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| 2. |
- Abdalla Elsayed, Maram E.A., et al.
(författare)
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Sickle cell retinopathy. A focused review
- 2019
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 257:7, s. 1353-1364
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To provide a focused review of sickle cell retinopathy in the light of recent advances in the pathogenesis, multimodal retinal imaging, management of the condition, and migration trends, which may lead to increased prevalence of the condition in the Western world. Methods: Non-systematic focused literature review. Results: Sickle retinopathy results from aggregation of abnormal hemoglobin in the red blood cells in the retinal microcirculation, leading to reduced deformability of the red blood cells, stagnant blood flow in the retinal precapillary arterioles, thrombosis, and ischemia. This may be precipitated by hypoxia, acidosis, and hyperosmolarity. Sickle retinopathy may result in sight threatening complications, such as paracentral middle maculopathy or sequelae of proliferative retinopathy, such as vitreous hemorrhage and retinal detachment. New imaging modalities, such as wide-field imaging and optical coherence tomography angiography, have revealed the microstructural features of sickle retinopathy, enabling earlier diagnosis. The vascular growth factor ANGPTL-4 has recently been identified as a potential mediator of progression to proliferative retinopathy and may represent a possible therapeutic target. Laser therapy should be considered for proliferative retinopathy in order to prevent visual loss; however, the evidence is not very strong. With recent development of wide-field imaging, targeted laser to ischemic retina may prove to be beneficial. Exact control of intraoperative intraocular pressure, including valved trocar vitrectomy systems, may improve the outcomes of vitreoretinal surgery for complications, such as vitreous hemorrhage and retinal detachment. Stem cell transplantation and gene therapy are potentially curative treatments, which may prevent retinopathy. Conclusions: There is lack of evidence regarding the optimal management of sickle retinopathy. Further study is needed to determine if recent progress in the understanding of the pathophysiology and diagnosis of sickle retinopathy may translate into improved management and outcome.
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| 3. |
- Al Oreany, Abdulaziz Abdulrahman, et al.
(författare)
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Congenital stationary night blindness with hypoplastic discs, negative electroretinogram and thinning of the inner nuclear layer
- 2016
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 254:10, s. 1951-1956
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe congenital stationary night blindness (CSNB) with negative electroretinogram, hypoplastic discs, nystagmus and thinning of the inner nuclear layer (INL). Methods: Retinal structure was analyzed qualitatively with spectral domain optical coherence tomography and wide field imaging. Retinal function was evaluated with full-field electroretinography (ffERG). Molecular genetic testing included next-generation sequencing (NGS) of the known genes involved in CSNB. Results: Patients presented with CSNB presented with nystagmus, high myopia, hypoplastic discs and negative ffERG with no measurable rod response. The retinas appeared normal and automated segmentation of retinal layers demonstrated a relative reduction of thickness of the INL. There was no significant change in the ffERG after prolonged 2 hour dark adaptation compared to standard 30 minute dark adaptation. Affected family members harboured the homozygous 1-bp deletion c.2394delC in exon 18 of the TRPM1 gene, whereas their unaffected parents were heterozygous carriers. Conclusions: This data expands the genotype and phenotype spectrum of CSNB. The lack of improvement of rod responses after prolonged dark adaptation, together with thinning of the INL, is compatible with postreceptoral transmission dysfunction in the bipolar cells. Such knowledge may prove useful in future development of treatment for outer retinal dystrophies, using opsin genes to restore light responses in survivor neurons in the inner retina.
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| 4. |
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| 5. |
- Andréasson, Sten, et al.
(författare)
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Cone implicit time as a predictor of visual outcome in macular hole surgery.
- 2014
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 252:12, s. 1903-1909
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Tidskriftsartikel (refereegranskat)abstract
- To investigate whether preoperative retinal function measured by full-field ERG and multifocal ERG is correlated to postoperative visual acuity after macular hole surgery.
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| 6. |
- Aring, Eva, 1959, et al.
(författare)
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Visual fixation development in children.
- 2007
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Ingår i: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 245:11, s. 1659-65
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The ability to keep steady fixation on a target is one of several aspects of good visual function. However, there are few reports on visual fixation during childhood in healthy children. METHODS: An infrared eye-tracking device (Orbit) was used to analyse binocular fixation behaviour in 135 non-clinical participants aged 4-15 years. The children wore goggles and their heads were restrained using a chin and forehead rest, while binocularly fixating a stationary target for 20 s. RESULTS: The density of fixations around the centre of gravity increased with increasing age (p < 0.01), and the time of fixation without intruding movements increased with increasing age (p = 0.02), while intruding saccades decreased with increasing age (p < 0.01). The number of blinks and drifts did not differ between 4 and 15 years, and there were no significant differences with regard to gender or laterality in any of the investigated variables. No nystagmus was observed. CONCLUSION: This study establishes values for visual fixation behaviour in a non-clinical population aged 4-15 years, which can be used for identifying children with fixation abnormalities.
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| 8. |
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| 9. |
- Barth, Henrik, et al.
(författare)
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A cross-linked hyaluronic acid hydrogel (Healaflow(®)) as a novel vitreous substitute
- 2016
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer. - 0721-832X .- 1435-702X. ; 254:4, s. 697-703
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Vitrectomy requires the substitution of the natural vitreous, as well as tamponading of retinal breaks. Clinically available alternatives such as gas and silicone oil have side effects such as inflammation, secondary glaucoma, cataract, and a need for head posturing. In this study, a hydrogel of cross-linked sodium hyaluronic acid (Healaflow(®)) is evaluated for use as a novel vitreous substitute.Methods: A combined 25-20-gauge pars plana vitrectomy with posterior vitreous detachment was performed in the right eye of twelve pigmented rabbits, with subsequent injection of approximately 1 ml Healaflow(®). Clinical evaluation, measurement of intraocular pressure (IOP), and full-field ERG were performed postoperatively. The rabbits were sacrificed at different time-points between 42 and 105 days. After enucleation, the eyes were examined macroscopically, photographed, and prepared for histological examination with routine microscopy and immunohistochemistry.Results: Healaflow(®) was successfully used with standard surgical procedures and remained translucent but did lose most of its viscosity during the postoperative period. One rabbit was lost due to unrelated causes. In two eyes iatrogenic partial retinal detachments were seen, and in two eyes significant cataract developed due to intra-operative complications. ERG-recordings revealed no toxic effect on rod or cone function. Routine microscopy and immunohistochemistry demonstrated normal morphology with some Müller cell activation (up-regulation of glial acidic fibrillary protein, GFAP) compared to unoperated eyes and no significant DNA-fragmentation (TUNEL-assay).Conclusions: Healaflow® did not affect retinal morphology or function negatively during long-term use as a vitreous substitute, making it highly interesting in this setting. An estimated retention time of a few weeks suggests potential for use as a short-term tamponade. Future work will include an increased ratio of cross-linking to prolong the structural integrity of the gel.
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| 10. |
- Barth, Henrik, et al.
(författare)
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A new model for in vitro testing of vitreous substitute candidates
- 2014
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - Hedidelberg, Germany : Springer. - 0721-832X .- 1435-702X. ; 252:10, s. 1581-1592
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe a new model for in vitro assessment of novel vitreous substitute candidates.Methods: The biological impact of three vitreous substitute candidates was explored in a retinal explant culture model; a polyalkylimide hydrogel (Bio-Alcamid (R)), a two component hydrogel of 20 wt.% poly (ethylene glycol) in phosphate buffered saline (PEG) and a cross-linked sodium hyaluronic acid hydrogel (Healaflow (R)). The gels where applied to explanted adult rat retinas and then kept in culture for 2, 5 and 10 days. Gel-exposed explants were compared with explants incubated under standard tissue culture conditions. Cryosections of the specimens were stained with hematoxylin and eosin, immunohistochemical markers (GFAP, Vimentin, Neurofilament 160, PKC, Rhodopsin) and TUNEL.Results: Explants kept under standard conditions as well as PEG-exposed explants displayed disruption of retinal layers with moderate pyknosis of all neurons. They also displayed moderate labeling of apoptotic cells. Bio-Alcamid (R)-exposed explants displayed severe thinning and disruption of retinal layers with massive cell death. Healaflow (R)-treated explants displayed normal retinal lamination with significantly better preservation of retinal neurons compared with control specimens, and almost no signs of apoptosis. Retinas exposed to Healaflow (R) and retinas kept under standard conditions showed variable labeling of GFAP with generally low expression and some areas of upregulation. PEG-exposed retinas showed increased GFAP labeling and Bio-Alcamid (R)-exposed retinas showed sparse labeling of GFAP.Conclusions: Research into novel vitreous substitutes has important implications for both medical and surgical vitreoretinal disease. The in vitro model presented here provides a method of biocompatibility testing prior to more costly and cumbersome in vivo experiments. The explant culture system imposes reactions within the retina including disruption of layers, cell death and gliosis, and the progression of these reactions can be used for comparison of vitreous substitute candidates. Bio-Alcamid (R) had strong adverse effects on the retina which is consistent with results of prior in vivo trials. PEG gel elicits reactions similar to the control retinas whereas Healaflow (R) shows protection from culture-induced trauma indicating favorable biocompatibility.
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| 11. |
- Barth, Henrik, et al.
(författare)
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Inflammatory responses after vitrectomy with vitreous substitutes in a rabbit model
- 2019
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer. - 0721-832X .- 1435-702X. ; 257:4, s. 769-783
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the inflammatory response of current and future potential vitreous substitutes in an experimental in vivo vitrectomy model.METHODS: Twenty-five gauge pars plana vitrectomy was performed in the right eye of 60 pigmented rabbits, with subsequent injection of 0.5-1.0 ml of Healaflow® (cross-linked hyaluronic acid, n = 12), Bio-Alcamid® (polyalkylimide, n = 8), silicone oil (n = 12), or balanced saline solution (BSS, n = 28). Postoperative clinical evaluation was performed; and the rabbits were sacrificed at 1 day, 1 week, or 1 month. The eyecups were then examined macroscopically; the retinas sectioned and stained with hematoxylin and eosin (Htx), and immunohistochemically labeled for glial fibrillary acidic protein (GFAP), CD45, galectin-3, CD68, and CD20. Unoperated left eyes from treated animals as well as eyes from untreated animals were used as controls.RESULTS: Vitrectomy without major complications was achieved in 46/60 eyes. The remaining 14 eyes were analyzed separately. One eye developed endophthalmitis after 1 week and was excluded. Eyes treated with Healaflow®, silicone oil, and BSS had a comparable appearance macroscopically and in Htx-stained sections, whereas Bio-Alcamid®-injected eyes exhibited increased macroscopic inflammation and severely affected retinas. GFAP upregulation was present in all treatment groups, most prominent in eyes treated with Bio-Alcamid® and silicone oil. Upregulation of CD45 and CD68 in the inner retina and vitreous space was most prominent with Bio-Alcamid® treatment, and these eyes together with their silicone oil-treated counterparts also displayed a stronger upregulation of CD20-labeled cells compared with remaining groups. General upregulation of galectin-3, mainly in the inner retina, was found in all groups. In eyes with perioperative complications, labeling of CD45, CD68, and especially GFAP was comparably high.CONCLUSIONS: We here describe differences in the postsurgery inflammatory profiles of existing and potential vitreous substitutes. Bio-Alcamid® and silicone oil display severe signs of gliosis and inflammation, whereas Healaflow® elicits minimal reactions comparable with BSS, highlighting its potential application as a vitreous substitute in a future clinical setting.
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| 12. |
- Bengtsson, Boel, et al.
(författare)
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Diurnal IOP fluctuation: not an independent risk factor for glaucomatous visual field loss in high-risk ocular hypertension.
- 2005
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 243:Mar 9, s. 513-518
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To establish whether intraocular pressure (IOP) fluctuations contribute to the risk of developing glaucoma in patients with high-risk ocular hypertension. Methods: Ninety patients included in the Malmo Ocular Hypertension Study were examined every 3 months with office-hours diurnal tension curves and computerised perimetry. Patients were followed up prospectively for 10 years or until glaucomatous visual field loss could be demonstrated. Poststudy data were included in the analyses, extending maximum follow-up to 17 years. Results: After 17 years, 37 patients had developed glaucomatous visual field defects. When applying univariate Cox regression analyses, mean IOP of all measurements during the prospective part of the study was a significant risk factor for developing glaucoma (95% confidence interval [CI] 1.08 - 1.39), while IOP fluctuations were almost significant ( 95% CI 0.98 - 1.93). When separating effects of mean IOP level and mean IOP fluctuation using Cox multiple regression analysis, only IOP level came out as significant ( 95% CI 1.09 - 1.38), and IOP fluctuations did not contribute to the risk ( 95% CI 0.80 - 1.60). IOP fluctuation depended linearly on IOP level ( p< 0.0001), i.e. IOP fluctuation was larger in eyes with higher IOP levels. Conclusion: IOP fluctuations were not an independent risk factor for the incidence of glaucomatous visual field loss in subjects with ocular hypertension.
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| 13. |
- Borisovsky, Gilad, et al.
(författare)
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Results of congenital cataract surgery with and without intraocular lens implantation in infants and children
- 2013
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 251:9, s. 2205-2211
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Tidskriftsartikel (refereegranskat)abstract
- Operations for congenital cataract in children in the past had resulted in aphakia. Improvement in surgical tools and techniques as well as in intraocular lens (IOL) implantation has led to correction of the aphakia by IOL implantation. We report the outcome of cataract surgery with and without IOL on these children in our institution between 1991-2008. In this retrospective cohort study, the medical records of all children who underwent surgery for congenital cataract were reviewed. The final study group included 144 children (218 eyes). Postoperative visual acuity (VA) was tested either by Teller Acuity Cards (in preverbal children) or by the Snellen chart. Data on VA status and postoperative complications were retrieved. Patients with bilateral cataract had better postoperative VA than patients with unilateral cataract (logMAR 0.559 +/- 0.455 vs. 0.919 +/- 0.685, respectively, P < 0.001). Children who underwent IOL implantation had better postoperative VA than those who did not, but the type of surgery had no significant effect after correction for the child's age at surgery (P = 0.346). Secondary cataract occurred more frequently in the extra-capsular cataract extraction (ECCE) + IOL implantation group than in the ECCE only group (20.6 % vs. 8.3 %, respectively, P = 0.018). Patients with bilateral cataract had better postoperative VA compared with those with unilateral cataract. The type of surgery had no effect on final VA, but there was a higher rate of secondary cataract in the ECCE + IOL patients compared to the ECCE only patients.
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| 14. |
- Cederlund, Martin, et al.
(författare)
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Vitreous levels of oxidative stress biomarkers and the radical-scavenger α(1)-microglobulin/A1M in human rhegmatogenous retinal detachment.
- 2013
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 251:3, s. 725-732
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore oxidative stress and the radical scavenger α(1)-microglobulin (A1M) in the vitreous body of human eyes with primary rhegmatogenous retinal detachment (RRD). METHODS: Levels of carbonyl groups, a marker of oxidative stress, and A1M were measured by ELISA and RIA in 14 vitreous samples derived from patients suffering from RRD, and compared with 14 samples from macula hole (MH) patients. Carbonyl group and A1M levels in RRD samples were statistically related to detachment characteristics. Analysis of total protein level, SDS-PAGE, and Western blotting of A1M was also performed. In a separate experiment, mRNA expression of A1M was measured by RT-PCR in rat retina explants. RESULTS: Levels of carbonyl groups and A1M varied widely in RRD vitreous samples, but were significantly higher in samples derived from eyes with large detachment area and macula-off status, while the presence of vitreous hemorrhage did not show any significant correlation. Compared with MH samples, RRD samples displayed significantly higher levels of A1M, whereas changes in total protein levels and carbonyl groups were not significant. Novel forms of A1M, not previously seen in plasma, were found in the vitreous body by Western blotting. Furthermore, A1M expression was seen in rat retina explants and was upregulated after 24 h of culturing. CONCLUSION: Oxidative stress is a prominent feature of human eyes with primary RRD, and is directly related to detachment severity. Affected eyes can launch a protective response in the form of the radical scavenger A1M possibly derived from the retina. The results thus indicate potential therapeutic cell loss prevention in RRD by employing the endogeneous radical scavenger A1M.
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| 15. |
- Crafoord, Sven, 1950-, et al.
(författare)
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Cellular migration into neural retina following implantation of melanin granules in the subretinal space
- 2000
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 238:8, s. 682-689
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Tidskriftsartikel (refereegranskat)abstract
- Background: In some retinal diseases and following transplantation of retinal pigment epithelium (RPE), melanin granules are liberated to the subretinal space. Our aim was to investigate the cellular response to implanted extracellular melanin. Methods: After pars plana vitrectomy, 17 albino rabbits received a suspension of melanin granules in the subretinal space. Postoperative examination included ophthalmoscopy, color fundus photography, histology using monoclonal antibodies identifying RPE cells (AE1/3), macrophages (RAM 11), B-lymphocytes (CD20) and T-lymphocytes (CD45), and electron microscopy. The follow-up time was 2 weeks, 4 weeks and 6 months. Results: On fundus photographs, the layer of melanin showed focal attenuation with lighter areas at 6 months. Melanin granules were phagocytosed by RPE cells and macrophages at 2 weeks, as identified by monoclonal antibodies. In areas where an abundance of melanin was present, multilayers of macrophages were seen associated with considerable photoreceptor damage. Pigment-laden cells invaded the neural retina. The cellular infiltration of the retina was focal, and when it involved the outer nuclear layer the photoreceptor damage was severe. Electron microscopy demonstrated the presence of melanosomes intracellularly in Müller glia. The process of phagocytosis and removal of melanin granules from the subretinal space was slow and not completed at 6 months. Conclusion: Our experiments show that implantation of melanin granules in the subretinal space of albino rabbits may induce a considerable phagocytic cellular response featuring the host’s RPE, macrophages and glial cells. The migration of pigment-laden cells into the neural retina was associated with focal photoreceptor damage.
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| 16. |
- Crafoord, Sven, et al.
(författare)
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Experimental vitreous tamponade using polyalkylimide hydrogel
- 2011
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 249:8, s. 1167-74
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate polyalkylimide as a possible vitreous tamponading agent.METHODS: A 20-gauge pars plana vitrectomy and posterior vitreous detachment were performed in the right eye of six pigmented rabbits. Approximately 1 ml of viscoelastic gel, polyalkylimide (Bio-Alcamid) was thereafter injected into the vitreous space. Full-field ERG and intraocular pressure (IOP, Tonopen) was measured pre-and postoperatively at regular intervals up to 28 days. At day 6 or 28, the rabbits were sacrificed and the eyes were examined macroscopically, photographed, and prepared for histological examination with routine microscopy.RESULTS: The viscoelastic hydrogel was successfully injected, and remained translucent with preserved gel properties throughout the postoperative period. The postoperative IOP was unchanged compared to preoperative values. Five of six eyes displayed retinal edema or pigmentary changes centrally while the periphery appeared intact. ERG recordings showed a radical decrease in rod- and cone-derived B-wave amplitudes. Histological examination confirmed varying degrees of edema combined with neuronal cell death within the retinal layers in the central part of the fundus, while the peripheral part appeared intact.CONCLUSION: Polyalkylimide displays favourable physical properties when used as a vitreous tamponade. However, the hydrogel causes functional and morphological retinal damage when in direct contact with the inner retina. Possible pathological mechanisms include osmotic imbalance and direct toxic effects, and modification of biochemical properties is warranted before clinical use will be possible.
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| 17. |
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| 18. |
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| 19. |
- Eriksson, Urban, 1964-, et al.
(författare)
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Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls
- 2011
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 249:3, s. 349-359
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Tidskriftsartikel (refereegranskat)abstract
- Cystoid macular edema (CME) is a well-known complication after cataract surgery, and diabetic retinopathy is reported to be an important risk factor for impaired visual recovery. In this prospective study, we compared visual outcome 6 months after surgery in eyes with moderate retinopathy and no previous ME with a control group, and observed the incidence of ME seen on fluorescein angiography (FA) and optical coherence tomography (OCT). Thirty-four patients with type-2 diabetes and 35 controls were enrolled. Best-corrected visual acuity (VA) letters ETDRS was measured pre-op, at day 7, week 6 and month 6. FA performed pre-op and at week 6 was divided into three leakage patterns. OCT performed pre-op, at week 6 and month 6 was qualitatively divided into three types. Macular thickness was measured in three circular fields (central subfield, inner and outer circle) from the macular maps. There was no statistically significant difference in VA before surgery, at day 7 or at 6 months, but at 6 weeks there was a significant difference with lower VA in the diabetic group. Six percent of control and 12% of diabetic eyes developed a clinical CME defined as a loss of > 5 letters between day 7 and week 6. Incidence of FA leakage was 23% in control and 76% in diabetic eyes. At 6 weeks, 20% of control and 44% of the diabetic eyes had qualitative changes on OCT. A statistically significant increase in thickness was observed for all three macular areas in both groups, part of it remaining at 6 months. There were, however, no differences in central macular thickness between the groups at any visit. Retinal thickening had poor correlation with VA. The final visual outcome in eyes with mild to moderate retinopathy, without previous ME, is as good as in normal eyes, but an increased frequency of macular changes may protract recovery of full vision. Changes on OCT or FA are often seen without any obvious effect on VA. OCT is as good as FA at detecting a clinical CME, and is the technique recommended for follow-up before FA is considered.
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| 20. |
- Ghosh, Fredrik, et al.
(författare)
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Immune privilege of allogeneic neuroretinal transplants in the subconjunctival space.
- 2008
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 246, s. 1715-1722
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The extent of site and tissue-associated immune privilege is of great interest in transplantation experiments involving the CNS. In the present paper we have explored neuroretinal immune privilege by transplantation to a non-immune privileged site. METHODS: Fetal and adult full-thickness rabbit neuroretinal grafts were placed in the subconjunctival space of immunocompetent rabbit hosts. Morphological examination was performed after 2-31 days (fetal grafts, n = 46), and after 8 days (adult grafts, n = 4). RESULTS: Hematoxylin and eosin-stained sections and immunohistochemistry directed against microtubule-associated protein 2 (MAP2) revealed surviving grafts containing retinal neurons in the majority of eyes with fetal grafts. In all specimens, a mild inflammatory reaction was evident as seen with major histocompatibility complex class II (MHC-II) labeling. Short-term grafts survived well and displayed lamination and rosette formation whereas older grafts appeared more disorganized and were more often rejected. Müller cell fibers labeled with glial fibrillary acidic protein (GFAP) were present in grafts from 15 days and onwards. Adult grafts were destroyed after 8 days. CONCLUSIONS: Allogeneic fetal full-thickness neuroretinal transplants can survive for several weeks in a non-immune privileged environment in which adult grafts are rapidly rejected. Fetal grafts gradually shrink, lose their architecture and go through a glial transformation accompanied by low-grade inflammation. The rabbit neuroretina thus appears to enjoy partial immune privilege, the extent of which depends on the development state of the tissue. The characterization of neuroretinal immune privilege will hopefully influence future clinical trials of retinal transplantation.
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| 21. |
- Ghosh, Fredrik, et al.
(författare)
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In vitro biomechanical modulation-retinal detachment in a box.
- 2016
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 254:3, s. 475-487
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Tidskriftsartikel (refereegranskat)abstract
- To illustrate the importance of biomechanical impact on tissue health within the central nervous system (CNS), we herein describe an in vitro model of rhegmatogenous retinal detachment (RRD) in which disruption and restoration of physical tissue support can be studied in isolation.
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| 22. |
- Ghosh, Fredrik, et al.
(författare)
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Long-term neuroretinal full-thickness transplants in a large animal model of severe retinitis pigmentosa.
- 2007
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 245:6, s. 835-846
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to explore neuroretinal transplantation in a large animal model of severe retinitis pigmentosa and to establish graft development, long-term survival, graft-host integration, and effects on the host retina. Methods Rhodopsin transgenic pigs, aged 6 months, received in one eye a fetal full-thickness neuroretinal sheet in the subretinal space by means of vitrectomy and retinotomy. Six months postoperatively, eyes were studied in the light microscope and with immunohistochemical markers. Full-field electroretinography (ERG) was performed at 4 and 6 months. Results Laminated grafts with well-organized photoreceptors, rod bipolar cells, and Muller cells were found in five of six eyes. Neuronal connections between graft and host retina were not seen. In the five eyes containing a graft, the number of surviving rods in the host retina was significantly higher compared with unoperated eyes. The ERG did not reveal any significant difference in b-wave amplitude between operated and control eyes, but the cone-derived response in operated eyes increased significantly from 4 to 6 months while the rod response in control eyes decreased significantly. Conclusions Fetal full-thickness neuroretina can be transplanted safely to an eye with severe retinal degeneration. In their major part, the transplants develop a normal laminated morphology and survive for at least 6 months. Graft and host retinal neurons do not form connections. Retinal function in the host is reduced initially by the surgical trauma, but the presence of a well-laminated graft counteracts this effect and rescues rods from degeneration.
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| 23. |
- Ghosh, F, et al.
(författare)
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MHC expression in fragment and full-thickness allogeneic embryonic retinal transplants
- 2000
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 238:7, s. 98-589
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The study was carried out to evaluate the expression of major histocompatibility complex (MHC) molecules in retinal transplants with different tissue integrity.METHODS: Twelve adult rabbits received an allogeneic subretinal neuroretinal transplant, in the form of either fragmented embryonic cells or a complete full-thickness embryonic retina. A controlled transvitreal approach was used for both transplantation types. The grafts were examined histologically after 31 or 49 days with hematoxylin and eosin staining and immunohistochemical analysis of MHC class I and class II expression.RESULTS: All five fragment transplants developed into rosettes. Two of them displayed MHC class I-labeled cells, and four MHC class II-labeled cells. The cells were concentrated on the scleral side of the graft, and there was also a marked increase of labeled cells in the choroid. MHC labeling was often associated with defects in the retinal pigment epithelium. Six of the seven full-thickness grafts displayed a laminated morphology with well-developed retinal layers. The seventh consisted of rosettes. None of these grafts displayed MHC class I- or class II-labeled cells.CONCLUSIONS: The findings suggest that host immune response against fragmented and intact neuroretinal grafts is different, indicating tissue integrity as one factor affecting graft-host immune interactions. The absence of immune response in full-thickness grafts is encouraging and important in the struggle to find therapies for retinal degenerative disease.
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| 24. |
- Ghosh, Fredrik, et al.
(författare)
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Protein kinase C expression in the rabbit retina after laser photocoagulation.
- 2005
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 243:8, s. 803-810
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Tidskriftsartikel (refereegranskat)abstract
- Background: Laser photocoagulation is a well-established treatment for diabetic retinopathy but the mechanism behind its effectiveness has not been elucidated. The protein kinase C (PKC) family is a group of enzymes which has been the subject of extensive interest in clinically related research since the advent of its role in the pathogenesis of diabetic retinopathy. With this study we wanted to explore whether PKC expression is altered in the retina after laser photocoagulation. Methods: Normal rabbit eyes were treated with laser photocoagulation of varying intensity and examined after 30 min to 7 weeks. Treated and untreated regions of the retina were investigated histologically with the MC5 monoclonal antibody against PKC. Labeling for glial fibrillary acidic protein (GFAP), as well as hematoxylin and eosin (H&E) staining was also performed to assess the laser-induced trauma. Results: In the normal retina, the MC5 antibody labeled rod bipolar cells and photoreceptor outer segments corresponding to PKC alpha. A translocated PKC expression with labeling concentrated in the rod bipolar terminals was seen in specimens examined 30 min after laser treatment, and after 1 week, no expression was seen in any part of the retina. After 2 weeks, PKC expression again indicated a translocated labeling pattern. After 5 weeks, labeling was found only in rod bipolar terminals in the peripheral retina. When comparing high- and low-intensity laser treatment 7 weeks postoperatively, no labeling was found in the high intensity-treated retinas, whereas low intensity-treated eyes displayed a near-normal labeling pattern. H&E staining revealed focal neuroretinal edema immediately after laser treatment, also in untreated areas. At later stages, destruction of the outer nuclear layer and migration of pigment epithelial cells in laser-lesioned areas was seen. GFAP-labeled Muller cells were seen 1 week postoperatively in the entire retina. Labeling after this time decreased, but was still present in laser spots after 5 and 7 weeks. Conclusions: Laser photocoagulation alters the expression of PKC in the entire normal rabbit retina. The response follows a temporal pattern and is also related to laser intensity. These findings may help to explain the high efficacy of laser treatment in diabetic retinopathy.
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| 25. |
- Gjörloff, Karin, et al.
(författare)
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mfERG in normal and lesioned rabbit retina.
- 2006
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 244:1, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- Background: To evaluate and describe the cone function in the normal and lesioned rabbit retina using the multifocal electroretinogram (mfERG). Methods: Twelve animals underwent a two-port vitrectomy with subsequent retinectomy in one eye. The area of removed retina was located in the nasal part of the visual streak, and measured approximately 1-2 disc diameters. Both eyes were investigated with mfERG preoperatively and up to 13 weeks postoperatively. A Burian-Allen bipolar contact lens with built-in infrared emitters was used to visualize the retina during the recordings. The averages of the trace array amplitudes in the lower nasal and temporal quadrants were calculated and statistically analyzed at the different time intervals. All eyes were examined histologically with hematoxylin and eosin staining. Results: The retina could be visualized during the mfERG examinations. Postoperatively, up to 3 weeks, amplitudes were reduced over the entire stimulated area in retinectomized eyes (2.20 mu V +/- 1.22 SD) as compared with preoperative examinations (3.40 mu V +/- 1.00 SD). After 7 weeks the amplitudes in the quadrant including the retinectomized area remained low (2.62 mu V +/- 1.02 SD), whereas they were higher than at earlier postoperative examinations in the lower unlesioned temporal quadrant (3.56 mu V +/- 0.71 SD) with a statistical difference between the quadrants. At 13 weeks this was even more pronounced. In unoperated eyes, the area corresponding to the visual streak displayed significantly higher amplitudes than the area superior to the myelinated streak, corresponding well to the cone distribution. High amplitudes were also detected in the area of the myelinated nerve fibers and optic nerve head, most likely as a result of scattering light. In histological sections, the retinectomized area had a diameter of 1-3 mm. Conclusions: This study shows that the mfERG technique can be used as a tool in experimental retinal research involving the rabbit eye, where retinal lesions down to at least 1 mm can be detected. One difficulty involves scattering light emanating from the relatively large optic disc and the myelinated nerve fibers, which makes the use of a mfERG system, in which the fundus can be visualized during stimulation, mandatory.
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| 26. |
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| 27. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Granstam, Elisabet, 1963-, et al.
(författare)
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Switching anti-VEGF agent for wet AMD : evaluation of impact on visual acuity, treatment frequency and retinal morphology in a real-world clinical setting
- 2021
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer Nature. - 0721-832X .- 1435-702X. ; 259:8, s. 2085-2093
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aim of the present cross-sectional real-world study is to evaluate the impact of switch of anti-VEGF agent from ranibizumab to aflibercept on visual acuity, treatment frequency and retinal morphology after 12 months in eyes with ongoing chronic treatment for wet age-related macular degeneration (AMD) compared to eyes not subjected to switch of anti-VEGF agent.Methods Data was obtained retrospectively from the Swedish Macular Register, spectral-domain optical coherence tomography (OCT) images and electronic patient charts. All eyes included were treated in the same clinical setting at the Department of Ophthalmology at the county hospital of Vastmanland in Vasteras, Sweden.Results In total, 282 and 359 eyes were included in the non-switch and switch cohorts, respectively. The cohorts were well balanced. Visual acuity remained stable during the observation period in both cohorts of eyes. The number of anti-VEGF treatments slowly declined over time in both cohorts of eyes and, consequently, the treatment intervals increased during the observation period. In eyes subjected to switch of anti-VEGF agent, planned treatment interval at 12 months was 7.6 (mean; SD 2.9) weeks compared to 6.8 (mean; SD 2.7) in the non-switch cohort (P = 0.001). OCT images demonstrated lower prevalence of intraretinal and subretinal fluid as well as pigment epithelial detachment at 12 months in eyes subjected to switch of anti-VEGF agent compared to non-switch eyes.Conclusion Switch of anti-VEGF agent from ranibizumab to aflibercept did not affect visual function whereas improvement in retinal morphology was observed. These findings suggest a beneficial effect of switching from ranibizumab to aflibercept in eyes with ongoing chronic anti-VEGF treatment irrespective of previous response to ranibizumab. Longer follow-up is required to further evaluate the potential clinical significance of this finding.
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| 32. |
- Grödum, Kirsti, et al.
(författare)
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Glaucoma and mortality.
- 2004
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 242:5, s. 397-401
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Tidskriftsartikel (refereegranskat)
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| 33. |
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| 34. |
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| 35. |
- Heijl, A, et al.
(författare)
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Long-term effects of timolol therapy in ocular hypertension : a double-masked, randomised trial
- 2000
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 238:11, s. 83-877
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Increased intraocular pressure (IOP) has been shown to be one of the most important risk factors for developing glaucoma. Yet it has not been clearly demonstrated that IOP-lowering treatment can reduce the incidence of glaucoma damage in patients with ocular hypertension. The aim of the current paper was to report the results of a long-term study addressing this very problem.METHODS: We conducted a randomised, double-masked study comparing timolol and placebo treatment in 90 patients with ocular hypertension plus some additional risk factor. Patients were followed at 3-month intervals prospectively for 10 years or until glaucomatous field loss could be demonstrated with computerised perimetry. A post-study analysis was performed including all available data, thus extending maximum follow-up to 17 years.RESULTS: After 5 years of follow-up eight patients in the placebo group and five patients in the timolol group had developed glaucomatous field loss (NS); the corresponding figures after 10 years were 15 patients in the placebo group and seven patients in the timolol group. Survival analysis showed a tendency but no statistically significant difference between treatment groups (P = 0.07). Study attrition was large. Eighteen patients in each group had developed glaucomatous field loss when also post-study data were included. IOP reduction was greater in eyes passing the 10-year visit without field loss (5.7 mmHg), than in those that reached an end-point (2.3 mmHg; P = 0.0002).CONCLUSION: In this long-term study we found a tendency but failed to prove a beneficial effect of topical timolol treatment in patients with elevated IOP, normal visual fields and some additional risk factor. The intent-to-treat analysis showed no difference between treatment groups. The high attrition shows the difficulties associated with very long follow-up.
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| 36. |
- Holm, Kristina, et al.
(författare)
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In diabetic eyes, multifocal ERG reflects differences in function between the nasal part and the temporal part of the macula.
- 2012
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 250:8, s. 1143-1148
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of the present study was to compare retinal function between the perifoveal nasal and perifoveal temporal areas of diabetic eyes using multifocalERG (mfERG). METHODS: We included 36 eyes from 27 patients with diabetes (age 58 ± 14 years; duration of diabetes 13 ± 9 years; HbA(1c) 7.1 ± 1.8%) and a control group with 18 eyes from 18 healthy subjects (age 57 ± 11 years). Retinal thickness was assessed with optical coherence tomography (OCT) in the perifoveal areas corresponding to the summed nasal and temporal inner and outer areas. MfERG amplitude and implicit time were recorded from corresponding areas. RESULTS: Diabetic eyes showed lower mfERG amplitude in the nasal area than in the temporal area (14 ± 6 vs 17 ± 7 nV/deg(2); p < 0.0001) and longer implicit time (31 ± 3 vs 30 ± 3 ms; p = 0.005). In the control group, there were no significant differences between the two areas. CONCLUSION: Diabetic eyes showed lower amplitude and longer implicit time in the nasal area than in the temporal, which might indicate that the nasal area is more vulnerable. These findings may be of importance for evaluation of diabetic maculopathy and outcome after laser treatment.
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| 37. |
- Holm, Kristina, et al.
(författare)
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Using multifocal electroretinography hard exudates affect macular function in eyes with diabetic retinopathy
- 2010
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 248:9, s. 1241-1247
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the influence of hard exudates on macular function in patients with diabetic retinopathy. METHODS: Thirty seven eyes from 27 diabetic patients, aged 57 +/- 14 years, diabetes duration 12.5 +/- 9 years, not previously treated with photocoagulation, underwent fundus photography, multifocal electroretinography (mfERG) and optical coherence tomography (OCT). Hard exudates were graded from fundus photography with superimposed OCT and a superimposed hexagonal pattern (mfERG) by one retinal specialist, unaware of mfERG and OCT results. We defined three groups; A = eyes with exudates in the analyzed zone, B = eyes with no exudates in the analyzed zone but elsewhere, and C = eyes with no exudates. The mfERG responses and OCT values from five defined areas in the macula were compared. RESULTS: MfERG showed that the implicit time was significantly prolonged in group A compared to group C in the central, middle and outer areas and in the nasal and temporal area (p = 0.045, 0.019, 0.017 and 0.035 and 0.016 respectively), in group B compared to group C in the central area (p = 0.016), and in group A compared to group B in the outer area (p = 0.035). Amplitude differed between group A and C in the middle area and outer area (14.2 +/- 5.2 nV/deg(2) vs 21.1 +/- 8.7 nV/deg(2), p = 0.037 and 14.1 +/- 3.9 nV/deg(2) vs 17.7 +/- 7.1 nV/deg(2) , p = 0.02 respectively), and between group B and C in the temporal area 14.5 +/- 2.2 nV/deg(2) vs 20.0 +/- 8.7 nV/deg(2), p = 0.017). Macular thickness assessed with OCT was similar between the groups. CONCLUSIONS: In eyes with diabetic retinopathy, hard exudates prolong the implicit time assessed with mfERG, compared to eyes without hard exudates, and independently of macular thickness. These results indicate that the hard exudates in the macular region, even at a distance from the fovea centre, have a deleterious effect on macular function.
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| 38. |
- Hougaard, Jesper, et al.
(författare)
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Modelling the normal retinal nerve fibre layer thickness as measured by Stratus optical coherence tomography.
- 2006
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 244, s. 1607-1614
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Tidskriftsartikel (refereegranskat)abstract
- Background: The variation in retinal nerve fibre layer thickness (RNFLT) as measured by Stratus optical coherence tomography (OCT) in healthy subjects may be reduced when the effect on RNFLT measurements of factors other than disease is corrected for, and this may improve the diagnostic accuracy in glaucoma. With this perspective we evaluated the isolated and combined effects of factors potentially affecting the Stratus OCT RNFLT measurements in healthy subjects. Methods: We included 178 healthy eyes of 178 subjects between 20 and 80 years of age. Participants underwent an extensive eye examination. Stratus OCT RNFLT was measured by three standard protocols, two with high and one with standard image resolution. Effects on RNFLT of age, gender, refractive error, axial length, lens nuclear colour and opalescence, intra-ocular pressure (IOP), and optic disc size were examined by univariate and multivariate analyses. Results: Age, refractive error, axial length, and lens nuclear colour and opalescence affected RNFLT in univariate analyses, whereas gender, IOP, and optic disc size had no significant effect. In multivariate analyses only age in combination with refractive error, or with axial length, was significant and explained 14.7-17.6% (R-2 stop) of the total variation of RNFLT, approximately 50% more than age alone. RNFLT decreased by 2.6-2.9 mu m per increasing decade of age and increased by 1.5-1.8 mu m per more positive diopter of spherical equivalent using full-circle measurements of the three standard protocols. These effects varied between measurement sectors. Conclusions: RNFLT as measured by Stratus OCT standard protocols was significantly affected by age and refractive status. The effect on global RNFLT of a difference in refractive error of 10 diopters corresponded to the effect of a difference in age of 60 years. Theoretically, the effect of refractive status may be explained by artefacts of RNFLT measurement circle placement. The results suggest that the diagnostic accuracy of Stratus OCT may be improved by considering refractive status in addition to age when RNFLT is measured. For this purpose spherical equivalent seems as effective as axial length.
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| 39. |
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| 40. |
- Ivert, L, et al.
(författare)
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Alteration in choroidal blood flow produced by local pressure
- 2006
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Ingår i: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. - : Springer Science and Business Media LLC. - 0721-832X. ; 244:10, s. 1339-1344
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Tidskriftsartikel (refereegranskat)
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| 41. |
- Ivert, L, et al.
(författare)
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Behavior of retinal epithelium to bleb detachment versus retinectomy
- 2007
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Ingår i: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. - : Springer Science and Business Media LLC. - 0721-832X. ; 245:2, s. 282-287
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Tidskriftsartikel (refereegranskat)
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| 42. |
- Ivert, L, et al.
(författare)
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Changes in the choroidal circulation of rabbit following RPE removal
- 2003
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Ingår i: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. - : Springer Science and Business Media LLC. - 0721-832X. ; 241:8, s. 656-666
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Tidskriftsartikel (refereegranskat)
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| 43. |
- Ivert, L, et al.
(författare)
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Long-term effects of short-term retinal bleb detachments in rabbits
- 2002
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Ingår i: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. - : Springer Science and Business Media LLC. - 0721-832X. ; 240:3, s. 232-237
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Tidskriftsartikel (refereegranskat)
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| 44. |
- Jacobi, Felix K, et al.
(författare)
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Phenotypic expression of the complete type of X-linked congenital stationary night blindness in patients with different mutations in the NYX gene
- 2002
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 240:10, s. 822-828
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe the clinical phenotype of the complete type of X-linked congenital stationary night blindness (CSNB1) with different types of mutations in the NYX gene. Methods: The clinical and genetic data from 18 male patients with eight different mutations from two ophthalmological institutes were reviewed. The variability in refractive error, reduced visual acuity and full-field electroretinogram (ERG) recordings was examined. Results Parameters were quantitatively analyzed based on the classification of mutations according to their predicted effect on protein structure and function. CSNB1 patients with mutations changing structurally conserved residues (n=12) tended to have a lower degree of myopia than patients with mutations of non-conserved residues (n=6). Visual acuity loss and the 30 Hz flicker ERG recordings were similar in the two groups. Values for the b/a amplitude ratio tended to be clustered in patients carrying the same mutation. Refractive error and the b/a amplitude ratio were highly correlated between the two eyes of an individual. Conclusions: These data suggest correlations between phenotypic expression in CSNB1 and individual genotypes as well as class types of mutations based on the extent of structural amino acid conservation. A high inter-eye correlation suggests that other genetic or environmental factors, rather than chance, play a part in determining the phenotypic diversity in CSNB1.
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| 45. |
- Johannesson, Gauti, et al.
(författare)
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Age-dependency of ocular parameters : a cross sectional study of young and elderly healthy subjects
- 2015
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer. - 0721-832X .- 1435-702X. ; 253:11, s. 1979-1983
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the effect of aging on ocular parameters, including intraocular pressure (IOP), measured with different tonometry methods in healthy young (HY) and healthy elderly (HE) subjects and to study the effect of corneal parameters on tonometry methods. In this prospective, cross-sectional study, fifty eyes of 50 HY subjects (28 females, 22-31 years of age) and 43 eyes of 43 HE subjects (22 females, 64-79) were included. IOP was measured with four tonometry methods in a standardized order: ocular response analyser (ORA), dynamic contour tonometry (DCT), applanation resonance tonometry (ART) and Goldmann applanation tonometry (GAT). Other measurements included axial length (AL), central corneal thickness (CCT), corneal curvature (CC), anterior chamber volume (ACV), corneal hysteresis (CH) and corneal resistance factor (CRF). The mean IOP (HY/HE; mmHg +/- standard deviation (SD)) was 12.2 +/- 2.2/14.1 +/- 3.5 with GAT. IOP was significantly higher (difference +/- standard error) in HE compared to HY measured with an ORA (+3.1 mmHg +/- 0.6), GAT (+1.9 +/- 0.6) and DCT (+1.6 +/- 0.6). No significant difference was found in IOP measured with ART. CH and ACV were significantly lower in HE compared to HY. There was no difference between the groups in CCT, CC, AL or CRF. No tonometry method was dependant on CCT or CC. IOP measured with an ORA and via DCT and GAT was higher in HE compared to HY Swedish subjects, while IOP measured with ART did not differ between the groups. In these homogeneous groups, tonometry methods were independent of CCT and CC.
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| 46. |
- Jóhannesson, Gauti, et al.
(författare)
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Can we trust intraocular pressure measurements in eyes with intracameral air?
- 2014
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Ingår i: Graefe's Archives for Clinical and Experimental Ophthalmology. - : Springer. - 0721-832X .- 1435-702X. ; 252:10, s. 1607-1610
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the effect of intracameral air on intraocular pressure (IOP) measurements using Goldmann applanation tonometry (GAT) and applanation resonance tonometry (ART) in an in-vitro porcine eye model.METHODS: IOP was measured on thirteen freshly enucleated eyes at three reference pressures: 20, 30, and 40 mmHg. Six measurements/method were performed in a standardized order with GAT and ART respectively. Air was injected intracamerally in the same manner as during Descemet's stripping endothelial keratoplasty (DSEK) and Descemet's membrane endothelial keratoplasty (DMEK), and the measurements were repeated.RESULTS: Measured IOP increased significantly for both tonometry methods after air injection: 0.7 ± 2.1 mmHg for GAT and 10.6 ± 4.9 mmHg for ART. This difference was significant at each reference pressure for ART but not for GAT.CONCLUSIONS: Although slightly affected, this study suggests that we can trust GAT IOP-measurements in eyes with intracameral air, such as after DSEK/DMEK operations. Ultrasound-based methods such as ART should not be used.
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| 47. |
- Kalaboukhova, Lada, 1975, et al.
(författare)
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Glaucoma follow-up by the Heidelberg retina tomograph--new graphical analysis of optic disc topography changes.
- 2006
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Ingår i: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie. - : Springer Science and Business Media LLC. - 0721-832X. ; 244:6, s. 654-62
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Heidelberg Retina Tomograph (HRT) is a commercially available instrument for the detection of glaucomatous damage by analysis of optic nerve head topography. The main purpose of the study was to investigate the ability of HRT to detect changes in optic disc topography indicating progression of optic neuropathy in eyes with open-angle glaucoma or, in eyes with ocular hypertension, conversion to open-angle glaucoma. METHODS: Fifty-nine subjects (34 with ocular hypertension, 25 with glaucoma) from the glaucoma service at Sahlgrenska University Hospital were included in this study. One eye of each patient was selected. All participants underwent thorough clinical examination, including HRT, high-pass resolution perimetry (HRP), and optic disk photography. After a mean follow-up time of 50 months, patients were re-examined. Based on analyses of optic disc photographs and HRP, eyes were classified into one of two groups: progressive or stable. The differences between baseline and follow-up HRT parameters in the two groups were analysed. The topographic HRT change images were also compared after digital image processing. A pixel ratio was calculated defined as the ratio between the area of pixels representing deepening of the disc surface and the total disc area. Receiver operating characteristic (ROC) curves for HRT parameters and pixel ratio were compared. RESULTS: In the group judged to have progressive optic neuropathy, a statistically significant change between baseline and follow-up examination was found for the following HRT parameters: cup shape measurement, classification index, the third moment in contour, cup/disc ratio, cup area, rim area, and area below reference). In the stable group no HRT parameters had changed significantly. A well-defined distinction between the two groups was found by comparing digitally processed HRT change images. The area under the ROC curve was larger for pixel ratio than for any of the HRT parameters. CONCLUSIONS: The HRT is a useful tool for long-term follow-up of glaucomatous optic neuropathy. Digital image processing of HRT change images could facilitate the detection of progressive change.
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| 48. |
- Kjellström, Ulrika, et al.
(författare)
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Dose-related changes in retinal function and PKC-alpha expression in rabbits on vigabatrin medication : Effect of vigabatrin in the rabbit eye.
- 2009
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 1435-702X .- 0721-832X. ; 247:8, s. 1057-1067
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To investigate, in a rabbit model, the effect of two different doses of vigabatrin (VGB) on retinal function and morphology. METHODS: Twenty-nine rabbits of mixed strain were divided into two groups, receiving either high-dose (n = 15) or low-dose (n = 14) oral VGB treatment (cumulative dose 29.8 +/- 2.9 g and 14.2 +/- 0.6 g respectively). Ten rabbits receiving water served as control animals. The rabbits underwent three baseline ff-ERG measurements before initiation of VGB medication and two ff-ERG registrations during treatment, after 8 and 12-14 weeks respectively. At the end of the study, the expression of protein kinase C-alpha (PKC-alpha), gamma amino butyric acid (GABA) A receptors, vimentin, glial fibrillary acidic protein (GFAP) and peanut agglutinin (PNA) was examined in retinal sections from all rabbits. RESULTS: In animals of the high-dose group, the ff-ERG measurements revealed a significant decrease of isolated rod b-wave amplitudes, combined rod-cone b-wave amplitudes and amplitudes of oscillatory potentials (OPs); OP1, OP2 and OP3. In the low-dose group, the b-wave amplitudes of combined rod-cone responses as well as OP2 and OP3 were significantly reduced. PKC-alpha labeling demonstrated a dose-related translocation of the enzyme in rod bipolar cells, also revealing a significant decline of the number of PKC-alpha labeled rod bipolar cells in treated animals. Vimentin labeling showed a dose-related deviant labeling pattern of Müller cells, with strikingly low labeling intensity in the outer parts of the cells; in the outer limiting membrane (OLM) as well as the outer nuclear layer (ONL). Labeling with antibodies against GABA A receptors and GFAP, as well as PNA staining, revealed no differences between treated animals and controls. CONCLUSIONS: In this study, VGB medication was associated, in a dose-related manner, with a decrease of ff-ERG amplitudes as well as with altered protein expression in rod bipolar cells and Müller cells, suggesting alterations of inner retinal function. The dose-related morphological and electrophysiological changes indicate a retinal pathology that may explain the constricted visual fields seen in some patients treated with VGB.
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| 49. |
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| 50. |
- Kozak, Igor, et al.
(författare)
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Teleophthalmology image-based navigated retinal laser therapy for diabetic macular edema : a concept of retinal telephotocoagulation
- 2017
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Ingår i: Graefe's Archive for Clinical and Experimental Ophthalmology. - : Springer Science and Business Media LLC. - 0721-832X .- 1435-702X. ; 255:8, s. 1509-1513
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Tidskriftsartikel (refereegranskat)abstract
- Background: To determine the feasibility and efficacy of a retinal telephotocoagulation treatment plan for diabetic macular edema. Methods: Prospective, interventional cohort study at two clinical sites. Sixteen eyes of ten subjects with diabetic macular edema underwent navigated focal laser photocoagulation using a novel teleretinal treatment plan. Clinic 1 (King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia) collected retinal images and fundus fluorescein angiogram. Clinic 2 (Palmetto Retina Center, West Columbia, SC, USA) created image-based treatment plans based on which macular laser photocoagulation was performed back at clinic 1. The primary outcome of the study was feasibility of image transfer and performing navigated laser photocoagulation for subjects with diabetic macular edema between two distant clinics. Secondary measures were change in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) by spectral-domain optical coherence tomography at 3 months after treatment. Results: The teleretinal treatment plan was able to be successfully completed in all 16 eyes. The mean logMAR BCVA at baseline was 0.49 ± 0.1, which remained stable (0.45 ± 0.1) 3 months after treatment (p = 0.060). The CRT improved from 290.1 ± 37.6 μm at baseline to 270.8 ± 27.7 μm 3 months after treatment (p = 0.005). All eyes demonstrated improvement in the area of retinal edema after laser photocoagulation, and no eyes demonstrated visual acuity loss 3 months after treatment. Conclusion: This study introduces the concept of retinal telephotocoagulation for diabetic macular edema, and demonstrates the feasibility and safety of using telemedicine to perform navigated retinal laser treatments regardless of geographical distance.
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