Macula

Distribution by Scientific Domains


Selected Abstracts


Differential expression of Na,K-ATPase , and , subunit genes in the developing zebrafish inner ear

DEVELOPMENTAL DYNAMICS, Issue 3 2003
Brian Blasiole
Abstract We have used whole-mount in situ hybridization to analyze Na,K-ATPase , and , subunit gene expression in the developing zebrafish ear. Four ,1-like (,1a.1, ,1a.2, ,1a.4, and ,1a.5) and two , (,1a and ,2b) subunit genes are expressed in ear beginning at mid-somitogenesis. Each gene exhibits a distinct spatial and temporal expression pattern. The ,1a.1 gene was ubiquitously expressed in the otic epithelium from mid-somitogenesis to 24 hr postfertilization (hpf). Expression of this gene was gradually reduced and by 48 hpf, ,1a.1 transcripts were no longer detectable in the ear. The ,1a.2 and ,1a.5 genes were expressed in regions that correspond to the anterior macula, lateral crista, and semicircular canal projections up to 48 hpf. At later stages, expression of these genes was limited to cells in the dorsolateral septum and semicircular canal projections. ,1a.4 and ,1a transcripts were ubiquitously expressed during ear development and were present in most otic tissues at 5 days postfertilization (dpf). Expression of the ,2b gene, on the other hand, was restricted to subsets of cells that form sensory epithelia. These results strongly suggest different functional roles for individual Na,K-ATPase genes in zebrafish ear development. Na,K-ATPase genes are likely to represent useful markers for the analysis of zebrafish otogenesis. Development Dynamics, 2003. © 2003 Wiley-Liss, Inc. [source]


Atlas of the developing inner ear in zebrafish

DEVELOPMENTAL DYNAMICS, Issue 4 2002
Michele Miller Bever
Abstract This report provides a description of the normal developing inner ear of the zebrafish, Danio rerio, with special focus on the pars inferior. Zebrafish specimens, ranging in age from 3 to 30 days postfertilization (dpf), were processed for standard histologic sections or with a paint-fill method to show three-dimensional morphogenesis of the membranous labyrinth. Adult zebrafish (age 2 years) were also processed for inner ear paint-fills. Although development of the semicircular canals occurs rapidly (by 3 dpf), the pars inferior develops more gradually during days 5,20 postfertilization. A rudimentary endolymphatic duct emerges by 8 dpf. Differentiated hair cells of the lagenar macula are evident by 15 dpf, in a chamber located lateral and posterior to the saccule. By 20 dpf, the saccule itself is separated from the utricle, but remains connected by means of the utriculosaccular foramen. The maculae neglectae, each with differentiated hair cells, lie on the floor of the utricle near this foramen. A medial connection between the sacculi of right and left ears, the transverse canal, is also complete by 20 dpf. A ridge of mesenchyme, previously undescribed, bisects the saccule in zebrafish fry at 20,30 dpf. The images in the paint-fill atlas should provide a baseline for future studies of mutant zebrafish ears. © 2002 Wiley-Liss, Inc. [source]


Use of oral fluorescein angiography in the diagnosis of macular oedema within a diabetic retinopathy screening programme

DIABETIC MEDICINE, Issue 12 2001
F. M. Razvi
Abstract Aims To assess if oral fluorescein angiography (OFA) is a suitable screening method to detect macular oedema in diabetic retinopathy. Methods Eighty-four diabetic patients were included in the study. They were from a consecutive series of patients attending the diabetic eye-screening clinic, with retinopathy at the macula requiring ophthalmology assessment. All patients were subsequently examined in the eye hospital, by ophthalmologist slit lamp biomicroscopy assessment as the gold standard, followed by oral fluorescein angiography. Results This study indicates a sensitivity of 92% and specificity of 81%. Only 4.8% of patients developed a minor reaction to oral fluorescein; 84.5% of images were of good quality. Conclusions Oral fluorescein angiography is an efficient and highly sensitive tool for the detection of macular oedema. It can be used as an adjunct in the diabetic screening service to identify patients with oedema within a disc diameter of the macula. Ultimately it will ensure that only necessary and smaller numbers of patients are referred to ophthalmologists. Diabet. Med. 18, 1003,1006 (2001) [source]


Color vision and macular recovery time in epileptic adolescents treated with valproate and carbamazepine

EUROPEAN JOURNAL OF NEUROLOGY, Issue 7 2006
A. Verrotti
Visual dysfunction has been reported in patients diagnosed with epilepsy. Some of these visual disturbances may be attributable to either the disease process, or the anticonvulsant therapy prescribed to control the seizures. The aims of our study were to evaluate whether color vision and macular function are impaired in epileptic adolescents, to study if the monotherapy with valproic acid (VPA) and carbamazepine (CBZ) can affect color vision and macular function and to determine the possible relationship between color vision, retinal function and antiepileptic drugs (AEDs) dosage and their serum concentrations. We examined 45 (16 male and 29 female, mean age ± SD, 15.71 ± 2.01 years) Caucasian epileptic patients suffering from various types of cryptogenic epilepsy before the beginning of therapy and after 1 year of VPA or CBZ monotherapy and 40 sex- and age-matched healthy controls. Color vision was assessed by Farnsworth Munsell (FM) 100-hue test and total error score (TES) was evaluated. This test consists of colored caps: the testee has to arrange the caps according to their colors macular function was assessed by nyctometry evaluating initial recovery time (IRT) and summation method (SM). This test evaluates visual acuity after a period of intense illumination of macula. Analysis of variance was used to evaluate the difference between controls and patients; moreover, Pearson's correlation test have been performed. Before the beginning of therapy, there were no differences in color vision and macular function between controls and epileptic patients. After 1 year, the patients, treated with VPA or CBZ, showed a deficit in FM 100-hue test. At nyctometry, all patients showed no significant variation of macular function between baseline evaluation and second evaluation at end of the follow-up. Our study demonstrates that, in our group of epileptic patients, epilepsy per se does not affect color vision and retinal function. In contrast, after 1 years of therapy with VPA and CBZ these patients showed a deficit in FM 100-hue test although nyctometry evaluation continued to be normal allowing to exclude an impairment in macular function. Further investigations are required to determine the pathophysiological alteration(s) that are at the basis of color perception defects. [source]


A case of Adamantiades-Behçet disease with ischemic optic neuritis (posterior optic neuropathy)

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 11 2007
Satoko Shima
Summary Adamantiades-Behçet disease (ABD) may present with cutaneous and ophthalmologic finings. A 29-year old woman complained of fever and general fatigue, along with erythema nodosum and vesiculo-pustular lesions on the legs, acneiform lesions, genital ulcerations and painful oral ulcers. She also complained of reduced visual acuity, visual disturbance and blurred vision in the left eye. Her left visual acuity was 6/20. Light reflex in the left eye was reduced. The relative afferent pupillary defect (RAPD) was positive in the left eye where a central scotoma was present. The vitreous was clear; the optic disc, macula, retina and iris were all normal. Uveitis was not observed. The patient was diagnosed with ischemic optic neuritis (posterior optic neuropathy) with ABD. Histopathological findings taken from a blister on the leg showed subepidermal bulla, dense dermal neutrophil infiltration, and extravasation of erythrocytes, suggesting leukocytoclastic vas-culitis. She was treated orally with high-dose corticosteroids (methylprednisolone 500 mg/d) for three days. Her general condition and ophthalmic symptoms resolved completely. Optic neuropathy with ABD is very rare; we know of two previous cases [1, 2] of ABD with ischemic posterior optic neuritis. [source]


Glycoconjugates in the otolithic membrane of herring larvae: a possible framework for encoding the life history recorder in fishes

JOURNAL OF FISH BIOLOGY, Issue 1 2002
P. Tytler
Glycoconjugates in the inner ear of herring Clupea harengus larvae, investigated by laser confocal and electron microscopy, were located mainly in the gelatinous layer of the otolithic membranes, forming a collar around the proximal surfaces of the otoliths. The site of secretion was located on the surface of the sensory macula, from which a colonnade of glycoconjugate streamers projected through the subcupular region to connect with the gelatinous layer of each otolith. An electron dense component of the outer gelatinous layers, shown by TEM to be closely associated with the sensory kinocilia, suggested that they provided a basis for the streamers and offered a potential role in directing the path of secretion. It is hypothesized that this highly structured glycoconjugate framework could provide a mechanism for localizing and containing ionic and protein gradients previously detected in this vicinity and which are considered to have a key role in driving the differential growth and mineralization of the otoliths. [source]


The Influence of Dietary Lutein and Zeaxanthin on Visual Performance

JOURNAL OF FOOD SCIENCE, Issue 1 2010
James M. Stringham
ABSTRACT:, The idea that normal constituents of the diet can influence visual function is not new. As early as 1782, Buzzi identified the yellow of the macula and Schulze (1866) specifically postulated that the yellow pigments led to improvements in human vision. These pigments were later found to be derived from dietary lutein and zeaxanthin that are known to be oxygenated carotenoids (xanthophylls). Walls and Judd (1933) postulated that these yellow intraocular pigments could improve visual performance by absorbing light scattered both within (for example, glare) and outside of the eye (increasing visual range by absorbing blue light scattered in the atmosphere), and by improving spatial vision through enhancing contrast and reducing chromatic blur. In this article, evidence for these ideas is reviewed with particular emphasis towards more recent data on glare effects. [source]


Remarks on the inner ear of elasmobranchs and its interpretation from skeletal labyrinth morphology

JOURNAL OF MORPHOLOGY, Issue 3 2001
John G. Maisey
Abstract The structure and function of the craniate inner ear is reviewed, with 33 apomorphic characters of the membranous labyrinth and associated structures identified in craniates, gnathostomes, and elasmobranchs. Elasmobranchs are capable of low-frequency semi-directional phonoreception, even in the absence of any pressure-to-displacement transducer such as ear ossicles. The endolymphatic (parietal) fossa, semicircular canals, and crista (macula) neglecta are all adapted toward phonoreception. Some (but not all) of the morphological features associated with phonoreception can be inferred from the elasmobranch skeletal labyrinth. Endocranial spaces such as the skeletal labyrinth also provide suites of morphological characters that may be incorporated into phylogenetic analyses, irrespective of how closely these spaces reflect underlying soft anatomy. The skeletal labyrinths of Squalus and Notorynchus are compared using silicone endocasts and high-resolution CT-scanning. The latter procedure offers several advantages over other techniques; it is more informative, nondestructive, preserves relationships of surrounding structures, and it can be applied both to modern and fossil material. J. Morphol. 250:236,264, 2001. © 2001 Wiley-Liss, Inc. [source]


Obesity, Lutein Metabolism, and Age-Related Macular Degeneration: A Web of Connections

NUTRITION REVIEWS, Issue 1 2005
Elizabeth J. Johnson PhD
Age-related macular degeneration (AMD) is a major cause of visual impairment in the United States. Currently there is no effective cure for this disease. Risk factors include decreased lutein and zeaxanthin status and obesity. Obesity is also an increasing public health concern. The alarming increase in the prevalence of obesity further exacerbates the public health concern of AMD. The mechanism by which obesity increases the risk of AMD may be related to the physiologic changes that occur with this condition. These include increased oxidative stress, changes in the lipoprotein profile, and increased inflammation. These changes would also result in an increased destruction and a decreased circulatory delivery of lutein and zeaxanthin to the macula of the eye. Therefore, the mechanism by which obesity is related to AMD risk may be through indirect effects on changes in lutein and zeaxanthin status and metabolism. [source]


Stereological study of postnatal development in the mouse utricular macula

THE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 2 2005
Mette Kirkegaard
Abstract This study describes the morphometric changes taking place in the utricular macula of mice with ages in geometric progression from 1 to 512 days after birth. By using design-based stereological methods, the total volume and surface area of the sensory epithelium as well the total number of the hair cells and supporting cells were estimated. Finally, the numerical density, volume density, and mean volume of the individual cell types were determined. The major changes were found in the number of the individual cell types during the first couple of weeks, and a mature composition of cell types was not attained until 16 days after birth. There was no change in the total number of cells and no decline in the number of hair cells within the time period studied. J. Comp. Neurol. 492:132,144, 2005. © 2005 Wiley-Liss, Inc. [source]


The inner ear of the lungfish Protopterus

THE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 3 2004
Christopher Platt
Abstract The sensory end organs of the inner ear of the lungfish, Protopterus, were examined using scanning and transmission electron microscopy. The utricle has a structure and hair cell orientation pattern that are typical for vertebrates, although the hair cells are unusually large. There are the typical three semicircular canals extending from the utricle, with the typical hair cell orientations, but the lateral canal sensory crista looks like the "hemicrista" of some amphibians and amniotes, lacking a saddle-shaped flare on one wall of the ampulla. Unlike most vertebrates that have the saccule and lagena as two separate pouches ventral to the utricle, the lungfish has a single large ventral pouch that contains a single large pasty otoconial mass. This mass covers two hair cell patches, each like a striola with prominent hair cell ciliary bundles, that are presumed to represent saccular and lagenar maculae. However, these two major sensory patches are not completely separate maculae because they lie within a less densely populated field of smaller hair cells, which forms an extrastriolar region that surrounds and fills the region between the two striolae of higher hair cell density. The more caudal lagenar striola is a vertically elongated stripe with hair cell orientation vectors facing antiparallel on either side of a midline drawn vertically along the macula, resembling the macula lagena of some bony fishes but not of tetrapods. The more rostral saccular striola is a curving band with hair cell orientation vectors facing away from its midline, but because this macula curves in three dimensions, the vectors at the rostral end of this striola are oriented mediolaterally, whereas the vectors on the caudal half of this striola are oriented dorsoventrally. The presence of a macula neglecta was confirmed near the posterior canal as a tiny single patch of a few dozen hair cells with all the cell orientations directed caudally. The ciliary bundles on the cells in the striolar-like regions of all of three otolithic organs average over 80 cilia, a number far greater than for any other fish studied to date. The features of the single sacculolagenar pouch with separate striolar-like regions, the cellular orientation in the otolith organs, and the large cells and ciliary bundles in Protopterus also were observed in specimens of the other extant lungfish genera, Lepidosiren and Neoceratodus. J. Comp. Neurol. 471:277,288, 2004. © 2004 Wiley-Liss, Inc. [source]


,-Aminobutyric acid is present in a spatially discrete subpopulation of hair cells in the crista ampullaris of the toadfish Opsanus tau

THE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 1 2004
Gay R. Holstein
Abstract Although ,-aminobutyric acid (GABA) and glutamate are known to be present in the vestibular sensory epithelia of a variety of species, the functional relationship between these two transmitters is not clear. The present study addresses the three-dimensional spatial distribution of GABA and glutamate immunoreactivity in the vestibular labyrinth of the oyster toadfish by using whole end organs labeled by immunofluorescence with monoclonal anti-GABA and/or antiglutamate antibodies and visualized as whole mounts by multiphoton confocal microscopy. We find glutamate-immunoreactive hair cells present throughout the sensory epithelium. In contrast, prominent GABA immunoreactivity is restricted to a small population of hair cells located in the central region of the crista. Double immunofluorescence reveals two distinct staining patterns in GABA-labeled hair cells. Most (,80%) GABA-labeled cells show trace levels of glutamate, appropriate for the metabolic/synthetic role of cytoplasmic glutamate. The remainder of the GABA-stained cells contain substantial levels of both GABA and glutamate, suggesting transmitter colocalization. In the toadfish utricle, glutamatergic hair cells are present throughout the macula. GABA-immunoreactive hair cells follow the arc of the striola, and most GABA-labeled receptor cells coexpress glutamate. The localization of GABA was explored in other species as well. In the pigeon, GABAergic hair cells are present throughout the crista ampullaris. Our findings demonstrate that multiple, neurochemically distinct types of hair cells are present in vestibular sensory epithelia. These observations, together with the excitatory activity generally associated with 8th nerve afferent fibers, strongly suggest that GABA serves an important, specific, and complex role in determining primary afferent response dynamics. J. Comp. Neurol. 471:1,10, 2004. © 2004 Wiley-Liss, Inc. [source]


Recent observations of AB Dor and interpretation

ASTRONOMISCHE NACHRICHTEN, Issue 4 2009
E. Budding
Abstract We use minimal empirical modelling techniques to interpret recent (2006,2007) photometry and spectroscopy of AB Dor. We compare, in particular, broadband (B and V) maculation effects with emission features in high-resolution Ca II K-line spectroscopy. We also compare emission effects in the Ca II Kand H, lines observed at different rotational phases. We refer to a broader multiwavelength campaign, of which these optical data were a part, involving X-ray and microwave observations to be published later. The broadband light curves are characterized by one outstanding macula, whereas the emission lines suggest 4 possible main chromospheric activity sites (,faculae'). These appear at a similar latitude and with comparable size to the main umbra, but there are significant displacements in longitude. However, one strong facular concentration near phase zero may have a physical relationship to the main macula. The derived longitudes of these features would have been affected by differential rotation operating over the several months between the spectroscopic and photometric observations, but the difference of at least ,30° between facula and umbra appears too great to allow their coincidence. The possibility of a large bipolar surface structure is considered, keeping in mind the bipolar character of solar activity centres: the activity of rapidly rotating cool stars being generally compared with that of the Sun, scaled up by a few orders of magnitude. Observed microwave activity may link to this same main photospheric and chromospheric centre picked up by the optical analysis. Characterization of macular and facular contributions in stellar activity sites would be improved with a closer timing of observations and higher signal to noise ratios in emission line data (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]


Goldenhar syndrome associated with prenatal maternal Fluoxetine ingestion: Cause or coincidence?

BIRTH DEFECTS RESEARCH, Issue 7 2010
Chantal Farra
Abstract Goldenhar syndrome, also known as oculo-auriculo-vertebral spectrum, is a complex, heterogeneous condition characterized by abnormal prenatal development of facial structures. We present the occurrence of Goldenhar syndrome in an infant born to a woman with a history of prenatal Fluoxetine ingestion throughout her pregnancy. Because this is the first reported case associating maternal Fluoxetine intake with fetal craniofacial malformations, a potential mechanism of injury is discussed. The propositus, a male born from nonconsanguinous parents, had facial asymmetry with right microtia and mandibular hypoplasia; he also had bilateral hypoplastic macula, scoliotic deformity of the thoracic spine, and ventricular septal defect. The mother was under treatment with Fluoxetine 20 mg/day prior to conception and maintained the same dosage throughout her pregnancy. The drug is a selective serotonin re-uptake inhibitor, the most widely prescribed for the treatment of depression. The occurrence of developmental aberrations may be caused by a profound serotonin receptor suppressive state in utero leading to aberrant clinical manifestations of the first and second branchial arches. Despite the very many limitations of case reporting of teratogenic events, it remains an important source of information on which more advanced research is based. Birth Defects Research (Part A) 2010. © 2010 Wiley-Liss, Inc. [source]


4341: Are visual evoked potentials and pattern ERG useful in neuro-ophthalmology?

ACTA OPHTHALMOLOGICA, Issue 2010
GE HOLDER
Purpose To describe the roles of VEP and PERG in clinical neuroophthalmology. Methods Case based examples. Results Objective visual system testing with electrophysiology allows the distinction between optic nerve and macular dysfunction, often difficult in clinical practice. Examples will be shown of the types of VEP abnormality that can occur in different disorders of optic nerve function. PERG should also be performed in the patient with visual symptoms; if the PERG suggests macular dysfunction, full-field ERG is indicated in order to determine whether that macular dysfunction is part of a generalised retinal process or is dysfunction localised to the macula. Electrophysiology further allows the diagnosis of non-organic visual loss and the quantification of visual system dysfunction. Conclusion The objective functional assessment with electrophysiology is an important part of the diagnostic armamentarium available to neuroophthalmologists. [source]


4224: The role of electrophysiology

ACTA OPHTHALMOLOGICA, Issue 2010
GE HOLDER
Purpose To describe the roles of electrophysiology in patients with medically unexplained visual loss Methods Standardised full-field and pattern ERGs and VEPs; additional pattern appearance VEPs to quantify visual system resolution when necessary in patients with suspected non-organic visual loss. Results Selected cases will be used to illustrate the roles of electrophysiology. A diagnosis of non-organic visual loss is confirmed by the demonstration of normal visual system function in the presence of symptoms that suggest otherwise. Patients with optic nerve disease may have a normal fundus appearance, and not all macular dysfunction is associated with an abnormal appearance of the macula; both pattern VEP and pattern ERG are needed in such cases. Further, there are many patients with retinal disease where the fundus appearance may be normal but ERGs are abnormal. Conclusion Objective functional assessment with electrophysiology is indispensable to the diagnosis and management of patients with medically unexplained visual loss. [source]


3411: Update on physiopathology of cystoid macular edema

ACTA OPHTHALMOLOGICA, Issue 2010
P MORA
Purpose To offer an overview on the historical and most recent acquisitions about the mechanisms that have been proposed to explain how cystoid macular edema (CME) develops. Methods Review of the literature and presentation of personal evidences and imagines. Results CME represents an excessive presence of fluid within the layers of the retina. A breakdown in the blood-retinal barrier normally is the causative event for fluid to accumulate in cystoid spaces within the retina. Several mechanisms have been proposed to explain the blood-retinal barrier alteration and consequent CME formation. The intraocular diffusion of inflammatory mediators (eg, prostaglandins), following mechanical or biological insults, remains the most proven evidence. Another mechanism refers to the role of tractional forces on the macula from disruption of the normal vitreoretinal interface. According to this theory, a release of mediators that lead to a breakdown of the blood-retinal barrier, would have triggered mainly by local forces. Photic injury, finally, has been implicated in the development of pseudophakic or post-vitrectomy CME. Conclusion A full comprehension of the pathogenesis of CME will significantly help in focussing and developing an effective treatment even for the chronic form of CME. [source]


4123: The use of the mfERG in the clinic

ACTA OPHTHALMOLOGICA, Issue 2010
A PALMOWSKI
Purpose This presentation is to give a brief overview on the application of the multifocal electroretinogram (mf-ERG) in the clinic. Methods The use of m-sequences as a stimulus sequence allows a high resolution topographic mapping of sensory function. The mf-ERG can be readily applied to detect outer retinal dysfunction in the area of the macula. Different retinal layers contribute to the waveform of the mf-ERG. This results in typical changes of the waveform, when these different layers are dysfunct. Results MF-ERG examples are shown, that demonstrate how this knowledge can be useful in the clinical evaluation of patients. Conclusion The mf-ERG is a helpful tool in the clinical evalutation of patients. [source]


Combined intravitreal anti-vascular endothelial growth factor (Avastin®) and photodynamic therapy to treat retinal juxtapapillary capillary haemangioma

ACTA OPHTHALMOLOGICA, Issue 5 2010
Stefan Mennel
Abstract. Objective:, Retinal capillary haemangioma complications are characterized by progressive exudation with consecutive intraretinal and subretinal leakage. A successful therapy without side-effects has not been found. We report a case of retinal juxtapapillary capillary haemangioma causing consecutive leakage with macular involvement. The tumour was treated with a combination of anti-vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) and was followed for 1 year. Methods:, A 44-year-old woman with retinal juxtapapillary capillary haemangioma in the right eye experienced a decrease of visual acuity from 20/20 to 20/60 because of a severe leakage from the tumour involving the macula with lipid depositions. Two sessions of PDT (sparing the part of the haemangioma located within the optic disc) and five injections of bevacizumab were applied in a period of 5 months. Visual acuity, visual field testing, retinal thickness measurements, fundus photography and fluorescein angiography were performed to evaluate the treatment effect. Results:, One year after the last injection, visual acuity increased to 20/40. All lipid exudates at the posterior pole resolved. Retinal thickness decreased from 490 to 150 ,m with the restoration of normal central macular architecture. Leakage in fluorescence angiography reduced significantly, but hyperfluorescence of the tumour was still evident. Visual field testing and angiography did not show any treatment-related vaso-occlusive side-effects. Conclusion:, In this single case, the combination of anti-VEGF and PDT appeared to be an effective strategy for the treatment of retinal juxtapapillary capillary haemangioma without side-effects. Further studies with a greater number of eyes and adequate follow-up are necessary to support these first clinical results. [source]


Correlation of fundus autofluorescence with photoreceptor morphology and functional changes in eyes with retinitis pigmentosa

ACTA OPHTHALMOLOGICA, Issue 5 2010
Taku Wakabayashi
Abstract. Purpose:, To assess and correlate fundus autofluorescence (FAF) characteristics with photoreceptor morphology and functional features in eyes with retinitis pigmentosa (RP). Methods:, Thirty-four eyes of 17 patients with RP were examined. We compared FAF images obtained by confocal scanning laser ophthalmoscopy with Spectral-domain optical coherence tomography (SD-OCT) and retinal function assessed by microperimetry. Results:, Normal FAF surrounded by a ring of increased FAF at the macular area was detected in 32 (94%) eyes. The diameter of the normal FAF was correlated significantly with the preserved area of the photoreceptor inner segment and outer segment (IS/OS) junction on SD-OCT (R = 0.939, p < 0.001). The area outside the ring was associated with loss of IS/OS junction and external limiting membrane (ELM). The ring of increased FAF demarcated the border between the central retina with preservation of the IS/OS junction and ELM, and the adjacent eccentric retina with loss of these bands. In two eyes of one patient, there was no preservation of normal FAF at the macula and the photoreceptor IS/OS junction was not detected on SD-OCT. The mean retinal sensitivity derived from microperimetry was correlated significantly with the area of normal FAF (R = 0.929, p = 0.007) and the preserved area of the IS/OS junction (R = 0.851, p = 0.032). Ten eyes had progressive reduction in size of the normal FAF inside the ring accompanied by decreased area of preserved IS/OS during 3.1 years. Conclusion:, FAF appears to reflect the integrity of the photoreceptor layer. It may serve as a secondary outcome measure for novel therapeutic strategies for RP. [source]


Optical coherence tomography is helpful in the diagnosis of foveal hypoplasia

ACTA OPHTHALMOLOGICA, Issue 4 2010
Gerd Holmström
Abstract. Purpose:, To investigate whether optical coherence tomography (OCT) is helpful in the diagnosis of foveal hypoplasia in children. Methods:, Children with albinism and aniridia were examined with Stratus OCT 3 software 4.0.1 (Carl Zeiss Meditec, Dublin, California, USA). A qualitative examination of the macular area was performed with a 128 A-scans/second-single-scan. Macular thickness was measured quantitatively with an automatic fast macular map protocol. The average thickness/volume of the macula was presented as numerical values and as a false colour code in nine modified early treatment of diabetic retinopathy study (ETDRS) areas (A1,A9). A previously collected control group of children was used for comparison. Results:, Macular thickness in 13 children with albinism and three children with aniridia was measured with OCT. Comparison with healthy children in the same population was performed. Patients with albinism and aniridia had significantly thicker central macula (A1) and foveola than children in the control group. Conclusion:, OCT was found to be useful in the diagnosis of foveal hypoplasia in children. [source]


Unilateral choroidal excavation in the macula detected by spectral-domain optical coherence tomography

ACTA OPHTHALMOLOGICA, Issue 3 2010
Yuka Wakabayashi
Abstract. Purpose:, To report clinical findings of three patients with unilateral peculiar choroidal excavation in the macula detected by spectral-domain (SD) optical coherence tomography (OCT). Methods:, Three cases with unilateral choroidal excavation in the macula detected by SD OCT. Fluorescein angiography (FA), indocyanine green angiography (IA), ultrasonography, visual field tests and multifocal electroretinography (mfERG) were performed. Results:, Although all three patients complained of metamorphopsia, visual acuity and central visual field were normal in the affected eyes. SD OCT demonstrated choroidal excavation in the macula despite a normal foveal contour along the inner retinal surface. The excavation involved the outer retinal layers up to the external limiting membrane in cases 1 and 2, while only the retinal pigment epithelium was involved in case 3. The excavation corresponded to foveal pigment mottling in cases 1 and 2 and to a parafoveal yellowish fusiform lesion in case 3. The lesions appeared hypoautofluorescent and unremarkable in FA except for circumferential hyperfluorescence in case 3 and hypofluorescent in IA. B-scan ultrasonography was unremarkable. MfERG in cases 1 and 2 was normal. Conclusions:, SD OCT demonstrated two types of choroidal excavation in the macula. More case accumulation and a longer follow-up will elucidate the pathogenesis and prognosis of the lesions. [source]


Functional and morphological changes in the eyes of Behçet's patients with uveitis

ACTA OPHTHALMOLOGICA, Issue 2 2010
Masaru Takeuchi
Abstract. Purpose:, Behçet's disease (BD) is a chronic, recurrent, multisystem disorder, and serious ocular involvement may lead to blindness. In some BD patients, latent tissue damage caused by recurrent ocular inflammation is not reflected by visual acuity or ophthalmoscopic findings. In this study, we evaluated the morphological and functional changes of ocular features related to duration of uveitis from onset in BD patients, and analysed their association with visual acuity. Methods:, Thirty-eight eyes of 20 patients with ocular BD were enrolled. Eyes with marked complications such as cataract, glaucoma, cystoid macular oedema, macular degeneration and optic atrophy were excluded from the study. During clinical remission of ocular inflammation, perimetric sensitivity and retinal thickness were measured by Micro Perimeter 1 (MP-1) and optical coherence tomography (OCT), respectively. The relationship between MP-1 and OCT findings, best-corrected visual acuity (BCVA) converted to logarithm of the minimum angle of resolution (logMAR) and duration from initial onset of uveitis were analysed statistically. Results:, logMAR correlated with perimetric sensitivity measured with MP-1 at the fovea, inner macula and outer macula, but not with retinal thickness based on OCT. The duration of uveitis correlated significantly with logMAR and with OCT-based retinal thickness at the fovea, inner macular and outer macula, but not with MP-1-derived retinal perimetric sensitivity. No correlation was found between OCT-based retinal thickness and the corresponding MP-1-derived retinal sensitivity at the fovea, inner macula or outer macula. Conclusion:, These results demonstrate that visual acuity, retinal perimetric sensitivity and retinal thickness decrease with an increase in the duration of uveitis in BD patients, but that retinal perimetric sensitivity is relatively preserved among these factors. [source]


Retinal artery occlusion following intravitreal anti-VEGF therapy

ACTA OPHTHALMOLOGICA, Issue 2 2010
Therese Von Hanno
Abstract. Purpose:, Anti-vascular endothelial growth factor (anti-VEGF) therapy effectively inhibits angiogenesis and is now enjoying widespread use in the treatment of age-related macular degeneration (AMD). It may also have a role in the treatment of macular oedema secondary to other conditions. VEGF is a signalling molecule that has a variety of roles, including vasoregulation and effects on the coagulation homeostasis. Anti-VEGF therapy may therefore have adverse effects on ocular blood flow. Methods:, Two cases of retinal artery occlusion after intravitreal injection of anti-VEGF are presented. Both patients were given the treatment to reduce macular oedema secondary to central retinal vein occlusion. Possible mechanisms are discussed. Results:, Patient 1 developed a central retinal artery occlusion within 1 month of an intravitreal injection of ranibizumab (Lucentis®). The macular oedema was totally resolved at 1 month; final visual acuity (VA) was light perception. Patient 2 developed a branch retinal artery occlusion in the macula 2 days after an intravitreal injection of bevacizumab (Avastin®). The macular oedema was almost resolved within 1 week and did not recur; final VA was 0.6. Conclusions:, Anti-VEGF therapy may have a role in the treatment of macular oedema caused by central retinal vein occlusions. However, our report indicates that the therapeutic principle may be associated with an increased risk of retinal arterial occlusions. [source]


Face down posturing for macular hole surgery.

ACTA OPHTHALMOLOGICA, Issue 2009
Is it really required?
Purpose Background: In macular hole surgery pars plana vitrectomy and intravitreal gas injection with or without inner limiting membrane peel, is considered the mainstay of treatment. The requirement for face down posturing is generally regarded as part of the traditional postoperative routine. Several mechanisms have been postulated to explain the action of the gas bubble including exertion of a large floatation force on the macula and prevention of the macular hole exposure to vitreous fluid. Recently the need to face down has been chalenged since this regime compromises patients' postoperative quality of life and it makes macular hole surgery almost impossible for individuals with mental or physical limitations. Methods Review of personal data and systermatic literature review of studies investigating macular hole surgery with shortened or eliminated face down posturing. Results There is considerable body of evidence suggesting successful anatomical and functional outcome in patients with shorter duration of posturing or no posturing at all following macular hole surgery. The pros and cons of each technique will be presented in detail. Conclusion Prone posturing following macular hole surgery provides no functional or anatomic benefit but it is associated with slower progression of cataract. Combined phacovitrectomy without face down positioning may be considered for phakic patients undergoing macular hole surgery. [source]


Segmentation of FD-OCT images shows selective loss of inner retinal layers in patients with DM and no or early DR

ACTA OPHTHALMOLOGICA, Issue 2009
FD VERBRAAK
Purpose Determine whether diabetes differentially affects specific retinal layers by comparing the thickness of six retinal layers in diabetic patients with no or minimal diabetic retinopathy (DR) to age- and gender-matched normal controls. Methods Forty-four patients with type 1 diabetes and no or minimal DR underwent full ophthalmic examination, stereoscopic fundus photographs and spectral domain optical coherence tomography (OCT). Following automated segmentation of intraretinal layers of the OCT images, mean thickness was calculated for 6 individual layers of the retina in the fovea, the pericentral area and the peripheral area of the central macula and compared to an age- and gender-matched control group. Results In type 1 diabetic patients with minimal DR, the retinal nerve fiber layer (p=0.00) and the ganglion cell/inner plexiform layer (p=0.02) were significantly thinner compared to age- and gender-matched controls. No other layers showed a significant difference. Conclusion Thinning of the total retina in diabetic patients with minimal DR relative to normal controls is due to a selective thinning of inner retinal layers and supports the concept that early DR includes a neuro-degenerative component. [source]


Cirrus HD OCT algorithms for macula and retinal nerve fiber analysis

ACTA OPHTHALMOLOGICA, Issue 2009
M HORNE
[source]


Slitlamp integrated OCT, what you can see, is what you can scan

ACTA OPHTHALMOLOGICA, Issue 2009
FD VERBRAAK
Purpose To present results of OCT images captured of the posterior and anterior segment of the eye using the SLSCAN-1, a new FD-OCT device integrated into a slit lamp. Methods Patients, seen in the outpatient clinic of the Academic Medical Center, were scanned with the SLSCAN-1, a newly developed OCT scanning device, integrated into a common slit lamp (figure 1). The OCT is a Fourier Domain OCT system (SLD light source, central wavelength 830 nm, bandwidth 30 nm, 1024 pixel CCD camera, scan speed 5k A-scans per second, 1024 A-scans per B-scan). The posterior segment scans have been captured using a standard indirect ophthalmic lens (Volk). A color fundus photography of the observed area is made at the same time (Topcon camera DC1, resolution = 3.24 Mp). Results For posterior segment imaging, the flexible optical arrangement of the slit lamp and the hand-held lens (Volk), allows the user to scan large areas of the retina (>45 degrees), depending on the pupil size of the patient. In all patients the macula and optic disk could be visualized without any difficulty. In the anterior segment mode, the SLSCAN-1 allows imaging of the cornea, anterior chamber, iris and parts of the lens. Conclusion The images made by the SLSCAN-, new slit lamp integrated FD-OCT, could be very useful to examine patients directly, both posterior and anterior, during regular slit lamp examinations. Commercial interest [source]


Electronic subretinal implants allow blind retinitis pigmentosa patients to read letters and recognize the direction of fine stripe patterns

ACTA OPHTHALMOLOGICA, Issue 2009
E ZRENNER
Purpose Restoration of letter reading and stripe pattern recognition in blind RP patients by placing subretinal implants transchoroidally near the macula, consisting of two arrays: 4x4 electrodes controlled retroauricularly via a subdermal line for direct stimulation ("DS array") and a "chip" (3x3x0,1 mm),1500 electrodes. Methods Letters and stripe pattern were presented to 3 patients via the light sensitive chip , by patterns steadily presented at a screen. On the DS array the sensation evoked by each individual pulse consists of whitish round dot, clearly separated from its neighbor. Patterns consisting of such 4 x 4 dots correspond to letters of approximately 5 cm diameter presented at 60 cm distance. Results Pat.1 correctly (20/24) recognized the direction of the letter "U", presented with the opening in four different directions (DS array). Pat.2 correctly (12/12) differentiated letters via DS array (e.g. COIL). With the light sensitive chip, he correctly (22/24) differentiated letters (e.g. LITZ; 8,5 cm high, 1.7 cm line width) steadily presented on a screen at 62 cm distance Pat.3 recognized (15/20 correct, 4AFC) the direction of lines or stripe patterns with the chip, as did Pat.1 (11/14, 2AFC) and Pat.2 (11/12 4AFC) up to 0.35 cycles/deg. Conclusion Active subretinal multielectrode implants with currents close to produce retinotopically correct patterns that allow for the first time recognition of individual letters and stripe patterns up to 0.35 cycles/deg clearly supporting the feasibility of light sensitive subretinal multi-electrode devices for restoration of useful vision. [source]


The Beijing Eye Study

ACTA OPHTHALMOLOGICA, Issue 3 2009
Jost B. Jonas
Abstract. Purpose:, This review presents and summarizes the findings of the Beijing Eye Study. Methods:, The Beijing Eye Study is a population-based study which included 4439 of 5324 subjects (aged , 40 years) who were initially examined in 2001. The study was repeated in 2006, when 3251 (73.2% of 4439, or 61.1% of 5324) of the original subjects participated. Participants underwent a series of examinations including: refractometry; pneumotonometry; biomicroscopy assisted by slit-lamp; optical coherence tomography of the anterior segment; photography of the cornea, lens, optic disc, macula and fundus; blood sampling for laboratory tests; blood pressure measurements, and determinations of anthropomorphic parameters. They were also asked to complete a questionnaire which included questions on socioeconomic parameters, and awareness and treatment of ocular and general diseases. Results:, We present normative data for refractive error, anterior segment measurements, intraocular pressure and optic disc structures and their associations, frequency and causes of visual impairment, blindness and visual field defects, prevalences of trachoma, pterygia, open-angle glaucoma and angle-closure glaucoma, cortical, nuclear and posterior subcapsular cataract, age-related macular degeneration, retinal vein occlusions, diabetes mellitus and diabetic retinopathy, myelinated nerve fibres, and retinitis pigmentosa, and associated and risk factors. Discussion:, These data may be helpful for dealing with public health issues in China and for assessing associated and risk factors of ocular and general diseases in general. [source]