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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.

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  • 2.
    Abrahamsson, M.
    et al.
    University of Gothenburg, Sweden.
    Carlsson, B.
    University of Gothenburg, Sweden.
    Törnqvist, M.
    University of Gothenburg, Sweden.
    Sterner, Bertil
    University of Gothenburg, Sweden.
    Sjöstrand, J.
    University of Gothenburg, Sweden.
    Changes of visual function and visual ability in daily life following cataract surgery2009In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 74, no 1, p. 69-73Article in journal (Refereed)
    Abstract [en]

    We conducted a prospective study of 56 patients aged 70 to 79 years undergoing cataract surgery, in order to determine the impact of surgery on subjective and objective measurements of visual ability. In 46 cases we could obtain all necessary data. Binocular visual acuity, near vision and contrast sensitivity improved due to surgery. Self-assessed ability to perform visually related tasks was examined in form of a questionnaire. The results show that there was no simple relationship between objective measurements and perceived visual ability. An impairment in preoperative visual acuity cannot be related to a specific loss of visual ability. In order to increase the quality of cataract surgery more subtly, subjective aspects of vision must be taken into consideration when operation is decided upon and in the evaluation of the results.

  • 3.
    Abu Ishkheidem, Imadeddin
    et al.
    Göteborgs universitet, Göteborg.
    Breimer, Martin
    Popovic, Zoran
    Göteborgs universitet, Göteborg.
    Nygren, Åsa
    Parkhagen, Madeleine
    Andersson Grönlund, Marita
    Göteborgs universitet, Göteborg.
    Health economic effects of DOIT, a new IT-system for diabetic retinopathy primary screening and secondary follow-up2022Conference paper (Other academic)
  • 4.
    Adil, Mohammed Yasin
    et al.
    Univ Oslo, Norway; Norwegian Dry Eye Clin, Norway.
    Xiao, Jiaxin
    Univ Oslo, Norway; Norwegian Dry Eye Clin, Norway.
    Olafsson, Jonatan
    Univ Oslo, Norway.
    Chen, Xiangjun
    Univ Oslo, Norway; Norwegian Dry Eye Clin, Norway; Arendal Hosp, Norway; Vestre Viken Hosp Trust, Norway; Univ Coll Southeast Norway, Norway.
    Lagali, Neil
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Raeder, Sten
    Norwegian Dry Eye Clin, Norway.
    Utheim, Oygunn A.
    Oslo Univ Hosp, Norway.
    Dartt, Darlene A.
    Harvard Med Sch, MA 02115 USA.
    Utheim, Tor P.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Univ Oslo, Norway; Vestre Viken Hosp Trust, Norway; Univ Coll Southeast Norway, Norway; Oslo Univ Hosp, Norway; Oslo Univ Hosp, Norway; Oslo Univ Hosp, Norway.
    Meibomian Gland Morphology Is a Sensitive Early Indicator of Meibomian Gland Dysfunction2019In: American Journal of Ophthalmology, ISSN 0002-9394, E-ISSN 1879-1891, Vol. 200, p. 16-25Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the relationship between meibomian gland (MG) morphology and clinical dry eye tests in patients with meibomian gland dysfunction (MGD). DESIGN: Cross-sectional study. SUBJECTS: Total 538 MGD patients and 21 healthy controls. METHODS: MG loss on meibography images of upper (UL) and lower lids (LL) was graded on a scale of 0 (lowest degree of MG loss) to 3. MG length, thickness, and interglandular space in the UL were measured. Clinical tests included meibum expression and quality, tear film break-up time, ocular staining, osmolarity, Schirmer I, blink interval timing, and Ocular Surface Disease Index (OSDI) questionnaire. RESULTS: Mean UL and LL meibogrades were significantly higher in MGD patients compared to controls (P amp;lt; .001 for UL and LL). The sensitivity and specificity of the meibograde as a diagnostic parameter for MGD was 96.7% and 85%, respectively. Schirmer I was significantly increased in MGD patients with meibograde 1 compared to patients with meibograde 0, 2, and 3 in the UL (P amp;lt; .05 ). MG thickness increased with higher meibograde (P amp;lt; .001). MG morphology correlated significantly but weakly with several clinical parameters (P amp;lt; .05). OSDI did not correlate with any MG morphologic parameter. CONCLUSIONS: Grading of MG loss using meibograde effectively diagnoses MGD. Compensatory mechanisms such as increased aqueous tear production and dilation of MGs make early detection of MGD difficult by standard clinical measures of dry eye, whereas morphologic analysis of MGs reveals an early stage of MGD, and therefore represents a complementary clinical parameter with diagnostic potential. (C) 2018 Elsevier Inc. All rights reserved.

  • 5.
    Adler, Jeremy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Colour blindness: journals should enable image redisplay2021In: Nature, ISSN 0028-0836, E-ISSN 1476-4687, Vol. 599, no 7883, p. 32-32Article in journal (Other academic)
  • 6.
    Adrian, Monica Lovestam
    et al.
    Lund Univ, Dept Ophthalmol, SE-22185 Lund, Sweden.
    Vassilev, Zdravko P.
    Bayer US, Whippany, NJ USA.
    Westborg, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Baseline visual acuity as a prognostic factor for visual outcomes in patients treated with aflibercept for wet age-related macular degeneration: data from the INSIGHT study using the Swedish Macula Register2019In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 97, no 1, p. 91-98Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess mean change in visual acuity (VA) overall and stratified by baseline VA after 1 and 2 years' treatment with aflibercept in a real-life setting.

    Methods: This was an observational cohort study using nationwide data from the Swedish Macula Register. Treatment-naive patient eyes with wet age-related macular degeneration and prescribed aflibercept from January 2013 to December 2014 were followed for 1 year (2478 eyes) or 2 years (831 eyes) to assess VA. Eyes were grouped by baseline VA.

    Results: Mean number of injections in patients treated according to label (72%) versus patients treated not according to label was 8.0 +/- 1.5 versus 4.4 +/- 0.8 (p < 0.0001) at 1 year, and 12.5 +/- 3.2 versus 7.3 +/- 1.9 (p < 0.0001) at 2 years. Among all eyes, mean VA increased from 61.3 +/- 13.4 Early Treatment Diabetic Retinopathy Study letters at baseline to 64.5 +/- 15.6 at 1 year and 65.1 +/- 15.1 letters at 2 years. At 2 years, eyes with good baseline vision (>= 70 letters) lost a mean of 2.4 +/- 11.3 to 72.3 letters, eyes with intermediate baseline VA (36-69 letters) gained 5.7 +/- 14.1 to 62.7 letters, and eyes with poor baseline VA (<= 35 letters) gained 13.2 +/- 18.3 to 41.0 letters. Also at 2 years, 75% of treated eyes were stable or had improved VA. Among eyes with intermediate baseline VA, near vision was significantly better among those treated according to label versus not according to label at 3 (p = 0.019), 6 (p = 0.0002) and 12 months (p <= 0.0001).

    Conclusion: While gain in vision was especially pronounced in eyes with poor baseline VA, good baseline VA was important for best prognosis.

  • 7.
    Agardh, Elisabet
    et al.
    Lund Univ, Malmö, Sweden.
    Hellgren, Karl-Johan
    Lund Univ, Malmö, Sweden.
    Bengtsson, Boel
    Lund Univ, Malmö, Sweden.
    Stable refraction and visual acuity in diabetic patients with variable glucose levels under routine care2011In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 89, no 2, p. 107-110Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate how refraction and visual acuity may vary in patients with diabetes under routine care.

    METHODS: Fifty-three eyes of 53 patients with various degrees of diabetic retinopathy were examined prospectively on four different occasions within a month. Refraction, best-corrected visual acuity (expressed as logMAR score) and blood glucose were measured on each occasion. Intraindividual variability was calculated as the range between the highest and lowest measurements. Associations between blood glucose levels and each of the other variables were tested by linear regression analysis for each patient.

    RESULTS: Refraction was completely stable in 43 patients and changed only slightly in 10, in whom the mean intraindividual variability of the spherical equivalent was 0.4 dioptres. Visual acuity test results were also highly reproducible. Mean intraindividual variability in visual acuity was 0.08 logMAR. Mean haemoglobin A1c (HbA1c) was 7.3 ± 1.5% but individual blood glucose levels ranged from 2.8 to > 22.2 mmol/l. Intraindividual variability ranged from 0.5 to 18.1 mmol/l, with a median of 6.0 mmol/l for the entire group. There were no associations between refraction or visual acuity and blood glucose levels or inter- or intraindividual glucose variations.

    CONCLUSION: Refraction and visual acuity test results were highly reproducible and stable in patients with reasonably well controlled diabetes but variable blood glucose levels under routine care.

  • 8.
    Ahl, Matilda
    et al.
    Division of Clinical Neurophysiology, Sweden;Lund Universtity, Sweden.
    Avdic, Una
    Division of Clinical Neurophysiology, Sweden;Lund Universtity, Sweden.
    Chary, Karthik
    University of Eastern Finland, Finland.
    Shibata, Keisuke
    Division of Clinical Neurophysiology, Sweden;Lund Universtity, Sweden.
    Chugh, Deepti
    Division of Clinical Neurophysiology, Sweden;Lund Universtity, Sweden.
    Mickelsson, Pernilla Lindén
    Division of Clinical Neurophysiology, Sweden.
    Kettunen, Mikko
    University of Eastern Finland, Finland.
    Strandberg, Maria Compagno
    Lund University, Sweden.
    Englund Johansson, Ulrica
    Lund University, Sweden.
    Sierra, Alejandra
    s, University of Eastern Finland, Finland.
    Ekdahl, Christine T.
    Inflammatory reaction in the retina after focal non-convulsive status epilepticus in mice investigated with high resolution magnetic resonance and diffusion tensor imaging2021In: Epilepsy Research, ISSN 0920-1211, E-ISSN 1872-6844, Vol. 176, article id 106730Article in journal (Refereed)
    Abstract [en]

    Pathophysiological consequences of focal non-convulsive status epilepticus (fNCSE) have been difficult to demonstrate in humans. In rats fNCSE pathology has been identified in the eyes. Here we evaluated the use of high-resolution 7 T structural T1-weighted magnetic resonance imaging (MRI) and 9.4 T diffusion tensor imaging (DTI) for detecting hippocampal fNCSE-induced retinal pathology ex vivo in mice. Seven weeks post-fNCSE, increased number of Iba1+ microglia were evident in the retina ipsilateral to the hemisphere with fNCSE, and morphologically more activated microglia were found in both ipsi- and contralateral retina compared to non-stimulated control mice. T1-weighted intensity measurements of the contralateral retina showed a minor increase within the outer nuclear and plexiform layers of the lateral retina. T1-weighted measurements were not performed in the ipsilateral retina due to technical difficulties. DTI fractional anisotropy(FA) values were discretely altered in the lateral part of the ipsilateral retina and unaltered in the contralateral retina. No changes were observed in the distal part of the optic nerve. The sensitivity of both imaging techniques for identifying larger retinal alteration was confirmed ex vivo in retinitis pigmentosa mice where a substantial neurodegeneration of the outer retinal layers is evident. With MR imaging a 50 % decrease in DTI FA values and significantly thinner retina in T1-weighted images were detected. We conclude that retinal pathology after fNCSE in mice is subtle and present bilaterally. High-resolution T1-weighted MRI and DTI independently did not detect the entire pathological retinal changes after fNCSE, but the combination of the two techniques indicated minor patchy structural changes.

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  • 9.
    Ahl, Matilda
    et al.
    Lund University, Sweden.
    Avdic, Una
    Lund University, Sweden.
    Skoug, Cecilia
    Lund University, Sweden.
    Ali, Idrish
    Lund University, Sweden.
    Chugh, Deepti
    Lund University, Sweden.
    Englund Johansson, Ulrica
    Lund University, Sweden.
    Ekdahl, Christine T
    Lund University, Sweden.
    Immune response in the eye following epileptic seizures2016In: Journal of Neuroinflammation, E-ISSN 1742-2094, Vol. 13, no 1, article id 155Article in journal (Refereed)
    Abstract [en]

    Background: Epileptic seizures are associated with an immune response in the brain. However, it is not known whether it can extend to remote areas of the brain, such as the eyes. Hence, we investigated whether epileptic seizures induce inflammation in the retina.

    Methods: Adult rats underwent electrically induced temporal status epilepticus, and the eyes were studied 6 h, 1, and 7 weeks later with biochemical and immunohistochemical analyses. An additional group of animals received CX3CR1 antibody intracerebroventricularly for 6 weeks after status epilepticus.

    Results: Biochemical analyses and immunohistochemistry revealed no increased cell death and unaltered expression of several immune-related cytokines and chemokines as well as no microglial activation, 6 h post-status epilepticus compared to non-stimulated controls. At 1 week, again, retinal cytoarchitecture appeared normal and there was no cell death or micro- or macroglial reaction, apart from a small decrease in interleukin-10. However, at 7 weeks, even if the cytoarchitecture remained normal and no ongoing cell death was detected, the numbers of microglia were increased ipsi- and contralateral to the epileptic focus. The microglia remained within the synaptic layers but often in clusters and with more processes extending into the outer nuclear layer. Morphological analyses revealed a decrease in surveying and an increase in activated microglia. In addition, increased levels of the chemokine KC/GRO and cytokine interleukin-1β were found. Furthermore, macroglial activation was noted in the inner retina. No alterations in numbers of phagocytic cells, infiltrating macrophages, or vascular pericytes were observed. Post-synaptic density-95 cluster intensity was reduced in the outer nuclear layer, reflecting seizure-induced synaptic changes without disrupted cytoarchitecture in areas with increased microglial activation. The retinal gliosis was decreased by a CX3CR1 immune modulation known to reduce gliosis within epileptic foci, suggesting a common immunological reaction.

    Conclusions: Our results are the first evidence that epileptic seizures induce an immune response in the retina. It has a potential to become a novel non-invasive tool for detecting brain inflammation through the eyes.

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  • 10.
    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, p. 149-155Article 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.

  • 11.
    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, E-ISSN 1552-5783, Vol. 51, no 7, p. 3494-3501Article 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.

  • 12.
    Akram, Muhammad Nadeem
    et al.
    University of South-Eastern Norway, Norway.
    Baraas, Rigmor C.
    University of South-Eastern Norway, Norway.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Improved wide-field emmetropic human eye model based on ocular wavefront measurements and geometry-independent gradient index lens2018In: Optical Society of America. Journal A: Optics, Image Science, and Vision, ISSN 1084-7529, E-ISSN 1520-8532, Vol. 35, no 11, p. 1954-1967Article in journal (Refereed)
    Abstract [en]

    There is a need to better understand the peripheral optics of the human eye and their correction. Current eye models have some limitations to accurately predict the wavefront errors for the emmetropic eye over a wide field. The aim here was to develop an anatomically correct optical model of the human eye that closely reproduces the wavefront of an average Caucasian-only emmetropic eye across a wide visual field. Using an optical design program, a schematic eye was constructed based on ocular wavefront measurements of the right eyes of thirty healthy young emmetropic individuals over a wide visual field (from 40&#x00B0; nasal to 40&#x00B0; temporal and up to 20&#x00B0; inferior field). Anatomical parameters, asymmetries, and dispersion properties of the eye&#x2019;s different optical components were taken into account. A geometry-independent gradient index model was employed to better represent the crystalline lens. The RMS wavefront error, wavefront shapes, dominant Zernike coefficients, nasal-temporal asymmetries, and dispersion properties of the developed schematic eye closely matched the corresponding measured values across the visual field. The developed model can help in the design of wide-field ophthalmic instruments and is useful in the study and simulations of the peripheral optics of the human eye.

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  • 13.
    Alahamami, Mastour A.
    et al.
    Indiana University, USA.
    Elsner, Ann E.
    Aeon Imaging, USA;Indiana University, USA.
    Baskaran, Karthikeyan
    Indiana University, USA.
    YoussefAgha, Ahmed H.
    Indiana University, USA.
    Brahm, Shane
    Indiana University, USA.
    Young, Stuart B.
    Indiana University, USA.
    Litvin, Taras V.
    University of California Berkeley, USA.
    Ozawa, Glen Y.
    University of California Berkeley, USA.
    Cuadros, Jorge
    University of California Berkeley, USA.
    Muller, Matthew S.
    Aeon Imaging, USA.
    Investigation of Photoreceptors in Diabetic Macular Edema2014In: IOVS, Orlando, Florida, USA, 2014, Vol. 155(13)Conference paper (Refereed)
    Abstract [en]

    Abstract Purpose: To evaluate the photoreceptor integrity in diabetic patients with macular edema using spectral domain optical coherence tomography (SD-OCT) Methods: We compared macular thickness in diabetic patients with and without macular edema to determine the role of damage to the external limiting membrane (ELM) or photoreceptors. Diabetic patients were selected from the screening study of &gt; 2000 minority patients seen at Eastmont Wellness Center, Oakland, CA. Patients underwent photoscreening with a Canon Cr-DGi nonmydriatic camera (Tokyo, Japan) and an iVue OCT (Optovue Inc, Fremont, CA). Retinal scans of 70 diabetic patients, age range 33-68 yr., were selected so that A) 50% of patients had clinical significant macular edema (CSME), as diagnosed by the presence of hard exudates within 1 disc diameter from the fovea in the color photos, B) the full range of central macular thicknesses in our population was included. And C) patients with CSME were the same age as those not diagnosed with CSME. We graded the retinal scans according to the external limiting membrane (ELM) integrity; 6 patients had damaged ELM and the remaining 64 had intact ELM. Similarly, we graded the retinal scans according to the photoreceptor integrity; 14 patients had damaged photoreceptors and the remaining 56 had intact photoreceptors Results: Average retinal thickness was 254 µm (±57.4) and 356 µm (±95.9) in patients with intact and damaged ELM, respectively; and was 240 µm (±30.0), and 363 µm (±90.0) in patients with intact and damaged photoreceptors, respectively. Retinal thickness means were significantly greater for patients with damaged compared with intact ELM ( P=0.031). Similarly, Retinal thickness means in patients with damaged photoreceptors were significantly greater compared to patients with intact photoreceptors ( P = 0.0001). We also observed that all 6 patients who have damaged ELM were diagnosed with CSME, but were not significantly older than the diabetic patients not diagnosed with CSME ( P = 0.393) Conclusions: ELM and photoreceptor layer damage are found more often when retinal thickness exceeds 355 µm. It is not known if this outer retinal damage is the result of the edema or whether there is more edema because the outer retinal blood brain barrier is failing

  • 14. Alahamami, Mastour A.
    et al.
    Elsner, Ann E.
    Indiana University School of Optometry, USA.
    Muller, Matthew S.
    Aeon Imaging, USA.
    Baskaran, Karthikeyan
    Indiana University School of Optometry, USA.
    Gast, Thomas J.
    Indiana University School of Optometry, USA.
    Litvin, Taras V.
    Indiana University School of Optometry, USA.
    Ozawa, Glen Y.
    University of California Berkeley, USA.
    Cuadros, Jorge
    University of California Berkeley, USA.
    Haggerty, Bryan P.
    Indiana University School of Optometry, USA.
    Malinovsky, Victor E.
    Indiana University School of Optometry, USA.
    Clark, Christopher A.
    Indiana University School of Optometry, USA.
    Brahm, Shane
    Indiana University School of Optometry, USA.
    Young, Stuart B.
    Indiana University School of Optometry, USA.
    Comparison of cysts in red and green images for diabetic macular edema2014Conference paper (Refereed)
    Abstract [en]

    Purpose: To improve the detection of macular cyst with photoscreening, we tested whether in a population of largely minority patients the red channel image from a color fundus camera visualizes cysts in diabetic macular edema better than the green channel image. In assessing diabetic retinas for clinically significant macular edema, the presence of cysts must be judged with respect to the central macula. Some grading programs use red free images, often derived from green channel images, to enhance visualization of retinal vessel damage or macular pigment, but some red and near infrared instruments have detected cysts better than short wavelength techniques. Methods: We evaluated macular cysts in 13 diabetic patients diagnosed with clinically significant macular edema, age range 33-68 years. Diabetic patients were selected from the screening study of >2000 underserved patients seen at Eastmont Wellness Center, Oakland, CA. Patients underwent photoscreening with a nonmydriatic color fundus camera (Canon Cr-DGi, Tokyo, Japan) and SD-OCT (iVue, Optovue Inc, Fremont, CA). The color fundus images for those patients were transformed into red and green channels to evaluate the appearance of macular cysts in red channel images and green channel images. The region of each cyst was compared SD-OCT scans (Adobe Photoshop CS5.1, San Jose, CA). Only cysts touching the central 1 mm around the fixation from the SD-OCT scans were sampled. Results: The average size of retinal cysts in red channel images, 124.57 µm (±106.96), was significantly greater than in green channel, 59.44 µm (±76.6), (p<0.006). Entire cysts could not be seen in 5 eyes in the green channel images. Conclusions: Our results indicate that the grading of cysts in the central macular might be improved by incorporating red channel images. There are a number of potential factors that could make cysts less visible in the green channel images, including poorer light penetration through to the deeper retina or macular pigment. Anterior segment issues impact more on green channel images. This population includes mostly minority patients who have dark fundi, and darker images.

  • 15.
    Alarcon, Aixa
    et al.
    Johnson Johnson Surg Vision Inc, Groningen, Netherlands..
    Canovas, Carmen
    Johnson Johnson Surg Vision Inc, Groningen, Netherlands..
    Van der Mooren, Marrie
    Johnson Johnson Surg Vision Inc, Groningen, Netherlands..
    Janakiraman, Priya
    Johnson Johnson Surg Vision Inc, Groningen, Netherlands..
    Rosen, Robert
    Johnson Johnson Surg Vision Inc, Groningen, Netherlands..
    Lundström, Linda
    KTH, School of Engineering Sciences (SCI), Applied Physics, Biomedical and X-ray Physics.
    Chang, Daniel H.
    Empire Eye Laser Ctr, Bakersfield, CA USA..
    Clinical measurements of peripheral contrast sensitivity in elderly phakic and pseudophakic eyes2022In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 63, no 7Article in journal (Other academic)
  • 16.
    Alhamami, Mastour
    et al.
    Indiana University, USA.
    Elsner, Ann
    Indiana University, USA;Aeon Imaging, USA.
    Malinovsky, Victor
    Indiana University, USA.
    Clark, Christopher
    Haggerty, Bryan
    Indiana University, USA.
    Ozawa, Glen
    University of California, USA.
    Cuadros, Jorge A
    University of California, USA ; EyePACS, USA.
    Baskaran, Karthikeyan
    Indiana University, USA.
    Gast, Thomas
    Indiana University, USA;Aeon Imaging, USA.
    Litvin, Taras
    University of California, USA.
    Muller, Matthew
    Aeon Imaging, USA.
    Brahm, Shane
    Indiana University, USA.
    Young, Stuart
    Indiana University, 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 2, p. 137-149Article 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.

  • 17.
    Al-Hawasi, Abbas
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Retinal ganglion cell examination with Optical Coherence Tomography reflects physiological and pathological changes in the eye and the brain.2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The retinal ganglion cell is situated in the inner retina and its axons, composing the retinal nerve fiber layer (RNFL), leave the eye to form the optic nerve. These cells develop embryologically from the forebrain and later during development re-establish connections with different parts of the brain serving different purposes. This unique position and connections make it possible to be investigated with different methods. Optical Coherence Tomography (OCT) is an accessible and easily operated clinical device that can provide a detailed image of this layer at a few micrometers level of precision in measurements. In this thesis we aimed to see whether examining these cells with OCT could reflect physiological and pathological changes in the eye and brain.

    In cases of optic neuritis (Paper I), the OCT examination showed early thickening of the peripapillary (pRNFL) followed by thinning which takes 6-9 months to reduce to below normal thickness without the ability to distinguish between the real from pseudo thinning. The ganglion cell -inner plexiform layer (GCL-IPL) layer, however, showed a thickness reduction within a few weeks to 3 months without pseudo thinning.         

    In cases of Idiopathic Intracranial Hypertension (IIH) (Paper II), the GCL-IPL remained unchanged and there was no difference in pRNFL thickness compared to healthy controls, whereas  the optic disc parameters of rim thickness, rim area, cup volume and cup/disc ratio differed significantly (P<0.05).

    In cases of benign multiple sclerosis (Paper IV), the OCT could detect that eyes which are not affected by optic neuritis had an annual thinning rate of the RNFL and GCL-IPL similar to a healthy population (P>0.05) which may indicate the benign course of the disease.       

    In cases of physiological factors affecting the GCL in healthy population (Paper III) the OCT examination showed that there was a significant thinning rate of the layer with age (P<0.05), but the thinning was not significant when sex and axial length of the eye were taken into consideration. Males had a thicker GCL volume than females and with age a significant reduction in GCL volume was noted in females but not in males. A Longer axial length of the eye found to be associated with thinner GCL volume.     

    In conclusion retinal ganglion cell changes detected with OCT can reflect physiological and pathological changes in the eye and brain.   

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  • 18.
    Al-Hawasi, Abbas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Retinal ganglion cell layer thickness and volume measured by OCT changes with age, sex, and axial length in a healthy population2022In: BMC Ophthalmology, E-ISSN 1471-2415, Vol. 22, no 1, article id 278Article in journal (Refereed)
    Abstract [en]

    Background The ganglion cell layer (GCL) measurements with Optical Coherence Tomography (OCT) are important for both ophthalmologists and neurologists because of their association with many ophthalmic and neurological diseases. Different factors can affect these measurements, such as brain pathologies, ocular axial length (AL) as well as age and sex. Studies conducted to measure the GCL have overlooked many of these factors. The purpose of this study is to examine the effect of age, sex, and AL on normal retinal GCL thickness and volume in a healthy population without any neurological diseases. Methods A prospective cross-sectional study was designed to measure GCL thickness and total volume with OCT with automated segmentation and manual correction where needed. Visual acuity, AL, and autorefraction were also measured. A mixed linear model was used to determine the association of the effect of the various parameters on the GCL thickness and volume. Results One hundred and sixteen eyes of 60 subjects (12-76 years of age, 55% female) were examined of which 77% had 0 +/- 2 D of spherical equivalent, and mean axial length was 23.86 mm. About 25% of the OCT-automated GCL measurements required manual correction. GCL thickness did not differ in similar anatomic regions in right and left eyes (P &gt; 0.05). GCL volume was greater in males relative to females after adjustment for age and axial length (1.13 +/- 0.07 mm(3) for males vs 1.09 +/- 0.09 mm(3) for females; P = 0.031). GCL thickness differed between males and females in the inner retinal ring (P = 0.025) but not in the outer ring (P = 0.66). GCL volume declined with age (P = 0.031) but not after adjustment for sex and axial length (P = 0.138). GCL volume declined with longer axial length after adjustment for age and sex (P = 0.048). Conclusion Age, sex and axial length should be taken into consideration when measuring the GCL thickness and volume with OCT. Automated OCT segmentation should be reviewed for manual adjustments.

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  • 19.
    Al-Hawasi, Abbas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Fagerholm, Per
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Link, Yumin
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Neurologiska kliniken i Linköping.
    Longitudinal Optical Coherence Tomography Measurement of Retinal Ganglion Cell and Nerve Fiber Layer to Assess Benign Course in Multiple Sclerosis2023In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 12, no 6, article id 2240Article in journal (Refereed)
    Abstract [en]

    A benign form of multiple sclerosis (BMS) is not easily diagnosed, but changes of the retinal ganglion cell layer-inner plexiform layer (GCL-IPL) and retinal nerve fiber layer (RNFL) may be sensitive to the disease. The aim of this study was to use optical coherence tomography (OCT) to investigate longitudinal changes of GCL-IPL and RNFL in BMS. Eighteen patients with BMS and 22 healthy control (HC) subjects were included, with a mean follow-up period of 32.1 months in BMS and 34.3 months in HC. Mean disease duration in BMS was 23.3 years, with 14 patients left untreated. Unilateral optic neuritis (ON) was found in eight patients. Non-ON eyes showed thinner GCL-IPL layer in the BMS group relative to HC (p &lt; 0.001). The thinning rate of GCL-IPL in non-ON BMS, however, was -0.19 +/- 0.15 mu m/year vs. 0 +/- 0.11 mu m/year for HC (p = 0.573, age-adjusted). Thinning rate of RNFL in non-ON BMS was -0.2 +/- 0.27 mu m/year vs. -0.05 +/- 0.3 mu m/year for HC (p = 0.454, age adjusted). Conclusions: Thinning rate of the GCL-IPL and RNFL in BMS is similar to the healthy population but differs from the thinning rate in relapsing-remitting MS, presenting a non-invasive OCT-based criterion for assessing a benign course in multiple sclerosis.

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  • 20.
    Ali, Sara
    et al.
    Department of Clinical Neuroscience, Göteborgs universitet Institutionen for neurovetenskap och fysiologi, Göteborg, Sweden.
    Lind, Alexandra
    Department of Clinical Neuroscience, Göteborgs universitet Institutionen for neurovetenskap och fysiologi, Göteborg, Sweden.
    Ovik, Titus
    Department of Clinical Neuroscience, Göteborgs universitet Institutionen for neurovetenskap och fysiologi, Göteborg, Sweden.
    Aring, Eva
    Department of Clinical Neuroscience, Göteborgs universitet Institutionen for neurovetenskap och fysiologi, Göteborg, Sweden; Department of Ophthalmology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Popovic, Zoran
    Department of Clinical Neuroscience, Göteborgs universitet Institutionen for neurovetenskap och fysiologi, Göteborg, Sweden.
    Dahlgren, Jovanna
    Department of Pediatrics, Göteborgs universitet, Institutionen for kliniska vetenskaper, Göteborg, Sweden.
    Andersson Grönlund, Marita
    Örebro University, School of Medical Sciences. Department of Clinical Neuroscience, Göteborgs universitet Institutionen for neurovetenskap och fysiologi, Göteborg, Sweden; Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Ocular Fundus Morphology and Visual Function in Adolescents Born Moderate-to-Late Preterm2023In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 64, no 8, article id 1424Article in journal (Other academic)
    Abstract [en]

    Purpose: Previous studies have mostly focused on ophthalmological complications associated with being born extremely preterm despite that moderate-to-late preterm (MLP) account for 85% of all preterm births. The aim was to examine fundus morphology and visual function in adolescents born MLP, in comparison with controls born full-term.

    Methods: A prospective population-based cohort study of 247 MLP individuals (110 girls, gestational age 32-36 weeks) with no syndromes or history of retinopathy of prematurity participated in a neonatal study in 2002-2004. Later on, they have been included in ophthalmological follow-up studies at age 8 (n=50) and 12 (n=22). In the present study, 50 adolescents (26 girls; mean age 16.5 years) were examined regarding best corrected visual acuity (BCVA), refraction, and ocular morphology, measured by optical coherence tomography (Topcon, Japan). A group of 50 adolescents (30 girls, mean age 16.7 years) born full-term served as controls. Participants with refraction outside +/-6 diopters were excluded. T-test was used for statistical analysis.

    Results: The MLP-group (n=48) showed a thinner macular retinal nerve fibre layer (RNFL) inner mean in right eye (RE) (26.4±1.5 vs 27.1±1.7 μm; p=0.029) and in left eye (LE) (26.3±1.5 vs 27.0±1.5 μm; p=0.022) compared with controls. A thinner macular RNFL outer mean was found both in RE (40.2±4.4 vs 42.6±4.2 μm; p=0.011) and LE (40.3±4.0 vs 42.1±4.3 μm; p=0.034) (Fig.1A-B). A thicker central macular retinal thickness (MRT) (249.3±20.9 vs 239.9±16.4 μm; p=0.016) and a thinner total peripapillary (pp)RNFL (104.8±8.8 vs 109.1±8.3 μm; p=0.027) were found in RE. The BCVA in best eye was lower in the MLP-group (n=50) compared with controls (-0.09±0.08 vs -0.12±0.09 logMAR; p=0.022). At age 8, MLP births showed a thinner total macular volume and a thicker foveal minimum, central MRT, and central macular RNFL in RE. At age 12, a thicker foveal minimum and thinner outer macular RNFL were found in LE.

    Conclusions: MLP-birth may be associated with ophthalmological macular and ppRNFL changes as well as lower BCVA in adolescence. Similar morphology findings have been shown at younger ages, thus the fundus results persist into young adulthood.

  • 21.
    Ali, Zaheer
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Zang, Jingjing
    Univ Zurich, Switzerland.
    Lagali, Neil S
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Schmitner, Nicole
    Univ Innsbruck, Austria.
    Salvenmoser, Willi
    Univ Innsbruck, Austria.
    Mukwaya, Anthony
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences.
    Neuhauss, Stephan C. F.
    Univ Zurich, Switzerland.
    Jensen, Lasse
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Kimmel, Robin A.
    Univ Innsbruck, Austria.
    Photoreceptor Degeneration Accompanies Vascular Changes in a Zebrafish Model of Diabetic Retinopathy2020In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 61, no 2, article id UNSP 43Article in journal (Refereed)
    Abstract [en]

    PURPOSE. Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness worldwide in the working-age population, and the incidence is rising. Until now it has been difficult to define initiating events and disease progression at the molecular level, as available diabetic rodent models do not present the full spectrum of neural and vascular pathologies. Zebrafish harboring a homozygous mutation in the pancreatic transcription factor pdx1 were previously shown to display a diabetic phenotype from larval stages through adulthood. In this study, pdx1 mutants were examined for retinal vascular and neuronal pathology to demonstrate suitability of these fish for modeling DR. METHODS. Vessel morphology was examined in pdx1 mutant and control fish expressing the fli1a:EGFP transgene. We further characterized vascular and retinal phenotypes in mutants and controls using immunohistochemistry, histology, and electron microscopy. Retinal function was assessed using electroretinography. RESULTS. Pdx1 mutants exhibit clear vascular phenotypes at 2 months of age, and disease progression, including arterial vasculopenia, capillary tortuosity, and hypersprouting, could be detected at stages extending over more than 1 year. Neural-retinal pathologies are consistent with photoreceptor dysfunction and loss, but do not progress to blindness. CONCLUSIONS. This study highlights pdx1 mutant zebrafish as a valuable complement to rodent and other mammalian models of DR, in particular for research into the mechanistic interplay of diabetes with vascular and neuroretinal disease. They are furthermore suited for molecular studies to identify new targets for treatment of early as well as late DR.

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  • 22.
    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, p. 267-276Article 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.

  • 23.
    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, E-ISSN 1552-5783, Vol. 50, no 11, p. 5120-5129Article 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.

  • 24.
    Allvin, K.
    et al.
    Gothenburg Pediatric Growth Research Center (GP-GRC), Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg and The Queen Silvia Children’s Hospital, Gothenburg, Sweden.
    Hellström, A.
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Dahlgren, J.
    Gothenburg Pediatric Growth Research Center (GP-GRC), Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg and The Queen Silvia Children’s Hospital, Gothenburg, Sweden.
    Andersson Grönlund, Marita
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Birth weight is the most important predictor of abnormal retinal vascularisation in moderately preterm infants2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 6, p. 594-600Article in journal (Refereed)
    Abstract [en]

    AIM: To find predictors of abnormal retinal vascularisation in moderately to late preterm newborn infants considered to have no risk of developing retinopathy of prematurity.

    METHODS: Seventy-eight infants (34 girls) were recruited from a longitudinal study of otherwise healthy premature children born at a gestational age of 32 + 0-36 + 6 weeks. Retinal vessel morphology was evaluated at mean postnatal age 7 days. Insulin-like growth factor-I (IGF-I) levels were analysed in umbilical cord blood.

    RESULTS: Of the 78 infants, 21 (27%) had abnormal retinal vessel morphology; they had significantly lower median (range) birth weight [1850 g, (1190-3260), vs. 2320, (1330-3580), p < 0.0001], shorter birth length [43.0 cm, (38-49), vs. 46.0, (40-50), p < 0.0001] and smaller head circumference [31.0 cm, (27.7-34.0), vs. 32.0, (27.5-36.5), p = 0.003]. They also had significantly lower gestational age [34 + 1 weeks, (32 + 2-35 + 3), vs. 34 + 6, (32 + 2-36 + 6), p = 0.004] and mean ± SD IGF-I levels (24.6 ± 17.0 μg/L vs. 46.7 ± 21.5, p < 0.0001). A higher percentage of these infants were small for gestational age (57.1% vs. 15.8%, p = 0.001), and maternal hypertension/preeclampsia rates were also higher (47.6% vs. 19.3%, p = 0.03). Step-wise logistic regression showed that birth weight was the strongest predictor of abnormal retinal vascularisation (p < 0.0001, odds ratio 0.040, 95% confidence interval 0.007-0.216).

    CONCLUSION: In this population of moderately to late preterm newborns, birth weight appeared to affect the retinal vascular system.

  • 25.
    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, p. 957-965Article in journal (Refereed)
  • 26.
    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)
  • 27.
    Alm, Albert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Wikström, Carl Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Ekström, Curt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Öhman, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    The effect of metoprolol on intra-ocular pressure in glaucoma. A pilot study.1979In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 57, no 2, p. 236-242, article id j.1755-3768.1979.tb00487.xArticle in journal (Refereed)
  • 28.
    Alm, Anna
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Phototherapeutic intrastromal corneal collagen cross-linking (PiXL) with two different UV irradiation protocols for treatment of low-grade myopia2017Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 29.
    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”.

  • 30.
    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, E-ISSN 1552-5783, Vol. 54, no 4, p. 2738-2745Article 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.

  • 31.
    Amylon, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Jämförelse av ögonansträngning vid läsning på papper och på mobilskärm2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of this study was to compare Digital Eye Strain DES-symptoms after reading on a printed hardcopy versus a smartphone. To understand if results obtained from earlier studies that have showed DES when reading in from computer also applies to smartphones.

    Methods: 16 participants in the study were asked to read a Swedish book quietly for 20 minutes, either on a hardcopy or on a smartphone. The participants were told to use their normal working distance while reading from book or smartphone. They read the same book with the same textsize and font in both conditions. Directly after reading the participants completed a written questionnaire that consisted of ten questions about their level of ocular discomfort during the task.  

    Results: This study showed significant differences in mean symptom scores between printed hardcopy and smartphone on three of the symptoms; blurred vision while viewing the text (p=0,016), eyestrain (0,023) and tired eyes (0,015). In all three cases the symptoms were higher during smartphone use. No significant differences were found between the other seven symptoms. There were a significant difference in reading distance, smartphone were held closer than the hardcopy.

    Conclusion: This study shows that the symptoms after smartphone use is perceived as more severe than after reading on a hardcopy. The three symptoms that showed a significant difference were all higher after smartphone use.

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  • 32.
    An, Hongbin
    et al.
    HUST, Sch Mech Sci & Engn, Wuhan 430074, Hubei, Peoples R China.
    Chen, Liangzhou
    HUST, Sch Mech Sci & Engn, Wuhan 430074, Hubei, Peoples R China.
    Liu, Xiaojun
    HUST, Sch Mech Sci & Engn, Wuhan 430074, Hubei, Peoples R China.
    Zhao, Bin
    HUST, Sch Mech Sci & Engn, Wuhan 430074, Hubei, Peoples R China.
    Zhang, Hong
    HUST, Tongji Med Coll, Tongji Hosp, Dept Ophthalmol, Wuhan 430074, Hubei, Peoples R China.
    Wu, Zhigang
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Microsystems Technology. HUST, Sch Mech Sci & Engn, Wuhan 430074, Hubei, Peoples R China.
    Microfluidic contact lenses for unpowered, continuous and non-invasive intraocular pressure monitoring2019In: Sensors and Actuators A-Physical, ISSN 0924-4247, E-ISSN 1873-3069, Vol. 295, p. 177-187Article in journal (Refereed)
    Abstract [en]

    Intraocular pressure (IOP) is a crucial physiological indicator of the visual system and play a key role in the diagnosis and treatment of glaucoma. However, the current handheld single measurement tools for IOP sensing cannot meet the future demands for glaucoma management. Thus, here we present the microfluidic contact lens sensors that could provide unpowered, continuous and non-invasive IOP monitoring. The microfluidic contact lens is comprised of a sensing layer of the micropatterned soft-elastomer and a hard plastic reference layer. The devices use the annular sensing chamber filled with the dyed liquid and a sensing microchannel as the IOP transducer. Resulting from the volume variance of the sensing chamber and caused by the deformation of the sensing layer under pressure, the IOP signal is detected as the displacement change of the dyed liquid's interface in the sensing channel, and in which, the displacement change can be optically observed by using the smart-phone camera. Based on the silicone rubber model eyeball, the sensing mechanism of the devices with different design parameters (the position of the sensing chambers and the dimension of the sensing channels) are explored by using the theoretical analyses and experimental investigations. The characteristics of these microfluidic contact lens sensors are tested, in which, the maximum sensitivity of the device (with the sensing chamber of 8.5 mm in diameter and the sensing channel of 100 x 40 um in size) can be achieved to 0.708 mm/mmHg in a working range of 0 (4) over tilde0 mmHg. Also, cyclical tests were conducted and indicated that the devices had a good reversibility and Long-term stability. Furthermore, the device (with the sensing chamber of 5.0 mm in diameter and the sensing channel of 150 x 40 urn in size) was test on the porcine eyes ex vivo, showing a sensitivity of 0.2832 mm/mmHg in a range of 8 (3) over tilde2 mmHg and, the device had a good reproducibility to its IOP change. This work provides a promising approach for unpowered, continuous and non-invasive monitoring of IOP.

  • 33.
    Andersson Grönlund, Marita
    et al.
    Institute of Clinical Neuroscience, Section of Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Department of Pediatric Ophthalmology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital/East, Gothenburg, Sweden.
    Andersson, Susann
    Institute of Clinical Neuroscience, Section of Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Aring, Eva
    Institute of Clinical Neuroscience, Section of Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Hård, Anna-Lena
    Institute of Clinical Neuroscience, Section of Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Hellström, Ann
    Institute of Clinical Neuroscience, Section of Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Ophthalmological findings in a sample of Swedish children aged 4-15 years2006In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 84, no 2, p. 169-176Article in journal (Refereed)
    Abstract [en]

    AIMS: To characterize ophthalmological findings in a sample of Swedish children aged 4-15 years.

    METHODS: A prospective cross-sectional comprehensive ophthalmological investigation was performed on a sample of 143 children (67 girls, 76 boys) aged 4-15 years.

    RESULTS: Visual acuity (VA) in the better eye >or=1.0 (<or=0.0 logMAR) was found in 79% of subjects. None of the children had VA in the better eye <0.5 (>0.3 logMAR). Amblyopia was found in 0.7% of subjects. A total of 68% of the children had no refractive errors. Hyperopia (>or=2.0 dioptres [D] in spherical equivalent [SE]) was found in 9% and myopia (>or=0.5 D SE) in 6% of children. Astigmatism (>or=0.75 D) was recorded in 22% and anisometropia (>or=1.0 D SE) in 3%. A total of 8% were optically corrected. Strabismus was recorded in 3.5%. Signs of visuoperceptual problems were reported in 3% of the children.

    CONCLUSION: This sample of Swedish children may serve as a comparison group regarding ophthalmological findings in children aged 4-15 years.

  • 34.
    Andersson Grönlund, Marita
    et al.
    Department of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Sweden.
    Andersson, Susann
    Department of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Sweden.
    Åkebrand, Rebecka
    Department of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Sweden.
    Seyedi Honarvar, Antovan K.
    Department of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Sweden.
    Sofou, Kalliopi
    Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Darin, Niklas
    Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Tulinius, Mar
    Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Ophthalmologic involvement in Leigh syndrome2017In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 95, no 1, article id e76Article in journal (Refereed)
  • 35.
    Andersson Grönlund, Marita
    et al.
    Institute of Clinical Neuroscience, Section of Ophthalmology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Aring, E.
    Institute of Clinical Neuroscience, Section of Ophthalmology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Hellström, A.
    Institute of Clinical Neuroscience, Section of Ophthalmology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Landgren, M.
    Department of Pediatrics, Hospital of Skaraborg, Skövde, Sweden.
    Strömland, K.
    Institute of Clinical Neuroscience, Section of Ophthalmology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Visual and ocular findings in children adopted from eastern Europe2004In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 88, no 11, p. 1362-1267Article in journal (Refereed)
    Abstract [en]

    AIMS: To evaluate ophthalmological findings in children adopted from eastern Europe.

    METHODS: A prospective study on 72/99 children, born 1990-5 and adopted from eastern Europe to western Sweden during 1993-7 was performed. The children (41 boys; mean age 7.5 years) were compared with an age and sex matched reference group ("ref") of Swedish children.

    RESULTS: 78% of the adopted children had abnormal ocular findings. 26% (ref 4%) had visual acuity (VA) of the better eye < or = 0.5 (> or = 0.3 logMAR) (p = 0.0001) and 8% (ref 0%) were visually impaired (p = 0.01). Amblyopia was found in 15% (ref 2%) (p = 0.005). 22% (ref 10%) were hyperopic (> or = 2.0 D SE) (NS) and 10% (ref 1%) were myopic (> or = 0.5 D SE) (p = 0.03). Astigmatism (> or = 0.75 D) was found in 51% (ref 23%) (p = 0.004). 32% (ref 2%) had strabismus (p<0.0001), mostly esotropia. Four cases had bilateral optic nerve hypoplasia, in three of whom a history of suspected prenatal alcohol exposure was documented. One child had congenital glaucoma. Signs of visuoperceptual problems were recorded in 37% (ref 1%) (p<0.0001).

    CONCLUSION: In this study, children adopted from eastern Europe had a high frequency of ophthalmological findings. Consequently, it is strongly recommended that an ophthalmological examination be performed in these children after arrival in their new home country.

  • 36.
    Andersson Grönlund, Marita
    et al.
    Section of Ophthalmology, Institute of Clinical Neuroscience, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Aring, E.
    Section of Ophthalmology, Institute of Clinical Neuroscience, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Landgren, M.
    Department of Paediatrics, The Hospital of Skaraborg, Skövde, Sweden.
    Hellström, A.
    Section of Ophthalmology, Institute of Clinical Neuroscience, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Visual function and ocular features in children and adolescents with attention deficit hyperactivity disorder, with and without treatment with stimulants2007In: Eye (London. 1987), ISSN 0950-222X, E-ISSN 1476-5454, Vol. 21, no 4, p. 494-502Article in journal (Refereed)
    Abstract [en]

    AIMS: To investigate visual function and ocular features in children with attention deficit hyperactivity disorder (AD/HD) and establish whether treatment with stimulants is reflected in functioning of the visual system.

    METHODS: Detailed ophthalmologic evaluations without and with stimulants were performed in 42 children (37 boys) with AD/HD, mean age 12 years, and compared with a reference group (ref; n=50; mean age 11.9 years; 44 boys). For a comparison between two groups, Mann-Whitney's U-test was used for ordered and continuous variables; for dichotomous variables, Fisher's exact test was used. For paired comparison (with and without treatment), sign test was used.

    RESULTS: In all, 83% had visual acuity of >0.8 (<0.1 logMAR) without treatment, 90% with stimulants (ref 98%; P=0.032 and n.s., respectively). Heterophoria was found in 29% without, and in 27% with, stimulants (ref 10%; P=0.038 and n.s., respectively) and subnormal stereovision (>60 s of arc) in 26% (ref 6%; P=0.016) without stimulants, and in 27%, with (P=0.014). Abnormal convergence (>6 cm or absent) was noted in 24% (ref 6%; P=0.031) without treatment and in 17%, with (n.s.). Astigmatism (> or =1.0 D) was observed in 24% (ref 6%; P=0.03), and signs of visuoperceptual problems in 21% (ref 2%; P=0.007). We found smaller optic discs (n=8/38) and neuroretinal rim areas (n=7/38) (P<0.0001) and decreased tortuosity of retinal arteries (n=6/34) (P=0.0002) than that of controls.

    CONCLUSIONS: Children with AD/HD had a high frequency of ophthalmologic findings, which were not significantly improved with stimulants. They presented subtle morphological changes of the optic nerve and retinal vasculature, indicating an early disturbance of the development of these structures.

  • 37.
    Andersson Grönlund, Marita
    et al.
    Drottning Silvias barn- och ungdomssjukhus, Sahlgrenska universitetssjukhuset/Östra, Göteborg.
    Aring, Eva
    Drottning Silvias barn- och ungdomssjukhus, Sahlgrenska universitetssjukhuset/Östra, Göteborg.
    Strömland, Kerstin
    Drottning Silvias barn- och ungdomssjukhus, Sahlgrenska universitetssjukhuset/Östra, Göteborg.
    Landgren, Magnus
    Skaraborgs sjukhus, Skövde.
    Svensson, Leif Å.
    Skaraborgs sjukhus, Skövde.
    Hellström, Ann
    Drottning Silvias barn- och ungdomssjukhus, Sahlgrenska universitetssjukhuset/Östra, Göteborg.
    Ögon- och synförändring vanligt hos adopterade från Östeuropa: [Eye and visual problems common in adoptees from Eastern Europe]2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 10, p. 676-678Article in journal (Refereed)
    Abstract [sv]

    78 procent av alla barn som adopterats från Östeuropa hade ögon- och synförändringar som synnedsättning, skelning, brytningsfel, medfödda missbildningar och problem med att tolka sina synintryck.Vi rekommenderar därför att samtliga barn som adopteras från Östeuropa genomgår en ögonundersökning som ett komplement till den barnmedicinska undersökningen så snart som möjligt efter ankomsten till Sverige.Ökad kännedom om hälsoproblem hos barnen är av stor betydelse för både adoptionsorganisationer, hälso- och sjukvården och skolor, och inte minst för föräldrarna. Kunskap om ett barns problem är en nödvändig förutsättning för att barnet ska få rätt hjälp i det nya hemlandet.

  • 38.
    Andersson Grönlund, Marita
    et al.
    Department of Paediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Dahlgren, J.
    Department of Paediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Aring, E.
    Department of Paediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Kraemer, M.
    Department of Paediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Hellström, A.
    Department of Paediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Ophthalmological findings in children and adolescents with Silver-Russell syndrome2011In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 95, no 5, p. 637-641Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate ophthalmological findings in children with Silver-Russell syndrome (SRS).

    METHODS: An ophthalmological evaluation including visual acuity (VA), refraction, strabismus, near point of convergence (NPC), slit-lamp examination, ophthalmoscopy, axial length measurements and full-field electroretinogram was performed on 18 children with SRS (8 girls, 10 boys; mean age 11.6 years). Fundus photographs were taken for digital image analysis. Data were compared with data on an age- and gender-matched reference group (ref) of school children (n=99).

    RESULTS: Seventeen out of 18 children with SRS had ophthalmological abnormalities. Best corrected VA of the best eye was <0.1 log of the minimal angle of resolution in 11 children (ref n=98) (p<0.0001), and 11 children had refractive errors (ref n=33) (p=0.05). Anisometropia (≥1 dioptre) was noted in three of the children (ref n=3) (p=0.046). Subnormal stereo acuity and NPC were found in 2/16 (ref=0) (p=0.02). The total axial length in both eyes was shorter compared with that in controls (p<0.006 and p<0.001). Small optic discs were found in 3/16, large cup in 3/16 and increased tortuosity of retinal vessels in 4/13 children with SRS.

    CONCLUSION: Children with SRS, who are severely intrauterine growth retarded, show significant ophthalmological abnormalities. Based on the present findings, ophthalmological examination is recommended in children with SRS.

  • 39.
    Andersson Grönlund, Marita
    et al.
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Honarvar, A. K. Seyedi
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Andersson, S.
    Institute of Neuroscience and Physiology/Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Moslemi, A. R.
    Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Oldfors, A.
    Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Holme, E.
    Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Tulinius, M.
    Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
    Darin, N.
    Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
    Ophthalmological findings in children and young adults with genetically verified mitochondrial disease2010In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 94, no 1, p. 121-127Article in journal (Refereed)
    Abstract [en]

    AIM: To describe ophthalmological phenotypes in patients with mitochondrial disease and known genotypes.

    METHODS: A retrospective study was performed on 59 patients (29 male, 30 female) with a mean age of 11.8 years who had mitochondrial disease with known DNA mutations. Fifty-seven of the 59 subjects underwent a detailed ophthalmological examination including visual acuity (VA), eye motility, refraction, slit-lamp examination, ophthalmoscopy and, in almost one-half of the cases, a full-field electroretinogram (ERG).

    RESULTS: Forty-six (81%) of the patients had one or more ophthalmological findings such as ptosis (n = 16), reduced eye motility (n = 22) including severe external ophthalmoplegia (n = 9), strabismus (n = 4), nystagmus (n = 9), low VA (n = 21), refractive errors (n = 26), photophobia (n = 4), and partial or total optic atrophy (n = 25). Pigmentation in the macula and/or periphery was noted in 16 patients. In 10/27 investigated individuals with full field ERG, retinal dystrophy was recorded in six different genotypes representing Kearns-Sayre syndrome (n = 5), Leigh syndrome (n = 1), Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) (n = 1), Myoclonus epilepsy with red ragged fibres (MERRF) (n = 1), Leber hereditary optic neuropathy (n = 1) and mitochondrial myopathy (n = 1).

    CONCLUSION: The results show that a majority of patients with mitochondrial disorders have ophthalmological abnormalities. We recommend that an ophthalmological examination, including ERG, be performed on all children and adolescents who are suspected of having a mitochondrial disease.

  • 40.
    Andersson Grönlund, Marita
    et al.
    Institute of Neuroscience and Physiology⁄Ophthalmology, Sahlgrenska Academy atGothenburg University, Gothenburg, Sweden.
    Landgren, Magnus
    Department of Paediatrics, Skaraborg Hospital, Skövde, Sweden.
    Strömland, Kerstin
    Institute of Neuroscience and Physiology⁄Ophthalmology, Sahlgrenska Academy atGothenburg University, Gothenburg, Sweden.
    Aring, Eva
    Institute of Neuroscience and Physiology⁄Ophthalmology, Sahlgrenska Academy atGothenburg University, Gothenburg, Sweden.
    Svensson, Leif
    Primary Care, Skövde, Sweden.
    Tuvemo, Torsten
    Department of Women’s and Children’s Health, Uppsala University, Uppsala,Sweden.
    Hellström, Ann
    Institute of Neuroscience and Physiology⁄Ophthalmology, Sahlgrenska Academy atGothenburg University, Gothenburg, Sweden.
    Relationships between ophthalmological and neuropaediatric findings in children adopted from Eastern Europe2010In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 88, no 2, p. 227-234Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study aimed to evaluate and relate visual function, ocular dimensions and neuropaediatric findings in adoptees from Eastern Europe.

    METHODS: We studied 72 of 99 children, born during 1990-95 and adopted from Eastern Europe to western Sweden during 1993-97. The children (mean age 7.5 years, range 4.8-10.5 years; 41 boys, 31 girls) were examined after a mean period of 5 years post-adoption by a multidisciplinary team. Correlations between ophthalmological findings and neuropaediatric data were analysed.

    RESULTS: Bivariate and regression analyses indicate a significant positive correlation between visual acuity (VA) and perceptual organization (p < 0.001), as well as between strabismus and verbal comprehension (p < 0.02). Fetal alcohol syndrome (FAS) was correlated with low VA (p < 0.02), subnormal stereovision (p < 0.009) and small optic discs (p < 0.02). Small head circumference was related to low VA (p < 0.015) and small optic discs (p < 0.03). Furthermore, small optic discs were related to low birthweight (p < 0.005) and preterm birth (p < 0.01). Large optic cups were correlated with poorer perceptual organization (p < 0.02).

    CONCLUSIONS: In this group of adoptees from Eastern Europe, ophthalmological findings were correlated to neuropaediatric findings, especially those arising from prenatal adverse events resulting in growth deficiency and central nervous system damage. Therefore, it is important and valuable with an ophthalmological examination in children adopted from Eastern Europe.

  • 41.
    Andersson Grönlund, Marita
    et al.
    Göteborgs universitet, Göteborg, Sweden.
    Lind, Alexandra
    Göteborgs universitet, Göteborg, Sweden.
    Garellick, Hanna
    Ovik, Titus
    Göteborgs universitet, Göteborg, Sweden.
    Dahlgren, Jovanna
    Göteborgs universitet, Göteborg, Sweden.
    Aring, Eva
    Göteborgs universitet, Göteborg, Sweden.
    Visual function and visual perception in adolescents born moderate-to-late preterm2023Conference paper (Refereed)
  • 42.
    Andersson Grönlund, Marita
    et al.
    Göteborgs universitet, Göteborg, Sweden.
    Razooqi, F.
    Yaseen, E.
    Lind, Alexandra
    Göteborgs universitet, Göteborg, Sweden.
    Andersson, Susann
    Göteborgs universitet, Göteborg, Sweden.
    Unilateral Pigmentary Retinopathy: A 36-year Follow-up2023Conference paper (Refereed)
  • 43.
    Andersson Grönlund, Marita
    et al.
    Institute of Clinical Neuroscience, Section of Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Stenevi, Ulf
    Institute of Clinical Neuroscience, Section of Ophthalmology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Lundeberg, Thomas
    Department of Physiology II, Karolinska Institute, Stockholm, Sweden.
    Acupuncture treatment in patients with keratoconjunctivitis sicca: a pilot study2004In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 82, no 3 Pt 1, p. 283-290Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate the effects of acupuncture in patients with keratoconjunctivitis sicca (KCS).

    MATERIAL AND METHODS: Twenty-five patients (20 women, five men) with KCS were randomly assigned to an acupuncture treatment group or a control group. The effects of acupuncture were evaluated by a questionnaire on symptoms, visual analogue scale recordings, registration of drop frequency, and dry eye tests. Ten acupuncture sessions were given. Follow-up was carried out after 2-3 weeks and again after a mean period of 8 months.

    RESULTS: Patients receiving acupuncture felt better at the first follow-up compared with the control group (p = 0.036). However, no statistical significance could be found concerning any change, or difference, in the total number of subjective symptoms, dosage frequency or, as indicated by the dry eye tests, tear quality, tear secretion and ocular surface disease.

    CONCLUSION: The results indicate that acupuncture has subjective beneficial effects in patients with KCS and could therefore be tried as a complement to ordinary treatment.

  • 44.
    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
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  • 45.
    Andersson, Susann
    et al.
    Göteborgs universitet, Göteborg, Sweden.
    Arvidsson, Sara
    Fluriach Dominguez, Nuria
    Andersson Grönlund, Marita
    Göteborgs universitet, Göteborg, Sweden.
    The role of history-taking in assessment of inherited retinal diseases2023Conference paper (Refereed)
  • 46.
    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.

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  • 47. 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, p. 8-15Article 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.

  • 48.
    Aring, Eva
    et al.
    Institute of Clinical Neuroscience, Department of Paediatrics, Göteborg University, Göteborg, Sweden; Dept. Paediatr. Ophthalmol., Queen Silvia Children's Hosp., Sahlgrenska Univ. Hosp./Östra, Göteborg, Sweden.
    Andersson Grönlund, Marita
    Institute of Clinical Neuroscience, Department of Paediatrics, Göteborg University, Göteborg, Sweden.
    Andersson, Susann
    Institute of Clinical Neuroscience, Department of Paediatrics, Göteborg University, Göteborg, Sweden.
    Hård, Anna-Lena
    Institute of Clinical Neuroscience, Department of Paediatrics, Göteborg University, Göteborg, Sweden.
    Ygge, Jan
    Section of Ophthalmology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Hellström, Ann
    Institute of Clinical Neuroscience, Department of Paediatrics, Göteborg University, Göteborg, Sweden.
    Strabismus and binocular functions in a sample of Swedish children aged 4-15 years2005In: Strabismus, ISSN 0927-3972, E-ISSN 1744-5132, Vol. 13, no 2, p. 55-61Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate strabismus, head posture, nystagmus, stereoacuity, ocular motility, near point of convergence (NPC) and accommodative convergence to accommodation ratio (AC/A) in a sample of Swedish children.

    METHODS: A prospective cross-sectional study was carried out on 143 children, 4-15 years of age.

    RESULTS: Heterotropia was found in five children (3.5%), four with esotropia and one with exotropia. One child with esotropia had a slight overaction of both inferior oblique muscles. Heterophoria was found in 37 children (26%) at near and/or distance fixation and it was four times more common at near than at distance. In 29 children, heterophoria was found at one distance only and orthophoria at the other. Orthophoria at both near and distance fixation was noted in 101 children (70.5%). The near point of convergence was < or =6 cm in 97% of the children and 97% had stereoacuity of 60" or better. In the whole group, the median AC/A ratio calculated with the heterophoria method was 5.6/1 prism diopters/diopters (PD/D) and with the gradient method, 1.3/1 PD/D. No anomalous head postures or nystagmus were observed and all children had normal versions.

    CONCLUSION: In this study, 143 well-defined children were investigated with a battery of accurately described tests, commonly used in clinical practice. These results are in agreement with those of other studies examining one or few variables in larger populations and the authors therefore conclude that their results may be used for comparisons with different patient groups.

  • 49.
    Armonaite, Laura
    et al.
    Division of Ophthalmology and Vision, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Repositioning of in-the-bag dislocated intraocular lenses: a randomized clinical trial comparing two surgical methods2023In: Ophthalmic Research, ISSN 0030-3747, E-ISSN 1423-0259, Vol. 66, no 1, p. 590-598Article in journal (Refereed)
    Abstract [en]

    Introduction: The aim of this study was to evaluate intraocular lens (IOL) tilt, IOL-induced astigmatism (IIA), refractive change, and impact of capsular fibrosis on IOL position after scleral fixation of dislocated IOL using two methods: ab externo scleral suture loop fixation (group A) and a modification, embracing the continuous curvilinear capsulorhexis (group B).

    Methods: In this prospective randomized clinical trial conducted at St. Erik Eye Hospital, 117 patients with dislocated IOL were randomized to group A (n = 61) or B (n = 56). Patients with ordinary pseudophakia (n = 60) served as controls. IOL tilt was measured three-dimensionally with anterior segment optical coherence tomography (AS-OCT).

    Results: The median IOL tilt was similar with both methods (A: 7.8°; B: 8.3°; p = 0.51) but higher than in ordinary pseudophakia (5.4°; p < 0.001). Both groups showed a myopic shift, p < 0.001. In cases without capsular fibrosis, the median IOL tilt was 15.5° in group A (n = 7) and 7.0° in group B (n = 5), p = 0.19. For each degree of IOL tilt, IIA increased by 0.075 D (p < 0.001). IOL position could be measured with AS-OCT in all patients given that the IOL was visible in the pupil.

    Conclusion: After IOL fixation surgery, IOL tilt is higher than in normal pseudophakia. A study involving more patients without capsular fibrosis could clarify whether IOL position is better with method B in this subgroup. IAA is low, but myopic shift is common. AS-OCT is useful for IOL tilt assessment after IOL fixation surgery.

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  • 50. Armonaite, Laura
    et al.
    Behndig, Anders
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
    Seventy-one cases of uveitis-glaucoma-hyphaema syndrome2021In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 99, no 1, p. 69-74Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To assess Uveitis-Glaucoma-Hyphaema syndrome (UGH syndrome) with focus on resolution, glaucoma development and risk factors.

    METHODS: This retrospective case-control study with a cross-sectional component was performed to compare three groups with 71 patients each: UGH syndrome, dislocated intraocular lens (IOL) without UGH syndrome and ordinary pseudophakia. Main outcome measures were resolution of the UGH syndrome, best-corrected visual acuity (BCVA) and the need of glaucoma therapy. We also assessed the IOL-iris contact signs and the use of blood thinners.

    RESULTS: Uveitis-Glaucoma-Hyphaema (UGH) syndrome resolved in 77 % of patients who underwent various kind of IOL surgery. Intraocular pressure (IOP) decreased and BCVA improved in the operated cases (p = 0.02 and p < 0.001, respectively), but not in the cases treated conservatively. Intraocular pressure (IOP) ≥22 mmHg at the first haemorrhage predicted the need of glaucoma therapy after UGH syndrome resolution (p = 0.002, area under the curve = 0.8). Fifty-one per cent of patients without preexisting glaucoma needed glaucoma therapy after UGH syndrome resolution. Pseudophacodonesis was seen more frequently in the UGH group than in the ordinary pseudophakia group (p = 0.001). Iris defects were not more frequent in the UGH group than in the Dislocated group but the types of defects differed (p < 0.0001). Blood thinners were not more frequent in UGH.

    CONCLUSION: In UGH syndrome, the results are better with surgical intervention than with conservative treatment, but surgery does not guarantee resolution. Pseudophacodonesis is a risk factor for UGH syndrome, but blood thinners are not, and iris defects are not specific to UGH syndrome. A high IOP at the first haemorrhage increases the risk for needing subsequent IOP-lowering therapy.

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