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  • 151.
    Manns, Manns
    et al.
    University of Miami, Dept. of Biomedical Engineering.
    Söderberg, PerUppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.Ho, Arthur
    Ophthalmic Technologies XXV2015Proceedings (redaktörskap) (Refereegranskat)
  • 152. Manns, Manns
    et al.
    Söderberg, PerUppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.Ho, Arthur
    Ophthalmic Technologies XXVI2016Proceedings (redaktörskap) (Refereegranskat)
  • 153.
    Manns, Manns
    et al.
    University of Miami, Dept. of Biomedical Engineering.
    Söderberg, PerUppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.Ho, Arthur
    Ophthalmic Technologies XXVIII2018Proceedings (redaktörskap) (Refereegranskat)
  • 154.
    Markasz, Laszlo
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Olsson, Karl-Wilhelm
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kärlkirurgi.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Sindelar, Richard
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Cluster Analysis of Early Postnatal Biochemical Markers May Predict Development of Retinopathy of Prematurity2020Ingår i: Translational Vision Science & Technology, E-ISSN 2164-2591, Vol. 9, nr 13, artikel-id 14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Growth factors and inflammatory and angiogenetic proteins are involved in the development of retinopathy of prematurity (ROP). However, no early biochemical markers are in clinical use to predict ROP. By performing cluster analysis of multiple biomarkers, we aimed to determine patient groups with high and low risk for developing ROP.

    Methods: In total, 202 protein markers in plasma were quantified by proximity extension assay from 35 extremely preterm infants on day 2 of life. Infants were sorted in groups by automated two-dimensional hierarchical clustering of all biomarkers. ROP was classified as stages I to III with or without surgical treatment. Predictive biomarkers were evaluated by analysis of variance and detected differences by two-sided paired t-test with Bonferroni corrections for multiple comparisons.

    Results: Differences in 39 biochemical markers divided infants without ROP into two control groups (control 1, n = 7; control 2, n = 5; P < 0.05). Sixty-six biochemical markers defined differences between the control groups (n = 13) and all ROP infants (n = 23; P < 0.05). PARK7, VIM, MPO, CD69, and NEMO were markedly increased in control 1 compared to all ROP infants (P < 0.001). Lower TNFRSF4 and higher HER2 and GAL appeared in infants with ROP as compared to control 1 and/or 2 (P < 0.05, respectively).

    Conclusions: Our data suggest that early elevated levels of PARK7, VIM, MPO, CD69, and NEMO may be associated with lower risk of developing ROP. Lower levels of TNFRSF4 with higher levels of HER2 and GAL may predict ROP development.

    Translational Relevance: Cluster analysis of early postnatal biomarkers may help to identify infants with low or high risk of developing ROP.

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  • 155.
    Mathew, Jessica
    et al.
    College of Optometry, University of Houston.
    Goosey, John
    Houston Eye Associates, Houston, Texas, USA.
    Söderberg, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Bergmanson, Jan
    College of Optometry, University of Houston.
    Lamellar changes in the keratoconic cornea2015Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 93, nr 8, s. 767-773Artikel i tidskrift (Refereegranskat)
  • 156. McKinlay, A F
    et al.
    Bernhardt, J H
    Ahlbom, A
    Cesarini, J P
    de Gruijl, F R
    Hietanen, M
    Owen, R
    Sliney, D H
    Söderberg, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Swerdlow, A J
    Taki, M
    Tenforde, T S
    Vecchia, P
    Veyret, B
    Matthes, R
    Repacholi, M H
    Diffey, B
    Mainster, M A
    Okuno, T
    Stuck, B E
    Guidelines on limits of exposure to ultraviolet radiation of wavelengths between 180 nm and 400 nm (incoherent optical radiation)2004Ingår i: Health Physics, ISSN 0017-9078, E-ISSN 1538-5159, Vol. 87, nr 2, s. 171-186Artikel, forskningsöversikt (Refereegranskat)
  • 157.
    Mejaddam, Assem
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Pircher, Achmed
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Aggregatibacter Endophthalmitis in a patient with Dentophobia2022Ingår i: Retinal cases & brief reports, ISSN 1935-1089, E-ISSN 1937-1578, Vol. Publish Ahead of PrintArtikel i tidskrift (Refereegranskat)
  • 158.
    Merkoudis, Nikolaos
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Matsson, Anna Wikberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Granstam, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Comparison of peroperative subconjunctival injection of methylprednisolone and standard postoperative steroid drops after uneventful cataract surgery2014Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, nr 7, s. 623-628Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PurposeTo compare the safety and efficacy of a single subconjunctival injection of methylprednisolone and a standard postoperative steroid regimen in terms of intraocular inflammation and intraocular pressure (IOP) after uncomplicated phacoemulsification surgery. MethodsTwo groups of 25 patients each were included in this prospective randomized controlled trial. Patients in the injection group were given a subconjunctival injection of 20mg methylprednisolone and the topical group received the conventional postoperative care with steroid eye drops (dexamethasone 1mg/ml). The patients were examined 1week and 1month after surgery. Slit-lamp evaluation of anterior chamber inflammation and IOP were performed. Changes in IOP of 2.4mmHg were considered clinically relevant. ResultsIn the injection group, mean IOP decreased from 15.42.2mmHg (baseline) to 14.1 +/- 3.2mmHg at 1week (p=0.03). The topical group had a stable IOP at 1week (16.3 +/- 2.6mmHg) compared to baseline (16.1 +/- 2.7mmHg; p=0.74). At 1month, mean IOP was 14.3 +/- 2.6mmHg (p=0.03) in the injection group and 15.6 +/- 2.3mmHg (p=0.2) in the topical group. The intragroup changes were neither statistically significant nor clinically relevant at any postoperative visit. Both groups had the highest values of intraocular inflammation at the 1-week postoperative visit, followed by a decline to barely traceable levels at 1month. The difference was not clinically relevant at any postoperative visit. ConclusionsThe subconjunctival injection of methylprednisolone appears to be as safe and effective as the conventional treatment, and it might therefore be considered for treatment of individuals with compliance issues.

  • 159. Meyer, L. M.
    et al.
    Kronschläger, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Wegener, A. R.
    Schleimpflug photography detects alterations in corneal density and thickness in patients with dry eye disease2014Ingår i: Der Ophthalmologe, ISSN 0941-293X, E-ISSN 1433-0423, Vol. 111, nr 10, s. 914-919Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dry eye disease is a common ocular surface disease that significantly affects the quality of life. Little is known about a potential impact of the disease on corneal morphology. This study was carried out to investigate for the first time if dry eye disease induces changes in corneal density and thickness. In total 97 patients suffering from dry eye disease and 33 healthy age-matched individuals were included in this prospective, randomized study. Corneal morphology was documented with Scheimpflug photography and analyzed for central corneal thickness and corneal density in five anatomical layers (i.e. epithelium, Bowman membrane, corneal stroma, Descemet membrane and endothelium). Corneal density was significantly reduced in the epithelium (p = 0.0053), Bowman membrane (p = 0.0049) and Descemet's membrane (p = 0.0385) in patients with dry eye syndrome compared to healthy controls. This decrease was age-dependant. Furthermore, central corneal thickness was significantly reduced in patients with dry eye syndrome compared to the control group (p = 0.0495). The change was again dependent on age with lower values at higher age. Central corneal thickness increased with age in the control group. The results of this study indicate that corneal morphology is subject to significant alterations in patients with dry eye disease. Scheimpflug photography provides not only unique information in lens trials but is also able to detect changes of corneal anatomy. However, further investigations with other anterior segment imaging techniques, such spectral domain optical coherence tomography (SD OCT/PentacamA (R)) are necessary to further evaluate the clinical consequences of these findings.

  • 160. Meyer, Linda M.
    et al.
    Dong, Xiuqin
    Wegener, Alfred
    Söderberg, Per
    St. Erik's Eye Hospital, Karolinska Institutet.
    Dose dependent cataractogenesis and Maximum Tolerable Dose (MTD(2.3:16)) for UVR 300 nm-induced cataract in C57BL/6J mice2008Ingår i: Experimental Eye Research, ISSN 0014-4835, E-ISSN 1096-0007, Vol. 86, nr 2, s. 282-289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the present study was to investigate the in vivo dose response function for UVR 300 nm-induced cataract in the C57BL/6J mouse lens and to establish a cataract threshold estimate expressed as Maximum Tolerable Dose (MTD(2.3:16)) for UVR 300 nm-induced cataract in the C57BL/6J mouse lens. Knowledge of the MTD(2.3:16) in the C57BL/6J mouse will permit quantitative in vivo comparison of UVR-B threshold sensitivity of knockout mice, e.g. animals deficient in key antioxidative enzymes or mice suffering from genetically predetermined eye disease, to wild type animals. Eighty C57BL/6J mice were divided into four dose groups. The animals were exposed unilaterally to 0, 2, 4, or 8 kJ/m(2) UVR 300 nm for 15 min (n=20). The radiation output of the UVR-source had lambda(max) at 302.6 nm with 5 nm full width at half maximum. Two days after exposure cataract was quantified as forward lens light scattering intensity in the exposed and the contralateral non-exposed lens. Morphological lens changes were documented using grid and dark field illumination photography. MTD(2.3:16) was estimated from the forward light scattering measurements. Two days after exposure mainly anterior subcapsular but also cortical and nuclear cataract developed in lenses that had received 2, 4, and 8 kJ/m(2) UVR 300 nm. Forward light scattering intensity increased with increasing UVR 300 nm dose. MTD(2.3:16) for the mouse lens was estimated to 2.9 kJ/m(2) UVR 300 nm. Lens light scattering intensity in the C57BL/6J mouse lens increases with UVR 300 nm in vivo dose in the range 0-8 kJ/m(2). The MTD(2.3:16) of 2.9 kJ/m(2) in the C57BL/6J mouse lens determined here, is essential to quantify and compare in vivo the impact of genetic modulation on lens susceptibility to oxidative stress and plan dose-ranges in future investigations of UVR 300 nm-induced cataract pathogenesis.

  • 161. Meyer, Linda M
    et al.
    Löfgren, Stefan
    St. Erik's Eye Hospital, Karolinska Institutet.
    Ho, Ye-Shih
    Lou, Marjorie
    Wegener, Alfred
    Holz, Frank
    Söderberg, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Absence of glutaredoxin1 increases lens susceptibility to oxidative stress induced by UVR-B2009Ingår i: Experimental Eye Research, ISSN 0014-4835, E-ISSN 1096-0007, Vol. 89, nr 6, s. 833-839Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We investigated if the absence of glutaredoxin1, a critical protein thiol repair enzyme, increases lens susceptibility to oxidative stress caused by in vivo exposure to ultraviolet radiation type B (UVR-B). Glrx(-/-) mice and Glrx(+/+) mice were unilaterally exposed in vivo to UVR-B for 15 min. Groups of 12 animals each received 4.3, 8.7, and 14.5 kJ/m(2) respectively. 48 h post UVR-B exposure, the induced cataract was quantified as forward lens light scattering. Cataract morphology was documented with darkfield illumination photography. Glutathione (GSH/GSSG) content was analyzed in Glrx(-/-) and Glrx(+/+) lenses. UVR-B exposure induced anterior sub-capsular cataract (ASC) in Glrx(-/-) and Glrx(+/+) mice. In Glrx(-/-) lenses the opacities extended further towards the lens equator than in wild type animals (Glrx(+/+)). Lens light scattering in Glrx(-/-) mice was increased in all dose groups compared to lenses with normal glutaredoxin1 function. The difference was more pronounced with increasing exposure dose. Lens sensitivity for UVR-B induced damage was significantly higher in Glrx(-/-) lenses compared to Glrx(+/+) lenses. The Glrx gene provides a 44% increase of protection against close to threshold UVR-B induced oxidative stress compared to the absence of the Glrx gene. In conclusion, the absence of glutaredoxin1 increases lens susceptibility to UVR-B induced oxidative stress in the mouse.

  • 162.
    Meyer, Linda
    et al.
    Herzog Carl Theodor Eye Clinic, Munich, Germany.
    Wegener, Alfred
    University Eye Clinic Bonn, Bonn, Germany.
    Holzt, Frank
    University Eye Clinic Bonn, Bonn, Germany.
    Kronschläger, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Bergmanson, Jan
    University of Houston, College of Optometry, Houston, TX, USA.
    Söderberg, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Ultrastructure of UVR-B-induced cataract and repair visualized with electron microscopy2014Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, nr 7, s. 635-643Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    The aim of the study is to investigate and visualize the ultrastructure of cataract morphology and repair, after in vivo exposure to double threshold dose UVR-B in the C57BL/6 mouse lens.

    Methods

    Twenty-six-week-old C57BL/6 mice received in vivo double threshold dose (6.4 kJ/m2) UVR-B for 15 min. The radiation output of the UVR-source had λMAX at 302.6 nm. After a latency period of 1, 2, 4 and 8 days following UVR-B exposure, the induced cataract was visualized with electron microscopy techniques. Induced, cataract was quantified as forward lens light scattering. Damage to the lens epithelium and the anterior cortex was investigated with light microscopy in toluidine blue-stained semi-thin sections, transmission electron microscopy (TEM), scanning electron microscopy (SEM) and dark field illumination photography.

    Results

    UVR-B-exposed lenses developed anterior subcapsular and/or cortical and nuclear cataract after 1 day. Lens light scattering peaked 2 days after exposure. Lens epithelial cell damage was seen in TEM as apoptotic cells, apoptotic bodies, nuclear chromatin condensation, and swollen and disrupted anterior cortex fibres throughout the sections of the whole anterior lens surface. These morphologic changes were also visualized with SEM. Within 8 days, anterior subcapsular cataract was repaired towards the anterior sutures.

    Conclusion

    UVR-B exposure of double cataract threshold dose induces a subtotal loss of epithelial cells across the whole anterior surface of the lens. This damage to the epithelium is repaired by epithelial cell movement from the equator towards the lens sutures, thus in retrograde direction to regular epithelial cell differentiation.

  • 163. Mody Jr, Vino C
    et al.
    Kakar, Manoj
    Elfving, Åse
    Söderberg, Per G
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Löfgren, Stefan
    Ascorbate in the guinea pig lens: dependence on drinking water supplementation2005Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 83, nr 2, s. 228-233Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To investigate whether lens ascorbate concentration can be elevated with drinking water supplementation. METHODS: Pigmented guinea pigs received drinking water supplemented with L-ascorbate, concentration 0.00, 2.84, 5.68 or 8.52 mm for a duration of 4 weeks. In addition, the chow fed to all animals contained 125 mmol L-ascorbate per kg of chow. At the end of the supplementation period, the guinea pigs were killed. Each lens was extracted. The lens was processed and ascorbate concentration was measured using high performance liquid chromatography (HPLC) with 254 nm ultraviolet radiation detection. The data were analysed with regression. RESULTS: At the end of the test period, all lenses were devoid of cataract as observed by slit-lamp examination. All lenses contained a detectable concentration of ascorbate. Estimated 95% confidence intervals for mean animal-averaged lens ascorbate concentrations (micromol/g wet weight of whole lens) per group were 0.51 +/- 0.04 (0.00 mm; n = 6), 0.70 +/- 0.18 (2.84 mm; n = 6), 0.71 +/- 0.11 (5.68 mm; n = 5), and 0.71 +/- 0.06 (8.52 mm; n = 6). Animal-averaged lens ascorbate concentration [Asc(lens)] (micromol/g wet weight lens) increased with ascorbate supplementation in drinking water [Asc(water)] (M), in agreement with the model: [Asc(lens)] = A - Be(-kAsc(water)]. CONCLUSION: Lens ascorbate concentration increases with drinking water supplementation in the guinea pig without cataract development. The currently presented method for measurement of whole lens ascorbate content is suitable.

  • 164. Mody Jr, Vino C
    et al.
    Kakar, Manoj
    Elfving, Åse
    Söderberg, Per G
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Löfgren, Stefan
    Ascorbate in the rat lens: dependence on dietary intake2005Ingår i: Ophthalmic Research, ISSN 0030-3747, E-ISSN 1423-0259, Vol. 37, nr 3, s. 142-149Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To establish a method for sample preparation to measure ascorbate in whole lenses and to investigate whether lens ascorbate concentration is dependent on dietary ascorbate intake. METHODS: Four groups of 3 young Sprague-Dawley rats each were fed chow containing L-ascorbate, either 0.0, 5.7, 57.0 or 114.0 mmol/kg for a duration of 4 weeks. Thereafter, each rat was sacrificed. The lens was extracted, photographed, and lens wet weight was measured. The lens was homogenized in 1.0 ml of 0.25% metaphosphoric acid, the homogenate was centrifuged and the supernatant ultrafiltered. The filtrate was injected into an ion exchange, reversed-phase Polypore H HPLC column equipped with a 254-nm ultraviolet detector. Samples were calibrated against an L-ascorbate standard. Polynomial regression analysis was performed on the data. RESULTS: All lenses were devoid of cataract. A 95% confidence interval for baseline content of ascorbate without any dietary intake was estimated to be 0.16+/-0.01 micromol/g wet weight of lens. The lens ascorbate concentration increased linearly with dietary ascorbate intake with an increased rate, estimated as a 95% confidence interval of 0.33+/-0.18 (micromol ascorbate) (g lens)-1)(mol ascorbate)-1 (kg chow) with r2=0.62. CONCLUSION: Lens ascorbate concentration linearly increases with dietary ascorbate intake without cataract development in the rat. The currently presented method for sample preparation to measure the whole-lens content of ascorbate is applicable.

  • 165. Mody Jr, Vino C
    et al.
    Kakar, Manoj
    Elfving, Åse
    Söderberg, Per G
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Löfgren, Stefan
    Ultraviolet radiation-B-induced cataract in albino rats: maximum tolerable dose and ascorbate consumption2006Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 84, nr 3, s. 390-395Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To investigate the maximum tolerable dose (MTD) for cataract induced by ultraviolet radiation-B (UVB) in 7-week-old albino rats and to study the effect of UVB eye exposure on lens ascorbate content. METHODS: Fifty 7-week-old albino Sprague Dawley rats were unilaterally exposed in vivo to 300-nm UVB under anaesthesia, receiving 0, 0.25, 3.5, 4.3 and 4.9 kJ/m(2). The MTD was estimated based on lens forward light scattering measurements. Lens ascorbate content was determined in the processed lens using high performance liquid chromatography with UVR detection. RESULTS: Animals exposed to UVB doses >or=3.5 kJ/m(2) developed cortical cataracts. The MTD for avoidance of UVB-induced cataract was estimated to 3.01 kJ/m(2). UVB exposure decreased lens ascorbate concentration in the exposed lens in line with UVB dose, H(e), according to the models: C = C(NonCo) + C(Co)e(-kH(e) ) for exposed lenses; C = C(NonCo) + C(Co) for non-exposed lenses, and C(d) = C(Co)(e(-kH(e) ) - 1). Parameters for consumable and non-consumable ascorbate were estimated to C(NonCo) = 0.04 and C(Co) = 0.11 micromol/g wet weight of lens. For lens ascorbate difference, tau = 1/k = 0.86 kJ/m(2). A total of 63% of UVB consumable ascorbate has been consumed after only tau = 0.86 kJ/m(2), while MTD(2.3 : 16) = 3.01 kJ/m(2), indicating that ascorbate decrease is in the order of 3.5 times more sensitive to detecting UVR damage in the lens than forward light scattering. CONCLUSIONS: The MTD for avoidance of UVB-induced cataract in the 7-week-old albino Sprague Dawley rat was estimated to be 3.01 kJ/m(2). In vivo UVB exposure of the rat eye decreases lens ascorbate content following an exponential decline, and suprathreshold doses cause greater effect than subthreshold doses.

  • 166.
    Mody Jr, Vino C
    et al.
    S:t Eriks Ögonsjukhs, Inst. f. neurovetenskap, KI.
    Kakar, Manoj
    S:t Eriks Ögonsjukhs, Inst. f. neurovetenskap, KI.
    Söderberg, Per G.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Löfgren, Stefan
    S:t Eriks Ögonsjukhus, Inst. för Neurovetenskap, KI.
    High lenticular tolerance to ultraviolet radiation-B by pigmented guinea-pig: application of a safety limit strategy for UVR-induced cataract2012Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 90, nr 3, s. 226-230Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this study was to determine a threshold measure, maximum tolerable dose (MTD), for avoidance of UVR-B-induced cataract in the pigmented guinea-pig.

    Methods: Thirty pupil-dilated anesthetized young female guinea-pigs, divided into five equal groups, received between 0 and 84.9 kJ/m(2) unilateral UVR-B. Lens extraction and in vitro lens photography occurred 24 hr after exposure. Measurement of intensity of lens light scattering served as quantifying tool for the degree of cataract. Data analysis included regression, using a second order polynomial model. The applied MTD concept was based on the UVR-B dose-response curve obtained for the pigmented guinea-pig. A smaller number of pigmented guinea-pigs, pigmented rats and albino rats underwent morphometric analysis of the anterior segment geometry.

    Results: All eyes exposed to UVR-B developed cataract in the anterior subcapsular region. MTD for avoidance of UVR-B-induced cataract was 69.0 kJ/m(2) in the pigmented guinea-pig. Iris was considerably thicker in the guinea-pig than in the rats. Lens blockage by the dilated iris was lowest in the guinea-pig.

    Conclusions: Maximum tolerable dose for avoidance of UVR-B-induced cataract in the pigmented guinea-pig was 69.0 kJ/m(2), over 10-fold higher than the threshold 5 kJ/m(2) obtained by Pitts et al. in the pigmented rabbit. Maximum tolerable dose is an appropriate method for estimation of toxicity for UVR-B-induced cataract in the guinea-pig. The pigmented guinea-pig is significantly less sensitive to UVR-B exposure than the pigmented rabbit and pigmented rat.

  • 167.
    Mohlin, Camilla
    et al.
    Linnaeus Univ, Linnaeus Ctr Biomat Chem, Chem & Biomed, Kalmar, Sweden.
    Petrus-Reurer, Sandra
    Karolinska Inst, St Erik Eye Hosp, Sect Ophthalmol & Vis, Dept Clin Neurosci, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Div Obstet & Gynecol, Stockholm, Sweden.
    Lanner, Fredrik
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Div Obstet & Gynecol, Stockholm, Sweden.
    Sandholm, Kerstin
    Linnaeus Univ, Linnaeus Ctr Biomat Chem, Chem & Biomed, Kalmar, Sweden.
    Nilsson, Per
    Linnaeus Univ, Linnaeus Ctr Biomat Chem, Chem & Biomed, Kalmar, Sweden;Univ Oslo, Dept Immunol, Oslo, Norway.
    Nilsson, Bo
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi.
    Nilsson Ekdahl, Kristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi. Linnaeus Univ, Linnaeus Ctr Biomat Chem, Chem & Biomed, Kalmar, Sweden.
    Is the polarized secretion of complement factor H of importance in age-related macular degeneration?2018Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 59, nr 9Artikel i tidskrift (Övrigt vetenskapligt)
  • 168.
    Mohlin, Camilla
    et al.
    Linnaeus Univ, Linnaeus Ctr Biomat Chem, Fac Hlth & Life Sci, Kalmar, Sweden.
    Sandholm, Kerstin
    Linnaeus Univ, Linnaeus Ctr Biomat Chem, Fac Hlth & Life Sci, Kalmar, Sweden.
    Kvanta, Anders
    Karolinska Inst, St Erik Eye Hosp, Sect Ophthalmol & Vis, Dept Clin Neurosci, Stockholm, Sweden.
    Nilsson Ekdahl, Kristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi. Linnaeus Univ, Linnaeus Ctr Biomat Chem, Fac Hlth & Life Sci, Kalmar, Sweden.
    Johansson, Kjell
    Orebro Univ, Sch Med Sci, Orebro, Sweden.
    A model to study complement involvement in experimental retinal degeneration2018Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, nr 1, s. 28-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The complement system (CS) plays a role in the pathogenesis of a number of ocular diseases, including diabetic retinopathy (DR), glaucoma, uveitis, and age-related macular degeneration (AMD). Given that many of the complex eye-related degenerative diseases have limited treatment opportunities, we aimed to mimic the in vivo retinal degenerative process by developing a relevant co-culture system.

    Method and materials: The adult porcine retina was co-cultured with the spontaneously arising human retinal pigment epithelial cells-19 (ARPE-19).

    Results: Inflammatory activity was found after culture and included migrating microglial cells, gliosis, cell death, and CS activation (demonstrated by a minor increase in the secreted anaphylotoxin C3a in co-culture). CS components, including C1q, C3, C4, soluble C5b-9, and the C5a receptor, were expressed in the retina and/or ARPE cells after culture. C1q, C3, and CS regulators such as C4 binding protein (C4BP), factor H (CFH), and factor I (CFI) were secreted after culture.

    Discussion: Thus, our research indicates that this co-culturing system may be useful for investigations of the CS and its involvement in experimental neurodegenerative diseases.

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  • 169.
    Molnar, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Structure and Function of the Retina in Children Born Extremely Preterm and in Children Born At Term2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Optical coherence tomography (OCT), multifocal electroretinography (mfERG) and full-field electroretinography (ffERG) give important information about retinal structure and function.

    Purpose: To collect normative data of macular Cirrus Spectral domain (SD)-OCT assessments and of mfERG measurements of healthy children (papers I and II). To assess the macular thickness with Cirrus SD-OCT and the retinal function with ffERG in 6.5-year-old children born extremely preterm and in children born at term (papers III and IV).

    Methods: Study participants aged 5-15 years and living in Uppsala County were randomly chosen from the Swedish Birth Register (papers I and II). In papers III and IV, the study participants consisted of children born extremely preterm and children born at term – all were aged 6.5 years. In paper III, the children were living in Stockholm and Uppsala health care regions and, in paper IV, in Uppsala health care region only. Macular thickness was assessed with Cirrus SD-OCT and macular function with mfERG, using the Espion Multifocal system and DTL-electrodes. The retinal function was assessed with ffERG and DTL-electrodes, using the Espion Ganzfield system.

    Results: Altogether, 58 children participated in paper I and 49 children in paper II. In paper I, the repeatability and reproducibility of the OCT assessments were good. In paper II, the results of the mfERG measurements were in accordance with retinal cone density and there were no significant differences between the right and left eyes. In paper III, 134 preterm children and 145 children born at term constituted the study population. The central macular thickness was significantly thicker in the preterm group than in the control group. Within the preterm group, gestational age (GA), former retinopathy of prematurity (ROP) and male gender were all important risk factors for an increased macular thickness. In paper IV, 52 preterm children and 45 control children constituted the study population. Significantly lower amplitudes and prolonged implicit times of the combined rod and cone responses, as well as of the isolated cone responses, were found in the preterm group when compared with the control group. In paper IV, there was no association between GA, ROP or male gender and the ffERG assessments.

    Conclusion: Normative data of Cirrus SD-OCT and mfERG assessments were reported. The results of the assessments were reliable. Children aged 6.5 years, born extremely preterm, had a significantly thicker central macula and both rod and cone function were significantly reduced in comparison to children born at term. ROP had an influence on retinal structure but not retinal function in the present cohorts. Our results suggest that retinal development is abnormal in children born extremely preterm. Long-term follow-up studies are necessary in order to evaluate the functional ophthalmological outcome in this vulnerable population of children growing up today.

    Delarbeten
    1. Macular thickness assessed with spectral domain OCT in a population-based study of children: normative data, repeatability and reproducibility and comparison with time domain OCT
    Öppna denna publikation i ny flik eller fönster >>Macular thickness assessed with spectral domain OCT in a population-based study of children: normative data, repeatability and reproducibility and comparison with time domain OCT
    2015 (Engelska)Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 93, nr 5, s. 470-475Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    PurposeTo collect data on macular thickness assessed with Cirrus OCT in healthy children in a population-based study, to examine the repeatability and reproducibility, and to compare the values with Stratus OCT. MethodsFifty-eight 6- to 15-year-old children, born at term, were examined. Best-corrected visual acuity and refraction were assessed. One examiner performed three OCT assessments, and the repeatability was calculated. Thereafter, a second examiner repeated the examinations to calculate the reproducibility. One eye was randomized to be included in the normal material. Finally, the second examiner assessed the macular thickness with the Stratus OCT. ResultsThe mean value (SD) of central macular thickness was 255 +/- 17m, and the total macular volume was 10.3 +/- 0.5mm(3). No correlations were found between macular thickness and age, gender or refraction. The coefficients of variance (CoVs) for both repeatability and reproducibility were <1.21%, and the intraclass correlations (ICCs) were over 0.86. The Cirrus OCT showed a 29% thicker central macular thickness than the Stratus OCT. ConclusionNormal values for macular thickness assessed with Cirrus OCT in healthy full-term children in a population-based study were reported. The assessments showed high repeatability and reproducibility. The values of Cirrus and Stratus OCT differed and the techniques were not interchangeable.

    Nyckelord
    children, normal values, optical coherence tomography, repeatability, reproducibility
    Nationell ämneskategori
    Oftalmologi
    Identifikatorer
    urn:nbn:se:uu:diva-260806 (URN)10.1111/aos.12695 (DOI)000358440700034 ()25726865 (PubMedID)
    Forskningsfinansiär
    Svenska läkaresällskapet
    Tillgänglig från: 2015-08-31 Skapad: 2015-08-25 Senast uppdaterad: 2017-12-04Bibliografiskt granskad
    2. Macular function measured by binocular mfERG and compared with macular structure in healthy children
    Öppna denna publikation i ny flik eller fönster >>Macular function measured by binocular mfERG and compared with macular structure in healthy children
    Visa övriga...
    2015 (Engelska)Ingår i: Documenta Ophthalmologica, ISSN 0012-4486, E-ISSN 1573-2622, Vol. 131, nr 3, s. 169-176Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    To create normative data in children from binocular multifocal ERG (mfERG) recordings and compare results with the macular thickness. Forty-nine 5- to 15-year-old healthy, full-term children were examined with Espion Multifocal System, using DTL electrodes. The stimulus matrix consisted of 37 hexagonal elements. Amplitudes, implicit times and response densities (presented in three rings) of the first-order component P1 were analyzed. Measurements of macular thickness were performed with spectral-domain Cirrus OCT. There were no significant differences between right and left eyes regarding mfERG recordings. Median P1 implicit times of Rings 1-3 of the 46 right eyes were 30.0, 30.0 and 30.8 ms and response densities 20.5, 10.9 and 7.6 nV/deg(2), respectively. Implicit time was longer in boys than in girls (p = 0.009, 0.039, 0.005 in Rings 1-3) and was correlated with age (r (s) = 0.417, 0.316, 0.274 in Rings 1-3). Implicit time in Ring 1 correlated significantly with the inner circle of the OCT measurements (p = 0.014). Binocular mfERG with DTL electrodes is a reliable test of the central macular function in children and correlates with macular structure. As previously not shown, there was a significant difference in implicit time between boys and girls.

    Nyckelord
    Binocular, Multifocal electroretinogram, DTL electrodes, Healthy children, Optic coherence tomography
    Nationell ämneskategori
    Oftalmologi
    Identifikatorer
    urn:nbn:se:uu:diva-270938 (URN)10.1007/s10633-015-9513-y (DOI)000365757200002 ()
    Tillgänglig från: 2016-01-05 Skapad: 2016-01-05 Senast uppdaterad: 2017-12-01Bibliografiskt granskad
    3. Central macular thickness in 6.5-year-old children born extremely preterm is strongly associated with gestational age even when adjusted for risk factors
    Öppna denna publikation i ny flik eller fönster >>Central macular thickness in 6.5-year-old children born extremely preterm is strongly associated with gestational age even when adjusted for risk factors
    Visa övriga...
    2017 (Engelska)Ingår i: Retina, ISSN 0275-004X, E-ISSN 1539-2864, Vol. 37, nr 12, s. 2281-2288Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Purpose:To assess the macular thickness in 6.5-year-old children born extremelypreterm (EPT) in comparison with children born at term and to investigate risk factorsassociated with the macular thickness in the preterm group.

    Methods:A population-based study of 6.5-year-old children born before the gestationalage of 27 weeks and age-matched control subjects. Macular assessments with opticalcoherence tomography were performed, and the results were compared with neonatal riskfactors and sex.

    Results:Adequate optical coherence tomography measurements were obtained from134 children born EPT (mean gestational age of 25 weeks [range 23–26]) and 145 controlsubjects. The mean (range) of central macula thickness was significantly increased (P,0.001)in the EPT group (right eyes: 282mm [238–356], left eyes: 283mm[229–351]), compared withthe control group (right eyes: 249mm [208–293], left eyes: 248mm[207–290]). A multiple linearmixed model analysis of the EPT group revealed gestational age, retinopathy of prematurity,and male gender as important risk factors for an increased macular thickness. The macularthickness decreased by 3.9mm per gestational week, when adjusted for retinopathy of pre-maturity and sex.

    Conclusion:Extremely preterm birth constitutes a substantial risk factor for a thickcentral macula, even when adjusted for retinopathy of prematurity and male gender.

    Ort, förlag, år, upplaga, sidor
    Lippincott Williams & Wilkins, 2017
    Nationell ämneskategori
    Oftalmologi
    Forskningsämne
    Oftalmiatrik
    Identifikatorer
    urn:nbn:se:uu:diva-317548 (URN)10.1097/IAE.0000000000001469 (DOI)000425214400009 ()28098724 (PubMedID)
    Forskningsfinansiär
    Svenska läkaresällskapetJerringfondenStockholms läns landsting
    Tillgänglig från: 2017-03-16 Skapad: 2017-03-16 Senast uppdaterad: 2018-04-10Bibliografiskt granskad
    4. Both rod and cone function are reduced in 6.5-year-old children born extremely preterm
    Öppna denna publikation i ny flik eller fönster >>Both rod and cone function are reduced in 6.5-year-old children born extremely preterm
    Visa övriga...
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nationell ämneskategori
    Oftalmologi
    Forskningsämne
    Oftalmiatrik
    Identifikatorer
    urn:nbn:se:uu:diva-317559 (URN)
    Tillgänglig från: 2017-03-16 Skapad: 2017-03-16 Senast uppdaterad: 2017-03-21
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  • 170.
    Molnar, Anna E. C.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Andreasson, Sten O. L.
    Lund Univ, Dept Ophthalmol, Lund, Sweden..
    Larsson, Eva K. B.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik. Uppsala Univ, Dept Neurosci, Ophthalmol, Uppsala, Sweden..
    Åkerblom, Hanna M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Holmström, Gerd E.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Macular function measured by binocular mfERG and compared with macular structure in healthy children2015Ingår i: Documenta Ophthalmologica, ISSN 0012-4486, E-ISSN 1573-2622, Vol. 131, nr 3, s. 169-176Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To create normative data in children from binocular multifocal ERG (mfERG) recordings and compare results with the macular thickness. Forty-nine 5- to 15-year-old healthy, full-term children were examined with Espion Multifocal System, using DTL electrodes. The stimulus matrix consisted of 37 hexagonal elements. Amplitudes, implicit times and response densities (presented in three rings) of the first-order component P1 were analyzed. Measurements of macular thickness were performed with spectral-domain Cirrus OCT. There were no significant differences between right and left eyes regarding mfERG recordings. Median P1 implicit times of Rings 1-3 of the 46 right eyes were 30.0, 30.0 and 30.8 ms and response densities 20.5, 10.9 and 7.6 nV/deg(2), respectively. Implicit time was longer in boys than in girls (p = 0.009, 0.039, 0.005 in Rings 1-3) and was correlated with age (r (s) = 0.417, 0.316, 0.274 in Rings 1-3). Implicit time in Ring 1 correlated significantly with the inner circle of the OCT measurements (p = 0.014). Binocular mfERG with DTL electrodes is a reliable test of the central macular function in children and correlates with macular structure. As previously not shown, there was a significant difference in implicit time between boys and girls.

  • 171.
    Molnar, Anna E. C.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Andreasson, Sten O.
    Lund Univ, Dept Ophthalmol, Lund, Sweden..
    Larsson, Eva K. B.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Åkerblom, Hanna M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik. Uppsala Univ, Dept Neurosci Ophthalmol, S-75185 Uppsala, Sweden..
    Holmström, Gerd E.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Reduction of Rod and Cone Function in 6.5-Year-Old Children Born Extremely Preterm2017Ingår i: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 135, nr 8, s. 854-861Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IMPORTANCE The function of rods and cones in children born extremely preterm has not yet been fully investigated. OBJECTIVE To compare retinal function via full-field electroretinographic (ffERG) recordings in 6.5-year-old children born extremely preterm with children born at term. DESIGN, SETTING, AND PARTICIPANTS A subcohort study was conducted from July 1, 2010, to January 15, 2014, of the national Extremely Preterm Infants in Sweden Study, including preterm children (< 27 weeks' gestational age) and children born at term, at 6.5 years of age and living in the Uppsala health care region in Sweden. Full-field electroretinography was performed binocularly, using DTL electrodes and electroretinographic (ERG) protocols with flash strengths of 0.009, 0.17, 3.0, and 12.0 candelas (cd)/s/m(2), together with 30-Hz flicker and 3.0 cd/s/m(2) single-cone flash. MAIN OUTCOMES AND MEASURES The ffERG recordings were analyzed, and their associations with gestational age and retinopathy of prematurity were examined. RESULTS Adequate ffERG recordings were obtained from 52 preterm children (19 girls and 33 boys; mean [SD] age at examination, 6.6 [0.1] years) and 45 children born at term (22 girls and 23 boys; mean [SD] age at examination, 6.6 [0.1] years). Lower amplitudes of the combined rod and cone responses (the a-wave of the dark-adapted ERG protocol of 3.0 cd/s/m(2): mean difference, -48.9 mu V [95% CI, -80.0 to -17.9 mu V]; P =. 003; the a-wave of the dark-adapted ERG protocol of 12.0 cd/s/m(2): mean difference, -55.7 mu V [95% CI, -92.5 to -18.8 mu V]; P = .004), as well as of the isolated cone response (30-Hz flicker ERG: mean difference, -12.1 mu V [95% CI, -22.5 to -1.6 mu V]; P = .03), were found in the preterm group in comparison with the group born at term. The implicit time of the combined rod and cone responses (the a-wave of the dark-adapted ERG protocol of 12.0 cd/s/m(2)) was longer (mean difference, 1.2 milliseconds [95% CI, 0.3-2.0 milliseconds]; P = .01) in the preterm group, as were the isolated cone responses (30-Hz flicker ERG: mean difference, 1.2 milliseconds [95% CI, 0.5-1.8 milliseconds]; P < .001), than in the group born at term. No association was found between the ffERG recordings and gestational age or retinopathy of prematurity in the preterm group. CONCLUSIONS AND RELEVANCE Both rod function and cone function were reduced in children born extremely preterm when compared with children born at term. There was no association with retinopathy of prematurity in the preterm group, which suggests that being born extremely preterm may be one of the main reasons for a general retinal dysfunction.

  • 172.
    Molnar, Anna E. C.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Andréasson, Sten O.
    Department of Ophthalmology, Lund University.
    Larsson, Eva K. B.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Åkerblom, Hanna M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Holmström, Gerd E.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Both rod and cone function are reduced in 6.5-year-old children born extremely pretermManuskript (preprint) (Övrigt vetenskapligt)
  • 173.
    Molnar, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Holmstrom, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Macular thickness assessed with spectral domain OCT in a population-based study of children: normative data, repeatability and reproducibility and comparison with time domain OCT2015Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 93, nr 5, s. 470-475Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PurposeTo collect data on macular thickness assessed with Cirrus OCT in healthy children in a population-based study, to examine the repeatability and reproducibility, and to compare the values with Stratus OCT. MethodsFifty-eight 6- to 15-year-old children, born at term, were examined. Best-corrected visual acuity and refraction were assessed. One examiner performed three OCT assessments, and the repeatability was calculated. Thereafter, a second examiner repeated the examinations to calculate the reproducibility. One eye was randomized to be included in the normal material. Finally, the second examiner assessed the macular thickness with the Stratus OCT. ResultsThe mean value (SD) of central macular thickness was 255 +/- 17m, and the total macular volume was 10.3 +/- 0.5mm(3). No correlations were found between macular thickness and age, gender or refraction. The coefficients of variance (CoVs) for both repeatability and reproducibility were <1.21%, and the intraclass correlations (ICCs) were over 0.86. The Cirrus OCT showed a 29% thicker central macular thickness than the Stratus OCT. ConclusionNormal values for macular thickness assessed with Cirrus OCT in healthy full-term children in a population-based study were reported. The assessments showed high repeatability and reproducibility. The values of Cirrus and Stratus OCT differed and the techniques were not interchangeable.

  • 174.
    Molnar, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Rosén, Rebecka M.
    Department of Clinical Neuroscience, Karolinska Institutet.
    Nilsson, Maria
    Department of Clinical Neuroscience, Karolinska Institutet.
    Larsson, Eva K B
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Holmström, Gerd
    Department of Clinical Neuroscience, Astrid Lindgren Children ’ s Hospital, Karolinska Institutet, Stockholm, Sweden.
    Hellgren, Kerstin M.
    Department of Clinical Neuroscience, Karolinska Institutet.
    Central macular thickness in 6.5-year-old children born extremely preterm is strongly associated with gestational age even when adjusted for risk factors2017Ingår i: Retina, ISSN 0275-004X, E-ISSN 1539-2864, Vol. 37, nr 12, s. 2281-2288Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose:To assess the macular thickness in 6.5-year-old children born extremelypreterm (EPT) in comparison with children born at term and to investigate risk factorsassociated with the macular thickness in the preterm group.

    Methods:A population-based study of 6.5-year-old children born before the gestationalage of 27 weeks and age-matched control subjects. Macular assessments with opticalcoherence tomography were performed, and the results were compared with neonatal riskfactors and sex.

    Results:Adequate optical coherence tomography measurements were obtained from134 children born EPT (mean gestational age of 25 weeks [range 23–26]) and 145 controlsubjects. The mean (range) of central macula thickness was significantly increased (P,0.001)in the EPT group (right eyes: 282mm [238–356], left eyes: 283mm[229–351]), compared withthe control group (right eyes: 249mm [208–293], left eyes: 248mm[207–290]). A multiple linearmixed model analysis of the EPT group revealed gestational age, retinopathy of prematurity,and male gender as important risk factors for an increased macular thickness. The macularthickness decreased by 3.9mm per gestational week, when adjusted for retinopathy of pre-maturity and sex.

    Conclusion:Extremely preterm birth constitutes a substantial risk factor for a thickcentral macula, even when adjusted for retinopathy of prematurity and male gender.

  • 175.
    Moren, Åsa
    et al.
    Vastmanland Cty Hosp, Dept Ophthalmol, SE-72189 Vasteras, Sweden.
    Sundbom, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Gastrointestinalkirurgi.
    Ottosson, Johan
    Orebro Univ, Fac Med & Hlth, Dept Surg, Orebro, Sweden.
    Granstam, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vastmanland Cty Hosp, Dept Ophthalmol, SE-72189 Vasteras, Sweden.
    Response: Debate continues. Gastric bypass surgery does not increase the risk for sight-threatening diabetic retinopathy2019Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 97, nr 5, s. E807-E808Artikel i tidskrift (Övrigt vetenskapligt)
  • 176. Morén, Åsa
    et al.
    Sundbom, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Gastrointestinalkirurgi.
    Ottosson, Johan
    Granstam, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Gastric bypass surgery does not increase the risk for sight-threatening diabetic retinopathy2018Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 96, nr 3, s. 279-282Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To study the occurrence and level of diabetic retinopathy (DRP) before and after planned bariatric surgery and to investigate potential risk factors for deterioration of DRP.

    METHODS: The Scandinavian Obesity Surgery Registry (SOReg) was used to identify diabetic patients who underwent gastric bypass (GBP) surgery at three centres in Sweden during 2008-2010. Information regarding DRP screening was obtained from ophthalmological patient charts. Patients who had DRP screening before and after GBP surgery were included in the study.

    RESULTS: The survey included 117 patients. Mean age was 50 (SD 10) years, body mass index (BMI) 43 (SD 8) kg/m(2) and HbA1c 64 (SD 18) mmol/mol before surgery. One year post-GBP, BMI was reduced to 31 (SD 6) kg/m(2) . HbA1c was 43 (SD 10) mmol/mol, and in 66% (77/117) treatment for diabetes had been discontinued. Occurrence of DRP before GBP was as follows: no DRP 62%, mild 26%, moderate 10%, severe 0% and proliferative DRP 2%. No significant changes in occurrence of DRP after surgery were observed. Twelve patients (16%) developed mild DRP. In seven patients with pre-existing DRP, deterioration was observed and two of these patients required treatment for sight-threatening DRP. No association between preoperative BMI, HbA1c or reduction in HbA1c and worsening of DRP was found.

    CONCLUSION: In a majority of patients, no deterioration of DRP following GBP was observed. Screening for DRP before planned surgery is recommended for all diabetic patients about to undergo bariatric surgery to identify any pre-existing DRP.

  • 177.
    Munsters, Josanne
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Tidehag Walan, Johanna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Sindelar, Richard
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Skin conductance measurement as a selective and continuous pain assessment method during eye examinations for retinopathy of prematurity2023Ingår i: Global Pediatrics, E-ISSN 2667-0097, Vol. 4, artikel-id 100056Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Assessing and managing pain in newborns is important for normal development and reduction of morbidity.

    Aim

    To assess whether skin conductance measurements (SCM) can be used as an objective method for measuring procedural pain during screening for retinopathy of prematurity (ROP) in preterm infants and to identify painful components of the examination.

    Methods

    65 separate SCM were performed in 33 infants born at <32 weeks gestational age (wGA) eligible for ROP screening (median 26+4 wGA, range 23+3 to 31+3; median weeks postmenstrual age 37+2, range 31+0 to 49+6). SCM was measured before, during and after eye examination (fundoscopy and/or wide-field digital retinal imaging [WFDRI]), and compared to changes in heart rate (HR), pulse oximetry saturation (SpO2) and behavioral state measured with the Neonatal Pain, Agitation and Sedation Scale (N-PASS).

    Results

    A major increase of SCM could be seen during both fundoscopy and WFDRI (p<0.01, respectively). No correlation was found between SCM and wGA. N-PASS changed significantly during ROP examination (p<0.01). While N-PASS could only distinguish painful response from baseline during fundoscopy and WFDRI, SCM detected responses during each stage of the investigations i.e. the application of mydriatics, fundoscopy, anesthetic drops, speculum and WFDRI. HR increased only during digital retinal imaging (p = 0.049), while SpO2 decreased only during fundoscopy (p = 0.042).

    Conclusion

    SCM may be used as a continuous and objective method to evaluate pain and its intensity during screening for ROP, enabling the separation of the different painful components of the investigation. Selecting and grading the different painful stages improves the possibility to assess and continue to improve pain management more specifically in these patients.

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  • 178.
    Nakamachi, Tomoya
    et al.
    Toyama Univ, Grad Sch Sci & Engn, Lab Regulatory Biol, 3190 Gofuku, Toyama, Toyama 9308555, Japan.;Showa Univ, Sch Med, Dept Anat, Shinagawa Ku, Tokyo 1428555, Japan..
    Ohtaki, Hirokazu
    Showa Univ, Sch Med, Dept Anat, Shinagawa Ku, Tokyo 1428555, Japan..
    Seki, Tamotsu
    Showa Univ, Sch Med, Dept Anat, Shinagawa Ku, Tokyo 1428555, Japan..
    Yofu, Sachiko
    Showa Univ, Sch Med, Dept Anat, Shinagawa Ku, Tokyo 1428555, Japan..
    Kagami, Nobuyuki
    Showa Univ, Sch Med, Dept Anat, Shinagawa Ku, Tokyo 1428555, Japan..
    Hashimoto, Hitoshi
    Osaka Univ, Grad Sch Pharmaceut Sci, Lab Mol Neuropharmacol, 1-6 Yamadaoka, Suita, Osaka 5650871, Japan.;Osaka Univ, Grad Sch Pharmaceut Sci, iPS Cell Based Res Project Brain Neuropharmacol &, 1-6 Yamadaoka, Suita, Osaka 5650871, Japan.;Osaka Univ, United Grad Sch Child Dev, Mol Res Ctr Childrens Mental Dev, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.;Kanazawa Univ, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.;Hamamatsu Univ Sch Med, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.;Chiba Univ, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.;Univ Fukui, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan..
    Shintani, Norihito
    Osaka Univ, Grad Sch Pharmaceut Sci, Lab Mol Neuropharmacol, 1-6 Yamadaoka, Suita, Osaka 5650871, Japan..
    Baba, Akemichi
    Hyogo Univ Hlth Sci, Chuo Ku, 1-3-6 Minatojima, Kobe, Hyogo 6508530, Japan..
    Mark, Laszlo
    Univ Pecs, Sch Med, Inst Biochem & Med Chem, Dept Analyt Biochem, Szigeti U 12, H-7624 Pecs, Hungary.;Univ Pecs, Imaging Ctr Life & Mat Sci, Szigeti U 12, H-7624 Pecs, Hungary.;Univ Pecs, Janos Szentagothai Res Ctr, Szigeti U 12, H-7624 Pecs, Hungary.;PTE MTA Human Reprod Res Grp, Szigeti U 12, H-7624 Pecs, Hungary..
    Lanekoff, Ingela
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC, Analytisk kemi.
    Kiss, Peter
    Univ Pecs, Ctr Neurosci, MTA PTE PACAP Lendulet Res Grp, Dept Anat, Szigeti U 12, H-7624 Pecs, Hungary..
    Farkas, Jozsef
    Showa Univ, Sch Med, Dept Anat, Shinagawa Ku, Tokyo 1428555, Japan.;Univ Pecs, Ctr Neurosci, MTA PTE PACAP Lendulet Res Grp, Dept Anat, Szigeti U 12, H-7624 Pecs, Hungary..
    Reglodi, Dora
    Univ Pecs, Ctr Neurosci, MTA PTE PACAP Lendulet Res Grp, Dept Anat, Szigeti U 12, H-7624 Pecs, Hungary..
    Shioda, Seiji
    Hoshi Univ, Global Res Ctr Innovat Life Sci, Innovat Drug Discovery, Shinagawa Ku, 4-41 Ebara 2 Chome, Tokyo 1428501, Japan..
    PACAP suppresses dry eye signs by stimulating tear secretion2016Ingår i: Nature Communications, E-ISSN 2041-1723, Vol. 7, artikel-id 12034Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dry eye syndrome is caused by a reduction in the volume or quality of tears. Here, we show that pituitary adenylate cyclase-activating polypeptide (PACAP)-null mice develop dry eye-like symptoms such as corneal keratinization and tear reduction. PACAP immunoreactivity is co-localized with a neuronal marker, and PACAP receptor (PAC1-R) immunoreactivity is observed in mouse infraorbital lacrimal gland acinar cells. PACAP eye drops stimulate tear secretion and increase cAMP and phosphorylated (p)-protein kinase A levels in the infraorbital lacrimal glands that could be inhibited by pre-treatment with a PAC1-R antagonist or an adenylate cyclase inhibitor. Moreover, these eye drops suppress corneal keratinization in PACAP-null mice. PACAP eye drops increase aquaporin 5 (AQP5) levels in the membrane and pAQP5 levels in the infraorbital lacrimal glands. AQP5 siRNA treatment of the infraorbital lacrimal gland attenuates PACAP-induced tear secretion. Based on these results, PACAP might be clinically useful to treat dry eye disorder.

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  • 179.
    Niaudet, Colin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Vaskulärbiologi.
    Petkova, Milena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Vaskulärbiologi.
    Jung, Bongnam
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Vaskulärbiologi.
    Lu, S.
    Max Planck Inst Heart & Lung Res, Dept Pharmacol, D-61231 Bad Nauheim, Germany.
    Laviña, Bàrbara
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Vaskulärbiologi.
    Offermanns, S.
    Max Planck Inst Heart & Lung Res, Dept Pharmacol, D-61231 Bad Nauheim, Germany.
    Brakebusch, C.
    Univ Copenhagen, Biotech Res & Innovat Ctr, Ole Maaloes Vej 5, DK-2200 Copenhagen, Denmark.
    Betsholtz, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Vaskulärbiologi.
    Adgrf5 contributes to patterning of the endothelial deep layer in retina2019Ingår i: Angiogenesis, ISSN 0969-6970, E-ISSN 1573-7209, Vol. 22, nr 4, s. 491-505Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Neovascularization of the inner retinal space is a major cause of vision loss. In retinal angiomatous proliferation (RAP) syndrome, newly formed vessels originate from the retinal plexus and invade the inner retinal space. However, the molecular pathways preventing subretinal vascularization remain largely unknown. In most murine models of RAP, pathological neo-vascularization occurs concomitantly with the development of the retinal vasculature. Here, we demonstrate that disturbing the sequence of morphogenetic events that shape the three-layered retinal vascular network leads to subretinal vascularization. Sprouts emerging from the perivenous region after the first postnatal week extended toward the retinal space where they merged into the deep layer. The small GTPase Rac1 was required for the formation of these vascular extensions and the vascular inner plexus is formed coaxially to the overarching veins. The adhesion receptor Adgrf5 was highly expressed in the endothelium of the central nervous system, where it regulates blood-brain barrier formation. The vascular superficial plexus of Adgrf5 mutant mouse retinae exhibited an increased vascular density in the perivenous areas with increased projections toward the inner plexus where they subsequently created hyper-dense endothelial cells (EC) clusters. Disturbing the perivenous pool of EC thus significantly altered the inner plexus formation. These abnormalities culminated in transient vascular protrusions in the inner retinal space. Taken together, these results reveal a previously unobserved vascular morphogenetic defect in Adgrf5 knockout mice, implicating a role for ADGRF5 in the initiation of subretinal vascularization. Our findings also illustrate how vein-derived EC shape the inner retinal layer formation and could control the appearance of angiomatous malformations.

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  • 180.
    Norman, Mikael
    et al.
    Karolinska Inst, Div Pediat, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Neonatal Med, Stockholm, Sweden;Swedish Neonatal Qual Registry, Umea, Sweden.
    Hellstrom, Ann
    Gothenburg Univ, Sahlgrenska Acad, Dept Ophthalmol, Inst Neurosci & Physiol, Gothenburg, Sweden.
    Hallberg, Boubou
    Karolinska Inst, Div Pediat, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Neonatal Med, Stockholm, Sweden.
    Wallin, Agneta
    St Erik Eye Hosp, Dept Pediat Ophthalmol & Strabismus, Stockholm, Sweden.
    Gustafson, Pelle
    Swedish Natl Patient Insurance, Stockholm, Sweden.
    Tornqvist, Kristina
    Lund Univ, Dept Clin Sci, Ophthalmol, Lund, Sweden.
    Hakansson, Stellan
    Swedish Neonatal Qual Registry, Umea, Sweden;Umea Univ, Dept Clin Sci Pediat, Umea, Sweden.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Prevalence of Severe Visual Disability Among Preterm Children With Retinopathy of Prematurity and Association With Adherence to Best Practice Guidelines2019Ingår i: JAMA Network Open, E-ISSN 2574-3805, Vol. 2, nr 1, artikel-id e186801Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IMPORTANCE Retinopathy of prematurity (ROP) can cause severe visual disability even in high-resource settings. A better understanding of the prevalence and processes leading to ROP-induced severe visual impairment may help health care professionals design preventive measures. OBJECTIVES To determine the prevalence of severe visual disability among children born preterm in Sweden, evaluate adherence to best practice, and determine the health system's structural capacity. DESIGN, SETTING, AND PARTICIPANTS Population-based, nationwide cohort study of 1 310 227 children born between January 1, 2004, and December 31, 2015, in Sweden, of whom 17 588 (1.3%) were born very preterm (<32 weeks of gestation). Children born preterm with a verified diagnosis of severe visual disability had their medical records reviewed for evaluation of ROP screening, diagnosis, and treatment. In addition, a questionnaire on structural capacity was sent to all ophthalmology departments. EXPOSURES Stages 4 and 5 ROP. MAIN OUTCOMES AND MEASURES The primary outcome was prevalence of severe visual disability (visual acuity similar to 20/200 for both eyes) associated with ROP stages 4 and 5. Secondary outcomes included adherence to national ROP guidelines using a predefined protocol with 15 key performance indicators for screening, diagnosis, and treatment; assessment of whether visual disability was deemed avoidable; and examination of structural capacity, including information on equipment and facilities, staffing, and patients. RESULTS Seventeen children (10 boys; mean [range] birth weight, 756 [454-1900] g; mean [range] gestational age, 25 [22-33] weeks) became severely visually disabled because of ROP, corresponding to a prevalence of 1 in 1000 very preterm infants (< 32 weeks of gestational age) and 1 in 77 000 for all live births. Severe visual impairment was considered potentially avoidable in 11 of 17 affected children (65%) owing to untimely or no screening, missed diagnosis, or untimely and suboptimal treatment. Large variations in infrastructure (facilities, guidelines, staffing, and annual patient numbers) were also identified as potential contributors to these findings. CONCLUSIONS AND RELEVANCE Retinopathy of prematurity still causes severe visual disability in Sweden, resulting in 1 affected infant per 1000 very preterm births. In most of these infants, noncompliance with best practice was identified, indicating that a significant proportion could have been avoided.

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  • 181.
    Ntoula, Evangelia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Nowinski, Daniel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Ophthalmological findings in children with non-syndromic craniosynostosis preoperatively and postoperatively up to 12 months after surgery2021Ingår i: BMJ Open Ophthalmology, E-ISSN 2397-3269, Vol. 6, nr 1, artikel-id e000677Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Craniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.

    Methods: Children referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6-12 months postoperatively at the children's local hospitals.

    Results: One hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.

    Conclusion: Ophthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

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  • 182.
    Ntoula, Evangelia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Nowinski, Daniel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Strabismus and refraction in non‐syndromic craniosynostosis: – A longitudinal study up to 5 years of age2023Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose To evaluate the refractive outcome and strabismus at 5 years of age, in children operated for various types of non-syndromic craniosynostosis, and further analyse the refractive and strabismic development over time.

    Methods Eighty-nine children, who had undergone operations for non-syndromic craniosynostosis, were examined at 5 years of age. These children also underwent ophthalmological examination preoperatively and up to 1 year after the operation. An age-matched control group including 32 healthy children was also recruited.

    Strabismus and eye motility were registered. Refraction was measured in cycloplegia.

    Results There was a difference regarding the refractive outcome between the different types of craniosynostosis. Higher values of hypermetropia were found in the metopic craniosynostosis group on both eyes. In the unicoronal craniosynostosis group, high values of hypermetropia and a higher degree of astigmatism were found on the side contralateral to the craniosynostosis. Strabismus was found in 11/88 children of whom 10/11 had unicoronal craniosynostosis. A vertical deviation on the side ipsilateral to the fused suture was highly prevalent (6/10 cases). Ophthalmological dysfunctions were rare in children operated for sagittal craniosynostosis.

    Conclusion Ocular manifestations such as strabismus, astigmatism and anisometropia were highly prevalent in children operated for unilateral coronal craniosynostosis. Children operated for metopic craniosynostosis had higher rates of hypermetropia. The screening and follow-up protocols need to be tailored with regard to the type of craniosynostosis.

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  • 183. Obstbaum, SA
    et al.
    Cioffi, GA
    Krieglstein, GK
    Fennerty, MB
    Alm, A
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. Oftalmiatrik.
    Araie, M
    Carassa, RG
    Greve, EL
    Hitchings, RA
    Kaufman, PL
    Kitazawa, Y
    Pongpun, PR
    R Jr, Susanna
    Wax, MB
    Zimmerman, TJ
    Gold standard medical therapy for glaucoma: defining the criteria identifying measures for an evidence-based analysis.2004Ingår i: Clin Ther, Vol. 26, nr 12, s. 2102-2120Artikel i tidskrift (Refereegranskat)
  • 184.
    Olafsdottir, Eydis
    et al.
    Natl Univ Hosp Reykjavik, Dept Ophthalmol, Reykjavik, Iceland.;Univ Iceland, Reykjavik, Iceland.;Orebro Univ Hosp, Dept Ophthalmol, S-70116 Orebro, Sweden..
    Andersson, Dan K. G.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Dedorsson, Inger
    Orebro Univ Hosp, Dept Ophthalmol, S-70116 Orebro, Sweden..
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Jansson, Stefan P. O.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Univ Orebro, Sch Hlth & Med Sci, Orebro Cty Council, Family Med Res Ctr, S-31705 Orebro, Sweden..
    Stefansson, Einar
    Natl Univ Hosp Reykjavik, Dept Ophthalmol, Reykjavik, Iceland.;Univ Iceland, Reykjavik, Iceland..
    Early detection of type 2 diabetes mellitus and screening for retinopathy are associated with reduced prevalence and severity of retinopathy2016Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 94, nr 3, s. 232-239Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PurposeTo explore whether the prevalence and severity of retinopathy differ in diabetes cohorts diagnosed through screening as compared with conventional health care. MethodsA total of 257 diabetes patients, 151 detected through screening and 106 through conventional clinical care, were included. Retinopathy was evaluated by fundus photography. The modified Airlie House adaptation of the Early Treatment Retinopathy Study protocol was used to grade the photographs. Averages of clinically collected fasting blood glucose (FBG), blood pressure and body mass index values were compiled from diabetes diagnosis until the eye examination. Blood chemistry, smoking habits and peripheral neuropathy were assessed at the time of the eye examination. ResultsAmong the screening-detected patients, 22% had retinopathy as compared to 51% among those clinically detected (p<0.0001). In a multivariate analysis, patients with retinopathy were more likely to have increased average FBG (OR 1.42, 95% CI 1.19-1.70 per mmol/l) and peripheral neuropathy (OR 2.75, 95% CI 1.40-5.43), but less likely to have screening-detected diabetes (OR 0.31, 95% CI 0.17-0.57). Similar results were found using increasing severity grade of retinopathy as outcome. The cumulative retinopathy prevalence for the screening-detected diabetes cohort as compared with the clinically diagnosed cohort was significantly lower from 10years' follow-up and onwards (p=0.0002). ConclusionsAmong patients with screening-detected diabetes, the prevalence of retinopathy and increasing severity of retinopathy were significantly lower than among those who had their diabetes diagnosed through conventional care, even when other risk factors for retinopathy such as duration, hyperglycaemia and blood pressure were considered. Early detection of diabetes reduces prediagnostic time spent with hyperglycaemia. In combination with early and regular screening for retinopathy, more effective prevention against retinopathy can be provided.

  • 185.
    Petursdottir, Dyrleif
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Refraction and its development in young adults born prematurely and screened for retinopathy of prematurity.2022Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 100, nr 2, s. 189-195Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To evaluate refraction and its development in young adults born prematurely, screened for retinopathy of prematurity, and to compare with individuals of the same age born at term.

    MATERIALS AND METHODS: The participants were 59 preterms, with a birthweight of ≤ 1500 g, and 43 term-born controls, all born during 1988-1990. The refraction was measured in cycloplegia, and the spherical equivalent (SE) was calculated. The axial length (AL), anterior chamber depth and corneal radius (CR) were measured, and the AL/CR ratio was calculated.

    RESULTS: The mean SE was -0.5 dioptres (D) (SD 2.5) in right eyes (REs) and -0.4 D (SD 2.3) in left eyes (LEs) of preterms, and -0.2 D (SD 1.5) in REs and -0.2 D (SD 1.5) in LEs of controls. The distribution of refraction was wider in the preterm group compared to the control group. In the preterm group, 12% had a SE ≥ 1.5 D, but none of the controls. Ten preterms, but none of the controls, had anisometropia ≥ 1.0 D. The prevalence of astigmatism ≥ 1.0 D was higher in preterms than controls. The SE decreased around 1 D in both preterms and controls from 10 to 25 years of age. The AL and CR were shorter in the preterms; however, the AL/CR ratio was similar in both groups. Within the preterm group, cryotherapy was correlated with astigmatism, but not with SE and anisometropia at this age.

    CONCLUSION: Prematurely born individuals had higher prevalence of refractive errors in young adulthood compared to term-born controls.

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  • 186.
    Petursdottir, Dyrleif
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Strabismus, stereoacuity, accommodation and convergence in young adults born premature and screened for retinopathy of prematurity2022Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 100, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose The aim of the study was to evaluate strabismus, stereoacuity, accommodation and convergence in prematurely born young adults; screened for retinopathy of prematurity in the neonatal period and compare with term-born individuals of the same age. Materials and methods The study participants included 59 prematurely born individuals with a birthweight of <= 1,500 grams and 44 term-born controls, all born during 1988-1990 in Stockholm County, Sweden. Ocular alignment was assessed with a cover test, stereoacuity with the TNO stereo test and the amplitude of accommodation and the near point of convergence with the Royal Air Force Rule. Results Seven of 59 (12%) preterms had manifest strabismus, 4/59 (7%) had esotropia and 3/59 (5%) exotropia. One of 44 (2%) controls had esotropia; no other controls had manifest strabismus. Stereoacuity was within normal limits in 38/59 (64%) preterms and 43/44 (98%) controls, p < 0.01; the difference remained after excluding those with strabismus. A neurological complication at 2.5 years of age was the strongest risk factor for subnormal stereoacuity within the preterm group after excluding those with strabismus. The mean amplitude of accommodation was poorer in the preterms than the controls in better (p < 0.05) and worse eyes (p < 0.05). The preterms were more likely to have an amplitude of accommodation below the minimum, according to Hofstetter's equation. There were no differences between the groups regarding the near point of convergence. Conclusion Prematurely born young adults had a higher prevalence of strabismus, reduced stereoacuity and worse amplitude of accommodation than term-born controls.

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  • 187.
    Petursdottir, Dyrleif
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Böhm, Birgitta
    Visual-motor functions are affected in young adults who were born premature and screened for retinopathy of prematurity.2021Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, nr 1, s. 127-133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To assess visual-motor integration in young adults previously included in a prospective study on the incidence of retinopathy of prematurity (ROP).

    METHODS: The study encompassed 59 preterm individuals, born 1988-1990, with a birth weight ≤1500 g, and 44 full-term controls, aged 25-29 years. Ophthalmological examination, including visual acuity and contrast sensitivity, and the Beery Visual-Motor Integration (VMI) with supplemental tests of visual perception and motor coordination, were performed. A short questionnaire was filled in.

    RESULTS: The preterm individuals had significantly lower scores than the controls in all VMI tests, median values and interquartile ranges: Beery VMI 87 (21) vs 103 (11), visual perception 97 (15) vs 101 (8) and motor coordination 97 (21) vs 102 (15), respectively. Within the preterm group, no correlations were found between the VMI tests and ROP, gestational age, birth weight or visual acuity. Contrast sensitivity was correlated to visual perception. Neurological complication at 2.5 years was a risk factor for lower scores on Beery VMI. The preterm subjects reported six times as many health problems as compared to the controls.

    CONCLUSION: Being born preterm seemed to have life-long effects. This study shows that visual-motor integration was affected in young adults born preterm.

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  • 188.
    Pircher, Achmed
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik. Kantonsspital Aarau, Dept Ophthalmol, Aarau, Switzerland..
    Killer, Hanspeter E.
    Kantonsspital Aarau, Dept Ophthalmol, Aarau, Switzerland.;Univ Basel, Univ Hosp Basel, Dept Biomed, Basel, Switzerland..
    Comment on: The role of intracranial pressure in glaucoma2021Ingår i: Eye (London. 1987), ISSN 0950-222X, E-ISSN 1476-5454, Vol. 35, nr 6, s. 1793-1793Artikel i tidskrift (Övrigt vetenskapligt)
  • 189.
    Pircher, Achmed
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik. Kantonsspital Aarau, Dept Ophthalmol, Aarau, Switzerland.
    Killer, Hanspeter E.
    Kantonsspital Aarau, Dept Ophthalmol, Aarau, Switzerland; Univ Basel, Univ Basel Hosp, Dept Biomed, Basel, Switzerland.
    The Influence of Translaminar Pressure Gradient and Intracranial Pressure in Glaucoma2020Ingår i: Journal of glaucoma, ISSN 1057-0829, E-ISSN 1536-481X, Vol. 29, nr 12, s. E141-E141Artikel i tidskrift (Övrigt vetenskapligt)
  • 190.
    Pircher, Achmed
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik. Univ Hosp Basel, Dept Ophthalmol, Basel, Switzerland.;Univ Basel, Basel, Switzerland..
    Neutzner, Albert
    Univ Basel, Basel, Switzerland.;Univ Hosp Basel, Dept Biomed, Basel, Switzerland..
    Montali, Margherita
    San Bassiano Hosp, Dept Ophthalmol, Bassano Del Grappa, Italy..
    Huber, Andreas
    Private Univ Principal Lie Triesen, Dept Med, Triesen, Liechtenstein..
    Scholl, Hendrik P. N.
    Univ Hosp Basel, Dept Ophthalmol, Basel, Switzerland.;Univ Basel, Basel, Switzerland.;Inst Mol & Clin Ophthalmol Basel, Basel, Switzerland..
    Berberat, Jatta
    Cantonal Hosp Aarau, Dept Neuroradiol, Aarau, Switzerland..
    Remonda, Luca
    Cantonal Hosp Aarau, Dept Neuroradiol, Aarau, Switzerland..
    Killer, Hanspeter E.
    Univ Basel, Basel, Switzerland.;Univ Hosp Basel, Dept Biomed, Basel, Switzerland..
    Lipocalin-type Prostaglandin D Synthase Concentration Gradients in the Cerebrospinal Fluid in Normal-tension Glaucoma Patients with Optic Nerve Sheath Compartmentation2021Ingår i: Eye and Brain, ISSN 1179-2744, Vol. 13, s. 89-97Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To report on the lipocalin-type prostaglandin D synthase (L-PGDS) concentrations in the cerebrospinal fluid (CSF) of the perioptic and lumbar subarachnoid space (SAS) in patients with radiologically proven optic nerve (ON) sheath compartmentation presenting as normal-tension glaucoma (NTG).

    Methods: Retrospective biochemical analysis of CSF in thirteen patients with ON sheath compartmentation presenting as NTG (four females, mean age 70 +/- 8 years). CSF was sampled from the SAS of the ON during ON sheath fenestration for ON sheath compartmentation and from the lumbar SAS at the time of lumbar puncture. Nephelometry was used for the quantification of L-PGDS and albumin concentration. Albumin was measured in order to assess the amount of contamination with serum in the CSF samples taken from the ON SAS. Main outcome measures were L-PGDS concentrations in the CSF of the perioptic and lumbar SAS.

    Results: Mean L-PGDS concentration was 24 +/- 8 mg/L in the lumbar SAS compared to 33 +/- 27 mg/L without correction of serum contamination and 45 +/- 39 mg/L after correction of serum contamination in the perioptic SAS. The difference between the lumbar and the perioptic SAS was statistically significant (P=0.0047 without correction of serum contamination, P=0.0002 with correction of serum contamination; Mann-Witney U-test).

    Conclusion: This study demonstrates a concentration gradient of L-PGDS levels within the CSF with a statistically significant higher concentration in the compartmentalized perioptic SAS compared to that in the lumbar SAS. Biochemical changes in the perioptic SAS might be involved in the pathophysiology in NTG patients with ON sheath compartmentation.

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  • 191. Pivodic, Aldina
    et al.
    E.H. Smith, Lois
    Hård, Anna-Lena
    Löfqvist, Chatarina
    Almeida, Ana Catarina
    Al-Hawasi, Abbas
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Lundgren, Pia
    Sunnqvist, Birgitta
    Tornqvist, Kristina
    Wallin, Agneta
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Gränse, Lotta
    Validation of DIGIROP models and decision support tool for prediction of treatment for retinopathy of prematurity on a contemporary Swedish cohort2022Ingår i: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, s. bjophthalmol-2021Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Aim: Retinopathy of prematurity (ROP) is currently diagnosed through repeated eye examinations to find the low percentage of infants that fulfil treatment criteria to reduce vision loss. A prediction model for severe ROP requiring treatment that might sensitively and specifically identify infants that develop severe ROP, DIGIROP-Birth, was developed using birth characteristics. DIGIROP-Screen additionally incorporates first signs of ROP in different models over time. The aim was to validate DIGIROP-Birth, DIGIROP-Screen and their decision support tool on a contemporary Swedish cohort.

    Methods: Data were retrieved from the Swedish national registry for ROP (2018–2019) and two Swedish regions (2020), including 1082 infants born at gestational age (GA) 24 to <31 weeks. The predictors were GA at birth, sex, standardised birth weight and age at the first sign of ROP. The outcome was ROP treatment. Sensitivity, specificity and area under the receiver operating characteristic curve (AUC) with 95% CI were described.

    Results: For DIGIROP-Birth, the AUC was 0.93 (95% CI 0.90 to 0.95); for DIGIROP-Screen, it ranged between 0.93 and 0.97. The specificity was 49.9% (95% CI 46.7 to 53.0) and the sensitivity was 96.5% (95% CI 87.9 to 99.6) for the tool applied at birth. For DIGIROP-Screen, the cumulative specificity ranged between 50.0% and 78.7%. One infant with Beckwith-Wiedemann syndrome who fulfilled criteria for ROP treatment and had no missed/incomplete examinations was incorrectly flagged as not needing screening.

    Conclusion: DIGIROP-Birth and DIGIROP-Screen showed high predictive ability in a contemporary Swedish cohort. At birth, 50% of the infants born at 24 to <31 weeks of gestation were predicted to have low risk of severe ROP and could potentially be released from ROP screening examinations. All routinely screened treated infants, excluding those screened for clinical indications of severe illness, were correctly flagged as needing ROP screening.

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  • 192.
    Pivodic, Aldina
    et al.
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Smith, Lois E. H.
    Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts.
    Hård, Anna-Lena
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Löfqvist, Chatarina
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Institute of Health Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Al-Hawasi, Abbas
    Division of Ophthalmology, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Lundgren, Pia
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Gränse, Lotta
    Department of Clinical Sciences, Ophthalmology, Skane University Hospital, Lund University, Lund, Sweden.
    Tornqvist, Kristina
    Department of Clinical Sciences, Ophthalmology, Skane University Hospital, Lund University, Lund, Sweden.
    Wallin, Agneta
    St Erik Eye Hospital, Stockholm, Sweden.
    Johansson, Helena
    Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia;Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Albertsson-Wikland, Kerstin
    Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nilsson, Staffan
    Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hellström, Ann
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Prognostic Value of Parenteral Nutrition Duration on Risk of Retinopathy of Prematurity2023Ingår i: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 141, nr 8, s. 716-716Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Importance  The prognostic impact of parenteral nutrition duration (PND) on retinopathy of prematurity (ROP) is not well studied. Safe prediction models can help optimize ROP screening by effectively discriminating high-risk from low-risk infants.

    Objective  To evaluate the prognostic value of PND on ROP; to update and validate the Digital ROP (DIGIROP) 2.0 birth into prescreen and screen prediction models to include all ROP-screened infants regardless of gestational age (GA) and incorporate PND; and to compare the DIGIROP model with the Weight, IGF-1, Neonatal, and ROP (WINROP) and Postnatal Growth and ROP (G-ROP) models.

    Design, Setting, and Participants  This retrospective study included 11 139 prematurely born infants from 2007 to 2020 from the Swedish National Registry for ROP. Extended Poisson and logistic models were applied. Data were analyzed from August 2022 to February 2023.

    Main Outcomes and Measures  Any ROP and ROP requiring treatment were studied in relation to PND. ROP treatment was the outcome in DIGIROP models. Sensitivity, specificity, area under the receiver operating characteristic curve, and adjusted OR (aOR) with 95% CI were the main measures. Internal and external validations were performed.

    Results  Of 11 139 screened infants, 5071 (45.5%) were girls, and the mean (SD) gestational age was 28.5 (2.4) weeks. ROP developed in 3179 infants (29%), treatment was given in 599 (5%), 7228 (65%) had PND less than 14 days, 2308 (21%) had PND for 14 days or more, and 1603 (14%) had unknown PND. PND was significantly correlated with ROP severity (Spearman r = 0.45; P < .001). Infants with 14 days or more of PND vs less than 14 days had faster progression from any ROP to ROP treatment (adjusted mean difference, −0.9 weeks; 95% CI, −1.5 to −0.3; P = .004). Infants with PND for 14 days or more vs less than 14 days had higher odds of any ROP (aOR, 1.84; 95% CI, 1.62-2.10; P < .001) and of severe ROP requiring treatment (aOR, 2.20; 95% CI, 1.73-2.80; P < .001). Among all 11 139 infants, the DIGIROP 2.0 models had 100% sensitivity (95% CI, 99.4-100). The specificity was 46.6% (95% CI, 45.6-47.5) for the prescreen model and 76.9% (95% CI, 76.1-77.7) for the screen model. G-ROP as well as the DIGIROP 2.0 prescreen and screen models showed 100% sensitivity on a validation subset (G-ROP: sensitivity, 100%; 95% CI, 93-100; DIGIROP prescreen: sensitivity, 100%; 95% CI, 93-100; DIGIROP screen: sensitivity, 100%; 95% CI, 93-100), whereas WINROP showed 89% sensitivity (95% CI, 77-96). Specificity for each prediction model was 29% (95% CI, 22-36) for G-ROP, 38% (95% CI, 32-46) for DIGIROP prescreen, 53% (95% CI, 46-60) for DIGIROP screen at 10 weeks, and 46% (95% CI, 39-53) for WINROP.

    Conclusion and Relevance  Based on more than 11 000 ROP-screened infants born in Sweden, PND of 14 days or more corresponded to a significantly higher risk of having any ROP and receiving ROP treatment. These findings provide evidence to support consideration of using the updated DIGIROP 2.0 models instead of the WINROP or G-ROP models in the management of ROP.

  • 193.
    Pivodic, Aldina
    et al.
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden;Stat Konsultgrp, Gothenburg, Sweden.
    Hård, Anna-Lena
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden.
    Löfqvist, Chatarina
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Hlth Care Sci, Gothenburg, Sweden.
    Smith, Lois E. H.
    Harvard Med Sch, Boston Childrens Hosp, Dept Ophthalmol, Boston, MA 02115 USA.
    Wu, Carolyn
    Harvard Med Sch, Boston Childrens Hosp, Dept Ophthalmol, Boston, MA 02115 USA.
    Bründer, Marie-Christine
    Univ Med Ctr Greifswald, Dept Ophthalmol, Greifswald, Germany.
    Lagreze, Wolf A.
    Univ Freiburg, Eye Ctr, Med Ctr, Fac Med, Freiburg, Germany.
    Stahl, Andreas
    Univ Med Ctr Greifswald, Dept Ophthalmol, Greifswald, Germany.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Albertsson-Wikland, Kerstin
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Physiol,Unit Endocrinol, Gothenburg, Sweden.
    Johansson, Helena
    Australian Catholic Univ, McKillop Hlth Inst, Melbourne, Vic, Australia;Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Nilsson, Staffan
    Chalmers Univ Technol, Math Sci, Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Biomed, Gothenburg, Sweden.
    Hellström, Ann
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden.
    Individual Risk Prediction for Sight-Threatening Retinopathy of Prematurity Using Birth Characteristics2020Ingår i: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 138, nr 1, s. 21-29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Question: Can a prediction model be constructed for retinopathy of prematurity needing treatment by using only birth characteristics data and applying advanced statistical methods?

    Findings: In this cohort study of 6947 infants born at gestational age 24 to 30 weeks, the prediction model incorporating only postnatal age, gestational age, sex, and birth weight provided a predictive ability for retinopathy of prematurity needing treatment that was comparable to current models requiring postnatal data (not always available). The risk for retinopathy of prematurity needing treatment increased up to 12 weeks' postnatal age irrespective of the infants' gestational age.

    Meaning: This prediction model identifying infants with a high risk for developing sight-threatening disease at an early time may improve the conditions for optimal screening. This cohort study creates and validates an easy-to-use prediction model using only birth characteristics and describes a continuous hazard function for retinopathy of prematurity treatment.

    Importance: To prevent blindness, repeated infant eye examinations are performed to detect severe retinopathy of prematurity (ROP), yet only a small fraction of those screened need treatment. Early individual risk stratification would improve screening timing and efficiency and potentially reduce the risk of blindness.

    Objectives: To create and validate an easy-to-use prediction model using only birth characteristics and to describe a continuous hazard function for ROP treatment.

    Design, Setting, and Participants: In this retrospective cohort study, Swedish National Patient Registry data from infants screened for ROP (born between January 1, 2007, and August 7, 2018) were analyzed with Poisson regression for time-varying data (postnatal age, gestational age [GA], sex, birth weight, and important interactions) to develop an individualized predictive model for ROP treatment (called DIGIROP-Birth [Digital ROP]). The model was validated internally and externally (in US and European cohorts) and compared with 4 published prediction models.

    Main Outcomes and Measures: The study outcome was ROP treatment. The measures were estimated momentary and cumulative risks, hazard ratios with 95% CIs, area under the receiver operating characteristic curve (hereinafter referred to as AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

    Results: Among 7609 infants (54.6% boys; mean [SD] GA, 28.1 [2.1] weeks; mean [SD] birth weight, 1119 [353] g), 442 (5.8%) were treated for ROP, including 142 (40.1%) treated of 354 born at less than 24 gestational weeks. Irrespective of GA, the risk for receiving ROP treatment increased during postnatal weeks 8 through 12 and decreased thereafter. Validations of DIGIROP-Birth for 24 to 30 weeks' GA showed high predictive ability for the model overall (AUC, 0.90 [95% CI, 0.89-0.92] for internal validation, 0.94 [95% CI, 0.90-0.98] for temporal validation, 0.87 [95% CI, 0.84-0.89] for US external validation, and 0.90 [95% CI, 0.85-0.95] for European external validation) by calendar periods and by race/ethnicity. The sensitivity, specificity, PPV, and NPV were numerically at least as high as those obtained from CHOP-ROP (Children's Hospital of Philadelphia-ROP), OMA-ROP (Omaha-ROP), WINROP (weight, insulinlike growth factor 1, neonatal, ROP), and CO-ROP (Colorado-ROP), models requiring more complex postnatal data.

    Conclusions and Relevance: This study validated an individualized prediction model for infants born at 24 to 30 weeks' GA, enabling early risk prediction of ROP treatment based on birth characteristics data. Postnatal age rather than postmenstrual age was a better predictive variable for the temporal risk of ROP treatment. The model is an accessible online application that appears to be generalizable and to have at least as good test statistics as other models requiring longitudinal neonatal data not always readily available to ophthalmologists.

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  • 194. Pivodic, Aldina
    et al.
    Johansson, Helena
    Smith, Lois E H
    Hård, Anna-Lena
    Löfqvist, Chatarina
    Yoder, Bradley A
    Hartnett, M Elizabeth
    Wu, Carolyn
    Bründer, Marie-Christine
    Lagrèze, Wolf A
    Stahl, Andreas
    Al-Hawasi, Abbas
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Lundgren, Pia
    Gränse, Lotta
    Sunnqvist, Birgitta
    Tornqvist, Kristina
    Wallin, Agneta
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Albertsson-Wikland, Kerstin
    Nilsson, Staffan
    Hellström, Ann
    Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity2022Ingår i: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 106, nr 11, s. 1573-1580Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/AIMS: Prematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights.

    METHODS: Data, including infants born at 24-30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6-14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions.

    RESULTS: ROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6-14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%.

    CONCLUSIONS: DIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24-30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.

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  • 195.
    Pétursdóttir, Dýrleif
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Ophthalmological follow-up in young adults born premature and screened for retinopathy of prematurity2021Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Prematurely born children have a higher risk of ophthalmological and neurodevelopmental disorders than those born at term. There is a paucity of long-term prospective follow-up studies on the visual function of prematurely born adults. The current study reported the outcome of young adult individuals born after the introduction of treatment for retinopathy of prematurity (ROP).

    The aim of the study was to assess visual function, visual-motor integration, refraction and its development, as well as strabismus, stereoacuity, accommodation and convergence in prematurely born young adults.

    The participants were prematurely born, between 1 November 1988 and 31 October 1990, having a birth weight of ≤1,500 g, in Stockholm County, Sweden. These individuals were initially part of a prospective population-based study on the incidence of ROP in the neonatal period, followed until 3.5 years of age, and examined again at 10 years of age, together with a control group of term born individuals. At 25–29 years of age, 59 of the preterms and 44 controls underwent an extensive ophthalmological examination and a developmental test of visual-motor integration.

    The preterms had lower visual acuity than the controls at distance and near. Mean deviation of the visual field was reduced in preterms, as was contrast sensitivity. A crowding ratio of ≥1.5 was more prevalent in preterms. In a test of visual-motor integration, the preterms had inferior results compared to controls, in which a neurological complication at 2.5 years of age was the strongest risk factor. The preterms had greater values of myopia and hyperopia, as well as anisometropia and astigmatism, where the highest risk was found in preterms who had been treated for ROP. The spherical equivalent decreased around 1 D in both groups from 10 years to 25–29 years of age. Strabismus was found in 7/59 (12%) preterms and 1/44 (2%) controls. More preterms had subnormal stereoacuity, where the strongest risk factor was a neurological complication at 2.5 years of age. Preterms had worse amplitude of accommodation. No differences were found regarding convergence.

    Prematurely born individuals had reduced visual function, worse visual-motor integration, higher prevalence of refractive errors and strabismus, and worse stereoacuity than term born controls in young adulthood. These lifelong effects could be correlated to previous cryotherapy for ROP or neurological complications, but not always, suggesting a role of prematurity per se.

    Delarbeten
    1. Visual function is reduced in young adults formerly born prematurely: a population-based study
    Öppna denna publikation i ny flik eller fönster >>Visual function is reduced in young adults formerly born prematurely: a population-based study
    2020 (Engelska)Ingår i: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 104, nr 4, s. 541-546Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aims To assess visual function in young adults born preterm and compare with full-term individuals of the same age. Methods Young adults, born preterm (birth weight <= 1500 g) in 1988-1990, previously included in a population-based study on the incidence of retinopathy of prematurity (ROP) in Stockholm County, Sweden were included. A control group of participants born at term, in the same area during the same time period, was used for comparison. Best-corrected visual acuities were assessed at distance and near with logMAR charts. Distance visual acuity was also measured with single symbols to calculate crowding. Visual fields were measured with Humphrey 24-2 and the mean deviation was noted. Contrast sensitivity was assessed with Vistech contrast sensitivity test and the area under the curve was calculated. Results Fifty-nine preterm (females 37) and 44 full-term (females 18) individuals were included. All individuals were between 25 and 29 years of age. Preterm individuals had significantly lower distance visual acuity (mean -0.08 (SD 0.11) vs -0.14 (SD 0.07) logMAR, p=0.009), near visual acuity (mean -0.08 (SD 0.11) vs -0.13 (SD 0.06) logMAR, p=0.049), mean deviation (mean -1.09 (SD 1.13) vs -0.80 (SD 1.03) dB, p=0.05) and contrast sensitivity (mean 2.02 (SD 0.19) vs 2.16 (SD 0.14), p<0.001) in the better eye compared with full-term individuals. The differences in distance visual acuity and contrast sensitivity were also evident after excluding persons with previous ROP and neurological complications. In multivariable analyses, treated ROP was a risk factor for reduced near visual acuity and visual fields. Conclusion Visual function seems to be reduced in prematurely born individuals even in adulthood. The reason may be prematurity per se since individuals without previous ROP or neurological complications are also affected. Synopsis Visual function, assessed as visual acuity, visual fields and contrast sensitivity, was reduced in young adults born preterm and previously included in a population-based study on the incidence of retinopathy of prematurity, as compared with controls.

    Ort, förlag, år, upplaga, sidor
    BMJ PUBLISHING GROUP, 2020
    Nyckelord
    long-term follow-up, prematurely born, retinopathy of prematurity (rop, visual function
    Nationell ämneskategori
    Oftalmologi
    Identifikatorer
    urn:nbn:se:uu:diva-410157 (URN)10.1136/bjophthalmol-2019-314429 (DOI)000524520300017 ()31302630 (PubMedID)
    Tillgänglig från: 2020-08-26 Skapad: 2020-08-26 Senast uppdaterad: 2021-04-19Bibliografiskt granskad
    2. Visual-motor functions are affected in young adults who were born premature and screened for retinopathy of prematurity.
    Öppna denna publikation i ny flik eller fönster >>Visual-motor functions are affected in young adults who were born premature and screened for retinopathy of prematurity.
    2021 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, nr 1, s. 127-133Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    AIM: To assess visual-motor integration in young adults previously included in a prospective study on the incidence of retinopathy of prematurity (ROP).

    METHODS: The study encompassed 59 preterm individuals, born 1988-1990, with a birth weight ≤1500 g, and 44 full-term controls, aged 25-29 years. Ophthalmological examination, including visual acuity and contrast sensitivity, and the Beery Visual-Motor Integration (VMI) with supplemental tests of visual perception and motor coordination, were performed. A short questionnaire was filled in.

    RESULTS: The preterm individuals had significantly lower scores than the controls in all VMI tests, median values and interquartile ranges: Beery VMI 87 (21) vs 103 (11), visual perception 97 (15) vs 101 (8) and motor coordination 97 (21) vs 102 (15), respectively. Within the preterm group, no correlations were found between the VMI tests and ROP, gestational age, birth weight or visual acuity. Contrast sensitivity was correlated to visual perception. Neurological complication at 2.5 years was a risk factor for lower scores on Beery VMI. The preterm subjects reported six times as many health problems as compared to the controls.

    CONCLUSION: Being born preterm seemed to have life-long effects. This study shows that visual-motor integration was affected in young adults born preterm.

    Ort, förlag, år, upplaga, sidor
    John Wiley & Sons, 2021
    Nyckelord
    preterm birth, retinopathy of prematurity, visual-motor integration, young adults
    Nationell ämneskategori
    Klinisk medicin Oftalmologi
    Forskningsämne
    Oftalmiatrik
    Identifikatorer
    urn:nbn:se:uu:diva-418247 (URN)10.1111/apa.15378 (DOI)000546077800001 ()32473041 (PubMedID)
    Tillgänglig från: 2020-08-31 Skapad: 2020-08-31 Senast uppdaterad: 2024-01-15Bibliografiskt granskad
    3. Refraction and its development in young adults born prematurely and screened for retinopathy of prematurity.
    Öppna denna publikation i ny flik eller fönster >>Refraction and its development in young adults born prematurely and screened for retinopathy of prematurity.
    2022 (Engelska)Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 100, nr 2, s. 189-195Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    PURPOSE: To evaluate refraction and its development in young adults born prematurely, screened for retinopathy of prematurity, and to compare with individuals of the same age born at term.

    MATERIALS AND METHODS: The participants were 59 preterms, with a birthweight of ≤ 1500 g, and 43 term-born controls, all born during 1988-1990. The refraction was measured in cycloplegia, and the spherical equivalent (SE) was calculated. The axial length (AL), anterior chamber depth and corneal radius (CR) were measured, and the AL/CR ratio was calculated.

    RESULTS: The mean SE was -0.5 dioptres (D) (SD 2.5) in right eyes (REs) and -0.4 D (SD 2.3) in left eyes (LEs) of preterms, and -0.2 D (SD 1.5) in REs and -0.2 D (SD 1.5) in LEs of controls. The distribution of refraction was wider in the preterm group compared to the control group. In the preterm group, 12% had a SE ≥ 1.5 D, but none of the controls. Ten preterms, but none of the controls, had anisometropia ≥ 1.0 D. The prevalence of astigmatism ≥ 1.0 D was higher in preterms than controls. The SE decreased around 1 D in both preterms and controls from 10 to 25 years of age. The AL and CR were shorter in the preterms; however, the AL/CR ratio was similar in both groups. Within the preterm group, cryotherapy was correlated with astigmatism, but not with SE and anisometropia at this age.

    CONCLUSION: Prematurely born individuals had higher prevalence of refractive errors in young adulthood compared to term-born controls.

    Ort, förlag, år, upplaga, sidor
    John Wiley & SonsWiley, 2022
    Nyckelord
    long-term follow-up, prematurely born, refraction, refractive development, retinopathy of prematurity
    Nationell ämneskategori
    Oftalmologi
    Identifikatorer
    urn:nbn:se:uu:diva-435182 (URN)10.1111/aos.14766 (DOI)000613729100001 ()33528099 (PubMedID)
    Tillgänglig från: 2021-02-22 Skapad: 2021-02-22 Senast uppdaterad: 2024-01-15Bibliografiskt granskad
    4. Strabismus, stereoacuity, accommodation and convergence in young adults born premature and screened for retinopathy of prematurity
    Öppna denna publikation i ny flik eller fönster >>Strabismus, stereoacuity, accommodation and convergence in young adults born premature and screened for retinopathy of prematurity
    2022 (Engelska)Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 100, nr 3Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Purpose The aim of the study was to evaluate strabismus, stereoacuity, accommodation and convergence in prematurely born young adults; screened for retinopathy of prematurity in the neonatal period and compare with term-born individuals of the same age. Materials and methods The study participants included 59 prematurely born individuals with a birthweight of <= 1,500 grams and 44 term-born controls, all born during 1988-1990 in Stockholm County, Sweden. Ocular alignment was assessed with a cover test, stereoacuity with the TNO stereo test and the amplitude of accommodation and the near point of convergence with the Royal Air Force Rule. Results Seven of 59 (12%) preterms had manifest strabismus, 4/59 (7%) had esotropia and 3/59 (5%) exotropia. One of 44 (2%) controls had esotropia; no other controls had manifest strabismus. Stereoacuity was within normal limits in 38/59 (64%) preterms and 43/44 (98%) controls, p < 0.01; the difference remained after excluding those with strabismus. A neurological complication at 2.5 years of age was the strongest risk factor for subnormal stereoacuity within the preterm group after excluding those with strabismus. The mean amplitude of accommodation was poorer in the preterms than the controls in better (p < 0.05) and worse eyes (p < 0.05). The preterms were more likely to have an amplitude of accommodation below the minimum, according to Hofstetter's equation. There were no differences between the groups regarding the near point of convergence. Conclusion Prematurely born young adults had a higher prevalence of strabismus, reduced stereoacuity and worse amplitude of accommodation than term-born controls.

    Ort, förlag, år, upplaga, sidor
    John Wiley & Sons, 2022
    Nyckelord
    Strabismus, Stereoacuity, Accommodation, Convergence, Retinopathy of prematurity, Long-term folllow-up
    Nationell ämneskategori
    Oftalmologi
    Forskningsämne
    Oftalmiatrik
    Identifikatorer
    urn:nbn:se:uu:diva-440015 (URN)10.1111/aos.14987 (DOI)000678975000001 ()34313013 (PubMedID)
    Tillgänglig från: 2021-04-13 Skapad: 2021-04-13 Senast uppdaterad: 2023-08-14Bibliografiskt granskad
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  • 196.
    Pétursdóttir, Dýrleif
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Visual function is reduced in young adults formerly born prematurely: a population-based study2020Ingår i: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 104, nr 4, s. 541-546Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims To assess visual function in young adults born preterm and compare with full-term individuals of the same age. Methods Young adults, born preterm (birth weight <= 1500 g) in 1988-1990, previously included in a population-based study on the incidence of retinopathy of prematurity (ROP) in Stockholm County, Sweden were included. A control group of participants born at term, in the same area during the same time period, was used for comparison. Best-corrected visual acuities were assessed at distance and near with logMAR charts. Distance visual acuity was also measured with single symbols to calculate crowding. Visual fields were measured with Humphrey 24-2 and the mean deviation was noted. Contrast sensitivity was assessed with Vistech contrast sensitivity test and the area under the curve was calculated. Results Fifty-nine preterm (females 37) and 44 full-term (females 18) individuals were included. All individuals were between 25 and 29 years of age. Preterm individuals had significantly lower distance visual acuity (mean -0.08 (SD 0.11) vs -0.14 (SD 0.07) logMAR, p=0.009), near visual acuity (mean -0.08 (SD 0.11) vs -0.13 (SD 0.06) logMAR, p=0.049), mean deviation (mean -1.09 (SD 1.13) vs -0.80 (SD 1.03) dB, p=0.05) and contrast sensitivity (mean 2.02 (SD 0.19) vs 2.16 (SD 0.14), p<0.001) in the better eye compared with full-term individuals. The differences in distance visual acuity and contrast sensitivity were also evident after excluding persons with previous ROP and neurological complications. In multivariable analyses, treated ROP was a risk factor for reduced near visual acuity and visual fields. Conclusion Visual function seems to be reduced in prematurely born individuals even in adulthood. The reason may be prematurity per se since individuals without previous ROP or neurological complications are also affected. Synopsis Visual function, assessed as visual acuity, visual fields and contrast sensitivity, was reduced in young adults born preterm and previously included in a population-based study on the incidence of retinopathy of prematurity, as compared with controls.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 197.
    Pétursdóttir, Dýrleif
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik. Department of Ophthalmology, Faculty of Medicine, National University Hospital University of Iceland Reykjavík Iceland.
    Åkerblom, Hanna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik. Centre for Clinical Research Västmanland Hospital of Västmanland Västerås Sweden.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Larsson, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Oftalmiatrik.
    Central macular morphology and optic nerve fibre layer thickness in young adults born premature and screened for retinopathy of prematurity2023Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, s. 1-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To investigate central retinal morphology and optic retinal nerve fibre layer (RNFL) in prematurely born young adults and compare to term born controls.

    Materials and Methods: The participants were 59 prematurely born individuals, with a birthweight <= 1.500 g, and 44 term born controls, all 25-29 years of age. Visual acuity (VA) and contrast sensitivity (CS) were assessed. The retinal macular thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness and RNFL thickness were assessed with Cirrus optical coherence tomography (OCT).

    Results: Central macular thickness was increased (mean 26.7 mu m) in prematurely born individuals compared to controls. The macular GC-IPL was thinner (mean 3.84 mu m), also when excluding those with previous retinopathy of prematurity (ROP) and those with neurological complications. Gestational age at birth and previous treatment of ROP were risk factors for a thicker macula, however, not for reduced GC-IPL. The average peripapillary RNFL was thinner (mean 4.61 mu m) in the prematurely born individuals, also when excluding those with previous ROP and/or neurological complications. Within the prematurely born group, treated ROP was correlated with increased average RNFL. Further, both better VA and CS were associated with thinner optic nerve RNFL and thicker average GC-IPL.

    Conclusion: Macular and optic nerve morphology were influenced by premature birth as assessed with OCT in adult individuals. Gestational age at birth and treatment for ROP seemed to affect central macular thickness, and treated ROP affected the peripapillary RNFL. Thus, retinal sequelae remained in adulthood.

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    fulltext
  • 198.
    Rautiainen, Susanne
    et al.
    Karolinska Inst, Inst Environm Med, Div Nutr Epidemiol, S-17177 Stockholm, Sweden..
    Lindblad, Birgitta Ejdervik
    Univ Orebro, Orebro Univ Hosp, Dept Ophthalmol, SE-70182 Orebro, Sweden..
    Morgenstern, Ralf
    Karolinska Inst, Inst Environm Med, Div Biochem Toxicol, S-17177 Stockholm, Sweden..
    Wolk, Alicja
    Karolinska Inst, Inst Environm Med, Div Nutr Epidemiol, S-17177 Stockholm, Sweden..
    Total Antioxidant Capacity of the Diet and Risk of Age-Related Cataract A Population-Based Prospective Cohort of Women2014Ingår i: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 132, nr 3, s. 247-252Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IMPORTANCE To our knowledge, no previous epidemiologic study has investigated the association between all antioxidants in the diet and age-related cataract. The total antioxidant capacity (TAC) concept aims to measure the capacity from all antioxidants in the diet by also taking synergistic effects into account. OBJECTIVE To investigate the association between the TAC of the diet and the incidence of age-related cataract in a population-based prospective cohort of middle-aged and elderly women. DESIGN, SETTING, AND PARTICIPANTS Questionnaire-based nutrition survey within the prospective Swedish Mammography Cohort study, which included 30 607 women (aged 49-83 years) who were observed for age-related cataract incidence for a mean of 7.7 years. EXPOSURE The TAC of the diet was estimated using a database of foods analyzed with the oxygen radical absorbance capacity assay. MAIN OUTCOMES AND MEASURES Information on incident age-related cataract diagnosis and extraction was collected through linkage to registers in the study area. RESULTS There were 4309 incident cases of age-related cataracts during the mean 7.7 years of follow-up (234 371 person-years). The multivariable rate ratio in the highest quintile of the TAC of the diet compared with the lowest was 0.87 (95% CI, 0.79-0.96; P for trend = .03). The main contributors to dietary TAC in the study population were fruit and vegetables (44.3%), whole grains (17.0%), and coffee (15.1%). CONCLUSIONS AND RELEVANCE Dietary TAC was inversely associated with the risk of age-related cataract. Future studies examining all antioxidants in the diet in relation to age-related cataract are needed to confirm or refute our findings.

  • 199. Risa, Øystein
    et al.
    Saether, Oddbjørn
    Kakar, Manoj
    Mody, Vino
    Löfgren, Stefan
    Söderberg, Per G
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Oftalmiatrik.
    Krane, Jostein
    Midelfart, Anna
    Time dependency of metabolic changes in rat lens after in vivo UVB irradiation analysed by HR-MAS 1H NMR spectroscopy2005Ingår i: Experimental Eye Research, ISSN 0014-4835, E-ISSN 1096-0007, Vol. 81, nr 4, s. 407-414Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The lens ability to protect against, and repair ultraviolet radiation (UVR) induced damages, is of crucial importance to avoid cataract development. The influence of UVR-induced damage and repair processes on the lens metabolites are not fully understood. Observation of short- and long-term changes in light scattering and the metabolic profile of pigmented rat lenses after threshold UVR exposure might serve to better understand the protective mechanisms in the lens. By using high resolution magic angle spinning (HR-MAS) 1H NMR spectroscopy it was possible to investigate the metabolites of intact rat lenses. Brown-Norway rats were exposed to 15 kJm(-2) UVB irradiation. One eye was exposed and the contralateral served as control. The rats were sacrificed 5, 25, 125, and 625 hr post-exposure and the lenses were removed. The degree of cataract was quantified by measurement of lens forward light scattering. Thereafter, proton NMR spectra from intact lenses were obtained and relative changes in metabolite concentrations were determined. The light scattering in the lens peaked at 25 hr post-exposure and decreased thereafter. The lowest level of light scattering was measured 625 hr after exposure. No significant changes in concentration were observed for the metabolites 5 and 25 hr post-exposure except the total amount of adenosine tri- and diphosphate (ATP/ADP) that showed a significant decrease already 5 hr after exposure. At 125 hr the lens concentrations of lactate, succinate, phospho-choline, taurine, betaine, myo-inositol, and ATP/ADP showed a significant decrease (p<0.05). Phenylalanine was the only metabolite that revealed a significant increase 125 hr post-exposure. At 625 hr most of the metabolic changes seemed to normalise back to control levels. However, the concentration of betaine and phospho-choline were still showing a significant decrease 625 hr after UVB irradiation. The impact of UVB irradiation on the metabolic profile did not follow the same time dependency as the development of cataract. While the light scattering peaked at 25 hr post-exposure, significant changes in the endogenous metabolites were observed after 125 hr. Both the metabolic changes and the light scattering seemed to average back to normal within a month after exposure. Significant decrease in osmolytes like taurine, myo-inositol and betaine indicated osmotic stress and loss of homeostasis. This study also demonstrated that HR-MAS 1H NMR spectroscopy provides high quality spectra of intact lenses. These spectra contain a variety of information that might contribute to a better understanding of the metabolic response to drugs or endogenous stimuli like UVB irradiation.

  • 200. Rodrigues, Ian A.
    et al.
    Sprinkhuizen, Sara M.
    Barthelmes, Daniel
    Blumenkranz, Mark
    Cheung, Gemmy
    Haller, Julia
    Johnston, Robert
    Kim, Ramasamy
    Klaver, Caroline
    McKibbin, Martin
    Ngah, Nor Fariza
    Pershing, Suzann
    Shankar, Dato
    Tamura, Hiroshi
    Tufail, Adnan
    Weng, Christina Y.
    Westborg, Inger
    Yelf, Catherine
    Yoshimura, Nagahisa
    Gillies, Mark C.
    Defining a Minimum Set of Standardized Patient-centered Outcome Measures for Macular Degeneration2016Ingår i: American Journal of Ophthalmology, ISSN 0002-9394, E-ISSN 1879-1891, Vol. 168, s. 1-12Artikel i tidskrift (Refereegranskat)
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