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  • 1.
    Abdulhusen, Maria
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Binokulärseende hos elitidrottare: En studie om djupseende, ackommodationsfacilitet och vergensfacilitet2011Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna studie var att ta reda på om elitidrottare som spelar en bollsport har bättre djupseende, bättre förmåga att kunna ändra fokus mellan olika avstånd och mer uthålliga ögonmuskler än personer som inte spelar någon bollsport alls.

    Metod: Mätningarna utfördes på femton innebandyspelare som spelar på elitnivå och femton personer som inte spelar någon bollsport. Medelåldern var 22 år i båda grupperna. Först fick varje försöksperson svara på en enkät, sedan mättes visus upp monokulärt och binokulärt på 3 m med en logMAR visustavla. Efter det mättes djupseendet med Randot stereotest på 40 cm och sedan mättes försökspersonens förmåga att kunna ändra fokus mellan olika avstånd. Detta gjordes på 40 cm med en flipper med styrkorna ±2,00D. Sista mätningen var att få ett mått på hur uthålliga försökspersonens ögonmuskler var, detta gjordes på 40 cm med en flipper av styrkorna 3Δ Bas In/ 12Δ Bas Ut.

    Resultat: Medelvärdet på djupseendet i respektive grupp visade ingen statistisk signifikant skillnad mellan de båda grupperna (p=0,70). Det fanns en signifikant skillnad på medelvärdet mellan de båda grupperna när det gäller förmågan att kunna ändra fokus mellan olika avstånd (p=0,02). Medelvärdet på uthålligheten av ögonmusklerna visade ingen signifikant skillnad mellan de båda grupperna (p=0,08).

    Slutsats: Studien visade att innebandyspelare på elitnivå har bättre förmåga att ändra fokus mellan olika avstånd. Studien visade även att innebandypelare på elitnivå inte har mer uthålliga ögonmuskler eller bättre djupseende än de som inte spelar någon bollsport alls.

  • 2.
    Ahlm, Clas
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Linderholm, M
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Alexeyev, O A
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology.
    Billheden, J
    Elgh, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology.
    Fagerlund, M
    Zetterlund, B
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neurophysiology.
    Settergren, B
    Central nervous system and ophthalmic involvement in nephropathia epidemica (European type of haemorrhagic fever with renal syndrome)1998In: Journal of Infection, ISSN 0163-4453, E-ISSN 1532-2742, Vol. 36, no 2, 149-155 p.Article in journal (Refereed)
    Abstract [en]

    Central nervous system (CNS) - related symptoms occur in haemorrhagic fever with renal syndrome (HFRS). To study the CNS and ophthalmic involvement in nephropathia epidemica (NE), the European type of HFRS, we included 26 patients in a prospective study. Most common CNS-related symptoms were headache (96%), insomnia (83%), vertigo (79%), nausea (79%), and vomiting (71%). Ophthalmic symptoms were reported by 82% of patients; 41% had photophobia and 50% had impaired vision. A transient loss of vision was recorded in one patient, who also had a generalized seizure. Minor white matter lesions were found in about half of the patients investigated with brain magnetic resonance imaging (MRI). Electroencephalography (EEG) showed severe alterations in only one patient, and slight and reversible patterns in another two patients. Neopterin, interleukin-6 and interferon-gamma levels in the cerebrospinal fluid (CSF) were elevated, which may indicate immune activation. However, we found no evidence of intrathecal NE virus replication. We conclude that CNS-related symptoms are common in NE, and transient ophthalmic involvement can be demonstrated in about half of the patients.

  • 3.
    Ahmadi, Mahboobah
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Liu, Jing-Xia
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Brännström, Thomas
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Andersen, Peter M
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Stål, Per
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Pedrosa-Domellöf, Fatima
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Human extraocular muscles in ALS2010In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, Vol. 51, no 7, 3494-3501 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE. To investigate the general morphology, fiber type content, and myosin heavy chain (MyHC) composition of extraocular muscles (EOMs) from postmortem donors with amyotrophic lateral sclerosis (ALS) and to evaluate whether EOMs are affected or truly spared in this disease. METHODS. EOM and limb muscle samples obtained at autopsy from ALS donors and EOM samples from four control donors were processed for immunohistochemistry with monoclonal antibodies against distinct MyHC isoforms and analyzed by SDS-PAGE. In addition, hematoxylin and eosin staining and nicotinamide tetrazolium reductase (NADH-TR) activity were studied. RESULTS. Wide heterogeneity was observed in the appearance of the different EOMs from each single donor and between donors, irrespective of ALS type or onset. Pathologic morphologic findings in ALS EOMs included presence of atrophic and hypertrophic fibers, either clustered in groups or scattered; increased amounts of connective tissue; and areas of fatty replacement. The population of fibers stained with anti-MyHCslow tonic was smaller than that of MyHCIpositive fibers and was mostly located in the orbital layer in most of the ALS EOM samples, whereas an identical staining pattern for both fiber populations was observed in the control specimens. MyHCembryonic was notably absent from the ALS EOMs. CONCLUSIONS. The EOMs showed signs of involvement with altered fiber type composition, contractile protein content, and cellular architecture. However, when compared to the limb muscles, the EOMs were remarkably preserved. EOMs are a useful model for the study of the pathophysiology of ALS.

  • 4.
    Alhamami, Mastour
    et al.
    Indiana University School of Optometry, USA.
    Elsner, Ann
    Indiana University School of Optometry, USA ; Aeon Imaging, USA.
    Malinovsky, Victor
    Indiana University School of Optometry, USA.
    Clark, Christopher
    Haggerty, Bryan
    Indiana University School of Optometry, USA.
    Ozawa, Glen
    University of California, USA.
    Cuadros, Jorge A
    University of California, USA ; EyePACS, USA.
    Baskaran, Karthikeyan
    Indiana University School of Optometry, USA.
    Gast, Thomas
    Indiana University School of Optometry, USA ; Aeon Imaging, USA.
    Litvin, Taras
    University of California, USA.
    Muller, Matthew
    Aeon Imaging, USA.
    Brahm, Shane
    Indiana University School of Optometry, USA.
    Young, Stuart
    Indiana University School of Optometry, USA.
    Miura, Masahiro
    Tokyo Medical University Ibaraki Medical Center, Japan.
    Comparison of Cysts in Red and Green Images for Diabetic Macular Edema2017In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 94, no 2Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate whether cysts in diabetic macular edema are better visualized in the red channel of color fundus camera images, as compared with the green channel, because color fundus camera screening methods that emphasize short-wavelength light may miss cysts in patients with dark fundi or changes to outer blood retinal barrier.

    Methods: Fundus images for diabetic retinopathy photoscreening were acquired for a study with Aeon Imaging, EyePACS, University of California Berkeley, and Indiana University. There were 2047 underserved, adult diabetic patients, of whom over 90% self-identified as a racial/ethnic identify other than non-Hispanic white. Color fundus images at nominally 45 degrees were acquired with a Canon Cr-DGi non-mydriatic camera (Tokyo, Japan) then graded by an EyePACS certified grader. From the 148 patients graded to have clinically significant macular edema by the presence of hard exudates in the central 1500 [mu]m of the fovea, we evaluated macular cysts in 13 patients with cystoid macular edema. Age ranged from 33 to 68 years. Color fundus images were split into red, green, and blue channels with custom Matlab software (Mathworks, Natick, MA). The diameter of a cyst or confluent cysts was quantified in the red-channel and green-channel images separately.

    Results: Cyst identification gave complete agreement between red-channel images and the standard full-color images. This was not the case for green-channel images, which did not expose cysts visible with standard full-color images in five cases, who had dark fundi. Cysts appeared more numerous and covered a larger area in the red channel (733 +/- 604 [mu]m) than in the green channel (349 +/- 433 [mu]m, p < 0.006).

    Conclusions: Cysts may be underdetected with the present fundus camera methods, particularly when short-wavelength light is emphasized or in patients with dark fundi. Longer wavelength techniques may improve the detection of cysts and provide more information concerning the early stages of diabetic macular edema or the outer blood retinal barrier.

  • 5.
    Allen, Peter M.
    et al.
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Radhakrishnan, Hema
    Vision Cooperative Research Centre, Australia ; University of Manchester, UK.
    Price, Holly
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Rae, Sheila
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Theagarayan, Baskar
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Calver, Richard I.
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    Sailoganathan, Ananth
    National Institute of Ophthalmic Sciences, Malaysia.
    Latham, Keziah
    Anglia Ruskin University, UK.
    O'Leary, Daniel J.
    Anglia Ruskin University, UK ; Vision Cooperative Research Centre, Australia.
    A randomised clinical trial to assess the effect of a dual treatment on myopia progression: the Cambridge anti-myopia study2013In: Ophthalmic & physiological optics, ISSN 0275-5408, E-ISSN 1475-1313, Vol. 33, no 3, 267-276 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the effect of a dual treatment modality for myopia, by improving accommodative functions, on myopia progression.

    METHODS: A double blind randomised control trial was conducted on 96 subjects. The treatment modality for the trial employed custom designed contact lenses which control spherical aberration in an attempt to optimise static accommodation responses during near-work, and a vision-training programme to improve accommodation dynamics. Myopia progression was assessed over a 2 year period using cycloplegic autorefraction and biometry.

    RESULTS: The mean progression was found to be -0.33 Dioptres (D) over the 2 years of the study. There was no interaction between contact lens treatment and vision training treatment at 24 months (p = 0.72). There was no significant treatment effect of either Vision Training or Contact Lens Spherical Aberration control on myopia progression.

    CONCLUSIONS: This study is unable to demonstrate that the progression of myopia can be reduced over a 2 year period by either of the two treatments aimed at improving accommodative function. Neither treatment group (contact lens or vision training) progressed at a slower rate over the 2 years of the study than did the appropriate control group.

  • 6.
    Allen, Peter M.
    et al.
    Anglia Ruskin University, UK.
    Radhakrishnan, Hema
    University of Manchester, UK.
    Rae, Sheila
    Anglia Ruskin University, UK.
    Calver, Richard I.
    Anglia Ruskin University, UK.
    Theagarayan, Baskar
    Anglia Ruskin University, UK.
    Nelson, Paul
    Prism Training Consultancy, UK.
    Osuobeni, Ebi
    Anglia Ruskin University, UK.
    Sailoganathan, Ananth
    Anglia Ruskin University, UK.
    Price, Holly
    Anglia Ruskin University, UK.
    O'Leary, Daniel J.
    Anglia Ruskin University, UK.
    Aberration control and vision training as an effective means of improving accommodation in individuals with myopia.2009In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, Vol. 50, no 11, 5120-5129 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To test the efficacy of a novel dual treatment for improving accommodative accuracy and dynamics in young persons with myopia.

    METHODS: Ninety-three young persons with myopia (mean spherical equivalent, -3.0 +/- 1.8 D; age 16.8 +/- 2.1 years; spherical aberration +0.06 +/- 0.04 microm) participated in the study. Custom-designed soft contact lenses were used to alter ocular SA to -0.10 microm to improve accommodative accuracy and reduce any lag of accommodation. A vision training regimen was performed for 18 minutes per day for up to 6 weeks to improve speed of dynamic accommodation. Control groups had contact lenses with no added SA and/or no exercises. To avoid any effects of natural levels of negative aberration on the results of the study, all participants who had negative SA were excluded.

    RESULTS: The treatment contact lenses produced a significant reduction in lag of accommodation (P < 0.05) at all proximal viewing distances measured. The vision training measurement and treatment resulted in a significant increase in distance facility rate for all groups compared with their own baselines (P < 0.05). Near facility rate improved in the vision training treatment group only compared with its baseline (P < 0.05). Both positive and negative response times for distant viewing were significantly shorter in all groups after training compared with their baseline values (P < 0.05). At near, the positive response times were decreased significantly (P < 0.05) in both groups, whereas the negative response times decreased significantly only in the vision training treatment group.

    CONCLUSIONS: After 3 months, the dual treatments (altering SA and vision training) used in the study were effective in modifying accommodation. The static accommodative response to targets at proximal distances was increased by the altered SA contact lenses and rates of dynamic accommodation improved with vision training.

  • 7.
    Alm, A.
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Oftalmiatrik.
    Schoenfelder, J.
    McDermott, J.
    A 5-year, multicenter, open-label, safety study of adjunctive latanoprost therapy for glaucoma.2004In: Arch Ophthalmol, Vol. 122, 957-965 p.Article in journal (Refereed)
  • 8.
    Alm, Albert
    et al.
    Ögonkliniken, Akademiska sjukhuset, Uppsala .
    Bengtsson, Boel
    Oftalmologi, SUS, Malmö.
    Calissendorff, Berit
    St Eriks ögonsjukhus, Stockholm.
    Eckerlund, Ingemar
    Swedish Council on Technology Assessment in Health Care, Stockholm.
    Heijl, Anders
    Department of Clinical Sciences, Ophthalmology in Malmö.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Öppenvinkelglaukom (grön starr): diagnostik, uppföljning och behandling. En systematisk litteraturöversikt.2008Report (Other academic)
  • 9.
    Alm, Håkan
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Är svenska optikerbutiker tillgängliga för rörelsehindrade människor?2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Legitimerade optiker står under Hälso- och sjukvårdslagen och har därmed samma skyldigheter som övrig hälso- och sjukvårdspersonal. En optiker ska således kunna ta emot och erbjuda sina tjänster till alla människor. Studiens syfte var att undersöka hur väl detta fungerar i praktiken. Detta gjordes genom att undersöka optikerbutiker och bedöma dess tillgänglighet för rullstolsburna människor. Undersökningsgruppen bestod av 20 optikerbutiker fördelade på en mindre respektive en större sydsvensk stad. En enkät konstruerades utifrån studiens syfte som butikerna fick svara på samt en checklista skapades innehållande följande bedömningsområden: dörrar, korridorer, gångar, dörröppnare, trösklar samt trappsteg. Resultatet visade på stora brister i tillgänglighet. Endast 20 % av butikerna klassades som tillgängliga och enkätsvaren visade att var femte optiker någon gång ej haft möjlighet att undersöka en patient på grund av dess funktionshinder. Studien visar att de svenska optikerbutikerna inte lever upp till Hälso- och sjukvårdslagens krav på ”vård på lika villkor för hela befolkningen”.

  • 10.
    Ambarki, Khalid
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Hallberg, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Jóhannesson, Gauti
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Zarrinkoob, Laleh
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Wåhlin, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Birgander, Richard
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Eklund, Anders
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Blood flow of ophthalmic artery in healthy individuals determined by phase-contrast magnetic resonance imaging2013In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, Vol. 54, no 4, 2738-2745 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Recent development of magnetic resonance imaging (MRI) offers new possibilities to assess ocular blood flow. This prospective study evaluates the feasibility of phase-contrast MRI (PCMRI) to measure flow rate in the ophthalmic artery (OA) and establish reference values in healthy young (HY) and elderly (HE) subjects.

    METHODS: Fifty HY subjects (28 females, 21-30 years of age) and 44 HE (23 females, 64-80 years of age) were scanned on a 3-Tesla MR system. The PCMRI sequence had a spatial resolution of 0.35 mm per pixel, with the measurement plan placed perpendicularly to the OA. Mean flow rate (Qmean), resistive index (RI), and arterial volume pulsatility of OA (ΔVmax) were measured from the flow rate curve. Accuracy of PCMRI measures was investigated using a vessel-phantom mimicking the diameter and the flow rate range of the human OA.

    RESULTS: Flow rate could be assessed in 97% of the OAs. Phantom investigations showed good agreement between the reference and PCMRI measurements with an error of <7%. No statistical difference was found in Qmean between HY and HE individuals (HY: mean ± SD = 10.37 ± 4.45 mL/min; HE: 10.81 ± 5.15 mL/min, P = 0.655). The mean of ΔVmax (HY: 18.70 ± 7.24 μL; HE: 26.27 ± 12.59 μL, P < 0.001) and RI (HY: 0.62 ± 0.08; HE: 0.67 ± 0.1, P = 0.012) were significantly different between HY and HE.

    CONCLUSIONS: This study demonstrated that the flow rate of OA can be quantified using PCMRI. There was an age difference in the pulsatility parameters; however, the mean flow rate appeared independent of age. The primary difference in flow curves between HE and HY was in the relaxation phase of the systolic peak.

  • 11.
    Andersson, Linda
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Hanteringsträning - tidsåtgång och trygghetskänsla för patienter vid isättning och urtagning av mjuka kontaktlinser2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 12.
    Andersson, Ulrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Helin, Ann-Sofi
    Halmstad University, School of Social and Health Sciences (HOS).
    Ögonsjuksköterskors upplevelser av att använda sin specifika omvårdnadskunskap vid telefonrådgivning2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Telephone counseling is a common form of care. In an increasing medical and technical development in ophthalmological care is ophthalmic nurses skills demanded by both patients, relatives and colleagues in other areas of health care. The purpose of this study was to examine the eye nurses experiences of telephone counseling in ophthalmology. The study was conducted using a qualitative approach and data were collected through semi-structured interview. The material was analyzed using qualitative content analysis. The results showed that eye nurses were confident and proud of their professional role. They experienced the work as fun, stimulating and challenging. They saw themselves as a pilot in the care of a large advisory role related to their specific knowledge. They also described some difficulties in triagera by phone. They wanted better assessment documentation but was confident in their assessments and any fear of notifications to the regulator were not revealed. They also expressed a need for training in counseling skills. Ophthalmic nurses lacked the time for collegial reflection to develop their professional attitude in the work of telephone counseling.

  • 13. Anjos, Rita
    et al.
    Vieira, Luisa
    Costa, Livio
    Vicente, André
    Ophthalmology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; Serviço de Oftalmologia, Hospital de Santo António dos Capuchos, Lisbon, Portugal.
    Santos, Arnaldo
    Alves, Nuno
    Amado, Duarte
    Ferreira, Joana
    Cunha, João Paulo
    Macular Ganglion Cell Layer and Peripapillary Retinal Nerve Fibre Layer Thickness in Patients with Unilateral Posterior Cerebral Artery Ischaemic Lesion: An Optical Coherence Tomography Study2016In: Neuro-ophthalmology (Aeolus Press. 1980), ISSN 0165-8107, E-ISSN 1744-506X, Vol. 40, no 1, 8-15 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of this study is to evaluate the macular ganglion cell layer (GCL) and peripapillary retinal nerve fibre layer (RNFL) thickness in patients with unilateral posterior cerebral artery (PCA) ischaemic lesions using spectral-domain optical coherence tomography (SD-OCT). A prospective, case-control study of patients with unilateral PCA lesion was conducted in the neuro-ophthalmology clinic of Centro Hospitalar Lisboa Central. Macular and peripapillary SD-OCT scans were performed in both eyes of each patient. Twelve patients with PCA lesions (stroke group) and 12 healthy normal controls were included in this study. Peripapillary RNFL comparison between both eyes of the same subject in the stroke group found a thinning in the superior-temporal (p = 0.008) and inferior-temporal (p = 0.023) sectors of the ipsilateral eye and nasal sector (p = 0.003) of the contralateral eye. Macular GCL thickness comparison showed a reduction temporally in the ipsilateral eye (p = 0.004) and nasally in the contralateral eye (p = 0.002). Peripapillary RNFL thickness was significantly reduced in both eyes of patients with PCA compared with controls, affecting all sectors in the contralateral eye and predominantly temporal sectors in the ipsilateral eye. A statistically significant decrease in macular GCL thickness was found in both hemiretinas of both eyes of stroke patients when compared with controls (p < 0.05). This study shows that TRD may play a role in the physiopathology of lesions of the posterior visual pathway.

  • 14.
    Aronsson, Catrin
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Hur skiljer sig ackommodationsamplituden mellan Nicaragua och Sverige?2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna undersökning var att mäta ackommodationsamplitud i Nicaragua och Sverige för att se om det är någon signifikant skillnad mellan länderna i åldersgrupperna mellan 8 år och 40 år. Värdena som togs fram jämfördes sedan med publicerad litteratur för att undersöka hur denna studies värde skiljer sig från dessa, samt vilken av de tidigare studierna som var mest lik denna studies framtagna värde på ackommodationsamplitud i förhållande till åldern.

    Metod: Mätningarna skedde på 113 personer i Nicaragua och 113 personer i Sverige. För att vara med i denna studie krävdes det att försökspersonerna översteg 8 år och understeg 40 år. Mätningarna genomfördes med push-up metoden med hjälp av en mätsticka med figuroptotyp i form av en fågel.

    Resultat: Av de mätningar som genomfördes blev genomsnittet av ackommodationsamplitud 10,3 D (strandard avvikelse ±9,7 D) i Nicaragua och 11,5 D (standard avvikelse ±6,5 D) i Sverige. Ingen signifikant skillnad finns mellan länderna, det vill säga land (Nicaragua eller Sverige) har ingen påverkan på ackommodations amplitud enligt denna studie. Signifikans finns dock mellan ålder och ackommodation, en bekräftelse på att ålder påverkar ackommodationen har således observerats.

    Slutsats: Någon signifikant skillnad i ackommodationsamplitud mellan Nicaragua och Sverige kunde enligt denna studie ej påvisas. I jämförelsen mellan avvikelserna från både Duane och Donders tabeller jämte denna studie kan det avläsas att tabellerna har underskattat mängd ackommodationsamplitud.

  • 15.
    Artzén, Ditte
    et al.
    S:t Erik Eye Hospital, Stockholm.
    Lundström, Mats
    EyeNet Sweden, Blekinge Hospital, Karlskrona.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Stenevi, Ulf
    Sahlgrenska University Hospital, Mölndal, .
    Lydahl, Eva
    Lake Mälare Hospital, Eskilstuna.
    Montan, Per
    St. Erik Eye Hospital, Stockholm.
    Capsule complication during cataract surgery: Case-control study of preoperative and intraoperative risk factors: Swedish Capsule Rupture Study Group report 2.2009In: Journal of cataract and refractive surgery, ISSN 0886-3350, ISSN ISSN 0886-3350, Vol. 35, no 10, 1688-1693 p.Article in journal (Refereed)
    Abstract [en]

    Abstract

    PURPOSE: To identify preoperative and intraoperative factors associated with a capsule complication; that is, a capsule tear or a zonular dehiscence during cataract surgery. SETTING: Ten ophthalmic surgery departments in Sweden. METHODS: A retrospective review of files of patients with a capsule complication and control patients with no complication operated on in 2003 was performed. RESULTS: The review comprised 324 patients with a capsule complication and 331 control patients. In the logistic regression analyses, preoperative conditions associated with a capsule complication were previous trauma, white and brunescent/hard cataract, and phacodonesis. The intraoperative factors of loose zonules, the use of trypan blue, and miosis were all statistically significantly overrepresented in the capsule complication group. The same was true for eyes operated on by surgeons with the least experience. CONCLUSIONS: By preoperatively identifying cataract cases with the identified risk factors and allocating them to surgeons with the longest experience, the number of capsule complications could be kept low. Operating early in the course of the disease to prevent the cataract from becoming a poor surgical risk and improving training of junior surgeons should further reduce the frequency of capsule complications.

  • 16.
    Arvidsson, Marie-Louise
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Vilken läshastighet ger den svenska versionen av internationellt standardiserade läshastighetstexter?2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund - Att läsa en tidning är en självklarhet för många  idag. Det är en naturlig del av vardagen att tillgodogöra sig skriftlig information. Det här är inte en självklar sanning. Många med nedsatt syn behöver använda hjälpmedel som förstorande optik och starkare belysning m m för att klara den här vardagliga situationen. Hur mäts läsförmågan som den synskadade har? Det finns olika lästester för det här syftet.  Testerna som finns sedan tidigare består av enstaka meningar i olika storlekar. I det EU-baserade AMD-Read projektet togs det fram ett set med 10st  nya  längre läshastighetstexter. Eftersom de här nyare texterna (IReST) består av längre sammanhängande meningar i varje lässtycke så finns möjligheten att mäta den faktiska läshastigheten som den synskadade har.  Det går att jämföra resultat före och efter korrektion eller synträning. Texterna finns standardiserade på finska, franska, tyska, engelska, portugisiska och arabiska.

    Syfte - Syftet med denna studie är att utvärdera den svenska versionen av IReST texterna. Frågeställningen var om de tio svenska texterna gav ett jämförbart resultat i läshastighet.

    Metod – 25 friska normalseende personer 19-35 år deltog i studien. Deltagarna fick en och en läsa de 10 läshastighetstexterna högt under tidtagning och röstinspelning. Texterna lästes i slumpvis ordning.

    Resultat -  Två av de tio texterna tog signifikant längre tid att läsa mot de övriga åtta. När det gäller antal fellästa tecken/minut fanns det ingen signifikant skillnad mellan de tio texterna.

  • 17.
    Aström, Siv
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Incidence and prevalence of pseudoexfoliation and open-angle glaucoma in northern Sweden: I. Baseline report.2007In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 8, 828-831 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the prevalence of pseudoexfoliation (PEX) syndrome and open-angle glaucoma (OAG) among 66-year-old people in the municipality of Skellefteå in northern Sweden.

    METHODS: A population-based study comprising 339 individuals, representing 40% of the age group and 87% of those randomly selected. The examination included tonometry, dilated slit-lamp biomicroscopy, optic disc evaluation and a visual field analysis if glaucoma was suspected.

    RESULTS: The overall prevalence of PEX syndrome was 23%[95% confidence interval (CI): 20-26%], 29% (CI: 24-34%) in women and 15% (CI: 10-19%) in men (P < 0.01). The intraocular pressure (IOP) in PEX eyes was higher (17.3 mmHg, SD 4.5 mmHg) than in eyes without PEX [15.7 mmHg, SD 3.7 mmHg; P < 0.001]. IOP exceeded 22 mmHg in 17% (CI: 11-23%) of the PEX eyes and in 3.0% (CI: 1.9-4.1%) of the non-PEX eyes. Seven individuals (2.1%) had OAG. Six were associated with PEX, i.e. 7.7% of the PEX individuals.

    CONCLUSION: PEX syndrome is common in northern Sweden, affecting every fourth individual reaching the age of 66 years. The prevalence in women is twice that in men. Elevated IOP is roughly six times more frequent in eyes with PEX than in eyes without PEX syndrome. The prevalence of OAG is 2.1%.

  • 18.
    Aurell, Sandra
    et al.
    Vastmanland Cty Hosp, AT Ctr, S-72189 Vasteras, Sweden..
    Granstam, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Vastmanland Cty Hosp, Dept Ophthalmol, Vasteras, Sweden..
    Bacterial keratitis in a Swedish county hospital: management and clinical outcome2016In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 94, no 3, E248-E249 p.Article in journal (Refereed)
  • 19.
    Austeng, Dordi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Retinopathy of Prematurity in Infants Born Before 27 Weeks of Gestation: A National Population-based Study in Sweden During 2004-20072010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Improved neonatal care has resulted in an increasing population of surviving infants. Neonatal morbidity in preterm infants is, however, high, and retinopathy of prematurity (ROP) is one of the major neonatal morbidities. Observations have suggested that ROP might have a different course in extremely preterm compared to more mature infants.

    Aims: To study the incidence, natural history and treatment of the disease, and the implications regarding screening recommendations for the population of extremely preterm infants.

    Methods: A national, population-based study of neonatal morbidity in infants born before 27 gestational weeks was performed in Sweden during 2004 to 2007. ROP screening started in the 5th postnatal week and continued until the retina was completely vascularized.

    Results: Of the 506 infants surviving until the first ROP examination, 73% developed ROP; 38% mild ROP and 35% severe ROP. Ninety-nine infants (20%) were treated. A log-linear relationship was found between severe ROP and gestational age (GA) at birth, and the risk of ROP was reduced by 50% for each week of increase in GA at birth (Paper I).

    Postmenstrual age (PMA) at onset of ROP was significantly related to GA at birth, as was the site of onset of ROP. ROP had a predilection to start in the nasal retina in the most immature infants. There were significant relations between PMA at onset of ROP and severity of ROP as well as between the site of onset of ROP and severe ROP (Paper III).

    The most immature infants had a higher risk of reaching treatment criteria for ROP, a higher risk of progression from ROP 3 to treatment criteria, and they reached these criteria at an earlier PMA than the less immature infants (Paper II).

    According to our results, the first examination can be postponed until a PMA of 31 weeks in infants born before 27 weeks of gestation, since onset of ROP 3 did not occur before this age, and criteria for treatment were not reached before 32 weeks. The majority of infants (75%) were treated during a limited period, i.e. before a PMA of 39 weeks (Paper IV).

  • 20.
    Austeng, Dordi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Källen, Karin B. M.
    Lund University.
    Ewald, Uwe W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Wallin, Agneta
    St.Erik's Eye Hospital.
    Holmström, Gerd E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Treatment for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden2010In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 94, no 9, 1136-1139 p.Article in journal (Refereed)
    Abstract [en]

    AIMS: To study various aspects of treatment for retinopathy of prematurity (ROP) in a Swedish population of extremely preterm infants born before 27 weeks of gestation. METHODS: A national, prospective and population-based study was performed in Sweden from April 1, 2004 to March 31, 2007. The criteria for treatment of ROP accorded with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. RESULTS: Twenty percent of the infants (99/506) were treated for ROP. The likelihood of reaching treatment criteria nearly doubled for each week of reduction in gestational age (GA) at birth. The first treatment was performed at an earlier postmenstrual age in the most immature infants. One third of the infants had more than one session of laser treatment. CONCLUSIONS: A high percentage of these extremely preterm infants required treatment for ROP. The likelihood of reaching treatment criteria increased with a decline in GA at birth. Although only a few infants progressed to ROP Stages 4 and 5, our findings indicate a potential for improvement of the treatment routines, both regarding timing and number of laser spots at the first treatment.

  • 21.
    Austeng, Dordi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Källen, Karin
    Hellström, Ann
    Jakobsson, Peter
    Lundgren, Pia
    Tornqvist, Kristina
    Wallin, Agneta
    Holmström, Gerd
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Regional differences in screening for retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden: the EXPRESS study2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 4, 311-315 p.Article in journal (Refereed)
    Abstract [en]

    Purpose:  The primary aim was to analyse regional incidences of retinopathy of prematurity (ROP) and frequencies of treatment and their relation to perinatal risk factors during a 3-year period. A secondary aim was to study adherence to the study screening protocol in the different regions.

    Methods:  A population-based study of neonatal morbidity in extremely preterm infants in Sweden (EXPRESS) was performed during 2004–2007. Screening for ROP was to start at postnatal age 5 weeks and to continue weekly until the retina was completely vascularized or until regression of ROP. Logistic regression analyses were used for evaluation of differences in incidence of Any ROP, ROP 3 or more and ROP Type 1 between the seven regions of the country.

    Results:  The regional incidence of ROP varied between 54% and 92% for Any ROP, between 25% and 43% for ROP stage 3 or more and between 8% and 23% of infants with ROP Type 1, all of whom were treated. There was no significant difference between the regions regarding ROP Type 1, even when adjusting for known risk factors for ROP.

    Conclusion:  The heterogeneity between the regions regarding the incidence of ROP was reduced with increasing severity of ROP, and there was no heterogeneity regarding frequency of treatment for ROP, which is the most important issue for the children. We cannot exclude observer bias regarding mild ROP and ROP stage 3 in this study.

  • 22.
    Austeng, Dordi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Källen, Karin
    Tornbladsinstitutet, Lund University.
    Hellström, Ann
    Section of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska Academy, University of Gothenburg .
    Tornqvist, Kristina
    Department of Ophthalmology, Lund University Hospital.
    Holmström, Gerd E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Natural history of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden2010In: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 128, no 10, 1289-1294 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the natural history of retinopathy of prematurity (ROP) in 506 extremely preterm infants born before 27 weeks' gestation in Sweden during a 3-year period.

    Methods: A national population–based study was performed in Sweden from April 1, 2004, to March 31, 2007. According to the study protocol, initial eye examinations were to be performed at postnatal week 5, and examinations were repeated until the retina was completely vascularized or until criteria for treatment were met. The examinations were to be performed weekly, enabling study of the course and severity of ROP. In infants without ROP or with mild ROP without progression during the latest examinations, further examinations were performed weekly or every other week from postmenstrual age 35 weeks.

    Results: During the study, 368 infants (72.7%) developed ROP. Postmenstrual age at onset of ROP was significantly related to severity of ROP, even when controlling for gestational age (ie, the earlier the onset of ROP, the higher the risk of developing severe ROP). Site of onset of ROP was significantly related to gestational age at birth. The risk of nasal onset was almost doubled for every week of decrease in gestational age at birth. Nasal onset was associated with severe ROP, even after adjusting for gestational age at birth.

    Conclusion: This population-based study confirms results of the Cryotherapy for Retinopathy of Prematurity study and shows new correlations regarding time and site of onset of ROP, both of which are associated with disease severity.

  • 23. Ayala, Marcelo N.
    et al.
    Söderberg, Per G.
    St. Erik’s Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
    Reversal of reciprocity failure for UVR-induced cataract with vitamin E2005In: Ophthalmic Research, ISSN 0030-3747, E-ISSN 1423-0259, Vol. 37, no 3, 150-155 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The authors have previously described that the photochemical reciprocity law does not apply for ultraviolet radiation (UVR)-induced cataract. The aim of this study was to elucidate if failure of the reciprocity reverses with vitamin E (alpha-tocopherol) administration. METHODS: Altogether, 80 rats were divided into one group fed alpha-tocopherol and one control group. For each group, half of rats were exposed to UVR for 5 min and the remaining rats for 15 min. RESULTS: Lenses exposed to UVR for 5 min showed no difference in light scattering between alpha-tocopherol-treated and untreated groups. Lenses exposed to UVR for 15 min showed significant difference in light scattering between alpha-tocopherol-treated and untreated groups. CONCLUSIONS: Failure in exposure time-intensity reciprocity for UVR-induced cataract with exposures shorter than 30 min may be due to consumption of antioxidants in the lens.

  • 24. Ayala, Marcelo
    et al.
    Strid, Hilja
    Örebro University, School of Health and Medical Sciences.
    Jacobsson, Ulrika
    Söderberg, Per G.
    p53 expression and apoptosis in the lens after ultraviolet radiation exposure2007In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, Vol. 48, no 9, 4187-4191 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To localize p53 protein and active caspase-3 in the albino rat lens and to compare p53 mRNA and active caspase-3 expression in ultraviolet radiation (UVR) 300 nm exposed lenses and their contralateral nonexposed controls. METHODS: Ten Sprague-Dawley albino rats were unilaterally exposed to 8 kJ/m(2) UVR, and the contralateral eyes were left nonexposed. In total, four exposed lenses and their respective contralateral nonexposed lenses were analyzed by immunohistochemistry to localize p53 and active caspase-3. In addition, six exposed and contralateral nonexposed lenses were analyzed by real-time RT-PCR. Quantified p53 and caspase-3 expression were compared between the in vivo UVR 300 nm exposed lenses and the contralateral nonexposed lenses. RESULTS: All lenses exposed to UVR developed cataract. Immunohistochemistry showed that p53 and active caspase-3 were localized in the lens epithelial cells. Quantified p53 and caspase-3 expression were significantly higher in lenses exposed to UVR than in nonexposed lenses. CONCLUSIONS: p53 and caspase-3 expression increase in lens epithelial cells after UVR exposure. In the lens, apoptosis induced by UVR may be associated with increased p53 expression.

  • 25. Backstrom, Gunnie
    et al.
    Lundberg, Björn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Intracameral acetylcholine effectively contracts pupils after dilatation with intracameral mydriatics2013In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 91, no 2, 123-126 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: To determine whether intracameral acetylcholine can contract pupils dilated with intracameral mydriatics in phacoemulsification cataract surgery. Methods: A total of 60 patients were included in this prospective randomized masked study performed at ornskoldsviks Hospital Eye Clinic. The patients were randomized and were given either topical placebo and an intracameral mydriatic solution (ICM) (cyclopentolate 0.1%, phenylephrine 1.5% and xylocaine 1%) (n=30) or topical mydriatics (TM) (cyclopentolate 0.85% and phenylephrine 1.5%) and xylocaine 1% intracamerally (n=30) at the start of surgery. After intraocular lens (IOL) implantation, 0.15ml 1% acetylcholine was given intracamerally in all cases. The pupil size was registered preoperatively, 45seconds after intracameral injection, after ophthalmic viscosurgical device (OVD) evacuation, 30seconds after acetylcholine injection, 2min after acetylcholine injection and the day after surgery. Results: The pupil contraction and pupil size after acetylcholine injection showed no significant differences at 30seconds (contraction 1.0 +/- 0.4 in ICM group versus 0.9 +/- 0.4 in TM group; p=0.75; size 4.8 +/- 1.1 in the ICM group versus 5.2 +/- 1.1 in the TM group; p=0.24) or at 2min (contraction 1.5 +/- 0.6 in the ICM group versus 1.4 +/- 0.6 in the TM group; p=0.63; size 4.3 +/- 0.9 in the ICM group versus 4.7 +/- 1.0 in the TM group; p=0.13). No difference in baseline pupil size after ophthalmic viscosurgical device (OVD) evacuation was seen between the two groups (5.8 +/- 0.9 in the ICM group versus 6.1 +/- 1.2 in the TM group; p=0.28). Conclusion: We here show that intracameral acetylcholine contracts pupils as effectively after dilatation with intracameral mydriatics as after dilatation with topical mydriatics. Cataract surgeons can feel comfortable and safe when using intracameral mydriatics, even if pupil contraction with acetylcholine should be required.

  • 26.
    Baptista, Antonio M. G.
    et al.
    University of Minho, Portugal.
    Joel, Monteiro
    Centro Hospitalar do Alto Ave, Portugal.
    Vieira, Marco
    Centro Hospitalar do Alto Ave, Portugal.
    Reimão, Pedro
    Centro Hospitalar do Alto Ave, Portugal.
    Rocha, Paulo
    University of Porto, Portugal.
    Rocha-Sousa, Amandio A.
    University of Porto, Portugal.
    Freitas, Cristina
    Hospital de Braga, Portugal.
    Macedo, António Filipe
    University of Minho, Portugal.
    Marques, Ana Patricia
    Nova University of Lisbon, Portugal.
    Santana, Rui
    Nova University of Lisbon, Portugal.
    Causes of Vision Impairment in Portugal: A hospital based study2015In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 56, no 7, 2118Article in journal (Refereed)
    Abstract [en]

    Purpose 

    Causes of vision impairment (VI) are influenced by factors such as race or socio-economic circumstances. Because of this collecting national information is important for planning reduction of vision loss. The aim of this study was to determine causes of vision impairment in a population visiting ophthalmology departments in public hospitals in Portugal.

    Methods 

    This study was designed according with the guidelines of the Vancouver Economic Burden of Vision Loss Group (IOVS, 2010, V51/4/1801). Recommendations are to collect hospital data during 1 year to determine causes of VI. We selected four public hospitals that are expected to have over 120-140K appointments per year. Files are analysed weekly to detect patients with vision impairment. Inclusion criteria are: visual acuity with the current refractive correction equal or less than 0.5 (20/40) in the better-seeing eye and/or a visual field of less than 20 degrees. Patients were selected by trained hospital staff (medics and orthoptists) and inserted in a database. Diagnoses were classified according the ICD9. Data collected included fundamental demographic information, main diagnosis, secondary diagnosis and comorbidities.

    Results 

    We have now 2462 patients selected that correspond to 4 to 33 weeks of data collection. The number of weeks is variable because we did not start all hospitals simultaneously. From the current number of cases detected, 58% are female, 1.9% are under 20, 8.2% are between 20 and 50 and 89.9% are 50 years or older. The leading causes of vision impairment among these patients are diabetic retinopathy (DR), cataract (C), glaucoma (GC) and age-related macular degeneration (AMD). Using the North American definition of VI the proportions are 26.8% for DR, 25.5% for C, 10.4% for GC and 8.2% for AMD. The remaining causes of VI have percentages below 5% and in total they correspond to approximately 29% of the cases detected.

    Conclusions 

    Our results show that the most common causes of vision impairment are eye diseases related with systemic conditions and aging of the population. Vision impairment was relatively low under the age of 20 and the causes were mostly inherited diseases. Numbers reported now will be more accurate at the end of the study but they already highlight the importance of targeting conditions such as diabetes.

  • 27.
    Baptista, António M. G.
    et al.
    University of Minho, Portugal.
    Sousa, Raul A. R. C.
    Rocha, Filomena A. S. Q.
    Sepúlveda Fernandes, Paula
    Macedo, António Filipe
    University of Minho, Portugal.
    The macular photostress test in diabetes, glaucoma, and cataract2013In: 8th Iberoamerican Optics Meeting and 11th Latin American Meeting on Optics, Lasers, and Applications, SPIE - International Society for Optical Engineering, 2013Conference paper (Refereed)
    Abstract [en]

    Purpose. The photostress recovery time test (PSRT) has been widely reported as a helpful screening clinical tool. However, the poor standardization of its measurement technique remains to be a limitation among clinicians. The purpose of this study is to apply a recommended clinical technique to measure the PSRT in some of the most commons eye diseases to ascertain whether these diseases affect the PSRT values. Methods. One hundred and one controls and 105 patients, with diagnosed diabetes (without visible signs of diabetic retinopathy), primary open angle glaucoma (POAG) or cataracts underwent photostress testing. The test was performed with a direct ophthalmoscope for illuminating the macula for 30 seconds. Participants belonged to three age classes: A, B and C; and were divided into four groups: control, diabetic, POAG and cataract. The age range for A, B and C classes were respectively 43-54, 55-64 and 65-74 years. The groups were also further compared within each age class. In addition, the influence of age on PSRT was evaluated using the control group. Results. Results demonstrate that PSRT changes with age (p<0.02). In class A, diabetic group had a faster PSRT than control group, (mean ± standard deviation) 20.22±7.51 and 26.14±8.34 seconds. The difference between these groups was statistical significant (t-test, p=0.012). Cataract and POAG groups did not affect the PSRT significantly. Conclusions. The technique used for the Photostress showed that diabetics, younger than 54 years, may have faster PSRT and that, aging delays PSRT

  • 28.
    Barth, Henrik
    et al.
    Department of Ophthalmology, Lund University Hospital, BMC, Lund, Sweden.
    Crafoord, Sven
    Örebro University, School of Medical Sciences. Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    Andréasson, Sten
    Department of Ophthalmology, Lund University Hospital, BMC, Lund, Sweden.
    Ghosh, Fredrik
    Department of Ophthalmology, Lund University Hospital, BMC, Lund, Sweden.
    A cross-linked hyaluronic acid hydrogel (Healaflow(®)) as a novel vitreous substitute2016In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 254, no 4, 697-703 p.Article in journal (Refereed)
    Abstract [en]

    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.

  • 29.
    Barth, Henrik
    et al.
    Department of Ophthalmology, Lund University, Lund, Sweden .
    Crafoord, Sven
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Ophthalmology.
    O'Shea, Timothy M.
    Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA .
    Pritchard, Christopher D.
    Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA .
    Langer, Robert
    Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA .
    Ghosh, Fredrik
    Department of Ophthalmology, Lund University, Lund, Sweden .
    A new model for in vitro testing of vitreous substitute candidates2014In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 252, no 10, 1581-1592 p.Article in journal (Refereed)
    Abstract [en]

    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.

  • 30.
    Barth, Henrik
    et al.
    Lund Univ, Dept Ophthalmol, Lund, Sweden..
    Crafoord, Sven W.
    Örebro University, School of Medical Sciences. Orebro University Hospital. Dept Ophthalmology.
    Arner, Karin
    Lund Univ, Dept Ophthalmol, Lund, Sweden..
    Ghosh, Fredrik K.
    Lund Univ, Dept Ophthalmol, Lund, Sweden..
    Cellular CD68 and CD45r0 positive inflammatory responses of vitrectomy with vitreous substitutes2016In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 57, no 12Article in journal (Refereed)
  • 31.
    Bartuma, Katarina
    et al.
    Karolinska Inst, St Erik Eye Hosp, Dept Vitreoretinal Dis, Stockholm, Sweden..
    Pal, Niklas
    Karolinska Inst, Dept Pediat, Astrid Lindgren Childrens Hosp, S-10401 Stockholm, Sweden..
    Kosek, Sonja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala Univ, Uppsala, Sweden..
    Holm, Stefan
    Karolinska Inst, Dept Pediat, Astrid Lindgren Childrens Hosp, S-10401 Stockholm, Sweden..
    All-Ericsson, Charlotta
    Karolinska Inst, St Erik Eye Hosp, Dept Vitreoretinal Dis, Stockholm, Sweden..
    A 10-year experience of outcome in chemotherapy-treated hereditary retinoblastoma2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 5, 404-411 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim is to report the 10-year retrospective experience of systemic chemotherapy for a population-based group of patients with hereditary retinoblastoma at a national referral centre. The outcomes include control rates, treatment side-effects, adjuvant therapy, failure rate, survival, secondary cancers and visual acuity. Methods: All patients (n = 24, 46 eyes) diagnosed with retinoblastoma and treated with systemic chemotherapy at a national referral centre during 2001-2011 were included. Data were extracted from medical records. Results: The patients were followed for a mean of 60 months (range 13-144). Four-six cycles of VEC was administered to all newly diagnosed group B/C/D/E eyes with bilateral disease and 83% (38 of 46) responded to the treatment. None of the patients discontinued chemotherapy because of adverse reactions. Altogether 26% (12 of 46) of the eyes received second-line therapy (other than thermotherapy, cryotherapy and chemotherapy). The failure rate was 35% (16 of 46) and mortality rate 0%. None of the patients developed CNS manifestations (metastases or trilateral retinoblastoma). One of the patients developed a second primary tumour (osteosarcoma) 4 years following retinoblastoma diagnosis. Altogether 17% (4 of 24) patients received radiation therapy, 28% (13 of 46) of the eyes had to be enucleated, and one patient underwent bilateral enucleation. The age-correlated visual acuity was mean of 73% of expected visual acuity. Conclusion: Group A/B retinoblastomas have a distinct chemotherapy response, while group C/D/E tumours do not respond as well. The success rate was 65%; while patients have a good prognosis for life, approximately one-third of all hereditary cases received radiation therapy or underwent enucleation.

  • 32.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Optimal Use of Peripheral Vision2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    People who lose their central vision have to rely on their peripheral vision for all visual tasks. The ability to resolve fine details in the periphery is reduced due to retinal limitations and the optical aberrations arising from the use of off-axis vision. The aim of this work is to improve vision by enhancing the image quality at the preferred retinal locus by means of correcting the optical errors. The focus of this thesis has been to measure and correct peripheral optical errors, as well as to evaluate their impact on resolution acuity in both normal and central visual field loss subjects.

     In order to measure peripheral optics we employed a COAS HD VR open view aberrometer which is based on the Hartmann-Shack principle. Psychophysical methods were used to evaluate peripheral grating resolution acuity. We assessed the repeatability of the wavefront sensor in measuring the peripheral ocular aberrations. The symmetry of peripheral ocular aberrations between the left and right eyes was examined. The influence of age on peripheral ocular aberrations was also investigated. We evaluated peripheral vision with sphero-cylindrical correction in healthy eyes and performed the first adaptive optics aberration correction at the preferred retinal locus of a single central visual field loss subject.

     We found that the aberrometer was repeatable and reliable in measuring peripheral ocular aberrations. There was mirror symmetry between the two eyes for most of the peripheral aberration coefficients. Age had a significant influence on peripheral ocular aberrations; there were larger amounts of higher-order aberrations in old eyes than in young eyes. Peripheral low contrast resolution acuity improved with peripheral refractive correction in subjects who had higher amounts of off-axis astigmatism. Finally, adaptive optics aberration correction improved both high and low contrast resolution acuity measured at the preferred retinal locus of the single low vision subject.

     Because of their versatility, open view aberrometers will hopefully be a standard clinical instrument at low vision clinics as they allow for measurements to be rapidly performed at any location in the visual field. The existence of off-axis astigmatism should be better communicated within the low-vision rehabilitation community. Currently, the off-axis refractive errors can be corrected with conventional methods and we hope that the higher-order aberrations can also be corrected in a more realistic ways in the future.  

     In conclusion, this thesis has shown that peripheral visual function can be improved by optical correction. The findings of this thesis have broadened the knowledge of peripheral optical errors and their influence on vision.

  • 33.
    Baskaran, Karthikeyan
    et al.
    Indiana University, USA.
    Elsner, Ann E.
    Indiana University, USA ; Aeon Imaging, USA.
    Muller, Matthew S.
    Aeon Imaging, USA.
    Haggerty, Bryan P.
    Indiana University, USA.
    Papay, Joel A.
    Indiana University, USA.
    Gast, Thomas
    Indiana University, USA ; Aeon Imaging, USA.
    Litvin, Taras V.
    University of California Berkeley, USA.
    Ozawa, Glen Y.
    University of California Berkeley, USA.
    Cuadros, Jorge
    University of California Berkeley, USA.
    Petrig, Benno L.
    Aeon Imaging, USA.
    Stability of fixation in diabetes patients with and without clinically significant macular edema2014Conference paper (Refereed)
    Abstract [en]

    Purpose - Eye diseases affecting central vision impair fixation and interfere with day-to-day tasks such as reading. Diabetic retinopathy and clinically significant macular edema (CSME) are leading causes of visual impairment in diabetes patients. The aim of this study is to find whether diabetic patients with CSME have poorer fixation stability compared to patients without CSME, by analyzing the fundus images obtained from the Laser Scanning Digital Camera (LSDC).

    Methods - Two hundred underserved, diabetic patients were screened for diabetic retinopathy at the Eastmont Wellness Center within the EyePACS telemedicine network, using LSDC. One eye of each patient who had diabetic retinopathy was included in this study. Non-mydriatic color fundus photos were classified for presence of CSME by two independent, certified EyePACS graders. The first 50 patients (25 males &amp; 25 females) with CSME were selected and 50 (27 males &amp; 23 females) diabetic patients without CSME were selected as controls. Mean age was 59 (±9) years for patients with CSME and was 55 (±10) years for patients without CSME. The subjects included 53% Hispanics, 26% African Americans and 21% other. A series of 20 images (36 deg field, 1024 X 1024 pixels, and 850 nm) were acquired at 11 fps. Eye positions were obtained by selecting a region of interest in the first image of each series and aligning the remaining images to that region by cross-correlation. The bi-contour ellipse area (BCEA) and the standard deviation of the Euclidean distance (SDED) were used to quantify fixation stability.

    Results - The fixation stability for patients with CSME was significantly worse than for those without CSME (t test: p &lt; 0.001, 0.007 for BCEA and SDED, respectively). The mean fixation stability obtained by the BCEA metric was 2.74 (±0.40) log(minArc2) and 2.34 (±0.42) log(minArc2) for patients with and without CSME, respectively. For SDED the mean was 48.4 (±28.8) microns and 34.6 (±20.4) microns for patients with and without CSME, respectively. The correlation with age was not significant for either group (R2 = 0.052, 0.011).

    Conclusions - Diabetic patients with CSME had poorer fixation stability than patients without CSME for both metrics. Fixation stability is a potential tool for assessing macular function and could be used for tracking the treatment and progression of macular edema.The LSDC images provide one method to quantify fixation stability rapidly.

  • 34.
    Baskaran, Karthikeyan
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Rosen, R.
    Lewis, Peter
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Unsbo, P.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Benefit of Adaptive Optics Aberration Correction at Preferred Retinal Locus2012In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 89, no 9, 1417-1423 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE.: To investigate the effect of eccentric refractive correction and full aberration correction on both high- and low-contrast grating resolution at the preferred retinal locus (PRL) of a single low-vision subject with a long-standing central scotoma. METHODS.: The subject was a 68-year-old women with bilateral absolute central scotoma due to Stargardt disease. She developed a single PRL located 25 degrees nasally of the damaged macula in her left eye, this being the better of the two eyes. High- (100%) and low-contrast (25 and 10%) grating resolution acuity was evaluated using four different correction conditions. The first two corrections were solely refractive error corrections, namely, habitual spectacle correction and full spherocylindrical correction. The latter two corrections were two versions of adaptive optics corrections of all aberrations, namely, habitual spectacle correction with aberration correction and full spherocylindrical refractive correction with aberration correction. RESULTS.: The mean high-contrast (100%) resolution acuity with her habitual correction was 1.06 logMAR, which improved to 1.00 logMAR with full spherocylindrical correction. Under the same conditions, low-contrast (25%) acuity improved from 1.30 to 1.14 logMAR. With adaptive optics aberration correction, the high-contrast resolution acuities improved to 0.89/0.92 logMAR and the low-contrast acuities improved to 1.04/1.06 logMAR under both correction modalities. The low-contrast (10%) resolution acuity was 1.34 logMAR with adaptive optics aberration correction; however, with purely refractive error corrections, she was unable to identify the orientation of the gratings. CONCLUSIONS.: Correction of all aberrations using adaptive optics improves both high- and low-contrast resolution acuity at the PRL of a single low-vision subject with long-standing absolute central scotoma

  • 35. Baskaran, Karthikeyan
    et al.
    Rosén, Robert
    KTH, School of Engineering Sciences (SCI), Applied Physics, Biomedical and X-ray Physics.
    Lewis, Peter
    Unsbo, Peter
    Gustafsson, Jörgen
    Benefit of Adaptive Optics Aberration Correction at Preferred Retinal Locus2012In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 89, no 9Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the effect of eccentric refractive correction and full aberration correction on both high and low contrast grating resolution at the preferred retinal locus (PRL) of a single low vision subject with a longstanding central scotoma.

    Methods: The subject was a 68 year-old female with bilateral absolute central scotoma due to Stargardt’s disease. She has developed a single PRL located 25° nasally of the damaged macula in her left eye, this being the better of the two eyes. High- (100%) and low contrast (25% & 10%) grating resolution acuity was evaluated using four different correction conditions. The first two corrections were solely refractive error corrections; namely habitual spectacle correction and full sphero-cylindrical correction. The latter two corrections were two versions of adaptive optics corrections of all aberrations; namely full sphero-cylindrical refractive correction with additional aberration correction and habitual spectacle correction with aberration correction.

    Results: The mean high contrast (100%) resolution acuity with her habitual correction was 1.06 logMAR, which improved to 1.00 logMAR with full sphero-cylindrical correction. Under the same conditions, low contrast (25%) acuity improved from 1.30 logMAR to 1.14 logMAR. With adaptive optics aberration correction, the high contrast resolution acuities improved to 0.92/0.89 logMAR and the low contrast acuities, to 1.06/1.04 logMAR under both correction modalities. The low contrast (10%) resolution acuity was 1.34 logMAR with adaptive optics aberration correction; however, with purely refractive error corrections she was unable to identify the orientation of the gratings.

    Conclusion: Correction of all aberrations using adaptive optics improves both high and low contrast resolution acuity at the PRL of a single low vision subject with longstanding absolute central scotoma.

  • 36.
    Baskaran, Karthikeyan
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Theagarayan, Baskar
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Carius, Staffan
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Repeatability of Peripheral Aberrations in Young Emmetropes2010In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 87, no 10, 751-759 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE.: The purpose of this study is to assess the intrasession repeatability of ocular aberration measurements in the peripheral visual field with a commercially available Shack-Hartmann aberrometer (complete ophthalmic analysis system-high definition-vision research). The higher-order off-axis aberrations data in young healthy emmetropic eyes are also reported.

    METHODS.: The aberrations of the right eye of 18 emmetropes were measured using an aberrometer with an open field of view that allows peripheral measurements. Five repeated measures of ocular aberrations were obtained and assessed in steps of 10 degrees out to +/-40 degrees in the horizontal visual field (nasal + and temporal -) and -20 degrees in the inferior visual field. The coefficient of repeatability, coefficient of variation, and the intraclass correlation coefficient were calculated as a measure of intrasession repeatability.

    RESULTS.: In all eccentric angles, the repeatability of the third- and fourth-order aberrations was better than the fifth and sixth order aberrations. The coefficient of variation was <30% and the intraclass correlation coefficient was >0.90 for the third and fourth order but reduced gradually for higher orders. There was no statistical significant difference in variance of total higher-order root mean square between on- and off-axis measurements (p > 0.05). The aberration data in this group of young emmetropes showed that the horizontal coma (C13) was most positive at 40 degrees in the temporal field, decreasing linearly toward negative values with increasing off-axis angle into the nasal field, whereas all other higher-order aberrations showed little or no change.

    CONCLUSIONS.: The complete ophthalmic analysis system-high definition-vision research provides fast, repeatable, and valid peripheral aberration measurements and can be used efficiently to measure off-axis aberrations in the peripheral visual field

  • 37.
    Baskaran, Karthikeyan
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Theagarayan, Baskar
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Carius, Staffan
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Influence of age on peripheral aberration2010Conference paper (Refereed)
    Abstract [en]

    The purpose of this study is to compare peripheral higher order aberrations in young

    and old emmetropic eyes across the horizontal (±40°) and inferior (–20°) visual field.

    Introduction

     

     

    People with central visual field loss use eccentric fixation for various visual tasks.

    Recently studies have shown that the correction of lower order aberrations (defocus &

    astigmatism) can improve eccentric vision in subjects with central visual field loss

    (CFL)[1]. The CFL subjects mostly correspond to older age groups who use eccentric

    fixation angles up to 20°–30°. While there have been studies comparing the off-axis

    lower order aberrations in normal young and old subjects[2], there is only one recent

    study, which has compared off-axis higher order aberrations in normal young and old

    emmetropic eyes up to 20° (horizontal and vertical) eccentricity[3]. In this study we

    have measured off-axis aberrations in a group of 10 young (23 ± 3 years) and 10 old

    (57 ± 4 years) emmetropes. The aberrations of the right eye were measured using

    COAS-HD VR Hartmann-Shack aberrometer in steps 10° out to ± 40° horizontally and

    –20° inferiorly in the visual field. Subjects rotated the eyes to view the fixation targets,

    which were red light emitting diodes, placed at 3 meter from the eye. The aberrations

    were quantified for a pupil area 5 mm in diameter.

    Discussion

     

     

    Mixed between-within subject’s analysis of variance of the horizontal coma C13

    showed that there was a statistically significant difference between age groups

    (p<0.05). The coma increased linearly in both groups from nasal to temporal visual

    field. The rate of change was greater in the old (slope = –0.027 μm/deg) compared

    to the young (slope = –0.012 μm/deg) emmetropes. In the inferior visual field,

    vertical coma C-13 changed linearly in both groups with higher values in old (slope =

    0.015 μm/deg) compared to young (slope = 0.006 μm/deg). The mean spherical

    aberration was positive in older emmetropes (0.053 μm) compared to young

    emmetropes (-0.030 μm). The HO RMS showed a quadratic increase in the

    periphery for both age groups. The HO RMS was greater in older emmetropes but it

    was not statistically significant (p>0.05) when compared to young emmetropes.

     

    Conclusions

     

     

    Our results show that there is an increase in coma, spherical aberration, and HO

    RMS with age in the periphery.

  • 38.
    Baskaran, Karthikeyan
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Theagarayan, Baskar
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Carius, Staffan
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Measurement of Off-axis Refraction with a Commercial Open Field Aberrometer2010Conference paper (Refereed)
    Abstract [en]

    Purpose:

    People with central visual field loss (CFL) use their remaining peripheral vision in order to see better when performing various visual related tasks. At large off-axis angles, the eccentric vision can be limited both by the low resolution capacity of the peripheral retina and by the optical aberrations caused due to oblique angles. Previous work has shown that eccentric correction of induced off-axis astigmatism can improve vision in a preferred retinal location (PRL) for people with CFL. However, the eccentric refraction is often difficult to determine with traditional refractive methods. This work therefore shows the use of a commercially available wavefront sensor to measure fast and reliable off-axis refraction. Data on off-axis refraction is also of interest in the field of myopia research.

    Methods:

    We used the new open-field high-definition complete ophthalmic analysis system, COAS HD -VR, to evaluate off-axis refraction. Using the special Vision Research tool in this system stimulus (fixation objects) can be presented in a large part of the visual field. The instrument can measure out to 40 degrees in the horizontal visual field and 20 degrees in the vertical visual field with a range from sphere +7 D to − 17 D. It measures astigmatism up to 10 D. This instrument also allows natural binocular viewing without obstacles. Aberrations of the right eye of 30 emmetropes (24 ± 4 years) were studied. Off-axis refraction and higher order (HO) aberrations were measured in steps of 10° out to ± 30° in the horizontal visual field

    Results:

    The first data on young emmetropic eyes with this new instrument showed promising results for low (LO) and higher order (HO) aberrations in the peripheral visual field. Of the LO aberrations, astigmatism increased significantly with the off–axis angle, from 0.25 D at 10° Nasal to 1.65 D at 30° Nasal. In the HO aberrations, coma (C13) showed a linear increase across the horizontal visual field (p < 0.05)

    Conclusions:

    The COAS HD-VR shows promising results and good usability for future research in evaluation of off-axis refraction. In future we believe the aberrometer can be used clinically to measure off-axis refractions in low vision patients.

  • 39.
    Baskaran, Karthikeyan
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Theagarayan, Baskar
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Carius, Staffan
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Ocular Aberrations in the Peripheral Visual Field With a Commercial Open-View Aberrometer2010In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 51, no 5, 3951Article in journal (Refereed)
    Abstract [en]

    PurposeThe interest in off-axis aberrations has increased with the discovery of a possible link between myopia development and peripheral optics. The most common technology to measure the off-axis aberrations is a Shack-Hartmann wavefront aberrometer. This is the first study to report peripheral aberrations in a large sample of emmetropic population with a commercial open-view Shack-Hartmann aberrometer. MethodsThe commercial open-view Shack-Hartmann aberrometer COAS-HD VR was used to measure the aberrations in the peripheral vision. Aberrations of the right eye of 30 emmetropes (24 {+/-} 4 years) were studied. Off-axis aberrations were measured in steps of 10{degrees} out to {+/-} 30{degrees} in the horizontal visual field. The subjects turned their eye to view the off-axis fixation target (light emitting diode placed at 3 meters) during the measurement. The resulting wavefront aberrations were parameterized with Zernike coefficients for a 5 mm diameter pupil. All analyzes are reported according to optical society of America (OSA) recommended standards. ResultsAberrations from the 2nd to 6th order and the total higher-order root-mean-square (HO RMS) were analyzed using one-way ANOVA. The defocus C02 was significantly myopic in the nasal visual field (+20{degrees}, +30{degrees}) whereas there was no significant difference in the temporal visual field. Astigmatism C22 increased quadratically from {+/-}10{degrees} in the periphery and coma C13 showed a linear increase across the horizontal visual field (p < 0.05). The spherical aberration C04 and the total HO RMS showed a significant change at {+/-}30o. ConclusionsOur results showed that in young emmetropes there was a significant increase of HO RMS at {+/-}30{degrees}, which is expected. Astigmatism, horizontal coma, and spherical aberration vary systematically across the horizontal visual field in agreement with Seidel theory. The findings of our study with a large sample of emmetropic population agree with the previous studies done with laboratory built aberrometers.

  • 40. Baskaran, Karthikeyan
    et al.
    Unsbo, Peter
    KTH, School of Engineering Sciences (SCI), Applied Physics, Biomedical and X-ray Physics.
    Gustafsson, Jörgen
    Influence of Age on Peripheral Ocular Aberrations2011In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 88, no 9, 1088-1098 p.Article in journal (Refereed)
    Abstract [en]

    Purpose. To compare peripheral lower and higher order aberrations across the horizontal (+/- 40 degrees) and inferior (-20 degrees) visual fields in healthy groups of young and old emmetropes. Methods. We have measured off-axis aberrations in the groups of 30 younger (24 +/- 3 years) and 30 older (58 +/- 5 years) emmetropes. The aberrations of OD were measured using the COAS-HD VR Shack-Hartmann aberrometer in 10 degrees steps to +/- 40 degrees horizontally and -20 degrees inferiorly in the visual field. The aberrations were quantified with Zernike polynomials for a 4 mm pupil diameter. The second-order aberration coefficients were converted to their respective refraction components (M, J(45), and J(180)). Mixed between-within subjects, analysis of variance were used to determine whether there were significant differences in the refraction and aberration components for the between-subjects variable age and the within-subjects variable eccentricity. Results. Peripheral refraction components were similar in both age groups. Among the higher order coefficients, horizontal coma (C(3)(1)) and spherical aberration (C(4)(0)) varied mostly between the groups. Coma increased linearly with eccentricity, at a more rapid rate in the older group than in the younger group. Spherical aberration was more positive in the older group compared with the younger group. Higher order root mean square increased more rapidly with eccentricity in the older group. Conclusions. Like the axial higher order aberrations, the peripheral higher order aberrations of emmetropes increase with age, particularly coma and spherical aberration.

  • 41.
    Baskaran, Karthikeyan
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Unsbo, Peter
    Biomedical and X-Ray Physics.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Influence of age on peripheral ocular aberrations.2011In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 88, no 9, 1088-1098 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE.: To compare peripheral lower and higher order aberrations across the horizontal (±40°) and inferior (-20°) visual fields in healthy groups of young and old emmetropes. METHODS.: We have measured off-axis aberrations in the groups of 30 younger (24 ± 3 years) and 30 older (58 ± 5 years) emmetropes. The aberrations of OD were measured using the COAS-HD VR Shack-Hartmann aberrometer in 10° steps to ±40° horizontally and -20° inferiorly in the visual field. The aberrations were quantified with Zernike polynomials for a 4 mm pupil diameter. The second-order aberration coefficients were converted to their respective refraction components (M, J45, and J180). Mixed between-within subjects, analysis of variance were used to determine whether there were significant differences in the refraction and aberration components for the between-subjects variable age and the within-subjects variable eccentricity. RESULTS.: Peripheral refraction components were similar in both age groups. Among the higher order coefficients, horizontal coma (C3) and spherical aberration (C4) varied mostly between the groups. Coma increased linearly with eccentricity, at a more rapid rate in the older group than in the younger group. Spherical aberration was more positive in the older group compared with the younger group. Higher order root mean square increased more rapidly with eccentricity in the older group. CONCLUSIONS.: Like the axial higher order aberrations, the peripheral higher order aberrations of emmetropes increase with age, particularly coma and spherical aberration.

  • 42.
    Beckman Rehnman, Jeannette
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    New methods to evaluate the effect of conventional and modified crosslinking treatment for keratoconus2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Today corneal crosslinking with ultraviolet-A photoactivation of riboflavin is an established method to halt the progression of keratoconus. In some cases, when the refractive errors are large and the visual acuity is low, conventional corneal crosslinking may not be sufficient. In these cases it would be desirable with a treatment that both halts the progression and also reduces the refractive errors and improves the quality of vision.

    Aims:  The aims of this thesis were to determine whether mechanical compression of the cornea during corneal crosslinking for keratoconus using a sutured rigid contact lens could improve the optical and visual outcomes of the treatment, and also to find methods to evaluate the effect of different corneal crosslinking treatment regimens.

    Methods: In a prospective, open, randomized case-control study, 60 eyes of 43 patients with progressive keratoconus, aged 18-28 years, planned for routine corneal crosslinking, and a corresponding age- and sex-matched control group was included. The patients were randomized to conventional corneal crosslinking (CXL; n=30) or corneal crosslinking with mechanical compression of the cornea during the treatment (CRXL; n=30).

    Biomicroscopy, autorefractometry, best spectacle corrected visual acuity, axial length measurement, Pentacam® HR Scheimpflug photography, pachymetry, intraocular pressure measurements and corneal biomechanical assessments were performed before treatment (baseline) and at 1 month and 6 months after the treatment.

    One of the articles evaluated and compared the optical and visual outcomes between CXL and CRXL, while the other three articles focused on methods to evaluate treatment effects. In Paper I, the corneal light scattering was manually quantified from Scheimpflug images throughout the corneal thickness at 8 measurements points, 0.0 to 3.0 mm from the corneal centre, in patients treated with CXL. In Paper IV the corneal densitometry (light scattering) was measured with the Pentacam® HR software, in 4 circular zones around the corneal apex and at 3 different depths of the corneal stroma, in both CXL and CRXL treated corneas. Paper III quantified the biomechanical effects of CXL in vivo.

    Results: Corneal light scattering after CXL showed distinctive spatial and temporal profiles and Applanation Resonance Tonometry (ART) -technology demonstrated an increased corneal hysteresis 1 and 6 months after CXL. When comparing the refractive and structural results after CXL and CRXL, CRXL failed to flatten the cornea, and the treatment did not show any benefits to conventional CXL treatment, some variables even indicated an inferior effect. Accordingly, the increase in corneal densitometry was also less pronounced after CRXL.

    Conclusions: Analysis of corneal light scattering/densitometry shows tissue changes at the expected treatment location, and may be a relevant variable in evaluating the crosslinking effect. ART -technology is an in vivo method with the potential to assess the increased corneal hysteresis after CXL treatment. By refining the method, ARTmay become a useful tool in the future. Unfortunately, CRXL does not improve the optical and visual outcomes after corneal crosslinking. Possibly, stronger crosslinking would be necessary to stabilize the cornea in a flattened position.

  • 43.
    Beckman Rehnman, Jeannette
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Hallberg, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Initial results from mechanical compression of the cornea during crosslinking for keratoconus2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 7, 644-649 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: To compare refractive changes after corneal crosslinking with and without mechanical compression of the cornea.

    Methods: In a prospective, open, randomized case-control study conducted at the Department of Ophthalmology, Umeå University Hospital, Sweden, sixty eyes of 43 patients with progressive keratoconus aged 18-28 years planned for corneal crosslinking and corresponding age- and sex-matched control subjects were included. The patients were randomized to conventional corneal crosslinking (CXL; n = 30) or corneal crosslinking with mechanical compression using a flat rigid contact lens sutured to the cornea during treatment (CRXL; n = 30). Subjective refraction and ETDRS best spectacle-corrected visual acuity (BSCVA), axial length measurement, keratometry and pachymetry were performed before and 1 and 6 months after treatment.

    Results: The keratoconus patients had poorer BSCVA, higher refractive astigmatism and higher keratometry readings than the control subjects at baseline (p < 0.01). In the CXL group, BSCVA increased from 0.19 ± 0.26 to 0.14 ± 0.18 logMar (p = 0.03), and the spherical equivalent improved from -1.9 ± 2.8 D to -1.4 ± 2.4 D (p = 0.03). Maximum keratometry readings decreased after CXL from 53.1 ± 4.9 D to 52.6 ± 5.2 D (p = 0.02), and the axial length decreased in the CXL group, likely due to post-treatment corneal thinning (p = 0.03). In the CRXL group, all the above variables were unaltered (p > 0.05).

    Conclusion: At 6 months, the refractive results from CRXL did not surpass those of conventional CXL treatment. Rather, some variables indicated a slightly inferior effect. Possibly, stronger crosslinking would be necessary to stabilize the cornea in the flattened configuration achieved by the rigid contact lens.

  • 44.
    Beckman Rehnman, Jeannette
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Hallberg, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Increased corneal hysteresis after corneal collagen crosslinking: a study based on applanation resonance technology2014In: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 132, no 12, 1426-1432 p.Article in journal (Refereed)
    Abstract [en]

    Importance: A reliable tool for quantification of the biomechanical status of the cornea in conjunction with corneal collagen crosslinking (CXL) treatment is needed.

    Objective: To quantify the biomechanical effects of CXL in vivo.

    Design, Setting, and Participants: A prospective, open, case-control study was conducted at the Department of Ophthalmology, Umeå University, Umeå, Sweden. Participants included 28 patients (29 eyes) aged 18 to 28 years with progressive keratoconus and corresponding age- and sex-matched healthy individuals serving as controls. All participants were monitored during a 6-month period between October 13, 2009, and November 5, 2012.

    Main Outcomes and Measures: Corneal hysteresis after CXL for keratoconus.

    Results: A difference in corneal hysteresis between the control group and the patients with keratoconus was found at baseline, both with an applanation resonance tonometer (ART) and an ocular response analyzer (ORA), at mean (SD) values of -1.09 (1.92) mm Hg (99% CI, -2.26 to 0.07; P = .01) and -2.67 (2.55) mm Hg (99% CI, -4.05 to -1.32; P < .001), respectively. Increased corneal hysteresis was demonstrated with an ART 1 and 6 months after CXL, at 1.2 (2.4) mm Hg (99% CI,-0.1 to 2.5; P = .02) and 1.1 (2.7) mm Hg (99% CI, -0.3 to 2.6; P = .04), respectively, but not with ORA. A decrease in corneal thickness was seen 1 and 6 months after treatment (-24 [26] µm, P < .001; and -11 [21] µm, P = .01, respectively), and a corneal flattening of -0.6 (0.7) diopters was seen at 6 months (P < .001). No significant change in intraocular pressure was identified in patients with keratoconus with any method, except for an increase at 1 month with Goldmann applanation tonometry (P = .005).

    Conclusions and Relevance: To our knowledge ART is the first in vivo method able to assess the increased corneal hysteresis after CXL treatment. Given the large-scale use of CXL in modern keratoconus treatment, a tool with this capacity has a great potential value. Refinement of the ART method of measuring and quantifying corneal biomechanical properties will be a subject of further studies.

  • 45.
    Beckman Rehnman, Jeannette
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Janbaz, Chris C.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Spatial distribution of corneal light scattering after corneal collagen crosslinking2011In: Journal of cataract and refractive surgery, ISSN 0886-3350, E-ISSN 1873-4502, Vol. 37, no 11, 1939-1944 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess the spatial distribution and time course of increased corneal light scattering after corneal collagen crosslinking (CXL) with riboflavin and ultraviolet-A irradiation.

    Setting: Umeå University Hospital Eye Clinic, Umeå, Sweden.

    Design: Case series.

    Methods: Eyes with keratoconus were examined with Scheimpflug photography before and 1 and 6 months after CXL. Corneal light scattering was quantified throughout the corneal thickness at 8 measurement points 0.0 to 3.0 mm from the central cornea.

    Results: The study comprised 11 eyes of 11 patients. Central corneal light scattering increased significantly 1 month after CXL (P<.001). At 6 months, it decreased (P=.002); however, it was still higher than pretreatment values (P<.001). Light scattering at 1 month was more pronounced in the superficialstroma, gradually diminishing to zero at 240 μm depth. It was greater at the corneal center than 1.0 to 3.0 mm from the center. At 6 months, a second peak of light scattering occurred between 240 μm and 340 μm depth. No increased light scattering deeper than 340 μm was seen at either time point.

    Conclusions: Corneal light scattering after CXL showed distinctive spatial and temporal profiles. Analysis of corneal light scattering may give an impression of tissue changes, the depth of the CXL treatment effect, and the corneal response to the treatment. Scheimpflug photography appears to be useful for this purpose.

  • 46.
    Beckman Rehnman, Jeannette
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Lindén, Christina
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Hallberg, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Treatment Effect and Corneal Light Scattering With 2 Corneal Cross-linking Protocols: A Randomized Clinical Trial2015In: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 133, no 11, 1254-1260 p.Article in journal (Refereed)
    Abstract [en]

    Importance: We describe and evaluate a complementary method to indirectly quantify the treatment effect of corneal cross-linking (CXL). Additional methods to indirectly quantify the treatment effect of CXL are needed.

    Objective: To assess the spatial distribution and the time course of the increased corneal densitometry (corneal light backscatter) seen after CXL with riboflavin and UV-A irradiation.

    Design, Setting, and Participants: Open-label randomized clinical trial of 43 patients (60 eyes) who were 18 to 28 years of age and had progressive keratoconus and a plan to be treated with CXL at Umeå University Hospital, Umeå, Sweden. The patients were randomized to receive conventional CXL (n = 30) using the Dresden protocol or CXL with mechanical compression of the cornea using a flat rigid contact lens sutured to the cornea during the treatment (CRXL) (n = 30). All participants were followed up during a 6-month period from October 13, 2009, through May 31, 2012.

    Interventions: Corneal cross-linking according to the Dresden protocol or CRXL.

    Main Outcomes and Measures: Change in corneal densitometry after CXL and CRXL for keratoconus.

    Results: Of the original 60 eyes included, 4 had incomplete data. A densitometry increase was seen after both treatments that was deeper and more pronounced in the CXL group (difference between the groups at 1 month in the center layer, zone 0-2 mm, 5.02 grayscale units [GSU], 95% CI, 2.92-7.12 GSU; P < .001). This increase diminished with time but was still noticeable at 6 months (difference between the groups at 6 months in the center layer, zone 0-2 mm, 3.47 GSU; 95% CI, 1.72-5.23 GSU; P < .001) and was proportional to the reduction in corneal steepness (R = -0.45 and -0.56 for CXL and CRXL, respectively).

    Conclusions and Relevance: The degree of corneal light backscatter relates to the reduction in corneal steepness after cross-linking and may become a relevant complement to other methods in evaluating the cross-linking effect, for example, when comparing different treatment regimens.

    Trial Registration: clinicaltrials.gov Identifier: NCT02425150.

  • 47.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Effects on pupil size and accommodation from topical lidocaine hydrochloride and tetracaine hydrochloride.2007In: Journal of Ocular Pharmacology and Therapeutics, ISSN 1080-7683, E-ISSN 1557-7732, Vol. 23, no 6, 591-8 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to quantify the mydriatic and cycloplegic effects from topically applied lidocaine hydrochloride 4% and tetracaine hydrochloride 1% in healthy volunteers. METHODS: Twenty-six (26) healthy volunteers age 23 +/- 2.5 years were included in this double-masked, randomized, intraindividually comparing study. All participants were given a drop of lidocaine 4% in 1 eye and tetracaine 1% in the contralateral eye three times with a 90-sec interval, which was subject to randomization. Before the eye drops, and 15, 30, 45, 60, 90, and 120 min after the application of the last drop, Scheimpflug photography was performed in each eye, and the near point was determined using a near-point ruler. Before the eye drops and at 60 and 120 min, the visual acuity was determined with the ETDRS chart. The extent and time course of the mydriatic and cycloplegic responses were determined. RESULTS: Significant pupil dilation was seen with both substances; an increase from 3.25 +/- 0.48 to 3.52 +/- 0.76 mm (8.8 +/- 3.9%; P = 0.036) at 30 min with lidocaine, and from 3.19 +/- 0.46 to 3.44 +/- 0.49 mm (8.8 +/- 2.9%; P = 0.008) at 45 min with tetracaine. A subgroup analysis revealed that a mydriatic effect could only be detected in eyes with pale irides (P < 0.01). In pigmented irides, a slight miotic effect was noted. A decrease in accommodation was also seen: from 9.8 +/- 1.6 to 9.1 +/- 1.7 D (6.3 +/- 2.9%) at 15 min with lidocaine, and from 9.7 +/- 1.4 to 8.8 +/- 1.5 D (7.8 +/- 3.7%) at 30 min with tetracaine. Again, the effect was more pronounced in pale irides (P < 0.05). Both substances induced a small increase in corneal thickness (P < 0.01). A substantial epithelial opacification was noted with tetracaine, but not with lidocaine. CONCLUSIONS: Lidocaine 4% and tetracaine 1% exhibit significant mydriatic effects upon topical administration in eyes with pale irides. The mydriatic effect is more rapid and prolonged with lidocaine than with tetracaine.

  • 48.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Immediate sequential cataract surgery: the pros and cons of a controversial approach.2009In: Acta Ophthalmologica, ISSN 1755-375X, Vol. 87, no 1, 2-3 p.Article in journal (Refereed)
  • 49.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Phacoemulsification in spherophakia with corneal touch2002In: Journal of cataract and refractive surgery, ISSN 0886-3350, E-ISSN 1873-4502, Vol. 28, no 1, 189-191 p.Article in journal (Refereed)
    Abstract [en]

    A phacoemulsification procedure with implantation of a foldable acrylic intraocular lens in a 31-year-old man with spherophakia is described. The procedure was necessitated by anterior dislocation of the spherophakic lens, with corneal endothelial contact and development of central corneal edema. With a careful approach, the procedure was uneventful and the outcome successful. Modern small-incision cataract surgery techniques are of great benefit in this type of complicated case.

  • 50.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    A case of unilateral acid burn.2003In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 81, no 5, 526-529 p.Article in journal (Refereed)
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