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| 3. |
- Alm, Albert
(författare)
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Effects of norepinephrine, angiotensin, dihydroergotamine, papaverine, isoproterenol, histamine, nicotinic acid, and xanthinol nicotinate on retinal oxygen tension in cats
- 1972
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Ingår i: Acta Ophthalmologica. - : Wiley. - 0001-639X .- 1755-375X. ; 50:5, s. 707-719
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Tidskriftsartikel (refereegranskat)abstract
- The oxygen tension in the vitreous body close to the retina, PvrO2, was determined continuously in cats. The effects on PvrO2 of intraarterial injections of various vasoactive drugs were determined. The vasoconstrictors norepinephrine, angiotensin and dihydroergotamine did not change PvrO2 in five cats. The same result was obtained with the vasodilators isoproterenol, histamine and xanthinol nicotinate in five cats, and with nicotinic acid in six cats, while papaverine invariably increased PvrO2 in seven cats when injected intraarterially and in two cats when injected intravenously. It is suggested that the ability to penetrate the blood-retinal barrier may play an important role in determining the effect of vaso-active drugs on retinal blood flow.
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| 4. |
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| 5. |
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| 6. |
- Alm, Albert, et al.
(författare)
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Five-year, Multicenter Safety Study of Fixed-combination Latanoprost/Timolol (Xalacom) for Open-angle Glaucoma and Ocular Hypertension
- 2011
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Ingår i: Journal of glaucoma. - 1057-0829 .- 1536-481X. ; 20:4, s. 215-222
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the safety of fixed-combination latanoprost/timolol (Xalacom) in patients requiring additional intraocular pressure (IOP) reduction over 5 years. Methods: This phase 3b, open-label, multicenter study included prostaglandin-naive participants with open-angle glaucoma or ocular hypertension insufficiently responsive to beta-blockers and requiring additional IOP reduction. Participants were evaluated at eleven 6-month visits. A masked assessor evaluated iris/eyelash changes at baseline and 12, 36, and 60 months. Increased iris pigmentation incidence was compared with a historic control from a similarly designed study evaluating latanoprost. Ocular and systemic adverse events were recorded. Results: Among 828/974 treated participants with assessable iris photographs, 233 (28.1%) developed increased iris pigmentation versus 127/380 (33.4%) in the historic controls. Participants with mixed eye colors exhibited greater susceptibility to overall increased iris pigmentation (85.8% in both studies). In this study, most participants (80.3%) with increased iris pigmentation developed only a weak increase. Eyelash changes were seen in 58.1% of participants and darkening of the eyelids in 5-6%; 14.1% experienced a serious adverse event. Adverse events resulted in treatment withdrawal in 133 (13.7%) participants. Most were nonserious ocular adverse events, about half of them ocular irritation. Only 3 of 13 serious systemic adverse events were considered to be drug related by the investigator. Mean IOP reductions were stable over 5 years. Conclusions: After 5 years, more than 70% of participants treated with fixed-combination latanoprost/timolol had no increased iris pigmentation. The fixed combination is safe and well tolerated for long-term treatment in patients with open-angle glaucoma or ocular hypertension.
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| 7. |
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| 8. |
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| 9. |
- Alm, Albert
(författare)
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Optic nerve and choroidal ciruculation: Physiology.
- 1998
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Ingår i: Nitric Oxide and Endothelin in the Pathogenesis of Glaucoma.. - : I O Haeflger, J Flammer, Lippincott, Raven, Philadelphia. ; , s. 34-
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 10. |
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| 13. |
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| 14. |
- Alm, Albert, et al.
(författare)
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Side effects associated with prostaglandin analog therapy
- 2008
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Ingår i: Survey of ophthalmology. - : Elsevier BV. - 0039-6257 .- 1879-3304. ; 53:Suppl. 1, s. S93-S105
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Forskningsöversikt (refereegranskat)abstract
- Topical prostaglandin analogs, which have become first-line therapy in the medical management of glaucoma, have an excellent safety profile with regard to systemic side effects, but are associated with several ocular side effects. Some of these are common, with no apparent serious consequences other than cosmetic, whereas others are much less common but represent potentially sight-threatening side effects. The former group includes conjunctival hyperemia, elongation and darkening of eyelashes, induced iris darkening, and periocular skin pigmentation. The latter group of side effects, which are relatively rare and lack definitive causal relationship to prostaglandin analog therapy, includes iris cysts, cystoid macular edema, anterior uveitis, and reactivation of herpes simplex keratitis. Most of the literature regarding side effects associated with prostaglandin analogs involves the use of latanoprost, probably because it was the first to be studied. There is no evidence, however, aside from less conjunctival hyperemia with latanoprost, that the commercially available prostaglandin analogs differ significantly with regard to side effects.
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| 15. |
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| 16. |
- Alm, Albert
(författare)
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The physiology of choroidal circulation.
- 1997
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Ingår i: Indocyanine Green Angiography. - : L A Yanuxxi, R W Flower, J S Slakter, Mosby, St louis. ; , s. 36-
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 17. |
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| 18. |
- Alm, Albert
(författare)
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Uveoscleral outflow.
- 2000
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Ingår i: Eye. ; 14, s. 488-
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Tidskriftsartikel (refereegranskat)
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| 19. |
- Alm, Albert, et al.
(författare)
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Uveoscleral outflow - A review
- 2009
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Ingår i: EXPERIMENTAL EYE RESEARCH. - : Elsevier BV. - 0014-4835 .- 1096-0007. ; 88:4, s. 760-768
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- The uveoscleral outflow route was described more than 40 years ago. Part of aqueous leaves the eye through the iris root. The ciliary muscle, and there are large species differences in the fraction of aqueous outflow that leaves the eye through this route. In non-human primates 40-50% of aqueous leaves the eye by the uveoscleral route. In human eyes most data has been collected by indirect calculations, with results suggesting a similar fraction, at least in eyes from younger individuals. An age-dependent reduction in uveoscleral flow in human eyes may explain the initial difference seen between non-human primate and human eyes. Unlike trabecular outflow, intraocular pressures within the normal range have little effect on uveoscleral outflow. This may be explained by the fact that changes in intraocular pressure have little effect on the pressure gradient for flow through the ciliary muscle, which is likely to be the rate-limiting step in uveoscleral outflow. The state of the ciliary muscle is important and contraction reduces while relaxation increases uveoscleral flow. Similar effects are achieved with cholinergic agonists and antagonists. Epinephrine increases uveoscleral flow, most likely through stimulating beta(2)-adrenergic receptors. Prostaglandin F-2 alpha and prostaglandin F-2 alpha-analogues effectively reduce intraocular pressure by increasing uveoscleral flow. This is mediated by structural changes in the extracellular matrix of the ciliary muscle, and is likely to contribute to a valuable excess route for aqueous and proteins during intraocular inflammation. Whether uveoscleral flow plays a significant role in any other eye disease is not clear. Thus, 40 years later we are able to successfully increase aqueous flow through the uveoscleral route, a valuable contribution to glaucoma treatment, but we still have only a limited understanding on its physiological role.
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| 20. |
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| 21. |
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| 22. |
- Bjärnhall, Gunilla, 1963-
(författare)
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Analysis of Angiographies in Human Healthy Eyes and in Open-angle Glaucoma : Retinal Mean Transit Time and Optic Nerve Head Circulation
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Purpose of the studies was to develop a more robust technique to determine retinal mean transit time in healthy and in glaucoma eyes and to evaluate the circulation of the optic nerve head in glaucoma patients.The retinal mean transit time impulse-response method was evaluated in human healthy eyes and normal values and reproducibility were tested.Fluorescein and indocyanine green angiographies were recorded and the pictures were analyzed to obtain retinal mean transit time and to evaluate the proportion of low-fluorescent pixels of the optic nerve head in the glaucoma patients. Visual field defects were correlated to loss of neuroretinal rim area.A disturbed circulation was observed in the glaucoma patients, whether primary or secondary to loss of nerve fibre tissue can not be determined from these studies.
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| 23. |
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| 24. |
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| 25. |
- Bjärnhall, Gunilla, et al.
(författare)
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Retinal mean transit time in patients with primary open-angle glaucoma and normal-tension glaucoma
- 2007
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Ingår i: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907 .- 1600-0420. ; 85:1, s. 67-72
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the mean transit time (MTT) of retinal circulation in eyes with primary open-angle glaucoma (POAG) and eyes with normal-tension glaucoma (NTG) and examine the possible relationship between MTT and visual field damage, expressed as mean deviation (MD). Methods: Video fluorescein angiography was performed in 40 patients with POAG or NTG. Dye curves for fluorescein passing through the retinal arteries and veins were used to calculate MTT in each patient with a computer-assisted technique based on an impulse-response analysis (MTTir). Results: We were able to analyse MTTir in all 40 angiograms. Mean (SD) MTTir was 5.0 (1.5) seconds in eyes with POAG and 4.7 (1.4) seconds in eyes with NTG. The difference was not statistically significant. There was a weak but significant correlation between the MD and MTTir (MTTir = 4.12–0.08*MD; r = −0.49, p = 0.0013). Conslusions: The results demonstrate that loss of neuronal tissue in glaucoma is combined with an effect on the retinal circulation and that the effect is similar in eyes with NTG and eyes with POAG.
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Botling Taube, Amelie, 1966-
(författare)
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Molecular and epidemiological studies on eyes with pseudoexfoliation syndrome
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Pseudoexfoliation (PEX) syndrome is an age-related condition characterized by the production and accumulation of extracellular fibrillary material in the anterior segment of the eye. PEX predisposes for several pathological conditions, such as glaucoma and complications during and after cataract surgery. The pathogenesis of PEX is not yet fully understood. It is multifactorial with genetics and ageing as contributing factors. We aimed to study the proteome in aqueous humor (AH) in PEX in order to increase the knowledge about its pathophysiology. Therefore, we developed sampling techniques and evaluated separation methods necessary for analyzing small sample volumes. Other objectives were to study the lens capsule in eyes with PEX regarding small molecules, and to investigate the association between PEX and cataract surgery in a population-based 30-year follow-up study.Samples of AH from eyes with PEX and control eyes were collected during cataract surgery. In pooled, and individual samples, various liquid based separation techniques and high resolution mass spectrometry were utilized. For quantitation, various methods for labeling, and label free techniques were applied. Lens capsules were collected from some of the patients, and analysed by imaging mass spectrometry. A cohort of 1,471 elderly individuals underwent a comprehensive ophthalmological examination at baseline. Medical information was obtained by questionnaires, and from medical records. Incident cases of cataract surgery were identified by review of medical records. In the initial study, several techniques were explored for protein detection, and a number of proteins were identified as differentially expressed. In the individually labelled samples, changes in the proteome were observed. Eyes with PEX contained higher levels of proteins involved in inflammation, oxidative stress, and coagulation, suggesting that these mechanisms are involved in the pathogenesis in PEX. The levels of β/γ-crystallins were significantly increased in PEX, which is a novel finding. In the lens capsules from individuals with PEX, changes in the lipid composition was observed with time-of-flight secondary ion mass spectrometry. These changes remain to be elucidated. By multivariate analysis, lens opacities were the first, and PEX the second most important predictor for cataract surgery, the later accounting for a 2.38-fold increased risk for cataract surgery.
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| 30. |
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| 31. |
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| 32. |
- Botling Taube, Amelie, 1966-, et al.
(författare)
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Proteomic analysis of the aqueous humour in eyes with pseudoexfoliation syndrome
- 2019
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Ingår i: British Journal of Ophthalmology. - : BMJ PUBLISHING GROUP. - 0007-1161 .- 1468-2079. ; 103:8, s. 1190-1194
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Tidskriftsartikel (refereegranskat)abstract
- Background/aims Pseudoexfoliation syndrome (PEX) is characterised by the production and accumulation of extracellular fibrillar material in the anterior segment of the eye. The pathogenesis of PEX is multifactorial with genetic factors and ageing as contributing factors. Previously, an increased concentration of beta-crystalline B2 (CRYBB2) was observed in the aqueous humour (AH) in eyes with PEX in a pooled material. Here, the protein content was examined on individual basis. Methods During cataract surgery, AH was sampled from patients with and without PEX, 10 eyes in each group. The proteins were digested and labelled with isotopomeric dimethyl labels, separated with high-pressure liquid chromatography and analysed in an Orbitrap mass analyzer. Results The concentration of complement factor 3, kininogen-1, antithrombin III and vitamin D-binding protein was increased in all eyes with PEX. Retinol-binding protein 3, glutathione peroxidase, calsyntenin-1 and carboxypeptidase E were decreased in eyes with PEX. Beta-crystalline B1 and CRYBB2 and gamma-crystalline D were up to eightfold upregulated in 4 of 10 in eyes with PEX. Conclusion The results indicate that oxidative stress and inflammation are contributing factors in the formation of PEX. Knowledge about the proteome in PEX is relevant for understanding this condition.
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| 33. |
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| 34. |
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| 35. |
- Ekström, Curt, 1944-, et al.
(författare)
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Pseudoexfoliation as a risk factor for prevalent open-angle glaucoma
- 2008
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-375X. ; 86:7, s. 741-746
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To estimate the risk of open-angle glaucoma (OAG) associated with exposure to pseudoexfoliation (PEX) and increased intraocular pressure (IOP). METHODS: In 1984-86, a cross-sectional, population-based survey was conducted in the municipality of Tierp, central Sweden. Its target population comprised 2429 residents aged 65-74 years. In addition to a sample of 760 people, patients previously diagnosed with glaucoma were examined. The prevalence of OAG in the target population was estimated from the prevalence in the sample and patients already diagnosed. A review of prevalent cases in 1984-86 was undertaken in 2006. RESULTS: Definite OAG was established in 77 cases, corresponding to a prevalence of 5.3% (95% confidence interval [CI] 4.4-6.2). Of these, 23 represented newly detected cases. The prevalence of PEX was 17.2% (95% CI 14.6-19.9), calculated from 134 cases in the population sample. When adjusting for gender, PEX was associated with a 4.7-fold (95% CI 2.2-9.4) increased risk of OAG. For clinical cases only, the risk was 16-fold (95% CI 4.8-56) greater in subjects with PEX, compared with those without PEX. In individuals without a previous diagnosis of glaucoma, an IOP > or = 20 mmHg was associated with a 9.7-fold (95% CI 3.7-27) increased risk, but PEX alone was not a risk factor for OAG (adjusted odds ratio = 0.96). CONCLUSIONS: Pseudoexfoliation was associated with OAG only in people previously diagnosed with the disease. In cases detected in the population-based survey, increased IOP was a serious risk factor.
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| 36. |
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| 37. |
- Ekström, Curt, 1944-
(författare)
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Studies on the Epidemiology of Open-angle Glaucoma
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Glaucoma is a common disease in the elderly population. Open-angle glaucoma (OAG) is the predominant form of glaucoma. Chronic simple glaucoma and capsular glaucoma, characterized by the occurrence of pseudoexfoliation in the anterior eye segment, are the most frequent types of OAG. The purpose of the present thesis was to study the epidemiology of OAG in the municipality of Tierp, whose population has a high exposure to pseudoexfoliation.In a case-finding study, the prevalence of known cases of OAG by December 31, 1983 was estimated to 1.4% in people ≥45 years of age. Sixty-three percent of all cases had capsular glaucoma. Patients with advanced glaucoma were older, had had the disease for longer, had higher mean initial intraocular pressure, and had more extensive visual field defects at the time of diagnosis.A population survey of people 65–74 years of age was conducted in 1984–86. The prevalence of OAG was 5.3%. Pseudoexfoliation was found in 17%, being more common in females. Pseudoexfoliation was associated with OAG only in people previously diagnosed with the disease (odds ratio = 16). In cases detected at the survey, an intraocular pressure ≥20 mmHg was a serious risk factor of having OAG (odds ratio = 9.7).In a 5-year follow-up study of participants in the population survey, increased intraocular pressure and pseudoexfoliation were recognized as independent risk factors for the development of OAG (standardized risk ratios = 3.4 and 9.8, respectively). Interaction between increased intraocular pressure and pseudoexfoliation was indicated. By May 2006, the incidence of OAG was estimated to 7.1 per 1,000 person-years. The incidence of capsular glaucoma was more than twice that of chronic simple glaucoma.The prevalence and incidence of OAG was higher than that reported from other studies conducted on Caucasian populations. The probable explanation for this finding is exposure to pseudoexfoliation.
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| 38. |
- Eriksson, Urban, et al.
(författare)
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A population-based study of macular thickness in full-term children assessed with Stratus OCT: normative data and repeatability.
- 2009
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 87:7, s. 741-745
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: We aimed to determine normal macular thickness values, assessed with optical coherence tomography (OCT), in a population of full-term children of normal birthweight. Methods: A total of 56 children, aged 5-16 years, randomly chosen from the population register, were examined with Stratus OCT. Only children with visual acuity < 0.2 logMAR, spherical equivalent of - 3 to + 3 D and astigmatism < 2 D were included. The fast macular map protocol was used and three examinations were performed in each eye. One eye was then randomized for further analyses. Mean values for the nine ETDRS areas, foveal minimum thickness and macular volume were calculated for 55 eyes. Coefficients of variance and intraclass correlations were calculated for each area. Results: All children co-operated well and no child was excluded for lack of concentration. Mean +/- standard deviation central macular thickness was 204 +/- 19 mum. Mean total macular volume was 7.11 +/- 0.35 mm(3). No correlations were found between age, gender and macular thickness. Coefficients of variance were < 2% and intraclass correlations were > 0.9 in all areas, except the foveal minimum. Conclusions: Normal values for macular thickness in healthy full-term children were reported. As the Stratus OCT provides normal values only for adults, these data are a better alternative for comparison with children with retinal abnormalities. We concluded that OCT is suitable for examining the retina in children aged 5-16 years and has the same high level of repeatability as in adults.
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| 39. |
- Eriksson, Urban, 1964-
(författare)
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Aspects of Optical Coherence Tomography (OCT) in Healthy Eyes and Eyes with Retinal Diseases
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Optical coherence tomography (OCT) is a technique in which cross-sectional images from intraocular tissue can be obtained. The quantitative and qualitative examinations are used for evaluating retinal diseases. Conventional OCT (Stratus) is mainly used, but the new Spectral domain (Cirrus) OCT, which has improved technology, may provide more reliable measurements.The aim of the study was to collect normal values of macular thickness in children and adults and to evaluate the effect of age and/or gender, to compare measurement variability in healthy eyes and eyes with age-related macular degeneration (AMD), to compare Stratus and Cirrus OCT and to study the effect of cataract surgery on macula.Sixty-seven healthy adults and 56 children, 30 patients with AMD, 34 patients with diabetes and cataract and 35 healthy controls were included. The quantitative maps in Stratus and Cirrus were used and manual correction of foveal location was evaluated. Qualitative OCT was compared to fluorescein angiography (FA) after cataract surgery.The mean values of macular thickness in Stratus OCT were 207µm in adults and 204 µm in children. The measurement variability was low. Macular thickness decreased with age in adults, but not in children. No correlation with gender was found. In eyes with wet AMD, there were small differences in measurement variability comparing Stratus and Cirrus OCT. After manual correction in Cirrus OCT, the coefficients of repeatability were improved to values close to the repeatability in normal eyes. Two thirds of the diabetic and half of the control eyes showed leakage on FA after cataract surgery. Qualitative OCT corresponded poorly to FA in diabetic eyes. A thicker macula, assessed with OCT, was often observed without any obvious effect on visual acuity. OCT was as good as FA in revealing clinically relevant changes in macula after surgery, and was the technique recommended for follow-up.
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| 40. |
- Eriksson, Urban, et al.
(författare)
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Is quantitative spectral-domain superior to time-domain optical coherence tomography (OCT) in eyes with age-related macular degeneration?
- 2012
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 90:7, s. 620-627
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to determine the variability of macular map measurements, for two generations of optical coherence tomography (OCT) instruments, in eyes with wet age related macular degeneration (AMD) and low visual acuity. Methods: Patients were examined with Stratus OCT and Cirrus HD-OCT. The macular thickness was assessed with the 'macular thickness map scan' and 'fast protocol' in Stratus and with the 512 × 128 and 200 × 200 cube protocols in Cirrus OCT. Two measurements were taken one directly after the other, at the first visit to analyse repeatability. Approximately 1 week later, a third measurement was taken to analyse reproducibility. In Cirrus OCT, a manual correction of foveal location was also performed. Repeatability and reproducibility were calculated as a coefficient of variance (CoV) and a coefficient of repeatability/reproducibility. Results: Repeatability for central macular thickness (expressed as CoV) was about three per cent for all protocols, and the coefficient of repeatability between 34 and 54 μm. Reproducibility (also expressed as CoV) was between four to seven per cent and coefficient of repeatability between 64 and 89 μm. After manual adjustment of foveal location in Cirrus OCT, the coefficient of repeatability improved to 12-18 μm, and the coefficient of reproducibility to 44-47 μm. Conclusions: In eyes affected by wet AMD, there were small differences in repeatability and reproducibility when comparing quantitative maps in Stratus and Cirrus OCT. However, when the software for manual correction of foveal position in Cirrus OCT was used, the variability decreased markedly, and the repeatability was close to what had been reported in normal eyes, demonstrating a significant, potential advantage of spectral-domain over time-domain OCT.
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| 41. |
- 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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| 42. |
- Eriksson, Urban, et al.
(författare)
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Macular thickness decreases with age in normal eyes : A study on the macular thickness map protocol in the Stratus OCT
- 2008
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 93:11, s. 1148-1452
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIM: Retinal and retinal nerve fibre layer (RNFL) thinning with age have been described in histological studies. In vivo techniques like optical coherence tomography (OCT), has shown thinning of optic nerve RNFL and the retina in specific areas. One would expect thinning of the total macula, but so far, a correlation with the quantitative OCT macular map tool and age has not been found. METHODS: Sixty-seven healthy individuals underwent three repeated scans in both eyes with the macular thickness map protocol in the Stratus OCT. That protocol divides the macula area in nine ETDRS fields.The RNFL was measured in one specific location close to the optic disc. Correlations between retinal, RNFL thickness, macular volume and age were determined. RESULTS: We found a statistically significant negative relationship between retinal thickness and age for all ETDRS areas, total macular volume and RNFL thickness. Retinal thickness decreased with 0,26-0,46 microm, the macula volume 0,01 mm(3) and RNFL with 0,09 microm per year. CONCLUSION: Retinal thickness within the area covered by the macular map significantly decreases with age. In the area examined in the papillomacular bundle, 20% of the retinal thinning is due to the RNFL and 80% due to thinning of other layers of the retina.
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| 43. |
- Eriksson, Urban, et al.
(författare)
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Repeatability in and interchangeability between the macular and the fast macular thickness map protocols : a study on normal eyes with Stratus optical coherence tomography
- 2009
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 87:7, s. 725-730
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To collect a normal material and to compare the macular and the fast macular thickness map protocols regarding normal values and repeatability. Methods: Sixty-seven individuals underwent three repeated scans with the macular thickness protocol; 45 of them also had three scans with the fast thickness protocol in Stratus optical coherence tomography (OCT). The maps were divided into nine ETDRS fields, where thickness values were presented. The repeatability was calculated as intraclass correlation coefficient (ICC), coefficient of variance (CV) and coefficient of repeatability (CR). For comparison between the two protocols, limits of agreement were determined according to Bland-Altman. Results: Normal values for the two protocols were very close. Repeatability was high. ICC for all areas was 0.92-0.98. CV was less than 1% and CR was 6-8 mum for both protocols, with the exception of the fovea in the fast protocol (where CV was 1.44% and CR 12.4 mum). Limits of agreement between the two protocols were less than 10 mum as a rule. Conclusion: Normal values for the protocols are equal and they both have excellent repeatability. The fast macular map is a good alternative with the possible exception of the fovea, where variation is twice that of the macular thickness map.
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| 44. |
- Hardenborg, Emilia, et al.
(författare)
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Protein content in aqueous humor from patients with pseudoexfoliation (PEX) investigated by capillary-LC MALDI-TOF/TOF MS
- 2009
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Ingår i: PROTEOMICS - Clinical Applications. - : Wiley. - 1862-8346 .- 1862-8354. ; 3:3, s. 299-306
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Tidskriftsartikel (refereegranskat)abstract
- Analysis of proteins in human body fluids is challenging since the composition of the sample often is rather complex. Here we present a method for analysis of proteins in aqueous humor from two groups of cataract patients, with and without pseudoexfoliation (PEX). Aqueous humor is an extracellular fluid contained in the anterior chamber of the eye between the cornea and iris. The limited volume of sample requires sophisticated analysis techniques. Our method is based on a total tryptic digestion of the sample followed by capillary LC-MALDI MS and MS/MS analysis of the peptides. The method is rapid, efficient and suitable as a complement or alternative to more commonly used methods based on gel electrophoretic experiments. With this method we found and unambiguously identified 30 nonredundant proteins. Proteins found include general transport proteins such as albumin and apolipoprotein A1 but also specific proteins involved in immune response, such as complement factors. Cystatin C, clusterin, and crystallins were also found. Although the number of proteins was roughly the same in both groups there was a significant difference in their identities. These findings may give some new insights into the pathophysiology of the PEX syndrome.
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| 45. |
- Hedman, Katarina, et al.
(författare)
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A pooled data analysis of three randomised, double-masked six-month clinical studies comparing the intraocular pressure reducing effect of latanoprost and timolol
- 2000
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Ingår i: European Journal of Ophthalmology. - 1120-6721 .- 1724-6016. ; 10:2, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To compare the intraocular pressure (IOP) reduction by latanoprost and timolol, and to study factors of prognostic value for assessing this reduction.METHODS:We analyzed 829 patients included in three phase 111 studies comparing six months' treatment with 0.005% latanoprost once daily and 0.5% timolol twice daily in patients with open-angle glaucoma or ocular hypertension. Analysis of covariance controlled for differences in baseline IOP and sex was used to assess the IOP reduction.RESULTS:Latanoprost reduced diurnal IOP (average of morning, noon and afternoon assessments) by 7.7 mmHg (31%) and timolol by 6.5 mmHg (26%) after six months of treatment. Thus the diurnal IOP was reduced 1.2 mmHg (18%) more with latanoprost than with timolol (p<0.001). Latanoprost-treated patients showed a further decrease in morning IOP of 0.7 mmHg (9%, p<0.001) from the initial morning IOP reduction obtained at two weeks. No such further decrease in IOP was seen with timolol. Higher baseline diurnal IOP resulted in a larger diurnal reduction during treatment with both drugs (p<0.001). Diurnal IOP in women was reduced 0.7 mmHg (11%) less than males with both drugs (p<0.001).CONCLUSIONS:Latanoprost was more effective than timolol in reducing mean diurnal IOP. The effect after two weeks was maintained for timolol while with latanoprost there was a further, significant IOP reduction from two weeks to six months. Baseline IOP was the only factor of clinical importance found to be of prognostic value for assessing the IOP reduction.
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| 46. |
- Hedman, Katarina
(författare)
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Pooling Data from Similar Randomized Clinical Trials Comparing Latanoprost with Timolol; Medical Results and Statistical Aspects
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Two different principles were studied. 1st - statistical analysis techniques were used to obtain medical results from a patient population. 2nd - the patient population was used to study the statistical analysis techniques. Medical conclusions: latanoprost and timolol treatment showed a statistically significant and clinically useful mean IOP-reduction in a typical worldwide clinical trial population. Latanoprost reduced the IOP 1.6 mm Hg more than timolol. The IOP-reduction was maintained with timolol and slightly enforced with latanoprost up to 6 months of treatment. The mean IOP-reduction was maintained during 2 years of latanoprost treatment. The overall risk of withdrawal due to insufficient IOP-reduction with latanoprost was 8%. The statistical methodological issues are of a general and reoccurring character in trial design of the IOP-reduction: should the statistical hypothesis testing be based on the mean intraocular pressure (IOP) or the proportion of patients who reach a specific IOP level, should the estimate of the IOP or IOP-reduction be based on single eyes, mean of bilaterally eligible and identically treated eyes or the difference between an eye with active treatment and a placebo treated contralateral eye, and is mean of replicated recordings useful? Statistical methodological conclusions: the most effective response variable varies with the selected patient population. Therefore, the trial design process should include a comparison of the variability, test power and required sample size for the possible response variables in a sample of the target population. At minimum a statistical consideration should be done.
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| 47. |
- Hedman, Katarina, et al.
(författare)
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The Effect of Latanoprost on Intraocular Pressure During 2 Years of Treatment
- 2002
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Ingår i: Survey of ophthalmology. - 0039-6257 .- 1879-3304. ; 47:S1, s. 65-76
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Tidskriftsartikel (refereegranskat)abstract
- Our objective was to study the intraocular pressure (IOP) in open-angle glaucoma or ocular hypertensive patients during long-term treatment with latanoprost. A total of 532 patients treated with 0.005% latanoprost were enrolled, including 493 and 113 patients treated for 6 and 24 months, respectively. Mean IOP was analyzed with the analysis of variance technique. The risk of treatment failure was analyzed with survival analysis technique. After 2 weeks of latanoprost treatment, the mean IOP was reduced 8.2 (32%) and 8.9 (34%) mm Hg in the subgroups of patients treated for 6 and 24 months, respectively. The change in mean IOP during 2 years of latanoprost treatment was not statistically significant (p = 0.15). Patients with primary open-angle glaucoma or ocular hypertension showed an 86% and 97% chance of receiving a sufficient IOP reduction with latanoprost (p < 0.01), repectively. The initial mean IOP reduction was maintained throughout the 2 years of treatment.
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| 48. |
- Heijl, Anders, et al.
(författare)
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Nordic research in ophthalmology.
- 2005
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Ingår i: Acta ophthalmologica Scandinavica. - : Wiley. - 1395-3907 .- 1600-0420. ; 83:3, s. 278-88
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Nordic ophthalmologists and vision scientists are active in many fields of eye research. This is most evident at the biannual Nordic Congress of Ophthalmology, most recently held in Malmö in June 2004. The authors here review some of the research in vision and ophthalmology presented at this meeting or published recently by Nordic scientists. This paper does not represent a comprehensive review of all Nordic research in the field, but attempts to give an overview of some of the activities underway in eye research in this part of the world.
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| 49. |
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