Descriptive questionnaires were collected from 25 eye centres in 14 countries. The questionnaire surveyed details of juvenile-onset Behçet’s disease with uveitis. Ethnic groups, clinical features, treatments and prognosis of paediatric-age Behçet’s disease were examined on a worldwide scale.

The clinical data of 135 juvenile-onset and 1227 adult-onset patients with uveitis were collected. The average age of disease diagnosis in the children was 11.7 years old. Of the ethnic groups identified 54% were from Middle East, 43% from Europe, but only 2% from East/South Asian countries. By contrast, 19.2% of adult patients were from East or South Asia. The frequency of genital ulcers in juvenile patients was 38.7%, which was significantly lower than in adult cases (53.5%; p<0.01).

Behçet’s disease with uveitis was less common in children than in adults in East/South Asia. Although the clinical features of the systemic disease were similar in children and adults, there was a lower frequency of genital ulceration in children.

The National Eye Institute Visual Function Questionnaire (NEI-VFQ) was translated into Chinese. Patients were recruited from Hong Kong, and their demographic data and visual acuity were documented. Psychometric properties of the CHI-VFQ-25, including internal consistency, test–retest reliability, item–scale correlations and construct validity were tested.

250 patients were recruited. The mean age of the patients was 66.04 (SD 14.00). 46% of them were male. The non-response rate and the floor and ceiling numbers of the CHI-VFQ-25 were calculated. The internal consistency was high in most subscales (except the general health and driving subscales), with Cronbach ranging from 0.72–0.90. The test–retest reliability was excellent (intraclass correlation coefficient >0.90). Patients with worse visual acuity had significantly lower scores on the CHI-VFQ-25 supporting construct validity.

The CHI-VFQ-25 is a reliable and valid tool for assessing the visual functions of Chinese patients with eye diseases in Hong Kong. Some questions had high non-response rates and should be substituted by the available alternatives.

583 patients with 641 eyes suffering from NLDO and chronic dacryocystitis were enrolled in this study. The RC-NLDO was performed in 506 eyes, with 135 eyes undergoing external dacryocystorhinostomy (EX-DCR) as controls. Patient follow-up for 54 months was evaluated by symptoms, dye disappearance test, lacrimal irrigation and digital subtraction dacryocystogram. The RC-NLDO was also performed in 12 rhesus monkeys for histopathological examination.

The clinical success rates were 93.1% in 506 cases of RC-NLDO and 91.11% in 135 cases of EX-DCR. The success rates for second surgery were achieved in 85.19% on RC-NLDO and 40.0% on EX-DCR. No major intra- or postoperative complications were observed in the RC-NLDO group. The mean operative duration was 12.5 min for RC-NLDO and 40.3 min for EX-DCR (p<0.001). A pathological study in rhesus monkeys demonstrated that the RC-NLDO wounded epithelium in nasolacrimal duct healed completely within 1 month without granulation tissue formation.

The findings demonstrate that the RC-NLDO is a simple and effective approach proven to recanalise the obstructed nasolacrimal duct with a comparable success rate to EX-DCR.

Eight patients with 5.5–22 years of CQ treatment underwent clinical examination, mfERG recording, FAF and NIA imaging using a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2) and sdOCT imaging (Spectralis OCT Heidelberg Retina Angiograph).

In three patients, all test results were normal after 5.5–16 years of CQ treatment. Five patients presented with variably progressed CQ retinopathy (10–22 years of treatment) and abnormalities in all tests. In the mildest case, pericentral reduction in mfERG amplitudes corresponded to increased pericentral FAF, reduced pericentral NIA and pericentral interruption of the photoreceptor inner/outer segment junction in the sdOCT. In all sdOCT scans, the outer nuclear layer thickness was reduced. More severe cases showed preserved subfoveal photoreceptors and function with marked changes in all examinations towards the periphery. The most severe case presented with additional loss of subfoveal photoreceptors.

MfERG, FAF, NIA and sdOCT detect early stages of CQ retinopathy. Loss of outer nuclear layer thickness might be the earliest indicator of CQ retinopathy.

Sixty-seven healthy individuals underwent three repeated scans in both eyes with the macular thickness map protocol in the Stratus OCT. That protocol divides the macula area into nine ETDRS fields. The RNFL was measured in one specific location close to the optic disc. Correlations between retinal, RNFL thickness, macular volume and age were determined.

We found a statistically significant negative relationship between retinal thickness and age for all ETDRS areas, total macular volume and RNFL thickness. Retinal thickness decreased by 0.26–0.46 µm, macula volume 0.01 mm³ and RNFL 0.09 µm per year.

Retinal thickness within the area covered by the macular map significantly decreases with age. In the area examined in the papillomacular bundle, 20% of the retinal thinning is due to the RNFL, and 80% is due to thinning of other layers of the retina.

28 eyes with nAMD and 10 healthy eyes were imaged using conventional time domain (TD) OCT as well as three spectral-domain (SD) OCT systems. Radial scans of 6 mm in size were compared between Stratus and Topcon OCT, in addition to raster scans of all three SD-OCT devices. Retinal thickness values were analysed.

Spectralis SD-OCT demonstrated the highest values of all OCT devices in central millimetre thickness (CMMT), and Topcon OCT raster scans showed the lowest values. Significant correlations could be found between the CMMT measurements of Cirrus and Spectralis OCT (r = 0.87). Analyses showed best segmentation for Cirrus and Spectralis SD-OCTs. Cirrus 200x200x1024 scans showed 4% and Stratus OCT 38% moderate or severe segmentation errors.

Retinal thickness values were generally higher in SD-OCT analysis. Different performances of automatic retinal thickness analysis indicate the potential of different software algorithms to quantify retinal morphology in nAMD. Further development of current algorithms may improve quantification of retinal thickness detection in the future even further.

Data from 209 eyes undergoing Cirrus OCT imaging with the Macular Cube protocol were collected. For each eye, the position of the automated retinal boundary lines used by the Cirrus OCT software for thickness calculations was assessed using a 6-point categorical scale. The presence of errors was correlated with various parameters including: retinal morphological features and disease diagnosis.

Errors of retinal boundary detection were observed in 57.5% of eyes but were severe in only 9.6% of eyes. The identification of subretinal fluid, subretinal tissue, pigment epithelium detachment or a diagnosis of choroidal neovascularisation was associated with more severe errors. Retinal cysts or a diagnosis of retinal vascular disease were less likely to be associated with significant error.

Retinal thickness measurement errors appear to occur less frequently with Fourier domain OCT (Cirrus OCT), but segmentation errors remain a concern, particularly in assessment of eyes with structurally complex retinal disease. With the recent release of multiple FDOCT systems, assessment of segmentation error may be an important factor in determining the relative merits of these systems.

Twenty-three eyes from 23 patients (11 men and 12 women, mean age 44.3 years) with SSOH were enrolled and 23 control subjects were matched for age and optic disc size. In addition to detailed ophthalmoscope examination and standard automated perimetry, OCT and HRT were performed for the quantitative assessment of the retinal nerve fibre layer (RNFL) and optic nerve head.

The OCT images showed that the eyes with SSOH had significantly thinner RNFL than the control subjects in all segments except for the papillomacular bundle area. The area under the receiver operator characteristic curve (AROC) was greatest for the RNFL thickness of superonasal one o’clock segment (AROC = 0.991, p<0.001) measured by the OCT, and for the rim area of superonasal segment (AROC = 0.837, p = 0.001) measured by the HRT.

More generalised thinning of the RNFL, beyond the superior retina, was identified in the eyes with SSOH. The OCT and HRT were valuable as ancillary diagnostic tests for SSOH, even in mild cases.

A prospective, randomised, controlled, open-label, exploratory study. Twenty subjects with active PDR were randomly assigned at a 1:1 ratio to receive treatment in one eye either with IVP (0.3 mg) every 6 weeks for 30 weeks or with PRP laser. Efficacy endpoints included regression of retinal neovascularisation (NV), changes from baseline in best-corrected visual acuity (BCVA) and foveal thickness. Safety outcomes included observed and reported adverse events.

In 90% of randomised eyes to IVP, retinal NV showed regression by week 3. By week 12, all IVP eyes were completely regressed and maintained through week 36. In the PRP-treated group, at week 36, two eyes demonstrated complete regression, two showed partial regression, and four showed persistent active PDR. The mean change in BCVA at 36 weeks was +5.8 letters in pegaptanib-treated eyes and –6.0 letters in PRP-treated eyes. Only mild to moderate transient ocular adverse events were reported with pegaptanib.

IVP produces short-term marked and rapid regression of diabetic retinal NV. Regression of NV was maintained throughout the study and at the final visit.

Forty-seven eyes of 47 consecutive patients with a BRVO who were treated with arteriovenous sheathotomy were studied. The patients were assigned prospectively to either Group R who received 30 mg of edaravone (Radicut) systemically during the vitrectomy or Group N who did not receive any drugs. The postoperative visual acuity was measured before and 12 months after the operation.

At 12 months postoperatively, the best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR) units improved significantly from 0.22 to 0.56 logMAR units in Group R and from 0.20 to 0.27 units in Group N (p = 0.016). Twenty-three of 27 cases (85%) in Group R and four of 15 cases (27%) in Group N showed an improvement in BCVA of >0.2 logMAR units (p = 0.0025).

The better visual acuity in patients given edaravone than those without endaravone during the arteriovenous sheathotomy suggests that edaravone improved the physiology of the retinal cells after the arteriovenous sheathotomy.

Prospective observational case series of five eyes of four patients presenting with OLD at the fovea defined as discrete lesions of 50–100 µm in size located at the level of the outer retina on biomicroscopy and imaged on optical coherence tomography (OCT) as cylindrical, well-demarcated interruption of hyper-reflective bands corresponding to the inner/outer segments junction of photoreceptors and to the complex retinal pigment epithelium–choriocapillaris; none of the enrolled patients had any positive history for direct sungazing, welding-arc or sunbed exposure, whiplash injury, ocular trauma, macular oedema/detachment or evidence of vitreomacular traction. The corresponding FAF images were evaluated.

In eyes with OLD, the neuroretina in the foveal region appeared to be thinner than in fellow, unaffected eyes. FAF revealed well-demarcated, hypoautofluorescent areas (corresponding in location to the OLD observed clinically and on OCT), surrounded by an irregular halo of relatively increased autofluorescence in the context of the greater hypoautofluorescent macular region.

Biomicroscopy, OCT and FAF findings of presumed idiopathic OLD of the fovea strongly resemble those observed in association with chronic solar retinopathy. In association with OCT, FAF might represent a useful technique with which to detect subtle solar-induced injuries of the retina.

A retrospective study of 133 patients undergoing standardised macular hole surgery with at least 3 months of postoperative follow-up. All patients underwent preoperative measurement of the maximum macular hole diameter using optical coherence tomography.

Multivariable regression analysis identified that age, preoperative visual acuity and macular hole size were significant predictors of visual success. The resulting model correctly classified the visual outcome of 80% of cases. Predicted rates of visual success varied from 93% in patients <60 years old with visual acuity better than 6/24 and a hole diameter of <350 µm, to 2% in patients those >79 years old with visual acuity of 6/60 or worse and hole diameter of >500 µm.

The results provide a simple and clinically useful model to employ when counselling patients on macular hole surgery.

We included 26 eyes with SO endotamponade (SO, n = 15; HSO, n = 11) using a Zeiss IOLMaster for measurement of axial length the day before and at least 6 weeks after SO removal. We analysed the intra-individual deviation between both measurements and signal-to-noise ratio (SNR) as a marker for signal quality. We included 16 contralateral eyes without history of vitreoretinal surgery to act as the control group.

The mean axial length was 24.76 (SD 2.07) mm (SO 24.63 (SD 2.12) mm, HSO 24.93 (SD 2.10) mm, control 24.95 (SD 2.61) mm) before and 24.75 (SD 1.96) mm after oil removal with a mean intra-individual deviation of 0.13 (SD 0.11) mm (SO 0.13 (SD 0.12) mm, HSO 0.13 (SD 0.09) mm, control 0.02 (SD 0.01) mm) while SNR at baseline was 5.7 (SD 3.5) (SO 6.6 (SD 4.0), HSO 4.4 (SD 2.2), control 8.6 (SD 3.9)).

In our analysis, optical biometry using PCI generated results with acceptable accuracy and signal quality for measurement of axial length in SO-filled eyes.

National postal questionnaire surveys of consultant ophthalmologists in the UK and Ireland.

76% of 928 surveyed ophthalmologists replied. 47 (7%) of the respondents operated on children aged <=2 with cataract. 41 (87%) of respondents performed primary IOL implantation, but 25% would not implant an IOL in a child under 1 year old. 88% of surgeons used limbal wounds, 80% manual capsulotomies, 98% posterior capsulotomies and 100% hydrophobic acrylic lenses. The SRK/T formula was most commonly used (70%). Exclusion criteria for primary IOL implantation varied considerably and included microphthalmos (64% of respondents), anterior and posterior segment anomalies (53%, 58%), and glaucoma (19%).

Primary IOL implantation in children <=2 has been widely adopted in the UK and Ireland. There is concordance of practice with regards to surgical technique and choice of IOL model. However, there is some variation in eligibility criteria for primary IOLs: this may reflect a lack of consensus on which children are most likely to benefit. Thus, there is a need for systematic studies of the outcomes of primary IOL implantation in younger children.

In a randomised trial, the effect of an educational programme on electronically measured compliance had been assessed. 149 families who participated in this trial completed a questionnaire based on the Protection Motivation Theory after 8 months of treatment. Families with compliance less than 20% of prescribed occlusion hours were interviewed to better understand their cause for non-compliance.

Poor compliance was most strongly associated with a high degree of distress (p<0.001), followed by low perception of vulnerability (p = 0.014), increased stigma (p = 0.017) and logistical problems with treatment (p = 0.044). Of 44 families with electronically measured compliance less than 20%, 28 could be interviewed. The interviews confirmed that lack of knowledge, distress and logistical problems resulted in non-compliance.

Poor parental knowledge, distress and difficulties implementing treatment seemed to be associated with non-compliance. For the same domains, the scores were more favourable for families who had received the educational programme than for those who had not.

78 OAG patients who underwent AGV implantation were matched with respect to age, preoperative surgery, preoperative IOP and preoperative medicines to 88 OAG patients who underwent trabeculectomy with MMC with a minimum of 3 years’ follow-up. The cumulative probability of success between the two groups with different criteria was analysed: (1) an IOP<=21 mm Hg and a reduction of IOP>=15% from baseline; and (2) an IOP<=18 mm Hg and a reduction of IOP>=20% from baseline. No loss of light perception, no additional glaucoma surgery and no hypotony were also required.

The 5-year cumulative probability of success was not statistically significant between eyes that had an AGV or trabeculectomy with MMC when success was defined as criteria A (p = 0.094). However, when success was defined according to criteria B, eyes undergoing trabeculectomy with MMC had a higher rate of success (p = 0.024).

Trabeculectomy with MMC has a significantly higher 5-year cumulative probability of success compared with AGV implants when greater reduction IOP is necessary.

The HRT reference plane (RP) defines structures above as "rim" and below as "cup." The Moorfields RP applies the Standard RP (located 50 µm posterior to the temporal disc margin) at baseline and maintains the distance between the Standard RP and the reference ring (located in the image periphery) for follow-up images. The Moorfields RP was applied to an HRT test–retest dataset, and rim area repeatability coefficients were calculated. Repeatability coefficients were compared between the Moorfields, Standard and 320 (located 320 µm posterior to the reference ring) RPs. The Moorfields RP was applied to HRT images from 198 ocular hypertensives, acquired over 6 years. HRT progression required rim area baseline/follow-up differences exceeding the repeatability coefficient in two or more sectors, with confirmation in at least one of two consecutive images. Field progression was assessed using Advanced Glaucoma Intervention Study criteria.

The Moorfields RP improved rim area repeatability compared with the Standard RP; repeatability was similar between the Moorfields and the 320 RP. The frequency of identified progression using Moorfields RP was 40% compared with 28% for the 320 RP. There was a greater percentage with concurrent field progression –15.1% (Moorfields RP) compared with 12.1% (320 RP).

Although rim area repeatability was similar using the 320 RP and the Moorfields RP, the latter resulted in greater rates of detection of change.

Eyes with anatomically narrow angles underwent ultrasound biomicroscopy of the posterior chamber and pupillary margin under dark- and light-room conditions to assess changes in posterior chamber anatomy and volume. All examinations were stored as real-time video. A frame-by-frame analysis was performed using a macro written for the ImageJ image-processing software.

Thirteen eyes were assessed. The mean patient age was 63.0 (SD 10.0) years, and the mean refractive error was 1.1 (1.9) dioptres. The horizontal mean pupillary diameter was 2.3 (0.6) mm and 3.5 (0.5) mm under light- and dark-room conditions, respectively (p<10^–7, paired t test). The mean posterior chamber volumes were unchanged under light and dark conditions (3.76 (1.09) vs 3.63 (0.78) mm³, p = 0.22, paired t test). Volumes were greater under light conditions in eight eyes and under dark conditions in five eyes.

The volume of the posterior chamber does not change significantly during dilation.

Data forms and questionnaires from consecutive, euthyroid patients with inactive GO who had undergone orbital decompression for disfiguring proptosis in 11 European centres were analysed.

Eighteen different (combinations of) approaches were used, the swinging eyelid approach being the most popular followed by the coronal and transconjunctival approaches. The average proptosis reduction for all decompressions was 5.0 (SD 2.1) mm. After three-wall decompression the proptosis reduction was significantly greater than after two-wall decompression. Additional fat removal resulted in greater proptosis reduction. Complications were rare, the most frequent being worsening of motility, occurring more frequently after coronal decompression. The average change in quality of life (QOL) in the appearance arm of the GO-QOL questionnaire was 20.5 (SD 24.8) points.

In Europe, a wide range of surgical approaches is used to reduce disfiguring proptosis in patients with GO. The extent of proptosis reduction depends on the number of walls removed and whether or not fat is removed. Serious complications are infrequent. Worsening of ocular motility is still a major complication, but was rare in this series after the swinging eyelid approach.

All patients with conjunctival melanoma from 1960 to 2005 in Sweden were identified through the Swedish Cancer Registry, cross-checked against hospital files, and validated by histopathological review (97.5%) or detailed hospital records (2.5%). The crude and age-standardised incidences were estimated separately for each sex and the annual change in incidence over time was estimated using a regression model with logarithmic incidence numbers. Time trends for the largest diameter, thickness and location of the tumour when diagnosed were analysed.

The age-standardised incidence of conjunctival melanoma increased significantly in men (n = 89) from 0.10 cases/million to 0.74 cases/million (p = 0.001) and in women (n = 81) from 0.06 cases/million to 0.45 cases/million (p = 0.007). The annual relative change in age-standardised incidence was 16.9% (95% confidence interval (CI) 12.2 to 21.6) in men and 19.5% (95% CI 9.3 to 29.7) in women. The age-specific incidence was higher in men and women >=65 years (1.48 and 1.39 cases/million, respectively) than in younger men and women (0.3 and 0.2 cases/million, respectively). During the period of study, tumours became smaller (p = 0.005) and thinner (p = 0.002) at the time of diagnosis and increasingly arose from parts of the conjunctiva exposed to ultraviolet radiation (p = 0.001).

The incidence of conjunctival melanoma increased in Sweden during the period 1960 to 2005.

Clinical files and conjunctival specimens of 20 patients with histologically diagnosed conjunctival MM were analysed. Sections were stained with LYVE-1 and podoplanin antibodies as specific lymphatic endothelial markers and Ki67 as proliferation marker. The tumour area and the area covered by LV (LVA), LV number (LVN) and LV density (LVD) were measured within the tumour and in the peritumoural area in digital images of the specimen. The LV results were correlated with the histopathological characteristics, tumour location, recurrence rate, mitomycin C therapy and presence of metastases.

LVs were detected in all specimens within the tumour and peritumourally. Significantly more Ki67⁺ proliferating lymphatic endothelial cells were detected in the tumour and in the peritumoural tissue up to 300 µm compared with the surrounding normal conjunctiva (>300 µm distance). There was a slightly positive correlation between the tumour size and the LVN and LVA in the 50 µm zone adjacent to the tumour. We did not find any significant correlations between LVs and histopathological and clinical characteristics (location, shape, relapses, metastases), possibly due to the small sample sizes. Non-limbal tumours with involvement of tarsus or fornix showed a tendency towards a higher LVD compared with limbal tumours.

Conjunctival MMs display tumour-associated LV within and around the tumour. The MM seems to induce lymphangiogenesis not only in the tumour, but also in its proximity.

Two fluorescent dyes, fluorescein sodium and 5-dodecanoylaminofluorescein (DAF), which is a free-fatty-acid conjugate of fluorescein, were applied to the right eye of 12 healthy volunteers. Fluorescent intensity of the precorneal tear film was measured at the central cornea every minute for 10 min for fluorescein sodium, and every 5 min for 50 min for DAF. The turnover rate was calculated by plotting fluorescent intensity against time in a semilog plot and expressed as %/min.

Turnover rates of fluorescein sodium and DAF were 10.3 (SD 3.7)%/min and 0.93 (0.36)%/min, respectively. The turnover rate of DAF was significantly lower than that of fluorescein sodium (p<0.05, Mann–Whitney test). The turnover rate of DAF positively correlated with that of fluorescein sodium (r = 0.93, p<0.05).

Our results indicate that the turnover of lipids in tears is much slower than the aqueous flow of tears, and that this lipid turnover is associated with the aqueous flow of tears in healthy adults.

TTR was measured using immunonephelometry in a group of patients (n = 77) in longstanding (>1 week) retinal detachment (n = 29), fresh (<1 week) retinal detachment (n = 17), macular holes (n = 20) or diabetic retinopathy (n = 11). Vitreous samples were taken at the start of every vitrectomy procedure. For reference values, cadaver specimens (n = 73) were used.

Reference values for vitreous TTR (median 18 mg/l; IQR 4 to 24 mg/l) comprised 2.2% of reference values for vitreous protein levels (median 538 mg/l; IQR 269 to 987 mg/l). Vitreous TTR values of patients were comparable in all disorders. Vitreous TTR values were higher in phakic (median 22.5 mg/l; IQR 10 to 27 mg/l) than in pseudophakic patients (median 12 mg/l; IQR 8 to 19 mg/l; p = 0.06). Postoperative change in visual acuity correlated well with vitreous TTR values found peroperatively (r_s = 0.408; p = 0.012). Both change in visual acuity and lens status were the only variables which proved to explain the variance of TTR (multiple correlation coefficient: 0.494; phakic status: t = 2.767; p = 0.0084; and change in visual acuity t = 2.924: p = 0.0056).

Vitreous fluid concentrations of TTR can be regarded as a biochemical marker for retinal function.

Histopathological examination, immunohistochemistry and multilocus polymerase chain reaction confirmed Toxoplasma gondii infection of the retina

Macroscopic examination of enucleated globe showed extensive retinal necrosis and vitreous detachment. Histological examination of retinal tissue identified numerous round-to-elliptical toxoplasmic cysts within the retina, with retinal necrosis and minimal choroidal inflammation. Immunohistochemical analyses confirmed that the cysts were due to T gondii. DNA extracted from formalin-fixed, paraffin-embedded tissue sections was subjected to multilocus polymerase chain reaction (PCR) analysis at the following typing loci: SAG1, SAG2, SAG3, SAG4, B1, NTS2, GRA6 and GRA7. DNA sequencing of positive PCR products at the NTS2, SAG1 and GRA7 loci confirmed the presence of a non-archetypal strain of T gondii infecting the eye of the patient experiencing a severe, atypical ocular toxoplasmosis

A highly divergent, non-archetypal strain of T gondii was responsible for causing a severe, atypical bilateral retinochoroiditis in a patient from Brazil.