Purpose: To improve the predictability, accuracy and stability of laser in-situ keratomileusis (LASIK), by evaluating the clinical, procedural and tissue response factors that affect refractive outcomes. Methods: Myopic LASIK surgeries (n=5,978) were carried out using the Technolas planoscan and Nidek EC-5000 excimer lasers. Clinical variables associated with a refractive outcome of within ??0.50 D of the target were identified using regression analysis. Possible procedural variations such as the timing of the procedure and accuracy of both the chosen keratome and excimer laser were evaluated. The predictability and accuracy of the ablation was assessed by measuring changes in corneal thickness during and after the procedure. Factors influencing the stability of refractive outcome were assessed. Results: Clinical factors associated with a refractive outcome of within ??0.50 D of the target included; corrections less than 5.00 DS (OR 0.21x, 95% CI 0.11-0.40x compared with corrections over -5.00 DS[referent]), patients younger than 40 years (patients over 50 OR 8.27x, 95% CI 3.41-20.03x, patients 40 to 50 years OR 1.93x, 95% CI 0.96-3.90x, compared with patients under 40[referent]) and average pre-operative curvatures between 43.50 and 45.50D (OR 0.39x, 95% CI 0.18-0.83 compared with curvatures of less than 43.50D [referent]). Refractive stability was improved using optic zone sizes between 5.5-6.0 mm, reduced myopic corrections, flatter pre-operative corneal curvatures and thicker corneal flaps (R??=25%, p&lt0.001). Procedural factors associated with poorer outcomes included: thinner measured flap thickness, deeper ablations and the use of the automated corneal shaper (ACS) microkeratome with a novice surgical team (R??=34%, p &lt 0.001). Delaying the ablation from 20 to 90 seconds (s) after flap lift was associated with a more stable refractive outcome at three months (p=0.017). In the 90 s following flap lift, the cornea thinned by 5??3%. The ablation rate per scan varied between procedures, however, the effect on refractive outcome was small (r=0.15, p=0.267). Changes in central corneal thickness indicated refractive stability (p=0.039). Conclusions: Applying the optimal clinical and procedural factors as described afforded a refractive outcome in a further 8% of cases, resulting in 94% to 96% of cases within ??0.50 DS of target. Refractive predictability was limited due to the inability of the keratome to produce a consistent corneal flap thickness and unexpected changes in corneal thickness. The accuracy of refractive outcome will decrease with larger ablations. The degree of refractive inaccuracy with high refractive corrections (&gt -10.00 D) can be over 1.00 D.

Purpose: To improve the predictability, accuracy and stability of laser in-situ keratomileusis (LASIK), by evaluating the clinical, procedural and tissue response factors that affect refractive outcomes. Methods: Myopic LASIK surgeries (n=5,978) were carried out using the Technolas planoscan and Nidek EC-5000 excimer lasers. Clinical variables associated with a refractive outcome of within ??0.50 D of the target were identified using regression analysis. Possible procedural variations such as the timing of the procedure and accuracy of both the chosen keratome and excimer laser were evaluated. The predictability and accuracy of the ablation was assessed by measuring changes in corneal thickness during and after the procedure. Factors influencing the stability of refractive outcome were assessed. Results: Clinical factors associated with a refractive outcome of within ??0.50 D of the target included; corrections less than 5.00 DS (OR 0.21x, 95% CI 0.11-0.40x compared with corrections over -5.00 DS[referent]), patients younger than 40 years (patients over 50 OR 8.27x, 95% CI 3.41-20.03x, patients 40 to 50 years OR 1.93x, 95% CI 0.96-3.90x, compared with patients under 40[referent]) and average pre-operative curvatures between 43.50 and 45.50D (OR 0.39x, 95% CI 0.18-0.83 compared with curvatures of less than 43.50D [referent]). Refractive stability was improved using optic zone sizes between 5.5-6.0 mm, reduced myopic corrections, flatter pre-operative corneal curvatures and thicker corneal flaps (R??=25%, p&lt0.001). Procedural factors associated with poorer outcomes included: thinner measured flap thickness, deeper ablations and the use of the automated corneal shaper (ACS) microkeratome with a novice surgical team (R??=34%, p &lt 0.001). Delaying the ablation from 20 to 90 seconds (s) after flap lift was associated with a more stable refractive outcome at three months (p=0.017). In the 90 s following flap lift, the cornea thinned by 5??3%. The ablation rate per scan varied between procedures, however, the effect on refractive outcome was small (r=0.15, p=0.267). Changes in central corneal thickness indicated refractive stability (p=0.039). Conclusions: Applying the optimal clinical and procedural factors as described afforded a refractive outcome in a further 8% of cases, resulting in 94% to 96% of cases within ??0.50 DS of target. Refractive predictability was limited due to the inability of the keratome to produce a consistent corneal flap thickness and unexpected changes in corneal thickness. The accuracy of refractive outcome will decrease with larger ablations. The degree of refractive inaccuracy with high refractive corrections (&gt -10.00 D) can be over 1.00 D.

Purpose: To improve the predictability, accuracy and stability of laser in-situ keratomileusis (LASIK), by evaluating the clinical, procedural and tissue response factors that affect refractive outcomes. Methods: Myopic LASIK surgeries (n=5,978) were carried out using the Technolas planoscan and Nidek EC-5000 excimer lasers. Clinical variables associated with a refractive outcome of within ??0.50 D of the target were identified using regression analysis. Possible procedural variations such as the timing of the procedure and accuracy of both the chosen keratome and excimer laser were evaluated. The predictability and accuracy of the ablation was assessed by measuring changes in corneal thickness during and after the procedure. Factors influencing the stability of refractive outcome were assessed. Results: Clinical factors associated with a refractive outcome of within ??0.50 D of the target included; corrections less than 5.00 DS (OR 0.21x, 95% CI 0.11-0.40x compared with corrections over -5.00 DS[referent]), patients younger than 40 years (patients over 50 OR 8.27x, 95% CI 3.41-20.03x, patients 40 to 50 years OR 1.93x, 95% CI 0.96-3.90x, compared with patients under 40[referent]) and average pre-operative curvatures between 43.50 and 45.50D (OR 0.39x, 95% CI 0.18-0.83 compared with curvatures of less than 43.50D [referent]). Refractive stability was improved using optic zone sizes between 5.5-6.0 mm, reduced myopic corrections, flatter pre-operative corneal curvatures and thicker corneal flaps (R??=25%, p&lt0.001). Procedural factors associated with poorer outcomes included: thinner measured flap thickness, deeper ablations and the use of the automated corneal shaper (ACS) microkeratome with a novice surgical team (R??=34%, p &lt 0.001). Delaying the ablation from 20 to 90 seconds (s) after flap lift was associated with a more stable refractive outcome at three months (p=0.017). In the 90 s following flap lift, the cornea thinned by 5??3%. The ablation rate per scan varied between procedures, however, the effect on refractive outcome was small (r=0.15, p=0.267). Changes in central corneal thickness indicated refractive stability (p=0.039). Conclusions: Applying the optimal clinical and procedural factors as described afforded a refractive outcome in a further 8% of cases, resulting in 94% to 96% of cases within ??0.50 DS of target. Refractive predictability was limited due to the inability of the keratome to produce a consistent corneal flap thickness and unexpected changes in corneal thickness. The accuracy of refractive outcome will decrease with larger ablations. The degree of refractive inaccuracy with high refractive corrections (&gt -10.00 D) can be over 1.00 D.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

The purpose of this study was to examine marketers view of alcohol advertising. Focus have been on its potential effect on the society, moral aspects and its relation to sustainability, identity, gender and celebrities. The method used was semi-structured interviews with eight marketers at three advertise agencies/production companies in Cape Town who have working experience of alcohol advertising and this have been analysed in relation to impact and identity theories as well as ethics. The result showed that majority of the marketers did not believe alcohol advertising increase alcohol consumption nor lead to alcohol abuse but rather create brand awareness and competition between brands. Their perception was also that alcohol brands are connected to identity in South Africa and that using celebrities in alcohol advertising could be highly effecting when using the right celebrity. One conclusion is that the participants did not suffer from moral myopia since they were fully aware of what harm alcohol could have on the society. Regarding moral discussion at work was it some of the marketers that did not talk about ethical issues which could be a sign of moral muteness but it is really hard to draw any conclusion about it after a short interview. / <p>Bild</p>

Using panel data analysis, this paper considers the impact of governance provisions on firm’sR&amp;D investment decisions. The current paper also contributes to the literature on corporategovernance and innovation by introducing an interaction dimension which captures theinfluence that internationalization of U.S. firms may have on R&amp;D investment decisions. Basedon a sample of 627 U.S. firms for the years 2008-2016 this paper’s results suggest thatgovernance provisions do not nurture or impede R&amp;D investments, and therefore the resultscasts doubt on the existence of a relationship between governance provisions and R&amp;Dintensity. The current paper’s findings also suggest that proposed effects of internationalizationdo not modify the relationship between entrenchment and R&amp;D for U.S. firms.

O peixe dourado é extensivamente utilizado em pesquisas sobre visão devido a diversos fatores: é um animal pecilotermo, o que possibilita manter sua retina ex-vivo viável para manipulação experimental por mais tempo; apresenta uma organização retiniana semelhante à de mamíferos; possui neurônios grandes, facilitando estudos eletrofisiológicos e morfológicos e, diferentemente de mamíferos, é dotado de neurogênese constante de alguns tipos celulares retinianos. A produção, composição e escoamento dos meios oculares nesta espécie, fundamentais para a formação de imagens sobre a retina, são, entretanto, pouco conhecidos. A variedade padrão desta espécie apresenta desenvolvimento ocular normal, enquanto a variedade demekin é extremamente míope por possuir crescimento ocular exagerado (buftalmia), condição característica de alguns tipos de glaucoma em mamíferos. O presente trabalho investigou aspectos morfofisiológicos do sistema de produção e drenagem do humor aquoso e a composição do humor vítreo nestas duas variedades de peixe dourado, com o objetivo de melhor compreender as causas subjacentes ao crescimento ocular do demekin. Para estudar a drenagem do humor aquoso, foram realizadas injeções de corante na câmara anterior de animais das duas variedades, com processamento histológico posterior em intervalos de tempo pré-determinados (5, 15, 30, 60, 120 minutos e 1, 2, 3 4 e 7 dias, n <= 3 olhos de cada variedade por grupo experimental). Não foram observadas diferenças na drenagem de humor aquoso entre as duas variedades. Em ambas, o humor aquoso é drenado principalmente pela malha trabecular contida na porção ventral do ângulo de drenagem, entre a íris e o ligamento anular. Duas vias secundárias de drenagem foram encontradas nas duas variedades de peixe dourado estudadas: (i) a via irídica e (ii) a drenagem através de vasos epirretinianos. Estas vias são aparentemente mais lentas do que a via trabecular, uma vez que foi encontrado corante nessas regiões até quatro dias após as injeções de corante na câmara anterior. Foi realizado também estudo ultraestrutural da retina e epitélio ciliar em ambas as variedades através de microscopia eletrônica de transmissão. O epitélio pigmentado da retina do demekin apresentou grânulos de melanina mais escassos, e observamos certa desorganização da camada de fotorreceptores, bem como redução da sua densidade. Através de aparato invasivo construído por Joselevitch e Smith (1997), foi mensurada a pressão intraocular (PIO) de 14 olhos de cada variedade. O demekin apresentou valores de PIO ligeiramente aumentados em relação ao animal padrão (3,6 ± 0,9 mmH2O para o demekin e 1,9 ± 0,6 mmH2O para o peixe dourado padrão). A composição proteica do corpo vítreo foi estudada através de eletroforese em gel de poliacrilamida utilizando um pool de humor vítreo de 4 animais da variedade padrão e 2 da variedade demekin. As proteínas de baixa massa molecular (entre 15 a 25 kDa) estavam expressas em ambas - embora com maior expressão na variedade padrão - e outras, de maior massa molecular, expressas apenas no humor vítreo do demekin (50-75 kDa e 150 kDa). Os resultados obtidos sugerem, portanto, que há diferenças importantes na ultraestrutura retiniana, na composição proteica do humor vítreo e na pressão intraocular do demekin. Para melhor compreensão do crescimento ocular desta variedade faz-se necessária a realização de um estudo proteômico, identificando quais são as proteínas do humor vítreo evidenciadas através da eletroforese, bem como estudos morfológicos em animais de diferentes tamanhos visando a quantificação dos danos retinianos decorrentes do seu crescimento ocular / The goldfish is extensively used in vision research due to several factors: it is a poikilothermic animal, which allows ex-vivo experiments using its retina for longer periods of time; its retinal organization is very similar to that of mammals; it has large neurons, which facilitates electrophysiological and morphological studies and, unlike mammals, it is endowed with constant neurogenesis of some retinal cell types. However, the production, composition and outflow of ocular media in this species, which are fundamental for image formation onto the retina, are poorly understood. The standard goldfish has normal eye development, while the Black Moor goldfish is extremely myopic due to excessive eye growth (buphthalmos), a condition that is present in certain types of mammalian glaucoma. The present study investigated morphophysiological aspects of the aqueous humor production and drainage system and vitreous humor composition in these two varieties of goldfish to better understand the causes underlying the eye growth of the Black Moor. To study the drainage of the aqueous humor, anterior chamber dye injections and histological processing were performed in animals of both varieties after predetermined time intervals (5, 15, 30, 60, 120 minutes and 1, 2, 3, 4, and 7 days, n <= 3 eyes of each variety for each experimental group). No differences were observed in the drainage of aqueous humor between the two varieties. In both, the aqueous humor is drained mainly by the trabecular meshwork contained in the ventral portion of the drainage angle, between the iris and the annular ligament. Two secondary drainage routes were found in the two goldfish varieties studied: (i) the iridic route and (ii) drainage through epiretinal vessels. These pathways are apparently slower than the trabecular route, since the dye was found in these regions 4 days after the injections. An ultrastructural study of the retina and ciliary epithelium was also carried out in both varieties through transmission electron microscopy. The retinal pigment epithelium of the Black Moor presented more scarce melanin granules and we observed some disorganization of the photoreceptor layer, as well as a reduction in its density. Through an invasive device constructed by Joselevitch and Smith (1997), the intraocular pressure (IOP) of 14 eyes of each variety was measured. The Black Moor presented slightly increased IOP values compared to the standard animal (3.6 ± 0.9 mmH2O for demekin and 1.9 ± 0.6 mmH2O for the standard goldfish). The protein composition of the vitreous body was studied by polyacrylamide gel electrophoresis using a vitreous humor pool of 4 animals of the standard variety and 2 of the Black Moor variety. Low molecular weight proteins (15 to 25 kDa) were expressed in both - although with greater expression in the standard variety - and others of higher molecular mass, expressed only in the vitreous humor of the Black Moor (50-75 kDa and 150 kDa). These results suggest, therefore, that there are important differences in the retinal ultrastructure, the protein composition of the vitreous humor and the intraocular pressure of the Black Moor. To better understand the ocular growth in this variety, it is necessary to carry out a proteomic study, identifying which are the vitreous humor proteins evidenced through electrophoresis, as well as morphological studies in animals of different sizes aiming the quantification of the retinal damages caused by its ocular growth

Abstract Stickler and Marshall syndromes are genetic disorders both inherited in an autosomal dominant manner. The genotype-phenotype correlation was performed in ten Stickler/Marshall syndrome patients with mutations in the COL11A1 gene. Four patients had a phenotype classified as Marshall syndrome based on early-onset severe hearing loss and characteristic facial dysmorphism. A splice site mutation in intron 50 of COL11A1 was found in these patients, while the remaining six patients had an overlapping Marshall-Stickler phenotype with a mutation elsewhere in the gene. These results indicate exon 50 as a hot spot for splice site mutations leading to a phenotype of Marshall syndrome rather than Stickler syndrome. Collagen II (COL2A1) precursor mRNA undergoes alternative splicing resulting in two different isoforms, IIA including exon 2 and IIB excluding exon 2. Recent evidence indicates that premature termination codon mutations in exon 2 cause Stickler syndrome with no or minimal extraocular manifestations. Two mutations were observed in this study: Cys64Stop, and a novel structural mutation, Cys57Tyr. Results from the COL2A1 mini-gene studies suggested that both mutations altered positive cis elements for splicing resulting in a lower IIA:IIB ratio. The results further emphasize the importance of exon 2 in the development and normal function of the eye. In addition, patients displaying eye phenotypes in the absence of extraocular manifestations should be analyzed first for exon 2 mutations. Linkage analysis identified a new locus for autosomal recessive nonsyndromic hearing loss (DFNB32) on chromosome 1p13.3-22.1 in a Tunisian family with congenital profound autosomal recessive deafness. The COL11A1 gene is located in this region and was analyzed as a candidate gene. No disease causing sequence variation was observed. The analysis of 85 English and 40 Finnish subjects with high myopia resulted in the identification 23 sequence variations in the SLRP genes LUM, FMOD, PRELP, and OPTC. The two intronic variations and seven amino acid changes, one synonymous and six non-synonymous, were not found in the 308 controls analyzed. Five changes were detected in opticin, and all but one were shown to co-segregate with high myopia in families with incomplete penetrance. The results suggested that sequence variations in the SLRP genes expressed in the eye are genetic risk factors underlying the pathogenesis of high myopia.

No description available.

Dans un contexte d’augmentation du nombre d’amétropes dans la population mondiale, et en conséquence, de l’accroissement du recours aux techniques de corrections chirurgicales, la compréhension et l’amélioration de celles-ci sont un enjeu crucial. Nous avons cherché à améliorer la prédictibilité de certains résultats postopératoires dans le cas d’un LASIK (Laser-Assisted In-Situ Keratomileusis), d’une PKR (Photorefractive Keratectomy) ou d'une chirurgie de la cataracte, et ainsi formuler des recommandations pratiques qui contribueraient au développement de stratégies de traitement davantage personnalisés. Pour cela, nous avons utilisé prospectivement des méthodologies de « contrôle de qualité » des chirurgies sur de larges échantillons de patients. Dans un premier temps, nous avons étudié la dynamique pupillaire dans le cadre de chirurgies au LASIK et notamment le rôle du centre pupillaire, point de référence important dans les stratégies de centrage. Nous avons également évalué la dynamique du diamètre pupillaire et les modifications du segment antérieur sur des yeux subissant une chirurgie de la cataracte. La seconde partie du travail s’est focalisée sur le rôle de l’épithélium dans la topographique cornéenne. Nous avons comparé les topographies spéculaires de l'épithélium et de la couche de Bowman sur des cornées saines et des cornées kératoconiques, présentant une myopie faible à modérée corrigée par PKR. Enfin, dans la dernière partie de notre recherche, nous nous sommes intéressés aux changements de paramètres anatomiques de l'oeil, des performances visuelles et de la qualité de vision subjective survenant dans un échantillon d’yeux myopes après un LASIK réalisé avec le laser WaveLight® Refractive Suite (Alcon® Laboratories Inc., USA). / While the number of ametropic eyes in the world’s population and consequently the use of surgical correction techniques is increasing, understanding and improving these techniques is a crucial issue. We sought to improve the predictability of certain postoperative results in the case of LASIK (Laser-Assisted In-Situ Keratomileusis), PRK (Photorefractive Keratectomy) and cataract surgery, and thus to formulate practical recommendations that would contribute to the development of more personalized treatment strategies. To achieve this objective, we have prospectively used "quality control" methodologies to assess surgeries performed on large samples of patients. First, we studied the pupillary dynamics in LASIK surgery and in particular the role of the pupillary centre, an important point of reference in the centration strategies. We also assessed the dynamics of pupillary diameter and anterior segment changes on eyes undergoing cataract surgery. The second part of the work focused on the role of the epithelium in the corneal topography. We compared specular topographies of the epithelium and Bowman's layer in healthy and keratoconus corneas with mild to moderate myopia corrected by PRK. Finally, in the last part of our research, we were interested in the changes in anatomical parameters of the eye, visual performance and subjective quality of vision occurring in a sample of myopic eyes after LASIK performed with the WaveLight® Refractive Suite (Alcon® Laboratories Inc., USA).