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  • 1.
    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)
  • 2.
    Aurell, Sandra
    et al.
    Vastmanland Cty Hosp, AT Ctr, S-72189 Vasteras, Sweden..
    Granstam, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. Vastmanland Cty Hosp, Dept Ophthalmol, Vasteras, Sweden..
    Bacterial keratitis in a Swedish county hospital: management and clinical outcome2016In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 94, no 3, p. E248-E249Article in journal (Refereed)
  • 3.
    Austeng, Dordi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Retinopathy of Prematurity in Infants Born Before 27 Weeks of Gestation: A National Population-based Study in Sweden During 2004-20072010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

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

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

    List of papers
    1. Incidence of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden
    Open this publication in new window or tab >>Incidence of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden
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    2009 (English)In: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 127, no 10, p. 1315-1319Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To determine the incidence of retinopathy of prematurity (ROP) in extremely preterm infants born before 27 weeks' gestation in Sweden during a 3-year period. METHODS: A national, prospective, population-based study was performed in Sweden from April 1, 2004, to March 31, 2007. The ophthalmologic part of the study was separately organized, and screening for ROP was performed beginning postnatal week 5. The criteria for the treatment of ROP agreed with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. RESULTS: During the study, 506 of 707 live-born infants survived until the first eye examination. Of these, 368 (72.7%) had ROP: 37.9% had mild ROP and 34.8% had severe ROP. Ninety-nine infants (19.6%) were treated. Gestational age at birth was a stronger predictor of ROP than was birth weight. A log-linear relationship between severe ROP and gestational age at birth was found in the present cohort, and the risk of ROP was reduced by 50% for each week of increase in gestational age at birth. CONCLUSIONS: Today, extremely preterm infants are surviving, and this population-based study with ROP as a primary outcome shows a higher incidence of this condition than in previously reported national cohorts.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-121732 (URN)10.1001/archophthalmol.2009.244 (DOI)000287329500008 ()19822848 (PubMedID)
    Available from: 2010-03-29 Created: 2010-03-29 Last updated: 2017-12-12Bibliographically approved
    2. Treatment for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden
    Open this publication in new window or tab >>Treatment for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden
    Show others...
    2010 (English)In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 94, no 9, p. 1136-1139Article in journal (Refereed) Published
    Abstract [en]

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

    Keywords
    Retinopathy of prematurity, extremely preterm, population-based, treatment
    National Category
    Ophthalmology
    Research subject
    Ophtalmology; Pediatrics
    Identifiers
    urn:nbn:se:uu:diva-121731 (URN)10.1136/bjo.2009.170704 (DOI)000282206500006 ()19951941 (PubMedID)
    Available from: 2010-03-29 Created: 2010-03-29 Last updated: 2017-12-12Bibliographically approved
    3. Natural history of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden
    Open this publication in new window or tab >>Natural history of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden
    Show others...
    2010 (English)In: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 128, no 10, p. 1289-1294Article in journal (Refereed) Published
    Abstract [en]

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

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

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

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

    Place, publisher, year, edition, pages
    American Medical Association, 2010
    Keywords
    Retinopathy of prematurity, extremely preterm, population-based, natural history
    National Category
    Ophthalmology
    Research subject
    Ophtalmology
    Identifiers
    urn:nbn:se:uu:diva-122983 (URN)10.1001/archophthalmol.2010.234 (DOI)000282844000007 ()
    Available from: 2010-04-22 Created: 2010-04-22 Last updated: 2017-12-12Bibliographically approved
    4.
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  • 4.
    Austeng, Dordi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Källen, Karin B. M.
    Lund University.
    Ewald, Uwe W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Wallin, Agneta
    St.Erik's Eye Hospital.
    Holmström, Gerd E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Treatment for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden2010In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 94, no 9, p. 1136-1139Article in journal (Refereed)
    Abstract [en]

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

  • 5.
    Austeng, Dordi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Källen, Karin
    Hellström, Ann
    Jakobsson, Peter
    Lundgren, Pia
    Tornqvist, Kristina
    Wallin, Agneta
    Holmström, Gerd
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Regional differences in screening for retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden: the EXPRESS study2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 4, p. 311-315Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 6.
    Austeng, Dordi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Källen, Karin
    Tornbladsinstitutet, Lund University.
    Hellström, Ann
    Section of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska Academy, University of Gothenburg .
    Tornqvist, Kristina
    Department of Ophthalmology, Lund University Hospital.
    Holmström, Gerd E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Natural history of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden2010In: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 128, no 10, p. 1289-1294Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

  • 8.
    Bartuma, Katarina
    et al.
    Karolinska Inst, St Erik Eye Hosp, Dept Vitreoretinal Dis, Stockholm, Sweden..
    Pal, Niklas
    Karolinska Inst, Dept Pediat, Astrid Lindgren Childrens Hosp, S-10401 Stockholm, Sweden..
    Kosek, Sonja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala Univ, Uppsala, Sweden..
    Holm, Stefan
    Karolinska Inst, Dept Pediat, Astrid Lindgren Childrens Hosp, S-10401 Stockholm, Sweden..
    All-Ericsson, Charlotta
    Karolinska Inst, St Erik Eye Hosp, Dept Vitreoretinal Dis, Stockholm, Sweden..
    A 10-year experience of outcome in chemotherapy-treated hereditary retinoblastoma2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 5, p. 404-411Article in journal (Refereed)
    Abstract [en]

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

  • 9.
    Berggren, Lennart
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Oftalmiatrik.
    Collegium medicum och de kringresande occulisterna2003In: Svensk Medicinhistorisk Tidskrift, Vol. 7, no 1, p. 179-189Article in journal (Other scientific)
  • 10.
    Berggren, Lennart
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Oftalmiatrik.
    En berättelse om en läkemedelsskandal2005Other (Other scientific)
  • 11.
    Berggren, Lennart
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Oftalmiatrik.
    Hur ögat uppfattar rörelse - ett favoritämne för både konstnär och neurofysiolog2004In: Läkartidningen, Vol. 101, no 30-31, p. 2430-2432Article in journal (Other scientific)
  • 12.
    Bjärnhall, Gunilla
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience.
    Analysis of Angiographies in Human Healthy Eyes and in Open-angle Glaucoma: Retinal Mean Transit Time and Optic Nerve Head Circulation2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Purpose of the studies was to develop a more robust technique to determine retinal mean transit time in healthy and in glaucoma eyes and to evaluate the circulation of the optic nerve head in glaucoma patients.

    The retinal mean transit time impulse-response method was evaluated in human healthy eyes and normal values and reproducibility were tested.

    Fluorescein and indocyanine green angiographies were recorded and the pictures were analyzed to obtain retinal mean transit time and to evaluate the proportion of low-fluorescent pixels of the optic nerve head in the glaucoma patients. Visual field defects were correlated to loss of neuroretinal rim area.

    A disturbed circulation was observed in the glaucoma patients, whether primary or secondary to loss of nerve fibre tissue can not be determined from these studies.

    List of papers
    1. Analysis of mean retinal transit time from fluorescein angiography in human eyes: normal values and reproducibilty.
    Open this publication in new window or tab >>Analysis of mean retinal transit time from fluorescein angiography in human eyes: normal values and reproducibilty.
    Show others...
    2002 In: Acta Ophthalmologica Scand, ISSN 1395-3907, Vol. 80, no 6, p. 652-655Article in journal (Refereed) Published
    Identifiers
    urn:nbn:se:uu:diva-97807 (URN)
    Available from: 2008-11-20 Created: 2008-11-20Bibliographically approved
    2. Retinal mean transit time in patients with primary open-angle glaucoma and normal-tension glaucoma
    Open this publication in new window or tab >>Retinal mean transit time in patients with primary open-angle glaucoma and normal-tension glaucoma
    Show others...
    2007 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 1, p. 67-72Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To compare the mean transit time (MTT) of retinal circulation in eyes with primary open-angle glaucoma (POAG) and eyes with normal-tension glaucoma (NTG) and examine the possible relationship between MTT and visual field damage, expressed as mean deviation (MD).

    Methods: Video fluorescein angiography was performed in 40 patients with POAG or NTG. Dye curves for fluorescein passing through the retinal arteries and veins were used to calculate MTT in each patient with a computer-assisted technique based on an impulse-response analysis (MTTir).

    Results: We were able to analyse MTTir in all 40 angiograms. Mean (SD) MTTir was 5.0 (1.5) seconds in eyes with POAG and 4.7 (1.4) seconds in eyes with NTG. The difference was not statistically significant. There was a weak but significant correlation between the MD and MTTir (MTTir = 4.12–0.08*MD; r = −0.49, p = 0.0013).

    Conslusions: The results demonstrate that loss of neuronal tissue in glaucoma is combined with an effect on the retinal circulation and that the effect is similar in eyes with NTG and eyes with POAG.

    Keywords
    normal-tension glaucoma, primary open-angle glaucoma, retinal blood flow, mean transit time, visual field defects, mean deviation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-97808 (URN)10.1111/j.1600-0420.2006.00780.x (DOI)000243634100012 ()17244213 (PubMedID)
    Available from: 2008-11-20 Created: 2008-11-20 Last updated: 2017-12-14Bibliographically approved
    3. The effect of elevated intraocular pressure on the retinal circulation in open-angle glaucoma and ocular hypertension.: A study on retinal mean transit time
    Open this publication in new window or tab >>The effect of elevated intraocular pressure on the retinal circulation in open-angle glaucoma and ocular hypertension.: A study on retinal mean transit time
    Show others...
    Manuscript (Other academic)
    Identifiers
    urn:nbn:se:uu:diva-97809 (URN)
    Available from: 2008-11-20 Created: 2008-11-20 Last updated: 2010-01-13Bibliographically approved
    4. The optic nerve head in open-angle glaucomaand ocular hypertension.: A study with fluorescein and ICG angiography
    Open this publication in new window or tab >>The optic nerve head in open-angle glaucomaand ocular hypertension.: A study with fluorescein and ICG angiography
    Show others...
    Manuscript (Other academic)
    Identifiers
    urn:nbn:se:uu:diva-97810 (URN)
    Available from: 2008-11-20 Created: 2008-11-20 Last updated: 2010-01-13Bibliographically approved
  • 13.
    Blixt, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Developmental Neuroscience.
    Hallböök, Finn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Developmental Neuroscience.
    Lineage tracing of horizontal and photoreceptor cells in the embryonic chicken retina2016In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 57, no 12Article in journal (Refereed)
  • 14.
    Botling Taube, Amelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Molecular and epidemiological studies on eyes with pseudoexfoliation syndrome2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Pseudoexfoliation (PEX) syndrome is an age-related condition characterized by the production and accumulation of extracellular fibrillary material in the anterior segment of the eye. PEX predisposes for several pathological conditions, such as glaucoma and complications during and after cataract surgery. The pathogenesis of PEX is not yet fully understood. It is multifactorial with genetics and ageing as contributing factors.

    We aimed to study the proteome in aqueous humor (AH) in PEX in order to increase the knowledge about its pathophysiology. Therefore, we developed sampling techniques and evaluated separation methods necessary for analyzing small sample volumes. Other objectives were to study the lens capsule in eyes with PEX regarding small molecules, and to investigate the association between PEX and cataract surgery in a population-based 30-year follow-up study.

    Samples of AH from eyes with PEX and control eyes were collected during cataract surgery. In pooled, and individual samples, various liquid based separation techniques and high resolution mass spectrometry were utilized. For quantitation, various methods for labeling, and label free techniques were applied. Lens capsules were collected from some of the patients, and analysed by imaging mass spectrometry. A cohort of 1,471 elderly individuals underwent a comprehensive ophthalmological examination at baseline. Medical information was obtained by questionnaires, and from medical records. Incident cases of cataract surgery were identified by review of medical records.

    In the initial study, several techniques were explored for protein detection, and a number of proteins were identified as differentially expressed. In the individually labelled samples, changes in the proteome were observed. Eyes with PEX contained higher levels of proteins involved in inflammation, oxidative stress, and coagulation, suggesting that these mechanisms are involved in the pathogenesis in PEX. The levels of β/γ-crystallins were significantly increased in PEX, which is a novel finding. In the lens capsules from individuals with PEX, changes in the lipid composition was observed with time-of-flight secondary ion mass spectrometry. These changes remain to be elucidated. By multivariate analysis, lens opacities were the first, and PEX the second most important predictor for cataract surgery, the later accounting for a 2.38-fold increased risk for cataract surgery.

    List of papers
    1. Protein content in aqueous humor from patients with pseudoexfoliation (PEX) investigated by capillary-LC MALDI-TOF/TOF MS
    Open this publication in new window or tab >>Protein content in aqueous humor from patients with pseudoexfoliation (PEX) investigated by capillary-LC MALDI-TOF/TOF MS
    Show others...
    2009 (English)In: PROTEOMICS - Clinical Applications, ISSN 1862-8346, E-ISSN 1862-8354, Vol. 3, no 3, p. 299-306Article in journal (Refereed) Published
    Abstract [en]

    Analysis of proteins in human body fluids is challenging since the composition of the sample often is rather complex. Here we present a method for analysis of proteins in aqueous humor from two groups of cataract patients, with and without pseudoexfoliation (PEX). Aqueous humor is an extracellular fluid contained in the anterior chamber of the eye between the cornea and iris. The limited volume of sample requires sophisticated analysis techniques. Our method is based on a total tryptic digestion of the sample followed by capillary LC-MALDI MS and MS/MS analysis of the peptides. The method is rapid, efficient and suitable as a complement or alternative to more commonly used methods based on gel electrophoretic experiments. With this method we found and unambiguously identified 30 nonredundant proteins. Proteins found include general transport proteins such as albumin and apolipoprotein A1 but also specific proteins involved in immune response, such as   complement factors. Cystatin C, clusterin, and crystallins were also found. Although the number of proteins was roughly the same in both groups there was a significant difference in their identities. These findings may give some new insights into the pathophysiology of the PEX syndrome.

    Keywords
    Aqueous humor, Capillary liquid chromatography, Human body fluids, MALDI-TOF MS/MS, Pseudoexfoliation syndrome
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-97814 (URN)10.1002/prca.200780077 (DOI)000264794700002 ()
    Available from: 2008-11-20 Created: 2008-11-20 Last updated: 2017-12-14Bibliographically approved
    2. Proteins in aqueous humor from cataract patients with and without pseudoexfoliation syndrome
    Open this publication in new window or tab >>Proteins in aqueous humor from cataract patients with and without pseudoexfoliation syndrome
    Show others...
    2012 (English)In: European journal of mass spectrometry, ISSN 1469-0667, E-ISSN 1751-6838, Vol. 18, no 6, p. 531-541Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to investigate the protein content in aqueous humor in eyes with and without pseudoexfoliations (PEX) and to evaluate the quantitative proteomics method, isobaric tagging for relative and absolute protein quantification (iTRAQ), in combination with two separation methods followed by matrix-assisted Laser desorption/ionization (MALDI) mass spectrometry and tandem mass spectrometry (MS/MS). During cataract surgery, samples of aqueous humor were collected from 20 eyes with PEX and from 18 control eyes. The relative concentrations of proteins in the pooled samples of ten PEX eyes and eight controls were evaluated after trypsin digestion and labeling of the peptides with (iTRAQ) reagent. Two separation methods, Liquid chromatography (LC) and capillary electrophoresis (CE) were used, followed by MALDI mass spectrometry and MS/MS. Furthermore, 1D gel electrophoresis was performed on the remaining ten pooled PEX samples and ten control samples. The gel material was separated by nano-liquid chromatography (nano-LC) followed by Linear-ion-trap quadrupole Fourier transformation ion cyclotron resonance (FT-ICR). Fifty four proteins were identified in the LC runs and 24 with CE. The relative concentrations of beta-crystallines B2 and S were raised and those of angiotensinogen and osteopontin lowered in the PEX sample compared to the control. The trends regarding beta-crystallines B2, angiotensinogen and osteopontin were confirmed by the 1D gel electrophoresis.

    Keywords
    pseudoexfoliations (PEX), isobaric tagging, protein quantification, proteomics, aqueous humour, osteopontin, angiotensinogen
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-197670 (URN)10.1255/ejms.1208 (DOI)000315745600007 ()
    Available from: 2013-04-02 Created: 2013-04-02 Last updated: 2017-12-06Bibliographically approved
    3. Proteomic Analysis of the Aqueous Humor in Eyes with Pseudoexfoliation Syndrome
    Open this publication in new window or tab >>Proteomic Analysis of the Aqueous Humor in Eyes with Pseudoexfoliation Syndrome
    (English)Article in journal (Refereed) Submitted
    Keywords
    Aqueous humor; Pseudoexfoliation syndrome; Quantitative proteomics; Dimethyl labelling; Mass spectrometry
    National Category
    Ophthalmology Analytical Chemistry
    Research subject
    Ophtalmology
    Identifiers
    urn:nbn:se:uu:diva-260949 (URN)
    Available from: 2015-08-26 Created: 2015-08-26 Last updated: 2015-10-01
    4. Imaging of Human Lens Capsules with Pseudoexfoliation Syndrome by Time of Flight Secondary Ion Mass Spectrometry (TOF-SIMS)
    Open this publication in new window or tab >>Imaging of Human Lens Capsules with Pseudoexfoliation Syndrome by Time of Flight Secondary Ion Mass Spectrometry (TOF-SIMS)
    (English)Manuscript (preprint) (Other academic)
    Keywords
    PEX, cataract, lens capsule, time of flight secondary mass spectrometry (TOF-SIMS), imaging mass spectrometry (IMS), sphingolipids
    National Category
    Ophthalmology
    Research subject
    Ophtalmology; Chemistry with specialization in Analytical Chemistry
    Identifiers
    urn:nbn:se:uu:diva-260946 (URN)
    Funder
    Swedish Research Council, 621-2011-4423
    Available from: 2015-08-26 Created: 2015-08-26 Last updated: 2015-10-01
    5. Pseudoexfoliation and cataract surgery: a population-based 30-year follow-up study
    Open this publication in new window or tab >>Pseudoexfoliation and cataract surgery: a population-based 30-year follow-up study
    2015 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 93, no 8, p. 774-777Article in journal (Refereed) Published
    Abstract [en]

    PURPOSE:

    To study the relationship between pseudoexfoliation (PEX) and cataract surgery in a population in which PEX is a common finding.

    METHODS:

    Survival analyses were performed in a cohort of 760 residents 65-74 years of age, examined in a population survey in the municipality of Tierp, Sweden, during 1984-1986. To expand the cohort, participants in other studies in Tierp were enrolled. Additionally, subjects were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978-2007. In total, the cohort comprised 1471 individuals, representing more than 15 900 person-years of risk. Information on cataract surgery was obtained from the glaucoma case records and from medical records.

    RESULTS:

    By the end of the study in August 2014, 564 subjects had undergone cataract surgery. Of these cases, 224 were affected by PEX at baseline. In multivariate analyses, PEX was the second most important predictor for cataract surgery after lens opacities, accounting for a 2.38-fold (95% confidence interval 2.01-2.84) increased risk.

    CONCLUSION:

    The results strongly suggest that PEX is a predictor for cataract surgery in the population under study.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2015
    Keywords
    cataract, cataract surgery, epidemiology, exfoliation syndrome, pseudoexfoliation, risk factor
    National Category
    Ophthalmology
    Research subject
    Ophtalmology
    Identifiers
    urn:nbn:se:uu:diva-260948 (URN)10.1111/aos12789 (DOI)000367654500034 ()
    Available from: 2015-08-26 Created: 2015-08-26 Last updated: 2017-12-04Bibliographically approved
  • 15.
    Botling Taube, Amelie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
    Konzer, Anne
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
    Alm, Albert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Bergquist, Jonas
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
    Proteomic Analysis of the Aqueous Humor in Eyes with Pseudoexfoliation SyndromeArticle in journal (Refereed)
  • 16.
    Botling Taube, Amelie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
    Mi, Jia
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
    Alm, Albert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Bergquist, Jonas
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
    Imaging of Human Lens Capsules with Pseudoexfoliation Syndrome by Time of Flight Secondary Ion Mass Spectrometry (TOF-SIMS)Manuscript (preprint) (Other academic)
  • 17. Breitbart, Eberhardt
    et al.
    Cesarini, Jean-Pierre
    de Gruijl, Frank
    Hietanen, Marja
    Mariutti, G
    Mc Kinley, Alister
    Okuno,
    Roy, C
    Schulmeister, Karl
    Sliney, David
    Söderberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Stuck, Bruce
    Swerdlow, Anthony
    Van Deventer, E
    Zeeb, H
    Protecting workers from ultraviolet radiation2007Book (Other academic)
  • 18.
    Bucht, Curry
    et al.
    Inst. för Klinisk Neurovetenskap, KI.
    Manneberg, Göran
    Biomedicinsk fysik och röntgenfysik, KTH.
    Recording the diffraction pattern reflected from corneal endothelium.2007In: Ophthalmic Technologies XVII / [ed] Manns F, Söderberg PG, Ho Arthur, Bellinghamn, WA, USA: SPIE , 2007, p. 10:1-10:8Conference paper (Refereed)
  • 19. Bucht, Curry
    et al.
    Söderberg, Per G.
    St. Erik's Eye Hospital (Sweden) and Mälarsjukhuset Eskilstuna (Sweden) and Univ. of Miami.
    Manneberg, Göran
    A model for corneal endothelial morphometry by diffraction2006In: Ophthalmic Technologies XVI: Proceedings of SPIE / [ed] Fabrice Manns; Per G. Söderberg; Arthur Ho, San José, CA: SPIE , 2006, Vol. 6138, p. 6138-O-1-6138-O-8Conference paper (Refereed)
  • 20. Bucht, Curry
    et al.
    Söderberg, Per G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Manneberg, Göran
    Fully automated corneal endothelial morphometry of images captured by clinical specular microscopy2010In: Ophthalmic Technologies XX / [ed] Fabrice Manns, Per G. Söderberg, Arthur Ho, San Francisco, CA: SPIE , 2010, p. 1E-1-1E-8Conference paper (Refereed)
  • 21. Bucht, Curry
    et al.
    Söderberg, Per G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Manneberg, Göran
    Fully automated corneal endothelial morphometry of images captured by clinical specular microscopy2009In: Ophthalmic Technologies XIX / [ed] Fabrice Manns; Per G. Söderberg; Arthur Ho, San José, CA: SPIE , 2009, Vol. 7163, p. 15:1-15:8Conference paper (Refereed)
  • 22. Bucht, Curry
    et al.
    Söderberg, Per G.
    St. Erik's Eye Hospital (Sweden) and Univ. of Miami.
    Manneberg, Göran
    The impact of horizontal offset of the cornea during corneal specular microscopy2008In: Ophthalmic Technologies XVIII: Proceedings of SPIE / [ed] Fabrice Manns; Per G. Söderberg; Arthur Ho; Bruce E. Stuck; Michael Belkin, San José, CA: SPIE , 2008, Vol. 6426, p. 13-1-13-9Conference paper (Refereed)
  • 23. Bucht, Curry
    et al.
    Söderberg, Per
    St Erik's Eye Hospital (Sweden) and Univ. of Miami.
    Manneberg, Göran
    Recording the dffraction pattern reflected from corneal endothelium2007In:  Ophthalmic Technologies XVII / [ed] Fabrice Manns, Per G. Söderberg, Arthur Ho, Bruce E. Stuck, Michael Belkin, San José, CA: SPIE , 2007, Vol. 6426, p. 10:1-10:8Conference paper (Refereed)
  • 24.
    Bucht, Curry
    et al.
    S:t Eriks Ögonsjukhus, Inst. f. Neurovetenskap, KI.
    Söderberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Manneberg, Göran
    Biomedicinsk fysik och röntgenfysik, Inst. för tillämpad fysik.
    Simulation of specular microscopy images of corneal endothelium, a tool for control of measurement errors2011In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 89, no 3, p. e242-e250Article in journal (Refereed)
    Abstract [en]

    Purpose: We aimed at developing simulation software capable of producing images of corneal endothelium close to identical to images captured by clinical specular microscopy with defined morphometrical characteristics. It was further planned to demonstrate the usefulness of the simulator by analysing measurement errors associated with a trained operator using a commercially available semi-automatic algorithm for analysis of simulated images.

    Methods: Software was developed that allows creation of unique images of the corneal endothelium expressing morphology close to identical with that seen in images of corneal specular microscopy. Several hundred unique images of the corneal endothelium were generated with randomization, spanning a physiological range of endothelial cell density. As an example of the usefulness of the simulator for analysis of measurement errors in corneal specular microscopy, a total of 12 of all the images generated were randomly selected such that the endothelial cell density expressed was evenly distributed over the physiological range of endothelial cell density. The images were transferred to a personal computer. The imagenet-640 software was used to analyse endothelial cell size variation, percentage of hexagonal endothelial cells, and endothelial cell density.

    Results: The simulator developed allows randomized generation of corneal specular microscopy images with a preset expected average and variation of cell structure. Calculated morphometric information of each cell is stored in the simulator. The image quality can secondarily be varied with a toolbox of filters to approximate a large spectrum of clinically captured images. As an example of the use of the simulator, measurement errors associated with one trained operator using the imagenet-640 software, and focusing on endothelial cell density, were examined. The functional dependence between morphometric information estimated with the imagenet-640 software algorithm and real morphometric information as provided by the simulator was analysed with regression. It was demonstrated that that the estimations of endothelial cell size variation was associated with a scaling error and that the random error was strongly dependent on the operator.

    Conclusion: The newly developed simulator for randomized generation of morphometrically defined corneal specular microscopy images for the first time makes it possible to estimate a spatial scaling error of an available semi-automatic algorithm and to determine the random measurement error of important morphometric estimates in a defined reference sample of images. It is anticipated that the simulator will be a valuable tool for the generation of a large set of morphometrically well-characterized corneal specular microscopy images that can be used for calibration among research centres, for minimization of random errors and for measurement of quality control. Simulated images will be useful for the development of fully automatic analysis of corneal endothelial cell morphometry.

  • 25. Castellini, Meryl
    et al.
    Wolf, Louise V.
    Chauhan, Bharesh K.
    Galileo, Deni S.
    Kilimann, Manfred W.
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Cell and Molecular Biology.
    Cvekl, A.
    Duncan, Melina K.
    Palm is expressed in both developing and adult mouse lens and retina2005In: BMC Ophthalmology, ISSN 1471-2415, E-ISSN 1471-2415, Vol. 5, p. 14-Article in journal (Refereed)
    Abstract [en]

    Background

    Paralemmin (Palm) is a prenyl-palmitoyl anchored membrane protein that can drive membrane and process formation in neurons. Earlier studies have shown brain preferred Palm expression, although this protein is a major water insoluble protein in chicken lens fiber cells and the Palm gene may be regulated by Pax6.

    Methods

    The expression profile of Palm protein in the embryonic, newborn and adult mouse eye as well as dissociated retinal neurons was determined by confocal immunofluorescence. The relative mRNA levels of Palm, Palmdelphin (PalmD) and paralemmin2 (Palm2) in the lens and retina were determined by real time rt-PCR.

    Results

    In the lens, Palm is already expressed at 9.5 dpc in the lens placode, and this expression is maintained in the lens vesicle throughout the formation of the adult lens. Palm is largely absent from the optic vesicle but is detectable at 10.5 dpc in the optic cup. In the developing retina, Palm expression transiently upregulates during the formation of optic nerve as well as in the formation of both the inner and outer plexiform layers. In short term dissociated chick retinal cultures, Palm protein is easily detectable, but the levels appear to reduce sharply as the cultures age. Palm mRNA was found at much higher levels relative to Palm2 or PalmD in both the retina and lens.

    Conclusion

    Palm is the major paralemmin family member expressed in the retina and lens and its expression in the retina transiently upregulates during active neurite outgrowth. The expression pattern of Palm in the eye is consistent with it being a Pax6 responsive gene. Since Palm is known to be able to drive membrane formation in brain neurons, it is possible that this molecule is crucial for the increase in membrane formation during lens fiber cell differentiation.

  • 26.
    Dalin, Frida
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Dermatology and Venereology. Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Adamus, Grazyna
    Oregon Hlth & Sci Univ, Casey Eye Inst, Ocular Immunol Lab, Portland, OR 97201 USA..
    Yang, Sufang
    Oregon Hlth & Sci Univ, Casey Eye Inst, Ocular Immunol Lab, Portland, OR 97201 USA..
    Landgren, Eva
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Palle, Josefine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hallgren, Åsa
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Frost, Britt-Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hugosson, Therese
    Lund Univ, Dept Clin Sci, Ophthalmol, Lund, Sweden..
    Landegren, Nils
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Autoimmunity. Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Eriksson, Daniel
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Andreasson, Sten
    Lund Univ, Dept Clin Sci, Ophthalmol, Lund, Sweden..
    Tabbara, Khalid F.
    Ctr Eye, Riyadh, Saudi Arabia..
    Kämpe, Olle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Autoimmunity. Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Alimohammadi, Mohammad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Dermatology and Venereology. Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Aryl Hydrocarbon Receptor-Interacting Protein-Like 1 in Cancer-Associated Retinopathy2016In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 123, no 6, p. 1401-1404Article in journal (Other academic)
  • 27.
    Ekström, Curt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Risk factors for incident open-angle glaucoma: a population-based 20-year follow-up study2012In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 90, no 4, p. 316-321Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the effect of potential risk factors on the development of open-angle glaucoma (OAG) in a population in which pseudoexfoliation (PEX) is a common finding.

    Methods: In 1984-1986, a population-based survey of 760 people aged 65-74 years was conducted in the municipality of Tierp, Sweden. From 1988 to 2006, a follow-up study of the 530 people with normal visual fields has been in progress. To increase the cohort, 273 ophthalmic outpatients were enroled. Reliable visual fields were available for 679 people, representing 6 126 person-years at risk. A time-weighted mean intraocular pressure (IOP) for all visits was calculated.

    Results: Sixty-four subjects developed definite OAG, 29 of whom were exposed to PEX. Risk factors associated with OAG were higher age, a positive family history, increased IOP and PEX. The age-standardized rate ratio (SRR) was 14.8 times (95% confidence interval [CI] 7.92-27.8) greater in subjects with mean IOP >/=20 mmHg than in those with mean IOP /=20 mmHg.

    Conclusion: Increased IOP and PEX were serious risk factors for incident OAG. The effect of PEX was mediated by increased IOP.

  • 28.
    Ekström, Curt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Botling Taube, Amelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Pseudoexfoliation and cataract surgery: a population-based 30-year follow-up study2015In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 93, no 8, p. 774-777Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    To study the relationship between pseudoexfoliation (PEX) and cataract surgery in a population in which PEX is a common finding.

    METHODS:

    Survival analyses were performed in a cohort of 760 residents 65-74 years of age, examined in a population survey in the municipality of Tierp, Sweden, during 1984-1986. To expand the cohort, participants in other studies in Tierp were enrolled. Additionally, subjects were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978-2007. In total, the cohort comprised 1471 individuals, representing more than 15 900 person-years of risk. Information on cataract surgery was obtained from the glaucoma case records and from medical records.

    RESULTS:

    By the end of the study in August 2014, 564 subjects had undergone cataract surgery. Of these cases, 224 were affected by PEX at baseline. In multivariate analyses, PEX was the second most important predictor for cataract surgery after lens opacities, accounting for a 2.38-fold (95% confidence interval 2.01-2.84) increased risk.

    CONCLUSION:

    The results strongly suggest that PEX is a predictor for cataract surgery in the population under study.

  • 29.
    Ekström, Curt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Open-angle glaucoma and Alzheimer´s disease: a population-based 30 year follow-up study2016In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 95, no 2, p. E157-E158Article in journal (Other academic)
  • 30.
    Ekström, Curt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Pseudoexfoliation and Alzheimer´s disease: a population-based 30-year follow-up study2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 4, p. 355-358Article in journal (Refereed)
  • 31.
    Ekström, Curt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Wilger, Sophia
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Pseudoexfoliation and aortic aneurysm: a long-term follow-up study.2018In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, p. 1-4, article id doi: 10.1111/aos.13882Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To study the relationship between pseudoexfoliation (PEX) and aortic aneurysm in a population with a high prevalence of PEX.

    METHODS: Survival analyses were performed in a cohort of 735 residents aged 65-74 years, examined in a population survey in the municipality of Tierp, Sweden, 1984-1986. To expand the sample size, 1040 people were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978-2007. In this way, the cohort comprised 1775 subjects, representing more than 25 400 person-years at risk. Medical records and autopsy reports were reviewed to identify subjects diagnosed with aneurysm. Those with a follow-up time shorter than 1 year were excluded.

    RESULTS: By the end of the study in September 2017, 60 new cases of aortic aneurysm had been found. Of these cases, 23% (14 subjects) were affected by PEX at baseline, compared with 28% among subjects without aneurysm. No association between PEX and aortic aneurysm was found (hazard ratio 0.97; 95% confidence interval 0.53-1.77).

    CONCLUSION: In this population-based study, we were unable to verify a relationship between PEX and the development of aortic aneurysm.

  • 32.
    Eriksson, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Aspects of Optical Coherence Tomography (OCT) in Healthy Eyes and Eyes with Retinal Diseases2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Optical coherence tomography (OCT) is a technique in which cross-sectional images from intraocular tissue can be obtained. The quantitative and qualitative examinations are used for evaluating retinal diseases. Conventional OCT (Stratus) is mainly used, but the new Spectral domain (Cirrus) OCT, which has improved technology, may provide more reliable measurements.

    The aim of the study was to collect normal values of macular thickness in children and adults and to evaluate the effect of age and/or gender, to compare measurement variability in healthy eyes and eyes with age-related macular degeneration (AMD), to compare Stratus and Cirrus OCT and to study the effect of cataract surgery on macula.

    Sixty-seven healthy adults and 56 children, 30 patients with AMD, 34 patients with diabetes and cataract and 35 healthy controls were included. The quantitative maps in Stratus and Cirrus were used and manual correction of foveal location was evaluated. Qualitative OCT was compared to fluorescein angiography (FA) after cataract surgery.

    The mean values of macular thickness in Stratus OCT were 207µm in adults and 204 µm in children. The measurement variability was low. Macular thickness decreased with age in adults, but not in children. No correlation with gender was found. In eyes with wet AMD, there were small differences in measurement variability comparing Stratus and Cirrus OCT. After manual correction in Cirrus OCT, the coefficients of repeatability were improved to values close to the repeatability in normal eyes. Two thirds of the diabetic and half of the control eyes showed leakage on FA after cataract surgery. Qualitative OCT corresponded poorly to FA in diabetic eyes. A thicker macula, assessed with OCT, was often observed without any obvious effect on visual acuity.  OCT was as good as FA in revealing clinically relevant changes in macula after surgery, and was the technique recommended for follow-up.

    List of papers
    1. Repeatability in and interchangeability between the macular and the fast macular thickness map protocols: a study on normal eyes with Stratus optical coherence tomography
    Open this publication in new window or tab >>Repeatability in and interchangeability between the macular and the fast macular thickness map protocols: a study on normal eyes with Stratus optical coherence tomography
    2009 (English)In: Acta ophthalmologica, ISSN 1755-3768, Vol. 87, no 7, p. 725-730Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To collect a normal material and to compare the macular and the fast macular thickness map protocols regarding normal values and repeatability. Methods: Sixty-seven individuals underwent three repeated scans with the macular thickness protocol; 45 of them also had three scans with the fast thickness protocol in Stratus optical coherence tomography (OCT). The maps were divided into nine ETDRS fields, where thickness values were presented. The repeatability was calculated as intraclass correlation coefficient (ICC), coefficient of variance (CV) and coefficient of repeatability (CR). For comparison between the two protocols, limits of agreement were determined according to Bland-Altman. Results: Normal values for the two protocols were very close. Repeatability was high. ICC for all areas was 0.92-0.98. CV was less than 1% and CR was 6-8 mum for both protocols, with the exception of the fovea in the fast protocol (where CV was 1.44% and CR 12.4 mum). Limits of agreement between the two protocols were less than 10 mum as a rule. Conclusion: Normal values for the protocols are equal and they both have excellent repeatability. The fast macular map is a good alternative with the possible exception of the fovea, where variation is twice that of the macular thickness map.

    Keywords
    macular thickness maps, normal values, optical coherence tomography, repeatability
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-104911 (URN)10.1111/j.1755-3768.2008.01345.x (DOI)000270999300006 ()18937816 (PubMedID)
    Available from: 2009-05-30 Created: 2009-05-30 Last updated: 2010-09-23Bibliographically approved
    2. A population-based study of macular thickness in full-term children assessed with Stratus OCT: normative data and repeatability.
    Open this publication in new window or tab >>A population-based study of macular thickness in full-term children assessed with Stratus OCT: normative data and repeatability.
    2009 (English)In: Acta ophthalmologica, ISSN 1755-3768, Vol. 87, no 7, p. 741-745Article in journal (Refereed) Published
    Abstract [en]

    Purpose: We aimed to determine normal macular thickness values, assessed with optical coherence tomography (OCT), in a population of full-term children of normal birthweight. Methods: A total of 56 children, aged 5-16 years, randomly chosen from the population register, were examined with Stratus OCT. Only children with visual acuity < 0.2 logMAR, spherical equivalent of - 3 to + 3 D and astigmatism < 2 D were included. The fast macular map protocol was used and three examinations were performed in each eye. One eye was then randomized for further analyses. Mean values for the nine ETDRS areas, foveal minimum thickness and macular volume were calculated for 55 eyes. Coefficients of variance and intraclass correlations were calculated for each area. Results: All children co-operated well and no child was excluded for lack of concentration. Mean +/- standard deviation central macular thickness was 204 +/- 19 mum. Mean total macular volume was 7.11 +/- 0.35 mm(3). No correlations were found between age, gender and macular thickness. Coefficients of variance were < 2% and intraclass correlations were > 0.9 in all areas, except the foveal minimum. Conclusions: Normal values for macular thickness in healthy full-term children were reported. As the Stratus OCT provides normal values only for adults, these data are a better alternative for comparison with children with retinal abnormalities. We concluded that OCT is suitable for examining the retina in children aged 5-16 years and has the same high level of repeatability as in adults.

    Keywords
    children, full-term, macular thickness, optical coherence tomography (OCT), repeatability
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-104400 (URN)10.1111/j.1755-3768.2008.01357.x (DOI)000270999300009 ()18811639 (PubMedID)
    Available from: 2009-05-30 Created: 2009-05-28 Last updated: 2010-10-04Bibliographically approved
    3. Macular thickness decreases with age in normal eyes: A study on the macular thickness map protocol in the Stratus OCT
    Open this publication in new window or tab >>Macular thickness decreases with age in normal eyes: A study on the macular thickness map protocol in the Stratus OCT
    2008 (English)In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 93, no 11, p. 1148-1452Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND/AIM: Retinal and retinal nerve fibre layer (RNFL) thinning with age have been described in histological studies. In vivo techniques like optical coherence tomography (OCT), has shown thinning of optic nerve RNFL and the retina in specific areas. One would expect thinning of the total macula, but so far, a correlation with the quantitative OCT macular map tool and age has not been found. METHODS: Sixty-seven healthy individuals underwent three repeated scans in both eyes with the macular thickness map protocol in the Stratus OCT. That protocol divides the macula area in nine ETDRS fields.The RNFL was measured in one specific location close to the optic disc. Correlations between retinal, RNFL thickness, macular volume and age were determined. RESULTS: We found a statistically significant negative relationship between retinal thickness and age for all ETDRS areas, total macular volume and RNFL thickness. Retinal thickness decreased with 0,26-0,46 microm, the macula volume 0,01 mm(3) and RNFL with 0,09 microm per year. CONCLUSION: Retinal thickness within the area covered by the macular map significantly decreases with age. In the area examined in the papillomacular bundle, 20% of the retinal thinning is due to the RNFL and 80% due to thinning of other layers of the retina.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-104910 (URN)10.1136/bjo.2007.131094 (DOI)000271091900009 ()19019921 (PubMedID)
    Available from: 2009-05-30 Created: 2009-05-30 Last updated: 2017-12-13Bibliographically approved
    4. Is quantitative spectral-domain superior to time-domain optical coherence tomography (OCT) in eyes with age-related macular degeneration?
    Open this publication in new window or tab >>Is quantitative spectral-domain superior to time-domain optical coherence tomography (OCT) in eyes with age-related macular degeneration?
    2012 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 90, no 7, p. 620-627Article in journal (Refereed) Published
    Abstract [en]

    Purpose: The aim of this study was to determine the variability of macular map measurements, for two generations of optical coherence tomography (OCT) instruments, in eyes with wet age related macular degeneration (AMD) and low visual acuity. Methods: Patients were examined with Stratus OCT and Cirrus HD-OCT. The macular thickness was assessed with the 'macular thickness map scan' and 'fast protocol' in Stratus and with the 512 × 128 and 200 × 200 cube protocols in Cirrus OCT. Two measurements were taken one directly after the other, at the first visit to analyse repeatability. Approximately 1 week later, a third measurement was taken to analyse reproducibility. In Cirrus OCT, a manual correction of foveal location was also performed. Repeatability and reproducibility were calculated as a coefficient of variance (CoV) and a coefficient of repeatability/reproducibility. Results: Repeatability for central macular thickness (expressed as CoV) was about three per cent for all protocols, and the coefficient of repeatability between 34 and 54 μm. Reproducibility (also expressed as CoV) was between four to seven per cent and coefficient of repeatability between 64 and 89 μm. After manual adjustment of foveal location in Cirrus OCT, the coefficient of repeatability improved to 12-18 μm, and the coefficient of reproducibility to 44-47 μm. Conclusions: In eyes affected by wet AMD, there were small differences in repeatability and reproducibility when comparing quantitative maps in Stratus and Cirrus OCT. However, when the software for manual correction of foveal position in Cirrus OCT was used, the variability decreased markedly, and the repeatability was close to what had been reported in normal eyes, demonstrating a significant, potential advantage of spectral-domain over time-domain OCT.

    Keywords
    age-related macular degeneration, quantitative optical coherence tomography, repeatability, reproducibility
    National Category
    Ophthalmology
    Research subject
    Ophtalmology
    Identifiers
    urn:nbn:se:uu:diva-184945 (URN)10.1111/j.1755-3768.2011.02112.x (DOI)000310548500017 ()
    Available from: 2012-11-19 Created: 2012-11-15 Last updated: 2017-12-07Bibliographically approved
    5. Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls
    Open this publication in new window or tab >>Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls
    Show others...
    2011 (English)In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 249, no 3, p. 349-359Article in journal (Refereed) Published
    Abstract [en]

    Cystoid macular edema (CME) is a well-known complication after cataract surgery, and diabetic retinopathy is reported to be an important risk factor for impaired visual recovery. In this prospective study, we compared visual outcome 6 months after surgery in eyes with moderate retinopathy and no previous ME with a control group, and observed the incidence of ME seen on fluorescein angiography (FA) and optical coherence tomography (OCT).

    Thirty-four patients with type-2 diabetes and 35 controls were enrolled. Best-corrected visual acuity (VA) letters ETDRS was measured pre-op, at day 7, week 6 and month 6. FA performed pre-op and at week 6 was divided into three leakage patterns. OCT performed pre-op, at week 6 and month 6 was qualitatively divided into three types. Macular thickness was measured in three circular fields (central subfield, inner and outer circle) from the macular maps.

    There was no statistically significant difference in VA before surgery, at day 7 or at 6 months, but at 6 weeks there was a significant difference with lower VA in the diabetic group. Six percent of control and 12% of diabetic eyes developed a clinical CME defined as a loss of > 5 letters between day 7 and week 6. Incidence of FA leakage was 23% in control and 76% in diabetic eyes. At 6 weeks, 20% of control and 44% of the diabetic eyes had qualitative changes on OCT. A statistically significant increase in thickness was observed for all three macular areas in both groups, part of it remaining at 6 months. There were, however, no differences in central macular thickness between the groups at any visit. Retinal thickening had poor correlation with VA.

    The final visual outcome in eyes with mild to moderate retinopathy, without previous ME, is as good as in normal eyes, but an increased frequency of macular changes may protract recovery of full vision. Changes on OCT or FA are often seen without any obvious effect on VA. OCT is as good as FA at detecting a clinical CME, and is the technique recommended for follow-up before FA is considered.

    Keywords
    Visual outcome, Phacoemulsification, Cystoid macular edema, Optical coherence tomography, Fluorescein angiography, Sub-clinical macular thickening
    National Category
    Medical and Health Sciences
    Research subject
    Ophtalmology
    Identifiers
    urn:nbn:se:uu:diva-128901 (URN)10.1007/s00417-010-1484-9 (DOI)000288454200003 ()20827486 (PubMedID)
    Available from: 2010-08-03 Created: 2010-08-02 Last updated: 2018-05-28Bibliographically approved
  • 33.
    Eriksson, Urban
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Alm, Albert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Larsson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Is quantitative spectral-domain superior to time-domain optical coherence tomography (OCT) in eyes with age-related macular degeneration?2012In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 90, no 7, p. 620-627Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to determine the variability of macular map measurements, for two generations of optical coherence tomography (OCT) instruments, in eyes with wet age related macular degeneration (AMD) and low visual acuity. Methods: Patients were examined with Stratus OCT and Cirrus HD-OCT. The macular thickness was assessed with the 'macular thickness map scan' and 'fast protocol' in Stratus and with the 512 × 128 and 200 × 200 cube protocols in Cirrus OCT. Two measurements were taken one directly after the other, at the first visit to analyse repeatability. Approximately 1 week later, a third measurement was taken to analyse reproducibility. In Cirrus OCT, a manual correction of foveal location was also performed. Repeatability and reproducibility were calculated as a coefficient of variance (CoV) and a coefficient of repeatability/reproducibility. Results: Repeatability for central macular thickness (expressed as CoV) was about three per cent for all protocols, and the coefficient of repeatability between 34 and 54 μm. Reproducibility (also expressed as CoV) was between four to seven per cent and coefficient of repeatability between 64 and 89 μm. After manual adjustment of foveal location in Cirrus OCT, the coefficient of repeatability improved to 12-18 μm, and the coefficient of reproducibility to 44-47 μm. Conclusions: In eyes affected by wet AMD, there were small differences in repeatability and reproducibility when comparing quantitative maps in Stratus and Cirrus OCT. However, when the software for manual correction of foveal position in Cirrus OCT was used, the variability decreased markedly, and the repeatability was close to what had been reported in normal eyes, demonstrating a significant, potential advantage of spectral-domain over time-domain OCT.

  • 34. Frennesson, Christina I.
    et al.
    Wadelius, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medical Genetics.
    Nilsson, Sven Erik G.
    Best vitelliform macular dystrophy in a Swedish family: genetic analysis and a seven-year follow-up of photodynamic treatment of a young boy with choroidal neovascularization2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 3, p. 238-242Article in journal (Refereed)
    Abstract [en]

    Abstract. Purpose: To determine the mutation in a Swedish family with Best disease (vitelliform macular dystrophy; VMD) and to investigate the short- and long-term effects of photodynamic treatment (PDT) on subretinal neovascularization in a young boy. Methods: The five members of three generations of a family with VMD underwent a thorough ophthalmological examination, including best-corrected visual acuity (VA), visual field, colour vision, biomicroscopy of the posterior segment (dilated), fundus photography and electro-oculography (EOG). For the proband, an eleven-year-old boy, his father and grandfather, dark adaptation test, angiography and electroretinography (ERG) were also performed. After PCR amplification, the genotype was determined by cleavage with restriction enzyme, specific for the W93C allele. Results: Four family members had an abnormal EOG response. All showed the W93C mutation in the VMD2 gene. Visual acuity ranged from 20/20 to 20/250. The fundus manifestations varied from minor pigmentary changes over egg yolk-like lesions to chorioretinal atrophy, and fluorescein angiography showed corresponding pathology. In the proband, VA decreased during follow-up from 0.5 (20/40) to 0.08 (20/250) due to a subfoveal neovascularization with haemorrhage, and PDT with visudyne was begun. The haemorrhage resolved within 2 months, and after three treatments, VA had increased to 0.25 (20/80). One year later, acuity had improved to 0.5 (20/40), and this result was stable throughout the 7 years of the follow-up. Conclusion: The mutation was determined to be W93C, the most common mutation in VMD in Sweden. In an eleven-year-old boy with subretinal neovascularization, PDT seemed to be beneficial also in a long-term follow-up.

  • 35.
    Galichanin, Konstantin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Exposure to subthreshold dose of UVR-B induces apoptosis in the lens epithelial cells and does not in the lens cortical fibre cells2017In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 95, no 8, p. 834-838Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to investigate in which part of the lens invivo exposure to subthreshold dose of UVR-B radiation induces apoptosis.

    Methods: Twenty 6-week-old female albino Sprague-Dawley rats were exposed to subthreshold dose (1kJ/m(2)) of UVR-B unilaterally and killed at 120hr after exposure. Lenses were enucleated and dissected on three regions: the lens epithelium, the cortex and the nucleus. The lens nucleus then was removed. Apoptosis markers p53 and caspase 3 were used to study apoptosis in the lens regions. qRT-PCR and Western blot were utilized to analyse the lenses.

    Results: TP53 and CASP3 mRNA expressions are increased in exposed lenses, both in the lens epithelium and in the cortex regions, in relation to non-exposed lenses. Expression of p53 protein is increased in exposed lens epithelium in relation to non-exposed lens epithelium. Caspase 3 protein is expressed in exposed lens epithelial cells, while it is not expressed in non-exposed lens epithelial cells. p53 and caspase 3 proteins are not expressed in either exposed nor non-exposed lens fibre cells.

    Conclusion: Exposure to UVR-B increases mRNA transcription of apoptosis marker p53 invivo in both regions of the lens and of apoptosis marker caspase 3 in the lens cortex. Exposure to UVR-B increases p53 and caspase 3 proteins expression just in the lens epithelium. In vivo exposure to subthreshold dose of UVR-B induces apoptosis in the lens epithelial cells and does not in the lens fibre cells.

  • 36.
    Galichanin, Konstantin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Svedlund, Jessica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
    Söderberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Kinetics of GADD45a, TP53 and CASP3 gene expression in the rat lens in vivo in response to exposure to double threshold dose of UV-B radiation2012In: Experimental Eye Research, ISSN 0014-4835, E-ISSN 1096-0007, Vol. 97, no 1, p. 19-23Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to investigate the evolution of expression of mRNA message for the genes for the genome stress sensor GADD45α, the apoptosis initiator TP53 and the apoptosis executor CASP3 in the rat lens in vivo in response to exposure to UVR around 300 nm. Forty six week old female albino Sprague-Dawley rats were unilaterally exposed to double threshold dose for cataract induction, 8 kJ/m2 (8.9 W/m2 for 15 min), of UVR (λmax = 300 nm). The animals were sacrificed at 1, 5, 24 and 120 h following exposure to UVR-B. For each of the GADD45α, TP53 and CASP3 genes, respectively, mRNA expression in the lenses was measured by quantitative RT-PCR. It was found that expression of mRNA for GADD45α transiently increases between 5 and 24 h after exposure. TP53 is slightly downregulated in exposed lenses at 1 and 5 h after exposure and thereafter the mRNA expression increases with a constant rate of 9.4∗10−3 rel. units/h to a 1.8 fold increase at 120 h after exposure. Expression of mRNA for CASP3 is downregulated at 1, 5 and 24 h after in vivo exposure and then increases with a constant rate of 4.7∗10−3 rel. units/h, upto a 1.3 fold upregulation at 120 h. Double threshold dose of UVR, for short delay onset of cataract, in vivo causes a transient upregulation of the stress sensor GADD45α, a concurrent downregulation of TP53 and CASP3, followed by a constant upregulation of TP53 that precedes a constant upregulation of CASP3.

  • 37.
    Galichanin, Konstantin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Yu, Zhaohua
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Söderberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Upregulation of GADD45a, TP53 and CASP3 mRNA expression in the rat lens after in vivo exposure to sub-threshold exposure to UVR B2014In: Journal of Ocular Biology, ISSN 2334-2838, Vol. 2, no 1, p. 5-Article in journal (Refereed)
    Abstract [en]

    Purpose:

    The objective of the present study was to investigate the evolution of mRNA expression of the stress sensor GADD45α, the apoptosis initiator TP53 and the apoptosis executor CASP3 in the rat lens after in vivo exposure to sub-threshold dose of UVR-B.

    Methods:

    Forty six-week-old female albino Sprague-Dawley rats were unilaterally exposed to a sub-threshold dose, 1 kJ/m2 (1.1 W/m2 for 15 min), of UVR (λmax = 300 nm). Anesthetized and dilated eyes were exposed to UVB radiation. The animals were sacrificed at 1, 5, 24 and 120 h post-exposure. mRNA expression of the GADD45α, TP53 and CASP3 genes in the lenses was measured by quantitative RT‑PCR, and fold change in mRNA expression between exposed and unexposed lenses was calculated.

    Results:

    mRNA expression for GADD45α increased to a 1.2 fold change at 1 h after exposure and then returned to no change at 120 h. mRNA expression for TP53 increased with a regression coefficient of 0.04 h-1 to a maximum of 1.67 fold change. mRNA expression for CASP3 increased with a regression coefficient of 4.5 x10-3 rel. units/h to a 1.46 fold change at 120 h after exposure.

    Conclusions:

    A sub-threshold in vivo exposure to UVR-B causes a transient upregulation of the stress sensor GADD45α at 1 h after exposure, a saturating upregulation of TP53 and a subsequent constant upregulation of CASP3 in the rat lens.

  • 38. Gole, Glen A.
    et al.
    Ells, Anna L.
    Katz, Ximena
    Holmström, Gerd
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Oftalmiatrik.
    Fielder, Alistair R.
    Capone, Antonio
    Flynn, John T.
    Good, William G.
    Holmes, Jonathan M.
    McNamara, J. Arch
    Palmer, Earl A.
    Quinn, Graham E.
    Shapiro, Michael J.
    Trese, Michael G. J.
    Wallace, David K.
    The International Classification of Retinopathy of Prematurity Revisited: An International Committee for the Classification of Retinopathy of Prematurity2005In: Arch Ophthalmol, Vol. 123, p. 991-999Article in journal (Refereed)
  • 39.
    Granstam, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanland Cty Hosp Vasteras, Ophthalmol, Vasteras, Sweden..
    Sjovall, Kersti
    Vastmanland Cty Hosp Vasteras, Ophthalmol, Vasteras, Sweden..
    Paul, Anna
    Vastmanland Cty Hosp Vasteras, Ophthalmol, Vasteras, Sweden..
    Eriksson, Laila
    Vastmanland Cty Hosp Vasteras, Ophthalmol, Vasteras, Sweden..
    Change of treatment strategy for wet AMD from PRN to Treat-and-Extend: 6 months experience from a Swedish county hospital2015In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 56, no 7, article id 5366Article in journal (Refereed)
  • 40.
    Granstam, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Västmanland City Hospital, Västeras.
    Sjovall, Kersti
    Västmanland City Hospital, Västeras.
    Paul, Anna
    Västmanland City Hospital, Västeras.
    Moren, Asa
    Västmanland City Hospital, Västeras.
    Anti VEGF-treatment for wet-AMD According to a Treat-and-Extend Protocol at a Swedish County Hospital: clinical outcomes at 12 Months2016In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 57, no 12Article in journal (Refereed)
  • 41.
    Granstam, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Westborg, Inger
    Umea Univ, Dept Clin Sci Ophthalmol, Umea, Sweden..
    Barkander, Anna
    Ostersund Cty Hosp, Dept Ophthalmol, Ostersund, Sweden..
    Börjesson, Malin
    Skelleftea Cty Hosp, Dept Ophthalmol, Skelleftea, Sweden..
    Lindahl, Sara
    Umea Univ Hosp, Dept Ophthalmol, Umea, Sweden..
    Meszaros, Eva
    Gavleborg Cty Hosp Gavle, Dept Ophthalmol, Gavle, Sweden..
    Wojciechowska-Zajac, Anna
    Sunderby Cty Hosp, Dept Ophthalmol, Sunderbyn, Sweden..
    Wagner, Philippe
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Albrecht, Susanne
    RC Syd, Swedish Macula Register, Karlskrona, Sweden..
    Karlsson, Niklas
    RC Syd, Swedish Macula Register, Karlskrona, Sweden..
    Bjarnhall, Gunilla
    RC Syd, Swedish Macula Register, Karlskrona, Sweden..
    Lovestam-Adrian, Monica
    Lund Univ, IKVL Inst Clin Sci, Ophthalmol, Lund, Sweden..
    Reduced occurrence of severe visual impairment after introduction of anti-Vascular Endothelial Growth Factor in wet age-related macular degeneration: a population- and register-based study from northern Sweden2016In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 94, no 7, p. 646-651Article in journal (Refereed)
    Abstract [en]

    PurposeTo study the occurrence of severe visual impairment (SVI) and treatment outcome at 12months in patients treated for wet age-related macular degeneration (AMD) by use of data from the Swedish Macula Register (SMR) and referrals to the regional low vision clinics in five northern counties. MethodsReferrals to low vision clinics during 2005, 2009 and 2013 and treatment outcome at 12months from the SMR database from 2008 until 2013 in patients >65years of age in five northern counties were included in the survey. ResultsThe rate of referral due to AMD was significantly reduced during the time period (-48%; p<0.001). At 12months, a significant slight mean improvement in logMAR visual acuity (VA) was observed (-0.01, SD 0.37; p<0.001) after a mean of 5.02.3 anti-vascular endothelial growth factor (VEGF)-injections were administered. Age and low baseline VA was associated with less favourable visual outcome (p<0.001). ConclusionReferral rate to low vision clinic is a valuable tool for estimating occurrence of SVI and fell between the years 2005 until 2013. Data from the SMR showed improvement in visual acuity on the whole, but also identified patients at high risk for developing SVI during anti-VEGF-treatment.

  • 42. Gustavsson, Carina
    et al.
    Martinell, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Dorkhan, Mozhgan
    Diabetic retinopathy in All Newly diagnosed Diabetic subjects in Skane (ANDIS), Sweden, during 2008-2013. Baseline findings.2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no SI, p. 20-20Article in journal (Other academic)
  • 43.
    Harun-Or-Rashid, Mohammad
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Developmental Neuroscience.
    Lindqvist, Niclas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Developmental Neuroscience.
    Hallböök, Finn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Developmental Neuroscience.
    Transactivation of EGF Receptors in Chicken Muller Cells by α2A-Adrenergic Receptors Stimulated by Brimonidine2014In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 55, no 6, p. 3385-3394Article in journal (Refereed)
    Abstract [en]

    Purpose: α2-Adrenergic receptor agonists are used in glaucoma treatment and have been shown to have some neuroprotective effects. We performed this study to test the hypothesis that epidermal growth factor receptors on chicken Müller cells are transactivated by α2-adrenergic receptors and we focused on the extracellular signal-activated kinases 1/2 (ERK) pathway. Methods: Embryonic chicken retina and cultures of primary Müller cells were stimulated by α2-adrenergic receptor agonist brimonidine. Immunostaining, qRT-PCR and western blot techniques in combination with Src-, epidermal growth factor receptor kinase-, and matrix metalloproteinase inhibitors were used for analysis of the cellular responses. Results: Our results showed that Müller cells express α2A-adrenergic receptors in vivo and in vitro and that brimonidine triggered a robust and transient phosphorylation of ERK1/2. This ERK-response was Src-kinase dependent, associated with tyrosine phosphorylation of epidermal growth factor receptors (phospho-Y1068, Y1173) and was mediated by matrix metalloproteinase-activity on the Müller cells. Conclusions: Müller cells express the α2A-adrenergic receptor and brimonidine triggers both Src-kinase- and matrix metalloproteinase-mediated autocrine ligand-dependent activation of epidermal growth factor receptors on Müller cell. This response is consistent with transactivation of epidermal growth factor receptors by stimulation of α2-adrenergic receptors.

  • 44.
    Hedin, Anders
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Oftalmiatrik.
    Ögonplastikkirurgi innebär ett återställande till det "normala"2000In: Läkartidningen, Vol. 97, no 47, p. 5444-5450Article in journal (Other scientific)
  • 45.
    Hedman, Katarina
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience.
    Pooling Data from Similar Randomized Clinical Trials Comparing Latanoprost with Timolol; Medical Results and Statistical Aspects2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Two different principles were studied. 1st - statistical analysis techniques were used to obtain medical results from a patient population. 2nd - the patient population was used to study the statistical analysis techniques.

    Medical conclusions: latanoprost and timolol treatment showed a statistically significant and clinically useful mean IOP-reduction in a typical worldwide clinical trial population. Latanoprost reduced the IOP 1.6 mm Hg more than timolol. The IOP-reduction was maintained with timolol and slightly enforced with latanoprost up to 6 months of treatment. The mean IOP-reduction was maintained during 2 years of latanoprost treatment. The overall risk of withdrawal due to insufficient IOP-reduction with latanoprost was 8%.

    The statistical methodological issues are of a general and reoccurring character in trial design of the IOP-reduction: should the statistical hypothesis testing be based on the mean intraocular pressure (IOP) or the proportion of patients who reach a specific IOP level, should the estimate of the IOP or IOP-reduction be based on single eyes, mean of bilaterally eligible and identically treated eyes or the difference between an eye with active treatment and a placebo treated contralateral eye, and is mean of replicated recordings useful? Statistical methodological conclusions: the most effective response variable varies with the selected patient population. Therefore, the trial design process should include a comparison of the variability, test power and required sample size for the possible response variables in a sample of the target population. At minimum a statistical consideration should be done.

    List of papers
    1. A pooled data analysis of three randomised, double-masked six-month clinical studies comparing the intraocular pressure reducing effect of latanoprost and timolol
    Open this publication in new window or tab >>A pooled data analysis of three randomised, double-masked six-month clinical studies comparing the intraocular pressure reducing effect of latanoprost and timolol
    2000 (English)In: European Journal of Ophthalmology, ISSN 1120-6721, E-ISSN 1724-6016, Vol. 10, no 2, p. 95-104Article in journal (Refereed) Published
    Abstract [en]

    PURPOSE:

    To compare the intraocular pressure (IOP) reduction by latanoprost and timolol, and to study factors of prognostic value for assessing this reduction.

    METHODS:

    We analyzed 829 patients included in three phase 111 studies comparing six months' treatment with 0.005% latanoprost once daily and 0.5% timolol twice daily in patients with open-angle glaucoma or ocular hypertension. Analysis of covariance controlled for differences in baseline IOP and sex was used to assess the IOP reduction.

    RESULTS:

    Latanoprost reduced diurnal IOP (average of morning, noon and afternoon assessments) by 7.7 mmHg (31%) and timolol by 6.5 mmHg (26%) after six months of treatment. Thus the diurnal IOP was reduced 1.2 mmHg (18%) more with latanoprost than with timolol (p<0.001). Latanoprost-treated patients showed a further decrease in morning IOP of 0.7 mmHg (9%, p<0.001) from the initial morning IOP reduction obtained at two weeks. No such further decrease in IOP was seen with timolol. Higher baseline diurnal IOP resulted in a larger diurnal reduction during treatment with both drugs (p<0.001). Diurnal IOP in women was reduced 0.7 mmHg (11%) less than males with both drugs (p<0.001).

    CONCLUSIONS:

    Latanoprost was more effective than timolol in reducing mean diurnal IOP. The effect after two weeks was maintained for timolol while with latanoprost there was a further, significant IOP reduction from two weeks to six months. Baseline IOP was the only factor of clinical importance found to be of prognostic value for assessing the IOP reduction.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-90322 (URN)10887918 (PubMedID)
    Available from: 2003-04-07 Created: 2003-04-07 Last updated: 2017-12-14Bibliographically approved
    2. The effect of latanoprost compared with timolol in African-American, Asian, European, Mexican and US glaucoma or ocular hypertensive patients
    Open this publication in new window or tab >>The effect of latanoprost compared with timolol in African-American, Asian, European, Mexican and US glaucoma or ocular hypertensive patients
    2002 (English)In: Survey of ophthalmology, ISSN 0039-6257, E-ISSN 1879-3304, Vol. 47, no 4S1, p. 77-89Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE:

    To study the intraocular pressure (IOP) reduction of latanoprost or timolol in a heterogeneous global population.

    METHODS:

    A total of 1,389 glaucoma or ocular hypertensive patients treated with 0.005% latanoprost once daily (n = 737) or 0.5% timolol twice daily (n = 652) from eight clinical trials were included. After 3-6 months of treatment, the IOP was analyzed with use of analysis of covariance.

    RESULTS:

    Latanoprost or timolol gave statistically significant mean diurnal IOP reduction in the African-American, Asian, Caucasian, and Mexican patients, latanoprost with 7.9 mm Hg and timolol with 6.4 mm Hg. The Asian and Mexican patients showed a larger difference in mean diurnal IOP reduction with use of the two drugs (range 1.8-3.1 mm Hg) than the European and U.S. patients (range 0.6-1.7 mm Hg, p = 0.030). Latanoprost produced similar mean diurnal IOP reduction in patients with and without previous glaucoma treatment other than prostaglandins.

    CONCLUSION:

    Latanoprost or timolol statistically significantly reduced the mean diurnal IOP in a heterogenous global population in eight clinical trials. The degree of reduction appeared to be clinically useful. The greatest difference in the mean diurnal IOP-lowering effect of latanoprost or timolol was observed in Mexican and Asian clinical trials.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-90323 (URN)10.1016/S0039-6257(02)00310-7, (DOI)12204703 (PubMedID)
    Available from: 2003-04-07 Created: 2003-04-07 Last updated: 2017-12-14Bibliographically approved
    3. The Effect of Latanoprost on Intraocular Pressure During 2 Years of Treatment
    Open this publication in new window or tab >>The Effect of Latanoprost on Intraocular Pressure During 2 Years of Treatment
    2002 (English)In: Survey of ophthalmology, ISSN 0039-6257, E-ISSN 1879-3304, Vol. 47, no S1, p. 65-76Article in journal (Refereed) Published
    Abstract [en]

    Our objective was to study the intraocular pressure (IOP) in open-angle glaucoma or ocular hypertensive patients during long-term treatment with latanoprost. A total of 532 patients treated with 0.005% latanoprost were enrolled, including 493 and 113 patients treated for 6 and 24 months, respectively. Mean IOP was analyzed with the analysis of variance technique. The risk of treatment failure was analyzed with survival analysis technique. After 2 weeks of latanoprost treatment, the mean IOP was reduced 8.2 (32%) and 8.9 (34%) mm Hg in the subgroups of patients treated for 6 and 24 months, respectively. The change in mean IOP during 2 years of latanoprost treatment was not statistically significant (p = 0.15). Patients with primary open-angle glaucoma or ocular hypertension showed an 86% and 97% chance of receiving a sufficient IOP reduction with latanoprost (p < 0.01), repectively. The initial mean IOP reduction was maintained throughout the 2 years of treatment.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-90324 (URN)10.1016/S0039-6257(02)00301-6 (DOI)12204702 (PubMedID)
    Available from: 2003-04-07 Created: 2003-04-07 Last updated: 2017-12-14Bibliographically approved
    4. Which endpoint: mean intraocular pressure or proportion of successful patients?
    Open this publication in new window or tab >>Which endpoint: mean intraocular pressure or proportion of successful patients?
    2003 (English)In: Journal of glaucoma, ISSN 1057-0829, E-ISSN 1536-481X, Vol. 12, no 4, p. 321-332Article in journal (Refereed) Published
    Abstract [en]

    A reduction in intraocular pressure in clinical trials can be determined through the mean intraocular pressure, through the proportion of patients who have the intraocular pressure reduced to a specific target intraocular pressure, or both. Since both these possible endpoints measure the shift of 2 intraocular pressure distributions, we recommend that only one of them be tested. In general, testing the difference between mean-values is much more efficient than testing the difference between proportions. However, proportions of successful patients are valuable in showing the clinical implication of a reduction in mean intraocular pressure, particularly when evaluating a moderate pressure reduction. The effect of a small mean intraocular pressure reduction on the probability to reach the target intraocular pressure is pointed out, particularly the fact that it can be substantial even if the mean reduction is smaller than the measurement error.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-90325 (URN)12897577 (PubMedID)
    Available from: 2003-04-07 Created: 2003-04-07 Last updated: 2017-12-14Bibliographically approved
    5. Estimating mean intraocular pressure of a group of patients; lessons learned by analyzing clinical trials of open-angle or ocular hypertensive patients
    Open this publication in new window or tab >>Estimating mean intraocular pressure of a group of patients; lessons learned by analyzing clinical trials of open-angle or ocular hypertensive patients
    In: Journal of GlaucomaArticle in journal (Refereed) Submitted
    Identifiers
    urn:nbn:se:uu:diva-90326 (URN)
    Available from: 2003-04-07 Created: 2003-04-07Bibliographically approved
  • 46.
    Hellgren, Kerstin M.
    et al.
    Astrid Lindgren Childrens Hosp, Dept Clin Neurosci, Karolinska Inst, MBC, Polhemsgatan 56, S-11282 Stockholm, Sweden..
    Tornqvist, Kristina
    Univ Lund Hosp, Dept Ophthalmol, S-22185 Lund, Sweden..
    Jakobsson, Peter G.
    Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Lundgren, Pia
    Umea Univ, Dept Ophthalmol, S-90187 Umea, Sweden..
    Carlsson, Birgitta
    Univ Orebro, Dept Ophthalmol, SE-70182 Orebro, Sweden..
    Kallen, Karin
    Lund Univ, Dept Obstet & Gynecol, Ctr Reprod Epidemiol, Lund, Sweden..
    Serenius, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hellstrom, Ann
    Univ Gothenburg, Sahlgrenska Acad, Sect Pediat Ophthalmol, Gothenburg, Sweden..
    Holmström, Gerd
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Ophthalmologic Outcome of Extremely Preterm Infants at 6.5 Years of Age Extremely Preterm Infants in Sweden Study (EXPRESS)2016In: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 134, no 5, p. 555-562Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE This follow-up study of extremely preterm (EPT) children (<27 weeks' gestational age [GA] at birth) revealed major eye and visual problems in 37.9%(147 of 388) of all EPT infants and in 55.4%(67 of 121) of the most immature subgroups at 6.5 years of age. These major eye and visual problems were strongly associated with treatment-requiring retinopathy of prematurity (ROP). OBJECTIVES To investigate the ophthalmologic outcome of a national cohort of EPT children at 6.5 years of age and to evaluate the impact of prematurity and ROP. DESIGN, SETTING, AND PARTICIPANTS All surviving EPT children born in Sweden between April 1, 2004, and March 31, 2007, were included and compared with a matched term control group, as part of a prospective national follow-up study. MAIN OUTCOMES AND MEASURES Visual acuity, refraction in cycloplegia, and manifest strabismus were evaluated and compared with GA at birth and with treatment-requiring ROP. RESULTS The study cohort comprised 486 participants. The mean (SD) GA of the children who were included was 25 (1) weeks, and 45.7%(222 of 486) were female. At a median age of 6.6 years, 89.3%(434 of 486) of eligible EPT children were assessed and compared with 300 control group children. In the EPT group, 2.1%(9 of 434) were blind, 4.8%(21 of 434) were visually impaired according to the World Health Organization criteria, and 8.8% (38 of 434) were visually impaired according to the study criteria. Strabismus was found in 17.4% (68 of 390) and refractive errors in 29.7%(115 of 387) of the EPT children compared with 0% (0 of 299) and 5.9% (17 of 289), respectively, of the control children (P<.001). Altogether at 6.5 years of age, 37.9%(147 of 388) of the EPT children had some ophthalmologic abnormality compared with 6.2%(18 of 290) of the matched control group (95% CI of the difference, 26.1%-37.2%). When treatment-requiring ROP was adjusted for, no significant association between GA and visual impairment could be detected. For refractive errors, the association with GA remained after adjustment for treatment-requiring ROP (odds ratio, 0.72; 95% CI, 0.58-0.91 for each 1-week increment). CONCLUSIONS AND RELEVANCE In a Swedish national cohort of EPT children at 6.5 years of age, major eye and visual problems were frequently found. Treatment-requiring ROP was a stronger impact factor than GA on visual impairment and strabismus, but not on refractive errors, as a whole. In modern neonatal intensive care settings, ophthalmologic problems continue to account for a high proportion of long-term sequelae of prematurity.

  • 47.
    Hellström, Ann
    et al.
    Univ Gothenburg, Sahlgrenska Acad, Sect Pediat Ophthalmol, Gothenburg, Sweden.
    Källen, Karin
    Lund Univ, Ctr Reprod Epidemiol, Lund, Sweden.
    Carlsson, Birgitta
    Örebro Univ, Dept Ophthalmol, Örebro, Sweden.
    Holmström, Gerd
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Jakobsson, Peter
    Linköping Univ, Dept Clin & Expt Med, Linköping, Sweden.
    Lundgren, Pia
    Umeå Univ, Dept Clin Sci, Ophthalmol, Umeå, Sweden.
    Serenius, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Stjernqvist, Karin
    Lund Univ, Dept Psychol, Lund, Sweden.
    Tornqvist, Kristina
    Lund Univ Hosp, Dept Ophthalmol, Lund, Sweden.
    Hellgren, Kerstin
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Extreme prematurity, treated retinopathy, bronchopulmonary dysplasia and cerebral palsy are significant risk factors for ophthalmological abnormalities at 6.5 years of age2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 5, p. 811-821Article in journal (Refereed)
    Abstract [en]

    Aim: This study evaluated the contributions of various prenatal and postnatal predictive factors to a documented high prevalence of ophthalmological abnormalities in children aged 6.5 years who were born extremely preterm.

    Methods: We carried out a prospective population‐based study of all children born in Sweden at a gestational age of 22 + 0 to 26 + 6 weeks based on the Extremely Preterm Infants in Sweden Study. The main outcome measures were a combined score of visual impairment, refractive errors and strabismus at 6.5 years of age. Models of univariate and multivariable regression were used to analyse potential prenatal and postnatal predictive factors at different clinically relevant time‐points from one minute after birth to 30 months.

    Results: We focused on 399 known extremely preterm survivors and compared them to 300 full‐term controls. Significant antecedents for ophthalmological abnormalities included prematurity per se, retinopathy of prematurity that required treatment, severe bronchopulmonary dysplasia and cerebral palsy. Severe intraventricular haemorrhage was no longer a significant risk factor when we adjusted it for the 30‐month cognitive and neuromotor development outcomes.

    Conclusion: This time‐course risk analysis model showed a changing panorama of significant risk factors for ophthalmological abnormalities in children aged 6.5 years who were born extremely preterm.

  • 48.
    Holmström, Gerd
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience. Oftalmiatrik.
    Horner's syndrome: an atypical presentation in a child with neurofibromatosis type 22006In: Eye, Vol. 20, p. 1472-1474Article in journal (Refereed)
  • 49.
    Holmström, Gerd
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Eriksson, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Hellgren, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Larsson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Optical coherence tomography is helpful in the diagnosis of foveal hypoplasia2010In: Acta Ophthalmologica, ISSN 1755-375X, Vol. 88, no 4, p. 439-442Article in journal (Refereed)
    Abstract [en]

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

  • 50.
    Holmström, Gerd
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
    Hellstrom, A.
    Univ Gothenburg, Sahlgrenska Acad, Queen Silvia Childrens Hosp, Sect Pediat Ophthalmol, Gothenburg, Sweden..
    Jakobsson, P.
    Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Lundgren, P.
    Umea Univ, Dept Clin Sci & Ophthalmol, Umea, Sweden..
    Tornqvist, K.
    Univ Lund Hosp, Dept Ophthalmol, Lund, Sweden..
    Wallin, A.
    St Erik Eye Hosp, Stockholm, Sweden..
    Screening for retinopathy of prematurity can be started in postmenstrual week 31 in very premature babies!2016In: Eye (London. 1987), ISSN 0950-222X, E-ISSN 1476-5454, Vol. 30, no 11, p. 1524-1525Article in journal (Refereed)
1234 1 - 50 of 162
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