydrogels for delivering proteins. The effect of various parameters of the hydrogel on protein release kinetics and mechanism of protein release was studied using the Korsmeyer-Peppas release model. Furthermore, we have studied the stability of released proteins in detail while comparing it with non-entrapped proteins under physiological conditions to understand the effect of formulation conditions on protein stability. The disc-shaped thiolated chitosan-based hydrogels provide a potentially useful platform to deliver ranibizumab and aflibercept for the treatments of ocular diseases such as wet AMD, DME and corneal neovascularization.

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

PubMed Central

Cruzat, Andrea; Qazi, Yureeda; Hamrah, Pedram

2016-01-01

In vivo confocal microscopy (IVCM) is becoming an indispensable tool for studying corneal physiology and disease. Enabling the dissection of corneal architecture at a cellular level, this technique offers fast and noninvasive in vivo imaging of the cornea with images comparable to that of ex vivo histochemical techniques. Corneal nerves bear substantial relevance to clinicians and scientists alike, given their pivotal roles in regulation of corneal sensation, maintenance of epithelial integrity, and proliferation and promotion of wound healing. Thus, IVCM offers a unique method to study corneal nerve alterations in a myriad of conditions, such as ocular and systemic diseases and following corneal surgery, without altering the tissue microenvironment. Of particular interest has been the correlation of corneal subbasal nerves to their function, which has been studied in normal eyes, contact lens wearers, and patients with keratoconus, infectious keratitis, corneal dystrophies, and neurotrophic keratopathy. Longitudinal studies have applied IVCM to investigate the effects of corneal surgery on nerves, demonstrating their regenerative capacity. IVCM is increasingly important in the diagnosis and management of systemic conditions such as peripheral diabetic neuropathy and, more recently, in ocular diseases. In this review, we outline the principles and applications of IVCM in the study of corneal nerves in various ocular and systemic diseases. PMID:27771327

Optimization and physicochemical characterization of a triamcinolone acetonide-loaded NLC for ocular antiangiogenic applications.

PubMed

Araújo, J; Gonzalez-Mira, E; Egea, M A; Garcia, M L; Souto, E B

2010-06-30

The purpose of this study was to develop a novel nanostructured lipid carrier (NLC) for the intravitreal-targeting delivery of triamcinolone acetonide (TA) by direct ocular instillation. A five-level central composite rotable design was used to study the influence of four different variables on the physicochemical characteristics of NLCs. The analysis of variance (ANOVA) statistical test was used to assess the optimization of NLC production parameters. The systems were produced by high pressure homogenization using Precirol ATO5 and squalene as solid and liquid lipids respectively, and Lutrol F68 as surfactant. Homogenization at 600 bar for 3 cycles of the optimized formulation resulted in the production of small NLC (mean diameter < 200 nm) with a homogeneous particle size distribution (polydispersity index (PI) approximately 0.1), of negatively charged surface (approximately |45| mV) and high entrapment efficiency (approximately 95%). Surface morphology was assessed by SEM which revealed fairly spherical shape. DSC, WAXS and FT-IR analyses confirmed that TA was mostly entrapped into the NLC, characterized by an amorphous matrix. In vivo Draize test showed no signs of ocular toxicity. 2010 Elsevier B.V. All rights reserved.

Cubic liquid crystalline nanoparticles: optimization and evaluation for ocular delivery of tropicamide.

PubMed

Verma, Purnima; Ahuja, Munish

2016-10-01

The purpose of this study was to investigate the potential of cubic liquid crystalline nanoparticles for ocular delivery of tropicamide. Ultrasound-assisted fragmentation of cubic liquid crystalline bulk phases resulted in cubic liquid crystalline nanoparticles employing Pluronic F127 as dispersant. The effects of process variables such as sonication time, sonication amplitude, sonication depth, and pre-mixing time on particle size and polydispersity index was investigated using central composite design. The morphology of tropicamide-loaded nanoparticles was found to be nearly cubical in shape by transmission electron microscopy observation. Further, small angle X-ray scattering experiment confirmed the presence of D and P phase cubic structures in coexistence. The optimized tropicamide-loaded cubic nanoparticles showed in vitro corneal permeation of tropicamide across isolated porcine cornea comparable to its commercial preparation, Tropicacyl®. Ocular tolerance was evaluated by Hen's egg-chorioallantoic membrane test and histological studies. The results of in vivo mydriatic response study demonstrated a remarkably higher area under mydriatic response curve (AUC 0→1440 min ) values of cubic nanoparticles over Tropicacyl® indicating better therapeutic value of cubic nanoparticles. Furthermore, tropicamide-loaded cubic nanoparticles exhibited prolonged mydriatic effect on rabbits as compared to commercial conventional aqueous ophthalmic solution.

Post DSAEK Optical Changes: A Comprehensive Prospective Analysis on the Role of Ocular Wavefront Aberrations, Haze, and Corneal Thickness

PubMed Central

Hindman, Holly B.; Huxlin, Krystel R.; Pantanelli, Seth M.; Callan, Christine L.; Sabesan, Ramkumar; Ching, Steven S.T.; Miller, Brooke E.; Martin, Tim; Yoon, Geunyoung

2014-01-01

Purpose To assess the visual impact of ocular wavefront aberrations, corneal thickness, and corneal light scatter prospectively after Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) in humans. Methods Data were obtained prospectively from 20 eyes pre-operatively and at 1, 3, 6, and 12 months post- DSAEK. At each visit, best spectacle corrected visual acuity (BSCVA) and visual acuity with glare (Brightness Acuity Testing - BAT) were recorded and ocular wavefront measurements and corneal Optical Coherence Tomography (OCT) performed. Magnitude and sign of individual Zernike terms (higher order aberrations HOA) were determined. Epithelial, host stromal, donor stromal, and total corneal thickness were quantified. Brightness, intensity profiles of OCT images were generated to quantify light scatter in the whole cornea, subepithelial region, anterior and posterior host stroma, interface, and donor stroma. Results Mean BSCVA and glare disability at low light levels improved from 1 to 12 months post-DSAEK. All corneal thicknesses and ocular lower- and HOAs were stable from 1 through 12 months, whereas total corneal, host stromal, and interface brightness intensities decreased significantly over the same period. A repeated measures ANOVA across the follow up period found that the change in scatter, but not the change in higher order aberrations, could account for the variability occurring in acuity from 1 to 12 months post-DSAEK. Conclusions While ocular HOAs and scatter are both elevated over normal post-DSAEK, our results demonstrate that improvements in visual performance occurring over the first year post-DSAEK are associated with decreasing light scatter. In contrast, there were no significant changes in ocular HOAs during this time. Because corneal light scatter decreased between 1 and 12 months despite stable corneal thicknesses over the same period, we conclude that factors that induced light scatter, other than tissue thickness or swelling (corneal edema), significantly impacted the visual improvements that occurred over time post-DSAEK. A better understanding of the cellular and extracellular matrix changes of the subepithelial region and interface, incurred by the surgical creation of a lamellar host -graft interface, and the subsequent healing of these tissues, is warranted. PMID:24162748

Endothelial TWIST1 Promotes Pathological Ocular Angiogenesis

PubMed Central

Li, Jie; Liu, Chi-Hsiu; Sun, Ye; Gong, Yan; Fu, Zhongjie; Evans, Lucy P.; Tian, Katherine T.; Juan, Aimee M.; Hurst, Christian G.; Mammoto, Akiko; Chen, Jing

2014-01-01

Purpose. Pathological neovessel formation impacts many blinding vascular eye diseases. Identification of molecular signatures distinguishing pathological neovascularization from normal quiescent vessels is critical for developing new interventions. Twist-related protein 1 (TWIST1) is a transcription factor important in tumor and pulmonary angiogenesis. This study investigated the potential role of TWIST1 in modulating pathological ocular angiogenesis in mice. Methods. Twist1 expression and localization were analyzed in a mouse model of oxygen-induced retinopathy (OIR). Pathological ocular angiogenesis in Tie2-driven conditional Twist1 knockout mice were evaluated in both OIR and laser-induced choroidal neovascularization models. In addition, the effects of TWIST1 on angiogenesis and endothelial cell function were analyzed in sprouting assays of aortic rings and choroidal explants isolated from Twist1 knockout mice, and in human retinal microvascular endothelial cells treated with TWIST1 small interfering RNA (siRNA). Results. TWIST1 is highly enriched in pathological neovessels in OIR retinas. Conditional Tie2-driven depletion of Twist1 significantly suppressed pathological neovessels in OIR without impacting developmental retinal angiogenesis. In a laser-induced choroidal neovascularization model, Twist1 deficiency also resulted in significantly smaller lesions with decreased vascular leakage. In addition, loss of Twist1 significantly decreased vascular sprouting in both aortic ring and choroid explants. Knockdown of TWIST1 in endothelial cells led to dampened expression of vascular endothelial growth factor receptor 2 (VEGFR2) and decreased endothelial cell proliferation. Conclusions. Our study suggests that TWIST1 is a novel regulator of pathologic ocular angiogenesis and may represent a new molecular target for developing potential therapeutic treatments to suppress pathological neovascularization in vascular eye diseases. PMID:25414194

The relation of functional visual acuity measurement methodology to tear functions and ocular surface status.

PubMed

Kaido, Minako; Ishida, Reiko; Dogru, Murat; Tsubota, Kazuo

2011-09-01

To investigate the relation of functional visual acuity (FVA) measurements with dry eye test parameters and to compare the testing methods with and without blink suppression and anesthetic instillation. A prospective comparative case series. Thirty right eyes of 30 dry eye patients and 25 right eyes of 25 normal subjects seen at Keio University School of Medicine, Department of Ophthalmology were studied. FVA testing was performed using a FVA measurement system with two different approaches, one in which measurements were made under natural blinking conditions without topical anesthesia (FVA-N) and the other in which the measurements were made under the blink suppression condition with topical anesthetic eye drops (FVA-BS). Tear function examinations, such as the Schirmer test, tear film break-up time, and fluorescein and Rose Bengal vital staining as ocular surface evaluation, were performed. The mean logMAR FVA-N scores and logMAR Landolt visual acuity scores were significantly lower in the dry eye subjects than in the healthy controls (p < 0.05), while there were no statistical differences between the logMAR FVA-BS scores of the dry eye subjects and those of the healthy controls. There was a significant correlation between the logMAR Landolt visual acuities and the logMAR FVA-N and logMAR FVA-BS scores. The FVA-N scores correlated significantly with tear quantities, tear stability and, especially, the ocular surface vital staining scores. FVA measurements performed under natural blinking significantly reflected the tear functions and ocular surface status of the eye and would appear to be a reliable method of FVA testing. FVA measurement is also an accurate predictor of dry eye status.

Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy

PubMed Central

2010-01-01

Background Although a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community. Methods A retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007. Results A total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%). Conclusions Adequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years. PMID:20459676

Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy.

PubMed

Ayanniyi, Abdulkabir A; Folorunso, Francisca N; Adepoju, Feyisayo G

2010-05-07

Although a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community. A retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007. A total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%). Adequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years.

An update on the surgical management of pterygium and the role of loteprednol etabonate ointment

PubMed Central

Sheppard, John D; Mansur, Arnulfo; Comstock, Timothy L; Hovanesian, John A

2014-01-01

Pterygium, a sun-related eye disease, presents as wing-shaped ocular surface lesions that extend from the bulbar conjunctiva onto the cornea, most commonly on the nasal side. Pterygia show characteristic histological features that suggest that inflammation plays a prominent role in their initial pathogenesis and recurrence. Appropriate surgery is the key to successful treatment of pterygia, but there is also a rationale for the use of anti-inflammatory agents to reduce the rate of recurrence following surgery. Multiple surgical techniques have been developed over the last two millennia, but these initially had little success, due to high rates of recurrence. Current management strategies, associated with lower recurrence rates, include bare sclera excision and various types of grafts using tissue glues. Adjunctive therapies include mitomycin C and 5-fluorouracil, as well as the topical ocular steroid loteprednol etabonate, which has been shown to have a lower risk of elevated intraocular pressure than have the other topical ocular steroids. Here, the surgical management of pterygium is presented from a historical perspective, and current management techniques, including the appropriate use of various adjunctive therapies, are reviewed, along with an illustrative case presentation and a discussion of the conjunctival forceps designed to facilitate surgical management. Despite thousands of years of experience with this condition, there remains a need for a more thorough understanding of pterygium and interventions to reduce both its incidence and postsurgical recurrence. Until that time, the immediate goal is to optimize surgical practices to ensure the best possible outcomes. Loteprednol etabonate, especially the ointment formulation, appears to be a safe and effective component of the perioperative regimen for this complex ocular condition, although confirmatory prospective studies are needed. PMID:24966664

TOWARD QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY: Visualizing Blood Flow Speeds in Ocular Pathology Using Variable Interscan Time Analysis.

PubMed

Ploner, Stefan B; Moult, Eric M; Choi, WooJhon; Waheed, Nadia K; Lee, ByungKun; Novais, Eduardo A; Cole, Emily D; Potsaid, Benjamin; Husvogt, Lennart; Schottenhamml, Julia; Maier, Andreas; Rosenfeld, Philip J; Duker, Jay S; Hornegger, Joachim; Fujimoto, James G

2016-12-01

Currently available optical coherence tomography angiography systems provide information about blood flux but only limited information about blood flow speed. The authors develop a method for mapping the previously proposed variable interscan time analysis (VISTA) algorithm into a color display that encodes relative blood flow speed. Optical coherence tomography angiography was performed with a 1,050 nm, 400 kHz A-scan rate, swept source optical coherence tomography system using a 5 repeated B-scan protocol. Variable interscan time analysis was used to compute the optical coherence tomography angiography signal from B-scan pairs having 1.5 millisecond and 3.0 milliseconds interscan times. The resulting VISTA data were then mapped to a color space for display. The authors evaluated the VISTA visualization algorithm in normal eyes (n = 2), nonproliferative diabetic retinopathy eyes (n = 6), proliferative diabetic retinopathy eyes (n = 3), geographic atrophy eyes (n = 4), and exudative age-related macular degeneration eyes (n = 2). All eyes showed blood flow speed variations, and all eyes with pathology showed abnormal blood flow speeds compared with controls. The authors developed a novel method for mapping VISTA into a color display, allowing visualization of relative blood flow speeds. The method was found useful, in a small case series, for visualizing blood flow speeds in a variety of ocular diseases and serves as a step toward quantitative optical coherence tomography angiography.

Formulation and process factors influencing product quality and in vitro performance of ophthalmic ointments.

PubMed

Xu, Xiaoming; Al-Ghabeish, Manar; Rahman, Ziyaur; Krishnaiah, Yellela S R; Yerlikaya, Firat; Yang, Yang; Manda, Prashanth; Hunt, Robert L; Khan, Mansoor A

2015-09-30

Owing to its unique anatomical and physiological functions, ocular surface presents special challenges for both design and performance evaluation of the ophthalmic ointment drug products formulated with a variety of bases. The current investigation was carried out to understand and identify the appropriate in vitro methods suitable for quality and performance evaluation of ophthalmic ointment, and to study the effect of formulation and process variables on its critical quality attributes (CQA). The evaluated critical formulation variables include API initial size, drug percentage, and mineral oil percentage while the critical process parameters include mixing rate, temperature, time and cooling rate. The investigated quality and performance attributes include drug assay, content uniformity, API particle size in ointment, rheological characteristics, in vitro drug release and in vitro transcorneal drug permeation. Using design of experiments (DoE) as well as a novel principle component analysis approach, five of the quality and performance attributes (API particle size, storage modulus of ointment, high shear viscosity of ointment, in vitro drug release constant and in vitro transcorneal drug permeation rate constant) were found to be highly influenced by the formulation, in particular the strength of API, and to a lesser degree by processing variables. Correlating the ocular physiology with the physicochemical characteristics of acyclovir ophthalmic ointment suggested that in vitro quality metrics could be a valuable predictor of its in vivo performance. Published by Elsevier B.V.

The Relationship Between Ocular Itch, Ocular Pain, and Dry Eye Symptoms (An American Ophthalmological Society Thesis).

PubMed

Galor, Anat; Small, Leslie; Feuer, William; Levitt, Roy C; Sarantopoulos, Konstantinos D; Yosipovitch, Gil

2017-08-01

To evaluate associations between sensations of ocular itch and dry eye (DE) symptoms, including ocular pain, and DE signs. A cross-sectional study of 324 patients seen in the Miami Veterans Affairs eye clinic was performed. The evaluation consisted of questionnaires regarding ocular itch, DE symptoms, descriptors of neuropathic-like ocular pain (NOP), and evoked pain sensitivity testing on the forehead and forearm, followed by a comprehensive ocular surface examination including corneal mechanical sensitivity testing. Analyses were performed to examine for differences between those with and without subjective complaints of ocular itch. The mean age was 62 years with 92% being male. Symptoms of DE and NOP were more frequent in patients with moderate-severe ocular itch compared to those with no or mild ocular itch symptoms. With the exception of ocular surface inflammation (abnormal matrix metalloproteinase 9 testing) which was less common in those with moderate-severe ocular itch symptoms, DE signs were not related to ocular itch. Individuals with moderate-severe ocular itch also demonstrated greater sensitivity to evoked pain on the forearm and had higher non-ocular pain, depression, and post-traumatic stress disorders scores, compared to those with no or mild itch symptoms. Subjects with moderate-severe ocular itch symptoms have more severe symptoms of DE, NOP, non-ocular pain and demonstrate abnormal somatosensory testing in the form of increased sensitivity to evoked pain at a site remote from the eye, consistent with generalized hypersensitivity.

The Relationship Between Ocular Itch, Ocular Pain, and Dry Eye Symptoms (An American Ophthalmological Society Thesis)

PubMed Central

Galor, Anat; Small, Leslie; Feuer, William; Levitt, Roy C.; Sarantopoulos, Konstantinos D.; Yosipovitch, Gil

2017-01-01

Purpose To evaluate associations between sensations of ocular itch and dry eye (DE) symptoms, including ocular pain, and DE signs. Methods A cross-sectional study of 324 patients seen in the Miami Veterans Affairs eye clinic was performed. The evaluation consisted of questionnaires regarding ocular itch, DE symptoms, descriptors of neuropathic-like ocular pain (NOP), and evoked pain sensitivity testing on the forehead and forearm, followed by a comprehensive ocular surface examination including corneal mechanical sensitivity testing. Analyses were performed to examine for differences between those with and without subjective complaints of ocular itch. Results The mean age was 62 years with 92% being male. Symptoms of DE and NOP were more frequent in patients with moderate-severe ocular itch compared to those with no or mild ocular itch symptoms. With the exception of ocular surface inflammation (abnormal matrix metalloproteinase 9 testing) which was less common in those with moderate-severe ocular itch symptoms, DE signs were not related to ocular itch. Individuals with moderate-severe ocular itch also demonstrated greater sensitivity to evoked pain on the forearm and had higher non-ocular pain, depression, and post-traumatic stress disorders scores, compared to those with no or mild itch symptoms. Conclusions Subjects with moderate-severe ocular itch symptoms have more severe symptoms of DE, NOP, non-ocular pain and demonstrate abnormal somatosensory testing in the form of increased sensitivity to evoked pain at a site remote from the eye, consistent with generalized hypersensitivity. PMID:29391860

Corneal Deformation Response and Ocular Geometry: A Noninvasive Diagnostic Strategy in Marfan Syndrome.

PubMed

Beene, Lauren C; Traboulsi, Elias I; Seven, Ibrahim; Ford, Matthew R; Sinha Roy, Abhijit; Butler, Robert S; Dupps, William J

2016-01-01

To evaluate corneal air-puff deformation responses and ocular geometry as predictors of Marfan syndrome. Prospective observational clinical study. Sixteen investigator-derived, 4 standard Ocular Response Analyzer (ORA), and geometric variables from corneal tomography and optical biometry using Oculus Pentacam and IOL Master were assessed for discriminative value in Marfan syndrome, measuring right eyes of 24 control and 13 Marfan syndrome subjects. Area under the receiver operating characteristic (AUROC) curve was assessed in univariate and multivariate analyses. Six investigator-derived ORA variables successfully discriminated Marfan syndrome. The best lone disease predictor was Concavity Min (Marfan syndrome 47.5 ± 20, control 69 ± 14, P = .003; AUROC = 0.80). Corneal hysteresis (CH) and corneal resistance factor (CRF) were decreased (Marfan syndrome CH 9.45 ± 1.62, control CH 11.24 ± 1.21, P = .01; Marfan syndrome CRF 9.77 ± 1.65, control CRF 11.03 ± 1.72, P = .01) and corneas were flatter in Marfan syndrome (Marfan syndrome Kmean 41.25 ± 2.09 diopter, control Kmean 42.70 ± 1.81 diopter, P = .046). No significant differences were observed in central corneal thickness, axial eye length, or intraocular pressure. A multivariate regression model incorporating corneal curvature and hysteresis loop area (HLA) provided the best predictive value for Marfan syndrome (AUROC = 0.85). This study describes novel biodynamic features of corneal deformation responses in Marfan syndrome, including increased deformation, decreased bending resistance, and decreased energy dissipation capacity. A predictive model incorporating HLA and corneal curvature shows greatest potential for noninvasive clinical diagnosis of Marfan syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Corneal Deformation Response and Ocular Geometry: A Non-invasive Diagnostic Strategy in Marfan Syndrome

PubMed Central

Beene, Lauren C.; Traboulsi, Elias I.; Seven, Ibrahim; Ford, Matthew R.; Roy, Abhijit Sinha; Butler, Robert S.; Dupps, William J.

2015-01-01

Purpose To evaluate corneal air-puff deformation responses and ocular geometry as predictors of Marfan syndrome. Design Prospective observational clinical study Methods Sixteen investigator-derived, 4 standard Ocular Response Analyzer (ORA), and geometric variables from corneal tomography and optical biometry using Oculus Pentacam and IOL Master were assessed for discriminative value in Marfan syndrome, measuring right eyes of 24 control and 13 Marfan syndrome subjects. Area under the receiver operating characteristic (AUROC) curve was assessed in univariate and multivariate analyses Results Six investigator-derived ORA variables successfully discriminated Marfan syndrome. The best lone disease predictor was Concavity Min (Marfan syndrome 47.5 ± 20, control 69 ± 14, p = 0.003; AUROC = 0.80). Corneal hysteresis and corneal resistance factor were decreased (Marfan syndrome CH 9.45 ± 1.62, control CH 11.24 ± 1.21, p = 0.01; Marfan syndrome CRF 9.77 ± 1.65, control CRF 11.03 ± 1.72, p = 0.01) and corneas were flatter in Marfan syndrome (Marfan syndrome Kmean 41.25 ± 2.09 D, control Kmean 42.70 ± 1.81 D, p = 0.046). No significant differences were observed in central corneal thickness, axial eye length, or intraocular pressure. A multivariate regression model incorporating corneal curvature and hysteresis loop area (HLA) provided the best predictive value for Marfan syndrome (AUROC = 0.85). Conclusions This study describes novel biodynamic features of corneal deformation responses in Marfan syndrome, including increased deformation, decreased bending resistance, and decreased energy dissipation capacity. A predictive model incorporating HLA and corneal curvature shows greatest potential for non-invasive clinical diagnosis of Marfan syndrome. PMID:26432567

Longitudinal study of iris concavity, corneal biomechanics, and correlations to ocular biometry in a cohort of 10- to 12-year-old UK schoolboys: 2-year follow-up data.

PubMed

Shah, Ameet; Lascaratos, Gerassimos; Garway-Heath, David F; Foster, Paul J; Barton, Keith

2014-06-10

To explore changes in iris curvature over a 2-year period. To investigate associations between iris curvature and ocular biometric parameters. To explore relationships between a number of nonocular measurements and ocular biometric parameters. Schoolboys enrolled 2 years previously were invited to return for anterior segment optical coherence tomography, corneal hysteresis (CH), corneal resistance factor (CRF), and axial biometric measurements. Refractive error was assessed and measures of height, weight, waist circumference, digit ratio, and percentage body fat taken. Mean spherical equivalent refraction reduced by 0.76 diopters and mean iris concavity, defined as a measurement of less than or equal to -0.1 mm, increased by 0.018 mm at distance fixation and 0.04 mm on accommodation. Compared with 2 years previously, the prevalence of iris concavity increased from 24% to 32% on distance fixation and from 65% to 84% on accommodation. Variables significantly associated with nonaccommodating iris curvature were anterior chamber depth (ACD, P = 0.029) and mean scleral spur angle (P = 0.0001). Variables significantly associated with accommodating iris curvature were ACD (P = 0.02), lens vault (P = 0.047), and scleral spur angle (P < 0.0001). Significant association was again found between CH and accommodating spur-to-spur distance (R(2) = 0.13, P = 0.007). Iris concavity was more prevalent in this cohort of schoolboys than 2 years earlier. The degree of concavity remains related to ACD and lens vault. The association between spur-to-spur distance and CH was similar at baseline and after 2 years. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Isolation of the ocular surface to treat dysfunctional tear syndrome associated with computer use.

PubMed

Yee, Richard W; Sperling, Harry G; Kattek, Ashballa; Paukert, Martin T; Dawson, Kevin; Garcia, Marcie; Hilsenbeck, Susan

2007-10-01

Dysfunctional tear syndrome (DTS) associated with computer use is characterized by mild irritation, itching, redness, and intermittent tearing after extended staring. It frequently involves foreign body or sandy sensation, blurring of vision, and fatigue, worsening especially at the end of the day. We undertook a study to determine the effectiveness of periocular isolation using microenvironment glasses (MEGS) alone and in combination with artificial tears in alleviating the symptoms and signs of dry eye related to computer use. At the same time, we evaluated the relative ability of a battery of clinical tests for dry eye to distinguish dry eyes from normal eyes in heavy computer users. Forty adult subjects who used computers 3 hours or more per day were divided into dry eye sufferers and controls based on their scores on the Ocular Surface Disease Index (OSDI). Baseline scores were recorded and ocular surface assessments were made. On four subsequent visits, the subjects played a computer game for 30 minutes in a controlled environment, during which one of four treatment conditions were applied, in random order, to each subject: 1) no treatment, 2) artificial tears, 3) MEGS, and 4) artificial tears combined with MEGS. Immediately after each session, subjects were tested on: a subjective comfort questionnaire, tear breakup time (TBUT), fluorescein staining, lissamine green staining, and conjunctival injection. In this study, a significant correlation was found between cumulative lifetime computer use and ocular surface disorder, as measured by the standardized OSDI index. The experimental and control subjects were significantly different (P<0.05) in the meibomian gland assessment and TBUT; they were consistently different in fluorescein and lissamine green staining, but with P>0.05. Isolation of the ocular surface alone produced significant improvements in comfort scores and TBUT and a consistent trend of improvement in fluorescein staining and lissamine green staining. Isolation plus tears produced a significant improvement in lissamine green staining. The subjective comfort inventory and the TBUT test were most effective in distinguishing between the treatments used. Computer users with ocular surface complaints should have a detailed ocular surface examination and, if symptomatic, they can be effectively treated with isolation of the ocular surface, artificial tears therapy, and effective environmental manipulations.

Vestibular-Evoked Myogenic Potentials in Bilateral Vestibulopathy

PubMed Central

Rosengren, Sally M.; Welgampola, Miriam S.; Taylor, Rachael L.

2018-01-01

Bilateral vestibulopathy (BVP) is a chronic condition in which patients have a reduction or absence of vestibular function in both ears. BVP is characterized by bilateral reduction of horizontal canal responses; however, there is increasing evidence that otolith function can also be affected. Cervical and ocular vestibular-evoked myogenic potentials (cVEMPs/oVEMPs) are relatively new tests of otolith function that can be used to test the saccule and utricle of both ears independently. Studies to date show that cVEMPs and oVEMPs are often small or absent in BVP but are in the normal range in a significant proportion of patients. The variability in otolith function is partly due to the heterogeneous nature of BVP but is also due to false negative and positive responses that occur because of the large range of normal VEMP amplitudes. Due to their variability, VEMPs are not part of the diagnosis of BVP; however, they are helpful complementary tests that can provide information about the extent of disease within the labyrinth. This article is a review of the use of VEMPs in BVP, summarizing the available data on VEMP abnormalities in patients and discussing the limitations of VEMPs in diagnosing bilateral loss of otolith function. PMID:29719527

A novel COL11A1 missense mutation in siblings with non-ocular Stickler syndrome.

PubMed

Kohmoto, Tomohiro; Tsuji, Atsumi; Morita, Kei-Ichi; Naruto, Takuya; Masuda, Kiyoshi; Kashimada, Kenichi; Enomoto, Keisuke; Morio, Tomohiro; Harada, Hiroyuki; Imoto, Issei

2016-01-01

Stickler syndrome (STL) is an autosomal, dominantly inherited, clinically variable and genetically heterogeneous connective tissue disorder characterized by ocular, auditory, orofacial and skeletal abnormalities. We conducted targeted resequencing using a next-generation sequencer for molecular diagnosis of a 2-year-old girl who was clinically suspected of having STL with Pierre Robin sequence. We detected a novel heterozygous missense mutation, NM_001854.3:n.4838G>A [NM_001854.3 (COL11A1_v001):c.4520G>A], in COL11A1, resulting in a Gly to Asp substitution at position 1507 [NM_001854.3(COL11A1_i001)] within one of the collagen-like domains of the triple helical region. The same mutation was detected in her 4-year-old brother with cleft palate and high-frequency sensorineural hearing loss.

[Ocular and visual alterations in computer workers contact lens wearers: scoping review].

PubMed

Tauste Francés, Ana; Ronda-Pérez, Elena; Seguí Crespo, María del Mar

2014-01-01

The high number of computer workers wearing contact lenses raises the question whether the sum of these two risk factors for eye health may cause a worsening of Computer Vision Syndrome. The aim of this review is to synthesize the knowledge about ocular and visual alterations related with computer use in contact lens wearers. International review of scientific papers (2003-2013) in Spanish and English, using Scoping Review method, in Medline through PubMed and in Scopus. The initial search provided 114 references, after applying inclusion/exclusion criteria six of them were included. All of them reveal that symptoms when using computer are more prevalent in contact lens wearers, with values of symptoms presentation prevalence ranging from 95.0% to 16.9% in wearers and from 57.5% to 9.9% in non-wearers, and four times more likely to develop dry eye [OR: 4.07 (95% CI: 3.52 to 4.71)]. Computer workers suffer more ocular and visual disturbances if they also are contact lens users, but studies are few and non conclusive. Likewise, further research regarding contact lens type and their conditions of use, both in symptoms and tear quality and ocular surface are needed. Silicone hydrogel lenses are associated with more comfort.

Ocular Nerve Growth Factor (NGF) and NGF Eye Drop Application as Paradigms to Investigate NGF Neuroprotective and Reparative Actions.

PubMed

Tirassa, Paola; Rosso, Pamela; Iannitelli, Angela

2018-01-01

The eye is a central nervous system structure that is uniquely accessible to local treatment. Through the ocular surface, it is possible to access the retina, optic nerve, and brain. Animal models of retina degeneration or optic nerve crush could thus serve as tools to investigate whether and how factors, which are anterogradely or retrogradely transported through the optic nerve, might contribute to activate neuroprotection and eventually regeneration. Among these factors, nerve growth factor (NGF) plays a crucial role during development of the visual system, as well as during the entire life span, and in pathological conditions. The ability of NGF to exert survival and trophic actions on the retina and brain cells when applied intraocularly and topically as eye drops is critically reviewed here, together with the effects of ocular neurotrophins on neuronal pathways influencing body rhythm, cognitions, and behavioral functions. The latest data from animal models and humans are presented, and the mechanism of action of ocularly administered NGF is discussed. NGF eye drops are proposed as an experimental strategy to investigate the role and cellular targets of neurotrophins in the mechanism(s) underlying neurodegeneration/regeneration and their involvement in the regulation of neurological and behavioral dysfunctions.

Screening for childhood strabismus by primary care physicians.

PubMed Central

Weinstock, V. M.; Weinstock, D. J.; Kraft, S. P.

1998-01-01

OBJECTIVE: To review the clinical classification of strabismus, to describe the timing and method of strabismus screening examinations, and to discuss the principles of treatment. QUALITY OF EVIDENCE: Current literature (1983 to 1995) was searched via MEDLINE using the MeSH headings strabismus, ocular motility disorders, and amblyopia. Articles were selected based on their date of publication, clinical relevance, and availability. Preference was given to more recent articles, articles with large numbers of subjects, and well-designed cohort studies. Official recommendations from academic groups were analyzed. Descriptions of clinical tests and their illustrations are based on classic texts. MAIN FINDINGS: Primary care physicians should screen all low-risk children. High-risk children (low birth weight, family history of strabismus, congenital ocular abnormality, or systemic conditions with vision-threatening ocular manifestations) should be referred to an ophthalmologist for screening. Screening should be performed in the neonatal period, at 6 months, and at 3 years (Grade A recommendation), as well as at 5 to 6 years (Grade B recommendation). Screening examination includes inspection, examining visual acuity, determining pupillary reactions, checking ocular alignment, testing eye movements, and ophthalmoscopy. CONCLUSIONS: Primary care physicians are essential to early detection of strabismus and amblyopia. Early detection can help minimize visual dysfunction, allow for normal development of binocular vision and depth perception, and prevent psychosocial dysfunction. PMID:9512837

Ocular oxygen consumption: estimates using vitreoperfusion in the cat.

PubMed

Blair, Norman P; Liu, Ting; Warren, Keith A; Glaser, David A; Kennedy, Marc; Tran, Huan; Larson, Christopher A; Atluri, Prasant; Saidel, Michael A; Blair, Michael P

2004-02-01

Little is known about the ocular oxygen consumption rate (QO2) in human diseases. Alterations in QO2 must occur in many conditions, such as retinal ischemia. We present a method of estimating QO2 that eventually could be used in patients during vitrectomy surgery. We performed vitreoperfusion (i.e., perfusion of the vitreous cavity after vitrectomy) in 14 cat eyes with no ocular blood flow. The solution contained nutrients at a high partial pressure of oxygen (PO2). In eight eyes, the retinas were undisturbed (Group 1), and in six eyes, we excised the retinas (Group 2). We estimated QO2 in both groups on the basis of the temporal decline of PO2 in the vitreoperfusion solution according to a pharmacokinetic model. The mean and standard deviation of QO2 was 3.2 +/- 0.8 microL/min in Group 1 and 0.4+/- 0.7 microL/min in Group 2, with the difference being the retinal contribution, 88%. In Group 1, metabolism, bulk flow, and diffusion accounted for 82, 13, and 5%, respectively, of the oxygen loss from the vitreoperfusion solution. We estimated ocular oxygen consumption by means of vitreoperfusion. Eventually, the pathophysiology of human diseases may be clarified by similar measurements during vitrectomy.

Color Doppler imaging of retinal diseases.

PubMed

Dimitrova, Galina; Kato, Satoshi

2010-01-01

Color Doppler imaging (CDI) is a widely used method for evaluating ocular circulation that has been used in a number of studies on retinal diseases. CDI assesses blood velocity parameters by using ultrasound waves. In ophthalmology, these assessments are mainly performed on the retrobulbar blood vessels: the ophthalmic, the central retinal, and the short posterior ciliary arteries. In this review, we discuss CDI use for the assessment of retinal diseases classified into the following: vascular diseases, degenerations, dystrophies, and detachment. The retinal vascular diseases that have been investigated by CDI include diabetic retinopathy, retinal vein occlusions, retinal artery occlusions, ocular ischemic conditions, and retinopathy of prematurity. Degenerations and dystrophies included in this review are age-related macular degeneration, myopia, and retinitis pigmentosa. CDI has been used for the differential diagnosis of retinal detachment, as well as the evaluation of retrobulbar circulation in this condition. CDI is valuable for research and is a potentially useful diagnostic tool in the clinical setting.

Recurrent parotitis as a presentation of primary pediatric Sjögren syndrome.

PubMed

Baszis, Kevin; Toib, Dana; Cooper, Megan; French, Anthony; White, Andrew

2012-01-01

Parotitis is a common condition seen in the pediatric population, usually as an isolated occurrence associated with viral or bacterial infection. The differential diagnosis expands when recurrent parotitis is encountered. One etiology is primary pediatric Sjögren syndrome (SS), an autoimmune condition typically associated with dryness of the eyes and mouth in adults. Pediatric patients often present with isolated recurrent bilateral parotitis, however, and we describe 4 such cases in children aged 9 to 17 years at presentation. Despite lack of ocular complaints, 3 of these patients had ocular findings on ophthalmologic exam. Our patients also exhibited classic laboratory abnormalities, including positive antinuclear antibody, SS A, and SS B antibodies; presence of rheumatoid factor; and hypergammaglobulinemia. Consideration of SS in the child with recurrent parotitis is important for timely and appropriate referral and treatment. We review the differential diagnosis of parotitis in children as well as the salient features of pediatric SS.

Nevus of Ota (oculodermal melanocytosis) in a dog.

PubMed

Malho, Pedro; Shea, Anita; Donaldson, David

2018-05-01

A 5-year-old, female, spayed Rhodesian Ridgeback presented with ocular melanocytosis and skin hyperpigmentation involving the distribution of the first and second divisions of the trigeminal nerve on the right side of the face. The dermatomal pattern of the hyperpigmentation was similar to nevus of Ota or oculodermal melanocytosis reported in humans. This condition has been associated with increased risk of developing secondary glaucoma and melanoma transformation in skin, ocular, orbital tissues, and the central nervous system. The clinical investigation and description of oculodermal melanocytosis (nevus of Ota) are presented for the first time in the dog. © 2017 American College of Veterinary Ophthalmologists.

A Case of Ocular Toxocariasis Successfully Treated with Albendazole and Triamcinolon

PubMed Central

Seong, San; Moon, Daruchi; Lee, Dong Kyu; Kim, Hyung Eun; Oh, Hyun Sup; Kim, Soon Hyun; Kwon, Oh Woong

2014-01-01

We present a case of ocular toxocariasis treated successfully with oral albendazole in combination with steroids. A 26-year-old male visited the authors' clinic with the chief complaint of flying flies in his right eye. The fundus photograph showed a whitish epiretinal scar, and the fluorescein angiography revealed a hypofluorescein lesion of the scar and late leakage at the margin. An elevated retinal surface and posterior acoustic shadowing of the scar were observed in the optical coherence tomography, and Toxocara IgG was positive. The patient was diagnosed with toxocariasis, and the condition was treated with albendazole (400 mg twice a day) for a month and oral triamcinolone (16 mg for 2 weeks, once a day, and then 8 mg for 1 week, once a day) from day 13 of the albendazole treatment. The lesions decreased after the treatment. Based on this study, oral albendazole combined with steroids can be a simple and effective regimen for treating ocular toxocariasis. PMID:25352704

Corneal aberrations in keratoconic eyes: influence of pupil size and centering

NASA Astrophysics Data System (ADS)

Comastri, S. A.; Perez, L. I.; Pérez, G. D.; Martin, G.; Bianchetti, A.

2011-01-01

Ocular aberrations vary among subjects and under different conditions and are commonly analyzed expanding the wavefront aberration function in Zernike polynomials. In previous articles, explicit analytical formulas to transform Zernike coefficients of up to 7th order corresponding to an original pupil into those related to a contracted displaced new pupil are obtained. In the present paper these formulas are applied to 20 keratoconic corneas of varying severity. Employing the SN CT1000 topographer, aberrations of the anterior corneal surface for a pupil of semi-diameter 3 mm centered on the keratometric axis are evaluated, the relation between the higher-order root mean square wavefront error and the index KISA% characterizing keratoconus is studied and the size and centering of the ocular photopic natural pupil are determined. Using these data and the transformation formulas, new coefficients associated to the photopic pupil size are computed and their variation when coordinates origin is shifted from the keratometric axis to the ocular pupil centre is analyzed.

Dry Eye Syndrome in Menopause and Perimenopausal Age Group.

PubMed

Peck, Travis; Olsakovsky, Leslie; Aggarwal, Shruti

2017-01-01

Dry eye disease (DED) is a multifactorial ocular surface disease that causes symptoms of ocular pain, discomfort, and decreased visual acuity. It significantly affects quality of life of patients. It is more prevalent in the females and is being specifically in the menopausal and postmenopausal age group. This is believed to be due to the changes in balance of sex hormones. Sex hormones - estrogens and androgens - influence production of all components of the tear film including aqueous layer, lipid, and mucin. Various mechanisms such as decrease in hormonal levels, shift in feedback mechanisms, and changes in receptor receptivity interplay to alter the ocular surface homeostasis and subsequently result in DED. Several studies have suggested potential role of hormone replacement therapy in menopause-associated dry eye symptoms. The purpose of this review is to help the non ophthalmic physicians about DED encountered commonly in menopausal age group. It is important for primary care physicians to understand DED due to its high prevalence, often debilitating symptoms and the potentially preventable and treatable nature of the condition.

A case of ocular toxocariasis successfully treated with albendazole and triamcinolon.

PubMed

Seong, San; Moon, Daruchi; Lee, Dong Kyu; Kim, Hyung Eun; Oh, Hyun Sup; Kim, Soon Hyun; Kwon, Oh Woong; You, Yong Sung

2014-10-01

We present a case of ocular toxocariasis treated successfully with oral albendazole in combination with steroids. A 26-year-old male visited the authors' clinic with the chief complaint of flying flies in his right eye. The fundus photograph showed a whitish epiretinal scar, and the fluorescein angiography revealed a hypofluorescein lesion of the scar and late leakage at the margin. An elevated retinal surface and posterior acoustic shadowing of the scar were observed in the optical coherence tomography, and Toxocara IgG was positive. The patient was diagnosed with toxocariasis, and the condition was treated with albendazole (400 mg twice a day) for a month and oral triamcinolone (16 mg for 2 weeks, once a day, and then 8 mg for 1 week, once a day) from day 13 of the albendazole treatment. The lesions decreased after the treatment. Based on this study, oral albendazole combined with steroids can be a simple and effective regimen for treating ocular toxocariasis.

Bilateral ocular abnormalities in a wild stranded harp seal (Phoca groenlandica) suggestive of anterior segment dysgenesis and persistent hyperplastic primary vitreous.

PubMed

Erlacher-Reid, Claire; Colitz, Carmen M H; Abrams, Ken; Smith, Ainsley; Tuttle, Allison D

2011-06-01

A male yearling harp seal (Phoca groenlandica) stranded and was brought to Mystic Aquarium & Institute for Exploration's Seal Rescue and Rehabilitation Center. The seal presented with a bilateral pendular vertical nystagmus, negative menace response, and a positive palpebral response. Ophthalmological examination by slit lamp biomicroscopy revealed perilimbal corneal edema, excessive iridal surface structures, pupils that appeared to be shaped improperly (dyscoria), and suspected cataracts. Attempts to dilate the pupils with both dark-lighted conditions and repeated dosages of 10% phenylephrine and 1% atropine ophthalmic solution in each eye (OU) were unsuccessful. Ocular ultrasonography findings suggested bilateral cataracts with flattened anterior-posterior (A-P) diameter and possible persistent hyperplastic primary vitreous. It is possible that these structural congenital abnormalities could produce further ocular complications for this seal including uveitis, secondary glaucoma, retinal detachment, and/or vitreal hemorrhage in the future. This case demonstrates the importance of a thorough ophthalmological examination in stranded wild animals, especially if their symptoms appear neurological.

Estimating the Osmolarities of Tears During Evaporation Through the "Eyes" of the Corneal Nerves.

PubMed

Hirata, Harumitsu; Mizerska, Kamila; Dallacasagrande, Valentina; Rosenblatt, Mark I

2017-01-01

A population of corneal neurons in rats preferentially sense and monitor the hyperosmolar conditions of tears when the tears begin to evaporate during corneal dryness. The present study exploited this ability in an effort to estimate tear osmolarities by comparing the responses to corneal dryness to their responses to hyperosmolar stimuli. Extracellular recordings were performed from single neurons in the trigeminal ganglia innervating the corneas of rats. To determine the extent to which the corneal neurons' responses to drying of the cornea were induced via the activation by hyperosmolar stimuli, we assessed the responses to ocular instillation of 500 and 600 mOsm/L, and a graded series of hyperosmolar stimuli ranging from 350 to 1000 mOsm/L. The magnitudes of the responses to drying of the cornea were matched almost exactly to those induced by the ocular instillation of the 600 mOsm/L stimuli but not the 500 mOsm/L solutions. The response magnitudes to a graded series of hyperosmolar solutions were nearly linear from the 350 to the 600 mOsm/L stimuli, but reached a plateau or declined slightly thereafter. Our results demonstrate that the tear osmolarity in rats could reach 600 to 1000 mOsm/L during ocular dryness. Furthermore, a spontaneous eye blink could be generated at a tear osmolarity of approximately 400 mOsm/L if the blink is solely determined by hyperosmolar tears, but ocular surface cooling also can become a major factor if hyperosmolar tears occurring during ocular dryness lower the threshold of activation of the neurons.

A comparison of symptoms after viewing text on a computer screen and hardcopy.

PubMed

Chu, Christina; Rosenfield, Mark; Portello, Joan K; Benzoni, Jaclyn A; Collier, Juanita D

2011-01-01

Computer vision syndrome (CVS) is a complex of eye and vision problems experienced during or related to computer use. Ocular symptoms may include asthenopia, accommodative and vergence difficulties and dry eye. CVS occurs in up to 90% of computer workers, and given the almost universal use of these devices, it is important to identify whether these symptoms are specific to computer operation, or are simply a manifestation of performing a sustained near-vision task. This study compared ocular symptoms immediately following a sustained near task. 30 young, visually-normal subjects read text aloud either from a desktop computer screen or a printed hardcopy page at a viewing distance of 50 cm for a continuous 20 min period. Identical text was used in the two sessions, which was matched for size and contrast. Target viewing angle and luminance were similar for the two conditions. Immediately following completion of the reading task, subjects completed a written questionnaire asking about their level of ocular discomfort during the task. When comparing the computer and hardcopy conditions, significant differences in median symptom scores were reported with regard to blurred vision during the task (t = 147.0; p = 0.03) and the mean symptom score (t = 102.5; p = 0.04). In both cases, symptoms were higher during computer use. Symptoms following sustained computer use were significantly worse than those reported after hard copy fixation under similar viewing conditions. A better understanding of the physiology underlying CVS is critical to allow more accurate diagnosis and treatment. This will allow practitioners to optimize visual comfort and efficiency during computer operation.

Tear Film Osmolarity in Subjects with Acute Allergic Rhinoconjunctivitis.

PubMed

Nitoda, Eirini; Lavaris, Anastasios; Laios, Konstantinos; Androudi, Sophia; Kalogeropoulos, Chris D; Tsatsos, Michael; Damaskos, Christos; Garmpis, Nikolaos; Moschos, Marilita M

2018-01-01

Acute allergic rhinoconjuctivitis is the most common form of ocular allergies. The pathogenetic mechanisms are based on an immunoglobulin E (IgE)-mediated hypersensitivity reaction. On the other hand, tear osmolarity has been suggested to be an index of ocular surface damage and inflammation. These data were the motive to investigate the levels of tear osmolarity in subjects with acute allergic rhinoconjuctivitis, before and after administration of artificial tears. Forty-five subjects with acute allergic rhinoconjuctivitis were randomly divided into three groups, based on the type of artificial tears that they received: Group A (Thera tears), Group B (Wet therapy) and Group C (Tears Naturale free). The eye drops were administered six times a day for 60 days and all subjects underwent grading of subjective symptoms and clinical examination at baseline and at the end of the treatment. The diagnosis of severe eye disease, which was based on ocular surface disease index (OSDI; Allergan, Inc, Irvine, CA, USA) and tear osmolarity values, concerned all patients at baseline. Although the administration of artificial tears significantly ameliorated the symptoms and the ocular variables in all groups, the results were better in the first group. Tear osmolarity was strongly and negatively correlated with tear film breakup time (BUT) and Schirmer I test at 2 months. Contrariwise, symptoms were eliminated, when tear osmolarity was decreased. Acute allergic rhinoconjuctivitis is characterized by tear hyperosmolarity, which can be rehabilitated with the administration of hypotonic artificial tears. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Mutation of SALL2 causes recessive ocular coloboma in humans and mice

PubMed Central

Kelberman, Daniel; Islam, Lily; Lakowski, Jörn; Bacchelli, Chiara; Chanudet, Estelle; Lescai, Francesco; Patel, Aara; Stupka, Elia; Buck, Anja; Wolf, Stephan; Beales, Philip L.; Jacques, Thomas S.; Bitner-Glindzicz, Maria; Liasis, Alki; Lehmann, Ordan J.; Kohlhase, Jürgen; Nischal, Ken K.; Sowden, Jane C.

2014-01-01

Ocular coloboma is a congenital defect resulting from failure of normal closure of the optic fissure during embryonic eye development. This birth defect causes childhood blindness worldwide, yet the genetic etiology is poorly understood. Here, we identified a novel homozygous mutation in the SALL2 gene in members of a consanguineous family affected with non-syndromic ocular coloboma variably affecting the iris and retina. This mutation, c.85G>T, introduces a premature termination codon (p.Glu29*) predicted to truncate the SALL2 protein so that it lacks three clusters of zinc-finger motifs that are essential for DNA-binding activity. This discovery identifies SALL2 as the third member of the Drosophila homeotic Spalt-like family of developmental transcription factor genes implicated in human disease. SALL2 is expressed in the developing human retina at the time of, and subsequent to, optic fissure closure. Analysis of Sall2-deficient mouse embryos revealed delayed apposition of the optic fissure margins and the persistence of an anterior retinal coloboma phenotype after birth. Sall2-deficient embryos displayed correct posterior closure toward the optic nerve head, and upon contact of the fissure margins, dissolution of the basal lamina occurred and PAX2, known to be critical for this process, was expressed normally. Anterior closure was disrupted with the fissure margins failing to meet, or in some cases misaligning leading to a retinal lesion. These observations demonstrate, for the first time, a role for SALL2 in eye morphogenesis and that loss of function of the gene causes ocular coloboma in humans and mice. PMID:24412933

Retrospective analysis of refractive errors in children with vision impairment.

PubMed

Du, Jojo W; Schmid, Katrina L; Bevan, Jennifer D; Frater, Karen M; Ollett, Rhondelle; Hein, Bronwyn

2005-09-01

Emmetropization is the reduction in neonatal refractive errors that occurs after birth. Ocular disease may affect this process. We aimed to determine the relative frequency of ocular conditions causing vision impairment in the pediatric population and characterize the refractive anomalies present. We also compared the causes of vision impairment in children today to those between 1974 and 1981. Causes of vision impairment and refractive data of 872 children attending a pediatric low-vision clinic from 1985 to 2002 were retrospectively collated. As a result of associated impairments, refractive data were not available for 59 children. An analysis was made of the causes of vision impairment, the distribution of refractive errors in children with vision impairment, and the average type of refractive error for the most commonly seen conditions. We found that cortical or cerebral vision impairment (CVI) was the most common condition causing vision impairment, accounting for 27.6% of cases. This was followed by albinism (10.6%), retinopathy of prematurity (ROP; 7.0%), optic atrophy (6.2%), and optic nerve hypoplasia (5.3%). Vision impairment was associated with ametropia; fewer than 25% of the children had refractive errors < or = +/-1 D. The refractive error frequency plots (for 0 to 2-, 6 to 8-, and 12 to 14-year age bands) had a Gaussian distribution indicating that the emmetropization process was abnormal. The mean spherical equivalent refractive error of the children (n = 813) was +0.78 +/- 6.00 D with 0.94 +/- 1.24 D of astigmatism and 0.92 +/- 2.15 D of anisometropia. Most conditions causing vision impairment such as albinism were associated with low amounts of hyperopia. Moderate myopia was observed in children with ROP. The relative frequency of ocular conditions causing vision impairment in children has changed since the 1970s. Children with vision impairment often have an associated ametropia suggesting that the emmetropization system is also impaired.

Sustained attention performance during sleep deprivation associates with instability in behavior and physiologic measures at baseline.

PubMed

Chua, Eric Chern-Pin; Yeo, Sing-Chen; Lee, Ivan Tian-Guang; Tan, Luuan-Chin; Lau, Pauline; Cai, Shiwei; Zhang, Xiaodong; Puvanendran, Kathiravelu; Gooley, Joshua J

2014-01-01

To identify baseline behavioral and physiologic markers that associate with individual differences in sustained attention during sleep deprivation. In a retrospective study, ocular, electrocardiogram, and electroencephalogram (EEG) measures were compared in subjects who were characterized as resilient (n = 15) or vulnerable (n = 15) to the effects of total sleep deprivation on sustained attention. Chronobiology and Sleep Laboratory, Duke-NUS Graduate Medical School Singapore. Healthy volunteers aged 22-32 years from the general population. Subjects were kept awake for at least 26 hours under constant environmental conditions. Every 2 hours, sustained attention was assessed using a 10-minute psychomotor vigilance task (PVT). During baseline sleep and recovery sleep, EEG slow wave activity was similar in resilient versus vulnerable subjects, suggesting that individual differences in vulnerability to sleep loss were not related to differences in homeostatic sleep regulation. Rather, irrespective of time elapsed since wake, subjects who were vulnerable to sleep deprivation exhibited slower and more variable PVT response times, lower and more variable heart rate, and higher and more variable EEG spectral power in the theta frequency band (6.0-7.5 Hz). Performance decrements in sustained attention during sleep deprivation associate with instability in behavioral and physiologic measures at baseline. Small individual differences in sustained attention that are present at baseline are amplified during prolonged wakefulness, thus contributing to large between-subjects differences in performance and sleepiness.

Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine.

PubMed

Owsley, Cynthia; McGwin, Gerald; Lee, David J; Lam, Byron L; Friedman, David S; Gower, Emily W; Haller, Julia A; Hark, Lisa A; Saaddine, Jinan

2015-02-01

The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care. To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings. A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings. The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings. A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7% having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1% of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7% of the other ocular findings were cataract. In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.

In utero eyeball development study by magnetic resonance imaging.

PubMed

Brémond-Gignac, D S; Benali, K; Deplus, S; Cussenot, O; Ferkdadji, L; Elmaleh, M; Lassau, J P

1997-01-01

The aim of this study was to measure fetal ocular development and to determine a growth curve by means of measurements in utero. Fetal ocular development was recorded by analysis of the results of magnetic resonance imaging (MRI). An anatomic study allowed definition of the best contrasted MRI sequences for calculation of the ocular surface. Biometric analysis of the values of the ocular surface in the neuro-ocular plane in 35 fetuses allowed establishment of a linear model of ocular growth curve in utero. Evaluation of ocular development may allow the detection and confirmation of malformational ocular anomalies such as microphthalmia.

Absence of an increase in the duration of the circadian melatonin secretory episode in totally blind human subjects

NASA Technical Reports Server (NTRS)

Klerman, E. B.; Zeitzer, J. M.; Duffy, J. F.; Khalsa, S. B.; Czeisler, C. A.

2001-01-01

The daily rhythm of melatonin influences multiple physiological measures, including sleep tendency, circadian rhythms, and reproductive function in seasonally breeding mammals. The biological signal for photoperiodic changes in seasonally breeding mammals is a change in the duration of melatonin secretion, which in a natural environment reflects the different durations of daylight across the year, with longer nights leading to a longer duration of melatonin secretion. These seasonal changes in the duration of melatonin secretion do not simply reflect the known acute suppression of melatonin secretion by ocular light exposure, but also represent long-term changes in the endogenous nocturnal melatonin episode that persist in constant conditions. As the eyes of totally blind individuals do not transmit ocular light information, we hypothesized that the duration of the melatonin secretory episode in blind subjects would be longer than those in sighted individuals, who are exposed to light for all their waking hours in an urban environment. We assessed the melatonin secretory profile during constant posture, dim light conditions in 17 blind and 157 sighted adults, all of whom were healthy and using no prescription or nonprescription medications. The duration of melatonin secretion was not significantly different between blind and sighted individuals. Healthy blind individuals after years without ocular light exposure do not have a longer duration of melatonin secretion than healthy sighted individuals.

Mechanisms of phosphenes in irradiated patients

PubMed Central

Mathis, Thibaud; Vignot, Stephane; Leal, Cecila; Caujolle, Jean-Pierre; Maschi, Celia; Mauget-Faÿsse, Martine; Kodjikian, Laurent; Baillif, Stéphanie; Herault, Joel; Thariat, Juliette

2017-01-01

Anomalous visual perceptions have been reported in various diseases of the retina and visual pathways or can be experienced under specific conditions in healthy individuals. Phosphenes are perceptions of light in the absence of ambient light, occurring independently of the physiological and classical photonic stimulation of the retina. They are a frequent symptom in patients irradiated in the region of the central nervous system (CNS), head and neck and the eyes. Phosphenes have historically been attributed to complex physical phenomena such as Cherenkov radiation. While phosphenes are related to Cherenkov radiation under high energy photon/electron irradiation conditions, physical phenomena are unlikely to be responsible for light flashes at energies used for ocular proton therapy. Phosphenes may involve a direct role for ocular photoreceptors and possible interactions between cones and rods. Other mechanisms involving the retinal ganglion cells or ultraweak biophoton emission and rhodopsin bleaching after exposure to free radicals are also likely to be involved. Despite their frequency as shown in our preliminary observations, phosphenes have been underreported probably because their mechanism and impact are poorly understood. Recently, phosphenes have been used to restore the vision and whether they might predict vision loss after therapeutic irradiation is a current field of investigation. We have reviewed and also investigated here the mechanisms related to the occurrence of phosphenes in irradiated patients and especially in patients irradiated by proton therapy for ocular tumors. PMID:28969095

High Resolution Chest Computerized Tomography in the Diagnosis of Ocular Sarcoidosis in a High TB Endemic Population.

PubMed

Babu, Kalpana; Shukla, Sai Bhakti; Philips, Mariamma

2017-04-01

To review the role of high resolution chest computed tomography (HRCT) in ocular sarcoidosis in a high TB endemic population. This was a retrospective study. Out of 140 cases, 54 had ocular sarcoidosis, while 86 cases had ocular tuberculosis. Abnormal HRCT findings was noted in 52 cases (96.3%) of ocular sarcoidosis compared with 55 cases (64.7%) of ocular tuberculosis (p = 0.001). Mediastinal lymphadenopathy was the most common finding in both groups (p = 0.544). Hilar lymphadenopathy and fissural nodules were significantly seen in ocular sarcoidosis (p = 0.001). Necrosis was seen in three cases of ocular sarcoidosis. In nearly half of the cases, it was not possible to differentiate between sarcoidosis and tuberculosis on HRCT. HRCT is a useful diagnostic tool in ocular sarcoidosis. Bilateral hilar lymphadenopathy and fissural nodules are significant findings in ocular sarcoidosis. A confident diagnosis of ocular sarcoidosis is made by the amalgamation of results of clinical, radiologic, and other laboratory investigations.

Association between vestibulo-ocular reflex suppression, balance, gait, and fall risk in ageing and neurodegenerative disease: protocol of a one-year prospective follow-up study.

PubMed

Srulijes, Karin; Mack, David J; Klenk, Jochen; Schwickert, Lars; Ihlen, Espen A F; Schwenk, Michael; Lindemann, Ulrich; Meyer, Miriam; Srijana, K C; Hobert, Markus A; Brockmann, Kathrin; Wurster, Isabel; Pomper, Jörn K; Synofzik, Matthis; Schneider, Erich; Ilg, Uwe; Berg, Daniela; Maetzler, Walter; Becker, Clemens

2015-10-09

Falls frequency increases with age and particularly in neurogeriatric cohorts. The interplay between eye movements and locomotion may contribute substantially to the occurrence of falls, but is hardly investigated. This paper provides an overview of current approaches to simultaneously measure eye and body movements, particularly for analyzing the association of vestibulo-ocular reflex (VOR) suppression, postural deficits and falls in neurogeriatric risk cohorts. Moreover, VOR suppression is measured during head-fixed target presentation and during gaze shifting while postural control is challenged. Using these approaches, we aim at identifying quantitative parameters of eye-head-coordination during postural balance and gait, as indicators of fall risk. Patients with Progressive Supranuclear Palsy (PSP) or Parkinson's disease (PD), age- and sex-matched healthy older adults, and a cohort of young healthy adults will be recruited. Baseline assessment will include a detailed clinical assessment, covering medical history, neurological examination, disease specific clinical rating scales, falls-related self-efficacy, activities of daily living, neuro-psychological screening, assessment of mobility function and a questionnaire for retrospective falls. Moreover, participants will simultaneously perform eye and head movements (fixating a head-fixed target vs. shifting gaze to light emitting diodes in order to quantify vestibulo-ocular reflex suppression ability) under different conditions (sitting, standing, or walking). An eye/head tracker synchronized with a 3-D motion analysis system will be used to quantify parameters related to eye-head-coordination, postural balance, and gait. Established outcome parameters related to VOR suppression ability (e.g., gain, saccadic reaction time, frequency of saccades) and motor related fall risk (e.g., step-time variability, postural sway) will be calculated. Falls will be assessed prospectively over 12 months via protocols and monthly telephone interviews. This study protocol describes an experimental setup allowing the analysis of simultaneously assessed eye, head and body movements. Results will improve our understanding of the influence of the interplay between eye, head and body movements on falls in geriatric high-risk cohorts.

Deviations of the visual upright in three dimensions in disorders of the brainstem: a clinical exploration.

PubMed

Frisén, Lars

2010-12-01

Deviations of the subjective visual vertical in the roll or fronto-parallel plane occur commonly in disorders of the brainstem and have been extensively explored. In contrast, little is known about deviations in other directions. The present retrospective study focused on deviations in the pitch (sagittal) direction in 176 patients with a wide variety of disorders. The test task was to set a self-illuminated rod in the apparent upright position, in total darkness. Abnormal results (outside ± 4°) were recorded in 58% of the subjects. Negative (top backward) deviations were the most common, particularly with mass lesions in the pineal region, obstructive hydrocephalus, cerebellar lesions and crowding at the craniocervical junction. Positive and negative deviations were about equally common with focal intra-axial lesions. Negative deviations appeared related to dorsal locations of lesions and vice versa. Normal pressure hydrocephalus, Parkinson's disease and progressive supranuclear palsy were associated with smaller deviations, without a clear directional preponderance, and a larger individual variability. Most subjects lacked overt clinical corollaries. The most common ocular signs were aqueduct syndromes (n = 17) and ocular tilt reactions (n = 12), which were associated with deviations in 47 and 92% of instances, respectively. Subjective corollaries of deviation were never reported, not even by those subjects who showed a dramatic improvement upon resolution of the underlying condition. Deviations were also assessed in roll in a subgroup of 40 patients with focal lesions. Thirty subjects returned abnormal results: 13% in roll, 47% in pitch and 40% in pitch and roll. The direction of roll deviation appeared primarily related to laterality, with clockwise deviations with right-sided lesions and vice versa. All subjects with ocular tilt reactions had combined pitch and roll deviations, implying a common neural substrate. Correlation analyses, geometrical modelling and experimental self-observations indicated that deviations in pitch were attributable to cyclotorsional asymmetries between the eyes. The frequent co-existence of abnormal pitch and roll results implies that the true axis of deviation in focal brainstem disorders commonly falls outside traditional reference planes. The term 'visual upright in three dimensions' is suggested to identify unrestricted measurements, preserving the established term 'visual vertical' for measurements confined to the roll plane. Assessment of the visual upright in three dimensions provides a new, quantitative angle on brainstem disorders. The test appears useful for identifying a ubiquitous yet clinically silent feature of brainstem disease and also for monitoring the evolution of underlying conditions. More detailed explorations appear well motivated.

Injectable Absorbable Ocular Inserts for Controlled Drug Delivery

DTIC Science & Technology

1997-07-01

conjunctiva for prolonged delivery of drugs to the anterior region of the eye (Gwon & Meadows, 1992). The dosage system was an elliptically shaped unit...1979) have reviewed many other gel formers which are available for preparing pharmaceutical gels. A.3.4.1. Hydrogels -- Hydrogels are materials which...denoted as hydrogels (or aquagels). Hydrogels based on crosslinked polymeric chains of methoxy poly(ethylene glycol) monomethacrylate having variable

Increases in Ocular Syphilis-North Carolina, 2014-2015.

PubMed

Oliver, Sara E; Cope, Anna Barry; Rinsky, Jessica L; Williams, Charnetta; Liu, Gui; Hawks, Stephanie; Peterman, Thomas A; Markowitz, Lauri; Fleischauer, Aaron T; Samoff, Erika

2017-10-30

Ocular syphilis is an inflammatory eye disease due to Treponema pallidum infection. In the United States, syphilis rates have increased since 2000; clusters of ocular syphilis were reported in 2015. We investigated ocular syphilis in North Carolina to describe the epidemiology and clinical course of disease. We reviewed syphilis cases reported to North Carolina during 2014-2015 and abstracted information from health department interviews for cases with ocular symptoms and no other defined etiology. To assess duration and severity of ocular symptoms, we also reviewed medical records and conducted structured interviews. We compared the prevalence of ocular manifestations among reported syphilis cases by demographic and clinical characteristics. Among 4232 syphilis patients, 63 (1.5%) had ocular syphilis: 21 in 2014 and 42 in 2015, a 100% increase. Total syphilis cases increased 35% through 2015. No patient with ocular syphilis named another ocular syphilis patient as a sex partner. Patients presented in all syphilis stages; 24 (38%) were diagnosed in primary or secondary syphilis. Ocular manifestations were more prevalent among syphilis patients who were male, aged ≥40 years, white, and infected with human immunodeficiency virus. No risk behaviors were associated with ocular syphilis. Among 39 interviewed patients, 34 (87%) reported reduced vision during infection; 12 (31%) reported residual visual symptoms posttreatment. In North Carolina, ocular syphilis increased from 2014 to 2015 and may be due to increased recognition of ocular manifestations, or a true increase in ocular syphilis. Many ocular syphilis patients experienced vision loss; however, most improved posttreatment. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

A pilot study: the efficacy of virgin coconut oil as ocular rewetting agent on rabbit eyes.

PubMed

Mutalib, Haliza Abdul; Kaur, Sharanjeet; Ghazali, Ahmad Rohi; Chinn Hooi, Ng; Safie, Nor Hasanah

2015-01-01

Purpose. An open-label pilot study of virgin coconut oil (VCO) was conducted to determine the safety of the agent as ocular rewetting eye drops on rabbits. Methods. Efficacy of the VCO was assessed by measuring NIBUT, anterior eye assessment, corneal staining, pH, and Schirmer value before instillation and at 30 min, 60 min, and two weeks after instillation. Friedman test was used to analyse any changes in all the measurable variables over the period of time. Results. Only conjunctival redness with instillation of saline agent showed significant difference over the period of time (P < 0.05). However, further statistical analysis had shown no significant difference at 30 min, 60 min, and two weeks compared to initial measurement (P > 0.05). There were no changes in the NIBUT, limbal redness, palpebral conjunctiva redness, corneal staining, pH, and Schirmer value over the period of time for each agent (P > 0.05). Conclusion. VCO acts as safe rewetting eye drops as it has shown no significant difference in the measurable parameter compared to commercial brand eye drops and saline. These study data suggest that VCO is safe to be used as ocular rewetting agent on human being.

Genetic Syndromes Associated with Congenital Cardiac Defects and Ophthalmologic Changes - Systematization for Diagnosis in the Clinical Practice.

PubMed

Oliveira, Priscila H A; Souza, Beatriz S; Pacheco, Eimi N; Menegazzo, Michele S; Corrêa, Ivan S; Zen, Paulo R G; Rosa, Rafael F M; Cesa, Claudia C; Pellanda, Lucia C; Vilela, Manuel A P

2018-01-01

Numerous genetic syndromes associated with heart disease and ocular manifestations have been described. However, a compilation and a summarization of these syndromes for better consultation and comparison have not been performed yet. The objective of this work is to systematize available evidence in the literature on different syndromes that may cause congenital heart diseases associated with ocular changes, focusing on the types of anatomical and functional changes. A systematic search was performed on Medline electronic databases (PubMed, Embase, Cochrane, Lilacs) of articles published until January 2016. Eligibility criteria were case reports or review articles that evaluated the association of ophthalmic and cardiac abnormalities in genetic syndrome patients younger than 18 years. The most frequent genetic syndromes were: Down Syndrome, Velo-cardio-facial / DiGeorge Syndrome, Charge Syndrome and Noonan Syndrome. The most associated cardiac malformations with ocular findings were interatrial communication (77.4%), interventricular communication (51.6%), patent ductus arteriosus (35.4%), pulmonary artery stenosis (25.8%) and tetralogy of Fallot (22.5%). Due to their clinical variability, congenital cardiac malformations may progress asymptomatically to heart defects associated with high morbidity and mortality. For this reason, the identification of extra-cardiac characteristics that may somehow contribute to the diagnosis of the disease or reveal its severity is of great relevance.

[Ocular cicatricial pemphigoid - state of the art in clinic and therapy for a problematic disease].

PubMed

Rübsam, A; Klein, J P; Pleyer, U

2013-08-01

The ocular cicatricial pemphigoid (OCP) belongs to a family of chronically progressive autoimmune disorders, predominantly affecting mucous membranes (mucous membrane pemphigoids). It is an immunopathologically heterogeneous group of disorders with variable phenotypes that share the unique feature of a subepidermal blistering, through disruption of the adhesion between epidermis and dermis. A key feature is the chronically active inflammation with consecutive fibrosis, leading to a partial or complete loss of function of the affected organ. The ocular disease as a chronic cicatrising conjunctivitis is a common manifestation of the mucous membrane pemphigoid. The identification of the subtle pathology and the prompt initiation of an appropriate therapy are of pivotal importance. One purpose is to prevent further vision loss due to extensive corneal scarring and life-threatening systemic complications, such as the formation of oesophageal or tracheal strictures. So far there are no prospective, randomised studies, regarding the therapy guidelines with an evidence level more than III. The autoimmune nature of the disease implies that systemic immunosuppression is the only effective treatment option, most notably in extended stages. The aim of our study is to give a guideline for a stage adjusted therapy with conventional immunosuppressants and to give a perspective for alternative therapies, especially for recalcitrant disease. Georg Thieme Verlag KG Stuttgart · New York.

Effect of isoproterenol, phenylephrine, and sodium nitroprusside on fundus pulsations in healthy volunteers.

PubMed

Schmetterer, L; Wolzt, M; Salomon, A; Rheinberger, A; Unfried, C; Zanaschka, G; Fercher, A F

1996-03-01

Recently a laser interferometric method for topical measurement of fundus pulsations has been developed. Fundus pulsations in the macular region are caused by the inflow and outflow of blood into the choroid. The purpose of this work was to study the influence of a peripheral vasoconstricting (the alpha 1 adrenoceptor agonist phenylephrine), a predominantly positive inotropic (the non-specific beta adrenoceptor agonist isoproterenol), and a non-specific vasodilating (sodium nitroprusside) model drug on ocular fundus pulsations to determine reproducibility and sensitivity of the method. In a double masked randomised crossover study the drugs were administered in stepwise increasing doses to 10 male and nine female healthy volunteers. Systemic haemodynamic variables and fundus pulsations were measured at all infusion steps. Fundus pulsation increased during infusion of isoproterenol with statistical significance versus baseline at the lowest dose of 0.1 microgram/min. Neither peripheral vasoconstriction nor peripheral vasodilatation affected the ocular fundus pulsations. Measurements of fundus pulsations is a highly reproducible method in healthy subjects with low ametropy. Changes of local pulsatile ocular blood flow were detectable with our method following the infusion of isoproterenol. As systemic pharmacological vasodilatation or vasoconstriction did not change fundus pulsations, further experimental work has to be done to evaluate the sensitivity of the laser interferometric fundus pulsation measurement in various eye diseases.

A Pilot Study: The Efficacy of Virgin Coconut Oil as Ocular Rewetting Agent on Rabbit Eyes

PubMed Central

Mutalib, Haliza Abdul; Kaur, Sharanjeet; Ghazali, Ahmad Rohi; Chinn Hooi, Ng; Safie, Nor Hasanah

2015-01-01

Purpose. An open-label pilot study of virgin coconut oil (VCO) was conducted to determine the safety of the agent as ocular rewetting eye drops on rabbits. Methods. Efficacy of the VCO was assessed by measuring NIBUT, anterior eye assessment, corneal staining, pH, and Schirmer value before instillation and at 30 min, 60 min, and two weeks after instillation. Friedman test was used to analyse any changes in all the measurable variables over the period of time. Results. Only conjunctival redness with instillation of saline agent showed significant difference over the period of time (P < 0.05). However, further statistical analysis had shown no significant difference at 30 min, 60 min, and two weeks compared to initial measurement (P > 0.05). There were no changes in the NIBUT, limbal redness, palpebral conjunctiva redness, corneal staining, pH, and Schirmer value over the period of time for each agent (P > 0.05). Conclusion. VCO acts as safe rewetting eye drops as it has shown no significant difference in the measurable parameter compared to commercial brand eye drops and saline. These study data suggest that VCO is safe to be used as ocular rewetting agent on human being. PMID:25802534

Sexual dimorphism and allometry in the sphecophilous rove beetle Triacrus dilatus.

PubMed

Marlowe, Maxwell H; Murphy, Cheryl A; Chatzimanolis, Stylianos

2015-01-01

The rove beetle Triacrus dilatus is found in the Atlantic forest of South America and lives in the refuse piles of the paper wasp Agelaia vicina. Adults of T. dilatus are among the largest rove beetles, frequently measuring over 3 cm, and exhibit remarkable variation in body size. To examine sexual dimorphism and allometric relationships we measured the length of the left mandible, ocular distance and elytra. We were interested in determining if there are quantifiable differences between sexes, if there are major and minor forms within each sex and if males exhibit mandibular allometry. For all variables, a t-test was run to determine if there were significant differences between the sexes. Linear regressions were run to examine if there were significant relationships between the different measurements. A heterogeneity of slopes test was used to determine if there were significant differences between males and females. Our results indicated that males had significantly larger mandibles and ocular distances than females, but the overall body length was not significantly different between the sexes. Unlike most insects, both sexes showed positive linear allometric relationships for mandible length and head size (as measured by the ocular distance). We found no evidence of major and minor forms in either sex.

A new VCAN/versican splice acceptor site mutation in a French Wagner family associated with vascular and inflammatory ocular features

PubMed Central

Brézin, Antoine P.; Nedelec, Brigitte; Barjol, Amandine; Rothschild, Pierre-Raphael; Delpech, Marc

2011-01-01

Purpose To detail the highly variable ocular phenotypes of a French family affected with an autosomal dominantly inherited vitreoretinopathy and to identify the disease gene. Methods Sixteen family members with ten affected individuals underwent detailed ophthalmic evaluation. Genetic linkage analysis and gene screening were undertaken for genes known to be involved in degenerative and exudative vitreoretinopathies. Qualitative reverse transcriptase-PCR analysis of the versiscan (VCAN) transcripts was performed after mutation detection in the VCAN gene. Results The first index patient of this French family was referred to us because of a chronic uveitis since infancy; this uveitis was associated with exudative retinal detachment in the context of a severe uncharacterized familial vitreoretinopathy. Genetic linkage was obtained to the VCAN locus, and we further identified a new pathogenic mutation at the highly conserved splice acceptor site in intron 7 of the VCAN gene (c.4004–2A>T), which produced aberrantly spliced VCAN transcripts. Conclusions Extensive molecular investigation allowed us to classify this familial vitreoretinopathy as Wagner syndrome. This study illustrates the need to confirm clinical diagnosis by molecular genetic testing and adds new ocular phenotypes to the Wagner syndrome, such as vascular and inflammatory features. PMID:21738396

The isolated MUC5AC gene product from human ocular mucin displays intramolecular conformational heterogeneity.

PubMed

Round, Andrew N; McMaster, Terence J; Miles, Mervyn J; Corfield, Anthony P; Berry, Monica

2007-06-01

Atomic force microscopy (AFM) has been used to show that human ocular mucins contain at least three distinct polymer conformations, separable by isopycnic density gradient centrifugation. In this work we have used affinity purification against the anti(mucin peptide core) monoclonal antibody 45M1 to isolate MUC5AC gene products, a major component of human ocular mucins. AFM images confirm that the affinity-purified polymers adopt distinct conformations that coidentify with two of those observed in the parent population, and further reveal that these two different conformations can be present within the same polymer. AFM images of the complexes formed after incubation of 45M1 with the parent sample reveal different rates of binding to the two MUC5AC polymer types. The variability of gene products within a mucin population was revealed by analyzing the height distributions along the polymer contour and periodicities in distances between occupied antibody binding sites. AFM analysis of mucin polymers at the single molecule level provides new information about the genetic origins of individual polymers and the contributions of glycosylation to the physicochemical properties of mucins, which can be correlated with information obtained from biochemistry, antibody binding assays, and molecular biology techniques.

Mixture model-based clustering and logistic regression for automatic detection of microaneurysms in retinal images

NASA Astrophysics Data System (ADS)

Sánchez, Clara I.; Hornero, Roberto; Mayo, Agustín; García, María

2009-02-01

Diabetic Retinopathy is one of the leading causes of blindness and vision defects in developed countries. An early detection and diagnosis is crucial to avoid visual complication. Microaneurysms are the first ocular signs of the presence of this ocular disease. Their detection is of paramount importance for the development of a computer-aided diagnosis technique which permits a prompt diagnosis of the disease. However, the detection of microaneurysms in retinal images is a difficult task due to the wide variability that these images usually present in screening programs. We propose a statistical approach based on mixture model-based clustering and logistic regression which is robust to the changes in the appearance of retinal fundus images. The method is evaluated on the public database proposed by the Retinal Online Challenge in order to obtain an objective performance measure and to allow a comparative study with other proposed algorithms.

A novel COL11A1 missense mutation in siblings with non-ocular Stickler syndrome

PubMed Central

Kohmoto, Tomohiro; Tsuji, Atsumi; Morita, Kei-ichi; Naruto, Takuya; Masuda, Kiyoshi; Kashimada, Kenichi; Enomoto, Keisuke; Morio, Tomohiro; Harada, Hiroyuki; Imoto, Issei

2016-01-01

Stickler syndrome (STL) is an autosomal, dominantly inherited, clinically variable and genetically heterogeneous connective tissue disorder characterized by ocular, auditory, orofacial and skeletal abnormalities. We conducted targeted resequencing using a next-generation sequencer for molecular diagnosis of a 2-year-old girl who was clinically suspected of having STL with Pierre Robin sequence. We detected a novel heterozygous missense mutation, NM_001854.3:n.4838G>A [NM_001854.3 (COL11A1_v001):c.4520G>A], in COL11A1, resulting in a Gly to Asp substitution at position 1507 [NM_001854.3(COL11A1_i001)] within one of the collagen-like domains of the triple helical region. The same mutation was detected in her 4-year-old brother with cleft palate and high-frequency sensorineural hearing loss. PMID:27081569

In situ-forming hydrogels for sustained ophthalmic drug delivery.

PubMed

Nanjawade, Basavaraj K; Manvi, F V; Manjappa, A S

2007-09-26

Ophthalmic drug delivery is one of the most interesting and challenging endeavors facing the pharmaceutical scientist. The conventional ocular drug delivery systems like solutions, suspensions, and ointments show drawbacks such as increased precorneal elimination, high variability in efficiency, and blurred vision respectively. In situ-forming hydrogels are liquid upon instillation and undergo phase transition in the ocular cul-de-sac to form visco-elastic gel and this provides a response to environmental changes. In the past few years, an impressive number of novel temperature, pH, and ion induced in situ-forming systems have been reported for sustain ophthalmic drug delivery. Each system has its own advantages and drawbacks. The choice of a particular hydrogel depends on its intrinsic properties and envisaged therapeutic use. This review includes various temperature, pH, and ion induced in situ-forming polymeric systems used to achieve prolonged contact time of drugs with the cornea and increase their bioavailability.

Comparison of Ocular Outcomes in Two 14-Day Bed Rest Studies

NASA Technical Reports Server (NTRS)

Cromwell, R. L.; Zanello, S. B.; Yarbough, P. O.; Taibbi, G.; Vizzeri, G.

2011-01-01

Reports of astronauts visual changes raised concern about ocular health during long-duration spaceflight. Some of these findings included hyperopic shifts, choroidal folds, optic disc edema, retinal nerve fiber layer (RNFL) thickening, and cotton wool spots. While the etiology remains unknown, hypotheses speculate that hypertension in the brain caused by cephalad fluid shifts during spaceflight is a possible mechanism for these ocular changes. Head-down tilt (HDT) bed rest is a spaceflight analog that induces cephalad fluid shifts. In addition, previous studies of the HDT position demonstrated body fluid shifts associated with changes in intraocular pressure (IOP). For these reasons, vision monitoring of HDT bed rest subjects was implemented for NASA bed rest studies. Subjects selected for these studies were healthy adults (14 males and 5 females). Average age was 37.5 plus or minus 9.1 years, weight was 77.4 plus or minus 11.3 Kg, and height was 173.4 plus or minus 7.2 14 cm. Controlled conditions followed for all NASA bed rest studies were implemented. These conditions included factors such as eating a standardized diet, maintaining a strict sleep wake cycle, and remaining in bed for 24 hours each day. In one study, subjects maintained a horizontal (0 degree) position while in bed and were exercised six days per week with an integrated resistance and aerobic training (iRAT) program. In the other study, subjects were placed at 6 degrees HDT while in bed and did not engage in exercise. All subjects underwent pre- and post bed rest vision testing. While the battery of vision tests for each study was not identical, measures common to both studies will be presented. These measures included IOP and measures that provided an indication of optic disc swelling as derived from optical coherence tomography (OCT) testing: average retinal nerve fiber layer (RNFL) thickness (millimeters), disc area (square millimeters), rim area (square millimters), and average cup to disc (C/D) ratio. For all measures, there was no significant difference between subject groups for pre-bed rest testing. Post bed rest values also remained similar between groups. Comparison of pre- to post bed rest testing within each group did not demonstrate any statistical differences. These preliminary results from 14-day bed rest studies suggest that the combination of exercise and horizontal bed rest as compared to 6 degrees HDT bed rest did not produce differences in the ocular response with regard to IOP and optic disc parameters. The ocular measures reported here only included pre- and post bed rest time points. Further investigation is needed to examine both the acute response and long term adaptation of structural and functional ocular parameters in the bed rest platform and determine its usefulness for studying spaceflight phenomena. From a clinical perspective, the ability to study ocular responses in the controlled environment of the bed rest platform can provide valuable information for the care of patients restricted to bed rest.

The repeatability of mean defect with size III and size V standard automated perimetry.

PubMed

Wall, Michael; Doyle, Carrie K; Zamba, K D; Artes, Paul; Johnson, Chris A

2013-02-15

The mean defect (MD) of the visual field is a global statistical index used to monitor overall visual field change over time. Our goal was to investigate the relationship of MD and its variability for two clinically used strategies (Swedish Interactive Threshold Algorithm [SITA] standard size III and full threshold size V) in glaucoma patients and controls. We tested one eye, at random, for 46 glaucoma patients and 28 ocularly healthy subjects with Humphrey program 24-2 SITA standard for size III and full threshold for size V each five times over a 5-week period. The standard deviation of MD was regressed against the MD for the five repeated tests, and quantile regression was used to show the relationship of variability and MD. A Wilcoxon test was used to compare the standard deviations of the two testing methods following quantile regression. Both types of regression analysis showed increasing variability with increasing visual field damage. Quantile regression showed modestly smaller MD confidence limits. There was a 15% decrease in SD with size V in glaucoma patients (P = 0.10) and a 12% decrease in ocularly healthy subjects (P = 0.08). The repeatability of size V MD appears to be slightly better than size III SITA testing. When using MD to determine visual field progression, a change of 1.5 to 4 decibels (dB) is needed to be outside the normal 95% confidence limits, depending on the size of the stimulus and the amount of visual field damage.

Contact lens fitting in a patient with Alport syndrome and posterior polymorphous corneal dystrophy: a case report.

PubMed

Rosa, Juliana Maria da Silva; Andrade Sobrinho, Marcelo Vicente de; Lipener, César

2016-02-01

Alport Syndrome is a hereditary disease that is caused by a gene mutation and affects the production of collagen in basement membranes; this condition causes hemorrhagic nephritis associated with deafness and ocular changes. The X-linked form of this disease is the most common and mainly affects males. Typical ocular findings are dot-and-fleck retinopathy, anterior lenticonus, and posterior polymorphous corneal dystrophy. Some cases involving polymorphous corneal dystrophy and corneal ectasia have been previously described. Here we present a case report of a 33-year-old female with Alport syndrome, posterior polymorphous corneal dystrophy, and irregular astigmatism, whose visual acuity improved with a rigid gas permeable contact lens.

Liquid Crystalline Nanoparticles as an Ophthalmic Delivery System for Tetrandrine: Development, Characterization, and In Vitro and In Vivo Evaluation

NASA Astrophysics Data System (ADS)

Liu, Rui; Wang, Shuangshuang; Fang, Shiming; Wang, Jialu; Chen, Jingjing; Huang, Xingguo; He, Xin; Liu, Changxiao

2016-05-01

The purpose of this study was to develop novel liquid crystalline nanoparticles (LCNPs) that display improved pre-ocular residence time and ocular bioavailability and that can be used as an ophthalmic delivery system for tetrandrine (TET). The delivery system consisted of three primary components, including glyceryl monoolein, poloxamer 407, and water, and two secondary components, including Gelucire 44/14 and amphipathic octadecyl-quaternized carboxymethyl chitosan. The amount of TET, the amount of glyceryl monoolein, and the ratio of poloxamer 407 to glyceryl monoolein were selected as the factors that were used to optimize the dependent variables, which included encapsulation efficiency and drug loading. A three-factor, five-level central composite design was constructed to optimize the formulation. TET-loaded LCNPs (TET-LCNPs) were characterized to determine their particle size, zeta potential, entrapment efficiency, drug loading capacity, particle morphology, inner crystalline structure, and in vitro drug release profile. Corneal permeation in excised rabbit corneas was evaluated. Pre-ocular retention was determined using a noninvasive fluorescence imaging system. Finally, pharmacokinetic study in the aqueous humor was performed by microdialysis technique. The optimal formulation had a mean particle size of 170.0 ± 13.34 nm, a homogeneous distribution with polydispersity index of 0.166 ± 0.02, a positive surface charge with a zeta potential of 29.3 ± 1.25 mV, a high entrapment efficiency of 95.46 ± 4.13 %, and a drug loading rate of 1.63 ± 0.07 %. Transmission electron microscopy showed spherical particles that had smooth surfaces. Small-angle X-ray scattering profiles revealed an inverted hexagonal phase. The in vitro release assays showed a sustained drug release profile. A corneal permeation study showed that the apparent permeability coefficient of the optimal formulation was 2.03-fold higher than that of the TET solution. Pre-ocular retention capacity study indicated that the retention of LCNPs was significantly longer than that of the solution ( p < 0.01). In addition, a pharmacokinetic study of rabbit aqueous humors demonstrated that the TET-LCNPs showed 2.65-fold higher ocular bioavailability than that of TET solution. In conclusion, a LCNP system could be a promising method for increasing the ocular bioavailability of TET by enhancing its retention time and permeation into the cornea.

α-Melanocyte-stimulating hormone ameliorates ocular surface dysfunctions and lesions in a scopolamine-induced dry eye model via PKA-CREB and MEK-Erk pathways.

PubMed

Ru, Yusha; Huang, Yue; Liu, Huijuan; Du, Juan; Meng, Zhu; Dou, Zexia; Liu, Xun; Wei, Rui Hua; Zhang, Yan; Zhao, Shaozhen

2015-12-21

Dry eye is a highly prevalent, chronic, and multifactorial disease that compromises quality of life and generates socioeconomic burdens. The pathogenic factors of dry eye disease (DED) include tear secretion abnormalities, tear film instability, and ocular surface inflammation. An effective intervention targeting the pathogenic factors is needed to control this disease. Here we applied α-Melanocyte-stimulating hormone (α-MSH) twice a day to the ocular surface of a scopolamine-induced dry eye rat model. The results showed that α-MSH at different doses ameliorated tear secretion, tear film stability, and corneal integrity, and corrected overexpression of proinflammatory factors, TNF-α, IL-1β, and IFN-γ, in ocular surface of the dry eye rats. Moreover, α-MSH, at 10(-4) μg/μl, maintained corneal morphology, inhibited apoptosis, and restored the number and size of conjunctival goblet cells in the dry eye rats. Mechanistically, α-MSH activated both PKA-CREB and MEK-Erk pathways in the dry eye corneas and conjunctivas; pharmacological blockade of either pathway abolished α-MSH's protective effects, suggesting that both pathways are necessary for α-MSH's protection under dry eye condition. The peliotropic protective functions and explicit signaling mechanism of α-MSH warrant translation of the α-MSH-containing eye drop into a novel and effective intervention to DED.

Ocular Fundus Photography as a Tool to Study Stroke and Dementia.

PubMed

Cheung, Carol Y; Chen, Christopher; Wong, Tien Y

2015-10-01

Although cerebral small vessel disease has been linked to stroke and dementia, due to limitations of current neuroimaging technology, direct in vivo visualization of changes in the cerebral small vessels (e.g., cerebral arteriolar narrowing, tortuous microvessels, blood-brain barrier damage, capillary microaneurysms) is difficult to achieve. As the retina and the brain share similar embryological origin, anatomical features, and physiologic properties with the cerebral small vessels, the retinal vessels offer a unique and easily accessible "window" to study the correlates and consequences of cerebral small vessel diseases in vivo. The retinal microvasculature can be visualized, quantified and monitored noninvasively using ocular fundus photography. Recent clinic- and population-based studies have demonstrated a close link between retinal vascular changes seen on fundus photography and stroke and dementia, suggesting that ocular fundus photography may provide insights to the contribution of microvascular disease to stroke and dementia. In this review, we summarize current knowledge on retinal vascular changes, such as retinopathy and changes in retinal vascular measures with stroke and dementia as well as subclinical makers of cerebral small vessel disease, and discuss the possible clinical implications of these findings in neurology. Studying pathologic changes of retinal blood vessels may be useful for understanding the etiology of various cerebrovascular conditions; hence, ocular fundus photography can be potentially translated into clinical practice. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

α-Melanocyte-stimulating hormone ameliorates ocular surface dysfunctions and lesions in a scopolamine-induced dry eye model via PKA-CREB and MEK-Erk pathways

PubMed Central

Ru, Yusha; Huang, Yue; Liu, Huijuan; Du, Juan; Meng, Zhu; Dou, Zexia; Liu, Xun; Wei, Rui Hua; Zhang, Yan; Zhao, Shaozhen

2015-01-01

Dry eye is a highly prevalent, chronic, and multifactorial disease that compromises quality of life and generates socioeconomic burdens. The pathogenic factors of dry eye disease (DED) include tear secretion abnormalities, tear film instability, and ocular surface inflammation. An effective intervention targeting the pathogenic factors is needed to control this disease. Here we applied α-Melanocyte-stimulating hormone (α-MSH) twice a day to the ocular surface of a scopolamine-induced dry eye rat model. The results showed that α-MSH at different doses ameliorated tear secretion, tear film stability, and corneal integrity, and corrected overexpression of proinflammatory factors, TNF-α, IL-1β, and IFN-γ, in ocular surface of the dry eye rats. Moreover, α-MSH, at 10−4 μg/μl, maintained corneal morphology, inhibited apoptosis, and restored the number and size of conjunctival goblet cells in the dry eye rats. Mechanistically, α-MSH activated both PKA-CREB and MEK-Erk pathways in the dry eye corneas and conjunctivas; pharmacological blockade of either pathway abolished α-MSH’s protective effects, suggesting that both pathways are necessary for α-MSH’s protection under dry eye condition. The peliotropic protective functions and explicit signaling mechanism of α-MSH warrant translation of the α-MSH-containing eye drop into a novel and effective intervention to DED. PMID:26685899

PRGF exerts more potent proliferative and anti-inflammatory effects than autologous serum on a cell culture inflammatory model.

PubMed

Anitua, E; Muruzabal, F; de la Fuente, M; Riestra, A; Merayo-Lloves, J; Orive, G

2016-10-01

Ocular graft versus host disease (oGVHD) is part of a systemic inflammatory disease that usually affects ocular surface tissues manifesting as a dry eye syndrome. Current treatments provide unsatisfactory results. Blood-derived products, like plasma rich in growth factors (PRGF) emerge as a potential therapy for this disease. The purpose of this study was to evaluate the tissue regeneration and anti-inflammatory capability of PRGF, an autologous platelet enriched plasma eye-drop, compared to autologous serum (AS) obtained from oGVHD patients on ocular surface cells cultured in a pro-inflammatory environment. PRGF and AS were obtained from four GVHD patients. Cell proliferation and inflammation markers, intercellular adhesion molecule-1 (ICAM-1) and cyclooxygenase-2 (COX-2), were measured in corneal and conjunctival fibroblastic cells cultured under pro-inflammatory conditions and after treatment with PRGF or AS eye drops. Moreover, cell proliferation increased after treatment with PRGF and AS, though this enhancement in the case of keratocytes was significantly higher with PRGF. PRGF eye drops showed a significant reduction of both inflammatory markers with respect to the initial inflammatory situation and to the AS treatment. Our results concluded that PRGF exerts more potent regenerative and anti-inflammatory effects than autologous serum on ocular surface fibroblasts treated with pro-inflammatory IL-1β and TNFα. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of Structural and Functional Ocular Outcomes Between 14- and 70 Day Bed Rest

NASA Technical Reports Server (NTRS)

Cromwell, R. L.; Taibbi, G.; Zanello, S. B.; Yarbough, P. O.; Ploutz-Snyder, R. J.; Vizzeri, G.

2016-01-01

Purpose: To compare structural and functional ocular outcomes in healthy human subjects undergoing 14- and/or 70-day head-down-tilt bed rest (HDTBR). We hypothesized the amount of HDTBR-induced ocular changes be affected by the HDTBR duration. Methods: The studies were conducted at the NASA Flight Analogs Research Unit, The University of Texas Medical Branch at Galveston, Galveston, TX. Participants were selected using NASA standard screening procedures. Standardized NASA screening procedures and bed rest conditions (e.g., strict sleep-wake cycle, standardized diet, continuous video monitoring) were implemented in both studies. Participants maintained a 6deg HDTBR position for 14 and/or 70 consecutive days and did not engage in exercise. Weekly ophthalmological examinations were conducted in the sitting (pre/post-bed rest only) and HDT positions. Ocular outcomes of interest included: near best-corrected visual acuity (BCVA); spherical equivalent, as determined by cycloplegic autorefraction; Goldmann applanation tonometry and iCare (Icare Finland Oy, Espoo, Finland) intraocular pressure (IOP) measurement; color vision; red dot test; modified Amsler grid test; confrontational visual field; stereoscopic color fundus photography; Spectralis OCT (Heidelberg Engineering, GmbH, Heidelberg, Germany) retinal nerve fiber layer thickness (RNFLT), peripapillary and macular retinal thicknesses. Mixed-effects linear models were used to compare pre- and post-HDTBR observations between 14- and 70-day HDTBR for our continuously scaled outcomes.

Fast circulation of cerebrospinal fluid: an alternative perspective on the protective role of high intracranial pressure in ocular hypertension.

PubMed

Wostyn, Peter; De Groot, Veva; Van Dam, Debby; Audenaert, Kurt; Killer, Hanspeter Esriel; De Deyn, Peter Paul

2016-05-01

As ocular hypertension refers to a condition in which the intraocular pressure is consistently elevated but without development of glaucoma, study of it may provide important clues to factors that may play a protective role in glaucoma. β-amyloid, one of the key histopathological findings in Alzheimer's disease, has been reported to increase by chronic elevation of intraocular pressure in animals with experimentally induced ocular hypertension and to cause retinal ganglion cell death, pointing to similarities in molecular cell death mechanisms between glaucoma and Alzheimer's disease. On the other hand, recent studies have reported that intracranial pressure is higher in patients with ocular hypertension compared with controls, giving rise to the idea that elevated intracranial pressure may provide a protective effect for the optic nerve by decreasing the trans-lamina cribrosa pressure difference. The speculation that the higher intracranial pressure reported in ocular hypertension patients may protect against glaucoma mainly through a lower trans-lamina cribrosa pressure difference remains at least questionable. Here, we present an alternative viewpoint, according to which the protective effect of higher intracranial pressure could be due, at least in part, to a pressure-independent mechanism, namely faster cerebrospinal fluid production leading to increased cerebrospinal fluid turnover with enhanced removal of potentially neurotoxic waste products that accumulate in the optic nerve. This suggests a new hypothesis for glaucoma, which, just like Alzheimer's disease, may be considered then as an imbalance between production and clearance of neurotoxins, including β-amyloid. If confirmed, then strategies to improve cerebrospinal fluid flow are reasonable and could provide a new therapeutic approach for stopping the neurotoxic β-amyloid pathway in glaucoma. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

Postural and Spatial Orientation Driven by Virtual Reality

PubMed Central

Keshner, Emily A.; Kenyon, Robert V.

2009-01-01

Orientation in space is a perceptual variable intimately related to postural orientation that relies on visual and vestibular signals to correctly identify our position relative to vertical. We have combined a virtual environment with motion of a posture platform to produce visual-vestibular conditions that allow us to explore how motion of the visual environment may affect perception of vertical and, consequently, affect postural stabilizing responses. In order to involve a higher level perceptual process, we needed to create a visual environment that was immersive. We did this by developing visual scenes that possess contextual information using color, texture, and 3-dimensional structures. Update latency of the visual scene was close to physiological latencies of the vestibulo-ocular reflex. Using this system we found that even when healthy young adults stand and walk on a stable support surface, they are unable to ignore wide field of view visual motion and they adapt their postural orientation to the parameters of the visual motion. Balance training within our environment elicited measurable rehabilitation outcomes. Thus we believe that virtual environments can serve as a clinical tool for evaluation and training of movement in situations that closely reflect conditions found in the physical world. PMID:19592796

Custom-made ocular prosthesis.

PubMed

Gunaseelaraj, Rajkumar; Karthikeyan, Suma; Kumar, Mohan N; Balamurugan, T; Jagadeeshwaran, A R

2012-08-01

An ocular defect may affect a patient psychologically. An ocular prosthesis is given to uplift the patient psychologically and improve the confidence. Ocular prosthesis can be custom made or a stock shell. To improve the comfort and matching of the prosthesis with that of the adjacent natural eye an custom made ocular prosthesis is preferred. Different techniques are available to fabricate a custom ocular prosthesis, here we have used paper iris disk technique.

Retinoblastoma Vitreous Seed Clouds (Class 3): A Comparison of Treatment with Ophthalmic Artery Chemosurgery with or without Intravitreous and Periocular Chemotherapy.

PubMed

Francis, Jasmine H; Iyer, Saipriya; Gobin, Y Pierre; Brodie, Scott E; Abramson, David H

2017-10-01

To compare the efficacy and toxicity of treating class 3 retinoblastoma vitreous seeds with ophthalmic artery chemosurgery (OAC) alone versus OAC with intravitreous chemotherapy. Retrospective cohort study. Forty eyes containing clouds (class 3 vitreous seeds) of 40 retinoblastoma patients (19 treated with OAC alone and 21 treated with OAC plus intravitreous and periocular chemotherapy). Ocular survival, disease-free survival and time to regression of seeds were estimated with Kaplan-Meier estimates. Ocular toxicity was evaluated by clinical findings and electroretinography: 30-Hz flicker responses were compared at baseline and last follow-up visit. Continuous variables were compared with Student t test, and categorical variables were compared with the Fisher exact test. Ocular survival, disease-free survival, and time to regression of seeds. There were no disease- or treatment-related deaths and no patient demonstrated externalization of tumor or metastatic disease. There was no significant difference in the age, laterality, disease, or disease status (treatment naïve vs. previously treated) between the 2 groups. The time to regression of seeds was significantly shorter for eyes treated with OAC plus intravitreous chemotherapy (5.7 months) compared with eyes treated with OAC alone (14.6 months; P < 0.001). The 18-month Kaplan-Meier estimates of disease-free survival were significantly worse for the OAC alone group: 67.1% (95% confidence interval, 40.9%-83.6%) versus 94.1% (95% confidence interval, 65%-99.1%) for the OAC plus intravitreous chemotherapy group (P = 0.05). The 36-month Kaplan-Meier estimates of ocular survival were 83.3% (95% confidence interval, 56.7%-94.3%) for the OAC alone group and 100% for the OAC plus intravitreous chemotherapy group (P = 0.16). The mean change in electroretinography responses was not significantly different between groups, decreasing by 11 μV for the OAC alone group and 22 μV for the OAC plus intravitreous chemotherapy group (P = 0.4). Treating vitreous seed clouds with OAC and intravitreous and periocular chemotherapy, compared with OAC alone, resulted in a shorter time to regression and was associated with fewer recurrences requiring additional treatment and fewer enucleations. The toxicity to the retina does not seem to be significantly worse in the OAC plus intravitreous chemotherapy group. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Choroidal retinoic acid synthesis: a possible mediator between refractive error and compensatory eye growth.

PubMed

Mertz, J R; Wallman, J

2000-04-01

Research over the past two decades has shown that the growth of young eyes is guided by vision. If near- or far-sightedness is artificially imposed by spectacle lenses, eyes of primates and chicks compensate by changing their rate of elongation, thereby growing back to the pre-lens optical condition. Little is known about what chemical signals might mediate between visual effects on the retina and alterations of eye growth. We present five findings that point to choroidal retinoic acid possibly being such a mediator. First, the chick choroid can convert retinol into all-trans-retinoic acid at the rate of 11 +/- 3 pmoles mg protein(-1) hr(-1), compared to 1.3 +/- 0.3 for retina/RPE and no conversion for sclera. Second, those visual conditions that cause increased rates of ocular elongation (diffusers or negative lens wear) produce a sharp decrease in all-trans-retinoic acid synthesis to levels barely detectable with our assay. In contrast, visual conditions which result in decreased rates of ocular elongation (recovery from diffusers or positive lens wear) produce a four- to five-fold increase in the formation of all-trans-retinoic acid. Third, the choroidal retinoic acid is found bound to a 28-32 kD protein. Fourth, a large fraction of the choroidal retinoic acid synthesized in culture is found in a nucleus-enriched fraction of sclera. Finally, application of retinoic acid to cultured sclera at physiological concentrations produced an inhibition of proteoglycan production (as assessed by measuring sulfate incorporation) with a EC50 of 8 x 10(-7) M. These results show that the synthesis of choroidal retinoic acid is modulated by those visual manipulations that influence ocular elongation and that this retinoic acid may reach the sclera in concentrations adequate to modulate scleral proteoglycan formation.

An impression cytology based study of ocular surface in an urban population.

PubMed

Mukhopadhyay, Somnath; Dutta, Jayanta; Mitra, Jayati; Prakash, Ratnesh; Datta, Himadri

2013-04-01

To assess the health of ocular surface in a defined urban population, conjunctival goblet cell density and degree of surface squamous metaplasia were utilized as study tools. Two thousand names of those aged between 20 and 79 years from the 2006 electoral register in ward number 63 of Kolkata Corporation area were initially selected. Normal healthy human volunteers without any history of ocular surface disorder were recruited and divided into five age-groups. Impression cytology samples were obtained from interpalpebral part of bulbar conjunctiva from all the participants fixated and stained by a single observer. A stratified, clustered, disproportionate, random sampling method was used. The software used in the statistical analysis was EPI Info. The tests applied were t test and ANOVA. A variation in the number of goblet cells according to gender (women having less cells) and age (20-30 years group having the highest number of cells) was found. Those working outdoors were found to have fewer goblet cells compared to those who stay indoors. The majority of the people had grade 1 cytological appearance in both males and females. There was no statistically significant difference in Nelson's grading with age. People using coal and kerosene to cook were found to have a smaller goblet cell density than those who cooked on LPG or those who did not cook at all. Besides age and sex, environmental factors like the method of cooking and occupational variables (like outdoor activity, prolonged period of computer use, etc.) modify the health of the ocular surface. The results of this study will help put these findings into perspective as public health problems.

Cytokine and chemokine levels in tears from healthy subjects.

PubMed

Carreño, Ester; Enríquez-de-Salamanca, Amalia; Tesón, Marisa; García-Vázquez, Carmen; Stern, Michael E; Whitcup, Scott M; Calonge, Margarita

2010-11-01

There is growing evidence for the existence of an 'immune tone' in normal tears. The aim of this study was to determine the levels of a large panel of cytokines and chemokines in tears obtained from healthy subjects. These levels can then serve as baseline values for comparison with patients suffering from ocular surface diseases. Nine healthy subjects participated in this study, and normal ocular surface health was documented by the results of a dry eye questionnaire, Schirmer strip wetting, and vital staining of the cornea. Four microliters of tears were collected from each eye and analysed separately with multiplex bead-based assays for the concentration of 30 cytokines and chemokines. Twenty-five cytokines/chemokines were detected. CCL11/Eotaxin1, GM-CSF, G-CSF, IFN-γ, IL-2, IL-3, IL-4, IL-5, IL-10, IL-13, IL-12p70, IL-15, CX3CL1/Fractalkine, TNF-α, epidermal growth factor, and CCL4/MIP-1β were present at 5-100 pg/ml. IL-1β, IL-6, IL-7A, CXCL8/IL-8, and CCL2/MCP-1 were present at 100-400 pg/ml. IL-1Ra, CXCL10/IP-10 and vascular endothelial growth factor were present at more than 1000 pg/ml. Multiplex bead-based assays are convenient for cytokine/chemokine detection in tears. Fracktalkine has been detected in human healthy tears for the first time. The knowledge of cytokine/chemokine concentrations in tears from normal subjects is an important reference for further comparison with patients suffering from ocular surface diseases. Variability in their levels can reflect a phenomenon of potential importance for the understanding of the ocular surface cytokine pattern. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

MULTIMODAL IMAGING OF MOSAIC RETINOPATHY IN CARRIERS OF HEREDITARY X-LINKED RECESSIVE DISEASES.

PubMed

Wu, An-Lun; Wang, Jung-Pan; Tseng, Yun-Ju; Liu, Laura; Kang, Yu-Chuan; Chen, Kuan-Jen; Chao, An-Ning; Yeh, Lung-Kun; Chen, Tun-Lu; Hwang, Yih-Shiou; Wu, Wei-Chi; Lai, Chi-Chun; Wang, Nan-Kai

2018-05-01

To investigate the clinical features in carriers of X-linked retinitis pigmentosa, X-linked ocular albinism, and choroideremia (CHM) using multimodal imaging and to assess their diagnostic value in these three mosaic retinopathies. We prospectively examined 14 carriers of 3 X-linked recessive disorders (X-linked retinitis pigmentosa, X-linked ocular albinism, and CHM). Details of abnormalities of retinal morphology were evaluated using fundus photography, fundus autofluorescence (FAF) imaging, and spectral domain optical coherence tomography. In six X-linked retinitis pigmentosa carriers, fundus appearance varied from unremarkable to the presence of tapetal-like reflex and pigmentary changes. On FAF imaging, all carriers exhibited a bright radial reflex against a dark background. By spectral domain optical coherence tomography, loss of the ellipsoid zone in the macula was observed in 3 carriers (50%). Regarding the retinal laminar architecture, 4 carriers (66.7%) showed thinning of the outer nuclear layer and a dentate appearance of the outer plexiform layer. All five X-linked ocular albinism carriers showed a characteristic mud-splatter patterned fundus, dark radial streaks against a bright background on FAF imaging, and a normal-appearing retinal structure by spectral domain optical coherence tomography imaging. Two of the 3 CHM carriers (66.7%) showed a diffuse moth-eaten appearance of the fundus, and all 3 showed irregular hyper-FAF and hypo-FAF spots throughout the affected area. In the CHM carriers, the structural changes observed by spectral domain optical coherence tomography imaging were variable. Our findings in an Asian cohort suggest that FAF imaging is a practical diagnostic test for differentiating X-linked retinitis pigmentosa, X-linked ocular albinism, and CHM carriers. Wide-field FAF is an easy and helpful adjunct to testing for the correct diagnosis and identification of lyonization in carriers of these three mosaic retinopathies.

Interleukin-6-driven inflammatory response induces retinal pathology in a model of ocular toxoplasmosis reactivation.

PubMed

Rochet, Élise; Brunet, Julie; Sabou, Marcela; Marcellin, Luc; Bourcier, Tristan; Candolfi, Ermanno; Pfaff, Alexander W

2015-05-01

Ocular inflammation is one of the consequences of infection with the protozoan parasite Toxoplasma gondii. Even if lesions are self-healing in immunocompetent persons, they pose a lifetime risk of reactivation and are a serious threat to vision. As there are virtually no immunological data on reactivating ocular toxoplasmosis, we established a model of direct intravitreal injection of parasites in previously infected mice with a homologous type II strain. Two different mouse strains with variable ability to control retinal infection were studied in order to describe protective and deleterious reaction patterns. In Swiss-Webster mice, which are already relatively resistant to primary infection, no peak of parasite load was observed upon reinfection. In contrast, the susceptible inbred strain C57BL/6 showed high parasite loads after 7 days, as well as marked deterioration of retinal architecture. Both parameters were back to normal on day 21. C57BL/6 mice also reacted with a strong local production of inflammatory and Th1-type cytokines, like interleukin-6 (IL-6), IL-17A, and gamma interferon (IFN-γ), while Swiss-Webster mice showed only moderate expression of the Th2 cytokine IL-31. Interestingly, rapid intraocular production of anti-Toxoplasma antibodies was observed in Swiss-Webster but not in C57BL/6 mice. We then localized the cellular source of different immune mediators within the retina by immunofluorescence. Finally, neutralization experiments of IFN-γ or IL-6 demonstrated the respective protective and deleterious roles of these cytokines for parasite control and retinal integrity during reinfection. In conclusion, we developed and immunologically characterized a promising mouse model of reactivating ocular toxoplasmosis. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

The accuracy of eyelid movement parameters for drowsiness detection.

PubMed

Wilkinson, Vanessa E; Jackson, Melinda L; Westlake, Justine; Stevens, Bronwyn; Barnes, Maree; Swann, Philip; Rajaratnam, Shantha M W; Howard, Mark E

2013-12-15

Drowsiness is a major risk factor for motor vehicle and occupational accidents. Real-time objective indicators of drowsiness could potentially identify drowsy individuals with the goal of intervening before an accident occurs. Several ocular measures are promising objective indicators of drowsiness; however, there is a lack of studies evaluating their accuracy for detecting behavioral impairment due to drowsiness in real time. In this study, eye movement parameters were measured during vigilance tasks following restricted sleep and in a rested state (n = 33 participants) at three testing points (n = 71 data points) to compare ocular measures to a gold standard measure of drowsiness (OSLER). The utility of these parameters for detecting drowsiness-related errors was evaluated using receiver operating characteristic curves (ROC) (adjusted by clustering for participant) and identification of optimal cutoff levels for identifying frequent drowsiness-related errors (4 missed signals in a minute using OSLER). Their accuracy was tested for detecting increasing frequencies of behavioral lapses on a different task (psychomotor vigilance task [PVT]). Ocular variables which measured the average duration of eyelid closure (inter-event duration [IED]) and the ratio of the amplitude to velocity of eyelid closure were reliable indicators of frequent errors (area under the curve for ROC of 0.73 to 0.83, p < 0.05). IED produced a sensitivity and specificity of 71% and 88% for detecting ≥ 3 lapses (PVT) in a minute and 100% and 86% for ≥ 5 lapses. A composite measure of several eye movement characteristics (Johns Drowsiness Scale) provided sensitivities of 77% and 100% for detecting 3 and ≥ 5 lapses in a minute, with specificities of 85% and 83%, respectively. Ocular measures, particularly those measuring the average duration of episodes of eye closure are promising real-time indicators of drowsiness.

Vision-related quality of life in patients with ocular chemical burns.

PubMed

Le, Qihua; Chen, Yan; Wang, Xin; Li, Yimin; Hong, Jiaxu; Xu, Jianjiang

2011-11-21

To assess vision-related quality of life in patients with ocular chemical burns by the application of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Eighty-seven patients with ocular chemical burns were enrolled in the study from January 1 through May 31, 2010. Apart from the collection of sociodemographic and clinical data, NEI VFQ-25 with an additional appendix question, being translated to Chinese, was administered to all subjects. Main outcome measures were comparison of the NEI VFQ-25 subscale item scores among subgroups and multivariate analysis of the NEI VFQ-25 subscale scores. Fifty-five subjects were bilaterally burned and the rest were unilaterally injured. The mean age of enrolled subjects was 39.4 ± 11.6 years, with the majority being male (98.9%) and worker (77.0%); the mean composite score of all subjects was 40.4 ± 23.8. The composite score and majority subscale scores of binocularly injured patients were significantly lower than those of monocularly injured patients. Further comparisons among groups divided by either clinical severity classification or best-corrected visual acuity (BCVA) produced similar results. The BCVA of both the better-seeing eye and the worse-seeing eye strongly correlated with the NEI VFQ-25 composite score (ρ = 0.664 and 0.498, both P = 0.000). Multivariate regression analysis revealed that the VFQ-25 composite score correlated significantly with the following independent variables: BCVA of the better-seeing eye and the worse-seeing eye, the injury classification of the less severely injured eye, and correct and immediate irrigation after injury as well. Ocular chemical burns have a significant and extensive impact on patients' visual function outcomes and vision-related quality of life.

The tear film and ocular mucins.

PubMed

Davidson, Harriet J; Kuonen, Vanessa J

2004-01-01

Abstract The trilaminar tear film, composed of the lipid, aqueous and mucin layers, has many functions including defending the ocular surface. The aqueous layer has several soluble antimicrobial factors that protect the ocular surface. Ocular mucins have recently been studied with regard to their role in the defense of the eye as well as in dry eye syndromes. To date, 15 mucin genes have been identified, and six of these mucin genes are localized to or secreted by ocular glands or epithelia. Understanding the production, secretion and function of ocular mucins will aid in the treatment of dry eye syndromes and ocular surface microbial infections.

Diagnosis of retinal detachments by a tele-ophthalmology screening program.

PubMed

McCord, Sarah A; Lynch, Mary G; Maa, April Y

2018-01-01

In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic. Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.

Does Posterior Capsule Opacification Affect the Results of Diagnostic Technologies to Evaluate the Retina and the Optic Disc?

PubMed Central

Garcia-Medina, Jose Javier; del Rio-Vellosillo, Monica; Santos-Bueso, Enrique

2015-01-01

The visual outcome obtained after cataract removal may progressively decline because of posterior capsular opacification (PCO). This condition can be treated by creating an opening in the posterior lens capsule by Nd:YAG laser capsulotomy. PCO optical imperfections cause several light reflection, refraction, and diffraction phenomena, which may interfere with the functional and structural tests performed in different ocular locations for the diagnosis and follow-up of ocular disease, like macular and optic nerve diseases. Some parameters measured by visual field examinations, scanning laser polarimetry, and optical coherence tomography (OCT) have changed after PCO removal. Imaging quality also changes following capsulotomy. Consequently, the results of ancillary tests in pseudophakic eyes for studying ocular diseases like glaucoma or maculopathies should be correlated with other clinical examinations, for example, slit-lamp biomicroscopy or funduscopy. If PCO is clinically significant, a new baseline should be set for future comparisons following capsulotomy when using automated perimetry and scanning laser polarimetry. To perform OCT in the presence of PCO, reliable examinations (considering signal strength) apparently guarantee that measurements are not influenced by PCO. PMID:26167499

[Hyperosmolarity: Intracellular effects and implication in dry eye disease].

PubMed

Warcoin, E; Clouzeau, C; Brignole-Baudouin, F; Baudouin, C

2016-09-01

Dry eye disease is a multifactorial disease affecting the lacrimal functional unit and which has a significant impact on the quality of life of patients. This pathology works as a vicious circle at the ocular surface in which hyperosmolarity of the tear film plays a key role. This review intends to describe the different reported intracellular effects induced by hyperosmolarity in cells: alteration of cytoskeleton, cell cycle slowdown, adaptation mechanisms triggered as restoration of cell volume and accumulation of compatible osmolytes, the crucial role of the osmoprotectant factor Nuclear Factor of the Activated T cells-5 (NFAT5), apoptosis, as well as oxidative stress and inflammatory responses caused by this particular condition. Reported effects of hyperosmolarity in the experimental studies specific of dry eye disease concerning ocular surface cells will be described in parallel. Indeed, these data allow to understand a part of the pathophysiology of the disease, and specially the links between tear hyperosmolarity and inflammation of the ocular surface, the second key of the pathology phenomenon. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Comparison of Ocular Outcomes in Two 14-Day Bed Rest Studies

NASA Technical Reports Server (NTRS)

Cromwell, Ronita L.; Zanello, S. B.; Yarbough, P. O.; Tabbi, G.; Vizzeri, G.

2012-01-01

Reports of astronauts' visual changes have raised concern about ocular health during long-duration spaceflight. Some of these findings include globe flattening with hyperopic shifts, choroidal folds, optic disc edema, retinal nerve fiber layer (RNFL) thickening, and cotton wool spots. While the etiology remains unknown, it is hypothesized that, in predisposed individuals, hypertension in the brain may follow cephalad fluid shifts during spaceflight. This possible mechanism of ocular changes may also apply to analogous cases of idiopathic intracranial hypertension (IIH) or pseudotumor cerebri on Earth patients. Head-down t ilt (HDT) bed rest is a spaceflight analog that induces cephalad fluid shifts. Previous studies of the HDT position demonstrated body fluid shifts associated with changes in intraocular pressure (IOP) but the conditions of bed rest varied among experiments, making it difficult to compare data and draw conclusions. For these reasons, vision evaluation of bed rest subjects was implemented for NASA bed rest studies since 2010, in an attempt to monitor vision health in subjects subjected to bed rest. Vision monitoring is thus currently performed in all NASA-conducted bed rest campaigns

Healthy and pathological cerebellar Spiking Neural Networks in Vestibulo-Ocular Reflex.

PubMed

Antonietti, Alberto; Casellato, Claudia; Geminiani, Alice; D'Angelo, Egidio; Pedrocchi, Alessandra

2015-01-01

Since the Marr-Albus model, computational neuroscientists have been developing a variety of models of the cerebellum, with different approaches and features. In this work, we developed and tested realistic artificial Spiking Neural Networks inspired to this brain region. We tested in computational simulations of the Vestibulo-Ocular Reflex protocol three different models: a network equipped with a single plasticity site, at the cortical level; a network equipped with a distributed plasticity, at both cortical and nuclear levels; a network with a pathological plasticity mechanism at the cortical level. We analyzed the learning performance of the three different models, highlighting the behavioral differences among them. We proved that the model with a distributed plasticity produces a faster and more accurate cerebellar response, especially during a second session of acquisition, compared with the single plasticity model. Furthermore, the pathological model shows an impaired learning capability in Vestibulo-Ocular Reflex acquisition, as found in neurophysiological studies. The effect of the different plasticity conditions, which change fast and slow dynamics, memory consolidation and, in general, learning capabilities of the cerebellar network, explains differences in the behavioral outcome.

Delivery of therapeutics for deep-seated ocular conditions - status quo.

PubMed

Nguyen, Hubert; Eng, Shawn; Ngo, Thanh; Dass, Crispin R

2018-04-19

There is a need for research into designing effective pharmaceutical systems for delivering therapeutic drugs to the posterior of the eye for glaucoma-related pathology, macular degeneration, diabetic retinopathy, macular oedema, retinitis and choroiditis. Conventionally, eye drops have been extensively utilised for topical drug delivery to the anterior segment of the eye, but are less effective for delivery of therapeutics to the back of the eye due to significant barriers hampering drug penetration into the target intraocular tissue. This review explores some of the current and novel delivery systems employed to deliver therapeutics to the back of the eye such as those using liposomes, ocular implants, in situ gels, and nanoparticles, and how they can overcome some of these limitations. Issues such as blinking, precorneal fluid drainage, tear dilution and turnover, conjunctiva and nasal drug absorption, the corneal epithelium, vitreous drug clearance, and the blood-ocular barriers are reviewed and discussed. Further studies are needed to address their shortcomings such as drug compatibility and stability, economic viability and patient compliance. © 2018 Royal Pharmaceutical Society.

Biofluid Mechanics Education at U Michigan

NASA Astrophysics Data System (ADS)

Grotberg, James

2007-11-01

At the University of Michigan, biofluid mechanics is taught in the Department of Biomedical Engineering with cross-listing in Mechanical Engineering. The course has evolved over 25 years and serves advanced undergraduates and graduate students. The course description is as follows: BiomedE/MechE 476 Biofluid Mechanics. CATALOG DESCRIPTION: This is an intermediate level fluid mechanics course which uses examples from biotechnology processes and physiologic applications including cellular, cardiovascular, respiratory, ocular, renal, orthopedic, and gastrointestinal systems. COURSE TOPICS: 1. Dimensional analysis (gastrointestinal, renal) 2. Approximation methods, numerical methods (biotechnology, respiratory) 3. Particle kinematics in Eulerian and Lagrangian references frames (biotechnology, respiratory) 4. Conservation of mass and momentum 5. Constitutive equations (blood, mucus) 6. Kinematic and stress boundary conditions: rigid, flexible, porous (cardio-pulmonary, cellular) 7. Surface tension phenomena (pulmonary, ocular) 8. Flow and wave propagation in flexible tubes (cardio-pulmonary) 9. Oscillatory and pulsatile flows (cardio-pulmonary, orthopedic) 10. High Reynolds number flows (cardio-pulmonary) 11. Low Reynolds number flows (biotechnology, cellular, vascular) 12. Lubrication theory (vascular, orthopedic) 13. Flow in poroelastic media (orthopedic, pulmonary, ocular) 14. Video presentations of laboratory experiments.

Hyperspectral optical imaging of human iris in vivo: characteristics of reflectance spectra

NASA Astrophysics Data System (ADS)

Medina, José M.; Pereira, Luís M.; Correia, Hélder T.; Nascimento, Sérgio M. C.

2011-07-01

We report a hyperspectral imaging system to measure the reflectance spectra of real human irises with high spatial resolution. A set of ocular prosthesis was used as the control condition. Reflectance data were decorrelated by the principal-component analysis. The main conclusion is that spectral complexity of the human iris is considerable: between 9 and 11 principal components are necessary to account for 99% of the cumulative variance in human irises. Correcting image misalignments associated with spontaneous ocular movements did not influence this result. The data also suggests a correlation between the first principal component and different levels of melanin present in the irises. It was also found that although the spectral characteristics of the first five principal components were not affected by the radial and angular position of the selected iridal areas, they affect the higher-order ones, suggesting a possible influence of the iris texture. The results show that hyperspectral imaging in the iris, together with adequate spectroscopic analyses provide more information than conventional colorimetric methods, making hyperspectral imaging suitable for the characterization of melanin and the noninvasive diagnosis of ocular diseases and iris color.

Pediatric Lupus – Are There Differences in Presentation, Genetics, Response to Therapy, Damage Accrual Compared to Adult Lupus?

PubMed Central

Brunner, Hermine I

2010-01-01

Summary Some complement deficiencies predispose to SLE early in life. Currently, there are no known unique physiological or genetic pathways that can explain the variability in disease phenotypes, as is suggested by studies directly and indirectly comparing cohorts of children and adults with SLE. Children present with more acute illness and have more frequent renal, hematologic and central nervous system involvement at the time of diagnosis compared to adults with SLE. Almost all children require corticosteroids during the course of their disease, and many are treated with immunosuppressive drugs. Despite of a general lack of co-morbid conditions, mortality rates remain higher with pediatric SLE compared to aSLE. Children and adolescents accrue more damage as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, especially in the renal, ocular and musculoskeletal organ systems. Conversely, cardiovascular mortality is more prevalent in adults with SLE. PMID:20202591

Update in Current Diagnostics and Therapeutics of Dry Eye Disease.

PubMed

Thulasi, Praneetha; Djalilian, Ali Reza

2017-11-01

Dry eye disease (DED) represents a heterogeneous group of conditions with tear film insufficiency and signs and/or symptoms of ocular surface irritation. The clinical manifestations of DED can be highly variable; hence the diagnosis is often based on a combination of symptoms, signs, and clinical tests, given that any one of these alone would miss a significant number of patients. Similarly, the treatment must often be tailored to each patient by targeting the specific mechanisms involved in his or her disease. The purpose of this review is to summarize recent advances that have allowed us to better recognize, categorize, and treat patients with DED. The most notable new diagnostic tests in DED are tear film osmolarity, inflammatory biomarkers, and meibomian gland imaging. Therapeutically, anti-inflammatory therapy, meibomian gland heating and expression, and scleral contact lenses are some of the latest options available for treating DED. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Visual Acuity’s Association with Levels of Leisure-Time Physical Activity Among Community-Dwelling Older Adults

PubMed Central

Swanson, Mark W; Bodner, Eric; Sawyer, Patricia; Allman, Richard

2013-01-01

Little is known about the affect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations controlling for potential confounders. In multivariate analyses, each lower step in visual acuity category below 20/50 was significantly associated with reduced odds of having a higher level of physical activity OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults. PMID:21945888

Retinoschisis and hyperopia associated with partial monosomy of 6q and partial trisomy of 11q.

PubMed

Bagheri, Nika; Bahl, Reecha S; Singh, Arun D; Rychwalski, Paul J

2014-06-01

Retinoschisis, or retinal lamellar splitting, can occur in a number of hereditary conditions. The most common cause of congenital or childhood onset retinoschisis is the clinical entity known as juvenile retinoschsis, which is caused by mutations in the X-linked retinoschisis 1 gene. Genes other than X-linked retinoschisis 1 gene have rarely been implicated in association with hereditary retinoschisis. We describe a 9-year-old male who presented with several phenotypic features associated with partial monosomy of chromosome 6q and partial trisomy of chromosome 11q, including myelomeningocele, mental and growth retardation, seizures, microcephaly, scoliosis, and facial dysmorphisms, as well as novel ocular findings including bilateral retinoschisis and hyperopia. This case report highlights the necessity for a detailed ophthalmic examination of patients with both 6q deletions as well as 11q duplications to ensure accurate and timely diagnosis and treatment of the complications associated with the described ocular conditions.

The effect of rebreathing and hyperventilation on retinal and choroidal vessels measured by spectral domain optical coherence tomography.

PubMed

Ozcimen, Muammer; Sakarya, Yasar; Goktas, Sertan; Sakarya, Rabia; Alpfidan, Ismail; Yener, Halil I; Demir, Lutfi S

2015-01-01

The purpose of this study was to examine the vasoreactivity in retina and choroid of the healthy eyes in response to experimentally altered partial arterial pressure of carbon dioxide (PaCO(2)) using a non-invasive technique, spectral domain optical coherence tomography (SD-OCT). The study included non-smoking participants between 18 and 35 years of age, having visual acuity of 20/20 and with no systemic and ocular diseases. At baseline, the participants breathed room air (normocapnia). Hypocapnia was created with the help of hyperventilation; for this, the participants were instructed to draw deep and quick breaths, resulting one breathing cycle per 2 s. To create hypercapnia subjects rebreathed from a 5 l bag at least 3 min. Choroidal thickness and retinal artery diameter were measured at baseline, and hyperventilation and rebreathing conditions by SD-OCT. Twenty eyes of 20 healthy subjects were included in this study. Their mean age was 24.90 ± 5.32 years. Hyperventilation caused a significant reduction in choroidal thickness, compared with baseline, at all points; whereas rebreathing caused no significant change at all points. The mean diameters of the arteries were 151.80 ± 7.88 μm, with a significant decline to 148.90 ± 7.25 μm at hyperventilation condition and a significant increase to 153.50 ± 7.88 μm at rebreathing condition (p = 0.018, p = 0.043, respectively). This study demonstrated that, SD-OCT was a useful tool in measuring the ocular vascular response under hypercapnia and hypocapnia conditions. These findings may be helpful for further understanding the physiological nature of ocular blood flow and this preliminary study provides a basis for future studies.

An in vitro approach to investigate ocular metabolism of a topical, selective β1-adrenergic blocking agent, betaxolol.

PubMed

Bushee, Jennifer L; Dunne, Christine E; Argikar, Upendra A

2015-05-01

1. Topical glaucoma treatments have often been limited by poor absorption and bioavailability. Betaxolol, a selective β1-blocker, has been well studied for its pharmacokinetics and disposition. Limited ocular, betaxolol metabolism data is available despite a growing number of novel ocular treatments. 2. In vitro ocular fractions indicated the formation of an active metabolite, across rat, rabbit and human, which was only observed historically in the liver. 3. Ocular metabolic profiles of preclinical toxicology species, rat and rabbit, were not predictive of human in vitro ocular data. M1 was specific to human and only captured by the liver data. 4. Liver S9 over predicted the extent of ocular metabolism compared to ocular fractions. Rabbit liver S9 fractions demonstrated extensive glucuronidation and higher parent turn-over in 1 h as compared to other matrices. 5. This research assesses in vitro species and organ differences across preclinical species and human. The complex data set highlights the need for an in vitro ocular system to explore poorly documented ocular metabolism.

Aquaporins in the eye: Expression, function, and roles in ocular disease☆

PubMed Central

Schey, Kevin L.; Wang, Zhen; Wenke, Jamie L.; Qi, Ying

2015-01-01

Background All thirteen known mammalian aquaporins have been detected in the eye. Moreover, aquaporins have been identified as playing essential roles in ocular functions ranging from maintenance of lens and corneal transparency to production of aqueous humor to maintenance of cellular homeostasis and regulation of signal transduction in the retina. Scope of review This review summarizes the expression and known functions of ocular aquaporins and discusses their known and potential roles in ocular diseases. Major conclusions Aquaporins play essential roles in all ocular tissues. Remarkably, not all aquaporin function as a water permeable channel and the functions of many aquaporins in ocular tissues remain unknown. Given their vital roles in maintaining ocular function and their roles in disease, aquaporins represent potential targets for future therapeutic development. General significance Since aquaporins play key roles in ocular physiology, an understanding of these functions is important to improving ocular health and treating diseases of the eye. It is likely that future therapies for ocular diseases will rely on modulation of aquaporin expression and/or function. This article is part of a Special Issue entitled Aquaporins. PMID:24184915

Cluster bomb ocular injuries.

PubMed

Mansour, Ahmad M; Hamade, Haya; Ghaddar, Ayman; Mokadem, Ahmad Samih; El Hajj Ali, Mohamad; Awwad, Shady

2012-01-01

To present the visual outcomes and ocular sequelae of victims of cluster bombs. This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006). Data were gathered from the reports to the Information Management System for Mine Action. There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308) of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67%) with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes), corneal foreign bodies (9 eyes), corneal decompensation (2 eyes), ruptured cataract (6 eyes), and intravitreal foreign bodies (10 eyes). The corneas of one patient had extreme attenuation of the endothelium. Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs.

Ocular sarcoidosis: new diagnostic modalities and treatment.

PubMed

Yang, Sung J; Salek, Sherveen; Rosenbaum, James T

2017-09-01

Ocular involvement in sarcoidosis is present in up to 80% of patients and is frequently manifested before diagnosis of the underlying systemic disease. Considering the therapeutic consequences, early diagnosis of the underlying disease is advantageous in patients presenting with ocular inflammation. There are several ocular findings suggestive of underlying sarcoidosis, such as granulomatous keratic precipitates, iris nodules, cells in the vitreous humor known as snowballs and snowbanks, and retinal periphlebitis. High suspicion is crucial for the diagnosis of sarcoidosis. This review on ocular sarcoidosis will mainly focus on new diagnostic and treatment modalities. Recent studies found possible new diagnostic indicators for the diagnosis of ocular sarcoidosis which include not only serum profiles but also vitreous sample analysis. Ophthalmologic imaging techniques have improved to investigate the ocular structure in detail. Results from recent uveitis clinical trials have included sarcoidosis as an underlying cause and have reported positive results. The diagnosis of ocular sarcoidosis can be challenging in some cases. High suspicion is important to diagnose ocular sarcoidosis with various laboratory and ophthalmic tools. There are many possible options for the treatment of ocular sarcoidosis including various biologic agents.

A Review of Ocular Graft-Versus-Host Disease.

PubMed

Munir, Saleha Z; Aylward, James

2017-05-01

: Graft-versus-host disease (GVHD) is a major complication that occurs following allogeneic hematopoietic stem cell transplantation, which is a potential curative therapy used in a variety of malignant or benign hematological diseases. Graft-versus-host disease primarily occurs in many organs, but most notably in the skin, lungs, gastrointestinal tract, liver, eyes, mucosa, and musculoskeletal system. Ocular manifestations of GVHD may precede other systemic GVHD findings, and it may be a poor prognosis for mortality. While all parts of the eye may be affected, ocular GVHD occurs primarily in the ocular surface. Dry eye disease or keratoconjunctivitis sicca is the most common presenting manifestation of chronic ocular GVHD. Dry eye disease in ocular GVHD is a multifactorial process, which involves destruction and fibrosis of lacrimal glands and conjunctiva, leading to tear film deficiency and instability. Depending on the severity of ocular involvement and response to treatment, ocular GVHD may cause decreased quality of life. Management of GVHD begins with prevention by understanding risk factors and by implementing prophylactic treatment after allogeneic hematopoietic stem cell transplantation. A multidisciplinary approach to the prevention and treatment of GVHD is important, and there are currently no preventive therapies available for ocular GVHD. Once diagnosed, ocular GVHD treatment strategies target ocular surface lubrication and support, tear film stabilization, inflammation reduction, and surgical intervention. The goal of this review is to define ocular GVHD and its categorical manifestations, as well as to describe the importance of comprehensive assessment, diagnosis, and ophthalmologic treatment and management of ocular GVHD with a multidisciplinary approach.

Quality of life in purely ocular myasthenia in Japan

PubMed Central

2014-01-01

Background Since there has been no conclusive evidence regarding the treatment of ocular myasthenia, treatment guidelines were recently issued by the European Federation of Neurological Societies/European Neurological Society (EFNS/ENS). However, the therapeutic outcomes concerning the quality-of-life (QOL) of patients with ocular myasthenia are not yet fully understood. Methods We investigated the therapeutic outcomes of patients with purely ocular myasthenia in a multicenter cross-sectional survey in Japan. To evaluate the severity of ocular symptoms, we used the ocular-quantitative MG (QMG) score advocated by Myasthenia Gravis Foundation of America. We used the Japanese translated version of the MG-QOL15, a self-appraised scoring system. Results Of 607 myasthenia gravis (MG) patients with an observation-duration of illness ≥ 2 years, the cases of 123 patients (20%) were limited to ocular muscles (purely ocular myasthenia). During the entire clinical course, 81 patients experienced both ptosis and diplopia, 36 had ptosis alone, and six had diplopia alone. Acetyl-cholinesterase inhibitors and prednisolone were used in 98 and 52 patients, respectively. Treatment improved ocular symptoms, with the mean reduction in ocular-QMG score of 2.3 ± 1.8 points. However, 47 patients (38%) failed to gain minimal manifestation or a better status. Patients with unfavorable outcomes also self-reported severe QOL impairment. Multivariate analyses showed that the pretreatment ocular-QMG score was associated with unfavorable outcomes, but not associated with the patient’s QOL. Conclusion A treatment strategy designed in accord with a patient's ocular presentation must be considered in order to improve ocular symptoms and the patient's QOL. PMID:24996227

Light responses and morphology of bNOS-immunoreactive neurons in the mouse retina

PubMed Central

Pang, Ji-Jie; Gao, Fan; Wu, Samuel M.

2010-01-01

Nitric oxide (NO), produced by NO synthase (NOS), modulates the function of all retinal neurons and ocular blood vessels and participates in the pathogenesis of ocular diseases. To further understand the regulation of ocular NO release, we systematically studied the morphology, topography and light responses of NOS-containing amacrine cells (NOACs) in dark-adapted mouse retina. Immunohistological staining for neuronal NOS (bNOS), combined with retrograde labeling of ganglion cells (GCs) with Neurobiotin (NB, a gap junction permeable dye) and Lucifer yellow (LY, a less permeable dye), was used to identify NOACs. The light responses of ACs were recorded under whole-cell voltage clamp conditions and cell morphology was examined with a confocal microscope. We found that in dark-adapted conditions bNOS-immunoreactivity (IR) was present primarily in the inner nuclear layer and the ganglion cell layer. bNOS-IR somas were negative for LY, thus they were identified as ACs; nearly 6 % of the cells were labeled by NB but not by LY, indicating that they were dye-coupled with GCs. Three morphological subtypes of NOACs (NI, NII and displaced) were identified. The cell density, inter-cellular distance and the distribution of NOACs were studied in whole retinas. Light evoked depolarizing highly sensitive ON-OFF responses in NI cells and less sensitive OFF responses in NII cells. Frequent (1 to 2 Hz) or abrupt change of light-intensity evoked larger peak responses. The possibility for light to modify NO release from NOACs is discussed. PMID:20503422

The Human Vertical Translation Vestibulo-ocular Reflex (tVOR): Normal and Abnormal Responses

PubMed Central

Liao, Ke; Walker, Mark F.; Joshi, Anand; Reschke, Millard; Strupp, Michael; Leigh, R. John

2010-01-01

Geometric considerations indicate that the human translational vestibulo-ocular reflex (tVOR) should have substantially different properties than the angular vestibulo-ocular reflex (aVOR). Specifically, tVOR cannot simultaneously stabilize images of distant and near objects on the retina. Most studies make the tacit assumption that tVOR acts to stabilize foveal images even though, in humans, tVOR is reported to compensate for less than 60% of foveal image motion. We have determined that the compensation gain (eye rotational velocity / required eye rotational velocity to maintain foveal target fixation) of tVOR is held steady at ~ 0.6 during viewing of either near or distant targets during vertical (bob) translations in ambient illumination. We postulate that tVOR evolved not to stabilize the image of the target on the fovea, but rather to minimize retinal image motion between objects lying in different depth planes, in order to optimize motion parallax information. Such behavior is optimized when binocular visual cues of both far and distant targets are available in ambient light. Patients with progressive supranuclear palsy or cerebellar ataxia show impaired ability to increase tVOR responses appropriately when they view near targets. In cerebellar patients, impaired ability to adjust tVOR responses to viewing conditions occurs despite intact ability to converge at near. Loss of the ability to adjust tVOR according to viewing conditions appears to represent a distinct disorder of vestibular function. PMID:19645882

Distribution and outcome of ocular lesions in snakes examined at a veterinary teaching hospital: 67 cases (1985-2010).

PubMed

Hausmann, Jennifer C; Hollingsworth, Steven R; Hawkins, Michelle G; Kass, Philip H; Maggs, David J

2013-07-15

To determine the distribution and clinical outcome of ocular lesions in snakes. Retrospective case series. 67 snakes with ocular lesions. Signalment, lesion duration, diagnosis, treatment, and clinical outcome were recorded for all snakes with ocular lesions that were examined at a veterinary teaching hospital from 1985 to 2010. 71 ocular lesions were detected in 67 of 508 (13%) snakes examined. Affected snakes were of the families Boidae, Pythonidae, Colubridae, and Viperidae. The distribution of ocular lesions did not vary by taxonomic family, age, or sex; however, snakes from the genus Epicrates with ocular lesions were overrepresented in the population. The most commonly diagnosed ocular lesions were retained spectacle (n = 41), pseudobuphthalmos or subspectacular abscess (13), trauma (8), and cataracts (4). Pseudobuphthalmos or subspectacular abscess developed more frequently in Colubridae than in non-Colubridae snakes. Of the 16 snakes with retained spectacles for which data were available, the lesion recurred once in 4 snakes and multiple times in 5 snakes. Results indicated that retained spectacle was the most common ocular lesion diagnosed in snakes. Compared with other snakes with ocular lesions, snakes of the genus Epicrates had a higher than expected frequency of ocular lesions in general and snakes of the family Colubridae had a higher than expected frequency of pseudobuphthalmos or subspectacular abscess.

Ocular Chromatic Aberrations and Their Effects on Polychromatic Retinal Image Quality

NASA Astrophysics Data System (ADS)

Zhang, Xiaoxiao

Previous studies of ocular chromatic aberrations have concentrated on chromatic difference of focus (CDF). Less is known about the chromatic difference of image position (CDP) in the peripheral retina and no experimental attempt has been made to measure the ocular chromatic difference of magnification (CDM). Consequently, theoretical modelling of human eyes is incomplete. The insufficient knowledge of ocular chromatic aberrations is partially responsible for two unsolved applied vision problems: (1) how to improve vision by correcting ocular chromatic aberration? (2) what is the impact of ocular chromatic aberration on the use of isoluminance gratings as a tool in spatial-color vision?. Using optical ray tracing methods, MTF analysis methods of image quality, and psychophysical methods, I have developed a more complete model of ocular chromatic aberrations and their effects on vision. The ocular CDM was determined psychophysically by measuring the tilt in the apparent frontal parallel plane (AFPP) induced by interocular difference in image wavelength. This experimental result was then used to verify a theoretical relationship between the ocular CDM, the ocular CDF and the entrance pupil of the eye. In the retinal image after correcting the ocular CDF with existing achromatizing methods, two forms of chromatic aberration (CDM and chromatic parallax) were examined. The CDM was predicted by theoretical ray tracing and measured with the same method used to determine ocular CDM. The chromatic parallax was predicted with a nodal ray model and measured with the two-color vernier alignment method. The influence of these two aberrations on polychromatic MTF were calculated. Using this improved model of ocular chromatic aberration, luminance artifacts in the images of isoluminance gratings were calculated. The predicted luminance artifacts were then compared with experimental data from previous investigators. The results show that: (1) A simple relationship exists between two major chromatic aberrations and the location of the pupil; (2) The ocular CDM is measurable and varies among individuals; (3) All existing methods to correct ocular chromatic aberration face another aberration, chromatic parallax, which is inherent in the methodology; (4) Ocular chromatic aberrations have the potential to contaminate psychophysical experimental results on human spatial-color vision.

Tietz/Waardenburg type 2A syndrome associated with posterior microphthalmos in two unrelated patients with novel MITF gene mutations.

PubMed

Cortés-González, Vianney; Zenteno, Juan Carlos; Guzmán-Sánchez, Martín; Giordano-Herrera, Verónica; Guadarrama-Vallejo, Dalia; Ruíz-Quintero, Narlly; Villanueva-Mendoza, Cristina

2016-12-01

Tietz syndrome and Waardenburg syndrome type 2A are allelic conditions caused by MITF mutations. Tietz syndrome is inherited in an autosomal dominant pattern and is characterized by congenital deafness and generalized skin, hair, and eye hypopigmentation, while Waardenburg syndrome type 2A typically includes variable degrees of sensorineural hearing loss and patches of de-pigmented skin, hair, and irides. In this paper, we report two unrelated families with MITF mutations. The first family showed an autosomal dominant pattern and variable expressivity. The second patient was isolated. MITF gene analysis in the first family demonstrated a c.648A>C heterozygous mutation in exon 8 c.648A>C; p. (R216S), while in the isolated patient, an apparently de novo heterozygous c.1183_1184insG truncating mutation was demonstrated in exon 10. All patients except one had bilateral reduced ocular anteroposterior axial length and a high hyperopic refractive error corresponding to posterior microphthalmos, features that have not been described as part of the disease. Our results suggest that posterior microphthalmos might be part of the clinical characteristics of Tietz/Waardenburg syndrome type 2A and expand both the clinical and molecular spectrum of the disease. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Ocular anatomy in medieval arabic medicine. A review.

PubMed

Laios, Konstantinos; Moschos, Marilita M; George, Androutsos

2016-01-01

In medieval Arabic medicine Ophthalmology had a central role. Ocular anatomy was described in many ophthalmological treatises of the physicians of the time. These physicians followed the doctrines of Galen according ocular anatomy, nevertheless their contribution to the history of ocular anatomy was the presentation of ocular anatomical sketches in their manuscripts for the fist time in medical history.

A COMPREHENSIVE INSIGHT ON OCULAR PHARMACOKINETICS

PubMed Central

Agrahari, Vibhuti; Mandal, Abhirup; Agrahari, Vivek; Trinh, Hoang My; Joseph, Mary; Ray, Animikh; Hadji, Hicheme; Mitra, Ranjana; Pal, Dhananjay; Mitra, Ashim K.

2017-01-01

Eye is a distinctive organ with protective anatomy and physiology. Several pharmacokinetics compartment model of ocular drug delivery has been developed for describing the absorption, distribution and elimination of ocular drugs in the eye. Determining pharmacokinetics parameters in ocular tissues is a major challenge because of the complex anatomy and dynamic physiological barrier of the eye. In this review, pharmacokinetics of these compartments exploring different drugs, delivery systems and routes of administration are discussed including factors affecting intraocular bioavailability. Factors such as pre-corneal fluid drainage, drug binding to tear proteins, systemic drug absorption, corneal factors, melanin binding, drug metabolism renders ocular delivery challenging and elaborated in this manuscript. Several compartment models are discussed those are developed in ocular drug delivery to study the pharmacokinetics parameters. There are several transporters present in both anterior and posterior segments of the eye which play a significant role in ocular pharmacokinetics and summarized briefly. Moreover, several ocular pharmacokinetics animal models and relevant studies are reviewed and discussed in addition to the pharmacokinetics of various ocular formulations. PMID:27798766

MRI in ocular drug delivery

PubMed Central

Li, S. Kevin; Lizak, Martin J.; Jeong, Eun-Kee

2008-01-01

Conventional pharmacokinetic methods for studying ocular drug delivery are invasive and cannot be conveniently applied to humans. The advancement of MRI technology has provided new opportunities in ocular drug-delivery research. MRI provides a means to non-invasively and continuously monitor ocular drug-delivery systems with a contrast agent or compound labeled with a contrast agent. It is a useful technique in pharmacokinetic studies, evaluation of drug-delivery methods, and drug-delivery device testing. Although the current status of the technology presents some major challenges to pharmaceutical research using MRI, it has a lot of potential. In the past decade, MRI has been used to examine ocular drug delivery via the subconjunctival route, intravitreal injection, intrascleral injection to the suprachoroidal space, episcleral and intravitreal implants, periocular injections, and ocular iontophoresis. In this review, the advantages and limitations of MRI in the study of ocular drug delivery are discussed. Different MR contrast agents and MRI techniques for ocular drug-delivery research are compared. Ocular drug-delivery studies using MRI are reviewed. PMID:18186077

Corneal erosion and Kindler syndrome.

PubMed

Signes-Soler, Isabel; Rodriguez-Prats, Jose Luis; Carbonell, Stella; Tañá-Rivero, Pedro

2013-01-01

To describe a very common corneal pathology in a patient with Kindler syndrome. We report the case of a 21-year-old woman, who presented to the Ophthalmology Department as an emergency presentation because of ocular pain in the left eye that radiated to other areas of the face and neck. After an exhaustive clinical interview, it was determined that the patient had a rare disease (Kindler syndrome). Ophthalmologic examination revealed corneal erosion on the left eye. No other significant conditions were found. After the application of conventional treatment, the corneal integrity was completely restored. We describe a very rare syndrome. Although conventional treatment restored corneal integrity, it is important to remember that ocular signs and symptoms are often associated with systemic pathologies.

Infantile bilateral glaucoma in a child with ectodermal dysplasia.

PubMed

Callea, Michele; Vinciguerra, Agatino; Willoughby, Colin E; Deroma, Laura; Clarich, Gabriella

2013-01-01

Ectodermal dysplasia is a rare disease which affects at least two ectodermal-derived structures such as hair, nails, skin, sweat glands and teeth. Approximately 200 different conditions have been classified as an ectodermal dysplasia and X-linked hypohidrotic ectodermal dysplasia (XHED) represents the commonest form. Clinically, XHED is characterized by hypotrichosis, hypohidrosis and hypodontia. A variety of ocular manifestations have been reported in XHED, the most common being dryness of eyes due to tear deficiency and instability of the film secondary to the absence of meibomian gland function. Here we report a child with the distinctive clinical features of XHED confirmed with molecular diagnosis who presented with infantile bilateral glaucoma, in addition to the classical ocular involvement in XHED.

Early onset bilateral juvenile myasthenia gravis masquerading as simple congenital ptosis.

PubMed

Alam, Md Shahid; Devi Nivean, Pratheeba

2017-01-01

Myasthenia gravis is an autoimmune disorder affecting the neuromuscular junction. Ocular myasthenia gravis presents as ptosis with extraocular motility restriction and is prone to be misdiagnosed as third nerve palsy or congenital or aponeurotic ptosis. Juvenile ocular myasthenia gravis in very young children is difficult to diagnose and can be easily labeled as a case of congenital ptosis, the more so when the condition is bilateral. We present a case of a two-year-old child who presented with bilateral ptosis and was diagnosed as a case of simple congenital ptosis elsewhere with the advice to undergo tarsofrontalis sling surgery. The child was diagnosed with juvenile myasthenia gravis on thorough history, examination, and systemic evaluation and was started on anti-myasthenic treatment.

Spectral domain optical coherence tomography imaging of retinal diseases in Singapore.

PubMed

Singh, Mandeep; Chee, Caroline K L

2009-01-01

In this retrospective case series, the authors reviewed cases of patients with macular disorders whose eyes had been imaged using spectral domain optical coherence tomography (SD-OCT) (Cirrus HD-OCT; Carl Zeiss Meditec, Inc., Dublin, CA). SD-OCT images were obtained from patients with a variety of ocular conditions attending a tertiary retinal clinic in Singapore from August 2007 to December 2007, according to standardized protocols. Images of 428 eyes from 301 patients were reviewed. Ocular diagnoses included diabetic macular edema, exudative age-related macular degeneration, central serous chorioretinopathy, cystoid macular edema, retinal vein and artery occlusions, infective chorioretinitis, and others. The authors present four cases of particular interest to illustrate how SD-OCT was useful in complementing the clinician's assessment of macular disease.

Oculomotor apraxia and dilated cardiomyopathy with ataxia syndrome: A case report.

PubMed

Benson, Matthew D; Ferreira, Patrick; MacDonald, Ian M

2017-01-01

Dilated cardiomyopathy with ataxia syndrome (DCMA) is a rare mitochondrial condition associated with early onset cardiomyopathy and non-progressive ataxia. The cardiac manifestations may be progressive and often severe, resulting in significant morbidity and mortality. While optic nerve atrophy has been described in patients with DCMA, to our knowledge, there have been no reports of additional ocular phenotypes. We present two related Dariusleut Hutterite patients with documented DCMA syndrome and disorders of ocular motility: poor smooth pursuit and difficulty initiating saccadic eye movements and maintaining target fixation. We thus report the first cases of oculomotor apraxia in DCMA syndrome. By identifying these associated findings early in life, we hope to improve both the clinical diagnostic accuracy and timeliness of intervention in cases of DCMA.

Hydroxyapatite ocular implant and non-integrated implants in eviscerated patients

PubMed Central

Gradinaru, S; Popescu, V; Leasu, C; Pricopie, S; Yasin, S; Ciuluvica, R; Ungureanu, E

2015-01-01

Introduction: This study compares the outcomes and complications of hydroxyapatite ocular implant and non-integrated ocular implants following evisceration. Materials and Methods: This is a retrospective study of 90 patients who underwent evisceration for different ocular affections, in the Ophthalmology Department of the University Emergency Hospital Bucharest, between January 2009 and December 2013. The outcomes measured were conjunctival dehiscence, socket infection, implant exposure and extrusion rate. Results: Forty-three patients had the hydroxyapatite implant (coralline–Integrated Ocular Implants, USA or synthetic–FCI, France) and forty-seven received non-integrated ocular implants (24 acrylic and 23 silicone). Five cases of socket infection, thirteen cases of extrusion and two cases of conjunctival dehiscence were encountered. Conclusions: There was a higher rate of conjunctival dehiscence with hydroxyapatite ocular implant, but implant extrusion and socket infection were found in non-integrated ocular implants. PMID:25914747

Utility of angiotensin-converting enzyme activity in aqueous humor in the diagnosis of ocular sarcoidosis.

PubMed

Mihailovic-Vucinic, Violeta; Popevic, Ljubica; Popevic, Spasoje; Stjepanovic, Mihailo; Aleksic, Andjelka; Stanojevic-Paovic, Anka

2017-10-01

Many studies include elevated activity of angiotensin-converting enzyme (ACE) in serum in sarcoidosis and in ocular sarcoidosis as well, but there are only a few analyzing ACE activities in aqueous humor. The aim of this study is to illuminate the diagnostic value of ACE in aqueous humor in patients with ocular sarcoidosis. We analyzed twenty patients with ocular sarcoidosis and 18 patients with nonocular involvement. All patients have biopsy-positive sarcoidosis of the lungs and/or mediastinal lymph nodes. Blood samples for ACE serum levels were obtained from all patients. Aqueous humor samples were taken by paracentesis with a 25-gauge needle in local anesthesia. With appropriate statistical tests, we compared ACE activity in serum and aqueous humor in patients with and without ocular sarcoidosis. The majority of our patients with ocular sarcoidosis were female (12/20), also in the group with systemic sarcoidosis and without ocular involvement (12/6). Mean age of the whole analyzed group of sarcoidosis patients was 45 ± 6 years. There is no statistically significant difference in ACE activity in serum between two groups of patients (with and without ocular sarcoidosis). There is statistically significant difference in ACE activity in aqueous humor among patients with ocular and nonocular sarcoidosis. ACE activity in aqueous humor is significantly higher in patients with ocular sarcoidosis. Increased ACE activity in aqueous humor can point to a diagnosis of ocular sarcoidosis, without the need for ocular biopsy.

Low vision rehabilitation and ocular problems among industrial workers in a developing country.

PubMed

Omar, R; Knight, V F; Aziz Mohammed, M A

2014-01-01

Work-related ocular injuries and illnesses were among the major causes of job absenteeism. This study was conducted to determine if low vision rehabilitation was provided following work-related ocular problems among industrial workers in a developing country. This was a retrospective analysis of case records. Randomly selected records of all employees from the Social Security Organization (SOCSO) Medical Board for 2004 who suffered from ocular injuries and illnesses were selected. Rates of ocular injuries and illnesses according to age, gender, races, types of injuries, types of industries, visual rehabilitation and types of medical interventions were tabulated and analysed. A total of 26 cases of ocular injuries and illnesses were identified where 46.2% suffered from ocular injuries. The remaining 53.8% had ocular and/or systemic diseases. The 40-49-yearold age group suffered the greatest number of injuries (26.92%). Ocular perforating injuries (66.67%) and ocular contusions (33.33%) were the most common types of ocular injury among industrial workers in Kuala Lumpur. Most injuries occurred among workers in the service industry (50%). Almost 60% of these injured workers did not receive any low vision rehabilitation after medical intervention while 25% were given contact lenses or spectacles as rehabilitation and remaining had surgery. The low vision rehabilitation is still unexplored in the management of ocular injuries and illnesses among industrial workers. Introducing low vision rehabilitation can benefit both workers and employers as it provides care beyond spectacles or contact lens prescriptions.

Conjunctival tumor caused by Epstein-Barr virus-related infectious mononucleosis: Case report and review of literature.

PubMed

Vaivanijkul, Juntarut; Boonsiri, Kreopun

2017-04-01

The conjunctival tumor associated with Epstein-Barr virus related infectious mononucleosis is a rare ocular manifestation. Only a few cases have been reported in the literature. We reported this rare condition that presented in a 5-year-old boy.

Long term safety and tolerability of Tafluprost 0.0015% vs Timolol 0.1% preservative-free in ocular hypertensive and in primary open-angle glaucoma patients: a cross sectional study.

PubMed

Rolle, Teresa; Spinetta, Roberta; Nuzzi, Raffaele

2017-08-03

The effects of preservatives of antiglaucoma medications on corneal surface and tear function have been widely shown in literature; it's not the same as regards the active compounds themselves. The purpose of our study was to compare Ocular Surface Disease (OSD) signs and symptoms of Tafluprost 0.0015% versus preservative free (PF) Timolol 0.1% eyedrops in ocular hypertensive (OH) and in primary open-angle glaucoma (POAG) patients. A cross-sectional study included patients in monotherapy for at least 36 months with Tafluprost 0.0015% (27) or PF Timolol 0.1% (24) and 20 healthy age and sex-matched volunteers. All subjects underwent clinical tests (Schirmer I and break-up time), in vivo confocal microscopy (IVCM) and were surveyed using Ocular Surface Disease Index (OSDI) and Glaucoma Symptoms Scale (GSS) questionnaires. The groups were compared with ANOVA, Kruskal-Wallis test, t-test, Mann-Whitney test and Bonferroni's adjustment of p-values. No significant differences were found in questionnaires scores, clinical tests, IVCM variables between therapy groups. Tafluprost 0.0015% group showed significantly higher OSDI score, basal epithelial cells density, stromal reflectivity, sub-basal nerves tortuosity (p = 0.0000, 0.037, 0.006, 0.0000) and less GSS score, number of sub-basal nerves (p = 0.0000, 0.037) than controls but similar clinical tests results (p > 0.05). PF Timolol group had significantly higher OSDI score, basal epithelial cells density, stromal reflectivity and sub-basal nerve tortuosity (p = 0.000, 0.014, 0.008, 0.002), less GSS score, BUT and number of sub-basal nerves (p = 0.0000, 0.026, 0.003) than controls. Compared to PF Timolol 0.1%, Tafluprost 0.0015% showed similar safety with regards to tear function and corneal status and a similar tolerability profile. Both therapy groups show some alterations in corneal microstructure but no side effects on tear function except for an increased tear instability in PF Timolol 0.1% group. Ophtalmologists should be aware that even PF formulations may lead to a mild ocular surface impairment.

Effect of benzalkonium chloride-free latanoprost ophthalmic solution on ocular surface in patients with glaucoma.

PubMed

Walimbe, Tejaswini; Chelerkar, Vidya; Bhagat, Purvi; Joshi, Abhijeet; Raut, Atul

2016-01-01

Benzalkonium chloride (BAK), included as a preservative in many topical treatments for glaucoma, induces significant toxicity and alters tear breakup time (TBUT). BAK-containing latanoprost, an ester prodrug of prostaglandin F2α, can cause ocular adverse events (AEs) associated with BAK. The purpose of this study was to evaluate the efficacy and safety of BAK-free latanoprost. A prospective, open-label, single-arm, multicenter, 8-week study in patients with primary open-angle glaucoma or ocular hypertension taking BAK-containing latanoprost for ≥12 months was performed. Patients were switched to BAK-free latanoprost ophthalmic solution 0.005% administered once daily, and eyes were assessed after 28 and 56 days. Primary efficacy and safety variables were TBUT and treatment-emergent AEs, respectively. At day 56, 40 eyes were evaluable. Mean TBUT increased significantly from baseline (3.67±1.60 seconds) to 5.03±2.64 and 6.06±3.39 seconds after 28 and 56 days of treatment with BAK-free latanoprost (P<0.0001). Ocular Surface Disease Index(©) (OSDI(©)) score also decreased significantly to 12.06±13.40 and 7.06±10.75 at 28 and 56 days, respectively, versus baseline (18.09±18.61, P<0.0001). In addition, inferior corneal staining score decreased significantly to 0.53 from baseline (0.85, P=0.0033). A reduction in conjunctival hyperemia and intraocular pressure was observed at both time points. No treatment-related serious AEs were evident and 12 (26.08%) treatment-emergent AEs occurred in seven patients, with eye pain and irritation being the most frequent. No clinically significant changes in vital signs or slit lamp examinations were observed. Results indicate that switching from BAK-containing latanoprost to BAK-free latanoprost resulted in significant improvements in TBUT, OSDI(©) score, and inferior corneal staining score, and measurable reductions in conjunctival hyperemia score. Furthermore, BAK-free latanoprost was well tolerated with only mild-to-moderate and self-limiting AEs. BAK-free latanoprost appears to be effective in protecting ocular surface integrity in glaucoma patients but further studies are needed to confirm this beneficial effect.

Ocular surface injury from a microwave superheated egg resulting in a pseudopterygium.

PubMed

Gagnon, Michael R; Dickinson, Paul J

2005-05-01

To describe the first case of ocular surface injury resulting in a pseudopterygium from a microwave superheated egg. Case report. A 12-year-old girl sustained an ocular surface injury resulting in a pseudopterygium from a microwave superheated egg. Microwave superheated eggs can result in ocular injury. This case illustrates the potential ocular danger involved with microwave ovens.

THE USE OF IODINE-125 AS A DIAGNOSTIC AGENT IN OPHTHALMOLOGY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Newell, F.W.; Goren, S.B.; Brizel, H.E.

The use of radioactive isotopes in ophthalmoiogy has been restricted by the physical properties of the radioactive compounds available. Beta-emitting compounds, such as radiophosphorus (P/sup 32/), are mainly useful in abnormalities of the anterior ocular segment. Gamma-emitting compounds are of value only if significant quantities are retained by ocular tissue, with the remainder being rapid excreted. Under these conditions, the radioactive target within the eye would not be obscured by surrounding radi tion, particularly that emanating from the intracranial circulation. Although P/sup 32/ has often been useful in the diagnosis of anterior segment neoplasms, its application to posterior segment andmore » orbital tumors has been disappoint ing. Subconjunctival dissection, rotation of the globe, an curved probes sometimes allow counting over the lesion but often do not. The probe used to measure the radioactivity must be in close proximity to the neoplasm. The test has proved to be of no value in the differential diagnosis of retinoblastoma. Its accuracy is reduced in the presence of active ocular inflammatory disease, following ocular surgery, and in one-eyed patients. Characteristics favorable to clinical use of radioisotopes are listed. lodine-125 in most of these respects qualifies as an excellent isotope for ocular use. It may be substituted advantageously for P/sup 32/ or I/ sup 131/ in many clinical and experimental situations in ophthalmology. The use of diiodofluorescein labeled with I/sup 125/ for detection of intraocular tumors is described; the procedure for its use is given in detail; and results in 39 patients are revealed. In the 19 patients with histologic evidence of neoplasm the test was correctly positive in 15 and a false negative result occurred in 4, an overall accuracy of 79%. In 20 patients with a variety of non-neoplastic ocular diseases there were no positive tests. Successful results are also reported on the efficacy of I/sup 125/-labeled diiodofluorescein as a diagnostic agent in the laboratory, the V-2 rabbit carcinoma being used as an experimental model. Clinical results of tests using I/sup 125/labeled tetracycline are also described. (BBB)« less

Cluster Bomb Ocular Injuries

PubMed Central

Mansour, Ahmad M.; Hamade, Haya; Ghaddar, Ayman; Mokadem, Ahmad Samih; El Hajj Ali, Mohamad; Awwad, Shady

2012-01-01

Purpose: To present the visual outcomes and ocular sequelae of victims of cluster bombs. Materials and Methods: This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006). Data were gathered from the reports to the Information Management System for Mine Action. Results: There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308) of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67%) with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes), corneal foreign bodies (9 eyes), corneal decompensation (2 eyes), ruptured cataract (6 eyes), and intravitreal foreign bodies (10 eyes). The corneas of one patient had extreme attenuation of the endothelium. Conclusions: Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs. PMID:22346132

Frequency-tuning characteristics of cervical and ocular vestibular evoked myogenic potentials induced by air-conducted tone bursts.

PubMed

Park, Hong Ju; Lee, In-Sik; Shin, Jung Eun; Lee, Yeo Jin; Park, Mun Su

2010-01-01

To better characterize both ocular and cervical vestibular evoked myogenic potentials (VEMP) responses at different frequencies of sound in 20 normal subjects. Cervical and ocular VEMPs were recorded. The intensities of sound stimulation decreased from the maximal intensity, until no responses were evoked. Thresholds, amplitudes, latencies and interaural amplitude difference ratio (IADR) at the maximal stimulation were calculated. Both tests showed the similar frequency tuning, with the lowest threshold and highest amplitude for 500-Hz tone-burst stimuli. Sound stimulation at 500Hz showed the response rates of 100% in both tests. Cervical VEMPs showed higher incidence than ocular VEMPs. Ocular VEMP thresholds were significantly higher than those of cervical VEMP. Cervical VEMP amplitudes were significantly higher than ocular VEMP amplitudes. IADRs of ocular and cervical VEMPs did not differ significantly. Ocular VEMP showed the similar frequency tuning to cervical VEMP. Cervical VEMP responses showed higher incidence, lower thresholds and larger amplitudes than ocular VEMP. Cervical VEMP is a more reliable measure than ocular VEMP, though the results of both tests will be complementary. Five hundred Hertz is the optimal frequency to use. Copyright 2009 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Diagnosis of ocular toxoplasmosis by two polymerase chain reaction (PCR) examinations: qualitative multiplex and quantitative real-time.

PubMed

Sugita, Sunao; Ogawa, Manabu; Inoue, Shizu; Shimizu, Norio; Mochizuki, Manabu

2011-09-01

To establish a two-step polymerase chain reaction (PCR) diagnostic system for ocular toxoplasmosis. A total of 13 ocular fluid samples (11 aqueous humor and 2 vitreous fluid) were collected from 13 patients with clinically suspected ocular toxoplasmosis. Ten ocular samples from other uveitis patients and 20 samples from subjects without ocular inflammation were used as controls. Two polymerase chain reaction (PCR) methods, i.e., qualitative multiplex PCR and quantitative real-time PCR, were used to measure the toxoplasma genome (T. gondii B1 gene). Qualitative multiplex PCR detected T. gondii B1 gene in the ocular fluids of 11 out of 13 patients with clinically suspected ocular toxoplasmosis. In real-time PCR, we detected high copy numbers of T. gondii DNA (5.1 × 10(2)-2.1 × 10(6) copies/mL) in a total of 10 patients (10/13, 77%). Only ocular toxoplasmosis scar lesions were observed in the three real-time PCR-negative patients. PCR assay results for the samples from the two control groups were all negative. The two-step PCR examination to detect toxoplasma DNA is a useful tool for diagnosing ocular toxoplasmosis.

Influenza Virus Respiratory Infection and Transmission Following Ocular Inoculation in Ferrets

PubMed Central

Belser, Jessica A.; Gustin, Kortney M.; Maines, Taronna R.; Pantin-Jackwood, Mary J.; Katz, Jacqueline M.; Tumpey, Terrence M.

2012-01-01

While influenza viruses are a common respiratory pathogen, sporadic reports of conjunctivitis following human infection demonstrates the ability of this virus to cause disease outside of the respiratory tract. The ocular surface represents both a potential site of virus replication and a portal of entry for establishment of a respiratory infection. However, the properties which govern ocular tropism of influenza viruses, the mechanisms of virus spread from ocular to respiratory tissue, and the potential differences in respiratory disease initiated from different exposure routes are poorly understood. Here, we established a ferret model of ocular inoculation to explore the development of virus pathogenicity and transmissibility following influenza virus exposure by the ocular route. We found that multiple subtypes of human and avian influenza viruses mounted a productive virus infection in the upper respiratory tract of ferrets following ocular inoculation, and were additionally detected in ocular tissue during the acute phase of infection. H5N1 viruses maintained their ability for systemic spread and lethal infection following inoculation by the ocular route. Replication-independent deposition of virus inoculum from ocular to respiratory tissue was limited to the nares and upper trachea, unlike traditional intranasal inoculation which results in virus deposition in both upper and lower respiratory tract tissues. Despite high titers of replicating transmissible seasonal viruses in the upper respiratory tract of ferrets inoculated by the ocular route, virus transmissibility to naïve contacts by respiratory droplets was reduced following ocular inoculation. These data improve our understanding of the mechanisms of virus spread following ocular exposure and highlight differences in the establishment of respiratory disease and virus transmissibility following use of different inoculation volumes and routes. PMID:22396651

[Do prisms according to Hans-Joachim Haase influence ocular prevalence?].

PubMed

Kromeier, Miriam; Schmitt, Christina; Bach, Michael; Kommerell, Guntram

2002-12-01

Ocular prevalence is defined as an unequal weighting of the eyes in the directional perception of stereo objects. Opinions differ as to the cause and relevance of ocular prevalence. Hans-Joachim Haase suggested that ocular prevalence is due to fixation disparity, brought about by incomplete compensation of heterophoria. He further suggested that prismatic spectacles determined by his "measuring and correcting methodology" (MKH) could restore bicentral fixation and thus establish a perceptual balance between both eyes. We examined 10 non-strabismic subjects with a visual acuity of > or = 1.0 in both eyes. It turned out that all 10 had a "fixation disparity type II", characterised according to Haase by a "disparate retinal correspondence". All subjects underwent the automatic Freiburg Ocular Prevalence Test, without and with MKH prisms. In addition we examined ocular prevalence under forced vergence and compared ocular prevalence with stereoacuity. Spontaneous ocular prevalence ranged between 1 and 69 %. Averaged over all 10 subjects, ocular prevalence without and with the MKH prisms were not significantly different. Statistical evaluation of single subjects revealed only in one of the 10 a significant difference (Bonferroni-corrected p = 0.001). In the subgroup of 5 subjects who underwent forced vergence, ocular prevalence remained unaltered between 0 and 18 Delta base out. The stereoscopic threshold of all 10 subjects ranged between 1.5 and 14.5 arcsec. There was no correlation between ocular prevalence and stereoscopic threshold (r = - 0.2, p = 0.5). Our results indicate that ocular prevalence is largely independent of phoria correction and vergence stress. The excellent stereoacuity of all subjects suggests that ocular prevalence is abandoned for the sake of optimal resolution when very small differences in depth have to be judged.

A geometric method for computing ocular kinematics and classifying gaze events using monocular remote eye tracking in a robotic environment.

PubMed

Singh, Tarkeshwar; Perry, Christopher M; Herter, Troy M

2016-01-26

Robotic and virtual-reality systems offer tremendous potential for improving assessment and rehabilitation of neurological disorders affecting the upper extremity. A key feature of these systems is that visual stimuli are often presented within the same workspace as the hands (i.e., peripersonal space). Integrating video-based remote eye tracking with robotic and virtual-reality systems can provide an additional tool for investigating how cognitive processes influence visuomotor learning and rehabilitation of the upper extremity. However, remote eye tracking systems typically compute ocular kinematics by assuming eye movements are made in a plane with constant depth (e.g. frontal plane). When visual stimuli are presented at variable depths (e.g. transverse plane), eye movements have a vergence component that may influence reliable detection of gaze events (fixations, smooth pursuits and saccades). To our knowledge, there are no available methods to classify gaze events in the transverse plane for monocular remote eye tracking systems. Here we present a geometrical method to compute ocular kinematics from a monocular remote eye tracking system when visual stimuli are presented in the transverse plane. We then use the obtained kinematics to compute velocity-based thresholds that allow us to accurately identify onsets and offsets of fixations, saccades and smooth pursuits. Finally, we validate our algorithm by comparing the gaze events computed by the algorithm with those obtained from the eye-tracking software and manual digitization. Within the transverse plane, our algorithm reliably differentiates saccades from fixations (static visual stimuli) and smooth pursuits from saccades and fixations when visual stimuli are dynamic. The proposed methods provide advancements for examining eye movements in robotic and virtual-reality systems. Our methods can also be used with other video-based or tablet-based systems in which eye movements are performed in a peripersonal plane with variable depth.

Examining the Convergent and Discriminant Validity of Visual and Mental Workload Using Ocular Activity Variables

DTIC Science & Technology

2010-03-01

Laboratory ATTN: RDRL- HRM -DI Aberdeen Proving Ground, MD 21005-5425 8. PERFORMING ORGANIZATION REPORT NUMBER ARL-TR-5132 9. SPONSORING... Automobile drivers can successfully manage lateral movement and appropriate acceleration parameters, and listening to a radio does not appear to...JOHN J KINGMAN RD STE 0944 FT BELVOIR VA 22060-6218 1 ARL FIRES CENTER OF EXCELLENCE FIELD ELEMENT ATTN RDRL HRM AF C HERNANDEZ

Development of loteprednol etabonate-loaded cationic nanoemulsified in-situ ophthalmic gel for sustained delivery and enhanced ocular bioavailability.

PubMed

Patel, Nirav; Nakrani, Happy; Raval, Mihir; Sheth, Navin

2016-11-01

A novel cationic nanoemulsified in-situ ophthalmic gel of loteprednol etabonate (LE) was developed to improve the permeability and retention time of formulations for overall improvement of drug's ocular bioavability. Capryol 90 (oil phase), tween 80 (surfactant) and transcutol P (cosurfactant) was selected as formulation excipients to construct pseudoternary phase diagrams and nanoemulsion region was recognized from diagrams. Spontaneous emulsification method was used to manufacture LE nanoemulsion and it was optimized using 3 2 factorial design by considering the amount of oil and the ratio of surfactant to cosurfactant (S mix ) as independent variables and evaluated for various physicochemical properties. Optimized NE was dispersed in Poloxamer 407 and 188 solution to form nanoemulsified sols that were predictable to transform into in-situ gels at corneal temperature. Drug pharmacokinetics of sterilized optimized in situ NE gel, NE-ISG2 [0.69% w/w Capryol 90, 0.99%w/w S mix (3:1), 13% Poloxamer 407, 4% w/w Poloxamer 188] and marketed formulation were assessed in rabbit aqueous humor. The in-situ gels were clear, shear thinning in nature and displayed zero-order drug release kinetics. NE-ISG2 showed the minimum ocular irritation potential and significantly (p < 0.01) higher C max and AUC (0-10 h) , delayed T max , extended mean residence time and improved (2.54-fold times) bioavailability compared to marketed formulation.

M.I.T./Canadian vestibular experiments on the Spacelab-1 mission: 6. Vestibular reactions to lateral acceleration following ten days of weightlessness

NASA Technical Reports Server (NTRS)

Arrott, A. P.; Young, L. R.

1986-01-01

Tests of otolith function were performed pre-flight and post-flight on the science crew of the first Spacelab Mission with a rail-mounted linear acceleration sled. Four tests were performed using horizontal lateral (y-axis) acceleration: perception of linear motion, a closed loop nulling task, dynamic ocular torsion, and lateral eye deviations. The motion perception test measured the time to detect the onset and direction of near threshold accelerations. Post-flight measures of threshold and velocity constant obtained during the days immediately following the mission showed no consistent pattern of change among the four crewmen compared to their pre-flight baseline other than an increased variability of response. In the closed loop nulling task, crewmen controlled the motion of the sled and attempted to null a computer-generated random disturbance motion. When performed in the light, no difference in ability was noted between pre-flight and post-flight. In the dark, however, two of the four crewmen exhibited somewhat enhanced performance post-flight. Dynamic ocular torsion was measured in response to sinusoidal lateral acceleration which produces a gravitionertial stimulus equivalent to lateral head tilt without rotational movement of the head. Results available for two crewmen suggest a decreased amplitude of sinusoidal ocular torsion when measured on the day of landing (R+0) and an increasing amplitude when measured during the week following the mission.

Effect of isoproterenol, phenylephrine, and sodium nitroprusside on fundus pulsations in healthy volunteers.

PubMed Central

Schmetterer, L; Wolzt, M; Salomon, A; Rheinberger, A; Unfried, C; Zanaschka, G; Fercher, A F

1996-01-01

AIMS/BACKGROUND: Recently a laser interferometric method for topical measurement of fundus pulsations has been developed. Fundus pulsations in the macular region are caused by the inflow and outflow of blood into the choroid. The purpose of this work was to study the influence of a peripheral vasoconstricting (the alpha 1 adrenoceptor agonist phenylephrine), a predominantly positive inotropic (the non-specific beta adrenoceptor agonist isoproterenol), and a non-specific vasodilating (sodium nitroprusside) model drug on ocular fundus pulsations to determine reproducibility and sensitivity of the method. METHODS: In a double masked randomised crossover study the drugs were administered in stepwise increasing doses to 10 male and nine female healthy volunteers. Systemic haemodynamic variables and fundus pulsations were measured at all infusion steps. RESULTS: Fundus pulsation increased during infusion of isoproterenol with statistical significance versus baseline at the lowest dose of 0.1 microgram/min. Neither peripheral vasoconstriction nor peripheral vasodilatation affected the ocular fundus pulsations. CONCLUSIONS: Measurements of fundus pulsations is a highly reproducible method in healthy subjects with low ametropy. Changes of local pulsatile ocular blood flow were detectable with our method following the infusion of isoproterenol. As systemic pharmacological vasodilatation or vasoconstriction did not change fundus pulsations, further experimental work has to be done to evaluate the sensitivity of the laser interferometric fundus pulsation measurement in various eye diseases. PMID:8703859

Genetic Syndromes Associated with Congenital Cardiac Defects and Ophthalmologic Changes - Systematization for Diagnosis in the Clinical Practice

PubMed Central

Oliveira, Priscila H. A.; Souza, Beatriz S.; Pacheco, Eimi N.; Menegazzo, Michele S.; Corrêa, Ivan S.; Zen, Paulo R. G.; Rosa, Rafael F. M.; Cesa, Claudia C.; Pellanda, Lucia C.; Vilela, Manuel A. P.

2018-01-01

Background Numerous genetic syndromes associated with heart disease and ocular manifestations have been described. However, a compilation and a summarization of these syndromes for better consultation and comparison have not been performed yet. Objective The objective of this work is to systematize available evidence in the literature on different syndromes that may cause congenital heart diseases associated with ocular changes, focusing on the types of anatomical and functional changes. Method A systematic search was performed on Medline electronic databases (PubMed, Embase, Cochrane, Lilacs) of articles published until January 2016. Eligibility criteria were case reports or review articles that evaluated the association of ophthalmic and cardiac abnormalities in genetic syndrome patients younger than 18 years. Results The most frequent genetic syndromes were: Down Syndrome, Velo-cardio-facial / DiGeorge Syndrome, Charge Syndrome and Noonan Syndrome. The most associated cardiac malformations with ocular findings were interatrial communication (77.4%), interventricular communication (51.6%), patent ductus arteriosus (35.4%), pulmonary artery stenosis (25.8%) and tetralogy of Fallot (22.5%). Conclusion Due to their clinical variability, congenital cardiac malformations may progress asymptomatically to heart defects associated with high morbidity and mortality. For this reason, the identification of extra-cardiac characteristics that may somehow contribute to the diagnosis of the disease or reveal its severity is of great relevance. PMID:29538527

Management of the ocular surface and tear film before, during, and after laser in situ keratomileusis.

PubMed

Albietz, Julie M; Lenton, Lee M

2004-01-01

To identify evidence-based, best practice strategies for managing the ocular surface and tear film before, during, and after laser in situ keratomileusis (LASIK). After a comprehensive review of relevant published literature, evidence-based recommendations for best practice management strategies are presented. Symptoms of ocular irritation and signs of dysfunction of the integrated lacrimal gland/ocular surface functional gland unit are common before and after LASIK. The status of the ocular surface and tear film before LASIK can impact surgical outcomes in terms of potential complications during and after surgery, refractive outcome, optical quality, patient satisfaction, and the severity and duration of dry eye after LASIK. Before LASIK, the health of the ocular surface should be optimized and patients selected appropriately. Dry eye before surgery and female gender are risk factors for developing chronic dry eye after LASIK. Management of the ocular surface during LASIK can minimize ocular surface damage and the risk of adverse outcomes. Long-term management of the tear film and ocular surface after LASIK can reduce the severity and duration of dry eye symptoms and signs. Strategies to manage the integrated ocular surface/lacrimal gland functional unit before, during, and after LASIK can optimize outcomes. As problems with the ocular surface and tear film are relatively common, attention should focus on the use and improvement of evidence-based management strategies.

Serological IgG avidity test for ocular toxoplasmosis.

PubMed

Suresh, Subramaniam; Nor-Masniwati, Saidin; Nor-Idahriani, Muhd Nor; Wan-Hazabbah, Wan-Hitam; Zeehaida, Mohamed; Zunaina, Embong

2012-01-01

The purpose of this study was to evaluate the immunoglobulin (Ig) G avidity of serological toxoplasmosis testing in patients with ocular inflammation and to determine the clinical manifestations of ocular toxoplasmosis. A retrospective review of all patients presenting with ocular inflammation to the Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2005 and 2009 was undertaken. Visual acuity, clinical manifestations at presentation, toxoplasmosis antibody testing, and treatment records were analyzed. A total of 130 patients with ocular inflammation were reviewed retrospectively. The patients had a mean age of 38.41 (standard deviation 19.24, range 6-83) years. Seventy-one patients (54.6%) were found to be seropositive, of whom five (3.8%) were both IgG and IgM positive (suggestive of recently acquired ocular toxoplasmosis) while one (0.8%) showed IgG avidity ≤40% (suggestive of recently acquired ocular toxoplasmosis) and 65 patients (50.0%) showed IgG avidity >40% (suggestive of reactivation of toxoplasmosis infection). Chorioretinal scarring as an ocular manifestation was significantly more common in patients with seropositive toxoplasmosis (P = 0.036). Eighteen patients (13.8%) were diagnosed as having recent and/or active ocular toxoplasmosis based on clinical manifestations and serological testing. Ocular toxoplasmosis is a clinical diagnosis, but specific toxoplasmosis antibody testing helps to support the diagnosis and to differentiate between reactivation of infection and recently acquired ocular toxoplasmosis.

Verification of Embolic Channel Causing Blindness Following Filler Injection.

PubMed

Tansatit, Tanvaa; Moon, Hyoung Jin; Apinuntrum, Prawit; Phetudom, Thavorn

2015-02-01

Ocular complications following cosmetic filler injections are serious situations. This study provided scientific evidence that filler in the facial and the superficial temporal arteries could enter into the orbits and the globes on both sides. We demonstrated the existence of an embolic channel connecting the arterial system of the face to the ophthalmic artery. After the removal of the ocular contents from both eyes, liquid dye was injected into the cannulated channel of the superficial temporal artery in six soft embalmed cadavers and different color dye was injected into the facial artery on both sides successively. The interior sclera was monitored for dye oozing from retrograde ophthalmic perfusion. Among all 12 globes, dye injections from the 12 superficial temporal arteries entered ipsilateral globes in three and the contralateral globe in two arteries. Dye from the facial artery was infused into five ipsilateral globes and in three contralateral globes. Dye injections of two facial arteries in the same cadaver resulted in bilateral globe staining but those of the superficial temporal arteries did not. Direct communications between the same and different arteries of the four cannulated arteries were evidenced by dye dripping from the cannulating needle hubs in 14 of 24 injected arteries. Compression of the orbital rim at the superior nasal corner retarded ocular infusion in 11 of 14 arterial injections. Under some specific conditions favoring embolism, persistent interarterial anastomoses between the face and the eye allowed filler emboli to flow into the globe causing ocular complications.

Anatomical manifestations of primary blast ocular trauma observed in a postmortem porcine model.

PubMed

Sherwood, Daniel; Sponsel, William E; Lund, Brian J; Gray, Walt; Watson, Richard; Groth, Sylvia L; Thoe, Kimberly; Glickman, Randolph D; Reilly, Matthew A

2014-02-24

We qualitatively describe the anatomic features of primary blast ocular injury observed using a postmortem porcine eye model. Porcine eyes were exposed to various levels of blast energy to determine the optimal conditions for future testing. We studied 53 enucleated porcine eyes: 13 controls and 40 exposed to a range of primary blast energy levels. Eyes were preassessed with B-scan and ultrasound biomicroscopy (UBM) ultrasonography, photographed, mounted in gelatin within acrylic orbits, and monitored with high-speed videography during blast-tube impulse exposure. Postimpact photography, ultrasonography, and histopathology were performed, and ocular damage was assessed. Evidence for primary blast injury was obtained. While some of the same damage was observed in the control eyes, the incidence and severity of this damage in exposed eyes increased with impulse and peak pressure, suggesting that primary blast exacerbated these injuries. Common findings included angle recession, internal scleral delamination, cyclodialysis, peripheral chorioretinal detachments, and radial peripapillary retinal detachments. No full-thickness openings of the eyewall were observed in any of the eyes tested. Scleral damage demonstrated the strongest associative tendency for increasing likelihood of injury with increased overpressure. These data provide evidence that primary blast alone (in the absence of particle impact) can produce clinically relevant ocular damage in a postmortem model. The blast parameters derived from this study are being used currently in an in vivo model. We also propose a new Cumulative Injury Score indicating the clinical relevance of observed injuries.

TFOS DEWS II Definition and Classification Report.

PubMed

Craig, Jennifer P; Nichols, Kelly K; Akpek, Esen K; Caffery, Barbara; Dua, Harminder S; Joo, Choun-Ki; Liu, Zuguo; Nelson, J Daniel; Nichols, Jason J; Tsubota, Kazuo; Stapleton, Fiona

2017-07-01

The goals of the TFOS DEWS II Definition and Classification Subcommittee were to create an evidence-based definition and a contemporary classification system for dry eye disease (DED). The new definition recognizes the multifactorial nature of dry eye as a disease where loss of homeostasis of the tear film is the central pathophysiological concept. Ocular symptoms, as a broader term that encompasses reports of discomfort or visual disturbance, feature in the definition and the key etiologies of tear film instability, hyperosmolarity, and ocular surface inflammation and damage were determined to be important for inclusion in the definition. In the light of new data, neurosensory abnormalities were also included in the definition for the first time. In the classification of DED, recent evidence supports a scheme based on the pathophysiology where aqueous deficient and evaporative dry eye exist as a continuum, such that elements of each are considered in diagnosis and management. Central to the scheme is a positive diagnosis of DED with signs and symptoms, and this is directed towards management to restore homeostasis. The scheme also allows consideration of various related manifestations, such as non-obvious disease involving ocular surface signs without related symptoms, including neurotrophic conditions where dysfunctional sensation exists, and cases where symptoms exist without demonstrable ocular surface signs, including neuropathic pain. This approach is not intended to override clinical assessment and judgment but should prove helpful in guiding clinical management and research. Copyright © 2017 Elsevier Inc. All rights reserved.

The 2016 Bowman Lecture Conjunctival curses: scarring conjunctivitis 30 years on

PubMed Central

Dart, J K

2017-01-01

This review is in two sections. The first section summarises 35 conditions, both common and infrequent, causing cicatrising conjunctivitis. Guidelines for making a diagnosis are given together with the use of diagnostic tests, including direct and indirect immunofluorescence, and their interpretation. The second section evaluates our knowledge of ocular mucous membrane pemphigoid, which is the commonest cause of cicatrizing conjunctivitis in most developed countries. The clinical characteristics, demographics, and clinical signs of the disease are described. This is followed by a review and re-evaluation of the pathogenesis of conjunctival inflammation in mucous membrane pemphigoid (MMP), resulting in a revised hypothesis of the autoimmune mechanisms causing inflammation in ocular MMP. The relationship between inflammation and scarring in MMP conjunctiva is described. Recent research, describing the role of aldehyde dehydrogenase (ALDH) and retinoic acid (RA) in both the initiation and perpetuation of profibrotic activity in MMP conjunctival fibroblasts is summarised and the potential for antifibrotic therapy, using ALDH inhibition, is discussed. The importance of the management of the ocular surface in MMP is briefly summarised. This is followed with the rationale for the use of systemic immunomodulatory therapy, currently the standard of care for patients with active ocular MMP. The evidence for the use of these drugs is summarised and guidelines given for their use. Finally, the areas for research and innovation in the next decade are reviewed including the need for better diagnostics, markers of disease activity, and the potential for biological and topical therapies for both inflammation and scarring. PMID:28106896

Clinical implications of mast cell involvement in allergic conjunctivitis.

PubMed

Elieh Ali Komi, D; Rambasek, T; Bielory, L

2018-03-01

The conjunctiva is a common site for the allergic inflammatory response due to it being highly vascularized, having constant exposure to environmental pollutants and allergenic pollens and having a unique conjunctival associated lymphoid tissue. The primary morbidity of anterior surface conjunctival disorders that include allergic conjunctivitis and tear film disorders is associated with its high frequency of involvement rather than its severity, although the more chronic forms can involve the cornea and lead to sight-threatening conditions. Ocular allergy is associated with IgE-mediated mast cell activation in conjunctival tissue leading to the release of preformed mediators including histamine and proteases and subsequent de novo formation of lipid-derived mediators and cytokines that trigger a cascade of cellular and molecular events leading to extensive migration and infiltration of inflammatory cells to the ocular surface. The trafficking of neutrophils, eosinophils, and lymphocytes to the ocular surface is due to establishing various chemokine gradients (mainly CCL11, CCL24, CCL5, MCP-3, and MCP-4), cell surface expression of adhesion molecules (such as VCAM-1 the ligand for VLA-4), and leukocyte adhesion to vascular endothelium. The release of preformed mediators underlies the acute ocular surface response while the secondary influx of inflammatory cells leading to the recruitment and activation of eosinophils and the subsequent activation of Th2 and Th1 lymphocytes at the level of the conjunctiva reflects the late-phase reaction. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Ocular hemodynamics and glaucoma: the role of mathematical modeling.

PubMed

Harris, Alon; Guidoboni, Giovanna; Arciero, Julia C; Amireskandari, Annahita; Tobe, Leslie A; Siesky, Brent A

2013-01-01

To discuss the role of mathematical modeling in studying ocular hemodynamics, with a focus on glaucoma. We reviewed recent literature on glaucoma, ocular blood flow, autoregulation, the optic nerve head, and the use of mathematical modeling in ocular circulation. Many studies suggest that alterations in ocular hemodynamics play a significant role in the development, progression, and incidence of glaucoma. Although there is currently a limited number of studies involving mathematical modeling of ocular blood flow, regulation, and diseases (such as glaucoma), preliminary modeling work shows the potential of mathematical models to elucidate the mechanisms that contribute most significantly to glaucoma progression. Mathematical modeling is a useful tool when used synergistically with clinical and laboratory data in the study of ocular blood flow and glaucoma. The development of models to investigate the relationship between ocular hemodynamic alterations and glaucoma progression will provide a unique and useful method for studying the pathophysiology of glaucoma.

Novel mutations in PAX6, OTX2 and NDP in anophthalmia, microphthalmia and coloboma.

PubMed

Deml, Brett; Reis, Linda M; Lemyre, Emmanuelle; Clark, Robin D; Kariminejad, Ariana; Semina, Elena V

2016-04-01

Anophthalmia and microphthalmia (A/M) are developmental ocular malformations defined as the complete absence or reduction in size of the eye. A/M is a highly heterogeneous disorder with SOX2 and FOXE3 playing major roles in dominant and recessive pedigrees, respectively; however, the majority of cases lack a genetic etiology. We analyzed 28 probands affected with A/M spectrum (without mutations in SOX2/FOXE3) by whole-exome sequencing. Analysis of 83 known A/M factors identified pathogenic/likely pathogenic variants in PAX6, OTX2 and NDP in three patients. A novel heterozygous likely pathogenic variant in PAX6, c.767T>C, p.(Val256Ala), was identified in two brothers with bilateral microphthalmia, coloboma, primary aphakia, iris hypoplasia, sclerocornea and congenital glaucoma; the unaffected mother appears to be a mosaic carrier. While A/M has been reported as a rare feature, this is the first report of congenital primary aphakia in association with PAX6 and the identified allele represents the first variant in the PAX6 homeodomain to be associated with A/M. A novel pathogenic variant in OTX2, c.651delC, p.(Thr218Hisfs*76), in a patient with syndromic bilateral anophthalmia and a hemizygous pathogenic variant in NDP, c.293 C>T, p.(Pro98Leu), in two brothers with isolated bilateral microphthalmia and sclerocornea were also identified. Pathogenic/likely pathogenic variants were not discovered in the 25 remaining A/M cases. This study underscores the utility of whole-exome sequencing for identification of causative mutations in highly variable ocular phenotypes as well as the extreme genetic heterogeneity of A/M conditions.

Novel mutations in PAX6, OTX2 and NDP in anophthalmia, microphthalmia and coloboma

PubMed Central

Deml, Brett; Reis, Linda M; Lemyre, Emmanuelle; Clark, Robin D; Kariminejad, Ariana; Semina, Elena V

2016-01-01

Anophthalmia and microphthalmia (A/M) are developmental ocular malformations defined as the complete absence or reduction in size of the eye. A/M is a highly heterogeneous disorder with SOX2 and FOXE3 playing major roles in dominant and recessive pedigrees, respectively; however, the majority of cases lack a genetic etiology. We analyzed 28 probands affected with A/M spectrum (without mutations in SOX2/FOXE3) by whole-exome sequencing. Analysis of 83 known A/M factors identified pathogenic/likely pathogenic variants in PAX6, OTX2 and NDP in three patients. A novel heterozygous likely pathogenic variant in PAX6, c.767T>C, p.(Val256Ala), was identified in two brothers with bilateral microphthalmia, coloboma, primary aphakia, iris hypoplasia, sclerocornea and congenital glaucoma; the unaffected mother appears to be a mosaic carrier. While A/M has been reported as a rare feature, this is the first report of congenital primary aphakia in association with PAX6 and the identified allele represents the first variant in the PAX6 homeodomain to be associated with A/M. A novel pathogenic variant in OTX2, c.651delC, p.(Thr218Hisfs*76), in a patient with syndromic bilateral anophthalmia and a hemizygous pathogenic variant in NDP, c.293 C>T, p.(Pro98Leu), in two brothers with isolated bilateral microphthalmia and sclerocornea were also identified. Pathogenic/likely pathogenic variants were not discovered in the 25 remaining A/M cases. This study underscores the utility of whole-exome sequencing for identification of causative mutations in highly variable ocular phenotypes as well as the extreme genetic heterogeneity of A/M conditions. PMID:26130484

Prolonged asymmetric vestibular stimulation induces opposite, long-term effects on self-motion perception and ocular responses.

PubMed

Pettorossi, V E; Panichi, R; Botti, F M; Kyriakareli, A; Ferraresi, A; Faralli, M; Schieppati, M; Bronstein, A M

2013-04-01

Self-motion perception and the vestibulo-ocular reflex (VOR) were investigated in healthy subjects during asymmetric whole body yaw plane oscillations while standing on a platform in the dark. Platform oscillation consisted of two half-sinusoidal cycles of the same amplitude (40°) but different duration, featuring a fast (FHC) and a slow half-cycle (SHC). Rotation consisted of four or 20 consecutive cycles to probe adaptation further with the longer duration protocol. Self-motion perception was estimated by subjects tracking with a pointer the remembered position of an earth-fixed visual target. VOR was measured by electro-oculography. The asymmetric stimulation pattern consistently induced a progressive increase of asymmetry in motion perception, whereby the gain of the tracking response gradually increased during FHCs and decreased during SHCs. The effect was observed already during the first few cycles and further increased during 20 cycles, leading to a totally distorted location of the initial straight-ahead. In contrast, after some initial interindividual variability, the gain of the slow phase VOR became symmetric, decreasing for FHCs and increasing for SHCs. These oppositely directed adaptive effects in motion perception and VOR persisted for nearly an hour. Control conditions using prolonged but symmetrical stimuli produced no adaptive effects on either motion perception or VOR. These findings show that prolonged asymmetric activation of the vestibular system leads to opposite patterns of adaptation of self-motion perception and VOR. The results provide strong evidence that semicircular canal inputs are processed centrally by independent mechanisms for perception of body motion and eye movement control. These divergent adaptation mechanisms enhance awareness of movement toward the faster body rotation, while improving the eye stabilizing properties of the VOR.

Prolonged asymmetric vestibular stimulation induces opposite, long-term effects on self-motion perception and ocular responses

PubMed Central

Pettorossi, V E; Panichi, R; Botti, F M; Kyriakareli, A; Ferraresi, A; Faralli, M; Schieppati, M; Bronstein, A M

2013-01-01

Self-motion perception and the vestibulo-ocular reflex (VOR) were investigated in healthy subjects during asymmetric whole body yaw plane oscillations while standing on a platform in the dark. Platform oscillation consisted of two half-sinusoidal cycles of the same amplitude (40°) but different duration, featuring a fast (FHC) and a slow half-cycle (SHC). Rotation consisted of four or 20 consecutive cycles to probe adaptation further with the longer duration protocol. Self-motion perception was estimated by subjects tracking with a pointer the remembered position of an earth-fixed visual target. VOR was measured by electro-oculography. The asymmetric stimulation pattern consistently induced a progressive increase of asymmetry in motion perception, whereby the gain of the tracking response gradually increased during FHCs and decreased during SHCs. The effect was observed already during the first few cycles and further increased during 20 cycles, leading to a totally distorted location of the initial straight-ahead. In contrast, after some initial interindividual variability, the gain of the slow phase VOR became symmetric, decreasing for FHCs and increasing for SHCs. These oppositely directed adaptive effects in motion perception and VOR persisted for nearly an hour. Control conditions using prolonged but symmetrical stimuli produced no adaptive effects on either motion perception or VOR. These findings show that prolonged asymmetric activation of the vestibular system leads to opposite patterns of adaptation of self-motion perception and VOR. The results provide strong evidence that semicircular canal inputs are processed centrally by independent mechanisms for perception of body motion and eye movement control. These divergent adaptation mechanisms enhance awareness of movement toward the faster body rotation, while improving the eye stabilizing properties of the VOR. PMID:23318876

Development of the EpiOcular(TM) eye irritation test for hazard identification and labelling of eye irritating chemicals in response to the requirements of the EU cosmetics directive and REACH legislation.

PubMed

Kaluzhny, Yulia; Kandárová, Helena; Hayden, Patrick; Kubilus, Joseph; d'Argembeau-Thornton, Laurence; Klausner, Mitchell

2011-09-01

The recently implemented 7th Amendment to the EU Cosmetics Directive and the EU REACH legislation have heightened the need for in vitro ocular test methods. To address this need, the EpiOcular(TM) eye irritation test (EpiOcular-EIT), which utilises the normal (non-transformed) human cell-based EpiOcular tissue model, has been developed. The EpiOcular-EIT prediction model is based on an initial training set of 39 liquid and 21 solid test substances and uses a single exposure period and a single cut-off in tissue viability, as determined by the MTT assay. A chemical is classified as an irritant (GHS Category 1 or 2), if the tissue viability is ≤ 60%, and as a non-irritant (GHS unclassified), if the viability is > 60%. EpiOcular-EIT results for the training set, along with results for an additional 52 substances, which included a range of alcohols, hydrocarbons, amines, esters, and ketones, discriminated between ocular irritants and non-irritants with 98.1% sensitivity, 72.9% specificity, and 84.8% accuracy. To ensure the long-term commercial viability of the assay, EpiOcular tissues produced by using three alternative cell culture inserts were evaluated in the EpiOcular-EIT with 94 chemicals. The assay results obtained with the initial insert and the three alternative inserts were very similar, as judged by correlation coefficients (r²) that ranged from 0.82 to 0.96. The EpiOcular-EIT was pre-validated in 2007/2008, and is currently involved in a formal, multi-laboratory validation study sponsored by the European Cosmetics Association (COLIPA) under the auspices of the European Centre for the Validation of Alternative Methods (ECVAM). The EpiOcular-EIT, together with EpiOcular's long history of reproducibility and proven utility for ultra-mildness testing, make EpiOcular a useful model for addressing current legislation related to animal use in the testing of potential ocular irritants. 2011 FRAME.

Ocular Manifestations of Noonan Syndrome: A Prospective Clinical and Genetic Study of 25 Patients.

PubMed

van Trier, Dorothée C; Vos, Anna M C; Draaijer, Renske W; van der Burgt, Ineke; Draaisma, Jos M Th; Cruysberg, Johannes R M

2016-10-01

To determine the full spectrum of ocular manifestations in patients with Noonan syndrome (NS). Prospective cross-sectional clinical and genetic study in a tertiary referral center. Twenty-five patients with NS (mean age, 14 years; range, 8 months-25 years) clinically diagnosed by validated criteria. All patients were examined by the same team following a detailed study protocol. Genetic analyses were performed in 23 patients. Ocular abnormalities of vision and refraction, external ocular features, ocular position and motility, anterior segment, posterior segment, and intraocular pressure. Ocular features of vision and refraction were amblyopia (32%), myopia (40%), and astigmatism (52%). External ocular features were epicanthic folds (84%), hypertelorism (68%), ptosis (56%), high upper eyelid crease (64%), lower eyelid retraction (60%), abnormal upward slanting palpebral fissures (36%), downward slanting palpebral fissures (32%), and lagophthalmos (28%). Orthoptic abnormalities included strabismus (40%), abnormal stereopsis (44%), and limited ocular motility (40%). Anterior segment abnormalities included prominent corneal nerves (72%) and posterior embryotoxon (32%). Additional ocular features were found, including nonglaucomatous optic disc excavation (20%), relatively low (<10 mmHg) intraocular pressure (22%), and optic nerve hypoplasia (4%). Mutations were established in 22 patients: 19 PTPN11 mutations (76%), 1 SOS1 mutation, 1 BRAF mutation, and 1 KRAS mutation. The patient with the highest number of prominent corneal nerves had an SOS1 mutation. The patient with the lowest visual acuity, associated with bilateral optic nerve hypoplasia, had a BRAF mutation. Patients with severe ptosis and nearly total absence of levator muscle function had PTPN11 mutations. All patients showed at least 3 ocular features (range, 3-13; mean, 7), including at least 1 external ocular feature in more than 95% of the patients. Noonan syndrome is a clinical diagnosis with multiple genetic bases associated with an extensive variety of congenital ocular abnormalities. Ocular features of NS are characterized by 1 or more developmental anomalies of the eyelids (involving the position, opening, and closure) associated with various other ocular abnormalities in childhood, including amblyopia, myopia, astigmatism, strabismus, limited ocular motility, prominent corneal nerves, and posterior embryotoxon. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Experimental Models of Ocular Infection with Toxoplasma Gondii

PubMed Central

Dukaczewska, Agata; Tedesco, Roberto; Liesenfeld, Oliver

2015-01-01

Ocular toxoplasmosis is a vision-threatening disease and the major cause of posterior uveitis worldwide. In spite of the continuing global burden of ocular toxoplasmosis, many critical aspects of disease including the therapeutic approach to ocular toxoplasmosis are still under debate. To assist in addressing many aspects of the disease, numerous experimental models of ocular toxoplasmosis have been established. In this article, we present an overview on in vitro, ex vivo, and in vivo models of ocular toxoplasmosis available to date. Experimental studies on ocular toxoplasmosis have recently focused on mice. However, the majority of murine models established so far are based on intraperitoneal and intraocular infection with Toxoplasma gondii. We therefore also present results obtained in an in vivo model using peroral infection of C57BL/6 and NMRI mice that reflects the natural route of infection and mimics the disease course in humans. While advances have been made in ex vivo model systems or larger animals to investigate specific aspects of ocular toxoplasmosis, laboratory mice continue to be the experimental model of choice for the investigation of ocular toxoplasmosis. PMID:26716018

Probabilistic Modeling of Intracranial Pressure Effects on Optic Nerve Biomechanics

NASA Technical Reports Server (NTRS)

Ethier, C. R.; Feola, Andrew J.; Raykin, Julia; Myers, Jerry G.; Nelson, Emily S.; Samuels, Brian C.

2016-01-01

Altered intracranial pressure (ICP) is involved/implicated in several ocular conditions: papilledema, glaucoma and Visual Impairment and Intracranial Pressure (VIIP) syndrome. The biomechanical effects of altered ICP on optic nerve head (ONH) tissues in these conditions are uncertain but likely important. We have quantified ICP-induced deformations of ONH tissues, using finite element (FE) and probabilistic modeling (Latin Hypercube Simulations (LHS)) to consider a range of tissue properties and relevant pressures.

Ocular Blood Flow Changes in Behçet Disease Patients with/without Thrombotic Disease

PubMed Central

Yüksel, Harun; Türkcü, Fatih M.; Hamidi, Cihat; Cingü, Abdullah K.; Çinar, Yasin; Şahin, Muhammed; Özkurt, Zeynep; Çaça, İhsan

2014-01-01

ABSTRACT In this study, the authors aimed to evaluate ocular blood flow changes in Behçet disease (BD) with and without thrombotic disease. Ninety eyes of 90 patients with a diagnosis of BD (30 eyes with active uveitis, 23 eyes with inactive uveitis, 25 eyes without ocular involvement, and 12 eyes without ocular involvement and with a history of thrombosis) and 30 eyes of 30 age- and sex-matched control patients without any systemic disease with a total of 120 eyes were evaluated. In all cases, ophthalmic, central retinal, and ciliary artery flow parameters were measured with colour Doppler ultrasonography (CDU). The ocular blood flow parameters of all vessels in patients with active uveitis were found to be affected. All the flow parameters in the CRAs of the study groups were significantly different from the control group (p < 0.001). Additionally, in non-ocular BD patients with thrombosis, blood flow parameters were affected more than the parameters in non-ocular BD patients without thrombosis and control patients. In conclusion, major haemodynamic changes were observed using CDU in the ophthalmic vessels of ocular Behçet patients. Also, CDU may detect ocular blood flow alterations before initial ocular clinical manifestations appear in BD patients PMID:27928286

Ocular Blood Flow Changes in Behçet Disease Patients with/without Thrombotic Disease.

PubMed

Yüksel, Harun; Türkcü, Fatih M; Hamidi, Cihat; Cingü, Abdullah K; Çinar, Yasin; Şahin, Muhammed; Özkurt, Zeynep; Çaça, İhsan

2014-01-01

In this study, the authors aimed to evaluate ocular blood flow changes in Behçet disease (BD) with and without thrombotic disease. Ninety eyes of 90 patients with a diagnosis of BD (30 eyes with active uveitis, 23 eyes with inactive uveitis, 25 eyes without ocular involvement, and 12 eyes without ocular involvement and with a history of thrombosis) and 30 eyes of 30 age- and sex-matched control patients without any systemic disease with a total of 120 eyes were evaluated. In all cases, ophthalmic, central retinal, and ciliary artery flow parameters were measured with colour Doppler ultrasonography (CDU). The ocular blood flow parameters of all vessels in patients with active uveitis were found to be affected. All the flow parameters in the CRAs of the study groups were significantly different from the control group ( p  < 0.001). Additionally, in non-ocular BD patients with thrombosis, blood flow parameters were affected more than the parameters in non-ocular BD patients without thrombosis and control patients. In conclusion, major haemodynamic changes were observed using CDU in the ophthalmic vessels of ocular Behçet patients. Also, CDU may detect ocular blood flow alterations before initial ocular clinical manifestations appear in BD patients.

Analysis of the volumetric relationship among human ocular, orbital and fronto-occipital cortical morphology

PubMed Central

Masters, Michael; Bruner, Emiliano; Queer, Sarah; Traynor, Sarah; Senjem, Jess

2015-01-01

Recent research on the visual system has focused on investigating the relationship among eye (ocular), orbital, and visual cortical anatomy in humans. This issue is relevant in evolutionary and medical fields. In terms of evolution, only in modern humans and Neandertals are the orbits positioned beneath the frontal lobes, with consequent structural constraints. In terms of medicine, such constraints can be associated with minor deformation of the eye, vision defects, and patterns of integration among these features, and in association with the frontal lobes, are important to consider in reconstructive surgery. Further study is therefore necessary to establish how these variables are related, and to what extent ocular size is associated with orbital and cerebral cortical volumes. Relationships among these anatomical components were investigated using magnetic resonance images from a large sample of 83 individuals, which also included each subject’s body height, age, sex, and uncorrected visual acuity score. Occipital and frontal gyri volumes were calculated using two different cortical parcellation tools in order to provide a better understanding of how the eye and orbit vary in relation to visual cortical gyri, and frontal cortical gyri which are not directly related to visual processing. Results indicated that ocular and orbital volumes were weakly correlated, and that eye volume explains only a small proportion of the variance in orbital volume. Ocular and orbital volumes were also found to be equally and, in most cases, more highly correlated with five frontal lobe gyri than with occipital lobe gyri associated with V1, V2, and V3 of the visual cortex. Additionally, after accounting for age and sex variation, the relationship between ocular and total visual cortical volume was no longer statistically significant, but remained significantly related to total frontal lobe volume. The relationship between orbital and visual cortical volumes remained significant for a number of occipital lobe gyri even after accounting for these cofactors, but was again found to be more highly correlated with the frontal cortex than with the occipital cortex. These results indicate that eye volume explains only a small amount of variation in orbital and visual cortical volume, and that the eye and orbit are generally more structurally associated with the frontal lobes than they are functionally associated with the visual cortex of the occipital lobes. Results also demonstrate that these components of the visual system are highly complex and influenced by a multitude of factors in humans. PMID:26250048

Ocular manifestations of rheumatoid arthritis and their correlation with anti-cyclic citrullinated peptide antibodies.

PubMed

Vignesh, Ammapati Paul Pandian; Srinivasan, Renuka

2015-01-01

To study the ocular manifestations of rheumatoid arthritis and to correlate the role of anti-cyclic citrullinated peptide antibody (anti-CCP antibody) with the ocular manifestations. Three-hundred and ninety-two eyes of the 196 rheumatoid arthritis patients who attended the ophthalmology outpatient department underwent a detailed ocular examination using slit lamp biomicroscopy and ophthalmoscopy. The tear function of all the patients was assessed using Schirmer's test, tear film break-up time and ocular surface staining. The anti-CCP antibody titers for all the rheumatoid arthritis patients were estimated using enzyme-linked immunosorbent assay tests. Seventy-seven patients (135 eyes, 39%) out of the 196 patients studied had ocular manifestations typical of rheumatoid arthritis. Dry eye was the most common manifestation (28%, 54 patients). Of the patients, 78% was females (60 patients). The mean duration of rheumatoid arthritis in patients with ocular manifestations was 5.4±2.7 years and without ocular manifestations was 2.1±1.6years. Three percent of the patients had episcleritis (six patients). Scleritis was present in 2% of the patients (four patients). Peripheral ulcerative keratitis and sclerosing keratitis was present in 1% of the population each (two patients each). Eighty-five percent (66 patients) had bilateral manifestations 15% (eleven patients) had unilateral manifestations. There was a strong association between the presence of anti-CCP antibodies and ocular manifestations of rheumatoid arthritis which was shown by the statistically significant P-value of <0.0001. Ocular manifestations are a significant part of the extra-articular manifestation of rheumatoid arthritis. Dry eye was the most common ocular manifestation. There was a statistically significant association between the presence of anti-CCP antibodies specific to rheumatoid arthritis and the ocular manifestations.

Ocular drug delivery systems: An overview

PubMed Central

Patel, Ashaben; Cholkar, Kishore; Agrahari, Vibhuti; Mitra, Ashim K

2014-01-01

The major challenge faced by today’s pharmacologist and formulation scientist is ocular drug delivery. Topical eye drop is the most convenient and patient compliant route of drug administration, especially for the treatment of anterior segment diseases. Delivery of drugs to the targeted ocular tissues is restricted by various precorneal, dynamic and static ocular barriers. Also, therapeutic drug levels are not maintained for longer duration in target tissues. In the past two decades, ocular drug delivery research acceleratedly advanced towards developing a novel, safe and patient compliant formulation and drug delivery devices/techniques, which may surpass these barriers and maintain drug levels in tissues. Anterior segment drug delivery advances are witnessed by modulation of conventional topical solutions with permeation and viscosity enhancers. Also, it includes development of conventional topical formulations such as suspensions, emulsions and ointments. Various nanoformulations have also been introduced for anterior segment ocular drug delivery. On the other hand, for posterior ocular delivery, research has been immensely focused towards development of drug releasing devices and nanoformulations for treating chronic vitreoretinal diseases. These novel devices and/or formulations may help to surpass ocular barriers and associated side effects with conventional topical drops. Also, these novel devices and/or formulations are easy to formulate, no/negligibly irritating, possess high precorneal residence time, sustain the drug release, and enhance ocular bioavailability of therapeutics. An update of current research advancement in ocular drug delivery necessitates and helps drug delivery scientists to modulate their think process and develop novel and safe drug delivery strategies. Current review intends to summarize the existing conventional formulations for ocular delivery and their advancements followed by current nanotechnology based formulation developments. Also, recent developments with other ocular drug delivery strategies employing in situ gels, implants, contact lens and microneedles have been discussed. PMID:25590022

Ocular drug delivery systems: An overview.

PubMed

Patel, Ashaben; Cholkar, Kishore; Agrahari, Vibhuti; Mitra, Ashim K

The major challenge faced by today's pharmacologist and formulation scientist is ocular drug delivery. Topical eye drop is the most convenient and patient compliant route of drug administration, especially for the treatment of anterior segment diseases. Delivery of drugs to the targeted ocular tissues is restricted by various precorneal, dynamic and static ocular barriers. Also, therapeutic drug levels are not maintained for longer duration in target tissues. In the past two decades, ocular drug delivery research acceleratedly advanced towards developing a novel, safe and patient compliant formulation and drug delivery devices/techniques, which may surpass these barriers and maintain drug levels in tissues. Anterior segment drug delivery advances are witnessed by modulation of conventional topical solutions with permeation and viscosity enhancers. Also, it includes development of conventional topical formulations such as suspensions, emulsions and ointments. Various nanoformulations have also been introduced for anterior segment ocular drug delivery. On the other hand, for posterior ocular delivery, research has been immensely focused towards development of drug releasing devices and nanoformulations for treating chronic vitreoretinal diseases. These novel devices and/or formulations may help to surpass ocular barriers and associated side effects with conventional topical drops. Also, these novel devices and/or formulations are easy to formulate, no/negligibly irritating, possess high precorneal residence time, sustain the drug release, and enhance ocular bioavailability of therapeutics. An update of current research advancement in ocular drug delivery necessitates and helps drug delivery scientists to modulate their think process and develop novel and safe drug delivery strategies. Current review intends to summarize the existing conventional formulations for ocular delivery and their advancements followed by current nanotechnology based formulation developments. Also, recent developments with other ocular drug delivery strategies employing in situ gels, implants, contact lens and microneedles have been discussed.

Effects of ocular surface strontium-90 beta radiotherapy in dogs latently infected with canine herpesvirus-1.

PubMed

Nicklin, Amanda M; McEntee, Margaret C; Ledbetter, Eric C

2014-12-05

Latent canine herpesvirus-1 (CHV-1) infections are common in domestic dogs, but stimuli causing viral reactivation and recrudescent disease are poorly understood. Immunosuppressive pharmaceuticals are currently the only experimentally established triggers for recurrent ocular CHV-1 infection in dogs; however, ocular CHV-1 shedding has been reported clinically following strontium-90 beta radiotherapy of the ocular surface and it has been speculated that radiotherapy can directly induce viral reactivation. Strontium-90 is used as a beta radiation source for the treatment of a variety of neoplastic and immune-mediated canine ocular surface diseases. In the present study, the effects of ocular surface strontium-90 beta radiotherapy in dogs latently infected with CHV-1 were evaluated. Ten mature dogs with experimentally induced latent CHV-1 infections were randomly divided into two groups: one group received a single fraction 50 Gy radiation dose in one application from a strontium-90 ophthalmic applicator and the second group received sham radiotherapy. Dogs were then monitored for 45 days for recurrent ocular CHV-1 infection using clinical and virological outcome measures. Clinical ophthalmic examinations, ocular sample CHV-1 PCR assays, and serum CHV-1 virus neutralizing antibody assays were performed at specified intervals. No abnormalities suggestive of recurrent CHV-1 ocular disease were observed on clinical examination in any dog during the study. Ocular viral shedding was not detected and CHV-1 virus neutralizing titers remained stable in all dogs. A single fraction 50 Gy radiation dose administered to the ocular surface by strontium-90 beta radiotherapy did not result in detectable recurrent ocular CHV-1 infection in mature dogs with experimentally induced latent infection. Copyright © 2014 Elsevier B.V. All rights reserved.

General purpose algorithms for characterization of slow and fast phase nystagmus

NASA Technical Reports Server (NTRS)

Lessard, Charles S.

1987-01-01

In the overall aim for a better understanding of the vestibular and optokinetic systems and their roles in space motion sickness, the eye movement responses to various dynamic stimuli are measured. The vestibulo-ocular reflex (VOR) and the optokinetic response, as the eye movement responses are known, consist of slow phase and fast phase nystagmus. The specific objective is to develop software programs necessary to characterize the vestibulo-ocular and optokinetic responses by distinguishing between the two phases of nystagmus. The overall program is to handle large volumes of highly variable data with minimum operator interaction. The programs include digital filters, differentiation, identification of fast phases, and reconstruction of the slow phase with a least squares fit such that sinusoidal or psuedorandom data may be processed with accurate results. The resultant waveform, slow phase velocity eye movements, serves as input data to the spectral analysis programs previously developed for NASA to analyze nystagmus responses to pseudorandom angular velocity inputs.

Age-related changes in human vestibulo-ocular reflexes: Sinusoidal rotation and caloric tests

NASA Technical Reports Server (NTRS)

Peterka, R. J.; Black, F. O.; Schoenhoff, M. B.

1989-01-01

The dynamic response properties of horizontal vestibulo-ocular reflex (VOR) were characterized in 216 human subjects ranging in age from 7 to 81 years. The object of this cross-sectional study was to determine the effects of aging on VOR dynamics, and to identify the distributions of parameters which describe VOR responses to caloric and to sinusoidal rotational stimuli in a putatively normal population. Caloric test parameters showed no consistent trend with age. Rotation test parameters showed declining response amplitude and slightly less compensatory response phase with increasing age. The magnitudes of these changes were not large relative to the variability within the population. The age-related trends in VOR were not consistent with the anatomic changes in the periphery reported by others which showed an increasing rate of peripheral hair cell and nerve fiber loss in subjects over 55 years. The poor correlation between physiological and anatomical data suggest that adaptive mechanisms in the central nervous system are important in maintaining the VOR.

Use of Lumbar Punctures in the Management of Ocular Syphilis.

PubMed

Reekie, Ian; Reddy, Yaviche

2018-01-01

Ocular syphilis has become rare in the developed world, but is a common presentation to ophthalmology departments in South Africa. We investigated the proportion of patients diagnosed with ocular syphilis who went on to receive lumbar punctures, and determined the fraction of these who had cerebrospinal fluid findings suggestive of neurosyphilis. We aimed to determine whether the use of lumbar punctures in ocular syphilis patients was beneficial in picking up cases of neurosyphilis. Retrospective study of case notes of patients admitted to two district hospitals in Durban, South Africa, with ocular syphilis over a 20-month period. A total of 31 of 68 ocular syphilis patients underwent lumbar puncture, and of these, eight (25.8%) had findings suggestive of neurosyphilis. Lumbar puncture in ocular syphilis patients should continue to be a routine part of the investigation of these patients; a large proportion of ocular syphilis patients show cerebrospinal fluid findings suggestive of neurosyphilis, are at risk of the complications of neurosyphilis, and should be managed accordingly.

Should intranasal corticosteroids be used for the treatment of ocular symptoms of allergic rhinoconjunctivitis? A review of their efficacy and safety profile.

PubMed

Lightman, Sue; Scadding, Glenis K

2012-01-01

Allergic rhinoconjunctivitis (ARC) presents as nasal symptoms, eye watering and additional signs of ocular allergy (e.g. itchy/burning eyes). Intranasal corticosteroids (INSs) are the most effective treatment for the nasal symptoms of seasonal allergic rhinitis (SAR; based on 4 meta-analyses) and are considered first-line therapy when nasal congestion forms a substantial component of the patient's rhinitis symptoms. Clinical trial evidence shows that INSs also provide some relief from ocular symptoms of SAR and seasonal ARC in adults. INSs probably alleviate eye watering, the main ocular symptom of SAR, by relieving nasal congestion. Other ocular symptoms also improve with INSs. The mechanism for this effect is unknown, but might relate to naso-ocular reflex reduction. There are limited data on ocular safety with INSs. However, the literature supports the use of INSs over several months as there appears to be no considerable increase in the risk of ocular hypertension or glaucoma. Copyright © 2012 S. Karger AG, Basel.

The role of microbial flora on the ocular surface.

PubMed

Miller, Darlene; Iovieno, Alfonso

2009-10-01

Presence and interplay of microbial flora at the ocular surface reveal dynamic and evolving interactions with implications for both ocular surface health and disease. Data in this area are scarce or non-existent. The purpose of this review is to provide a snapshot of new and emerging developments in this area over the last 12 months. Recent findings signal potential roles for ocular surface microbial flora in both the preservation and extension of ocular surface health and in the initiation of new or escalation of common surface disorders. Contributions range from priming surface epithelial immune cells to regulating mucin composition and production. Other findings explore the emergent role of ocular microbial flora cross talk with pattern recognition receptors to protect and strengthen local and adaptive mucosal immunity while preserving vision. Deciphering the functional role of microbial communities at the ocular surface could bring new insights into and clarify the epidemiology and pathology of ocular surface dynamics in health and disease.

Unilateral proptosis revealing a fronto-ethmoidal mucocele.

PubMed

Lajmi, Houda; Hmaied, Wassim; Ben Jalel, Wady; Ben Romdhane, Khaoula; Chelly, Zied; El Fekih, Lamia

2017-06-01

Backgroud: The fronto-ethmoidal mucocele is a benign condition leading commonly to limited eye movement or ocular pain but it could also induce visual acuity impairment by compressing the optic nerve Aim: To discuss, through a case report, different ophthalmologic manifestations of the fronto-ethmoidalmucocele. Reported case: A 46-years-old man with no general history consulted for a bilateral ocular redness and itching. He reported, however, a mild protrusion of his left globe evolving for oneyear. The clinical examination revealed a unilateral proptosis in the left eye with a discrete limitation of theadduction. A brain and orbital computer tomography (CT)and a magnetic resonance imaging(MRI)revealed a grade I exophthalmos caused by an oval formation of fluid density in the left anterior and posterior ethmoidal cells in addition to the frontal sinus,driving theeyeball and internal oculomotor muscles back and out.The patient was referred to otorhinolaryngology department for a precocious surgical management. The ophtalmologic manifestations of the disease depend on the location, the size of the formation and involvement of adjacent structures. The loss of vision and the apex syndrome due to the compressionof the ocular globe are the most serious complications.

Ocular larva migrans caused by Toxocara cati in Mongolian gerbils and a comparison of ophthalmologic findings with those produced by T. canis.

PubMed

Akao, N; Takayanagi, T H; Suzuki, R; Tsukidate, S; Fujita, K

2000-10-01

To elucidate the pathogenic potential of Toxocara cari, we observed the ophthalmologic changes of the fundi in Mongolian gerbils, Meriones unguiculatus, after oral inoculation of 17 embryonated eggs/g body weight. Ophthalmic conditions in 8 T. cati-infected gerbils were monitored using an ophthalmoscope from day 0 to day 156 and were compared with those of 57 T. canis-infected gerbils. The results showed that T. cati larvae migrated into the eye of the gerbil and then elicited ophthalmic changes, including retinal (25%) and vitreous (50%) hemorrhaging, vasculitis (37.5%), and exudative lesions (25%). Lesions were less prevalent, however, in T. cati-infected than in T. canis-infected gerbils. Unlike in T. canis-infected gerbils, the hemorrhagic lesions did not reappear in T. cati-infected gerbils after they were absorbed. These findings suggested that T. cati larvae are a potentially hazardous pathogen for ocular toxocariasis and that Mongolian gerbils infected with T. cati may be a useful model for the study of human ocular toxocariasis caused by T. cati. This is the first study to report that T. cati larvae can induce ophthalmic lesions in the retina of gerbils.

Current Perspectives of Prophylaxis and Management of Acute Infective Endophthalmitis.

PubMed

Tranos, Paris; Dervenis, Nikolaos; Vakalis, Athanasios N; Asteriadis, Solon; Stavrakas, Panagiotis; Konstas, Anastasios G P

2016-05-01

Endophthalmitis is an intraocular inflammatory condition which may or may not be caused by infective agents. Noninfectious (sterile) endophthalmitis may be attributable to various causes including postoperative retained soft lens matter or toxicity following introduction of other agents into the eye. Infectious endophthalmitis is further subdivided into endogenous and exogenous. In endogenous endophthalmitis there is hematogenous spread of organisms from a distant source of infection whereas in exogenous endophthalmitis direct microbial inoculation may occur usually following ocular surgery or penetrating eye injury with or without intraocular foreign bodies. Acute infective endophthalmitis is usually exogenous induced by inoculation of pathogens following ocular surgery, open-globe injury and intravitreal injections. More infrequently the infective source is internal and septicemia spreads to the eye resulting in endogenous endophthalmitis. Several risk factors have been implicated including immunosuppression, ocular surface abnormalities, poor surgical wound construction, complicated cataract surgery with vitreous loss and certain types of intraocular lens. Comprehensive guidelines and recommendations on prophylaxis and monitoring of surgical cases have been proposed to minimize the risk of acute endophthalmitis. Early diagnosis and prompt management of infective endophthalmitis employing appropriately selected intravitreal antibiotics are essential to optimize visual outcome.

Occlusive retinal vasculitis in a patient with West Nile virus.

PubMed

Teitelbaum, Bruce A; Newman, Tricia L; Tresley, David J

2007-11-01

West Nile virus (WNV) was first identified in the United States in 1999. In addition to a spectrum of systemic manifestations, several ocular conditions secondary to the virus have been reported, including chorioretinitis, uveitis and optic neuritis. Age and diabetes mellitus (DM) have been reported to be associated risk factors for the more severe forms of the systemic disease. Only seven cases of occlusive retinal vasculitis have been reported in patients with WNV infection. A 60-year-old Asian male presented with complaints of decreased vision in his left eye. He had been hospitalised approximately seven weeks earlier with meningo-encephalitis secondary to presumed WNV infection, at which time he was also diagnosed with DM. The visual loss coincided with the manifestation of systemic WNV infection. Old peripheral chorioretinal lesions without active inflammation in both eyes were consistent with WNV infection. In addition, retinal haemorrhage and cotton wool spots were noted in the posterior pole of both eyes with severe macular ischaemia in the left eye. Occlusive retinal vasculitis is an uncommon ocular manifestation of WNV, which should be suspected in patients with meningitis or encephalitis who reside in endemic areas with ocular findings of the disease.

Ocular surface changes in thyroid eye disease.

PubMed

Ismailova, Dilyara S; Fedorov, Anatoly A; Grusha, Yaroslav O

2013-04-01

To study the incidence and risk factors of ocular surface damage in thyroid eye disease (TED) and to determine histological changes underlying positive vital staining in this condition. Forty-six patients (92 eyes) with TED were included in this study. Routine ophthalmologic examination, Schirmer test I, vital staining and corneal sensitivity were performed. Fifteen patients with positive vital staining underwent impression cytology and incisional biopsy. Positive vital staining with lissamine green was observed in 56 eyes (60.9%), 30 patients (65.2%). The average degree of staining was 4.57 ± 0.44 (National Eye Institute Workshop grading system). Severe dry eye syndrome was found in 16%. The following histological changes of conjunctiva were revealed: significant epithelial dystrophy with cell polymorphism, goblet cells loss, excessive desquamation and epithelial keratinization with local leukocytic infiltration of substantia propria. According to our results dry eye syndrome is present in 65.2% of patients (60.9% eyes) with TED. Significant risk factors of ocular surface damage in TED were exophthalmos, lagophthalmos, palpebral fissure height and lower lid retraction. Positive conjunctival staining results from punctuate epithelial erosions and excessive desquamation of superficial cells. Histopathologic changes detected in conjunctiva consistent with dry eye and are not specific for TED.

The Role of Magnesium in the Pathogenesis and Treatment of Glaucoma

PubMed Central

Korkmaz, Şafak; Sül, Sabahattin; Tufan, Hasan Ali; Aydın, Bahri; Dileköz, Ergin

2014-01-01

Glaucoma is characterized by chronic optic neuropathy resulting in progressive vision loss. Not only is glaucoma considered as a condition of elevated intraocular pressure (IOP), but also other risk factors may play a role in the pathogenesis of glaucomatous optic nerve damage. Vascular dysregulation in ocular blood flow and oxidative stress are currently suggested as important risk factors for glaucomatous retinal ganglion cell loss. New treatment modalities that improve ocular blood flow and reduce oxidative stress have been investigated in many studies. Magnesium (Mg) is thought to be one of the molecules that has a treatment potential in glaucoma. Mg has been shown to improve blood flow by modifying endothelial function via endothelin-1 (ET-1) and endothelial nitric oxide (NO) pathways. Mg also exhibits neuroprotective role by blocking N-methyl-D-aspartate (NMDA) receptor-related calcium influx and by inhibiting the release of glutamate, and hence protects the cell against oxidative stress and apoptosis. Both improvement in ocular blood flow and prevention of ganglion cell loss would make magnesium a good candidate for glaucoma management. Further studies on the effect of Mg may open a new therapeutic era in glaucoma. PMID:27433524

Xeroderma pigmentosum: a case report and review of the literature.

PubMed

Feller, L; Wood, N H; Motswaledi, M H; Khammissa, R A G; Meyer, M; Lemmer, J

2010-06-01

Inherited molecular defects in nucleotide excision repair genes cause the autosomal recessive condition xeroderma pigmentosum. Xeroderma pigmentosum is characterized by photo-hypersensitivity of sun-exposed tissues, and by a several thousand-fold increase in the risk of developing malignant neoplasms of the skin and of the eyes. Mutations in xeroderma pigmentosum genes that regulate nucleotide excision repair, not only predispose persons with xeroderma pigmentosum to multiple malignancies, but also promote premature cutaneous and ocular ageing, and in some cases promote progressive neurodegenerative changes. This paper describes a case of xeroderma pigmentosum with advanced cutaneous squamous cell carcinoma, actinic cheilitis and ocular lesions in a 19-year-old black woman. The extensive ultraviolet radiation-induced skin and eye damage are evidence of neglect of sun-protection and lack of appropriate medical care from childhood.

Prothese d'oeil photonique

NASA Astrophysics Data System (ADS)

Lapointe, Jerome

The eye is a vital organ not only in terms of vision and as an important element of facial expression, but also as the first point of contact between people. The loss of an eye has a far-reaching impact on an individual's psyche. Additionally, it affects the patient's professional and social life. Cosmetic rehabilitation with custom made ocular prostheses gives such individuals social and professional acceptance and mitigates problems of re-integration in society. For centuries, ocularists and eye surgeons have worked together to try to create an eye as close to a realistic one possible. All efforts and investments to improve the appearance of ocular prostheses are neutralized by the immobility of the pupil. The objective of this MSc project was to develop a system varying the pupil diameter of ocular prostheses according to the ambient light conditions. The thesis, thus presents the main achievements related to this project. Several researchers have proposed ideas to solve this problem, for example, with the use of liquid crystals, sources of light, LED display, photochromics, magnetic and polarized materials. However, none of these inventions has shown real success. The three main causes for failure include limited space available for integration, the rugged conditions of the ocular prosthesis manufacturing process and the need for a device to be self-powered and autonomous. During this Master's project, several technologies were studied to eventually converge to the liquid crystal display (LCD) solution. Several parameters were tested to successfully demonstrate the first LCD, to our knowledge, surviving the rugged conditions of the ocular prosthesis manufacturing steps. The operating principle of the device developed is very simple. An LC cell is placed in front of the iris image with a pupil of minimum size. This pupil is in fact a series of solar cells. The LC cell contains concentric ring-shaped pixels, which stop the light around the pupil to sequentially alter its diameter. When the ambient light increases, the ring-shaped pixels are activated sequentially to become transparent, the iris is then visible and the pupil appears smaller. A passive and autonomous electronic circuit is also developed in the context of this study. This circuit, which controls the LC cell pixels, is self-powered by nine solar cells interconnected in series. In the final device, the set of solar cells will be integrated into a space equal to the minimum size of the pupil. The design of such a cell is proposed in this paper. The full design of an ocular prosthesis with a dynamic pupil is also proposed and discussed. The number of artificial eyes produced each year is large. A mass produced cheap solution, which would fit the requirements for many patients, would be economically advantageous. The design of such a device is also proposed and discussed in this paper. Several constraints and foreseeable problems in the manufactured prototype are discussed and potential solutions are presented. In addition, a future works to be undertaken to manufacture a working prototype is proposed. Finally, two new approaches to solve the static pupil problem are discussed. The first also uses an LC cell but with an electrode configuration that would avoid the use of an electrical circuit. The second approach is completely different. The device would be based on micromirrors instead of the LC. Some preliminary results are presented. Our team hopes to make a working prototype within three years. Using a clinical trial, Dr. Boulos' team hopes to demonstrate that the dynamic pupil will have a positive impact on the self-worth and quality of life of patients.

The prevalence of ocular lesions associated with hypertension in a population of geriatric cats in Auckland, New Zealand.

PubMed

Carter, J M; Irving, A C; Bridges, J P; Jones, B R

2014-01-01

To provide an estimate of the prevalence of ocular lesions associated with hypertension in geriatric cats in Auckland, New Zealand and to evaluate the importance of examination of the ocular fundi of cats over eight years of age. A total of 105 cats ≥8 years of age were examined and clinical signs recorded. Blood was collected for the laboratory measurement of the concentrations of blood urea nitrogen (BUN), glucose and creatinine in serum, urine was collected for determination of urine specific gravity (USG), and blood pressure (BP) was measured using high definition oscillometry equipment. A cat was determined to have systemic hypertension with a systolic BP ≥160 mm Hg and a diastolic BP ≥100 mm Hg. Each animal had an ocular fundic examination using a retinal camera to diagnose ocular lesions associated with hypertension, including retinopathies, choroidopathies and optic neuropathies. Blood pressure was successfully recorded in 73 cats. Of these, 37 (51%) had no hypertensive ocular lesions and no underlying disease diagnosed, 24 (33%) had no hypertensive ocular lesions detected, but underlying disease such as chronic kidney disease, hyperthyroidism or diabetes mellitus was diagnosed, and 12 (16%) cats had evidence of hypertensive ocular lesions. Ten of the cats with hypertensive ocular lesions were hypertensive at the time of the first visit and two were normotensive. One additional cat had hypertensive ocular lesions, but it was not possible to obtain consistent BP readings in this animal. Chronic kidney disease was the most commonly diagnosed concurrent disease in cats with hypertensive ocular lesions (n=6). Mean systolic BP for cats with hypertensive ocular lesions (168.0 (SE 6.29) mm Hg) was higher than for those with no ocular lesions (144.7 (SE 3.11) mm Hg) or those with no lesions but with underlying disease (146.0 (SE 4.97) mm Hg) (p=0.001). Ocular fundic examination of cats over eight years of age allows identification of cats with hypertensive ocular lesions, often before the owner or veterinarian is aware the cat has a problem with its vision. This may result in diagnosis of systemic hypertension allowing early treatment and resolution of lesions. The current study demonstrates that ocular lesions resulting from hypertension occur frequently enough in cats in Auckland to support the recommendation for fundic examination in cats over eight years of age as part of the routine physical examination.

Solute Dynamics and Imaging in the Tear Film on an Eye-shaped Domain

NASA Astrophysics Data System (ADS)

Braun, R. J.; Li, Longfei; Henshaw, William; Driscoll, Tobin; King-Smith, P. E.

2015-11-01

The concentration of ions in the tear film (osmolarity) is a key variable in understanding dry eye symptoms and disease, yet its global distribution is not available; direct measurements are restricted to a region near the temporal canthus. It has been suggested that imaging methods that use solutes such as fluorescein can be used as a proxy for estimating the osmolarity. The concentration of fluorescein is not measured directly either but the intensity as a function of concentration and thickness of the film is well established. We derived a mathematical model that couples multiple solutes and fluid dynamics within the tear film on a 2D eye-shaped domain. The model includes the physical effects of evaporation, surface tension, viscosity, ocular surface wettability, osmolarity, osmosis, fluorescence and tear fluid supply and drainage. We solved the governing system of coupled nonlinear PDEs using the Overture computational framework developed at LLNL, together with a hybrid time stepping scheme (using variable step BDF and RKC). Results of our numerical simulations provide new insight about the osmolarity distribution and its connection with images obtained in vivo over the whole ocular surface and in local regions of tear thinning due to evaporation and other effects. This work was supported in part by NSF grants 1022706 and 1412085, and NIH grant 1R01EY021794.

Plasticity of the human otolith-ocular reflex

NASA Technical Reports Server (NTRS)

Wall, C. 3rd; Smith, T. R.; Furman, J. M.

1992-01-01

The eye movement response to earth vertical axis rotation in the dark, a semicircular canal stimulus, can be altered by prior exposure to combined visual-vestibular stimuli. Such plasticity of the vestibulo-ocular reflex has not been described for earth horizontal axis rotation, a dynamic otolith stimulus. Twenty normal human subjects underwent one of two types of adaptation paradigms designed either to attenuate or enhance the gain of the semicircular canal-ocular reflex prior to undergoing otolith-ocular reflex testing with horizontal axis rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about a vertical axis with a 0.2 Hz optokinetic stripe pattern that was deliberately mismatched in peak velocity. Pre- and post-adaptation horizontal axis rotations were at 60 degrees/s in the dark and produced a modulation in the slow component velocity of nystagmus having a frequency of 0.17 Hz due to putative stimulation of the otolith organs. Results showed that the magnitude of this modulation component response was altered in a manner similar to the alteration in semicircular canal-ocular responses. These results suggest that physiologic alteration of the vestibulo-ocular reflex using deliberately mismatched visual and semicircular canal stimuli induces changes in both canal-ocular and otolith-ocular responses. We postulate, therefore, that central nervous system pathways responsible for controlling the gains of canal-ocular and otolith-ocular reflexes are shared.

Solid lipid nanoparticles for ocular drug delivery.

PubMed

Seyfoddin, Ali; Shaw, John; Al-Kassas, Raida

2010-01-01

Ocular drug delivery remains challenging because of the complex nature and structure of the eye. Conventional systems, such as eye drops and ointments, are inefficient, whereas systemic administration requires high doses resulting in significant toxicity. There is a need to develop novel drug delivery carriers capable of increasing ocular bioavailability and decreasing both local and systemic cytotoxicity. Nanotechnology is expected to revolutionize ocular drug delivery. Many nano-structured systems have been employed for ocular drug delivery and yielded some promising results. Solid lipid nanoparticles (SLNs) have been looked at as a potential drug carrier system since the 1990s. SLNs do not show biotoxicity as they are prepared from physiological lipids. SLNs are especially useful in ocular drug delivery as they can enhance the corneal absorption of drugs and improve the ocular bioavailability of both hydrophilic and lipophilic drugs. SLNs have another advantage of allowing autoclave sterilization, a necessary step towards formulation of ocular preparations. This review outlines in detail the various production, characterization, sterilization, and stabilization techniques for SLNs. In-vitro and in-vivo methods to study the drug release profile of SLNs have been explained. Special attention has been given to the nature of lipids and surfactants commonly used for SLN production. A summary of previous studies involving the use of SLNs in ocular drug delivery is provided, along with a critical evaluation of SLNs as a potential ocular delivery system.

Corneal Expression of SLURP-1 by Age, Sex, Genetic Strain, and Ocular Surface Health

PubMed Central

Swamynathan, Sudha; Delp, Emili E.; Harvey, Stephen A. K.; Loughner, Chelsea L.; Raju, Leela; Swamynathan, Shivalingappa K.

2015-01-01

Purpose Although secreted Ly6/urokinase-type plasminogen activator receptor–related protein-1 (Slurp1) transcript is highly abundant in the mouse cornea, corresponding protein expression remains uncharacterized. Also, SLURP1 was undetected in previous tear proteomics studies, resulting in ambiguity about its baseline levels. Here, we examine mouse corneal Slurp1 expression in different sexes, age groups, strains, and health conditions, and quantify SLURP1 in human tears from healthy or inflamed ocular surfaces. Methods Expression of Slurp1 in embryonic day-13 (E13), E16, postnatal day-1 (PN1), PN10, PN20, and PN70 Balb/C, FVBN, C57Bl/6, and DBA/2J mouse corneas, Klf4Δ/ΔCE corneas with corneal epithelial–specific ablation of Klf4, migrating cells in wild-type corneal epithelial wound edge, and in corneas exposed to pathogen-associated molecular patterns (PAMPs) poly(I:C), zymosan-A, or Pam3Csk4 was examined by QPCR, immunoblots, and immunofluorescent staining. Human SLURP1 levels were quantified by ELISA in tears from 34 men and women aged 18 to 80 years. Results Expression of Slurp1, comparable in different strains and sexes, was low in E13, E16, PN1, and PN10 mouse corneas, and increased rapidly after eyelid opening in a Klf4-dependent manner. We found Slurp1 was downregulated in corneas exposed to PAMPs, and in migrating cells at the wound edge. Human SLURP1 expression, comparable in different sexes and age groups, was significantly decreased in tears from inflamed ocular surfaces (0.34%) than those from healthy individuals (0.77%). Conclusions These data describe the influence of age, sex, genetic background, and ocular surface health on mouse corneal expression of Slurp1, establish the baseline for human tear SLURP1 expression, and identify SLURP1 as a useful diagnostic and/or therapeutic target for inflammatory ocular surface disorders. PMID:26670825

Preimplantation genetic diagnosis as a strategy to prevent having a child born with an heritable eye disease.

PubMed

Yahalom, Claudia; Macarov, Michal; Lazer-Derbeko, Galit; Altarescu, Gheona; Imbar, Tal; Hyman, Jordana H; Eldar-Geva, Talia; Blumenfeld, Anat

2018-05-21

In developed countries, genetically inherited eye diseases are responsible for a high percentage of childhood visual impairment. We aim to report our experience using preimplantation genetic diagnostics (PGD) in order to avoid transmitting a genetic form of eye disease associated with childhood visual impairment and ocular cancer. Retrospective case series of women who underwent in vitro fertilization (IVF) and PGD due to a familial history of inherited eye disease and/or ocular cancer, in order to avoid having a child affected with the known familial disease. Each family underwent genetic testing in order to identify the underlying disease-causing mutation. IVF and PGD treatment were performed; unaffected embryos were implanted in their respective mothers. Thirty-five unrelated mothers underwent PGD, and the following hereditary conditions were identified in their families: albinism (10 families); retinitis pigmentosa (7 families); retinoblastoma (4 families); blue cone monochromatism, achromatopsia, and aniridia (2 families each); and Hermansky-Pudlak syndrome, Leber congenital amaurosis, Norrie disease, papillorenal syndrome, primary congenital cataract, congenital glaucoma, Usher syndrome type 1F, and microphthalmia with coloboma (1 family each). Following a total of 88 PGD cycles, 18 healthy (i.e., unaffected) children were born. Our findings underscore the importance an ophthalmologist plays in informing patients regarding the options now available for using prenatal and preimplantation genetic diagnosis to avoid having a child with a potentially devastating genetic form of eye disease or ocular cancer. This strategy is highly relevant, particularly given the limited options currently available for treating these conditions.

Vestibulo-ocular response and balance control in children and young adults with mild-to-moderate intellectual and developmental disability: a pilot study.

PubMed

Zur, Oz; Ronen, Ayelet; Melzer, Itshak; Carmeli, Eli

2013-06-01

The vestibulo-ocular response (VOR) may not be fully developed in children with an intellectual and developmental disability (IDD). This study aimed to identify the presence of VOR deficit in children and young adults with unspecified mild-to-moderate intellectual and developmental disability and its effect on balance control. Twenty-one children and young adults with IDD ranging in age from 8 to 22 years (mean 17.5 ± 3.9 years) were included in the study. The VOR was evaluated with the Head Impulse Test and the Static and Dynamic Visual Acuity Test (S&D-VAT). Postural stability was measured in an upright standing position by the Clinical Test for Sensory Interaction in Balance (CTSIB), single leg stance (SLS) during eyes open and eyes closed, and Romberg stance under eyes open and eyes closed conditions using a force platform. Reduced vestibulo-ocular responses were found in 13 of 21 (62%) participants who were able to complete testing. In the fifth condition of the CTSIB (standing on foam with eyes closed), those without VOR deficit were able to maintain balance longer than those with VOR deficit (29 s [median 30] vs. 12s [median 7.3], respectively; p=0.03). The study demonstrates potential effects of VOR deficit in children and young adults with IDD and some significant differences in balance control between those with and without a VOR deficit. VOR function in children and young adults with IDD should be routinely tested to enable early detection of deficits. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ocular delivery systems for topical application of anti-infective agents.

PubMed

Duxfield, Linda; Sultana, Rubab; Wang, Ruokai; Englebretsen, Vanessa; Deo, Samantha; Rupenthal, Ilva D; Al-Kassas, Raida

2016-01-01

For the treatment of anterior eye segment infections using anti-infective agents, topical ocular application is the most convenient route of administration. However, topical delivery of anti-infective agents is associated with a number of problems and challenges owing to the unique structure of the eye and the physicochemical properties of these compounds. Topical ocular drug delivery systems can be classified into two forms: conventional and non-conventional. The efficacy of conventional ocular formulations is limited by poor corneal retention and permeation resulting in low ocular bioavailability. Recently, attention has been focused on improving topical ocular delivery of anti-infective agents using advanced drug delivery systems. This review will focus on the challenges of efficient topical ocular delivery of anti-infective agents and will discuss the various types of delivery systems used to improve the treatment anterior segment infections.

Association between Exposure to Smartphones and Ocular Health in Adolescents.

PubMed

Kim, Joowon; Hwang, Yunji; Kang, Seungheon; Kim, Minhye; Kim, Tae-Shin; Kim, Jay; Seo, Jeongmin; Ahn, Hyojeong; Yoon, Sungjoon; Yun, Jun Pil; Lee, Yae Lim; Ham, Hyunsoo; Yu, Hyeong Gon; Park, Sue K

2016-08-01

Smartphone use has dramatically increased in recent years. Smartphones may have adverse health effects, particularly on the eyes, because users stare at the screen for a much longer time than they do with ordinary mobile phones. The objective of this study was to elucidate the relationship between smartphone use and ocular symptoms among adolescents. Information on smartphone use and ocular symptoms (blurring, redness, visual disturbance, secretion, inflammation, lacrimation and dryness) related to eye fatigue and strain from 715 adolescent subjects from three cities in Korea was obtained using a structured questionnaire. Ocular health was scored using number of ocular symptoms. Odds ratios (ORs), 95% confidence intervals (95% CIs) and p-values for ocular symptoms were calculated with binomial and multinomial logistic regression models. Higher prevalence rates for ocular symptoms were observed in groups with greater exposure to smartphones (p < 0.05). Longer daily smartphone use was associated with a higher likelihood of having multiple ocular symptoms (5-7 symptoms out of 7 symptoms; p = 0.005). Excessive/intermittent use (>2 hours daily and ≤2 hours continuously) and excessive/persistent use (>2 hours daily and >2 hours continuously) compared to shorter use (<2 hours daily) were associated with multiple ocular symptoms (OR 2.18, 95% CI 1.09-4.39; OR 2.26, 95% CI 1.11-4.57, respectively). A higher lifetime exposure to smartphones was associated with a higher likelihood of having multiple ocular symptoms (OR 3.05, 95% CI 1.51-6.19; p = 0.001). Increasing exposure to smartphones can have a negative impact on ocular health in adolescents.

Meibomian gland dysfunction and ocular discomfort in video display terminal workers.

PubMed

Fenga, C; Aragona, P; Cacciola, A; Spinella, R; Di Nola, C; Ferreri, F; Rania, L

2008-01-01

Meibomian gland dysfunction (MGD) is one of the most common ocular disorders encountered in clinical practice. The clinical manifestations of MGD are related to the changes in the tear film and ocular surface with symptoms of ocular discomfort. In recent years, many surveys have evaluated symptoms associated with the use of Video Display Terminals (VDT), and VDT use is recognized as a risk factor for eye discomfort. The aim of the present study was to determine if the presence of MGD contributes to the signs and symptoms of ocular discomfort during the use of VDT. In course of a routine health surveillance programme, a group of 70 subjects fulfilled the inclusion criteria and responded to a questionnaire about symptoms of ocular discomfort. The following ocular tests were performed: tear break-up time, fluorescein corneal stain, and basal tear secretion test. A total of 52 subjects out of 70 (74.3%) had MGD. A statistically significant correlation between the symptoms of ocular discomfort and hours spent on VDT work was observed in the total population (r=0.358; P=0.002; 95% CI 0.13-0.54) and in the group of subjects with MGD (r=0.365; P=0.009; 95% CI 0.103-0.58). Such correlation was not shown in subjects without MGD. The high prevalence of MGD among the subjects with symptoms of ocular discomfort suggests that this diagnosis should be considered when occupational health practitioners encounter ocular complaints among VDT operators. It appears that MGD can contribute to the development of ocular discomfort in VDT operators.

Response to treatment of myasthenia gravis according to clinical subtype.

PubMed

Akaishi, Tetsuya; Suzuki, Yasushi; Imai, Tomihiro; Tsuda, Emiko; Minami, Naoya; Nagane, Yuriko; Uzawa, Akiyuki; Kawaguchi, Naoki; Masuda, Masayuki; Konno, Shingo; Suzuki, Hidekazu; Murai, Hiroyuki; Aoki, Masashi; Utsugisawa, Kimiaki

2016-11-17

We have previously reported using two-step cluster analysis to classify myasthenia gravis (MG) patients into the following five subtypes: ocular MG; thymoma-associated MG; MG with thymic hyperplasia; anti-acetylcholine receptor antibody (AChR-Ab)-negative MG; and AChR-Ab-positive MG without thymic abnormalities. The objectives of the present study were to examine the reproducibility of this five-subtype classification using a new data set of MG patients and to identify additional characteristics of these subtypes, particularly in regard to response to treatment. A total of 923 consecutive MG patients underwent two-step cluster analysis for the classification of subtypes. The variables used for classification were sex, age of onset, disease duration, presence of thymoma or thymic hyperplasia, positivity for AChR-Ab or anti-muscle-specific tyrosine kinase antibody, positivity for other concurrent autoantibodies, and disease condition at worst and current. The period from the start of treatment until the achievement of minimal manifestation status (early-stage response) was determined and then compared between subtypes using Kaplan-Meier analysis and the log-rank test. In addition, between subtypes, the rate of the number of patients who maintained minimal manifestations during the study period/that of patients who only achieved the status once (stability of improved status) was compared. As a result of two-step cluster analysis, 923 MG patients were classified into five subtypes as follows: ocular MG (AChR-Ab-positivity, 77%; histogram of onset age, skewed to older age); thymoma-associated MG (100%; normal distribution); MG with thymic hyperplasia (89%; skewed to younger age); AChR-Ab-negative MG (0%; normal distribution); and AChR-Ab-positive MG without thymic abnormalities (100%, skewed to older age). Furthermore, patients classified as ocular MG showed the best early-stage response to treatment and stability of improved status, followed by those classified as thymoma-associated MG and AChR-Ab-positive MG without thymic abnormalities; by contrast, those classified as AChR-Ab-negative MG showed the worst early-stage response to treatment and stability of improved status. Differences were seen between the five subtypes in demographic characteristics, clinical severity, and therapeutic response. Our five-subtype classification approach would be beneficial not only to elucidate disease subtypes, but also to plan treatment strategies for individual MG patients.

21 CFR 886.4360 - Ocular surgery irrigation device.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over the...

21 CFR 886.4360 - Ocular surgery irrigation device.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over the...

21 CFR 886.4360 - Ocular surgery irrigation device.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over the...

21 CFR 886.4360 - Ocular surgery irrigation device.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over the...

21 CFR 886.4360 - Ocular surgery irrigation device.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ocular surgery irrigation device. 886.4360 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to be suspended over the...

Ocular surface injury from a microwave superheated liquid.

PubMed

Gagnon, Michael R; Walter, Keith A

2004-03-01

To describe the ocular surface injury resulting from a microwave superheated liquid. Case report. A 40-year-old man sustained an ocular surface injury from a microwave superheated liquid. The injury resulted in limbal stem cell damage requiring an autograft limbal stem cell transplantation. We are unaware of previous reports of microwave superheated liquids resulting in ocular injury. Microwave superheating of liquids is a potential ocular danger that should be brought to the attention of both ophthalmologists and their patients.

Accuracy of vision technicians in screening ocular pathology at rural vision centres of southern India.

PubMed

Suram, Vasantha; Addepalli, Uday Kumar; Krishnaiah, Sannapaneni; Kovai, Vilas; Khanna, Rohit C

2016-03-01

There is paucity of data on the inter-observer agreement and diagnostic accuracy between a primary-care technician (vision technician) and an ophthalmologist. Hence, the current study was conducted to assess the accuracy of vision technicians, to screen potentially sight-threatening ocular conditions at rural vision centres of southern India and their agreement with an ophthalmologist. In July to August 2010, patients presenting to seven vision centres in Adilabad district (Andhra Pradesh) were selected and screened in a masked manner by seven vision technicians followed by an examination by a consultant ophthalmologist. Agreement was assessed between vision technicians and the ophthalmologist for screening of potential sight-threatening ocular conditions and decisions for referral. The ophthalmologist's findings were considered as the reference standard. Two hundred and seventy-nine patients were enrolled at seven vision centres with a mean age of 32.9 ± 21.8 years. Agreement for screening of ocular pathology was 0.82 (95 per cent CI, 0.8-0.83). There was excellent agreement for cataract (0.97; 95 per cent CI, 0.93-1), refractive error (0.98; 95 per cent CI, 0.96-1), corneal pathology (1.0; 95 per cent CI, 1.0-1.0) and other anterior segment pathology (0.95; 95 per cent CI, 0.9-1); the agreement was moderate to fair for detection of glaucoma suspects (0.43; 95 per cent CI, 0.28-0.60) and retinal pathology (0.39; 95 per cent CI, 0.14-0.63). Sensitivity for screening of anterior segment pathology was 94.6-100 per cent. There was a fair to moderate sensitivity for glaucoma suspect; 35.6 per cent (95 per cent CI, 21.9-51.2) and retinal pathology 26.3 per cent (95 per cent CI, 9.2-51.2). Specificity for screening of ocular pathology was 98.2 to 100 per cent. The kappa (κ) agreement for referral for any pathology was 0.82 (0.8-0.83) CONCLUSION: As there is good agreement between the vision technicians and the ophthalmologist for screening and referral of anterior segment pathology but moderate to fair for glaucoma suspects and retinal pathology, vision technicians would be a good resource at the primary level to screen for anterior segment pathology; however, they may need further training to detect posterior segment pathology. © 2016 Optometry Australia.

Effect of varying light intensity on welfare indices of broiler chickens grown to heavy weights

USDA-ARS?s Scientific Manuscript database

The effects of varying light-intensity on ocular, immue, fear, and leg health of broiler chickens grown to heavy weights under environmentally controlled conditions were evaluated. Four identical trials were conducted with two replications per trial. In each trial, 600 Ross 308 chicks were randomly ...

Visual and Ocular Control Anomalies in Relation to Reading Difficulty.

ERIC Educational Resources Information Center

Bedwell, C. H.; And Others

1980-01-01

The visual behavior under both static and dynamic viewing conditions was examined in a group of 13-year-old successful readers, compared with a group of the same age retarded in reading. Research supports the notion that problems of dynamic binocular vision and control while reading are important. (Author/KC)

Surgical management of anomalous head posture because of horizontal gaze palsy or acquired vertical nystagmus.

PubMed

Campos, E C; Schiavi, C; Bellusci, C

2003-07-01

To confirm the effectiveness of the Kestenbaum-Anderson principle in the surgical management of compensatory head posture because of horizontal gaze palsy and acquired vertical nystagmus. Nine patients with anomalous head posture because of horizontal gaze palsy, and four patients with acquired vertical nystagmus and oscillopsia and compensatory torticollis underwent surgery according to the Kestenbaum-Anderson principle. As in the treatment of congenital nystagmus, the eyes have to be shifted in the orbits, in the direction of anomalous head posture. Homonymously based prisms were used preoperatively to assess the potential benefit of surgery. At the time of surgery, the clinical conditions of the patients had been stable for at least 1 year. After surgery, compensatory head posture and visual performances improved in all cases and the results remained stable for at least 2 years. Contrary to what is generally believed, the ocular condition of the patients with compensatory head posture secondary to neurological causes can be often improved with surgery. The aim of surgery is obviously not to modify ocular motility, but rather to improve the head position.

The eye disease of Jefferson Davis (1808-1889).

PubMed

Hertle, Richard W; Spellman, Robert

2007-01-01

The only Confederate president, Jefferson Davis, led a long and eventful life. He was a Mississippi planter, a husband, a father, West Point graduate, war hero, congressman, senator, secretary of war, and finally President of the Confederate States of America. In many ways he was a study of contrast with his northern counterpart Abraham Lincoln. Davis was personally courageous and a rich, educated, southern aristocrat who did not deeply understand the political process or have the refined personal skills necessary to work well with others. Prior to his Presidency he served with distinction in two wars, but as a result of his confederate activity and pro-slavery philosophy he is one of the least discussed famous Americans. Davis's health was a constant problem and he suffered an almost fatal attack of 'malaria' in 1836. In the winter of 1857-1858, he again was seriously ill and by the end of February 1858, a chronic, relapsing, ocular inflammatory condition began. Using historical evidence from multiple sources, this paper will propose a diagnosis of the Confederate President's ocular condition and consider how this could have influenced his military and political decisions.

The eye disease of Jefferson Davis (1808-1889).

PubMed

Hertle, Richard W; Spellman, Robert

2006-01-01

The only Confederate president, Jefferson Davis, led a long and eventful life. He was a Mississippi planter, a husband, a father, West Point graduate, war hero, congressman, senator, secretary of war, and finally President of the Confederate States of America. In many ways he was a study of contrast with his northern counterpart, Abraham Lincoln. Davis was personally courageous and a rich, educated, southern aristocrat who did not deeply understand the political process or have the refined personal skills necessary to work well with others. Prior to his Presidency he served with distinction in two wars, but as a result of his confederate activity and pro-slavery philosophy he is one of the least discussed famous Americans. Davis's health was a constant problem and he suffered an almost fatal attack of "malaria" in 1836. In the winter of 1857-1858 he again was seriously ill and by the end of February 1858 a chronic, relapsing, ocular inflammatory condition began. Using historical evidence from multiple sources, this paper will propose a diagnosis of the Confederate President's ocular condition and consider how this could have influenced his military and political decisions.

The Kenny syndrome, a rare type of growth deficiency with tubular stenosis, transient hypoparathyroidism and anomalies of refraction.

PubMed

Majewski, F; Rosendahl, W; Ranke, M; Nolte, K

1981-03-01

One family (3 cases) with the Kenny syndrome and a second family (3 cases) with features of Kenny syndrome but lacking medullary stenosis are reported. The main symptoms in both families are proportionate dwarfism, cortical thickening of tubular bones, variable anomalies of the calvaria, anemia, transient hypoparathyroidism and variable ocular anomalies. The latter include microphthalmia, and moderate-to-severe myopia or hyperopia. In the first family there was medullary stenosis of most tubular bones. In the second family two cases exhibited mild-to-moderate cortical thickening of tubular bones, but absent or mild medullary stenosis. Possible variability of the Kenny syndrome is discussed. Endocrine studies failed to demonstrate any permanent disturbance of parathormone or calcitonin metabolism, or GH deficiency. Pathogenesis remains unclear. Autosomal dominant inheritance seems to be likely.

Immunogenicity testing of therapeutic antibodies in ocular fluids after intravitreal injection.

PubMed

Wessels, Uwe; Zadak, Markus; Reiser, Astrid; Brockhaus, Janis; Ritter, Mirko; Abdolzade-Bavil, Afsaneh; Heinrich, Julia; Stubenrauch, Kay

2018-04-11

High drug concentrations in ocular fluids after intravitreal administration preclude the use of drug-sensitive immunoassays. A drug-tolerant immunoassay is therefore desirable for immunogenicity testing in ophthalmology. Immune complex (IC) antidrug antibody (ADA) assays were established for two species. The assays were compared with the bridging assay in ocular and plasma samples from two preclinical studies. The IC assays showed high drug tolerance, which enabled a reliable ADA detection in ocular fluids after intravitreal administration. The IC assays were superior to the bridging assay in the analysis of ocular fluids with high drug concentrations. The IC assay allows a reliable ADA detection in matrices with high drug concentrations, such as ocular fluids.

Dry Eye Management: Targeting the Ocular Surface Microenvironment.

PubMed

Zhang, Xiaobo; M, Vimalin Jeyalatha; Qu, Yangluowa; He, Xin; Ou, Shangkun; Bu, Jinghua; Jia, Changkai; Wang, Junqi; Wu, Han; Liu, Zuguo; Li, Wei

2017-06-29

Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment.

Dry Eye Management: Targeting the Ocular Surface Microenvironment

PubMed Central

Zhang, Xiaobo; Jeyalatha M, Vimalin; Qu, Yangluowa; He, Xin; Ou, Shangkun; Bu, Jinghua; Jia, Changkai; Wang, Junqi; Wu, Han; Liu, Zuguo

2017-01-01

Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment. PMID:28661456

Corneal Sensitivity in Tear Dysfunction and its Correlation with Clinical Parameters and Blink Rate

PubMed Central

Rahman, Effie Z.; Lam, Peter K.; Chu, Chia-Kai; Moore, Quianta; Pflugfelder, Stephen C.

2015-01-01

Purpose To compare corneal sensitivity in tear dysfunction due to a variety of causes using contact and non-contact esthesiometers and to evaluate correlations between corneal sensitivity, blink rate and clinical parameters. Design Comparative observational case series. Methods Ten normal and 33 subjects with tear dysfunction [meibomian gland disease (n = 11), aqueous tear deficiency (n = 10) - without (n = 7) and with (n = 3) Sjögren syndrome (SS) and conjunctivochalasis (n = 12)] were evaluated. Corneal sensitivity was measured with Cochet-Bonnet and air jet esthesiometers and blink rate by electromyelography. Eye irritation symptoms, tear meniscus height, tear break-up time (TBUT), and corneal and conjunctival dye staining were measured. Between group means were compared and correlations calculated. Results Compared with control (Cochet-Bonnet 5.45 mm, air esthesiometer 3.62 mg), mean sensory thresholds were significantly higher in aqueous tear deficiency using either Cochet-Bonnet (3.6 mm; P = 0.003) or air (11.7 mg; P = 0.046) esthesiometers, but were not significantly different in the other groups. Reduced corneal sensitivity significantly correlated with more rapid TBUT and blink rate, and greater irritation and ocular surface dye staining with one or both esthesiometers. Mean blink rates were significantly higher in both aqueous tear deficiency and conjunctivochalasis compared with control. Among all subjects, blink rate positively correlated with ocular surface staining and irritation and inversely correlated with TBUT. Conclusion Amongst conditions causing tear dysfunction, reduced corneal sensitivity is associated with greater irritation, tear instability, ocular surface disease and blink rate. Rapid blinking is associated with worse ocular surface disease and tear stability. PMID:26255576

Gaze Behavior in One-Handed Catching and Its Relation with Interceptive Performance: What the Eyes Can't Tell

PubMed Central

Cesqui, Benedetta; Mezzetti, Maura; Lacquaniti, Francesco; d'Avella, Andrea

2015-01-01

In ball sports, it is usually acknowledged that expert athletes track the ball more accurately than novices. However, there is also evidence that keeping the eyes on the ball is not always necessary for interception. Here we aimed at gaining new insights on the extent to which ocular pursuit performance is related to catching performance. To this end, we analyzed eye and head movements of nine subjects catching a ball projected by an actuated launching apparatus. Four different ball flight durations and two different ball arrival heights were tested and the quality of ocular pursuit was characterized by means of several timing and accuracy parameters. Catching performance differed across subjects and depended on ball flight characteristics. All subjects showed a similar sequence of eye movement events and a similar modulation of the timing of these events in relation to the characteristics of the ball trajectory. On a trial-by-trial basis there was a significant relationship only between pursuit duration and catching performance, confirming that keeping the eyes on the ball longer increases catching success probability. Ocular pursuit parameters values and their dependence on flight conditions as well as the eye and head contributions to gaze shift differed across subjects. However, the observed average individual ocular behavior and the eye-head coordination patterns were not directly related to the individual catching performance. These results suggest that several oculomotor strategies may be used to gather information on ball motion, and that factors unrelated to eye movements may underlie the observed differences in interceptive performance. PMID:25793989

Errors Associated with IOLMaster Biometry as a Function of Internal Ocular Dimensions

PubMed Central

Faria-Ribeiro, Miguel; Lopes-Ferreira, Daniela; López-Gil, Norberto; Jorge, Jorge; González-Méijome, José Manuel

2014-01-01

Purpose To evaluate the error in the estimation of axial length (AL) with the IOLMaster partial coherence interferometry (PCI) biometer and obtain a correction factor that varies as a function of AL and crystalline lens thickness (LT). Methods Optical simulations were produced for theoretical eyes using Zemax-EE software. Thirty-three combinations including eleven different AL (from 20 mm to 30 mm in 1 mm steps) and three different LT (3.6 mm, 4.2 mm and 4.8 mm) were used. Errors were obtained comparing the AL measured for a constant equivalent refractive index of 1.3549 and for the actual combinations of indices and intra-ocular dimensions of LT and AL in each model eye. Results In the range from 20 mm to 30 mm AL and 3.6–4.8 mm LT, the instrument measurements yielded an error between −0.043 mm and +0.089 mm. Regression analyses for the three LT condition were combined in order to derive a correction factor as a function of the instrument measured AL for each combination of AL and LT in the theoretical eye. Conclusions The assumption of a single “average” refractive index in the estimation of AL by the IOLMaster PCI biometer only induces very small errors in a wide range of combinations of ocular dimensions. Even so, the accurate estimation of those errors may help to improve accuracy of intra-ocular lens calculations through exact ray tracing, particularly in longer eyes and eyes with thicker or thinner crystalline lenses. PMID:24766863

Tear cytokine profile as a noninvasive biomarker of inflammation for ocular surface diseases: standard operating procedures.

PubMed

Wei, Yi; Gadaria-Rathod, Neha; Epstein, Seth; Asbell, Penny

2013-12-23

To provide standard operating procedures (SOPs) for measuring tear inflammatory cytokine concentrations and to validate the resulting profile as a minimally invasive objective metric and biomarker of ocular surface inflammation for use in multicenter clinical trials on dry eye disease (DED). Standard operating procedures were established and then validated with cytokine standards, quality controls, and masked tear samples collected from local and distant clinical sites. The concentrations of the inflammatory cytokines in tears were quantified using a high-sensitivity human cytokine multiplex kit. A panel of inflammatory cytokines was initially investigated, from which four key inflammatory cytokines (IL-1β, IL-6, INF-γ, and TNF-α) were chosen. Results with cytokine standards statistically satisfied the manufacturer's quality control criteria. Results with pooled tear samples were highly reproducible and reliable with tear volumes ranging from 4 to 10 μL. Incorporation of the SOPs into clinical trials was subsequently validated. Tear samples were collected at a distant clinical site, stored, and shipped to our Biomarker Laboratory, where a masked analysis of the four tear cytokines was successfully performed. Tear samples were also collected from a feasibility study on DED. Inflammatory cytokine concentrations were decreased in tears of subjects who received anti-inflammatory treatment. Standard operating procedures for human tear cytokine assessment suitable for multicenter clinical trials were established. Tear cytokine profiling using these SOPs may provide objective metrics useful for diagnosing, classifying, and analyzing treatment efficacy in inflammatory conditions of the ocular surface, which may further elucidate the mechanisms involved in the pathogenesis of ocular surface disease.

The Endocytic Recycling Regulatory Protein EHD1 Is Required for Ocular Lens Development

PubMed Central

Arya, Priyanka; Rainey, Mark A.; Bhattacharyya, Sohinee; Mohapatra, Bhopal; George, Manju; Kuracha, Murali R; Storck, Matthew D.; Band, Vimla; Govindarajan, Venkatesh; Band, Hamid

2015-01-01

The C-terminal Eps15 homology domain-containing (EHD) proteins play a key role in endocytic recycling, a fundamental cellular process that ensures the return of endocytosed membrane components and receptors back to the cell surface. To define the in vivo biological functions of EHD1, we have generated Ehd1 knockout mice and previously reported a requirement of EHD1 for spermatogenesis. Here, we show that approximately 56% of the Ehd1-null mice displayed gross ocular abnormalities, including anophthalmia, aphakia, microphthalmia and congenital cataracts. Histological characterization of ocular abnormalities showed pleiotropic defects that include a smaller or absent lens, persistence of lens stalk and hyaloid vasculature, and deformed optic cups. To test whether these profound ocular defects resulted from the loss of EHD1 in the lens or in non-lenticular tissues, we deleted the Ehd1 gene selectively in the presumptive lens ectoderm using Le-Cre. Conditional Ehd1 deletion in the lens resulted in developmental defects that included thin epithelial layers, small lenses and absence of corneal endothelium. Ehd1 deletion in the lens also resulted in reduced lens epithelial proliferation, survival and expression of junctional proteins E-cadherin and ZO-1. Finally, Le-Cre-mediated deletion of Ehd1 in the lens led to defects in corneal endothelial differentiation. Taken together, these data reveal a unique role for EHD1 in early lens development and suggest a previously unknown link between the endocytic recycling pathway and regulation of key developmental processes including proliferation, differentiation and morphogenesis. PMID:26455409

Peripheral Prism Glasses: Effects of Dominance, Suppression and Background

PubMed Central

Ross, Nicole C.; Bowers, Alex R.; Optom, M.C.; Peli, Eli

2012-01-01

Purpose Unilateral peripheral prisms for homonymous hemianopia (HH) place different images on corresponding peripheral retinal points, a rivalrous situation in which local suppression of the prism image could occur and thus limit device functionality. Detection with peripheral prisms has primarily been evaluated using conventional perimetry where binocular rivalry is unlikely to occur. We quantified detection over more visually complex backgrounds and examined the effects of ocular dominance. Methods Detection rates of 8 participants with HH or quadranopia and normal binocularity wearing unilateral peripheral prism glasses were determined for static perimetry targets briefly presented in the prism expansion area (in the blind hemifield) and the seeing hemifield, under monocular and binocular viewing, over uniform gray and more complex patterned backgrounds. Results Participants with normal binocularity had mixed sensory ocular dominance, demonstrated no difference in detection rates when prisms were fitted on the side of the HH or the opposite side (p>0.2), and had detection rates in the expansion area that were not different for monocular and binocular viewing over both backgrounds (p>0.4). However, two participants with abnormal binocularity and strong ocular dominance demonstrated reduced detection in the expansion area when prisms were fitted in front of the non-dominant eye. Conclusions We found little evidence of local suppression of the peripheral prism image for HH patients with normal binocularity. However, in cases of strong ocular dominance, consideration should be given to fitting prisms before the dominant eye. Although these results are promising, further testing in more realistic conditions including image motion is needed. PMID:22885783

Ocular Pseudoexfoliation and Cardiovascular Disease: A National Cross-Section Comparison Study

PubMed Central

French, Dustin D; Margo, Curtis E; Harman, Lynn E

2012-01-01

Background: Pseudoexfoliation is a systemic disorder characterized by the deposition of extracellular matrix material. The microfibrillar material that gives rise to the condition is visible clinically in the anterior segment of the eye, and is also found in other tissues, including blood vessels, skin, gallbladder, kidneys, lungs, and heart. Aims: The present study aims to determine whether ocular pseudoexfoliation is associated with selected cardiovascular diseases. Materials and Methods: A cross-section comparison study was conducted with the help of the Veterans Health Administration databases, using the International Classification of Diseases, Ninth revision, Clinical Modification for pseudoexfoliation of lens capsule and pseudoexfoliation glaucoma. Selected cardiovascular diseases and risk factors for cardiovascular disease were identified using the appropriate medical codes. Patients with primary open-angle glaucoma, chronic sinusitis, and benign prostatic hyperplasia served as the comparison groups. A logistic regression model was used to control for age, gender, race, and major cardiovascular risk factors. Results: There were 6,046 case patients with pseudoexfoliation; approximately half were diagnosed with pseudoexfoliation glaucoma. Various stages of ischemic heart disease, cardiomyopathy, and aortic aneurysm were significantly associated with ocular pseudoexfoliation, after controlling for age, gender, race, and major cardiovascular risk factors. Associations, in general, were less demonstrable relative to the primary open-angle glaucoma comparison group. Conclusion: Associations of ocular pseudoexfoliation with cardiovascular diseases were generally fewer and less pronounced when compared to patients with primary open-angle glaucoma. These results add to the results of earlier studies, which suggest that open-angle glaucoma itself might be a risk factor for certain cardiovascular disorders. PMID:23112968

Errors associated with IOLMaster biometry as a function of internal ocular dimensions.

PubMed

Faria-Ribeiro, Miguel; Lopes-Ferreira, Daniela; López-Gil, Norberto; Jorge, Jorge; González-Méijome, José Manuel

2014-01-01

To evaluate the error in the estimation of axial length (AL) with the IOLMaster partial coherence interferometry (PCI) biometer and obtain a correction factor that varies as a function of AL and crystalline lens thickness (LT). Optical simulations were produced for theoretical eyes using Zemax-EE software. Thirty-three combinations including eleven different AL (from 20mm to 30mm in 1mm steps) and three different LT (3.6mm, 4.2mm and 4.8mm) were used. Errors were obtained comparing the AL measured for a constant equivalent refractive index of 1.3549 and for the actual combinations of indices and intra-ocular dimensions of LT and AL in each model eye. In the range from 20mm to 30mm AL and 3.6-4.8mm LT, the instrument measurements yielded an error between -0.043mm and +0.089mm. Regression analyses for the three LT condition were combined in order to derive a correction factor as a function of the instrument measured AL for each combination of AL and LT in the theoretical eye. The assumption of a single "average" refractive index in the estimation of AL by the IOLMaster PCI biometer only induces very small errors in a wide range of combinations of ocular dimensions. Even so, the accurate estimation of those errors may help to improve accuracy of intra-ocular lens calculations through exact ray tracing, particularly in longer eyes and eyes with thicker or thinner crystalline lenses. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

Ocular oxygen consumption during vitreoperfusion in the cat.

PubMed

Blair, N P

2000-01-01

Little is known about the total ocular oxygen consumption rate (QO2) in human diseases. Reductions in QO2 may indicate the amount of tissue loss produced by conditions such as retinal ischemia. We sought a method to estimate QO2 that eventually could be used in patients during vitrectomy surgery. We performed vitreoperfusion (perfusion of the vitreous cavity after vitrectomy) in 22 cat eyes with no ocular blood flow. The solution contained nutrients and a high partial pressure of oxygen (PO2). In 8 eyes we placed an oxygen electrode on the sclera, choroid, or outer retina to evaluate oxygen delivery from the vitreoperfusion solution (group 1). In 8 eyes the retinas were undisturbed (group 2), and in 6 eyes we excised the retinas (group 3). In groups 2 and 3 we estimated QO2 from the temporal decline of PO2 in the vitreoperfusion solution according to a pharmacokinetic model. Group 1 demonstrated oxygenation of the entire retina. The means and standard deviations of QO2 were 3.2 +/- 0.8 and 0.4 +/- 0.7 microL/min in groups 2 and 3, respectively, the difference being the retinal contribution, 88%. In group 2, metabolism accounted for an average of 82% of the oxygen loss from the vitreoperfusion solution, whereas flow and diffusion accounted for 13% and 5%, respectively. Ocular oxygen consumption can be estimated by means of vitreoperfusion. Further developments may allow measurements in patients during vitreous surgery to clarify the pathophysiology of their diseases and assess the amount of retinal tissue that has been lost.

Relationship between Reinforcement and Eye Movements during Ocular Motor Training with Learning Disabled Children.

ERIC Educational Resources Information Center

Punnett, Audrey F.; Steinhauer, Gene D.

1984-01-01

Four reading disabled children were given eight sessions of ocular motor training with reinforcement and eight sessions without reinforcement. Two reading disabled control Ss were treated similarly but received no ocular motor training. Results demonstrated that reinforcement can improve ocular motor skills, which in turn elevates reading…

Multiple etiologies of equine recurrent uveitis--A natural model for human autoimmune uveitis: A brief review.

PubMed

Witkowski, Lucjan; Cywinska, Anna; Paschalis-Trela, Katarzyna; Crisman, Mark; Kita, Jerzy

2016-02-01

Equine recurrent uveitis (ERU) has various etiologies, with Leptospira infection and genetic predisposition being the leading risk factors. Regardless of etiology, expression of ocular proteins associated with maintenance of the blood-ocular barrier is impaired in ERU. The recurring-remitting cycle of ERU repeatedly disrupts the blood-ocular barrier, allowing the previously immune-privileged ocular environment to become the site of a progressive local autoimmune pathology that ultimately results in tissue destruction and vision loss. The immune-mediated process involves humoral and cellular mechanisms. Intraocular antibodies either produced in the eye or that leak through the blood-ocular barrier, are often present at higher levels than in serum and react with antigens in ocular tissue of horses with ERU. Ocular infiltration of auto-aggressive lymphocytes occurs with each uveitis episode and is the most crucial contributor to inflammation and eye damage. Recurring uveitis episodes may be initiated when epitopes of an ocular antigen become visible to the immune system (intramolecular spreading) or another autoantigen (intermolecular spreading), resulting in a new inflammatory reaction. Copyright © 2015 Elsevier Ltd. All rights reserved.

Incorporation of liquid lipid in lipid nanoparticles for ocular drug delivery enhancement

NASA Astrophysics Data System (ADS)

Shen, Jie; Sun, Minjie; Ping, Qineng; Ying, Zhi; Liu, Wen

2010-01-01

The present work investigates the effect of liquid lipid incorporation on the physicochemical properties and ocular drug delivery enhancement of nanostructured lipid carriers (NLCs) and attempts to elucidate in vitro and in vivo the potential of NLCs for ocular drug delivery. The CyA-loaded or fluorescein-marked nanocarriers composed of Precifac ATO 5 and Miglyol 840 (as liquid lipid) were prepared by melting-emulsion technology, and the physicochemical properties of nanocarriers were determined. The uptake of nanocarriers by human corneal epithelia cell lines (SDHCEC) and rabbit cornea was examined. Ex vivo fluorescence imaging was used to investigate the ocular distribution of nanocarriers. The in vitro cytotoxicity and in vivo acute tolerance were evaluated. The higher drug loading capacity and improved in vitro sustained drug release behavior of lipid nanoparticles was found with the incorporation of liquid lipid in lipid nanoparticles. The uptake of nanocarriers by the SDHCEC was increased with the increase in liquid lipid loading. The ex vivo fluorescence imaging of the ocular tissues indicated that the liquid lipid incorporation could improve the ocular retention and penetration of ocular therapeutics. No alternation was macroscopically observed in vivo after ocular surface exposure to nanocarriers. These results indicated that NLC was a biocompatible and potential nanocarrier for ocular drug delivery enhancement.

The mucosal surfaces of both eyes are immunologically linked by a neurogenic inflammatory reflex involving TRPV1 and substance P.

PubMed

Guzmán, Mauricio; Miglio, Maximiliano S; Zgajnar, Nadia R; Colado, Ana; Almejún, María B; Keitelman, Irene A; Sabbione, Florencia; Fuentes, Federico; Trevani, Analía S; Giordano, Mirta N; Galletti, Jeremías G

2018-06-04

Immunological interdependence between the two eyes has been reported for the cornea and the retina but not for the ocular mucosal surface. Intriguingly, patients frequently report ocular surface-related symptoms in the other eye after unilateral ocular surgery. Here we show how unilateral eye injuries in mice affect the mucosal immune response of the opposite ocular surface. We report that, despite the lack of lymphatic cross-drainage, a neurogenic inflammatory reflex in the contralateral conjunctiva is sufficient to increase, first, epithelial nuclear factor kappa B signaling, then, dendritic cell maturation, and finally, expansion of effector, instead of regulatory, T cells in the draining lymph node, leading to disrupted ocular mucosal tolerance. We also show that damage to ocular surface nerves is required. Using pharmacological inhibitors and agonists, we identified transient receptor potential vanilloid 1 (TRPV1) channel as the receptor sensing tissue damage in the injured eye and substance P released in the opposite ocular surface as the effector of the sympathetic response. Finally, blocking either step prevented subsequent ocular allergic reactions in the opposite eye in a unilateral corneal alkali burn model. This study demonstrates that both ocular surfaces are immunologically linked and suggests potential therapeutic targets for intervention.

Nanocrystal for ocular drug delivery: hope or hype.

PubMed

Sharma, Om Prakash; Patel, Viral; Mehta, Tejal

2016-08-01

The complexity of the structure and nature of the eye emanates a challenge for drug delivery to formulation scientists. Lower bioavailability concern of conventional ocular formulation provokes the interest of researchers in the development of novel drug delivery system. Nanotechnology-based formulations have been extensively investigated and found propitious in improving bioavailability of drugs by overcoming ocular barriers prevailing in the eye. The advent of nanocrystals helped in combating the problem of poorly soluble drugs specifically for oral and parenteral drug delivery and led to development of various marketed products. Nanocrystal-based formulations explored for ocular drug delivery have been found successful in achieving increase in retention time, bioavailability, and permeability of drugs across the corneal and conjunctival epithelium. In this review, we have highlighted the ocular physiology and barriers in drug delivery. A comparative analysis of various nanotechnology-based ocular formulations is done with their pros and cons. Consideration is also given to various methods of preparation of nanocrystals with their patented technology. This article highlights the success achieved in conquering various challenges of ocular delivery by the use of nanocrystals while emphasizing on its advantages and application for ocular formulation. The perspectives of nanocrystals as an emerging flipside to explore the frontiers of ocular drug delivery are discussed.

The pathology of dry eye: the interaction between the ocular surface and lacrimal glands.

PubMed

Stern, M E; Beuerman, R W; Fox, R I; Gao, J; Mircheff, A K; Pflugfelder, S C

1998-11-01

Most dry-eye symptoms result from an abnormal, nonlubricative ocular surface that increases shear forces under the eyelids and diminishes the ability of the ocular surface to respond to environmental challenges. This ocular-surface dysfunction may result from immunocompromise due to systemic autoimmune disease or may occur locally from a decrease in systemic androgen support to the lacrimal gland as seen in aging, most frequently in the menopausal female. Components of the ocular surface (cornea, conjunctiva, accessory lacrimal glands, and meibomian glands), the main lacrimal gland, and interconnecting innervation act as a functional unit. When one portion is compromised, normal lacrimal support of the ocular surface is impaired. Resulting immune-based inflammation can lead to lacrimal gland and neural dysfunction. This progression yields the OS symptoms associated with dry eye. Restoration of lacrimal function involves resolution of lymphocytic activation and inflammation. This has been demonstrated in the MRL/lpr mouse using systemic androgens or cyclosporine and in the dry-eye dog using topical cyclosporine. The efficacy of cyclosporine may be due to its immunomodulatory and antiinflammatory (phosphatase inhibitory capability) functions on the ocular surface, resulting in a normalization of nerve traffic. Although the etiologies of dry eye are varied, common to all ocular-surface disease is an underlying cytokine/receptor-mediated inflammatory process. By treating this process, it may be possible to normalize the ocular surface/lacrimal neural reflex and facilitate ocular surface healing.

Long-term mortality of patients with septic ocular or central nervous system complications from pyogenic liver abscess: a population-based study.

PubMed

Lin, Yi-Tsung; Liu, Chia-Jen; Chen, Tzeng-Ji; Fung, Chang-Phone

2012-01-01

Taiwan is endemic for pyogenic liver abscess (PLA). Septic ocular or central nervous system (CNS) complications derived from PLA can result in catastrophic disability. We investigated the epidemiology and long-term prognosis of PLA patients with septic ocular or CNS complications over an 8-year period. We extracted 21,307 patients with newly diagnosed PLA from a nationwide health registry in Taiwan between 2000 and 2007. The frequency of and risk factors for PLA with septic ocular or CNS complications were determined. The 2-year survival of these patients was compared between those with and without septic ocular or CNS complications. Septic ocular or CNS complications accounted for 2.1% of all PLA patients. Age and the Charlson comorbidity index were significantly lower in PLA patients with ocular or CNS complications than those without. Diabetes and age <65 years were independent predictors of septic ocular or CNS complications. The 2-year mortality of patients with septic ocular or CNS complications was similar to those without complications (24.8% vs. 27.5%, p = 0.502). However, among patients <65 years old and a Charlson index ≤ 1, the 2-year mortality was significantly higher in those with than without complications (18.6% vs. 11.8%, p = 0.001). Physicians should recognize that catastrophic disability due to ocular or neurological complications from PLA could lead to a poor long-term prognosis, and should follow-up these patients more closely.

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia

PubMed Central

Velasquez, Luis F; Restrepo, Carlos A; Paulo, Jose D; Donado, Jorge; Muñoz, Marta L; Aristizabal, John J

2013-01-01

Introduction: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes. Methods: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012. Results: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge. Conclusions: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma. PMID:24892238

Ocular Adverse Events Associated with Antibody–Drug Conjugates in Human Clinical Trials

PubMed Central

Miller, Paul E.; Mannis, Mark J.

2015-01-01

Abstract This article reviews ocular adverse events (AEs) reported in association with administration of antibody–drug conjugates (ADCs) in human clinical trials. References reporting ocular toxicity or AEs associated with ADCs were collected using online publication searches. Articles, abstracts, or citations were included if they cited ocular toxicities or vision-impairing AEs with a confirmed or suspected association with ADC administration. Twenty-two references were found citing ocular or vision-impairing AEs in association with ADC administration. All references reported use of ADCs in human clinical trials for treatment of various malignancies. The molecular target and cytotoxic agent varied depending on the ADC used. Ocular AEs affected a diversity of ocular tissues. The most commonly reported AEs involved the ocular surface and included blurred vision, dry eye, and corneal abnormalities (including microcystic corneal disease). Most ocular AEs were not severe (≤ grade 2) or dose limiting. Clinical outcomes were not consistently reported, but when specified, most AEs improved or resolved with cessation of treatment or with ameliorative therapy. A diverse range of ocular AEs are reported in association with administration of ADCs for the treatment of cancer. The toxicologic mechanism(s) and pathogenesis of such events are not well understood, but most are mild in severity and reversible. Drug development and medical professionals should be aware of the clinical features of these events to facilitate early recognition and intervention in the assessment of preclinical development programs and in human clinical trials. PMID:26539624

The temperature-sensitive mutants of Toxoplasma gondii and ocular toxoplasmosis.

PubMed

Lu, Fangli; Huang, Shiguang; Kasper, Lloyd H

2009-01-22

The risk of blindness caused by ocular toxoplasmosis supports efforts to improve our understanding for control of this disease. In this study, the involvement of CD8(+), CD4(+), B cell, and IL-10 gene in the immune response of primary ocular infection with the temperature-sensitive mutant (ts-4) of the RH Toxoplasma gondii strain, and in the protective immunity of ocular ts-4 vaccination and challenge with RH strain was investigated in murine models utilizing inbred C57BL/6 mice-deficient in CD4(+), CD8(+), B cells (microMT), or IL-10 gene. Compared to naive mice, all WT and mutant mice had different degree of ocular pathological changes after ts-4 ocular infection, in which both CD8 KO and IL-10 KO mice showed the most severe ocular lesions. Immunized by ts-4 intracameral (i.c.) inoculation, all mutant mice had partially decreased vaccine-induced resistance associated with increased ocular parasite burdens after RH strain challenge. A significant increase of the percentages of B cells and CD8(+) T cells in the draining lymph nodes were observed in WT and IL-10 KO mice after either infection or challenge. The levels of specific anti-toxoplasma IgG in both eye fluid and serum from all the mice were significantly increased after ts-4 i.c. immunization, except microMT mice. These results suggest that the avirulent ts-4 of T. gondii inoculated intracamerally can induce both ocular pathology and ocular protective immunity; CD4(+), CD8(+), B cell, and IL-10 gene are all necessary to the vaccine-induced resistance to ocular challenge by virulent RH strain, in which CD8(+) T cells are the most important component.

Incidence and Risk Factors of Ocular Infection Caused by Staphylococcus aureus Bacteremia

PubMed Central

Jung, Jiwon; Lee, Junyeop; Yu, Shi Nae; Kim, Yong Kyun; Lee, Ju Young; Sung, Heungsup; Kim, Mi-Na; Kim, Sung-Han; Lee, Sang-Oh; Choi, Sang-Ho; Woo, Jun Hee; Lee, Joo Yong; Kim, Yang Soo

2016-01-01

Staphylococcus aureus bacteremia (SAB) often leads to ocular infections, including endophthalmitis and chorioretinitis. However, the incidence, risk factors, and outcomes of ocular infections complicated by SAB are largely unknown. We retrospectively analyzed the incidence and risk factors of ocular involvement in a prospective cohort of patients with SAB at a tertiary-care hospital. Ophthalmologists reviewed the fundoscopic findings and classified the ocular infections as endophthalmitis or chorioretinitis. During the 5-year study period, 1,109 patients had SAB, and data for 612 (55%) who underwent ophthalmic examinations within 14 days after SAB onset were analyzed. Of those 612 patients, 56 (9% [95% confidence interval [CI], 7 to 12%]) had ocular involvement, including 15 (2.5%) with endophthalmitis and 41 (6.7%) with chorioretinitis. In a multivariate analysis, infective endocarditis (adjusted odds ratio [aOR], 5.74 [95% CI, 2.25 to 14.64]) and metastatic infection (aOR, 2.38 [95% CI, 1.29 to 4.39]) were independent risk factors for ocular involvement. Of the 47 patients with ocular involvement who could communicate, only 17 (36%) had visual disturbances. Two-thirds of the patients with endophthalmitis (10/15 patients) were treated with intravitreal antibiotics combined with parenteral antibiotics, whereas all of the patients with chorioretinitis were treated only with systemic antibiotics. No patients became blind. Among 42 patients for whom follow-up assessments were available, the ocular lesions improved in 29 (69%) but remained the same in the others. Ocular involvement was independently associated with death within 30 days after SAB onset. Ocular involvement is not uncommon among patients with SAB. Routine ophthalmic examinations should be considered for patients with infective endocarditis or metastatic infections caused by SAB. PMID:26824952

Incomplete response to artificial tears is associated with features of neuropathic ocular pain.

PubMed

Galor, Anat; Batawi, Hatim; Felix, Elizabeth R; Margolis, Todd P; Sarantopoulos, Konstantinos D; Martin, Eden R; Levitt, Roy C

2016-06-01

Artificial tears are first-line therapy for patients with dry eye symptoms. It is not known, however, which patient factors associate with a positive response to therapy. The purpose of this study was to evaluate whether certain ocular and systemic findings are associated with a differential subjective response to artificial tears. Cross-sectional study of 118 individuals reporting artificial tears use (hypromellose 0.4%) to treat dry eye-associated ocular pain. An evaluation was performed to assess dry eye symptoms (via the dry eye questionnaire 5 and ocular surface disease index), ocular and systemic (non-ocular) pain complaints and ocular signs (tear osmolarity, tear breakup time, corneal staining, Schirmer testing with anaesthesia, and eyelid and meibomian gland assessment). The main outcome measures were factors associated with differential subjective response to artificial tears. By self-report, 23 patients reported no improvement, 73 partial improvement and 22 complete improvement in ocular pain with artificial tears. Patients who reported no or partial improvement in pain with artificial tears reported higher levels of hot-burning ocular pain and sensitivity to wind compared with those with complete improvement. Patients were also asked to rate the intensity of systemic pain elsewhere in the body (other than the eye). Patients who reported no or incomplete improvement with artificial tears had higher systemic pain scores compared with those with complete improvement. Both ocular and systemic (non-ocular) pain complaints are associated with a differential subjective response to artificial tears. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A situational analysis of ocular health promotion in the South African primary health-care system.

PubMed

Sithole, Hlupheka Lawrence

2017-03-01

South Africa has a serious burden of avoidable blindness and visual impairment, which may be due to poor ocular health promotional policies and programs or implementation. Therefore, this paper sought to critically analyse the South African primary health-care policies and programs, to identify the components of ocular health promotional policies and programs as well as how they are currently being implemented and to suggest areas that can be improved in order to minimise the burden of blindness and visual impairment. Triangulated quantitative and qualitative research methods were used in the study. Questionnaire and interviews were used to solicit data from national and provincial managers of different health directorates. Eye-care managers from each province also completed the questionnaire. Furthermore, relevant health policy and program documents from national and provincial departments of health were studied to identify areas relating to ocular health promotion. The study found varying degrees of implementation of various ocular health promotional activities in the provinces with the majority of respondents (62 per cent) indicating that ocular health promotion was not part of their responsibility and another 81 per cent revealing that vision screening does not form part of their health promotional programs. It further revealed a lack of a dedicated directorate for ocular health-care issues and the absence of an integrated ocular health promotional policy. Ocular health promotional activities were absent in other provinces. This may be a major contributing factor to poor ocular health promotion in South Africa and hence, the high prevalence of blindness and visual impairment. Therefore, it is recommended that an integrated ocular health promotional model (directorate and policies) be developed and be part of the South African primary health-care system. © 2016 Optometry Australia.

Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China: 2006–2011

PubMed Central

Qi, Ying; Zhang, Feng-Yan; Peng, Guang-Hua; Zhu, Yu; Wan, Guang-Ming; Wang, Wen-Zhan; Ma, Jing; Ren, Shi-Jie

2015-01-01

AIM To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region. METHODS A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed. RESULTS This study included 5964 eyes of 5799 patients. The average age was 35.5±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59y age group. Most patients were farmers and workers (51.9%). The most common injuries were firework related (24.5%), road traffic related (24.2%), and work related (15.0%). Among the most common causative agents were firecrackers (24.5%), followed by metal/knife/scissors (21.4%). Most injuries occurred in January (14.2%), February (27.0%), and August (10.0%). There were 8.5% patients with ocular injuries combined with other injuries. The incidence of open ocular injuries (4585 eyes, 76.9%) was higher than closed ocular injuries (939 eyes, 15.7%). The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score (OTS) predicted final visual acuity at non light perception (NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%, and light perception (LP)/hand motion (HM) and 1/200-19/200 with a specificity of 100%. CONCLUSIONS This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS. PMID:25709927

Protecting the ocular surface and improving the quality of life of dry eye patients: a study of the efficacy of an HP-guar containing ocular lubricant in a population of dry eye patients.

PubMed

Rolando, Maurizio; Autori, Silvia; Badino, Francesco; Barabino, Stefano

2009-06-01

The aim of this study was to evaluate the efficacy of a non-Newtonian tear substitute containing 0.4% polyethylene glycol 400 (PEG 400) and 0.3% propylene glycol in an 0.18% hydroxypropyl-guar (HPG) containing vehicle (Systane Lubricant Eye Drops; Alcon) in reducing the signs and symptoms of dry eye, as well as its effect on ocular protection. Twenty patients with moderate to severe dry eye were enrolled in a 28-day prospective, randomized, controlled study. Subjects self-administered the HPG containing ocular lubricant four times daily (QID) over the study duration. After 28 days, the effect of the HPG containing ocular lubricant was evaluated by means of the Global Staining Score (a measure of the corneal and conjunctival staining), inter-blink tear film stability, Ocular Protection Index (OPI), and subjective symptoms. The HPG containing ocular lubricant produced statistically significant improvements compared with baseline in dry eye symptoms (P < 0.0001 at Days 7, 14, and 28); in ocular surface staining, as measured by a reduction in the Global Staining Score (P < 0.0001 at Days 7, 14, and 28); and in the OPI (P = 0.0025 at Day 14 and P = 0.0067 at Day 28). The improvements in ocular surface staining and dry eye symptoms with the HPG containing ocular lubricant -- evident as early as the first follow-up visit (Day 7) and continued throughout the 28 days of the study with a concurrent, increase in OPI to a level greater than unity -- indicate that this preparation is a fast-acting, long-lasting, and effective treatment for dry eye. In concurrence with the results from previously published clinical studies, the HPG containing ocular lubricant has shown efficacy in alleviating the signs and symptoms of dry eye as well as affording improved ocular surface protection.

Ocular injuries and eye care seeking patterns following injuries among cocoa farmers in Ghana.

PubMed

Bert, Boadi-Kusi Samuel; Rekha, Hansraj; Percy, Mashige Khathutshelo

2016-03-01

The work environment of cocoa farmers exposes them to several ocular hazards that predispose them to eye diseases and injuries. However, the extent of ocular injuries and health seeking patterns following these injuries are unknown among cocoa farmers in Ghana. To determine the prevalence of ocular injuries and health seeking behaviour following injury among cocoa farmers in Ghana. Five hundred and fifty six participants were recruited through simple random sampling using a multistage approach from four cocoa growing districts in Ghana. A structured questionnaire was used to collect relevant information such as demography, ocular hazards and injuries experienced. An ocular examination was also conducted to assess the eye health of the participants. Descriptive and regression statistics were used to analyze the data. The rate of ocular injuries was calculated by using the number of injuries reported that resulted in lost work time/days divided by the number of worker years at risk of injury (sum of years worked in cocoa farms for all the participants). The rate of ocular injuries was 11.3/1000 worker years (95% CI: 9.4 - 31) which led to lost work time of 37.3/1000 worker years (95% CI: 34.1 - 40.8). The major causes of ocular injury were plants/branches (n=73, 51.1%), chemicals (n=27, 18.9%), cocoa pod/husk (n=14, 9.8%) and occurred mostly during weeding, harvesting and chemical spraying. Few (n=34, 6.1%) participants reported the use of ocular protection. Fifty-five (38.5%) participants visited the local chemical shops, while 37 (25.9%) visited hospitals/clinics for ocular treatment of their injuries. There is a high rate of ocular injuries among cocoa farmers who make insufficient use of appropriate eye care services. There is the need for eye health education among cocoa farmers in Ghana.

Associations between oral and ocular dryness, labial and whole salivary flow rates, systemic diseases and medications in a sample of older people.

PubMed

Smidt, D; Torpet, L A; Nauntofte, B; Heegaard, K M; Pedersen, A M L

2011-06-01

To investigate the associations between age, gender, systemic diseases, medications, labial and whole salivary flow rates and oral and ocular dryness in older people. Symptoms of oral and ocular dryness, systemic diseases, medications (coded according to the Anatomical therapeutic chemical (ATC) classification system), tobacco and alcohol consumption were registered, and unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 668 randomly selected community-dwelling elderly aged 65-95. Presence of oral (12%) and ocular (11%) dryness was positively correlated. Oral dryness was associated with low UWS, SWS and LS, and ocular dryness with low UWS and SWS. Oral and ocular dryness was related to female gender, but not to age. Only four persons in the healthy and nonmedicated subgroups reported oral and ocular dryness. The numbers of diseases and medications were higher in the older age groups and associated with oral and ocular dryness, low UWS, SWS and LS. On average, women were slightly older, reported more oral and ocular dryness and had lower UWS, SWS, LS and higher numbers of diseases and medications. High prevalence and odds ratios for oral dryness were associated with metabolic, respiratory and neurological diseases and intake of thyroid hormones, respiratory agents (primarily glucocorticoids), psycholeptics and/or psychoanaleptics, antineoplastics, proton pump inhibitors, antidiabetics, loop diuretics, antispasmodics, quinine and bisphosphonates. Ocular dryness was especially associated with neurological diseases and intake of psycholeptics and/or psychoanaleptics. Intake of magnesium hydroxide, antithrombotics, cardiac agents, thiazides, beta-blockers, calcium channel blockers, ACE inhibitors/angiotensin II antagonists, statins, glucosamine, paracetamol/opioids, ophthalmologicals and certain combination therapies was related to oral and ocular dryness. In older people, oral and ocular dryness are associated with low salivary flow rates, specific as well as high number of diseases and medications, but neither with age and gender per se nor with tobacco and alcohol consumption. New detailed information concerning associations between medications and oral and ocular dryness has been obtained using the ATC classification system. © 2010 John Wiley & Sons A/S.

Effect of intermittent shear stress on corneal epithelial cells using an in vitro flow culture model.

PubMed

Hampel, Ulrike; Garreis, Fabian; Burgemeister, Fabian; Eßel, Nicole; Paulsen, Friedrich

2018-04-27

The aim of this study was to establish and to evaluate an in vitro model for culturing human telomerase-immortalized corneal epithelial (hTCEpi) cells under adjustable medium flow mimicking the movements of the tear film on the ocular surface. Using an IBIDI pump system, cells were cultured under unidirectional, continuous or oscillating, discontinuous medium flow. Cell surface and cytoskeletal architecture were investigated by scanning electron microscopy and immunofluorescence. Gene expression of e-cadherin, occludin, tight junction protein (TJP), desmoplakin, desmocollin and mucins was investigated by real-time PCR. Protein expression of desmoplakin, TJP, occludin and e-cadherin was analyzed by western blot and localization was detected by immunofluorescence. Rose bengal staining was used to assess mucin (MUC) barrier integrity. MUC1, -4 and -16 proteins were localized by immunofluorescence. Medium flow-induced shear stress dramatically changed cellular morphology of hTCEpi. Cells subjected to discontinuous shear stress displayed the typical flattened, polygonal cell shape of the superficial layer of stratified squamous epithelia. Cell surfaces showed less bulging under shear stress and less extracellular gaps. The mRNA expression of E-cadherin, occludin and TJP were increased under oscillatory medium flow. Desmoplakin and occludin protein were upregulated under oscillatory shear stress. Stress fiber formation was not aligned to flow direction. MUC1, -4, and -16 protein were localized under all culture conditions, a regulation on mRNA expression was not detectable. Rose Bengal uptake was diminished under unidirectional conditions. Our findings suggest that shear stress as it occurs at the ocular surface during blinking exerts marked effects on corneal epithelial cells, such as changes in cellular morphology and expression of cell junctions. The described model may be useful for in vitro investigations of ocular surface epithelia as it represents a much more physiologic reproduction of the in vivo situation than the commonly applied static culture conditions. Copyright © 2018. Published by Elsevier Inc.

Clinical features of paediatric uveitis at a tertiary referral centre in São Paulo, SP, Brazil.

PubMed

Souto, Fernanda Maria Silveira; Giampietro, Bárbara Vilela; Takiuti, Julia Thiemi; Campos, Lucia Maria Arruda; Hirata, Carlos Eduardo; Yamamoto, Joyce Hisae

2018-06-15

To analyse the clinical features, systemic associations, treatment and visual outcomes of uveitis in children from a referral centre in São Paulo, Brazil. Clinical records of patients under 16 years old who attended the Uveitis Service, Hospital das Clinicas, Faculdadede Medicina, Universidade de São PauloFMUSP, between April and September 2017, were reviewed retrospectively. Patients with incomplete medical records, previous ocular trauma, or less than six6 months of follow-up were excluded. Thirty-nine children (25 female/14 male) were included. There was predominance of bilateral (89.7%), asymptomatic (56.4%) and recurrent/chronic cases (84.6%). The mean age at study inclusion was 10.7±3.4 years (range 3-16 years). Improvement or preservation of visual acuity (VA) was observed in 27 patients (84%); VA was not informed in 8 patients. Patients were referred early to tertiary centre (55% within 6 months of uveitis diagnosis). Anterior uveitis was the most common involvement (46%), followed by intermediate uveitis (26%). Juvenile idiopathic arthritis (JIA)-associated uveitis (41%) and immune-mediated intermediate uveitis (25.6%) were the principal non-infectious conditions; ocular toxoplasmosis (7.7%) and toxocariasis (5.1%) were the most common infectious conditions. Ocular complications were observed at first visit in 46% of patients and in 90% during final evaluation. Oral prednisone, immunosuppressive therapy (IMT) and/or biologic agents were used in all non-infectious conditions (32 children, 82%); IMT and/or biologic agents were used in all patients with JIA-associated uveitis and in 50% of patients with immune-mediated intermediate uveitis. Paediatric patients with uveitis are referred early to this centre and, although severe, adequate management with systemic IMT may preserve VA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Treatment of patients with neurotrophic keratitis stages 2 and 3 with plasma rich in growth factors (PRGF-Endoret) eye-drops.

PubMed

Sanchez-Avila, Ronald Mauricio; Merayo-Lloves, Jesus; Riestra, Ana Cristina; Fernandez-Vega Cueto, Luis; Anitua, Eduardo; Begoña, Leire; Muruzabal, Francisco; Orive, Gorka

2018-06-01

To provide preliminary data about efficacy and safety of plasma rich in growth factors (PRGF) eye-drops in neurotrophic keratitis (NK) and to analyze the possible influence of certain variables on treatment outcomes. This retrospective study included patients with stages 2-3 of NK treated with PRGF eye-drops. Primary endpoint was the resolution time of corneal ulcer defect. Outcome measures including percentage of ulcer closure at 4 weeks, Ocular Surface Disease Index (OSDI), Best-Corrected Visual Acuity (BCVA) and Visual Analogue Scale (VAS) were also evaluated before and after treatment with PRGF. The influence of some patients' clinical variables on results was assessed. Safety assessment was also performed reporting all adverse events. Thirty-eight treated eyes in a total of thirty-one patients were evaluated, of which five cases had no prior response to autologous serum treatment. Most cases (97.4%) achieved the complete resolution of corneal defect/ulcer. Mean resolution time was 11.4 weeks (SD = 13.7). A statistical significant (p < 0.05) reduction in OSDI (60.9%), VAS frequency (59.9%), VAS severity (57.0%) and improvement in BCVA (52.8%) was observed. The results were stratified according to the pathology stage and to the identified potential effect modifiers variables. Only one adverse event was reported in one patient (2.6%). PRGF eye-drops could be a safe and effective therapeutic option for patients with stages 2-3 of NK, showing high rates of corneal defect/ulcer resolution in short times, either in reducing signs and symptoms of NK, and therefore preventing the progression of NK to greater ocular complications.

A retrospective study on the outcomes of cataract surgery in an Eastern Regional Health Authority hospital of Trinidad and Tobago

PubMed Central

Sonron, Ebiakpo-aboere; Bridgemohan, Petra; Sharma, Subash

2015-01-01

Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA) hospital in Trinidad and Tobago. Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral) at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA). The outcome variable of interest was Snellen’s post-operative (presenting) VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses. Results. Good outcome (presenting VA 6/18 or better) was seen in 350 (67%) eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346–3.380]), hypertension (OR = 0.520; 95% CI [0.381–0.928]), surgical procedure (OR = 1.56; 95% CI [1.004–2.425]), good preoperative VA (OR = 0.388, 95% CI [0.211–0.714]), borderline preoperative VA (OR = 0.485; 95% CI = [0.278–0.843]) and year of first visit to clinic (OR = 2.243; 95% CI [1.215–4.141]). Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced. PMID:26357596

Changes of the eye optics after iris constriction☆

PubMed Central

Montés-Micó, Robert; Hernández, Patricio; Fernández-Sánchez, Vicente; Bonaque, Sergio; Lara, Francisco; López-Gil, Norberto

2011-01-01

Purpose To evaluate the possible change in the optics of the human eye after iris constriction. Methods Ocular aberrations were measured under natural viewing conditions in 26 eyes. The measured eyes fixated on a dim target while the contralateral eye was either occluded (so the measured eye had a large pupil) or highly illuminated (so the measured eye had a small pupil). The measured eyes fixated to a dim target placed 0.5 D beyond the subject’s far point. Zernike values obtained in both situations were compared within the same pupil diameter corresponding to the one obtained under the high illumination condition. Results Significant variation in some aberration coefficients were found between the two illumination conditions. Specially, spherical aberration (SA) increased significantly after pupil miosis (P = .0017). The mean increase of SA measured was 0.018 microns, for a 3-mm pupil. Mean values of other ocular aberrations also vary significantly after pupil miosis (changes were larger than the standard deviation of the repeated measurements). A mean paraxial hyperopic shift of one third of diopter was found after iris constriction. Conclusion Iris constriction slightly modifies the optics of the eye. The small hyperopic shift of the best image plane after iris constriction may be explained by a change in the lens shape and/or position.

The Accuracy of Eyelid Movement Parameters for Drowsiness Detection

PubMed Central

Wilkinson, Vanessa E.; Jackson, Melinda L.; Westlake, Justine; Stevens, Bronwyn; Barnes, Maree; Swann, Philip; Rajaratnam, Shantha M. W.; Howard, Mark E.

2013-01-01

Study Objectives: Drowsiness is a major risk factor for motor vehicle and occupational accidents. Real-time objective indicators of drowsiness could potentially identify drowsy individuals with the goal of intervening before an accident occurs. Several ocular measures are promising objective indicators of drowsiness; however, there is a lack of studies evaluating their accuracy for detecting behavioral impairment due to drowsiness in real time. Methods: In this study, eye movement parameters were measured during vigilance tasks following restricted sleep and in a rested state (n = 33 participants) at three testing points (n = 71 data points) to compare ocular measures to a gold standard measure of drowsiness (OSLER). The utility of these parameters for detecting drowsiness-related errors was evaluated using receiver operating characteristic curves (ROC) (adjusted by clustering for participant) and identification of optimal cutoff levels for identifying frequent drowsiness-related errors (4 missed signals in a minute using OSLER). Their accuracy was tested for detecting increasing frequencies of behavioral lapses on a different task (psychomotor vigilance task [PVT]). Results: Ocular variables which measured the average duration of eyelid closure (inter-event duration [IED]) and the ratio of the amplitude to velocity of eyelid closure were reliable indicators of frequent errors (area under the curve for ROC of 0.73 to 0.83, p < 0.05). IED produced a sensitivity and specificity of 71% and 88% for detecting ≥ 3 lapses (PVT) in a minute and 100% and 86% for ≥ 5 lapses. A composite measure of several eye movement characteristics (Johns Drowsiness Scale) provided sensitivities of 77% and 100% for detecting 3 and ≥ 5 lapses in a minute, with specificities of 85% and 83%, respectively. Conclusions: Ocular measures, particularly those measuring the average duration of episodes of eye closure are promising real-time indicators of drowsiness. Citation: Wilkinson VE; Jackson ML; Westlake J; Stevens B; Barnes M; Swann P; Rajaratnam SMW; Howard ME. The accuracy of eyelid movement parameters for drowsiness detection. J Clin Sleep Med 2013;9(12):1315-1324. PMID:24340294

A multicenter, retrospective chart review study comparing index therapy change rates in open-angle glaucoma or ocular hypertension patients newly treated with latanoprost or travoprost-Z monotherapy.

PubMed

Fain, Joel M; Kotak, Sameer; Mardekian, Jack; Bacharach, Jason; Edward, Deepak P; Rauchman, Steven; Brevetti, Teresa; Fox, Janet L; Lovelace, Cherie

2011-06-13

Because latanoprost and the original formulation of travoprost that included benzalkonium chloride (BAK) have been shown to be similar with regard to tolerability, we compared initial topical intraocular pressure (IOP)-lowering medication change rates in patients newly treated with latanoprost or travoprost-Z monotherapy. At 14 clinical practice sites, medical records were abstracted for patients with a diagnosis of open-angle glaucoma or ocular hypertension and who were ≥40 years of age, had a baseline and at least one follow-up visit, and had no prior history of ocular prostaglandin use. Data regarding demographics, ocular/systemic medical histories, clinical variables, therapy initiations and reasons for changes, adverse events, and resource utilization were recorded from randomly chosen eligible charts. Primary outcomes were rates of and reasons for changing from the initial therapy within six months and across the full study period (1000 days). Data from 900 medical charts (latanoprost, 632; travoprost-Z, 268) were included. For both cohorts, average follow-up was >1 year. Cohorts were similar with regard to age (median ~67 years), gender distribution (>50% female), and diagnosis (~80% with open-angle glaucoma). Within six months, rates of index therapy change for latanoprost versus travoprost-Z were 21.2% (134/632) and 28.7% (77/268), respectively (p = 0.0148); across the full study period, rates were 34.5% (218/632) and 45.2% (121/268), respectively (p = 0.0026). Among those who changed their index therapy, insufficient IOP control was the most commonly reported reason followed by adverse events; hyperemia was the most commonly reported adverse event at index therapy change. In this "real world" study of changes in therapy in patients prescribed initial monotherapy with latanoprost with BAK or travoprost-Z with SofZia, medication changes were common in both treatment groups but statistically significantly more frequent with travoprost-Z.

A comparison of two different formulations of diclofenac sodium 0.1% in the treatment of inflammation following cataract-intraocular lens surgery.

PubMed

Mester, Ulrich; Lohmann, Chris; Pleyer, U; Steinkamp, G; Völcker, E; Kruger, H; Raj, Palaniswamy Sunder

2002-01-01

To compare the efficacy, tolerability and local tolerance of diclofenac sodium 0.1% containing hydroxypropylgamma cyclodextrin preserved with benzalkonium chloride 0.005% (Voltaren Ophtha CD), with that of diclofenac sodium 0.1% preserved with thiomersal 0.004% (Voltaren Ophtha) in the treatment of inflammation after cataract-intraocular lens surgery. Randomised 2:1, double-masked, parallel-group study in six centres in Germany. 299 patients scheduled to undergo phacoemulsification with posterior chamber intraocular lens implantation. Study medications were instilled four times in the 30 minutes before surgery and four times daily from the first postoperative day. The key efficacy variable was the reduction in anterior chamber flare (photons/millisecond) from day 1 to day 6 to 8. Patients underwent comprehensive ocular examinations, including laser flaremetry (KOWA), preoperatively and postoperatively at days 1, 6 to 8 and 24 to 32. 268 patients (Voltaren Ophtha CD 177, Voltaren Ophtha 91) completed the day 6 to 8 visit without any protocol violations. Reduction in the degree of intraocular inflammation with Voltaren Ophtha CD was equivalent to that achieved with Voltaren Ophtha at the day 6 to 8 [95% confidence interval (CI) -3.07 to +0.54] and day 24 to 32 (95% CI -1.44 to +1.40) visits. Although there was no significant (p = 0.464) difference between the two study groups in patients' global assessment of local tolerance at day 24 to 32, ocular discomfort was significantly (p = 0.023) less with Voltaren Ophtha CD compared with Voltaren Ophtha. Voltaren Ophtha CD was as effective and well tolerated but had less ocular discomfort compared with Voltaren Ophtha in the treatment of ocular inflammation after phacoemulsification with intraocular lens implantation. This new formulation of diclofenac sodium 0.1% may be used as an alternative to the existing formulations of ophthalmic diclofenac sodium 0.1%.

Comparison of choroidal and optic nerve head blood flow regulation during changes in ocular perfusion pressure.

PubMed

Schmidl, Doreen; Boltz, Agnes; Kaya, Semira; Werkmeister, Rene; Dragostinoff, Nikolaus; Lasta, Michael; Polska, Elzbieta; Garhöfer, Gerhard; Schmetterer, Leopold

2012-07-01

We compared the response of choroidal and optic nerve head blood flow (ChBF, ONHBF) in response to an increase in ocular perfusion pressure (OPP) during isometric exercise and during a decrease in OPP during an artificial increase in intraocular pressure (IOP). We included 96 healthy subjects in our study. In 48 subjects OPP was increased by 6 minutes of squatting, and either ONHBF (n = 24) or ChBF (n = 24) was measured continuously. In 48 other healthy subjects either ONHBF (n = 24) or ChBF (n = 24) was measured continuously during a period of artificial increase in IOP using a suction cup. All blood flow measurements were done using laser Doppler flowmetry. During all experiments the response in blood flow was less pronounced than the response in OPP, indicating for flow regulation. During isometric exercise ChBF regulated better than ONHBF (P = 0.023). During artificial IOP increase ONHBF regulated better than ChBF (P = 0.001). Inter-individual variability in blood flow responses was high. During squatting ONHBF decreased considerably below baseline ONHBF when OPP fluctuated in 3 subjects, although OPP still was much higher than at baseline. This phenomenon was not observed in the choroid. Our data indicate that regulation of ChBF and ONHBF during changes in OPP is different and complex. In some subjects performing squatting, considerable ONHBF reductions were observed during OPP fluctuations, although OPP still was high. Whether this predisposes to ocular disease remains unclear.

Albinism: Particular Attention to the Ocular Motor System

PubMed Central

Hertle, Richard W.

2013-01-01

The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a) periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has “typical” types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function. PMID:24014991

Ocular changes with oxaliplatin.

PubMed

O'Dea, Denise; Handy, Catherine M; Wexler, Ann

2006-04-01

Ocular toxicity, although uncommon, can occur with many chemotherapeutic agents. Platinum compounds have been documented to produce a variety of ocular side effects, and reports have been made of ocular toxicity with oxaliplatin. This article reports on four patients who experienced ocular symptoms while receiving oxaliplatin. The symptoms included tunnel vision and visual loss with postural changes. One patient had objective findings that included papilledema. All of the changes were reversible. Oxaliplatin will continue to be used widely, so clinicians treating patients with it must be alert for unusual toxicities such as those described in this article.

The evaluation of eye pain with a normal ocular exam.

PubMed

Lee, Andrew G; Brazis, Paul W

2003-12-01

Eye pain with or without associated head or face pain is a common complaint to the ophthalmologist. The ocular exam may reveal the etiology (e.g., corneal disease, angle closure glaucoma) but typically the exam is normal. This paper reviews the evaluation and management of eye pain with a "normal" ocular exam, including: 1) subtle findings on ocular exam; 2) transient findings on exam, and 3) no abnormal ocular findings. Ophthalmologists should be aware of the various etiologies for eye pain and the specific and distinctive features that make the diagnosis.

Ocular pulsation correlates with ocular tension: the choroid as piston for an aqueous pump?

PubMed

Phillips, C I; Tsukahara, S; Hosaka, O; Adams, W

1992-01-01

In 26 random out-patients, including 13 treated glaucoma patients and ocular hypertensives, the higher the ocular tension, the greater the pulse amplitude, by Alcon pneumotonometry, at a statistically significant level. In a single untreated hypertensive, when 2-hourly pneumotonometry was done for 24 h, the correlation was similar and significant. The higher the diastolic blood pressure, the higher the ocular pulsation, also significantly. Pulsation is suggested to be a pump, the choroid being the piston, contributing (1) to an increase in the outflow of aqueous humour and (2) to a homeostatic mechanism contributing to normalization of the intra-ocular pressure, wherein pulsation increases or decreases, as the intraocular pressure increases or decreases, respectively.

Ocular toxoplasmosis and retinal detachment: five case reports.

PubMed

Kianersi, F; Naderi Beni, A; Ghanbari, H; Fazel, F

2012-10-01

Ocular toxoplasmosis is a potentially blinding cause of posterior uveitis. Retinal detachment is rare complication of ocular toxoplasmosis. To report the clinical course and prognosis of retinal breaks and detachments occurring in patients with ocular toxoplasmosis. This study was a retrospective, non-comparative case series of five patients with ocular toxoplasmosis who had consulted us with retinal detachment. All of the participants had retinal detachment after severe and treatment resistant toxoplasmic retinochoroiditis, leaving one of them with decreased visual acuity to light perception in spite of treatment and final visual acuity was 20/100 or better in four patients. The functional prognosis for the patients with retinal detachment was poor. Careful retinal examination in ocular toxoplasmosis is warranted, especially in patients with severe intraocular inflammation.

The Significance of the Discordant Occurrence of Lens Tumors in Humans versus Other Species

PubMed Central

Albert, Daniel M.; Phelps, Paul O.; Surapaneni, Krishna R.; Thuro, Bradley A.; Potter, Heather D.; Ikeda, Akihiro; Teixeira, Leandro B. C.; Dubielzig, Richard R.

2015-01-01

Purpose The purpose of this study was to determine in which species and under what conditions lens tumors occur. Design A review of data bases of available human and veterinary ocular pathological material and the previously reported literature. Participants Approximately 18,000 patients who had ocular surgical specimens submitted and studied at the University of Wisconsin School of Medicine and Public Health (UWSMPH) between 1920 and 2014 and 45,000 ocular veterinary cases from the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW) between 1983 and 2014. Methods Material in two major archived collections at the University of Wisconsin medical and veterinary schools were studied for occurrence of lens tumors. Tumor was defined as “a new growth of tissue characterized by progressive, uncontrolled proliferation of cells.” In addition, cases presented at 3 major eye pathology societies (Verhoeff-Zimmerman Ophthalmic Pathology Society, Eastern Ophthalmic Pathology Society, and The Armed Forces Institute of Pathology Ophthalmic Alumni Society) from 1975 through 2014 were reviewed. Finally, a careful search of the literature was carried out. Approval from the IRB to carry out this study was obtained. Main Outcome Measures The presence of tumors of the lens. Results The database search and literature review failed to find an example of a lens tumor in humans. In contrast, examples of naturally occurring lens tumors were found in cats, dogs, rabbits, and birds. 4.5% of feline intraocular and adnexal neoplasms (234/5153) in the veterinary school database were designated as feline ocular post-traumatic sarcoma (FOPTS), a tumor previously demonstrated to be of lens epithelial origin. Similar tumors were seen in rabbit eyes, a bird, and in a dog. All four species with lens tumors had a history of either ocular trauma or protracted uveitis. The literature search also revealed cases where lens tumors were induced in zebrafish, rainbow trout, hamsters, and mice, by carcinogenic agents (methylcholanthrene, thioacetamide), oncogenic viruses (SV40, HPV-16), and genetic manipulation. Conclusions Our results suggest that lens tumors do not occur in humans. In contrast, following lens capsule rupture, a lens tumor can occur in other species. We hypothesize that a genetic mechanism exists which prevents lens tumors in humans. PMID:26130328

The cortical column: a structure without a function

PubMed Central

Horton, Jonathan C; Adams, Daniel L

2005-01-01

This year, the field of neuroscience celebrates the 50th anniversary of Mountcastle's discovery of the cortical column. In this review, we summarize half a century of research and come to the disappointing realization that the column may have no function. Originally, it was described as a discrete structure, spanning the layers of the somatosensory cortex, which contains cells responsive to only a single modality, such as deep joint receptors or cutaneous receptors. Subsequently, examples of columns have been uncovered in numerous cortical areas, expanding the original concept to embrace a variety of different structures and principles. A ‘column’ now refers to cells in any vertical cluster that share the same tuning for any given receptive field attribute. In striate cortex, for example, cells with the same eye preference are grouped into ocular dominance columns. Unaccountably, ocular dominance columns are present in some species, but not others. In principle, it should be possible to determine their function by searching for species differences in visual performance that correlate with their presence or absence. Unfortunately, this approach has been to no avail; no visual faculty has emerged that appears to require ocular dominance columns. Moreover, recent evidence has shown that the expression of ocular dominance columns can be highly variable among members of the same species, or even in different portions of the visual cortex in the same individual. These observations deal a fatal blow to the idea that ocular dominance columns serve a purpose. More broadly, the term ‘column’ also denotes the periodic termination of anatomical projections within or between cortical areas. In many instances, periodic projections have a consistent relationship with some architectural feature, such as the cytochrome oxidase patches in V1 or the stripes in V2. These tissue compartments appear to divide cells with different receptive field properties into distinct processing streams. However, it is unclear what advantage, if any, is conveyed by this form of columnar segregation. Although the column is an attractive concept, it has failed as a unifying principle for understanding cortical function. Unravelling the organization of the cerebral cortex will require a painstaking description of the circuits, projections and response properties peculiar to cells in each of its various areas. PMID:15937015

Mutations in MAB21L2 result in ocular Coloboma, microcornea and cataracts.

PubMed

Deml, Brett; Kariminejad, Ariana; Borujerdi, Razieh H R; Muheisen, Sanaa; Reis, Linda M; Semina, Elena V

2015-01-01

Ocular coloboma results from abnormal embryonic development and is often associated with additional ocular and systemic features. Coloboma is a highly heterogeneous disorder with many cases remaining unexplained. Whole exome sequencing from two cousins affected with dominant coloboma with microcornea, cataracts, and skeletal dysplasia identified a novel heterozygous allele in MAB21L2, c.151 C>G, p.(Arg51Gly); the mutation was present in all five family members with the disease and appeared de novo in the first affected generation of the three-generational pedigree. MAB21L2 encodes a protein similar to C. elegans mab-21 cell fate-determining factor; the molecular function of MAB21L2 is largely unknown. To further evaluate the role of MAB21L2, zebrafish mutants carrying a p.(Gln48Serfs*5) frameshift truncation (mab21l2Q48Sfs*5) and a p.(Arg51_Phe52del) in-frame deletion (mab21l2R51_F52del) were developed with TALEN technology. Homozygous zebrafish embryos from both lines developed variable lens and coloboma phenotypes: mab21l2Q48Sfs*5 embryos demonstrated severe lens and retinal defects with complete lethality while mab21l2R51_F52del mutants displayed a milder lens phenotype and severe coloboma with a small number of fish surviving to adulthood. Protein studies showed decreased stability for the human p.(Arg51Gly) and zebrafish p.(Arg51_Phe52del) mutant proteins and predicted a complete loss-of-function for the zebrafish p.(Gln48Serfs*5) frameshift truncation. Additionally, in contrast to wild-type human MAB21L2 transcript, mutant p.(Arg51Gly) mRNA failed to efficiently rescue the ocular phenotype when injected into mab21l2Q48Sfs*5 embryos, suggesting this allele is functionally deficient. Histology, immunohistochemistry, and in situ hybridization experiments identified retinal invagination defects, an increase in cell death, abnormal proliferation patterns, and altered expression of several ocular markers in the mab21l2 mutants. These findings support the identification of MAB21L2 as a novel factor involved in human coloboma and highlight the power of genome editing manipulation in model organisms for analysis of the effects of whole exome variation in humans.

An introduction to OCT in retinal disease.

PubMed

Baxter, Kim

2015-01-01

Ocular coherence tomography (OCT) has been available to ophthalmologists for many years and has had a significant impact on the diagnosis and treatment of many eye conditions. This fast and non-invasive way to image the eye has had a considerable effect on ophthalmic photography services. OCT can be used to assess the structure of the cornea, iris, anterior chamber, optic nerve and retina. This article focuses upon its use in retinal conditions and explores how the technique is used to aid treatment and diagnosis.

TrkB Activators for the Treatment of Traumatic Vision Loss

DTIC Science & Technology

2016-10-01

R01EY017841. P30EY06360, DoD COMRP Grant W81XWH1210255. DoD COMRP Grant WSlXWH-12-1-0436 OPTll - Dry eye diagnosis Staining of Ocul ar Surface: Optimizing...Diagnosis and Interpretation. Basis of Successful Surgery and Adaptive Therapy of Dry Eye GYSBERT VAN SETTEN St Eriks Eye Hospital. KaraUnska...lnstitutet. Stockholm. Sweden Dry eye disease (OED) is a condition of the ocular surface condition that is increasingly recognized to affect not only

Ocular Trauma From Dog Bites: Characterization, Associations, and Treatment Patterns at a Regional Level I Trauma Center Over 11 Years.

PubMed

Prendes, Mark A; Jian-Amadi, Arash; Chang, Shu-Hong; Shaftel, Solomon S

2016-01-01

Canine bites frequently result in periocular injury. The authors aimed to further characterize the dog breeds, types of injuries inflicted, and treatment outcomes. A retrospective chart review was performed on all dog bites recorded in the University of Washington trauma registry from 2003 to 2013. Cases involving ocular injury were further investigated to identify ocular tissues affected, treatment patterns, and outcomes. A total of 342 dog bite victims were identified, of whom 91 sustained ocular trauma (27%). The mean age of patients with ocular injuries was significantly lower than those without (14.1 ± 1.9 vs. 30.0 ± 1.3 years, p < 0.001). Children bitten by dogs were 4.2 times more likely to sustain ocular injuries than adults (45.2% vs. 10.8%). The most common breed of dog inflicting ocular injury was the pit bull (25%). Forty percent of patients with ocular trauma sustained canalicular lacerations and epiphora was noted in only 3 patients (8%) after repair. Three percent had orbital fractures and 2% sustained ruptured globes. Infections were rare, affecting only 2% of patients. To our knowledge, this study is the largest to date to report the incidence and characteristics of ocular injuries sustained from dog bites. These injuries were disproportionately more common in children and have a high incidence of canalicular laceration. Though rare, globe injuries and orbital fractures were seen in this population. Importantly, this study establishes that pit bulls are the most frequent breed associated with ocular injuries from dog bites.