OPHTHALMOLOGY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
ii
ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Ophthalmology: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84137-3 1. Ophthalmology-Popular works. I. Title.
iii
Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail:
[email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.
iv
Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on ophthalmology. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
v
About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
vi
About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
vii
Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON OPHTHALMOLOGY ................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Ophthalmology.............................................................................. 5 E-Journals: PubMed Central ....................................................................................................... 57 The National Library of Medicine: PubMed ................................................................................ 58 CHAPTER 2. NUTRITION AND OPHTHALMOLOGY ......................................................................... 87 Overview...................................................................................................................................... 87 Finding Nutrition Studies on Ophthalmology ............................................................................ 87 Federal Resources on Nutrition ................................................................................................... 88 Additional Web Resources ........................................................................................................... 89 CHAPTER 3. ALTERNATIVE MEDICINE AND OPHTHALMOLOGY ................................................... 91 Overview...................................................................................................................................... 91 National Center for Complementary and Alternative Medicine.................................................. 91 Additional Web Resources ........................................................................................................... 95 General References ....................................................................................................................... 96 CHAPTER 4. DISSERTATIONS ON OPHTHALMOLOGY ..................................................................... 97 Overview...................................................................................................................................... 97 Dissertations on Ophthalmology ................................................................................................. 97 Keeping Current .......................................................................................................................... 98 CHAPTER 5. PATENTS ON OPHTHALMOLOGY ................................................................................ 99 Overview...................................................................................................................................... 99 Patents on Ophthalmology........................................................................................................... 99 Patent Applications on Ophthalmology..................................................................................... 123 Keeping Current ........................................................................................................................ 131 CHAPTER 6. BOOKS ON OPHTHALMOLOGY .................................................................................. 133 Overview.................................................................................................................................... 133 Book Summaries: Federal Agencies............................................................................................ 133 Book Summaries: Online Booksellers......................................................................................... 134 The National Library of Medicine Book Index ........................................................................... 141 Chapters on Ophthalmology ...................................................................................................... 141 Directories.................................................................................................................................. 145 CHAPTER 7. MULTIMEDIA ON OPHTHALMOLOGY ....................................................................... 147 Overview.................................................................................................................................... 147 Bibliography: Multimedia on Ophthalmology ........................................................................... 147 CHAPTER 8. PERIODICALS AND NEWS ON OPHTHALMOLOGY .................................................... 149 Overview.................................................................................................................................... 149 News Services and Press Releases.............................................................................................. 149 Newsletter Articles .................................................................................................................... 150 Academic Periodicals covering Ophthalmology......................................................................... 151 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 155 Overview.................................................................................................................................... 155 NIH Guidelines.......................................................................................................................... 155 NIH Databases........................................................................................................................... 157 Other Commercial Databases..................................................................................................... 160 APPENDIX B. PATIENT RESOURCES ............................................................................................... 161 Overview.................................................................................................................................... 161 Patient Guideline Sources.......................................................................................................... 161 Finding Associations.................................................................................................................. 169 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 171
viii Contents
Overview.................................................................................................................................... 171 Preparation................................................................................................................................. 171 Finding a Local Medical Library................................................................................................ 171 Medical Libraries in the U.S. and Canada ................................................................................. 171 ONLINE GLOSSARIES................................................................................................................ 177 Online Dictionary Directories ................................................................................................... 177 OPHTHALMOLOGY DICTIONARY........................................................................................ 179 INDEX .............................................................................................................................................. 245
1
FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with ophthalmology is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about ophthalmology, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to ophthalmology, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on ophthalmology. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to ophthalmology, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on ophthalmology. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
3
CHAPTER 1. STUDIES ON OPHTHALMOLOGY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on ophthalmology.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and ophthalmology, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “ophthalmology” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Oral Manifestations of Ehlers-Danlos Syndrome Source: Journal of the Canadian Dental Association. 67(6): 330-334. June 2001. Contact: Available from Canadian Dental Association. 1815 Alta Vista Drive, Ottowa, ON K1G 3Y6. (613) 523-1770. E-mail:
[email protected]. Website: www.cda-adc.ca. Summary: Ehlers Danlos syndrome (EDS) is a rare hereditary disease of the connective tissue which can present oral manifestations. In this article, the authors presents a brief history of the disease, along with the epidemiology and characteristics of the eight main phenotypes of the syndrome. The article also describes the case of the a 12 year old patient presenting with hypermobility of the temporomandibular joint (TMJ) and capillary fragility, and highlights the precautions to take when treating patients with this syndrome. The authors emphasize that oral examination can be instrumental in
4
Ophthalmology
establishing a diagnosis of EDS. The classic signs of EDS are joint hypermobility; hyperelasticity of skin, which is soft, thin, and fragile; the presence of dystophic scars; and a tendency to bleed excessively, manifested by bruises and hematomas. The presence of the classic signs of the syndrome should prompt the clinician to arrange dermatology, genetics, rhematology, cardiology, and ophthalmology consults to confirm and type the diagnosis of EDS. The dentist should perform treatment observing precautions appropriate to this condition. 5 figures. 24 references. •
Spotlight on the Ophthalmic Registered Nurse Source: Diabetes Forecast. 45(7): 76-77. July 1992. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article describes the work of certified registered nurses in ophthalmology. Topics include the number of nurses in this specialty; the ophthalmic nurses' professional organization, the American Society of Ophthalmic Registered Nurses (ASORN); progress in eye care in the past few years; diabetic retinopathy; eye doctors diagnosing diabetes; the need for people with diabetes to get regular eye examinations; and the role of the eyes as windows to the body's health. 1 figure.
•
Painful Chewing and Blindness: Signs and Symptoms of Temporal Arteritis Source: JADA. Journal of the American Dental Association. 131(12): 1738-1741. December 2000. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: This article presents a case report that illustrates the need to consider temporal arteritis in the differential diagnosis of jaw or tooth pain. This disease affects the cranial arteries, more frequently in women and usually in those older than age 60 years, causing jaw pain, visual symptoms, headache, scalp pain, and sometimes blindness. In this case, a 71 year old man had jaw pain that increased with chewing and speaking, scalp tenderness, and dimming vision. A temporal artery biopsy confirmed the diagnosis of temporal arteritis. Treatment with decreasing amounts of oral steroids over 23 months was successful in relieving his signs and symptoms and in saving his vision. The authors caution that patients with this disease may seek care from their dentist first, so dentists must maintain a high index of suspicion. Jaw or tooth pain is the most reliable clinical symptom in the diagnosis of temporal arteritis. Diagnosis and timely referral for treatment with oral steroids can prevent blindness. This disease, which has been called the prime medical emergency in ophthalmology, also should be considered a prime medical emergency for dentists. 2 figures. 21 references.
•
Preferred Practice Pattern for Diabetic Retinopathy Source: Diabetes Spectrum. 4(2): 64-65. March-April 1991. Summary: This article reviews and summarizes the Preferred Practice Pattern for Diabetic Retinopathy, a guide prepared by the American Academy of Ophthalmology. These standards of care were established as a result of three major nationwide clinical research studies that investigated ways to reduce the threat of visual loss from diabetes. Of significant importance to health-care providers are the suggested examination schedule for patients with diabetes and suggested management recommendations; both are summarized in tables in this article. 4 tables. 1 reference.
Studies
5
Federally Funded Research on Ophthalmology The U.S. Government supports a variety of research studies relating to ophthalmology. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to ophthalmology. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore ophthalmology. The following is typical of the type of information found when searching the CRISP database for ophthalmology: •
Project Title: ADULT THERAPEUTIC CLINICAL TRIALS PROGRAM FOR AIDS Principal Investigator & Institution: Eron, Joseph J.; Associate Professor; Medicine; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 30-SEP-1987; Project End 31-DEC-2004 Summary: (adapted from the application's abstract): The applicants propose to continue their multidisciplinary multi-year research program, that will integrate institutional expertise in infectious diseases, neurology, ophthalmology, gynecology, pharmacology, immunology, retrovirology, herpes viruses, and numerous clinical resources in North Carolina. The main focus is the evaluation of novel therapies for HIV-infected persons. Clinical investigators at the UNC and two satellite units, Greensboro, and Charlotte will study new compounds active against HIV and associated infections, malignancies, and neurologic disorders in new patients and follow previously enrolled patients. This proposes to continue a high rate of accrual among minorities, women, and intravenous (I.V.) drug users. The trials will be of all Phases (I, II, and III) and types. Patients will be followed for in vivo evidence of study drug effects on HIV, Mycobacterium avium intracellular complex (MAC), cytomegalovirus (CMV), herpes simplex virus (HSV), and other opportunistic infections using the ACTG-certified retrovirology and immunology virus laboratory, as well as UNC hospital laboratories. Pharmacokinetics (PK) will be monitored in the General Clinical Research Center (GCRC) and Microbiology and Pharmacology Laboratories. Concepts for new protocols will originate by participation in the Executive, Neurology, and Complications of HIV, HIV Pharmacology and Immunology ACTG committees. The established scientific advisory board (SAB) also will be involved in concept development. The UNC group application has new proposals for many trials including the eradication of HIV, simplification of regimens, novel therapies, improving adherence and immune restoration. Outreach to the community may be accomplished through the community advisory boards (CAB) at
2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
6
Ophthalmology
each site, the website and through a statewide newsletter. Finally, low protocol costs may be maintained by cost sharing with NIH grants (GCRC, Pediatric ACTU, Center for AIDS Research (CFAR), as well as with UNC Hospitals, and the Departments of Medicine, Neurology, Ophthalmology, Microbiology and School of Pharmacy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFECTIONS
AMINOGLYCOSIDE/RNA
INTERACTIONS
AND
CORNEAL
Principal Investigator & Institution: Rando, Robert R.; Gustavus Adolphus Pfeiffer Professor; Biological Chem & Molecular Pharm; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-DEC-1998; Project End 30-NOV-2003 Summary: RNA molecules are able to form precise three-dimensional structures which can be binding-sites for small organic molecules. An understanding of the rules that govern RNA/small molecule recognition processes rules would allow for an approach to our long-term goal of the de novo design of antagonists directed at particular RNA structures, in much the same way that inhibitors are designed for protein-based enzymes and receptors. Specific inhibitors designed to inhibit RNA molecules could be of enormous interest in ophthalmology and generally in medicine, in the design, for example, of small-molecules that can specifically interfere with the expression of mutant proteins that can lead to retinal degeneration, and in the design of small molecules that can antagonize RNA molecules from infectious disease producing organisms. This proposal describes approaches to gaining an understanding of the rules by which certain classes of naturally occurring RNA antagonists, the aminoglycosides, are recognized by specific RNA molecules. Random RNA molecules are selected by column methods to bind to defined aminoglycoside containing antibiotics with high affinity and specificity. New quantitative fluorescence methods are developed to determine the affinities and stoichiometries of antibiotic binding to the selected RNA aptamers. Novel chemical approaches are developed to reveal the regions of the aptamers which define the binding-sites for the specific antibiotic. High field NMR structural studies on the high affinity binding aptamers are planned. Those motifs in the specific RNA aptamers which recognize particular aminoglycosides will be determined and used as a guide for the future design of specific antagonists directed against naturally occurring RNA molecules. Two biologically occurring RNA molecules of particular interest in this context are the procaryotic 16S rRNA decoding region and the HIV-RRE transcriptional activator region. Quantitative structure-activity studies on aminoglycoside binding to the decoding and RRE regions leads to the design of novel aminoglycosidemimetic diversity libraries containing l,3(2)-hydroxylamine moieties. Specific antagonists directed against the decoding and RRE regions of RNA will be prepared and studies quantitatively. These antagonists are expected to be starting points for the design of drugs useful in the treatment of corneal infections. Overall, the studies described herein will serve as the basis for a general program on the design of specific RNA antagonists. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BECTON DICKINSON FLOW CYTOMETRY SYSTEM Principal Investigator & Institution: Prabhakar, Bellur S.; Professor and Head; Microbiology and Immunology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004
Studies
7
Summary: (provided by applicant): The University of Illinois at Chicago College of Medicine and the campus Research Resources Center (RRC), request funds for a stateof-the-art cell sorter from the Shared Instrumentation Grant Program. Within the last three years, the number of basic science and clinical science researchers requiring flow cytometry has tripled. The primary reason for the increased demand for flow cytometry stems from the successful recruitment of a number of new faculty members (Bellur Prabhakar, PhD, Jim Cook, MD, Cristiana Rastellini, MD, Richard Ye, MD, PhD, Bin He, PhD, Oscar Colamonici, MD. Mahmood Ghassemi, PhD, Jianxun Li, PhD, Tom Hope, PhD, Prasad Kanteti, PhD, Zuoming Sun, PhD, etc). The Cancer Center and the Dept. of Pathology with new Heads, are each in the process of recruiting 8-10 new researchers and the Dept. of Ophthalmology is recruiting a new cular immunologist. These recruitments will in crease the demand for research instrumentation like flow cytometry.The secondary reason driving our request for a new flow cytometer is that our NIH funding has doubled in the last 4-5 years due to our university's commitment to expand and strengthen basic and clinical science programs in the areas of genetics, cancer research, organ transplantation, cell biology, immunology and infectious diseases, further increasing the demand for and access to a state-of-the-art flow cytometer. At present, the RRC, a campus core facility, houses a Flow Cytometry Laboratory with an earlier generation Coulter flow cytometer, an Epics Elite ESP, acquired in 1995, that lacks the sorting speed, precision and versatility required of today's advanced technology applications. Even this instrument is no longer manufactured and thus parts and service will not be available beyond 2004. making an upgrade of the instrument not prudent. Increased demand for flow cytometry due to enhanced research activity through new faculty recruitment and the decommissioning of the Epics 753 have created an acute need for a new flow cytometer. Technologically advanced flow cytometers (Coulter Altra, Becton Dickinson FACS Vantage SE and Cytomation MoFlo) are now available with improved sorting speed, sorting precision, biohazard protection, multicolor analysis and other applications required for contemporary research in cell biology, immunology and infectious diseases. Careful evaluation of the three available systems prompted our users group to recommend the BD FACS Vantage SE since it would satisfy the needs of our institution's NIH-funded investigators. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CATARACT MANAGEMENT TRIAL--VISUAL FUNCTION AND COSTS Principal Investigator & Institution: Mangione, Carol M.; Assistant Professor of Medicine; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 15-MAR-2001; Project End 30-JUN-2001 Summary: Cataract extraction and intraocular lens implantation (CE/IOL) is the most common surgery performed on Medicare beneficiaries accounting for $3.4 billion in the 1991 budget(2). Previous research indicates that approximately 25 percent of patients who undergo CE/IOL have less than a 30 percent chance of reporting improvements in vision function after surgery. These investigators have developed a clinical decision tool that identifies persons who are unlikely to report improvements after CE/IOL (3). However, without a clinical trial, it is impossible to know if patients with low predicted probability for improvement after CE/IOL would have had even greater declines in functioning without surgery. The proposed Intervention Study (IS) will answer this important clinical question. To determine visual outcome for persons with low
8
Ophthalmology
probability for improvements after CE/IOL when managed with non-surgical care, these investigators propose a randomized clinical trial. The goal of this IS is to determine the functional and financial outcomes of surgical versus non-surgical management of age-associated cataracts among patients with low predicted probability of improvement in visual functioning after surgery. The study will also identify the psychophysical mechanisms related to change in visual function that underlie the intervention's effect on functional status. In preparation for the IS, an 18 month IDS is also proposed. The IDS will examine design characteristics that may influence ophthalmologists' and patients' willingness to participate in the IS. The IDS will test the integration of the IS into routine care, and will determine consent rates for randomization. This information will influence the number of ophthalmology practices needed to complete the IS. Most importantly, the IDS will provide a better understanding of the barriers to participation in among non-consenters from diverse cultural backgrounds. This information will be used to refine the IS protocol. Finally the IDS will assess the reliability and validity of two accepted methods of utility assessment to identify the preferred method for use in the IS. In conclusion, the IS addresses a critical step in the evaluation of a clinical, evidence-based approach for identifying patients who are likely to benefit from a common surgical procedure. Findings from the study should improve selections of persons for CE/IOL. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CATARACTOGENESIS IN HYPERFERRITINEMIA CATARACT SYNDROME Principal Investigator & Institution: Brooks, David G.; Medicine; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: Hyperferritinemia cataract syndrome (HCS) is a recently discovered genetic disease defined by elevated serum ferritin and cataracts. Dysregulation of L ferritin gene expression is the basis of this human disorder. Specifically, mutations in a discrete regulatory region of the L ferritin gene, the iron' response element, lead to over production of wild type L ferritin protein. Although ferritin is found at high levels in all tissues and extracellular fluids examined to date, cataracts are the only proven pathologic consequence of this constitutive over expression of ferritin. The mechanism of cataract formation in hyperferritinemia cataract syndrome (HCS) is unknown. Understanding the pathobiology of cataractogenesis in HCS is essential to design a rational approach to cataract prevention and treatment. The objective 9f this proposal is to determine the mechanism of HCS cataractogenesis with a long term goal of developing effective preventive and/or therapeutic strategies for these cataracts. The mechanism of cataract formation in HCS will likely have broader implications for cataract formation in general. The specific aims of this proposal all involve investigation of ferritin in eye. First, the normal expression of ferritin in lens and lens cell lines will be determined. Second, over expression of L ferritin in human cell lines and in mouse will be generated as models of HCS. Third, quantitative expression and distribution of L ferritin in HCS lens material will be determined. An animal model that reproduces cataract promises opportunity to 1investigate cataract formation as a function of the interaction of HCS genotype with environmental factors including iron, antioxidants and UV light. This proposal describes a 4 year training program in which the applicant will acquire the requisite experience to become an independent clinician scientist. The sponsor and collaborator's extensive experience in clinical ophthalmology, eye histopathology, genetic cataract and mouse genetics will complement the applicant's
Studies
9
prior training in molecular biology, internal medicine and clinical genetics. A strong ophthalmology research program will provide the requisite environment in which to transition the applicant to being an independent physician/researcher in genetics and eye disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL TRIALS IN CATARACT PREVENTION Principal Investigator & Institution: Congdon, Nathan G.; Ophthalmology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: The candidate has a background in clinical ophthalmology and ocular epidemiology, and proposes to extend his work and prevention of eye disease into the field of cataract prevention. This application outlines a three-phase training program in cataract-related clinical trials. In the first phase, class classroom training in the theory of clinical trials will be undertaken at the Center for Clinical Trials of the Johns Hopkins School of Public Health under Dr. Curtis Meinert. Courses in Biostatistics and Epidemiology will provide a theoretical framework for the remainder of the training. The second phase will involve practical training in clinical trials under the auspices of the Age-Related Eye Disease Study. (AREDS). AREDS is a randomized, controlled clinical trial designed to explore in prospective fashion the impact of anti-oxidants and other factors on the progression of age-related cataract. The candidate will be supervised by the Study Chairman, Dr. Frederick Ferris, in a program that will include participation in monthly meetings of the AREDS Study Operations Committee and annual meetings of the Data Monitoring Committee and AREDS Technical Group in Bethesda, participation in Quality Control Site Visits and other activities of the Coordinating Center, and analysis of study data. In the final phase of training, the candidate will design and execute a clinical trial, a follow-up on the Linxian Cataract Trials in China. These were the first randomized, controlled trials to demonstrate that supplementation with anti-oxidants could retard progression of cataract. The proposed study will take advantage of continued examination of this cohort, now aged 55 years and above, by the National Cancer Center Institute for cancer-related events, to obtain unique information on the long-term effects of anti-oxidant treatment on lens opacity over 15 years. This study will exploit the candidate's fluency in written and spoken Chinese. Dr. Sheila West will provide overall direction through the three phases of training. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CLINICAL VISION RESEARCH UNIT AT UAB Principal Investigator & Institution: Owsley, Cynthia; Professor; Ophthalmology; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (Applicant's Abstract) Clinical vision research is a high priority at the University of Alabama at Birmingham (UAB). This priority has been tangibly realized through the establishment of the Clinical Research Unit in the Department of Ophthalmology and the appointment of Cynthia Owsley, PhD, MSPH as its Director. The primary goal of this R21 application is to increase the patient-oriented research capability at UAB in the area of eye disease and vision impairment. This area of research has been a largely untapped, but very promising reservoir of opportunity at UAB for public health scientists. The Clinical Research Unit will provide the research resources and infrastructure to facilitate clinical and epidemiological research projects of the
10
Ophthalmology
highest quality among participating faculty. These resources will consist of personnel who will provide collaboration and consultation on: (1) biostatistics and study methodology, (2)database design and data acquisition systems, (3) project management, (4) "grantsmanship", such as identifying grants programs relevant to faculty interests, developing ideas into tangible proposals, and constructing budgets, and (5) facilitating faculty training through encouraging enrollment into existing clinical research training programs on the UAB campus and/or through NIH's clinical scientist training program (K-awards). The UAB community represents a unique venue for clinical vision research. First, the clinical vision research faculty at UAB represents all three types of degree professionals in vision: MDs, ODs, and PhDs, who already work collaboratively. This type of professional interaction is not possible at many institutions where only one or two of the three types of professionals are on the faculty, but not all three. Second, NIH and DHHS have called for scientists to meet the challenge of eliminating health disparities in the U.S. population. The focus of most of our faculty research projects will be on subpopulations that have a higher prevalence of eye disease, vision impairment and decrements in health-related quality of life as compared to the general population (e.g., African Americans, older adults, nursing home residents, persons with low vision). Furthermore, UAB has already established many community relations and research infrastructure contacts with these subpopulations that will immediately facilitate our research efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COLLABORATIVE IMAGE ANNOTATION IN OPHTHALMOLOGY Principal Investigator & Institution: Jain, Pramod; Innovative Decision Technologies, Inc. 9000 Cypress Green Dr, Ste 108 Jacksonville, Fl 32256 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): Longer-term objective is to develop a commercial internet-based collaborative image annotation system that will be used by physicians in both clinical and clinical trials settings. This software will accomplish two goals. First, it will significantly enhance the objectivity, ease and accuracy in reading, interpreting and tracking areas of pathology in an image. Second, it will facilitate effective collaboration among physicians and support personnel at multiple clinical centers. This software will embody three technological innovations: rich annotations tied to areas of pathology in an image; web-browser based markings of images and automated computation of physical properties; and collaborative technology to securely retrieve, store and search rich annotations. Phase I and II will focus on research and development of this technology with ophthalmic images. Research approach is to: Collect functional and technical requirements from two sources the Fundus Photography Reading Center (FPRC) in Madison, WI, and Univ. of Florida Ophthalmology (UFO) in Jacksonville, FL; design and develop the collaborative image annotation system with Ophthalmic images; beta test the application at FPRC and UFO. Benefits will be: superior quality data through objective reading, interpretation and tracking (over multiple visits) of areas of pathology in images; faster turn around on image reading and interpretation through paperless, web-based user-friendly system; and easier searching, statistical analysis and documentation of results. Potential commercial applications are: Ophthalmology reading centers; Collaboration system for clinical trials in image related medical areas; Clinical diagnosis, treatment and monitoring of diseases based on sequential imaging, Computer-based instruction, training and testing on image related medical topics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
11
Project Title: COLLABORATIVE INITIAL GLAUCOMA TREATMENT STUDY Principal Investigator & Institution: Simmons, Steven T.; Ophthalmology; Albany Medical College of Union Univ Union University Albany, Ny 12208 Timing: Fiscal Year 2001; Project Start 01-JUL-1993; Project End 30-JUN-2003 Summary: The intent of this application is to document the ability of the Albany Medical College, Department of Ophthalmology to participate as an effective and productive clinical center in the proposed multicenter clinical trial, entitled "Collaborative Initial Glaucoma Treatment Study" (CIGTS). This study's purpose is to evaluate whether initial treatment of open angle glaucoma is more effective by means of a stepped, medial regimen or by means of a surgical approach. The Albany Medical College's Clinical Center will participate in the CIGTS by identifying and recruiting eligible patients, administering the treatment regimen as assigned by the CIGTS's Coordinating Center and defined within the study's Manual of Operations, following and retaining study patients, recording and transferring study data to the Coordinating Center, and contributing to reports that will present the CIGTS results. As a clinical center in the Collaborative Initial Glaucoma Treatment Study, the Glaucoma Service at the Albany Medical College, Department of Ophthalmology, Lions Eye Institute, offers a state of the art clinical research facility for the diagnosis and treatment of glaucoma. The three investigators have extensive experience in glaucoma research and have large consultative practices specializing in glaucoma ( greater than 15, 000 glaucoma patient visits /year). In addition, 26 community board certified ophthalmologists have enrolled to actively participate with this center in the study. As a group, they offer a large clinical base in Northeastern New York ( greater than 150,000 patient visits/year) which maximizes patient recruitment and care. In a 3 month trial recruitment for this study using the criteria outlined in the Manual of Operations, this center identified 18 qualifying patients, representing adequate potential for patient recruitment (Appendix 1). This center expects to recruit 3 patients per month for participation in this study. The study population will include both sexes and patients of a variety of ethnic and racial backgrounds consistent with this geographical region of the country. Details are provided of our plans to identify, recruit, follow, and retain these patients, our intent to obtain consistently high quality data on the visual outcomes of treatment, and the personnel and facilities available within our center to carry out the provisions of the CIGTS's Manual of Operations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CORE FACILITY FOR THE VISUAL SCIENCES Principal Investigator & Institution: Lass, Jonathan H.; Professor and Chair; Ophthalmology; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 31-MAR-2002 Summary: Twenty-eight principal investigators, conducting vision research at Case Western Reserve University, University Hospitals of Cleveland, and the Cleveland Veterans Administration Medical Center have constituted a core group from the Departments of Ophthalmology, Genetics, Neurology, Neurosciences, and pathology at CWRU to develop multidisciplinary approach to examine major areas of study in the visual sciences: the CWRU Visual Sciences Research Center. The proposed NEI Core Facility will facilitate collaboration among this group of investigators that includes nine NEI-funded principal investigators and nine with pending or planned submissions. The Core Facility will be composed of three research support modules: 1. The Tissue Culture
12
Ophthalmology
and Cell Analysis Module will assist investigators to establish and maintain a variety of cell lines, provide tissue preparation for histology, electron microscopy, and immunocytochemistry, and offer access to state-of-the-art facilities for flow cytometry, cell sorting, and confocal microscopy. 2. The Molecular Biology Module will provide skilled technical expertise, equipment and techniques for sequencing clone and amplified DNA, PCR amplification and analysis of DNA and RNA, quantitation and digital imaging of DNA gels, bacterial transfection and expression of proteins, and storage of commonly used bacterial strains, vectors, and cDNA constructs. 3. The Specialized Animal Resources Module will provide technical and handling support, isolation racks and cages, and boarding for the production of progeny of specialized mouse and rat strains that are relevant to studies of the eyes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Edelhauser, Henry F.; Professor; Ophthalmology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2001; Project Start 01-APR-1986; Project End 31-MAR-2006 Summary: Continued support is requested for the NEI Core Center Grant in the Department of Ophthalmology at Emory University. This Core Center Grant renewal application includes three Modules: (1) Structural Biology, (2) Analytical Biochemistry/Molecular Biology, and (3) Epidemiology and Biostatistics. The past Core Center Grant has successfully utilized supporting collaborative vision research and service involving 33 faculty (including more than 20 NEI funded principal investigators), 20 postdoctoral fellows, six predoctoral fellows and generating over 250 publications over the past five years. Renewal of these basic Core activities will allow us to maintain and expand this high level of productivity in vision research. The scope of research services proposed for each of the Modules reflects expanded scientific capabilities. The Structural Biology Module adds immunohistochemistry, confocal microscopy and fluorescence image analysis to the light and electron microscopy services. With the new 7,000 square feet of research space dedicated to molecular biology and molecular genetics research in the Department of Ophthalmology, we have expanded our Analytical Biochemistry/Molecular Biology Module, including gene array technologies. The Epidemiology and Biostatistics Module proposes to expand its services to basic research projects as well as clinical research projects. The Core Modules have and will continue to enhance our research productivity by providing common centralized services to stimulate and facilitate collaborative studies between faculty and to attract other university disciplines to vision research. This Core faculty also services as a central vision research facility in Atlanta where faculty from Emory University, Yerkes Regional Primate Center, George Institute of Technology, Georgia State University, the Veterans Administration Medical Center and the Centers for Disease Control and Prevention can undertake collaborative studies in vision research. The Core facilities also serves a role in the research projects of our pre- and postdoctoral fellows supported by our departmental NEI Training Grant, recently renewed for the next five years (1995-2004). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Anderson, Robert E.; Professor; Ophthalmology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126
Studies
13
Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 30-JUN-2004 Summary: Support is requested for an NEI Core Center Grant in the Department of Ophthalmology at the University of Oklahoma Health Sciences Center (OUHSC) in Oklahoma City. Four Modules are proposed: Image Acquisition and Production, Instrumentation, Animal Resources, and Analytical Biochemistry. The first three are housed in the Dean A. McGee Eye Institute (DMEI) building in recently renovated facilities that includes 2,000 square feet for the core modules and 8,900 square feet for research laboratories. Analytical Biochemistry is housed nearby in 291 square feet of newly renovated space in the Biochemistry & Molecular Biology Department. These facilities will be utilized by 16 participating faculty from the ophthalmology and other departments, postdoctoral fellows, graduate students, and other laboratory personnel. These four core modules will increase productivity of the vision research activities t the OUHSC by providing stable, centralized services with core personnel. The modules will promote and enhance funded projects by providing resources that allow multidisciplinary approaches, facilitate the initiation of pilot studies; promote collaborative research projects between investigators, especially clinical and basic vision scientists; aid in the recruitment of other vision researchers to the OUHSC; provide opportunities for researchers on campus to initiate vision research projects, in collaboration with vision Core Center investigations, and provide resources for graduate students and postdoctoral fellows in vision research laboratories. The Provost, Dean of the College of Medicine, Dean of the Graduate College, President and CEO of the Dean McGee Eye Institute, and Chairman of the Board of the Dean McGee Eye Foundation have committed to support the vision Core Center by providing laboratory space; funds for renovation of laboratory space, stipends for graduate students; partial support for core modules, including new instruments and core personnel salaries; and partial support for faculty salaries. This broad-based institutional support will ensure that each Core Module is staffed and supplied to complete sere the needs of basic and clinical vision researchers at the OUHSC. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Rao, Narsing A.; Professor; Doheny Eye Institute 1450 San Pablo St Los Angeles, Ca 90033 Timing: Fiscal Year 2001; Project Start 30-SEP-1979; Project End 31-MAR-2005 Summary: Funds are requested for continued funding of our Core Grant for Vision Research (EY03040). Since its inception in 1978, this grant has supported the development and growth of a premier program in vision research at the Doheny Eye Institute in association with the Department of Ophthalmology of the University of Southern California at Los Angeles. The Core consists of five service modules: Biostatitistics, Histology and Immunopathology, Tissue Culture, Specialized Microscopy and Vivarium. It supports the salaries of expert supervisor/technicians and a modest amount of supplies for each module. The Director of each module holds at least 1 NEI RO1 grant. The faculty holds 17 NEI RO1 or U10 grants. Productivity of the group has been excellent over the past grant period, with 153 peer review publications, most of which represent collaborative studies. The Core grant has supported the addition of two new faculty, one of whom has been awarded an RO1 grant with the help of preliminary data gathered using the facilities of the Tissue Culture, Specialized Microscopy and Vivarium modules. Each of our NEI grants relies heavily on one or more services provided by the Core modules. The expert staff associated with the modules could not be afforded or justified by the demands of any one grant, but are fully justified by the
14
Ophthalmology
requirements of the combined faculty. The great strength of this program is the level of support it provides a broad range of NEI-supported investigators. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Kaufman, Herbert E.; Professor and Head; Ophthalmology; Louisiana State Univ Hsc New Orleans New Orleans, La 70112 Timing: Fiscal Year 2001; Project Start 01-APR-1979; Project End 31-MAR-2004 Summary: The purpose of this Core grant is to provide support for the extensive vision research program at the LSU Medical Center, which is centered in the LSU Eye Center Department of Ophthalmology and includes investigators in the LSU Neuroscience Center, the Department of Cell Biology and Anatomy, the Department of Microbiology, Immunology and Parasitology, and the Department of Physiology. To this end, four Modules are proposed: the OCULAR STRUCTURE AND IMAGE ANALYSIS MODULE, which provides light and electron microscopy and image analysis for the documentation of anatomical observations, as well as the services of a system analyst for customizing computer-based image analysis routines for specific applications; the CULTURE MODULE, which provides viruses, bacteria, plasmids, and cells, as well as technical expertise in the management and use of these materials; the INSTRUMENT SHOP MODULE, which provides high quality instrument design and fabrication technical advice for the construction of specialized equipment for research; and the CLINICAL TRIALS AND BIOMETRY MODULE, which provides the services of a biostatistician to aid in the design, preparation, management, and analysis of clinical studies and basic science studies that are preliminary to future clinical studies, as well as a clinical coordinator to assist in implementation of clinical study protocols. The addition of a systems analyst to the Ocular Structure and Image Analysis Module represents a shift in emphasis from the former Computer and Biostatistics Module, with its programming function for mainframe processing, which has been replaced by distributed computing in PCs and workstations. The combination of clinical trials and biometry into a single Module provides experimental design and analysis services in one unit. The vision research program encompasses 22 Module Directors and Participating Investigators wit 27 R01/U10/K08/R37/R43 grants and subcontracts. For these investigators and their collaborators within and outside the LSU Medical Center, the Core grant provides services not available within the confines of any one research grant and, as such, has been an essential factor in the support of this productive group of scientists for the past 19 years. It is hoped that future support will enable the continuation of this high level of quality and productivity in the years to come. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Johnson, Dianna A.; Professor; Ophthalmology; University of Tennessee Health Sci Ctr Health Science Center Memphis, Tn 38163 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2005 Summary: Having established the Center for Vision Research and The Ophthalmology Institute within the past two years, The University of Tennessee, Memphis, is providing major resources to support vision research. Part of the expanded support is reflected in the growth of the Department of Ophthalmology which has gained several basic and clinical scientist over the past four years. This expansion complements a strong vision research group within the Departments of Anatomy and Neurobiology, and Physiology,
Studies
15
as well as investigators at two neighboring institutions-St. Jude Children's Research Hospital and Southern College of Optometry. At present, over 20 active vision scientists with funded research programs participate in the Center for Vision Research. To enhance ongoing NEI-supported programs, four core modules that each serve active facets of our group's research will be supported. The Imaging Module contains a highresolution digital image analysis system for light microscopy, a rapid-response calcium imaging system, an inverted fluorescence photomicroscope, and a state-of the-art motorized cryostat. The Molecular Biology Module provides automated DNA sequencing and genotyping, quantitative real-time PCR, and gene array chip scanning technology. The Cell Biology Module provides a central facility for acquiring, storing, and culturing human donor tissues and human cell lines for morphologica1, biochemical, and genetic analysis. The Bioinformatics Module assists in computer-based database management, biostatistical analyses, Internet publication of large datasets, high level software support for image analysis and genomics, and basic research design and interpretation. Modules are housed within the newly established Ophthalmology Institute and in the Neuroscience Institute, allowing easy access to all research groups. Strong institutional support has been pledged for this effort and includes a total outlaw of $250,000 for equipment, technical support, and instrument service contract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Candia, Oscar A.; Professor; Ophthalmology; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2001; Project Start 01-FEB-1977; Project End 30-JUN-2005 Summary: We request continuing support for a Vision Research Center in the Department of Ophthalmology. The funds will provide investigators in our Center shared resources that are vital for the continuation of current research programs and efficient development of new programs. Our Center is structured into 42 discrete resource/service modules: Machine Shop; Electronics/Computers; Research Photography-Imaging; and Histology/Microscopy. In addition to enhancing the research environment and productivity by providing common centralized services, our Center stimulates and facilitates collaborative studies and strives to attract to vision research scientists in other health-related disciplines. Our group consists of 9 independent investigators who have NEI grants, 5 associate investigators and fellows. Research is conducted in several scientific disciplines such as biochemistry, pharmacology, physiology, cell biology, and neurology. Areas of active research include glaucoma; cataracts; corneal diseases; aqueous humor dynamics; fluid and electrolyte transport in cornea, lens and ciliary epithelium; role of membrane receptors in regulation of intraocular pressure; electroretinogram and visual evoked potentials; visual control of the oculomotor system; mechanisms of glutamate excitotoxicity in glaucoma and methods of neuroprotection; optical imaging, electrophysiological recordings and computer simulations to study the architecture and dynamics of the visual system; and degenerative diseases of the retina. The support of the CORE Center grant is complemented by a strong commitment of the Department and the Mount Sinai Medical Center to excellence in vision research. NEI funds are requested for 4 of the 7 modules. Our Vision Research Center has facilities with an area of more than 15,000 sq. ft. organized as individual laboratories and common space where modules operate. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
16
Ophthalmology
•
Project Title: CORE RESOURCES FOR VISION RESEARCH AT MUSC Principal Investigator & Institution: Crosson, Craig E.; Professor; Ophthalmology; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2008 Summary: (provided by applicant): The goal of this infrastructure development request is to enhance the research environment and accelerate the research objectives of NEIfunded vision scientists at the Medical University of South Carolina (MUSC), facilitate growth, and increase multi-disciplinary collaborative research in the visual system. This request will improve vision research at MUSC by supporting key elements of vision research infrastructure, and by providing new access for vision researchers to cutting edge technology that is not normally supported through the R01 funding mechanism. To accomplish this, two modules are proposed: a Tissue and Organ Culture module, and a Proteomics module. The two modules will be used by at least eight NEI-funded investigators from the Departments of Ophthalmology and Pharmacology who comprise highly interactive and collegial vision research group at MUSC. The infrastructure development grant will be directed by an established vision researcher in the Department of Ophthalmology. Projects benefiting from this infrastructure activity include research on retinoid photochemistry, biology of phototransduction, retinal degeneration, glaucoma, retinal neovascularization, structure-function studies of the retina and retinal pigment epithelium proteins, genetics of photoreceptor development, membrane receptors, lens protein structure in aging and cataractogenesis, and corneal transplantation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CORE--BIOSTATISTICS Principal Investigator & Institution: Cumberland, William Glen.; Professor and Chair; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-DEC-2007 Summary: The Biostatistics Core is designed to serve as a centralized resource for biostatistical expertise to support AIDS research at UCLA. The aims of this Core are to enhance HIV/AIDS research and to establish and foster long-term collaborations between clinical, basic and behavioral researchers and biostatisticians at UCLA. This collaboration improves the biostatistical aspects of the AIDS research undertaken at UCLA and ensures that AIDS investigators have access to expert statistical consultation and support, and that the most appropriate and up-to-date methods are used. The kinds of support range from simple consultations to long-term collaborations and grant writing. The Core provides support to AIDS research in the following areas: statistical modeling and expertise to researchers in basic science departments, survey designs and analysis of observational data to social science departments, design of experiments and analysis for interventional studies, and data modeling and analysis for clinical departments. Further it fosters the development of biostatistical methodology for immediate use by researchers in these groups. The Core supports AIDS projects in numerous departments of the Schools of Medicine, Public Health, Nursing and Policy: Medicine, Health Services, Pediatrics, Ophthalmology, Microbiology and Immunology, Nursing, OB Gynecology, Hematology and Oncology, Public Policy, Epidemiology, and Psychiatry. A consequence of the emphasis on long-term collaborative interactions is that this will lead to grant submissions and funding from other sources, thus allowing
Studies
17
the Biostatistics Core to be available to focus on establishing new collaborations and supporting new research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DATA COORDINATING CENTER FOR EARLY GLAUCOMA TRIAL Principal Investigator & Institution: Leske, M Cristina.; Distinguished Professor; Preventive Medicine; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2001; Project Start 02-JUN-1993; Project End 31-MAY-2003 Summary: The Early Manifest Glaucoma Trial (EMGT) is the first large randomized, controlled clinical trial to evaluate the effect of lowering the intraocular pressure (IOP) on the progression of newly detected open-angle glaucoma. As such, it is an extremely important study designed to address a major unresolved issue in ophthalmology. The primary aim of the EMGT is to compare the effect of immediate therapy to lower the IOP (laser trabeculoplasty and betaxolol) versus late or no treatment on the progression of newly detected open-angle glaucoma, as measured by increasing visual field loss or optic disc changes. The primary aim will be achieved by conducting a randomized clinical trial of 300 patients that will compare glaucoma progression in initially treated vs untreated patients with newly detected open-angle glaucoma. This comparison will allow quantification of the effect of immediate IOP-lowering treatment on progression during the followup period. Patients will be followed every three months until the development of glaucoma progression endpoints for a minimum of four years. Secondary aims are to: 1) determine the extent of IOP reduction attained by treatment; 2) explore the factors that may Influence progression; and, 3) describe the natural history of newly detected glaucoma. The proposed EMGT is a collaborative effort that involves a Clinical Center (CC) in Malmo, Sweden, a Disc Photography Reading Center in Lund both at the University of Lund, Sweden, a Data Center (DC) at the State University of New York, Stony Brook, NY and the National Eye Institute. The study originated from a proposal prepared by the CC that was approved and funded by the Swedish Medical Research Council. Funding was limited to a study of 200 patients and involved only the CC. The present collaboration involves several design changes (e.g., increase in study power from 70% to 90% and sample size to 300 patients, incorporation of rigorous clinical trial methodology, inclusion of an independent DC and a Data Safety and Monitoring Committee) to strengthen the original study plan and enhance interpretation of EMGT results. The DC will be involved in all aspects of the study design, implementation and analysis. The specific responsibilities of the DC are to: 1) serve as a collaborating partner in the EMGT and provide epidemiologic and biostatistical input to the organization, design, conduct and analysis of the trial; 2) collaborate in the development and distribution of forms, documents and protocols; 3) develop, implement and maintain quality assurance procedures for all aspects of the study; 4) develop and monitor the randomization process; 5) be responsible for data management, processing and analysis; 6) prepare reports for study committees to monitor recruitment, data collection, adverse effects, endpoints and data quality; 7) coordinate and document study meetings and communications between centers; and 8) collaborate in preparing publications of the results. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: DEVELOPMENT NEUROPROTECTION
OF
AN
ORBITAL
ENDOSCOPE
FOR
Principal Investigator & Institution: Mawn, Louise A.; Ophthalmology and Visual Scis; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917
18
Ophthalmology
Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 30-JUL-2004 Summary: (Applicant's Abstract) Current treatment modalities for optic nerve related blindness focus on topical drug application to lower intra-ocular pressure, systemic antiinflammatory/immune suppression with steroids, or surgical decompression of the nerve sheath. The long-term goal of this research is to create a novel treatment approach for optic nerve axonal disease. The project objectives are to design, construct and test an orbital endoscope for visualization and treatment of optic nerve diseases. Clinical applications of the proposed orbital endoscope include implantation of a slow release drug delivery mechanism for direct and sustained treatment of glaucoma or orbital tumors such as meningiomas, local application of immunosuppressive or neuroprotective agents in diseases such as optic neuritis or traumatic optic neuropathy and laser application to open the nerve sheath in pseudotumor cerebri. Specific project aims include developing an endoscope capable of safely reaching the posterior orbit, developing delivery ports, and demonstrating the safety in an animal model. The design will include an endoscopic image fiber bundle, illuminator bundle, and a delivery channel. This design driven development of an orbital endoscope will have a high impact on many of the blinding diseases which are currently poorly treated. The resultant capability to directly treat optic nerve disease will be a major advance for Ophthalmology. Collaboration on this unprecedented approach includes the expertise of an orbital surgeon/neuroophthalmologist, glaucoma specialist and optical engineer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIABETIC RETINOPATHY SCREENING IN A PRIMARY CARE SETTING Principal Investigator & Institution: Dean, Juli M.; Surgery; Meharry Medical College 1005-D B Todd Blvd Nashville, Tn 37208 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 30-JUN-2004 Summary: (provided by applicant):At least 16 million Americans have DM, mostly type 2, with the number expected to rise to 22 million by 2025. Both the American Academy of Ophthalmology (AAO) and American Diabetes Association (ADA) guidelines recommend examination upon diagnosis of type 2 diabetes mellitus (DM) and at least annually thereafter for detection and management of diabetic retinopathy. Yet, only about one quarter of those diagnosed with the disease actually receive the appropriate eye care. The facts that diabetic retinopathy (DR) is the most frequent cause of visual loss in Americans aged 20-74 and that disparities in morbidity and mortality due to diabetes are well documented in African-Americans and other minority populations, bear witness our inadequate detection method. To date, no population-based studies using digital cameras and a simpler (less than seven stereoscopic fields) acquisition protocol have been tested in the United States. The National Eye Institute's Visual Function Questionnaire (NEI-VFQ-25) is a relatively new screening tool, which assesses visual function and vision-specific quality of life. Its use in a high-risk minority population has yet to be studied. 1) Determine whether or not the proposed populationbased screening program for detection of DR in high-risk patients with DM is more effective at meeting AAO and ADA screening guidelines than the standard of care (ophthalmology referral by PCP). This program will use digital fundus imaging (DFI) at the time of the primary care encounter, circumventing the need for ophthalmology referral for screening purposes. 2) To determine whether, in this population, glycosylated hemoglobin (HbA1c) is a predictor of the level of diabetic retinopathy based on DFI while controlling for concomitant eye disease, age, race and gender. 3) a) Correlate composite and domain scores of the National Eye Institute's visual function
Studies
19
questionnaire-25 (NEI-VFQ-25) with visual acuity (VA) to determine whether an association exists between them in a high-risk, minority population, in which it has not yet been tested.b) To assess visual function and vision-specific quality of life in the DR screening cohort. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EARLY MANIFEST GLAUCOMA TRIAL Principal Investigator & Institution: Heijl, Anders; University of Lund Box 1703 Lund, Timing: Fiscal Year 2001; Project Start 02-JUN-1993; Project End 31-MAY-2003 Summary: The Early Manifest Glaucoma Trial is intended to study whether and to what extent current standard therapy, reduction of the intraocular pressure, influences the course of chronic open angle glaucoma. It is a prospective, randomized study in which two groups of patients, one treated with laser trabeculoplasty and betaxolol and the other untreated, are closely followed with computerized perimetry and fundus photography. The project has been reviewed and approved by the Swedish Medical Research Council (051192) and by the Ethics Committee of the Medical Faculty of the University of Lund (061592). Funding has been obtained for an open study on 200 participants to be carried out at the Department of Ophthalmology at the General Hospital of Malmo, Sweden. Preliminary studies of screening methods begun in 1991. Recruitment for the trial started October 5 1992. The present application is requesting support for a number of modifications intended to strengthen the original study plan. They include: - a major increase in the number of participants (from 200 to over 300). This would improve the power of the study to detect a limited but clinically meaningful effect (from approximately 70 to 90 per cent) at the cost of a greatly expanded community screening effort. - the incorporation of a masking protocol intended to minimize potential sources of bias - the employment of a clinic coordinator - the establishment of an independent disc reading center - the participation of an independent data center with responsibilities described in a separate application. - the participation of an independent data and safety monitoring committee. It is expected, that the large scale community screening effort to recruit study participants with as yet undetected glaucoma, will require screening of 20,000 to 30,000 Malmo citizens in appropriate age groups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: FAST OCT TECHNOLOGY FOR COMPREHENSIVE DIAGNOSTIC IMAGING Principal Investigator & Institution: De Boer, Johannes F.; Assistant Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 30-JUN-2007 Summary: (provided by applicant): Over the past 10 years, optical coherence tomography (OCT) has undergone a rapid development from inception to a versatile method for non-invasive high-resolution optical imaging. A wide range of medical diagnostic applications has been explored in ophthalmology, cardiology and in early cancer diagnosis in general. Preliminary studies have demonstrated that OCT can facilitate the accurate diagnosis of a variety of diseases when used in a point-sampling protocol analogous to random biopsy. The potential diagnostic applications having the highest impact, however, require screening or surveillance of large tissue volumes. The relatively slow image acquisition rate of current OCT technology therefore represents a significant barrier to its utility as a powerful clinical tool. Since the current technology
20
Ophthalmology
commonly operates at its theoretical limit for efficient light collection, dramatic improvements in imaging speed can only be obtained through a technological paradigm shift. We propose to develop a new, parallel detection principle for OCT that is several hundred-fold more efficient than current state of the art technology and that provides vastly improved image acquisition rate and resolution. The system design of the proposed technology is tailored to three high-impact clinical goals: early detection and monitoring of glaucoma, the second-leading cause of blindness in the U.S, detection and characterization of vulnerable coronary plaques responsible for acute myocardial infarction, and comprehensive surveillance for esophageal neoplasia in patients with Barrett's esophagus. Three clinical pilot studies, using technology developed in this work, will be conducted to test system performance relevant to achieving these goals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENES FOR KERATOCONUS AND OCULAR FEATURES IN TRISOMY 21 Principal Investigator & Institution: Bergwerk, Katherine L.; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 90048 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: This application for a Mentored Patient-Oriented Clinical Scientist Development Award (K23) seeks support for Katherine Bergwerk, MD, a staff ophthalmologist at Cedars-Sinai Medical Center (CSMC), who recently completed a Clinical fellowship in Ophthalmic Genetics at CSMC and U.C.L.A.'s Jules Stein Eye institute. Under the mentorship of Julie R. Korenberg, MD, PhD, and Yaron S. Rabinowitz, MD, Dr. Bergwerk will pursue investigation of gene loci for keratoconus and other ocular abnormalities in patients with partial trisomies and tetrasomies of chromosome 21. Identifying a gene for keratoconus may allow for early detection of the disease and may enable medical therapy to be developed to retard its progression. This will obviate the need for the current therapy of multiple complex contact lens fittings or corneal transplantation surgery. Keratoconus is a major cause of visual disability and one of the leading causes for penetrating keratoplasty in the United States. In the process of completing comprehensive ocular examinations on these rare patients for keratoconus, attempts will be made to make genotype-phenotype correlations of other eye abnormalities in patients with Down syndrome. Dr. Rabinowitz is a prominent researcher in the field of ophthalmic genetics, who has established a candidate region for a keratoconus gene locus. This region is a 5.4 centimorgan (cM) region which is 11 cM distal to the centromere on the long arm of chromosome 21 (see appendix A). Review of the literature suggests that keratoconus may occur as much as 300 Xs more commonly in Down syndrome patients than in the general population. Dr. Korenberg is a renowned molecular geneticist who has served on the Human Genome Project for defining genes on Chromosome 21. Her unique population of partial trisomy Down syndrome patients are the ideal group to use in refining a gene locus for keratoconus and to make genotype- phenotype correlations of ocular features of Down syndrome. Under Dr. Rabinowitz and Dr. Korenberg's mentorship and with institutional support from the Divisions of Medical Genetics and Ophthalmology at CSMC, Dr. Bergwerk will further her training in clinical genetic research, and enhance her skills in clinical and molecular genetics. Dr. Bergwerk aspires to achieve her goal of becoming an independent investigator who is capable of solving clinical problems in a research laboratory. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
21
Project Title: GROWTH FACTORS IN MAMMALIAN EYE DEVELOPMENT Principal Investigator & Institution: Bennett, Jeffrey L.; Neurology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-JUL-1998; Project End 30-JUN-2003 Summary: (Candidate's Abstract) The ultimate aim of this proposal is to formulate a multifaceted program which will guide my development as an independent scientist. This goal is to be accomplished through a mixture of basic research and educational activities. My research will be focused on determining the biologic function of the neurotrophins brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in the development and maintenance of the mammalian eye. These endeavors will be complemented by extramural workshops, instruction in ocular pathology, and participation at scientific meetings. I have spent the past several years completing my doctoral research and professional training. I am now prepared to embark on a longterm career in academic neuro-ophthalmology, combining clinical practice with basic research. The University of Colorado will provide me with an ideal environment in which to accomplish my immediate and long-term goals. The combined faculties and resources of the Department of Neurology, Ophthalmology, and Molecular, Cellular, and Developmental Biology are particularly well suited for providing me with training in nervous system and eye development, mouse genetics, histochemistry, and transgenic and embryonic stem cell technology. Under the research mentorship of Dr. Kevin Jones, I will investigate the biologic roles of BDNF and NT-3 in the neuroretina and anterior segment of the eye. A multidisciplinary approach will address questions in three main areas. First, the cell specific expression of BDNF and NT-3 and their respective receptors. TrkB and TrkC, will be examined in the neuroretina, lens, ciliary body, and cornea. We will identify the specific cells expressing BDNF, NT-3, TrkB, and TrkC using dual-label immunohistochemistry and confocal microscopy. These results will suggest possible functions for these neurotrophins in the eye. Second, the biologic functions of BDNF and NT-3 in the neuroretina will be investigated using subregion-restricted gene knockout technology. Mice will be generated which lack BDNF and NT-3 in the neuroretina. To achieve this, we will use Cre/loxP-mediated recombination restricted by either the Six3 or Brn-3b promoter. Cre recombinase will be expressed either as a transgene or as a dicistronic message using an intervening ribosome entry sequence (IRES). Third, the biologic role of BDNF and NT-3 in the anterior segment of the eye will be characterized following our recent finding of regulated neurotrophin expression in the ciliary body epithelium, lens epithelium, and cornea. Restricted gene knockouts will be constructed using dicistronic Cre expression driven from the endogenous aquaporin-1 gene. These studies should provide novel insight into the molecular genetics of eye development, potentially broaden our understanding of degenerative eye disorders and open new avenues for their treatment with growth factors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: HIGH RESOLUTION BLOOD FLOW MAPPING IN OCULAR TISSUES Principal Investigator & Institution: Ferrara, Katherine W.; Professor; Biomedical Engineering Div; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2001; Project Start 01-MAY-1996; Project End 31-AUG-2004 Summary: We have developed a new high-frequency ultrasound scanning system that provides the opportunity to obtain a two-dimensional map of blood flow in the anterior
22
Ophthalmology
segment of the eye in one second, with spatial resolution on the order of 40 microns and velocity resolution on the order of 0.2 mm/s. This represents approximately an order of magnitude improvement in resolution over existing techniques, and provides the first non-invasive opportunity to evaluate blood flow in arterioles and venules in opaque tissues. In addition, a new strategy to estimate capillary volume and flow rate has been developed by combining a theoretical model and a system to interrogate individual contrast microbubbles. This new suite of tools can be applied to improve the understanding of the mechanisms of ophthalmic diseases including glaucoma and agerelated macular degeneration as well as the mechanisms and effectiveness of treatment options. Here, we specifically address glaucoma. The clinical significance of an improvement in the management of ophthalmic diseases is enormous since 3 million people in the US alone suffer from glaucoma, 100,000 per year suffer some form of ocular trauma, and over 6 million people in the US suffer from degenerative retinal diseases. Most experts agree that glaucoma is a series of conditions characterized by a particular form of optic nerve damage that is often associated with elevated intra-ocular pressure, although the mechanisms responsible for damage and successful therapy are not understood. Many drug therapies for glaucoma are assumed to decrease intra-ocular pressure through the constriction of arterioles in the ciliary body, however, it has been impossible to measure these changes in ciliary body blood flow, or to measure optic nerve head perfusion. Our new technique to estimate arteriolar diameter and flow rate will be evaluated in a human study of glaucoma therapies. Contrast-assisted methods for the estimation of capillary volume and flow rate will be developed for the high resolution requirements of ophthalmology. This requires the further development of our experimental system, the evaluation of new contrast agents with higher resonant frequencies, and the validation of our new strategies for the estimation of capillary density. These new techniques will be used to evaluate perfusion in the ciliary body and in the optic nerve head in an animal model study of drug therapies, and compared with the output of a scanning laser Doppler flowmeter. In conjunction with this study, mechanical damage to the vessel wall will be directly assessed through the use of fluorescent markers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HIGH-RESOLUTION IMAGING OF OCULAR MELANOMA AND RETINA Principal Investigator & Institution: Bartsch, Dirk-Uwe G.; Associate Professor; Ophthalmology; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2001; Project Start 01-FEB-2001; Project End 31-JAN-2004 Summary: (Applicant's Description): High-resolution imaging allows improved understanding of retinal disease and pathological conditions, particularly in prognosis of malignant choroidal melanoma, age-related macular degeneration, diabetic retinopathy, ocular complications of AIDS and glaucoma. The eye can only be regarded as a diffraction-limited optical system up to a pupil diameter of 3 mm. Standard retinal imaging technology uses a 3 mm imaging aperture to avoid the higher order aberrations of the outer cornea. However, if these higher order aberrations can be compensated, diffraction-limited imaging at 7 or 8 mm pupil diameter can be achieved. The numerical aperture of the diffraction-limited eye at 7 or 8 mm pupil will allow to visualize retinal detail that was previously not achievable in ophthalmology. To achieve this goal we plan to develop a wavefront sensor that will allow us to measure the existing aberrations of the measured eye. We will test it in an eye model, in animal eyes and in
Studies
23
human eyes. The wavefront sensor will be attached to a fundus camera and scanning laser ophthalmoscopes. The second aim is to use an adaptive wavefront compensator to correct the aberrations in a feed-back loop setup. We will test the complete system of wavefront sensor and wavefront compensator in an eye model, in animal eyes and in human eyes. The wavefront compensator will be attached to a fundus camera and scanning laser ophthalmoscopes. The third aim is to used digital image processing to correct for the portion of the residual aberrations that could not be compensated with the adaptive wavefront compensator due to mechanical considerations. Our group has previous developed a wavefront sensor and wavefront compensator based on a micromachined membrane deformable mirror. Due to the limited number of electrodes, slow speed of our computer system and the mechanical stiffness of the membrane we were not able to completely correct all measured aberrations. Our preliminary work shows that the system is capable of allowing wavefront correction. In this study we plan to improve the acquisition speed of our wavefront sensor and wavefront compensator to allow rapid wavefront compensation. Our preliminary results have shown that even the best aberration compensation still suffers from residual wave aberrations. Since we can measure and characterize these aberrations, we can develop digital inverse filter based on our experience in image reconstruction to correct the acquired images. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMMUNE MECHANISMS OF OCULAR INFLAMMATORY DISEASE Principal Investigator & Institution: Gordon, Lynn K.; Jules Stein Eye Institute; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 01-MAR-1997; Project End 31-AUG-2001 Summary: The immediate goal of the candidate is to develop scientific expertise in molecular immunology and ocular biochemistry as applied to the definition of pathogenic autoantigens. This will lead to the long-term goal of an independent research program on the pathogenesis of ocular inflammatory diseases. The candidate has a strong background in clinical ophthalmology with a demonstrated interest in ocular inflammation. Past graduate school success in basic research is evidence of her scientific abilities. However, the lag time between graduate school and re-entry into basic research demands a period of mentored scientific retraining. UCLA will provide an outstanding scientific environment that will allow the candidate to develop current expertise in molecular biology and immunology. The health-relatedness of the project is that it specifically attempts to define candidate antigens that drive certain endogenous human inflammatory diseases of the eye, which can be used as the basis for novel diagnostic tests and therapeutic interventions. Although many immune-mediated inflammatory diseases are thought to result from activated CD4 T cells, B cell activation and clonal expansion is expected to occur in tandem. These selected B cells have the same antigenic specificity of the pathogenic T cell, and their antibodies offer an important tool to characterize the target antigen driving the immune response. The subject of this proposal is to use new techniques iii antibody phage display cloning to isolate marker antibodies and candidate antigens for a distinctive type of uveitis that commonly occurs with ulcerative colitis (UC). The first aim is to determine whether a unique marker antibody in UC, pANCA, is associated with inflammatory uveitis. This will be tested by ELISA and immunofluorescence screening of human sera for the distinct UC form of pANCA. The correlation between disease activity and level of autoantibody will also be determined. The second aim is to identify uveal antigens that react with 5-3, a human recombinant monoclonal antibody to the pANCA antigen. If
24
Ophthalmology
such antigens are identified, they will be characterized by protein biochemistry, or if necessary, by molecular cloning. Disease association of the antigen will be tested by characterizing the B and T cell responses to the antigen. The third aim is to develop a comprehensive library of uveal antigens reactive with the UC antibody response. Biochemical and immunologic characterization of these antigens will be performed following the experimental model of the preceding aim. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTEGRATIVE IMMUNOLOGY TRAINING PROGRAM Principal Investigator & Institution: Scheuermann, Richard H.; Director; Center for Immunology; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2003; Project Start 01-JUL-1980; Project End 31-AUG-2008 Summary: (provided by applicant): The purpose of the Integrative Immunology Training Program at U.T. Southwestern is to provide comprehensive training of predoctoral and postdoctoral fellows in the conduct of modem immunology research. The goal is to produce sophisticated and highly trained scientists who are capable of developing research programs to investigate normal immune system function and the defects in immune system function that contribute to human disease. This goal is achieved through an integrated combination of training activities that includes formal advanced coursework in Cellular and Molecular Immunology, Genetic Manipulation of the Immune System, Tumor Immunology and Bioinformatics, research fellowship proposal development and oral defense in the form of a Qualifying Exam, regular Works-in-Progress seminars, teaching opportunities, career development programs and interdisciplinary laboratory research. The training program revolves around the Immunology Graduate Program, one of the eight graduate programs in the Division of Cellular and Molecular Biology at U.T. Southwestern. The training program includes thirty-two faculty from several departments/divisions on campus, including Immunology, Microbiology, Pathology, Cancer Immunology, Rheumatology, Neurology, Internal Medicine, Dermatology and Ophthalmology. Research projects pursued in the participating laboratories include investigations of the cellular, molecular and genetic determinants of the autoimmune diseases systemic lupus erythematosis, multiple sclerosis and rheumatoid arthritis; mechanisms of natural killer cell activation and killing; complexities of antigen processing and presentation; mechanisms of tumor cell homing and migration; regulation of tumor cell growth in vitro and in vivo; regulation of normal lymphocyte development and migration; signal transduction in normal and malignant lymphocytes; immune response to HIV and other infectious agents; and development of anti-tumor immunotoxins. The rationale for this training program reflects the need for research scientists with training in immunology given that the immune system plays both positive and negative roles in a variety of human diseases and clinical situations, including cancer prevention and treatment, organ transplantation, autoimmunity, immunodeficiency and infectious disease. With this submission, this training program enters its 27th year of training excellence. Our previous trainees have left the program with strong publications records to excellent research positions in academia and industry. The leadership positions held by many of our faculty and previous trainees reflect the high quality of the training program provided. PARTICIPATING FACULTY: The 32 training faculty include 14 professors, 6 associate professors, and 9 assistant professors. 10 of the training faculty are women. All of the faculty are at the University of Texas Southwestern. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
25
Project Title: JEM-123O ELECTRON MICROSCOPE Principal Investigator & Institution: Ryugo, David K.; Professor; Otolaryn & Head & Neck Surgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2004 Summary: (provided by applicant): We are requesting funds to purchase an electron microscope to replace our current 17-year-old one that has become increasingly unreliable. The proposed microscope will be used by a group of 11 users primarily from the Departments of Otolaryngology-Head & Neck Surgery and Ophthalmology at the Johns Hopkins University School of Medicine. A total of 13 projects will be supported by 8 RO1, 2 KO8, 1 K23, and several nonfederal grants. The purchase of this microscope is crucial for the continued progress of research supported by NIH programs. The breadth of the projects is broad but unified by a foundation in structural neurobiology. Projects include (a) studies of the synaptic organization and plasticity of the mammalian auditory system; (b) histopathologic studies of the human eye; (c) ultrastructural examinations of sensory receptors and associated structures of the eyes and ears in normal, pathologic, and/or genetically altered animals; (d) localization of molecules (cytoskeletal and synaptic proteins, growth factors, or ion channels) in eyes and ears that pertain to normal function; (e) identification of growth factors that enhance photoreceptor growth; and (f) gene transfer experiments involving factors that influence laryngeal nerve growth, reinnervation, and muscle development. Conceptual and technical approaches utilized by the different research groups emphasize the common themes that link these various projects. Our work is highly dependent upon electron microscopy, and the proposed purchase will provide its users with a reliable instrument that is equipped with a number of advanced features that are currently unavailable anywhere at our institution. Award of this instrument will have an immediate and positive effect on the productivity of these projects. It will serve to catalyze interdisciplinary discussions among users, provide a valuable teaching tool for our trainees, and enhance the progress of biomedical research on hearing, vision, and voice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: JOHNS HOPKINS ADULT AIDS CLINICAL TRIALS UNIT Principal Investigator & Institution: Flexner, Charles W.; Associate Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-JAN-2000; Project End 31-DEC-2004 Summary: (adapted from applicant's abstract): Johns Hopkins University has had an ACTU since its inception in 1986. The Unit is administratively within the Division of Infectious Diseases as a component of the Johns Hopkins HIV Care Program, but it is configured to make maximum use of relevant institutional resources with investigators from multiple departments and divisions including Pharmacology, Neurology, Ophthalmology, Gynecology, Pathology and Internal Medicine. The Hopkins ACTU has provided leadership to the ACTG scientific agenda and has provided HIV clinical trials to Baltimore, a city that ranks ninth among metropolitan areas in AIDS rates. The performance record for the last grant cycle shows average enrollment, data performance and a rank of No. 3 in scientific contributions. Assets of this ACTU include leadership and scientific expertise in virology (B. Jackson), immunology (H. Lederman, T. Quinn, R. Bollinger), quality of life assessment (A. Wu), neurology (J. McArthur), pharmacology (C. Flexner), CMV retinitis (D. Jabs), and mycobacteriology (R. Chaisson). This unit has a subunit in the prison system, has developed an ACTG study of tuberculosis in Haiti and has high enrollment of injection drug users and African-Americans. This application
26
Ophthalmology
proposes to continue a scientific portfolio that has depth and diversity to support the ACTG scientific agenda and a clinical trials program that includes good data performance and the enrollment of high priority participants. All current investigators will continue in their present roles as will the three advanced technology laboratories. Three new investigators, Dr. R. Siliciano (latent reservoirs of HIV), Dr. Richard Moore (HIV outcomes, cost and cost effectiveness), and Dr. David Thomas (hepatitis C coinfection) will be added. Preference will be given to protocols that reflect emphasis areas of the Hopkins ACTU, especially pharmacology, neurology, immunology, mycobacteriology, hepatitis C, long-term outcomes (quality of life and cost analyses) and simplified ART regimens (to better serve the patients). There will be emphasis on enhanced enrollment with a new peer recruiter and a new subunit to increase the catchment area. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LONGITUDINAL OPHTHALMOLOGY
STATISTICAL
METHODS
FOR
Principal Investigator & Institution: Davidow, Amy L.; Prev Med and Community Health; Univ of Med/Dent Nj Newark Newark, Nj 07103 Timing: Fiscal Year 2001; Project Start 01-FEB-2001; Project End 31-JAN-2003 Summary: (Applicant's Abstract) The proposed project is a two year study to develop inferential and study design aspects of a linear statistical model appropriate to the analysis of longitudinal ophthalmologic data and to apply the improved model in a reanalysis of a data set obtained from the Early Treatment Diabetic Retinopathy Study (ETDRS). The relevant statistical model is the repeated-measures random effects/AR(l) model for continuous data due to Heitjan and Sharma. This model incorporates crosscorrelation between eyes and longitudinal correlation among measurements obtained from a single eye. The re-analysis of the ETDRS data set will consider the effects of aspirin on visual acuity measured continuously. A previously published analysis (ETDRS Report Number 8) analyzed a categorical version of visual acuity, ignoring longitudinal correlation and handling cross-correlation between eyes by analyzing eyes separately. The repeated measures random effects /AR(l) model has already been utilized by Heitjan and Sharma in a published study of intraocular pressure, using the expected information to perform statistical inference. Simulation studies have shown that it performs well in the balanced data case. Our first objective is to develop better inferential methods so as to 1) handle unbalanced (i.e., missing) data such as that arising when only one eye of two has the disease of interest and/or when the number of followup visits varies with subject, 2) control for the use of a possibly mis-specified variance structure, and 3) compensate for the use of estimated variance parameters in the standard error of the fixed effects, a procedure that may result in an underestimation of the standard error. This objective will be accomplished by the following: 1) replacing the expected information with the observed information, the observed information being a more reliable method of performing statistical inference in the presence of missing data, 2) using the robust (sandwich) variance estimator, a method that can control for a possibly mis-specified variance structure, and 3) approximating the degrees of freedom so as to control for the possibility of underestimated standard errors. Methodological advances will be incorporated into a computer package to be made available on the World Wide Web. Our second objective is to carry out power and sample size calculations for several different longitudinal ophthalmologic study designs, under various assumptions about the prevalence of bi-ocular versus uni-ocular disease, differential treatment allocation, loss-to-follow-up, and expected adherence to study
Studies
27
treatment(s). The implications of treatments applied at the eye-level (e.g., photocoagulation) as well as systemically applied treatments (e.g., aspirin) on sample size, frequency of evaluation, and power will be considered. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MAX-ENTROPY CONTROL FOR HIGH QUALITY DIGITAL IMAGING Principal Investigator & Institution: Truitt, Paul W.; Kestrel Corporation 3815 Osuna Ne Albuquerque, Nm 87109 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 30-MAY-2002 Summary: A low-cost, high-resolution, high-contrast color digital camera optimized for ophthalmology will be demonstrated. The maximum entropy camera will be tested for its effectiveness in meeting the image quality requirements for telemedicine and for remote screening of pre-proliferative and proliferative diabetic retinopathy. The proposed device exploits recent technological advances in high sensitivity CCD cameras and digital signal processing electronics. Today's low cost 8-bit CCD cameras do not have the dynamic range to image the human retina, which is characterized by regions of high reflectivity (20-40 percent), such as the optic disc, and very low reflectivity (<2 percent), such as the macula and fovea. Existing digital cameras used in ophthalmology are not designed to deal with the high dynamic range and do not consider the special resaturated characteristics of the retina. The proposed device will be shown to offer significant improvement over existing digital color cameras by addressing each of the deficiencies mentioned. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: MECHANICAL STRESS AND THE HEAT-TREATMENT OF SOFT TISSUE Principal Investigator & Institution: Humphrey, Jay D.; Professor; Biomedical Engineering; Texas A&M University System College Station, Tx 778433578 Timing: Fiscal Year 2001; Project Start 04-AUG-2001; Project End 31-JUL-2004 Summary: (Provided by Applicant): The ever-increasing clinical use of heat to treat disease and injury has been driven primarily by advances in laser, micro-wave, radiofrequency and similar technologies, not a fundamental understanding of the biothermomechanics. Heat is used, e.g., in cardiology, dermatology, gynecology, oncology, ophthalmology, orthopedics, and urology. Recent uniaxial studies in our lab reveal that whereas increasing temperature hastens the thermal-damage process, increased loading during heating delays it. Fortunately, the potential complexity of this coupling is simplified by our discovery of a 1-0 time-temperature-load equivalency. The same outcome can be achieved via a multitude of different combinations of heating and mechanical loads if the duration of a non-dimensional (scaled) heating time is the same. This scaling is done by dividing the actual heating time by a temperature- and loaddependent characteristic time, which exhibits an Arrhenius behavior. This reveals that loading influences the process via the activation entropy, not energy. No prior clinical trial of a heating device or strategy has accounted for this coupling. Without such information, optimization will remain elusive. Note, therefore, that most tissues and organs are subjected to multiaxial stresses, thus there is a need to quantify the effects of multiaxial stresses on the thermal process as well as the effects of thermal damage on the multiaxial mechani-cal properties. No such data are available. Rather than focusing
28
Ophthalmology
on a particular clinical protocol, the goal of this work is to assess the biaxial thermomechanics of collagenous membranes. We shall focus on collagen since it is the primary structural protein in the body, and thus it is present in most tissues that are heat-treated clinically and it is responsible for most of the post-heating structural integrity. Achieving our aims will have much broader impact, however. We recently showed that data from the literature on cell death and the denaturation of other proteins exhibit the same characteristic time-temperature equivalency that we discovered via tests on collagen -- we expect the current findings to similarly provide qualitative insight into the multiaxial thermomechanical behavior of many tissues. The possible multiaxial states of stress that can exist in vivo, or that can be induced by clinical interventions, is almost unlimited. We submit that the most prudent approach to developing a multiaxial theory that has broad predictive capabil-ity is to perform a broad series of isothermal biaxial-isotonic and isothermal biaxial-isometric tests. These data will be sufficient to formulate the requisite constitutive relations, which in turn will be evaluated further using data from combined isometric and isotonic test conditions and non-isothermal heatings. These consitutive relations will allow future evaluation of candidate protocols, from which the most promising can be chosen for animal testing I clinical trials. Without a firmer understanding of the effects of multiaxial stress on thermal-damage processes, we will continue to evaluate particular clinical devices and strategies by trial-and-error. There is a need for a firmer scientific understanding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MENTAL RETARDATION & DEVELOPMENTAL DISABILITIES RESEARCH Principal Investigator & Institution: Volpe, Joseph J.; Professor of Pediatrics & Neurology; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2001; Project Start 01-AUG-1996; Project End 30-JUN-2006 Summary: (provided by applicant): This Center grant requests funding for seven core facilities to support a broadly-based research program in the study of mental retardation and developmental disabilities. The seven core facilities are: Administrative, Multimedia, Imaging, Cellular Neuroscience, Gene Manipulation, Molecular Genetics, and Cell Sorter. The Cores have undergone major development and support the research of 65 investigators. The research is in two programmatic areas, i.e., Genetics and Neuroscience. In Genetics, directed by Dr. Louis Kunkel, there are seven major research efforts, which include the molecular genetics of neuromuscular disease, somatic cell genetics, gene therapy and stem cell research. In Neuroscience, there are three major programs, i.e., Basic Neuroscience, Clinical Neuroscience/Behavior and Developmental Biology. The Basic Neuroscience Program, directed by Dr. Michael Greenberg, consists of 27 investigators whose research efforts span a broad spectrum of interdigitated research in molecular, cellular, and systems neurobiology, with a strong overall emphasis on development and developmental neurological disorders. A research project in Basic Neuroscience, proposed in this application as a "New Program", addresses "Signaling Mechanisms Mediating Axon Guidance Effects of Semaphorin 3A" (Zhigang He, Ph.D.). A second major program in Neuroscience, i.e., Clinical Neuroscience/Behavior, directed by the Center Director, includes 27 investigators whose research efforts include such areas as neonatal brain injury, behavioral development, learning disturbances, structural/functional brain imaging, and molecular genetics of human brain development. These areas of clinical research interdigitate with the basic research in the MRRC. A third exciting program in Neuroscience, i.e., Developmental Biology, directed by Dr. Merton Bernfield, addresses
Studies
29
such areas as mechanisms of embryonic development, serpin biology and regulation of pregnancy duration. The multidisciplinary approaches to the research of this MRRC include the various basic science disciplines within Genetics and Neuroscience, and the clinical science fields of Neurology, Pediatrics, Neonatology, Infectious Disease, Endocrinology, Metabolism, Genetics, Cardiology, Neurosurgery, Neuropathology, Ophthalmology, Psychiatry, and Psychology. The basic science programs are housed in over 70,000 square feet of the Enders Pediatric Research Building. The clinical research programs are centered in the adjacent Children?s Hospital. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MENTORED INVESTIGATION
FELLOWSHIP--UVEITIS
AND
CLINICAL
Principal Investigator & Institution: Jabs, Douglas A.; Professor; Ophthalmology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2005 Summary: This application is for a Midcareer Investigator Award in Patient-Oriented Research, the goal of which is to provide support for principal investigator to mentor clinical fellows in the Division of Ocular Immunology in patient-oriented research. The goal of the fellowship program is to develop independent investigators, capable of assuming leadership roles in clinical investigation. The proposed fellowship program will be based in the clinical division of Ocular Immunology in the Department of Ophthalmology but will interact with the multidisciplinary Graduate Training Program in Clinical Investigation at Johns Hopkins and with the Johns Hopkins Center for Clinical Trials, which is based primarily in the School of Hygiene and Public Health. A fellowship program has been designed which will provide for formal research training after one year of clinical fellowship in the area of uveitis and immune-mediated ocular disorders. Trainees will be enrolled in either the Johns Hopkins Graduate Training Program in Clinical Investigation or in the Center for Clinical Trials' Clinical Trials Training Program. Trainees will participate in structured schedule of didactic course work followed by a research project culminating in a thesis leading to an advanced degree (e.g. Ph.D). in the relevant area. The principal investigator will be the primary mentor for the clinical activities and for the research projects. Research experience will be derived from the principal investigator's ongoing patient-oriented research activities, including his chairmanship of the Studies of Ocular Complications of AIDS Research Group, and his own ongoing epidemiologic study into the occurrence of resistant cytomegalovirus (CMV) in patients being treated for CMV retinitis, the CMV Retinitis and Viral Resistance project. Individuals successfully pursuing this training program should emerge well qualified to conduct patient-oriented research as independent investigators. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MICROARRAY ANALYSIS OF RETINAL DEGENERATION IN MICE Principal Investigator & Institution: Zeiss, Caroline J.; Comparative Medicine; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): Neurodegenerative diseases are characterized by inexorable degeneration of post-mitotic neurons and are largely refractory to therapy. One important subset of these diseases, retinitis pigmentosa (RP), affects a terminally differentiated neuronal population, the rod photoreceptor, and leads to blindness. In
30
Ophthalmology
contrast to the majority of other neurodegenerative diseases, RP is caused by wellcharacterized single gene defects, and affects an anatomically accessible portion of the nervous system. The central hypothesis in this proposal is that despite differing genetic etiologies, mechanisms of neuronal degeneration converge upon common critical pathways. Identification of such pathways would advance understanding of neuronal homeostasis and is a prerequisite for developing effective therapies. The proposed research will combine two strategies to identify genes promoting photoreceptor death in multiple genetically distinct mouse models of retinal degeneration. The Principal Investigator (PI) has performed preliminary cDNA array experiments in the rd-1 mouse and has generated a working model of molecular events during early photoreceptor death. Using rd-1 as a benchmark model, the PI will: 1) assess whether similar expression patterns occur in three additional, genetically distinct models of RP (the rds mouse, the tulpl mouse and the rhodopsin mutant mouse) and, 2) eliminate, in the rd-1 mouse, selected genes which are overexpressed in rd-1, and correlate the effects upon the rd-1 retinal phenotype and gene expression pattern. The PI has identified three genes [caspase-3, tumor necrosis factor receptor 1 (TNFR1), and early growth response-1 (EGR-1)], as candidates for this approach, and has performed preliminary experiments with caspase-3. By integrating data from both strategies, the PI will be able to establish cause and effect relationships between individual genes that promote photoreceptor apoptosis in one or more models of RP. The training and research undertaken will extend and broaden the candidate's previous training in veterinary medicine, anatomic pathology, and graduate training in molecular genetics of photoreceptor disorders, leading to true scientific independence. Training will be undertaken at the Yale University School of Medicine under the mentorship of Dr. Colin Barnstable, Professor of Neurobiology and Ophthalmology, who is an internationally recognized molecular biologist using mouse models of retinal development and degeneration. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR GENETICS OF MYOPIA Principal Investigator & Institution: Young, Terri L.; Associate Professor; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2003 Summary: Dr. Terri Young is a pediatric ophthalmologist and Assistant Professor of Ophthalmology at the University of Minnesota. This award will enhance the candidate's potential for success by providing support for investigations into the molecular genetics of exaggerate eye growth, or myopia. Myopia, or nearsightedness is a refractive condition of the eyes with high incidence in the United States and one of the leading causes of blindness. Severe myopia predisposes the eye to glaucoma, macular degeneration, and retinal detachment. Genetic and environmental influences have been implicated, but specific factors responsible for myopia in humans have not bee identified. Several studies support the hypothesis that heredity is a major factor. In order to better understand the molecular genetics of myopia, we propose to characterize potential genetic factors of myopia through family studies with genome screening and linkage analysis. The overall goal of this proposal is to map genes responsible for familial severe myopia. Currently, 51 families have been recruited with an autosomal dominant pattern of inheritance of severe myopia (refractive error less than or equal to 6.00 diopters). Highly informative short tandem repeat polymorphisms have been utilized to confirm linkage and subsequently narrow the chromosomal region of interest. Significant linkage (Lod score= 6.24) has been identified at a locus on chromosome 18 in 8 families. Recently, significant linkage has been identified at a
Studies
31
second locus on chromosome 12 (Lod score = 3.01) in one large multigeneration family. These potential candidate regions for myopia, as well as others that may be identified with the genome screen will be examined for mutations. This project is important to further our understanding of the molecular genetics of myopia, and may be generalized to enhance out understanding of the mechanisms of eye growth, whether normal, diminished, or excessive. Dr. Young's career goal is to flourish as a clinical scientist, with an established independent laboratory program in ophthalmic genetics. Dr. Richard king, the proposed sponsor, has extensive experience in the genetic analysis of complex diseases. The co-sponsors in this proposal will provide expertise in molecular genetics, ophthalmic genetics, and statistical analysis and epidemiology. With the support of the Mentored Clinical Scientist Development Award, the candidate will obtain a solid foundation in molecular genetics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NAMOSCALE TOPOGRAPHIC CONTROL OF CELL BEHAVIOR Principal Investigator & Institution: Abrams, George A.; Surgical Sciences; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2006 Summary: The fundamental goals of this project are to test the hypotheses that: 1) nanoscale topographic features of the substratum underlying corneal epithelial cells modulate the distribution of cytoskeletal elements 2) nanoscale topographic features alter the expression and clustering of integrins at focal adhesion sites 3) inactivation of G-proteins, such as Rho, modulate the impact that nanoscale topographical features of the substratum have on cell behaviors. These investigations will provide insight into the effects of substratum topography on cytoskeletal response and related cell signaling pathways. Completely synthetic matrices will be used that have nanotextured surfaces with features of similar type and dimension to that of the "native" corneal epithelial basement membrane. This allows the impact of nanoscale substratum topography, independent of specific ligand- receptor mediated events, to be evaluated. It is possible that improved cell performance will be observed on nanoscale textured synthetic surfaces providing preliminary evidence on techniques to improve epithelial cell performance on corneal prosthetics. The candidate of this application has obtained the DVM degree and specialty training in Comparative Ophthalmology. This proposal will coincide with achievement of the Ph.D. degree which will provide a firm foundation for a career as an independent clinician/biomedical researcher. The training environment: In addition to having state of the art facilities, the University of Wisconsin fosters a rich collaborative environment between disciplines. The training program will be focussed on development of the candidate into a successful, independent, biomedical researcher fully prepared to launch a successful career as a clinician/scientist. The majority of supervision will be provided by Christopher J. Murphy, an internationally known investigator in the areas of corneal wound healing and neuropeptides. The mentoring committee consists of respected experts in cell signaling and cytoskeletal interactions, nanoscale topographic surface fabrication, and imaging techniques. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEURO-OPHTHALMOLOGY VIRTUAL EDUCATION LIBRARY Principal Investigator & Institution: Lombardo, Nancy T.; Eccles Health Sciences Library; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006
32
Ophthalmology
Summary: (provided by applicant): Neuro-Ophthalmology deals with visual problems and with the visual system as it relates to the brain. Diagnosis and interpretation of neuro-ophthalmologic disorders involves visual observations of the eye. These visual elements can be captured and digitized for use as teaching and learning tools. Those elements involving motion are ideally suited for digital video, as they are completely visual and can usually be captured in short time periods. Understanding of the processes and movement involved in any given case would be greatly enhanced by carefully constructed supplemental animations. Much of the information can also be conveyed using still images. This project aims to create a model for development of digital collections through academic library and professional society partnerships using electronic publishing technologies and a collaboration between the Spencer S. Ecctes Health Sciences Library and a the North American Neuro-Ophthalology Society (NANOS). The project will initiate mechanisms for creating, indexing and sharing these digital media, enabling faculty, residents and students to find and use visual examples of neure-ophthalmologic problems for non-profit educational purposes. A shared digital repository will allow faculty, residents and students to witness and familiarize themselves with the unique traits of disorders that are rarely seen, as well as common neuro-ophthalmologic disorders. These materials will be available for incorporation in personal, customized teaching and learning units. The goals of the project are to: Create a model for development of digital collections through academic library and professional society partnerships using electronic publishing technologies, resulting in a shared repository of digital neuro-ophthalmology materials. Utilize the Health Education Assets Library to standardize indexing to insure effective access and high quality search and retrieval, and to allow faculty contributions to the collection. Provide a mechanism to allow educators to download material for incorporation into personal, customized educational units Promote and evaluate the use and impact of the collection Train content contributors, or technicians from contributor's institutions, in basic indexing and digitization techniques to insure continual growth and enhancement of the digital collection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEW STERILIZATION METHOD FOR CONTACT LENSES AND CASES Principal Investigator & Institution: Elrod, Don B.; Research Scientist; Lynntech, Inc. College Station, Tx 77840 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2004 Summary: (provided by applicant): Contact lenses (CLs) are a successful form of vision control, and the number of people wearing CLs has swelled to 85 million worldwide-32 million nationwide. Many CL wearers are unaware of the potential risks. The most serious complication of CL wear is sight threatening corneal ulceration caused by microbial keratitis (MK). An estimated 30,000 cases of MK occur annually in the US. The use of CLs, especially extended wear lenses, is a significant risk factor for MK. The American Academy of Ophthalmology states, "High prevalence of inadequate CL disinfection, CL storage-case contamination, and contaminated CL solutions among CL users have been reported.' To reduce the risk of CL-associated MK, improvements in tens care products and users compliance with recommend lens care regimes are desperately needed. Only 25-35 percent of CL wearers follow all of their recommended lens care instructions. A new sterilization method is proposed for CLs and lens cases that should improve patient compliance by simplifying their lens care regime and offer significant advantages over current disinfectants-at two orders of magnitude lower
Studies
33
concentration the proposed biocide is more effective than hydrogen peroxide against a broader range of organisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OCULAR HYPERTENSION TREATMENT STUDY (OHTS) Principal Investigator & Institution: Soltau, Joern B.; Assistant Professor; Ophthalmology and Visual Scis; University of Louisville University of Louisville Louisville, Ky 40292 Timing: Fiscal Year 2001; Project Start 01-JAN-1994; Project End 31-DEC-2003 Summary: This is an application to become a participating Clinical Center int he Ocular Hypertension Treatment Study (OHTS). The complete details of the OHTS rationale, design, and methods are contained in the OHTS Manual of Procedures. This proposal provides complete documentation of the ability of the Department of Ophthalmology and Visual Sciences of the University of Louisville College of Medicine to screen large numbers of ocular hypertensive patients and to enroll at lease 50 eligible patients over a 24-month period. Documentation is provided of the capabilities of the proposed investigators and their staff for performance of the study in accordance with the details of the OHTS Manual of Procedures. The chairman of the Department of Ophthalmology and Visual Sciences is an investigator and has committed the resources of the department to this study. In addition, all fellowship-trained glaucoma specialists in the Louisville community are co-investigators and are committed to the success of this study. This unanimous support represents the strength of the commitment of the Department of Ophthalmology and the glaucoma community in Louisville to the Ocular Hypertension Treatment Study. Patients will be drawn from two general eye clinics, three glaucoma sub-specialty practices and d large health maintenance organization. By conducting this study in the kentucky Lions Eye Research Institute (KLERI), we ensure that we will have ample facilities and personnel for the protocol. We have space dedicated for clinical research. We have experienced personnel to cross cover the study personnel. The clinical coordinator/technician is experienced in ophthalmic photography and will be trained to back up our ophthalmic photographer. We have a study coordinator working on other projects who will be crossed-trained to back up the clinical coordinator/technician. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: OCULAR HYPERTENSION TREATMENT STUDY (OHTS) Principal Investigator & Institution: Brandt, James D.; Ophthalmology; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2001; Project Start 01-JAN-1994; Project End 31-DEC-2003 Summary: (Investigator's Abstract) "This is an application from the Department of Ophthalmology at the University of California, Davis to become a participating Clinical Center in the Ocular Hypertension Treatment Study (OHTS). The principal and coinvestigators, along with other members of the UC Davis Department of Ophthalmology, have an established track record participating as clinical centers in large, multi-center studies. UC Davis participated successfully as a clinical center in the Cryo-ROP study and has been selected as the Visual Field Reading Center for both the Optic Neuritis Treatment Trial (ONTT) and for the Ocular Hypertension Treatment Study (OHTS). During the past several years, the principal and co-investigator have been involved in several collaborative studies of perimetry and clinical psychophysics in glaucoma (EY-03424-13). In ongoing and active cooperation with practitioners in private
34
Ophthalmology
practice, at the local Veterans Administration Outpatient Clinic and at a large multiclinic HMO (Kaiser Permanente Medical Group), large numbers of ocular hypertensive patients have been successfully recruited and retained for longitudinal psychophysical studies. From January 1, 1992 through December 31, 1992, we have recruited and retained 249 patients for these studies. These patients were recruited using selection criteria similar to those for the OHTS; using the somewhat stricter entry criteria established for OHTS, we estimate that we would have been able to recruit 101 eligible patients during the same twelve month period. This proposal provides complete documentation of the ability of the Department of Ophthalmology at the University of California, Davis to screen large numbers of ocular hypertensive patients and to enroll at least 50 eligible patients over a 24-month period. Documentation is provided of the capabilities of the proposed investigators and their staff for the performance of the study in accord with the details of the OHTS Manual of Procedures, the nature and extent of their commitment to the Ocular Hypertension Treatment Study at the University of California, Davis, and a list of organizations and practitioners in the area who will refer or follow patients screened for enrollment and randomization to treatment in the OHTS clinical trial." Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OCULAR INSERT FOR THE TREATMENT OF GLAUCOMA Principal Investigator & Institution: Leahy, Charles D.; Vista Scientific, Llc 1 Dundee Pk, Ste 8B Andover, Ma 01810 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Using a unique polymer matrix, tailored to the chemistry of the drug, timolol, and molded into an ocular insert in a design compatible with the conjunctival sac, we will affect the release of drug for the treatment of glaucoma over a 30 to 90 day period. Customizing a matrix with such specific chemistry is an innovative approach to ocular inserts. The long duration of release at constant rates achieved via this approach, as evidenced by Phase I in vitro results, represents a significant advance in the field and will have implications on efforts at many companies and institutions working towards extended release of drugs in ophthalmology. In Phase II we intend to show feasibility of the insert design in humans, as well as measure drug release rates in an animal model. Concurrently, we will develop a molding process similar to that used in contact lens manufacture. Efforts will be coordinated in three key fields: material development and chemistry, design and process engineering and clinical/biological studies. The specific aims are:1. Produce ocular insert material containing 1.0 percent to 5.0 percent timolol and determine the release kinetics over this concentration range from test samples.2. Develop a cast molding, photopolymerization process and produce "small" and "medium" size inserts.3. Demonstrate the safety of the ocular insert material (non-drug loaded) utilizing both in vitro and in vivo testing.4. Determine the comfort and stability of the ocular insert (non-drug loaded) in a selected patient clinical study utilizing both the "small" and "medium" size inserts.5. Determine the in vivo release characteristics of the timolol-containing ocular insert in the rabbit model.6. Develop a business plan that will be presented to potential corporate partners to secure Phase Il funding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: OPHTHALMIC ANTIBIOTIC RESISTANCE STUDY Principal Investigator & Institution: Wilhelmus, Kirk R.; Professor; Ophthalmology; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030
Studies
35
Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2004 Summary: (Applicant's Abstract) Microbial keratitis is a common, economically important ocular disease that, despite the availability of antimicrobial therapy, can reduce vision and the quality of life. A major unresolved issue is the role of the microbiology laboratory in guiding decision-making. The goal of this pilot research is to use clinical and microbiologic data from patients who have had microbial corneal infection to determine how antimicrobial resistance affects outcome. Using a retrospective cohort study design, this epidemiological investigation will examine the effect of the appropriateness of initial antibiotic therapy and the in vitro susceptibility profile of corneal isolates on vision, length of antibiotic treatment, and ocular complications requiring surgery. Multivariable logistic-regression and proportionalhazards analyses will control for potential confounders (including demographic variables, disease duration, severity parameters, and adjunctive therapy) and will consider possible effect modifiers (such as microbial taxonomy and minimal inhibitory concentration) to determine adjusted relative effect measures. The knowledge derived from this research has a potentially high impact on vision research and on clinical practice and has the potential to direct broader investigations into the problem of antimicrobial resistance and the optimal use of antibiotics in ophthalmology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OXIDE GLASS FIBER OPTIMIZED FOR SHORT PULSE IR LASERS Principal Investigator & Institution: Tran, Danh C.; Infrared Fiber Systems, Inc. 2301-A Broadbirch Dr Silver Spring, Md 20904 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2003 Summary: There is a clinical need for optimized optical fiber transmission of short pulse mid-infrared laser radiation for surgical laser applications. Large potential medical markets such as cosmetic skin resurfacing, dentistry, and ophthalmology utilize the Er: YAG and Er:YSGG lasers for therapeutic procedures. The goal of this Phase I study is to further develop the germanium oxide glass fibers made by IFS so that they may be used in these applications. There are three aims of this study: (1) Testing and development of fibers using a short-pulse ER:YAG laser for potential ophthalmic applications requiring further precision, (2) Testing at high-power, high pulse repetition rates for dental and cosmetic applications requiring rapid removal of large amounts of tissue, and (3) development of more compatible germanium oxide fibers. Further Phase II work will be done on the continued fiber development and the development of specialized fiber probe tip designs for flexible delivery of laser radiation during custom surgical laser procedures. PROPOSED COMMERCIAL APPLICATIONS: IR fiber able to deliver laser energy from short pulse mid-infrared lasers would have many applications in laser surgery and dentistry, including ophthalmology and dermatology, for example. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: P30-CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Epstein, David L.; Professor; Ophthalmology; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001; Project Start 01-MAR-1985; Project End 30-JUN-2006 Summary: Eighteen NEI-supported principal investigators and their collaborators from Duke University (Duke), The University of North Carolina at Chapel Hill (UNC) and North Carolina State University (NCSU) quest continuing support for a Core Grant for Vision Research. These investigators are from Departments of Ophthalmology,
36
Ophthalmology
Neurobiology, Pathology, Medicine, Cell Biology, Genetics, and Radiation Oncology. Research interests of the group range from mapping disease genes to finding effective therapy for specific eye disorders and from basic mechanisms of neural development to functional organization of the visual cortex. Over the past 15 years, we have used the Core Grant support to develop and update our resource modules, thus enhancing the capabilities of individual investigators and our institutions to conduct vision research. Our Core Grant program affords an infrastructure capable of providing a broad range of technical support and an atmosphere conducive to sharing current techniques; both are critical to the successful research of the individual investigators. Furthermore, the same infrastructure facilitates the participation of clinical ophthalmologists at Duke and thus supports and enhances studies that aim at translating the discoveries from basic research into new diagnostic and therapeutic applications to eye diseases. Hence, our Core Grant program increases productivity of research on vision and its disorders by promoting and strengthening ongoing interactions between NEI-funded investigators and stimulating new interdisciplinary research. In addition to providing shared support for the NEI-funded investigators and to facilitate collaborative studies with other investigators, the Core Grant program also attracts non-NEI funding for vision research. These research activities are conforming to the NEI National Research Plan, thereby furthering the mission of the NEI. We request continuing support for three resource modules: Morphology/Image Processing Module, Molecular Biology/Genetics Module, and Animal Surgery Module. Continued support of these shared resources is vital to enhancing the quality and productivity of vision research at our universities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: P30-CORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Liebman, Paul A.; Professor; Biochemistry and Biophysics; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-JUN-1975; Project End 31-AUG-2005 Summary: (Applicant's Abstract) The broad, long term objective of this application is to provide Core support services for 24 principal investigators that will enhance their capabilities, productivity, and collaborative interactions and to encourage the acquisition of new faculty into Vision Research. The PIs are roughly divided into three subgroups. These are molecular, neural systems and clinical vision researchers, whose individual research is approved and funded by the National Eye Institute. Support services include Instrumentation, Molecular Biology, Biostatistics and ComputationIllustration. Each service facility provides long-standing continuity and expertise in its specialty. Design and construction of optical, electrophysiological and mechanical original research instruments or modification of commercial equipment is provided by the Instrumentation Module. DNA sequencing, gene mapping and polymerase chain reactions are performed by the Molecular Biology service. Experimental design and data analysis in clinical population or laboratory studies is provided by Biostatistics. Expert assistance in the use of scientific data display and analysis software, image analysis and graphic output is provided by Computation-Illustration. Together, these facilities accelerate progress, enrich interaction and provide collaborative opportunities for translation of basic research into clinical application in vision and ophthalmology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: PHYSICIAN SCIENTIST TRAINING IN CANCER MEDICINE Principal Investigator & Institution: Wilding, George A.; Professor of Medicine; Medicine; University of Wisconsin Madison 750 University Ave Madison, Wi 53706
Studies
37
Timing: Fiscal Year 2001; Project Start 01-AUG-1988; Project End 31-MAY-2004 Summary: The purpose of the Physician Scientist Training Program in Cancer Medicine is to enhance research training opportunities at the University of Wisconsin for physician scientists in the field of cancer medicine. During the past decade, the number of physicians entering academic medicine has decline, partly because of a limited number of institutions committed to the training of physician investigators. As a cancer center with a strong record of training high quality physician investigators and with particularly successful interactions between its laboratory and clinical programs, the University of Wisconsin Comprehensive Cancer Center is an excellent site for a formal research training program in cancer medicine. Participants in this program receive at least two years of investigative training in one of the established research programs of the UWCCC, such as radiobiology, drug development, biological response modifiers/immunology, genitourinary tract cancers, breast cancer, cell adhesion and signaling, carcinogenesis in in vitro human model systems, and cancer prevention. Trainees work closely with a faculty mentor on a specific project in one of the above areas. Projects are presented to the Physician Scientist Training Grant Committee by the trainee both orally and in written NIH grant format with progress reports presented to this Committee every six months. Trainees are also required to take the basic clinical trials biostatistics course offered by the Department of Biostatistics and are expected to take at least one other relevant course from the numerous graduate level courses offered on the UW campus. Applicants are drawn from the UW training programs in Medical Oncology, Radiation Therapy, Pediatric Oncology, Hematology and Internal Medicine. Candidates from other training program such as Urology, Surgical Oncology, Ophthalmology, Gastroenterology, etc. are considered if the applicant commits himself to focusing on a cancer related project and wishes to pursue a career in cancer medicine. Trainees are chosen based on the depth and quality of the applicant's research proposal. Five traineeships are awarded each year. Since the inception of this program in 1988, 21 trainees have completed their training. Fourteen of these trainees have assumed positions in academic medicine on the faculties of university cancer centers. Three additional trainees are negotiating with institutions for academic positions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROLACTIN AS A LACRIMAL GLAND IMMUNOREGULATOR Principal Investigator & Institution: Schechter, Joel E.; Cell & Neurobiology; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2001; Project Start 01-APR-1994; Project End 31-MAR-2002 Summary: Dry eye disease is one of the most frequently encountered clinical problems in ophthalmology. It is common in aged individuals where atrophy and decrease in formation of tears is associated with chronic inflammation, and also occurs in Sjogren's syndrome, an autoimmune disease characterized by lymphocytic infiltration and loss of lacrimal acinar cells. Sjogren's syndrome predominantly afflicts postmenopausal women, and this implicates reproductive hormones as modulators of lacrimal gland secretory and immune function. The potential role(s) of androgens and estrogen in the etiology of lacrimal gland dysfunction is being studied extensively, but the role(s) of prolactin (PRL) is only beginning to be explored. PRL is well known as a general modulator of immune function in mammals, and the long term objective of this proposed research is to elucidate the role of PRL in the regulation of immune function in the lacrimal gland. We have obtained preliminary evidence that PRL is present in lacrimal gland acinar cells, and in this location it has both an endogenous and an exogenous origin. The specific aims of this proposal are to: 1) Define pathways for the
38
Ophthalmology
processing of PRL from the two origins by lacrimal acinar cells. 2) Define mechanisms involved in the regulation of release of PRL from lacrimal acinar cells. 3) Determine whether two types of receptors for PRL occur on lacrimal acinar cells, and define pathways for the processing of these receptors after binding PRL. 4) Test the hypothesis that PRL acts as an intracrine and/or autocrine regulator of the expression of Class II major histocompatibility molecules (MHC II) by lacrimal acinar cells. 5) Test the hypothesis that a PRL-like molecule secreted by lacrimal acinar cells can modulate proliferation of interstitial lymphocytes in response to antigen presentation by lacrimal acinar cells. We will use rats for in vivo studies on the uptake and secretion of exogenous PRL by the lacrimal gland, and rabbits to isolate lacrimal acinar cells for short-term culture to study the role(s) of endogenous and exogenous PRL on the regulation of surface expression of MHC II molecules by lacrimal acinar cells. Our primary approach will be light and electron microscopic immunocytochemistry to localize PRL, PRL receptors, MHC II molecules, and lysosomal enzymes. We will also use SDS-PAGE, autoradiography and RIA to identify PRL and PRL receptors, and an in vitro antigen presenting system consisting of isolated acinar cells and antigen-primed T cells to examine the role of PRL in the activation of lymphocytes by antigen presented by the acinar cells. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROTEIN AND HISTOLOGY MINICORE GRANT FOR VISION RESEARCH Principal Investigator & Institution: Sharma, Krishna K.; Associate Professor; Ophthalmology; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2008 Summary: (provided by applicant): The vision research faculty in the Department of Ophthalmology at the University of Missouri propose to establish two research modules to support the ongoing activities in the department. The Protein expression and analysis module (Module #1) will be setup under the direction of Dr. Sharma for crystallin expression, isolation, and analysis. This module will support the need of investigators who will need large quantities of crystallins, need assistance in the analysis of lens or retinal constituents and the need to culture of whole lenses or lens epithelial cells. The establishment of lens epithelial cells in culture will allow us to look into signal transduction and gene expression under in vivo conditions. The establishment of protein analysis module will allow us to share the existing resources and increase our ability to offer support to recently joined faculty and the new faulty we plan on recruiting under the mission enhancement program. The Histology and image analysis module (Module #2) will be a facility for analyzing eye tissue samples from transgenic animals or pathologic specimens or donor tissues. This module will be directed by Dr. Reneker. It will foster the ongoing collaboration between the NEI supported projects within the department. In addition, the module will offer the much needed support for the research projects initiated by our new faculty. Therefore the main objectives of this proposal are to: a) enhance research infrastructure for vision science research at University of Missouri School of Medicine, b) enhance the opportunities for joint research projects and provide logistical support for joint projects, c) support the needs of new vision research faculty. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
39
Project Title: PTERYGIUM EVALUATION PROJECT Principal Investigator & Institution: Twelker, J Daniel.; Optometry; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 31-MAR-2002 Summary: J. Daniel Twelker, O.D. completed his undergraduate degree in Spanish at the University of California, Davis (as well as the prerequisites for optometry school) and is fluent in Spanish. He graduated from the University of California, Berkeley School of Optometry in 1992 and now is a licensed optometrist working both in general practice and research. While working in the Mission District of San Francisco and in La Clinica de la Raza in Oakland, California. Dr. Twelker observed, that many of his patients suffered from pterygium, a triangular growth of abnormal tissue which grows from the conjunctiva onto the cornea, often causing blurred vision, irritation, and poor cosmesis. His goal is to become a clinically-based vision researcher in order to study pterygium, as well as other ocular disorders, which affect the Hispanic community and broader populations. Dr. Twelker was recently accepted into the Graduate Program in Vision Science at the University of California, Berkeley. He will complete coursework in vision science, biostatistics, and epidemiology. He will work under the primary mentorship of Ian L. Bailey, O.D., M.S. who developed the Bailey-Lovie visual acuity measurement chart and assisted in the development of the Lens Opacities Classification System (LOCS) III. Mark Mannis, M.D., F.A.C.S. and William A. Satariano, Ph.D. will also mentor the candidate. Dr. Mannis is a corneal surgeon and Professor of Ophthalmology at the University of California, Davis and Dr. Satariano is a Professor of Epidemiology at the University of California, Berkeley, School of Public Health. In order to better conduct epidemiological and clinical studies of pterygium, there needs to be a reliable, standardized photodocumentation, measurement, and grading method. The Pterygium Evaluation Project will the develop, describe, and implement such a method. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: QUANTIFICATION OF GLAUCOMATOUS OPTIC NEUROPATHY Principal Investigator & Institution: Girkin, Christopher; Ophthalmology; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: (Applicant's Abstract) This application proposes a training plan to develop Christopher Girkin, MD into an independent clinician-scientist specializing in investigations of optic nerve structure and visual function. Dr. Girkin is a board certified ophthalmologist with subspecialty training in both neuro-ophthalmology and glaucoma with prior research experience involving the relationship between optic disc structure and visual function in glaucoma. This training program will consist of mentored research, advanced coursework leading to a Masters in Science in Public Health, and multi-disciplinary conferences. Mentored research will be conducted under the direction of a mentorship committee composed of Dr. Cynthia Owsley, Director of the UAB Clinical Research Unit and Dr. Gerald McGwin, Director of the Epidemiology Unit in the UAB Center for Injury Sciences. Dr. David Roth and Dr. Robert Weinreb, Director of the UCSD Glaucoma Service will serve as consultants on the project and as committee members. This research will be conducted through the UAB Optic Nerve Imaging Center that Dr. Girkin has developed over the past two years. Quantitative techniques that evaluate optic disc structure in vivo and specialized visual field tests have been developed to better quantify glaucoma. However, each of these techniques has individual weaknesses and detects different aspects of glaucomatous damage. This
40
Ophthalmology
project proposes that a composite variable developed from these instruments will better quantify glaucomatous damage. This composite can then be used to determine the measurements or combinations of measurements that best quantify glaucomatous damage defined by confirmatory factor analysis and compare this measurement model in Caucasian and African-American subjects both cross-sectionally and longitudinally. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RENOVATION OF WILMER RESARCH FACILITY Principal Investigator & Institution: Miller, Edward D.; Md; None; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2004 Summary: (provided by applicant): Research facility renovation will enhance the research mission of the Wilmer Ophthalmological Institute (Department of Ophthalmology, Johns Hopkins University). Renovation of two existing areas will provide more effective utilization to improve and expand present and planned research activities. First, a clinical research center will be produced by renovation of 1/2 floor of a former dormitory building, changing 15 individual bedrooms into flexible clinical research and data interaction space, meeting rooms, and a biostatistical core facility. High speed computer network connections will be provided to link this research facility to collaborators within and outside Hopkins Information Systems. This facility will house existing and newly funded programs for research in aging, preventive ophthalmology, and HIV/AIDS research, and a department biostatistical core. Second, the 40-year-old animal quarters and animal surgical suite will be reconfigured to allow new research, expand animal housing, and eliminate some crippling malfunctions. Outdated and non-functional equipment and space will be replaced to generate three animal operating rooms, an ocular imaging facility, modern lighting and computer controls. The animal quarters serves 15 Wilmer research groups and is a fully functional animal care facility for specialized vision research, a component of the Johns Hopkins Comparative Medicine Department. The renovation will enhance core infrastructure for Wilmer's research, whose budget increased by 35 percent over the past five years without major facility renovation. There are presently over 70 million blind persons worldwide, with one million of these estimated to live in the United States of America. The mission of the Wilmer Institute is to promote better vision through patient care, teaching and research into blinding conditions. The research to be carried out in the facilities described here, with the specific funded programs now ongoing, are directed at those high priority questions described in Vision Research: A National Plan, the publication of the National Eye Institute that details the areas most in need of active investigation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: RESEARCH TRAINING IN INHERITED NEUROLOGICAL DISEASE Principal Investigator & Institution: Leppert, Mark F.; Professor; Human Genetics; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant) This is a revised application for a grant to create a program in Research Training in Inherited Neurologic Diseases at the University of Utah. Nineteen faculty members serve as research preceptors for trainees, and the faculty consists of both physician-scientists and basic scientists. Research groups participating in the Training Program include the Neuromuscular Division (Dept. of
Studies
41
Neurology); the Division of Medical Genetics (Dept. of Pediatrics); and the Departments of Human Genetics, Neurobiology and Anatomy, and Ophthalmology. Areas represented include genetics of movement disorders, genetics of demyelinating disorders, studies of virally-mediated gene transfer, and targeted gene disruption through homologous recombination. Research opportunities for trainees include exposure to large kindreds for linkage mapping and genotype/phenotype correlation studies, and exposure to modern techniques of molecular biology, genetic epidemiology, linkage analysis, and genomic analysis. A plan is presented for a highly focused two-year postdoctoral training program, with a didactic curriculum as part of the first year which will provide the trainee with the necessary background and knowledge base for clinical research. This application requests support for one physician-scientist post-doctoral trainee in the first year, and two trainees in each of the subsequent years. In addition, in response to comments in the previous review, funding support is requested for two predoctoral candidates per year, to be competitively selected from trainees within the University's multidisciplinary Neuroscience and Molecular Biology programs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RETINAL ANTIOXIDANT GENES INDUCED BY PHOTIC INJURY Principal Investigator & Institution: Chen, Lin; Ophthalmology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The candidate, Lin Chen, is determined to become a physician scientist and devote herself to both patient care and vision research. Her immediate career goal is to become an independent investigator. Although she has completed her graduate training in both basic science and clinical medicine, she will greatly benefit from the mentored clinical scientist development award. During the award period, she will acquire new research skills such as microarray analysis and mouse genetics, and obtain further training in the responsible conduct of research, and in communication and networking. The Scheie Eye Institute provides an ideal research environment for the candidate's career development. Dr. Chen's mentor, Dr. Jean Bennett, has a long track record of training scientists at all levels. She and the six other eye research faculty in the Kirby Center for Molecular Ophthalmology are eager to support Dr. Chen's career development. These faculty members have expertise in ophthalmic molecular biology, histology, gene transfer, animal models of retinal degeneration, and animal ERG. The Kirby Center is a cohesive team of eye researchers with state-of-the-art equipment occupying an 11,000 sq. ft. floor in the heart of the Penn biomedical research community. The scientific objective of this proposal is to understand the role of oxidative stress in age-related macular degeneration, the leading cause of irreversible blindness in the elderly. Specifically, this proposal will investigate the role of natural antioxidant genes in the mouse photic injury model, a model of photo-oxidative photoreceptor injury, and in human AMD specimens. The research design will employ microarray analysis of differences in antioxidant gene expression in normal mouse retinas versus photic injury retinas and in AMD eyes versus normal agematched eyes. It will also use transgenic and knockout mice to investigate the role of ceruloplasmin, an antioxidant found in Dr. Chen's preliminary studies to be upregulated following photic injury. This information will help define the mechanisms by which the retina protects itself from oxidative stress, which is important in the pathogenesis of AMD, as demonstrated by the Age-Related Eye Disease Study. New information about the specific mechanisms of oxidative damage and natural antioxidant
42
Ophthalmology
protection in the retina will suggest new agents for protection and treatment of patients with AMD, preserving their vision. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SCLERAL BUCKLE PLACEMENT IN OPEN-GLOBE INJURIES Principal Investigator & Institution: Arroyo, Jorge G.; Massachusetts Eye and Ear Infirmary 243 Charles St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: (Candidate?s Abstract) Although the United States has some of the best medical schools, residencies and fellowships in the world, this medical training is focused on delivering excellent care to patients, rather than developing the research skills necessary to carry out effective clinical investigation. In order for young academic faculty members to take the next step towards becoming independent clinical investigators, further training to obtain these necessary skills is required. The candidate and his mentor, Dr. Louise Ryan, Professor of Biostatists, propose to accomplish this in the following manner: 1) Didactic courses will be taken at the Harvard School of Public Health in clinical epidemiology and biostatistics toward a Masters in Public Health. 2) The candidate will analyze ocular trauma patient data and publish clinical studies in conjunction with Dr. David Hemenway, Director of the Harvard Injury Control Research Center. 3) The candidate will attend weekly clinical research conferences at Harvard Medical School and Harvard School of Public Health. 4) The candidate will participate in the NIH-sponsored Submacular Surgery Trials under the direction of the study chairman, Dr. Nell Bressler. And finally, 5) these clinical research skills will be directly applied towards designing, organizing and obtaining funding for a randomized , prospective multi-center clinical trail entitled, "Prophylatic Scleral Buckle Placement in Posterior Open-globe Injuries." During this final phase, the candidate will work closely with Dr. Evangelos gregoudas, Director of the Retina Service and the Retina research Institute at the Massachusetts Eye 7 Ear Infirmary. The candidate?s long term goal is to obtain independent funding for clinical research studies in the area of ocular trauma and will make a significant contribution to the field of Ophthalmology. The K-23 grant will thus help provide the candidate with a crucial first step towards becoming an inde3pendent clinical researcher and an expert in the field of ocular trauma. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: SENSORY AND MOTOR FUSION IN ABNORMAL BINOCULAR VISION Principal Investigator & Institution: Fredenburg, Patricia M.; Vision Sciences; University of Houston 4800 Calhoun Rd Houston, Tx 77004 Timing: Fiscal Year 2001; Project Start 15-SEP-2001; Project End 31-AUG-2006 Summary: I, Patricia M. Fredenburg, am an optometrist licensed to practice in Virginia and Texas. After 11 years of practicing optometry, primarily in an ophthalmology practice, I decided to return to school to pursue a career in an academic environment. While I enjoy clinical instruction, I hope to do research into basic mechanisms in binocular vision, since teaching at the graduate school level is my goal, and topics in this area are particularly difficult for many professional students to understand. My research career development plan includes didactic course work in computer science, perception, and statistics, as well as hands-on participation in experiments in binocular vision in the lab of Ron Harwerth, O.D., Ph.D, at the University of Houston College of Optometry. Normal binocular vision allows the development of ocular sensory and motor
Studies
43
interactions that enable the individual to interpret his/her spatial environment. Depthdistance information obtained from the combination of binocular and monocular cues abundantly present in the environment is essential for the efficient performance of many everyday activities and occupations, yet 34% of the population who have abnormal binocular vision have an impaired ability to use the available information. The longterm objectives of the proposed research is to gain a better understanding of the functional alterations that occur in individuals with abnormal binocular vision. The knowledge gained from the research can help determine whether early surgical intervention in strabismus is essential to maximize the potential for the development of normal binocular vision and whether other, non-surgical treatments might enhance the therapeutic outcome. The proposed research, therefore, will use psychophysical techniques to further qualify and quantify the sensory and motor responses of subjects with stereodeficiencies and/or motor anomalies, and the responses compared to those of subjects with normal binocular vision, in order to determine how their sensory and oculomotor systems respond differently to various aspects of the visual stimulus. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SERINE PROTEINASE INHIBITORS IN OCULAR SURFACE EPITHELIA Principal Investigator & Institution: Lavker, Robert M.; Professor; Dermatology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-FEB-2000; Project End 31-JAN-2004 Summary: (adapted from the applicant's abstract): The anterior surface of the eye functions as a barrier to the external environment and protects the delicate structures of the anterior segment from injury. This protection is provided through the elaboration of the corneal, limbal, and conjunctival epithelia. Proteinases represent a class of molecules that are capable of influencing proliferation, differentiation and cells death; activities involved in epithelial homeostasis. The plasminogen activator (PA) cascade is one such proteinase system. Some of its components have been localized in ocular surface epithelia. Recent data have localized the proteinase inhibitor, plasminogen activator inhibitor type 2 (PAI-2) in human corneal, limbal, and conjunctival epithelia. Two pools of this inhibitor appear to be present within these epithelial cells, an active form and a cleaved (inactive) form. The hypothesis to be tested is that PAI-2, by interacting with an intracellular proteinase, serves to protect the cell from premature proteolytic damage or death. The specific aims of this application are 1) to localize PAI-2 mRNA and antigen in human corneal and conjunctival epithelia in vivo and in vitro and determine the PAI-2 species present in vivo; 2) to identify the proteinase(s) that cleaves PAI-2 in human corneal epithelial cells; 3) to characterize biochemically PAI-2 and its interacting proteinase(s) in human conjunctival epithelial cells; and 4) to define the phenotype of corneal and conjunctival epithelial cells with increased and decreased levels of PAI-2. The long term goal is to understand the role that PAI-2 and its target proteinases play in ocular anterior segment epithelial homeostasis. These studies will serve as a baseline for future studies on the therapeutic use of PAI-2 in ophthalmology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: SHORT TERM TRAINING: STUDENTS IN HEALTH PROFESSIONAL SCH Principal Investigator & Institution: Bullimore, Mark A.; Associate Professor; Ohio State University 1960 Kenny Road Columbus, Oh 43210
44
Ophthalmology
Timing: Fiscal Year 2003; Project Start 01-MAY-1998; Project End 30-APR-2008 Summary: (provided by applicant): Short-term research training support is requested for ten students recruited from schools and colleges of optometry to a three-month summer rotation at The Ohio State University College of Optometry.The goal of the training program is to encourage students to embark on a career in eye research. The training will be conducted in the laboratories of 20 well-established eye and vision researchers, primarily members of the College of Optometry but with representation from the Molecular, Cellular and Developmental Biology, Ophthalmology, Psychology, and Veterinary Medicine. The research expertise of the faculty mentors can be divided into three clearly identifiable program areas: ocular epidemiology, biological sciences, and visual perception. This critical mass of vision researchers possess nearly 20 current National Institutes of Health and National Science Foundation research grants between them and includes 14 National Eye Institute grantees. Collectively, the mentors are currently training over 30 enrolled graduate students. The majority of mentors are members of the Graduate Program in Vision Science which was established over 50 years ago and has since trained more than 140 graduate students. Trainees will participate for three months on a full-time basis during the summer following their first year of optometry training. The Training Program will include regular seminars and participation in the ongoing research in an assigned mentor's laboratory. Recruitment will be directed at students at all schools and colleges in the United States with particular emphasis on the recruitment of minority students Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SHORT TERM TRNG-STUDENTS IN HEALTH PROFESSIONAL SCHOOLS Principal Investigator & Institution: Keyser, Kent T.; Professor; Physiological Optics; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2003; Project Start 30-SEP-1982; Project End 31-MAR-2008 Summary: (provided by applicant): Thirty five vision scientists at the University of Alabama at Birmingham seek to provide short-term interdisciplinary vision research training for optometry and medical professional students, and optometry and ophthalmology residents. The faculty comprise a campus-wide vision research community representing eleven departments from the Schools of Medicine, Engineering, Natural Sciences and Mathematics, Optometry, Public Health, Social and Behavioral Sciences, and Veterans Affairs. The faculty hold a total of 24 NEI grants with total funding of $4.8 M. There is considerable research collaboration among the participating faculty, and a history of joint sponsorship of student research. The participating faculty have modern, well-equipped laboratories, with over 20,000 square fee in School of Optometry Buildings alone, and access to an array of state-of-the-art shared research facilities. Support is requested for six predoctoral and four postdoctoral positions per year. Training will be offered to optometry and medical students, and optometry and ophthalmology residents. There is an outstanding pool of potential predoctoral trainees who enter the UAB Medical and Optometry Schools. There are similarly well qualified potential trainees who come for residency training in optometry or ophthalmology. The predoctoral positions are requested for trainees working directly towards the O.D. or the M.D. degree, and the postdoctoral positions are requested for students who have completed their professional program. A formal trainee evaluation system has been established, and mechanisms for assisting trainees to seek additional research training are available through the medical and optometry combined degree
Studies
45
programs, or through the various NIH-funded K mechanisms following the completion of the professional program Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SHORT-TERM RESERCH TRAINING: STUDENTS IN HEALTH SCHOOLS Principal Investigator & Institution: Forrest, John N.; Professor; None; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-JUN-1992; Project End 31-MAY-2007 Summary: (provided by applicant) The Yale University School of Medicine has a long tradition and record of accomplishments in the training of medical students for careers in academic medicine and research. This application is a competitive renewal of a training grant (Short-Term Training: Students in Health Professional Schools) first awarded to the School in 1987-88. The purpose of the renewal is to provide intensive short-term training in research for selected pre-doctoral medical students in the most outstanding laboratories and training sites in the Yale University School of Medicine. The specific laboratory experiences will range from fundamental molecular biology, cellular and organ physiology to applied clinical research in cardiovascular and pulmonary disease. The program is designed to attract the most highly qualified medical students into careers as physician-scientists in the biomedical sciences. An extensive follow-up documents a high level of subsequent research training and research productivity among previously supported students. Trainees will be chosen upon application of pre-doctoral medical students who have completed in good standing one year of the curriculum of the Yale University School of Medicine. Thirtytwo students per year will be selected competitively for this short-term training support on the basis of the quality of a formal written proposal of the planned research and the quality of the mentor and the training environment. The participating departments and sections will include: cell biology, cellular and molecular physiology, dermatology, diagnostic radiology, epidemiology and public health, genetics, immunobiology, internal medicine (cardiology, digestive diseases, endocrinology, hematology, infectious disease, nephrology, pulmonary, rheumatology), laboratory medicine, molecular biophysics and biochemistry, neurology, neurosurgery, ophthalmology, pathology, pediatrics, pharmacology, surgery, and therapeutic radiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: STABILIZED MICROSURGERY
ADAPTIVE
OPTICS
IMAGING
LASER
Principal Investigator & Institution: Hammer, Daniel X.; Physical Sciences, Inc. 20 New England Business Center Andover, Ma 01810 Timing: Fiscal Year 2003; Project Start 19-SEP-2003; Project End 31-AUG-2005 Summary: Recent advances in ophthalmic imaging have revolutionized the ability of clinicians to visualize and understand a wide variety of diseases of the eye. Although these advanced diagnostic instruments indirectly indicate a course of treatment, they are generally not directly coupled to a particular therapy. We propose to design, develop, and construct an innovative diagnostic instrument, the core elements of which will be integral to the delivery of a new treatment modality. The diagnostic instrument will use scanning laser ophthalmoscopy (SLO) at its core, with unique and necessary enhancements of adaptive optics and retinal tracking used to increase imaging performance and clinical utility. The instrument will be used to precisely deliver laser
46
Ophthalmology
pulses for several different potential therapeutic applications. By use of ultrashort laser pulses of femtosecond or picosecond duration, microsurgical damage can be created at spatially-confined locations, without collateral damage to critical adjacent layers, and with lower energies than other laser surgery. The system will be constructed at Physical Sciences Inc. (PSI) and the imaging performance will be evaluated there on artificial targets and on a limited number of human subjects. The system will then be transported to the laser laboratory (AFRIJHEDO) at Brooks AFB for initial testing in an appropriate animal model. The PSI investigators will be assisted by experts in the field of adaptive optics for retinal imaging, clinical ophthalmology, and ultrashort pulse laser generation and delivery. The unique use of an advanced, high-resolution imaging system for both imaging and delivery of laser pulses for specific therapies constitutes the direct, complete, and efficient integration of detection and treatment modalities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STATISTICAL CLUSTER DATA
METHODS
FOR
OPHTHALMOLOGIC
AND
Principal Investigator & Institution: Rosner, Bernard A.; Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2005 Summary: (provided by applicant): Correlated data are the norm in ophthalmologic data, due to correlated response for paired eyes. An abundance of methods are now available that enhance standard models by incorporating clustering effects (Rosner, 1984; Liang and Zeger, 1986). These methods are limited usually to either normally distributed or binary outcomes. However, many scales used in ophthalmology are continuous, but non-normally distributed (e.g. visual field area). Other scales are ordinal and non-normally distributed, but are sometimes treated as normally distributed as well (e.g. diabetic retinopathy grade). Nonparametric methods are a natural approach for such scales. In this proposal, we propose a model for incorporating clustering effects for ranked data and use this model to extend tests such as the Mann-Whitney U test for the clustered data situation. In addition, we propose extensions to allow for tied values and to adjust for other covariate effects. Another issue in ophthalmologic data is that some endpoints are composite in nature (e.g. nuclear cataract, cortical cataract, PSC cataract, control). An interesting issue is that the risk factor profile for some risk factors may be different for different types of cataract, while for other risk factors it may be the same. (Marshall & Chisholm, 1985). We propose to use a flexible type of polytomous regression model in this setting and to enhance it by considering matched designs as well as outcome categories that are not mutually exclusive. Furthermore, we propose to develop a user-friendly software package to easily fit such models including use of stepwise regression strategies. A third area of interest is the use of correlated data methods in a small sample setting. Most previous methods developed have good asymptotic properties but depend on at least a moderately sized sample for their validity.We propose to extend existing methods of exact inference by incorporating clustering effects and making these methods available by exportable software. Finally, the area under the ROC curve is frequently used as a measure of goodness-of-fit for logistic regression models. However, its use is problematic if separate logistic models are fit for the right and left eyes of an individual in ophthalmologic studies. We propose to extend traditional ROC curve methods (Hanley and McNeil, 1982) to the clustered data situation where outcome on fellow eyes may be either concordant (bilateral cases) or discordant (unilateral cases). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
Project Title: STEREOSCOPIC MACULOPATHY
GRADING
SYSTEM
FOR
47
AGE-RELATED
Principal Investigator & Institution: Soliz, Peter N.; Director Biomedical Imaging; Kestrel Corporation 3815 Osuna Ne Albuquerque, Nm 87109 Timing: Fiscal Year 2001; Project Start 01-APR-1999; Project End 30-NOV-2002 Summary: Kestrel is developing a commercial computer-based grading system for 2D and stereo visualization and analysis of digital fundus images with a user- selectable level of automation geared toward clinical application and use in epidemiological studies of ARMD. The specific aims of this project are to develop and validate a commercial-quality Stereo ARMD grading system (ARMD GS) and to perform a longitudinal study that will demonstrate clinical and research capabilities not available through current light-box based methods. The ability to display digital images in a familiar 3D format allows the advantages of digital technology to greatly enhance traditional methods without sacrificing the benefits of manual grading. Kestrel will enhance the Phase I Stereo ARMD GS through an evolutionary path that provides improvements in stages. Initial enhancement will include automatic registration of time series images to facilitate longitudinal study and user-directed semi-automatic segmentation of lesions. The final stage will automatically segment the entire image at once without user direction. The various levels of system automation will allow the user a choice as to the most appropriate tool for a given application. The final system will be demonstrated and validated through a retrospective longitudinal study of 40 subjects. PROPOSED COMMERCIAL APPLICATION: A market exists for computer-aided grading system at the major epidemiological fundus grading centers throughout the world. As a screening and surveillance system, the 2,500 retail eyecare centers would benefit economically from the proposed system. Kestrel's system will streamline the grading centers' process, thus enabling the centers to keep pace with the growing research requirements in ophthalmology. Eyecare centers could improve their capability for screening for ARMD, diabetic retinopathy, and other diseases presenting in the reitna. At present, we initiated discussions for beta testing at sites such as the Joslin Eye Center, the University of Wisconsin, and Scheie Eye Center. The estimated market size for medical image management hardware and software is 2.52 billion dollars. Potential market share for computer-assisted stereo system is estimated at 50 million dollars over a ten year period. The application of the stereo retinal-image visualization and evaluation system extends to other retinal diseases, which require stereo viewing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TAMOXIFEN-INDUCED KNOCK-OUT OF A RETINAL GENE Principal Investigator & Institution: Tsang, Stephen H.; Jules Stein Eye Institute; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2008 Summary: This proposal is designed to provide a diverse and extensive research experience in molecular biology, biochemistry, and electrophysiology that will allow the applicant to develop into a mature scientist-clinician with an outstanding potential to contribute to both academic ophthalmology and basic science research. All components of training are incorporated in the curriculum of the EyeSTAR program based at UCLA. The research project will focus on the generation of tissue- and time- specific modifications in the gene encoding the gamma subunit of cGMP- phosphodiesterase
48
Ophthalmology
(PDEgamma) by using an inducible knockout system. The entire coding region of the PDEgamma will be flanked by 34-base pair Cre-recombinase recognition sites (loxP) introduced into the gene locus by homologous recombination. After germline transmission, mice Pdeglox1/Pdegtm1 bearing the modified allele will be crossed with mice expressing the Cre-recombinase/steroid hormone receptor fusion protein under the control of the genomic locus of the beta subunit of PDE (Pdeb). The use of Crerecombinase/steroid hormone receptor fusion protein will allow the regulation of Crerecombinase activity with exogenously applied steroids. Gaining temporal and spatial control of gene expression is essential for the elucidation of gene function in the whole organism. The proposed studies will develop tools that will ease the deletion of genes from the genome in specific cells and at specific times. Understanding of the mechanisms controlling photoreceptor signaling and degeneration in Pdeglox1/Pdegtm1 mice may help to develop strategies for the prevention or slowing of human retinal dystrophies. Dr. Debora Farber is nationally recognized for her biochemical and molecular biological studies of retinal degenerations, in particular retinitis pigmentosa. Dr. Farber will serve as mentor for the PI'S postdoctoral studies. In addition, UCLA has an outstanding panel of faculty members many of whom have professional relationships with Dr. Farber and can serve as scientific consultants to the PI. The proposed project will be at the cutting edge of current research is an ideal area with which to begin a scientific career. The EyeSTAR program also incorporates three years of clinical training in ophthalmology leading to certification and specialty board eligibility. This intense three-year residency program providers a vast clinical experience in diagnosis and treatment of the complete scope of ophthalmologic problems as well as a number of didactic activities including lectures, special seminars, and attendance at clinical research meetings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TELEMEDICAL DIAGNOSIS OF RETINOPATHY OF PREMATURITY Principal Investigator & Institution: Chiang, Michael F.; Ophthalmology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The candidate has a background in engineering, medicine, and ophthalmology, and plans to extend his career into the clinical applications of communications and information technology. This proposal will support the candidate's career development through a two-phase training program. In the first phase, intensive didactic instruction through the Columbia University Department of Medical Informatics will provide background in medical informatics, computer science, biostatistics, and clinical research. A mentor who is an international authority in clinical medical informatics will supervise this work. He will provide guidance during the entire award period. The second phase will involve the design, implementation, and evaluation of a telemedical network for the remote diagnosis of Retinopathy of Prematurity (ROP) in low birth weight infants. Studies will be conducted to test an underlying hypothesis: that telemedical detection of ROP will prove to be safe, accurate, and efficient, and will provide important advantages over existing diagnostic methods with respect to speed, outcome, cost, and satisfaction. The development of a computerized infrastructure for health care has the potential to dramatically improve the delivery of medical care and research. Ophthalmology is particularly well suited for this area of investigation because it is technology-driven and visually oriented. This project will be supervised by an ophthalmology Co-Mentor who is an international authority on ROP, and a medical informatics Co-Mentor who has special expertise in
Studies
49
telemedicine. Columbia University has a strong existing framework in medical information systems, telemedicine, and public health, which will be leveraged to complete this training and research program successfully. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE MOLECULAR BASIS OF PSEUDOEXFOLIATION SYNDROME Principal Investigator & Institution: Challa, Pratap; Ophthalmology; Duke University Durham, Nc 27706 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): This grant proposal outlines a five-year training program for the development of an academic career in molecular biology. The principal investigator is a fellowship-trained clinician who proposes to expand and diversify his scientific ability through intensive coursework and reentered research training. The didactic portion of this program will consist of graduate level coursework at Duke University and regular sessions with the proposed mentors, Drs Klintworth and Bowes Rickman. Dr Klintworth is director of the Ophthalmic Genetics Center at Duke University and has expertise in studying genetically determined diseases of the eye. Dr Bowes Rickman is an Assistant Professor of Ophthalmology and Cell Biology and has expertise in characterizing mRNAs and proteins in ocular disorders. The proposed research is to investigate the molecular mechanisms that are associated with the development of pseudoexfoliation syndrome (PEX) and pseudoexfoliation syndrome with glaucoma (PEX-G) using gene array technologies. PEX is an idiopathic systemic disease characterized by fibrillar deposits in multiple ocular and non-ocular tissues. PEX is the most common identifiable cause of open angle glaucoma worldwide and is phenotypically distinct from primary open angle glaucoma. Growing evidence suggests that PEX is a late onset inherited disorder. Despite the prevalence of PEX and PEX-G little is known about their underlying molecular mechanisms. In short, we propose to: 1) Identify genes or ESTs involved in the pathogenesis of PEX using gene array technologies 2) Characterize/deduce gene sequences 3) Identify differences in gene expression between PEX and PEX-G and 4) Ascertain and recruit additional PEX patients and families. These investigations are critical to understanding the molecular basis of PEX and any modifying genetic factors that would predispose to the development of glaucoma. The Ophthalmology department at Duke University is an ideal setting for training physician-scientists and has an established track record of strong support for promising clinician-scientists. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: TRAINING GRANT IN VISION RESEARCH Principal Investigator & Institution: Schall, Jeffrey D.; Professor; Psychology; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2004; Project Start 01-DEC-1993; Project End 30-NOV-2008 Summary: (provided by applicant): Sixteen members of the Vanderbilt Vision Research Center (VVRC) request continued support for predoctoral and postdoctoral training. Vision researchers at Vanderbilt have maintained an exceptionally strong training record with excellent research progress. Aggressive faculty recruiting during the last grant period has doubled the number of qualified preceptors and the number of NEIfunded research grants extending the program of research and training from traditional psychophysics and visual neuroscience to molecular eye research. Individuals trained during the last grant period have obtained competitive postdoctoral or faculty positions
50
Ophthalmology
and developed independent careers in vision research. Training will continue in visual neuroscience and psychophysics and will be extended to molecular mechanisms in the eye such as transduction, retinal processing and retinal disease. Specific program requirements for predoctoral trainees include (1) The Visual System, a course teamtaught by program faculty, (2) additional courses specified by the trainee's graduate program selected from an extensive curriculum covering molecular biology, neuroscience, perception and engineering, (3) participation in the Vanderbilt Vision Research Seminar series and related seminars on campus, (4) participation in international scientific meetings such as Association for Research in Vision & Ophthalmology, Vision Science Society and Society for Neuroscience, (5) participation in a Responsible Conduct of Research program, and (6) most importantly, research supervised by one or more preceptors. Postdoctoral trainees are required to fulfill the same requirements except (2) while they prepare an independent NRSA proposal. Trainees will be recruited nationally with emphasis on minority sources. Alliances with traditionally African-American institutions in Nashville such as Meharry Medical College, Fisk University and Tennessee State University facilitate minority recruiting. This training program develops independent, academic vision researchers through interdisciplinary training in vision and eye research fostered by the number and cohesiveness of vision and eye researchers at Vanderbilt. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRAINING IN COMPUTATIONAL NEUROSCIENCE Principal Investigator & Institution: Ulinski, Philip S.; Professor; Biology; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2001; Project Start 15-JUL-1999; Project End 30-JUN-2004 Summary: The 21st century promises extraordinary progress in understanding the neural bases of animal and human behavior. Much of the work will depend upon a greater integration of information across levels of biological organization and a greater reliance upon quantitative approaches than has historically been the case. The next century, thus, also poses the challenge of educating young scientists in a broader and more flexible way than has historically been the case. Computational neuroscience is one of the areas in which integrative and quantitative approaches to neuroscience and behavior will be increasingly important. Accordingly, funds are requested here for six predoctoral training slots for the Computational Neuroscience Program that has been established at the University of Chicago. The Program has two specific aims: (1) to train young scientists with a working knowledge of neuroscience at levels of organization ranging from molecular neurobiology to cognitive science, (2) to train young scientists who have basic expertise in both mathematical and experimental approaches to important problems in neuroscience. Students will gain degrees through existing, degree-granting units (Mathematics, Neurobiology, Organismal Biology and Anatomy, Ophthalmology and Visual Science and Psychology) and participate in a training program that has six components: (1) background training in mathematics, biology or psychology, (2) three core courses in computational neuroscience, (3) elective courses, (4) a computational neuroscience seminar series, (5) laboratory rotations and (6) dissertation research. Thirteen training faculty are drawn from seven department, ranging from Mathematics to Neurology. They are involved in research ranging from structure/function relationships in voltage-gated sodium channels, to sensorimotor transformations in song birds, to connectistic models of language and semantics in humans. A key feature of the program is that most of the faculty is involved in combined mathematical and experimental approaches to neuroscience and behavior.
Studies
51
The predoctoral training program is one component in a larger computational neuroscience program that includes expanding undergraduate and postdoctoral education components. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRAINING IN VIRAL ONCOLOGY Principal Investigator & Institution: Mertz, Janet E.; Oncology; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2001; Project Start 01-JUL-1980; Project End 31-MAR-2006 Summary: (Applicant's Description): The purpose of this program is to provide training in viral oncology at the postdoctoral level. Trainees undertake a program of laboratory research with one or more faculty members. There are no formal course requirements or examinations; however, postdoctoral trainees audit appropriate lecture and seminar courses in virology and oncology. In addition, they are expected to publish, study independently, regularly attend and speak at seminars, journal clubs, and research meetings, and learn about the research of other trainees and faculty. Weekly seminars in both Tumor Virology and Molecular Virology serve as a focus for the training program. All trainees regularly attend one or both of these seminars and present at least one research report on their work every year. Trainers also attend one or both of these seminars which, on occasion, include outside speakers and highlights of recently held conferences. The faculty associated with this program are affiliated with several different schools and departments. They carry out research on viruses infecting a variety of organisms and employ a wide range of techniques. This variety of techniques and organisms insures a broad experience to trainees on this grant. The progress of all trainees is monitored by frequent (usually weekly) consultation with one or more trainers, by the yearly presentation of research results in the weekly seminars, and by the requirement for written annual progress reports for additional years of support. Trainees must have either a Ph.D. in biochemistry, microbiology, virology, oncology, genetics, or related areas, or a D.V.M. or an M.D. with an interest in viral oncology. Trainees are selected for support on this grant from applications received by faculty in this program. All applicants are required to provide a C.V., publication list, three letters of recommendation, and a statement of the specific research training proposed. A committee composed of the Program Director and 2 or 3 other senior trainers selects the trainees from among these applicants. After the training period, which is usually 2-3 years, trainees are qualified to assume responsible research positions related to tumor virology in a variety of institutions. Facilities associated with this training program are well-equipped virology, molecular biology, biochemistry and biotechnology laboratories in the McArdle Laboratory for Cancer Research, the Institute for Molecular Virology, and the Departments of Biochemistry, Chemical Engineering, Medical Microbiology and Immunology, Ophthalmology and Visual Sciences, and Pathology and Laboratory Medicine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: TRAINING PROGRAM FOR CLINICAL RESEARCH ON AIDS Principal Investigator & Institution: Shearer, William T.; Professor of Pediatrics; Pediatrics; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 30-JUN-2002 Summary: (Adapted from the application) This competitive renewal application proposes a continuation of the current "Training Program for Clinical Research on
52
Ophthalmology
AIDS" at the Baylor College of Medicine, with an increase in the number of postdoctoral trainees supported from two to four per year based on the quality and productivity of the three program graduates and one continuing trainee. Trainees also have the opportunity to obtain a Masters Degree in Public Health from the University of Texas School of Public Health. The Training Program for Clinical Research on AIDS has a three-part structure which includes 1) laboratory-based clinical research, 2) clinical research trials, and 3) clinical epidemiology. A total of 14 investigators comprise the faculty directly associated with the training program. An array of opportunities in clinical research is available to the trainees. These include a number of clinical pediatric research projects at the Texas Children's Hospital and the Baylor College of Medicine main campus, including a pediatric ACTU, a Women and Infants Transmission Study (WITS), and a number of R01-supported pediatric investigations, all fostered through the Baylor Center for AIDS Research (CFAR) grant. A Virologic Core facility, under the direction of Dr. Blaine Hollinger, serves as a resource for all of the clinical research activities. Additional, federally-funded research projects are available in the Departments of Molecular Genetics, Microbiology and Immunology, and Ophthalmology, as well as through the Houston Veteran's Affairs Medical Center and the Thomas Street Clinic. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRAINING PROGRAM IN THE MOLECULAR BASES OF EYE DISEASE Principal Investigator & Institution: Kazlauskas, Andrius; Associate Professor; Schepens Eye Research Institute Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 01-FEB-1997; Project End 31-JAN-2006 Summary: (Applicant's Abstract) A postdoctoral training program that fosters research addressing the underlying molecular basis of eye diseases has been created through the Department of Ophthalmology at Harvard Medical School. The program is designed to provide expertise in the most current molecular research techniques and to equip the trainees with a knowledge of the outstanding problems in ophthalmology. Thirty-two faculty mentors, all with appointments or affiliations with the Department of Ophthalmology at Harvard Medical School, are drawn from laboratories of the Massachusetts Eye and Ear Infirmary, the Schepens Eye Research Institute, the Brigham and Women's Hospital, the Longwood Campus Basic Science Departments and the Department of Molecular and Cellular Biology on the Cambridge Campus. These mentors command well funded programs, research opportunities for ophthalmic and vision research using current molecular techniques, and have excellent facilities. Since 1997, when the Training Program was initiated, 10 trainees have matriculated, and 3 new trainees have been admitted within the past month. Each trainee is expected to spend two to three years in training. Trainees (i) participate in full-time research to obtain a mastery of molecular techniques in biochemistry, cell biology, genetics, immunology, or neurobiology as applied to ophthalmology and vision; (ii) acquire training in ophthalmic problems through a series of didactic courses, clinical grand rounds, seminars, journal clubs, meetings; and (iii) write and submit grant proposals to obtain individual support for second and third year of training under the guidance of a formal course in principles of grant submission. In this renewal application, we seek support to extend our program for five additional years. We propose to increase the number of trainees admitted per year to 9 over the course of this period, and to expand the applicant pool to include MDs and DVMs who have completed their
Studies
53
ophthalmology training. Our goal is to train the next generation of investigators who can address problems of diagnoses, prevention, and treatment of diseases of the eye. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRAINING PROGRAM IN THE NEUROSCIENCES Principal Investigator & Institution: Llinas, Rodolfo R.; Chairman; Physiology and Neuroscience; New York University School of Medicine 550 1St Ave New York, Ny 10016 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2005 Summary: (ADAPTED FROM THE APPLICANT'S ABSTRACT): This application is for a new, broad based neuroscience program at the New York University School of Medicine. The training faculty includes 28 distinguished neuroscientists representing the Departments of Cell Biology, Neurology, Neurosurgery, Ophthalmology, Pharmacology, and Physiology & Neuroscience. The diverse research interests of the program faculty include molecular neurobiology, developmental genetics, synaptogenesis, neuron and glial cell structure and function, signal transduction, ion channel and receptor function, motor and sensory systems, brain imaging and cognition. This program will provide solid, broad based training of predoctoral students, with the overall goal to produce competitive, skillful neuroscientists positioned to make significant and diverse contributions to the field. Towards this goal, trainees will participate in a number of core and advanced courses, weekly seminars, journal clubs and tutorials that are designed to ensure broad exposure in the neurosciences. Research collaborations between trainees and participating faculty will be fostered through initial laboratory rotations followed by mentoring of dissertation studies by individual faculty members. The basic and clinical neuroscientists that make up the program faculty will emphasis training relevant to disorders of the nervous system such as Alzheimer's, multiple sclerosis, Parkinson's, muscular dystrophy, Tay-Sachs, stroke and spinal cord injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: ULTRASONIC EVALUATION OF OCULAR TISSUES Principal Investigator & Institution: Lizzi, Frederic L.; Research Director; Riverside Research Institute 156 William St, 9Th Fl New York, Ny 10038 Timing: Fiscal Year 2002; Project Start 06-DEC-1996; Project End 30-NOV-2003 Summary: This research is conducted jointly by Riverside Research Institute (RRI) and Cornell University Medical College (CUMC). Its long-term objective is to advance the diagnosis, treatment planning, and treatment monitoring of ocular diseases, primarily glaucoma, a leading cause of blindness. Interwoven engineering efforts (at RRI) and clinical studies (at CUMC) will build upon previous methods that have successfully diagnosed ocular tumors by analyzing radio-frequency (RF) echo signals to extract information not available with conventional ultrasound systems. Novel very-highfrequency ultrasound (VHFU) techniques will be used to substantially advance tissue evaluations. Digital RF data will be acquired during multi-plane VHFU scanning of the entire anterior segment. Acquired data will be segmented for use in highly detailed- 3-D representations of anterior structures involved in glaucoma and hypotony. Elements as small as 20 micromoles will be resolved. Biometric data (dimensions, surface areas, volumes) will be derived for relevant compartments, including the anterior chamber and ciliary processes. Internal microstructure of selected volumes will be evaluated in terms of the effective sizes, concentrations, mechanical properties, and shapes of tissue
54
Ophthalmology
constituents as small as 5 micromoles. Tissue assays will be performed using advanced l-D and 2-D spectral techniques designed using a theoretical scattering model of tissue microstructure. The methods will be validated in laboratory and animal experiments. Measured features will be compared with light and acoustic microscopy to elucidate sensitivity to specific microstructural elements. A statistical framework will relate measurement and system variables to estimator precision. Animal and clinical studies will use data-base techniques to investigate the utility of these methods in evaluating glaucoma, hypotony, and small anterior tumors. Glaucoma studies will assay ciliary body morphology and response to drugs. 3-D techniques will assay the conformation and microstructure of key structures, including ciliary processes, ciliary muscles, and the trabecular meshwork. Studies in normotensive humans will establish control values for tissue parameters as a function of accommodation and age. Chronic open-angle glaucoma patients will be examined to quantify changes in the trabecular meshwork and alterations in ciliary body volume and scattering structure. Effects of glaucoma medication will be quantified. Simplified, standardized output formats of useful parameters will be derived to foster use of these techniques in ophthalmology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VERY-HIGH-FREQUENCY OPHTHALMOLOGY
ULTRASOUND
ARRAYS
FOR
Principal Investigator & Institution: Ketterling, Jeffrey A.; Riverside Research Institute 156 William St, 9Th Fl New York, Ny 10038 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant): The ultimate objective of this research is to improve the care of ocular diseases and disorders, including glaucoma, ocular trauma and tumors, and vision deficiencies by providing clinicians with dramatically improved ultrasonic images of the entire anterior eye. The proposed research combines advanced high frequency, high-resolution ultrasonic annular-array transducers with novel digital signal processing concepts specifically designed to overcome several limits that have been reached with conventional high-frequency ultrasound systems; for example, the arrays improve the depth of focus by a factor of 10. The arrays are operated in a digital synthetic-aperture mode that permits dynamic focusing of both transmitted pulses and received echo signals. The dynamic focusing permits the microstructure of the anterior of the eye to be "in focus" throughout the entire tissue depth; currently, very high resolution (30 mu m) is available only in sub-millimeter focal depths. The program also uses digital frequency-equalization processing techniques to improve the spatial uniformity of focused beams and received echoes; this technique provides uniform sensitivity for imaging tissue microstructure. Synthetic-aperture and frequencyequalization techniques are combined to potentiate concepts that digitally enhance axial resolution (to better than 25 mu m) for biometric assays of the cornea and superior image detail. These techniques are also used to improve speckle suppression and image contrast, providing stable, characteristic grayscale images of complex microstructural segments e.g., the cilliary body and anterior ocular tumors. The proposed methods permit near real-time generation of 2-D images of the eye. To reach its goals, the program combines thorough digital simulations and transducer design, transduce fabrication, integrated digital processing and display, and laboratory testing. Concepts are validated and refined using scans of in-vitro porcine eyes and in-vivo rabbit eyes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
55
Project Title: VISION RESEARCH CENTER (CORE) Principal Investigator & Institution: Wilson, Steven E.; Professor; Ophthalmology; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 01-JUN-1976; Project End 31-MAY-2006 Summary: Investigators who have achieved independent National Eye Institute (NEI) funding will be provided with additional shared support to enhance their own and University of Washington's capability for conducting vision research. Collaborative studies will be attracted to research on the visual system by present of this shared support. A modular organizational structure will be maintained, with each module devoted to a specific activity that would be impractical or less efficient to support on an individual research grant. Each module will support a service or resource that enhances or facilitates the research efforts of a core group of investigators each having independent funding. Some sharing of resources and services with non-NEI-funded collaborators and with investigators new to vision research will occur. Proposed modules include: Biochemistry/Immunology (B/I), Molecular Techniques (MT), Morphology/Morphometry (M/M), Psychophysics/Physiology (P/P), and Research Imaging (RI). Areas of investigation include retinal and chroidal diseases, corneal wound healing, corneal diseases, lens and cataract, glaucoma, strabismus, amblyopia, visual processing, and ocular development. Specific disciplines that will be brought to bear on these problems include: behavioral studies, biochemistry, biostatistics, molecular biology, cell biology, clinical investigation, immunology, microbiology, morphometry, neurophysiology, and pathology. This project will elucidate basic mechanisms that underlie the function of the eye and the visual system and apply this knowledge and other information to the solution of problems in vision and ophthalmology. Collaboration among investigators from the University of Washington and elsewhere will be promoted. This proposal will improve the effectiveness of funding available on individual research project grants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: VISION RESEARCH INFRASTRUCTURE DEVELOPMENT GRANT (R24) Principal Investigator & Institution: Giblin, Frank J.; Professor; None; Oakland University Rochester, Mi 483094401 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): The objective of this R24 application is to enhance the research capabilities of Oakland University's vision researchers, and promote collaborative research among the vision research community within the University and the affiliated William Beaumont Hospital, Department of Ophthalmology. Ten investigators, seven from the Eye Research Institute at O.U. and three from the O.U. Department of Biological Sciences, are designated as participants in the program. Six of the investigators hold independent NEI research awards, and one has a first-award application currently under review. Programs include lens and cataract, retinal biochemistry and metabolism in health and disease, the role of extracellular matrix in ganglion cell death in glaucoma, photoreceptor-related mechanisms of retinal degeneration and coordination of gene expression in retinal development. Support is requested for two Modules, Cell and Molecular Biology, and Ocular Structure and Imaging, in order to reorganize and expand existing Tissue Culture and Electron Microscopy/Histology Modules from a prior NEI Core Grant held by O.U. for the past 16 years. The Cell and Molecular Biology Module will provide assistance to O.U. vision
56
Ophthalmology
researchers in the areas of tissue culture, basic molecular techniques, DNA sequencing and microarray technology, the latter in conjunction with the Sensory DNA Array Facility at the Kellogg Eye Center, University of Michigan. The Ocular Structure and Imaging Module will enhance the vision research environment of R24 participants by providing state-of-the-art capabilities for ultrastructure and imaging analysis using epifluorescence, routine light and confocal microscopy, as well as scanning and transmission electron microscopy. The availability of the requested facilities on a shared-use basis will greatly increase the vision research capabilities of O.U. investigators as well as Ophthalmologists, Residents and Fellows at Beaumont Hospital, who would otherwise not be able to afford the sophisticated equipment and services associated with the advanced techniques that are described. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: WILMER INST. MENTORED CLINICAL RESEARCH SCHOLAR PROGRAM Principal Investigator & Institution: Quigley, Harry A.; Ophthalmology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2008 Summary: (Provided by the applicant): The Wilmer Institute Mentored Clinical Research Scholar Program (Wilmer CRS) is a multidisciplinary, educational effort centered in the Department of Ophthalmology, Johns Hopkins University School of Medicine, whose purpose is the provision of skills in patient--oriented research to young faculty members in the Vision Sciences, Ophthalmic Epidemiology, Clinical Trials, Genetics, and Technology Assessment, among others. Building on a successful track-record of training clinician scientists, the Wilmer CRS will formally link the existing programs administered within the department under Director Harry A. Quigley, and Wilmer CRS Program Advisory Committee Members: Douglas Jabs, Oliver Schein, Don Zack, Peter Campochiaro, and Sheila West. In addition to these faculty members, Lead Mentors will include Nathan Congdon, David Friedman, John Gottsch, Susan Vitale, Ruben Adler, Robert Massof, Kathleen Turano, James Tielsch, Joanne Katz, Irene Maumenee, Barbara Hawkins, and Curtis Meinert. The Wilmer CRS will administer didactic courses and personal mentored instruction in a wide variety of research areas to two candidates per year. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: YOUNG SCIENTIST SUPPORT FOR VISION STUDIES Principal Investigator & Institution: Blanks, Janet C.; Professor and Director; Association for Res in Vision & Ophthal Rockville, Md 208521606 Timing: Fiscal Year 2001; Project Start 01-DEC-1979; Project End 30-JUN-2002 Summary: The Association for Research in Vision and Ophthalmology (ARVO) requests continued support for travel funds for young investigators to attend its annual meetings for the next five years. The funds requested will provide partial travel support (approximately 70 percent of the cost) for 75 young investigators each year. Fellowship applications are sent out to the entire ARVO membership each year. To be eligible for a travel award, an individual must be a US citizen or permanent resident, have completed postdoctoral training or a residency within the past four years or be a current trainee, not have received an ARVO travel fellowship previously, not hold a current federal grant, and be first author on an abstract accepted for presentation. Over 90 percent of the submitted abstracts are selected for presentation each year. Recipients of travel
Studies
57
awards are selected by the meeting program committee. Of the 375 travel fellowship applications received for the 1996 meeting, a total of 105 (28 percent) received support, 69 (18 percent) of which were support by NEI. Up to 25 percent of the NEI-supported travel awards can go to minorities. ARVO waives the meeting registration fee for travel fellowship recipients, and ARVO covers all administrative expenses associated with the grant. The application was submitted by Dr. Janice Burke on behalf of ARVO. Dr. Burke is ARVO's Executive Vice President and a Professor at the Medical College of Wisconsin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “ophthalmology” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for ophthalmology in the PubMed Central database: •
A Classification Scheme for Ophthalmology. by Matas B.; 1963 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=197939
•
A Galaxy of Old Japanese Medical Books With Miscellaneous Notes on Early Medicine in Japan Part IV. Ophthalmology, Psychiary, Dentistry. by Mestler GE.; 1956 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=200027
•
Abstracts on Military and Aviation Ophthalmology and Visual Sciences. by Grunwell JR Jr.; 1954 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=199794
•
CD-Atlas of Ophthalmology. by Quandt KP.; 2000 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=35248
•
The application of selected evaluative measures to the library's monographic ophthalmology collection. by Gallagher KE.; 1981 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=226776
•
The Association of Vision Science Librarians' citation analysis of Duane's Clinical Ophthalmology. by Martin Watson M.; 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=141192
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
58
Ophthalmology
•
Why choose ophthalmology? by Anderson D, Romanchuk K.; 2003 May 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=155953
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with ophthalmology, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “ophthalmology” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for ophthalmology (hyperlinks lead to article summaries): •
14th International Neuro-Ophthalmology Society (INOS) Meeting, Buenos Aires, Argentina, May 5-8, 2002. Author(s): McFadzean RM, Mejico LJ. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2002 December; 22(4): 305-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464735&dopt=Abstract
•
29th annual North American Neuro-Ophthalmology Meeting, Snowbird, Utah, February 8-13, 2003. Author(s): Sedwick LA. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2003 September; 23(3): 242-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14531413&dopt=Abstract
•
A cost study of teleconsultation for primary-care ophthalmology and dermatology. Author(s): Lamminen H, Lamminen J, Ruohonen K, Uusitalo H. Source: Journal of Telemedicine and Telecare. 2001; 7(3): 167-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346477&dopt=Abstract
6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
Studies
59
•
A critical appraisal of current knowledge and future directions of ergophthalmology: consensus document of the ICOH Committee on 'Work and Vision'. Author(s): Piccoli B; ICOH Scientific Committee. Source: Ergonomics. 2003 March 15; 46(4): 384-406. Review. Erratum In: Ergonomics. 2003 June 20; 46(8): 873. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637175&dopt=Abstract
•
A meeting of ophthalmology minds from North and South America. Author(s): Boyd-Monk H. Source: J Ophthalmic Nurs Technol. 1999 November-December; 18(6): 252-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10795197&dopt=Abstract
•
A structured curriculum on ethics for ophthalmology residents is not valuable. Author(s): Smith ME. Source: Archives of Ophthalmology. 2002 July; 120(7): 965. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12096970&dopt=Abstract
•
A structured curriculum on ethics for ophthalmology residents is valuable. Author(s): Day SH. Source: Archives of Ophthalmology. 2002 July; 120(7): 963-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12096969&dopt=Abstract
•
A study of perforating eye injuries at the Ophthalmology Department, National University of Malaysia. Author(s): Zainal M, Goh PP. Source: Med J Malaysia. 1997 March; 52(1): 12-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10968048&dopt=Abstract
•
A survey of eye trauma and diseases at a teaching hospital: implications for training in occupational ophthalmology in Nigeria. Author(s): Asuzu MC, Bekibele C, Ashaye AO. Source: Occupational Medicine (Oxford, England). 2000 April; 50(3): 193-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10912363&dopt=Abstract
•
Accurate intraocular pressure measurement-the myth of modern ophthalmology? Author(s): Shah S. Source: Ophthalmology. 2000 October; 107(10): 1805-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11013176&dopt=Abstract
60
Ophthalmology
•
Adjustable sutures in pediatric ophthalmology and strabismus. Author(s): Strominger MB, Richards R. Source: J Ophthalmic Nurs Technol. 2000 May-June; 19(3): 142-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11249243&dopt=Abstract
•
Advances in immuno-ophthalmology. Author(s): Bielory L. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2000 May; 84(5): 471-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10830997&dopt=Abstract
•
Amalgamation of the International Society of Refractive Surgery and the American Academy of Ophthalmology. Author(s): Holladay J, Salz J, Waring GO 3rd. Source: Journal of Refractive Surgery (Thorofare, N.J. : 1995). 2003 May-June; 19(3): 299300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777024&dopt=Abstract
•
American ophthalmology graduate medical education and the web: current state of internet resource utilization. Author(s): Mayo GL, Lindhorst GC, Rosende C. Source: American Journal of Ophthalmology. 2003 May; 135(5): 708-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719082&dopt=Abstract
•
Analysis of publication trends in two internationally renowned ophthalmology journals. Author(s): Ang A, Tong L, Bhan A. Source: The British Journal of Ophthalmology. 2001 December; 85(12): 1497-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11734527&dopt=Abstract
•
Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO), Fort Lauderdale, Florida, May 5-10, 2002. Author(s): Sadun AA, Bose S. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2003 March; 23(1): 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616094&dopt=Abstract
•
Assessment of new technologies: the excimer laser in ophthalmology. Author(s): Lance JM, Regnier G. Source: Can J Ophthalmol. 2001 April; 36(3): 121-4. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11367582&dopt=Abstract
Studies
61
•
Assessment of ophthalmology residents' contact lens training. Author(s): Macaluso DC, Andre M, Caroline PJ, Suhler EB, Rich LF. Source: The Clao Journal : Official Publication of the Contact Lens Association of Ophthalmologists, Inc. 2000 October; 26(4): 221-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11071347&dopt=Abstract
•
Association for Research in Vision and Ophthalmology. Author(s): Romano PE. Source: Binocul Vis Strabismus Q. 2000 Winter; 15(4): 358-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11187153&dopt=Abstract
•
Attitudes to research and research training among ophthalmologists and ophthalmology trainees in New Zealand. Author(s): Jayasundera T, Fisk M, McGhee CN. Source: Clinical & Experimental Ophthalmology. 2003 August; 31(4): 294-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880452&dopt=Abstract
•
Automated perimetry: a report by the American Academy of Ophthalmology. Author(s): Delgado MF, Nguyen NT, Cox TA, Singh K, Lee DA, Dueker DK, Fechtner RD, Juzych MS, Lin SC, Netland PA, Pastor SA, Schuman JS, Samples JR; American Academy of Ophthalmology. Ophthalmic Technology Assessment Committee 2001-2002 Glaucoma Panel. Source: Ophthalmology. 2002 December; 109(12): 2362-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466186&dopt=Abstract
•
Benchmarks for ranking and improving ophthalmology residency programs. Author(s): Lee AG. Source: Archives of Ophthalmology. 2001 September; 119(9): 1395-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11545660&dopt=Abstract
•
Best practice treatment algorithm for primary open-angle glaucoma: implications for U.S. ophthalmology practice. Author(s): Serle J, Cantor L, Gross R, Katz J, Mundorf T, Noecker R, Severin T, Simmons S, Walt J, Casciano J, Evans S, Doyle J. Source: Manag Care Interface. 2002 July; 15(7): 37-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12143296&dopt=Abstract
•
Carbonic anhydrase inhibition in ophthalmology: aqueous humor secretion and the development of sulfonamide inhibitors. Author(s): Maren TH. Source: Exs. 2000; (90): 425-35. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11268528&dopt=Abstract
62
Ophthalmology
•
Carbonic anhydrase inhibition in ophthalmology: carbonic anhydrases in cornea, lens, retina and lacrimal gland. Author(s): Wistrand PJ. Source: Exs. 2000; (90): 413-24. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11268527&dopt=Abstract
•
Careers in ophthalmology. Author(s): Alwitry A. Source: Bmj (Clinical Research Ed.). 2002 June 1; 324(7349): S169. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12043740&dopt=Abstract
•
Citation analysis and journal impact factors in ophthalmology and vision science journals. Author(s): Sims JL, McGhee CN. Source: Clinical & Experimental Ophthalmology. 2003 February; 31(1): 14-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580889&dopt=Abstract
•
Clinical and Experimental Ophthalmology online. Author(s): Gillies MC. Source: Clinical & Experimental Ophthalmology. 2002 October; 30(5): 315. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12213153&dopt=Abstract
•
Clinical decision making in ophthalmology. Author(s): van der Meulen J, Rahi J. Source: The British Journal of Ophthalmology. 2002 June; 86(6): 599-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034675&dopt=Abstract
•
Clinical research in pediatric ophthalmology: the Pediatric Eye Disease Investigator Group. Author(s): Beck RW. Source: Current Opinion in Ophthalmology. 2002 October; 13(5): 337-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218466&dopt=Abstract
•
Clinician-scientists in ophthalmology. Author(s): Weinreb RN. Source: Archives of Ophthalmology. 2001 February; 119(2): 277-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11176993&dopt=Abstract
Studies
63
•
Collagen vascular diseases: cutaneous manifestations in ophthalmology. Author(s): Meldrum ML, Kurban RS, Foster CS, Albert DM, O'Brien JM. Source: Ophthalmic Plastic and Reconstructive Surgery. 2000 November; 16(6): 459-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11106192&dopt=Abstract
•
Color-Doppler sonography in ophthalmology. Author(s): Cianci R, Mander A, Santarelli G, Lai S, Faraglia V, Pulcinelli G, Ciano G, Manfredini P, Mariotti A, Clemenzia G. Source: Minerva Cardioangiol. 2000 March; 48(3): 61-7. English, Italian. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10838835&dopt=Abstract
•
Comparing light sensitivity, linearity and step response of electronic cameras for ophthalmology. Author(s): Kopp O, Markert S, Tornow RP. Source: Biomed Tech (Berl). 2002; 47 Suppl 1 Pt 2: 602-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12465250&dopt=Abstract
•
Considerations for choosing an electronic medical record for an ophthalmology practice. Author(s): DeBry PW. Source: Archives of Ophthalmology. 2001 April; 119(4): 590-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11296027&dopt=Abstract
•
Corticosteroids in ophthalmology. Author(s): Pleyer U, Sherif Z. Source: Ernst Schering Res Found Workshop. 2002; (40): 65-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355729&dopt=Abstract
•
Corticosteroids in ophthalmology: past-present-future. Author(s): Sherif Z, Pleyer U. Source: Ophthalmologica. Journal International D'ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde. 2002 September-October; 216(5): 305-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12424394&dopt=Abstract
•
Cyclophotocoagulation: a report by the American Academy of Ophthalmology. Author(s): Pastor SA, Singh K, Lee DA, Juzych MS, Lin SC, Netland PA, Nguyen NT. Source: Ophthalmology. 2001 November; 108(11): 2130-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11713091&dopt=Abstract
64
Ophthalmology
•
Danish ophthalmology from 1950 to 1975. Author(s): Ehlers N. Source: Acta Ophthalmologica Scandinavica. Supplement. 2002 April; 234: 46-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12082977&dopt=Abstract
•
Developmental genetics in ophthalmology. Author(s): Graw J, Loster J. Source: Ophthalmic Genetics. 2003 March; 24(1): 1-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660863&dopt=Abstract
•
Developmental neurogenetics and neuro-ophthalmology. Author(s): Bennett JL. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2002 December; 22(4): 286-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464733&dopt=Abstract
•
Digital database for clinical ophthalmology and telemedicine. Author(s): Warnicki JW, Justice J Jr, Justice MK. Source: Insight (American Society of Ophthalmic Registered Nurses). 2001 JulySeptember; 26(3): 81-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11677507&dopt=Abstract
•
Double-vision: stereo photography in ophthalmology. Author(s): Colton B. Source: The Journal of Audiovisual Media in Medicine. 2001 June; 24(2): 71-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11428313&dopt=Abstract
•
Endonasal dacryocystorhinostomy: a report by the American Academy of Ophthalmology. Author(s): Woog JJ, Kennedy RH, Custer PL, Kaltreider SA, Meyer DR, Camara JG. Source: Ophthalmology. 2001 December; 108(12): 2369-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11733286&dopt=Abstract
•
Epidemiology in ophthalmology. Author(s): Wilson MR. Source: Archives of Ophthalmology. 2001 September; 119(9): 1374-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11545647&dopt=Abstract
Studies
65
•
Ethics in ophthalmology. Author(s): Sloan SH. Source: Trans Am Acad Ophthalmol Otolaryngol. 1977 September-October; 83(5): Op849-52. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11643426&dopt=Abstract
•
European ophthalmology from a British perspective. Author(s): Kirkness CM. Source: The British Journal of Ophthalmology. 2002 February; 86(2): 128-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11815332&dopt=Abstract
•
Evaluation of patient waiting times at an academic ophthalmology clinic. Author(s): Kapustiak J, Ling H. Source: J Med Pract Manage. 2000 March-April; 15(5): 228-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10915514&dopt=Abstract
•
Evidence-based neuro-ophthalmology: advances in treatment. Author(s): Balcer LJ. Source: Current Opinion in Ophthalmology. 2001 December; 12(6): 387-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11734677&dopt=Abstract
•
Evidence-guided ophthalmology. Author(s): Fong DS, Ferris FL 3rd. Source: Archives of Ophthalmology. 2001 April; 119(4): 585-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11296026&dopt=Abstract
•
False and non-localizing signs in neuro-ophthalmology. Author(s): Lepore FE. Source: Current Opinion in Ophthalmology. 2002 December; 13(6): 371-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441839&dopt=Abstract
•
Financing new drug development in ophthalmology. Author(s): Novack GD. Source: Journal of Glaucoma. 2000 April; 9(2): 195-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10782633&dopt=Abstract
•
Founding and early history of the American Association for Pediatric Ophthalmology and Strabismus. Author(s): Parks MM. Source: J Aapos. 2001 August; 5(4): 199-202. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11507577&dopt=Abstract
66
Ophthalmology
•
Health, medicine, and ophthalmology. Author(s): Masket S. Source: American Journal of Ophthalmology. 2000 September; 130(3): 379-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11183559&dopt=Abstract
•
Implementing a nurse-led telephone advice system in ophthalmology. Author(s): Rendell J. Source: Insight (American Society of Ophthalmic Registered Nurses). 1999 OctoberDecember; 24(4): 112-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907912&dopt=Abstract
•
Improved student learning in ophthalmology with computer-aided instruction. Author(s): Devitt P, Smith JR, Palmer E. Source: Eye (London, England). 2001 October; 15(Pt 5): 635-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11702976&dopt=Abstract
•
Increasing geriatrics expertise in ophthalmology. Author(s): Lee AG, Liesegang T. Source: Ophthalmology. 2002 April; 109(4): 635-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927417&dopt=Abstract
•
Information technology and ophthalmology. Author(s): Sangwan VS. Source: Indian J Ophthalmol. 2000 September; 48(3): 169-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11217248&dopt=Abstract
•
International ophthalmology strategic plan to preserve and restore vision-vision for the future. Author(s): Straatsma BR, Coscas GJ, Naumann GO, Spivey BE, Taylor HR, Tso MO. Source: American Journal of Ophthalmology. 2001 September; 132(3): 403-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530055&dopt=Abstract
•
International ophthalmology strategic plan to preserve and restore vision-vision in the future. Author(s): Roy H. Source: American Journal of Ophthalmology. 2002 April; 133(4): 591; Author Reply 591. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11931816&dopt=Abstract
•
International transmission of tele-ophthalmology images. Author(s): Yogesan K, Constable IJ, Morgan W, Soebadi DY. Source: Journal of Telemedicine and Telecare. 2000; 6(1): 41-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10824390&dopt=Abstract
Studies
67
•
Intracameral anesthesia: a report by the American Academy of Ophthalmology. Author(s): Karp CL, Cox TA, Wagoner MD, Ariyasu RG, Jacobs DS. Source: Ophthalmology. 2001 September; 108(9): 1704-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11535476&dopt=Abstract
•
Intraocular lens implantation in the absence of capsular support: a report by the American Academy of Ophthalmology. Author(s): Wagoner MD, Cox TA, Ariyasu RG, Jacobs DS, Karp CL; American Academy of Ophthalmology. Source: Ophthalmology. 2003 April; 110(4): 840-59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12689913&dopt=Abstract
•
Intrastromal corneal ring segments for low myopia: a report by the American Academy of Ophthalmology. Author(s): Rapuano CJ, Sugar A, Koch DD, Agapitos PJ, Culbertson WW, de Luise VP, Huang D, Varley GA. Source: Ophthalmology. 2001 October; 108(10): 1922-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11581075&dopt=Abstract
•
Introduction to apoptosis in ophthalmology. Author(s): Carella G. Source: Eur J Ophthalmol. 2003 April; 13 Suppl 3: S5-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749671&dopt=Abstract
•
IOLs, innovation, and ethics in pediatric ophthalmology: let's be honest. Author(s): Levin AV. Source: J Aapos. 2002 June; 6(3): 133-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075287&dopt=Abstract
•
Is acupuncture an useful tool for pain-treatment in ophthalmology? Author(s): Nepp J, Jandrasits K, Schauersberger J, Schild G, Wedrich A, Sabine GL, Spacek A. Source: Acupuncture & Electro-Therapeutics Research. 2002; 27(3-4): 171-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638737&dopt=Abstract
•
Is ophthalmology evidence based? A clinical audit of the emergency unit of a regional eye hospital. Author(s): Lai TY, Wong VW, Leung GM. Source: The British Journal of Ophthalmology. 2003 April; 87(4): 385-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12642295&dopt=Abstract
68
Ophthalmology
•
Ketamine anaesthesia for paediatric ophthalmology surgery. Author(s): Pun MS, Thakur J, Poudyal G, Gurung R, Rana S, Tabin G, Good WV, Ruit S. Source: The British Journal of Ophthalmology. 2003 May; 87(5): 535-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714385&dopt=Abstract
•
Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy: a report by the American Academy of Ophthalmology. Author(s): Sugar A, Rapuano CJ, Culbertson WW, Huang D, Varley GA, Agapitos PJ, de Luise VP, Koch DD. Source: Ophthalmology. 2002 January; 109(1): 175-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772601&dopt=Abstract
•
Lasers in ophthalmology. Author(s): Gilmour MA. Source: The Veterinary Clinics of North America. Small Animal Practice. 2002 May; 32(3): 649-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064046&dopt=Abstract
•
Lasers in ophthalmology. Author(s): Seitz B, Langenbucher A. Source: Lancet. 2000 December; 356 Suppl: S26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191482&dopt=Abstract
•
Litigation in ophthalmology. Author(s): Laatikainen L. Source: Acta Ophthalmologica Scandinavica. 2003 August; 81(4): 319-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12859255&dopt=Abstract
•
Looking into the mirror: research productivity in Australian ophthalmology. Author(s): McMenamin PG. Source: Clinical & Experimental Ophthalmology. 2003 August; 31(4): 281-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880449&dopt=Abstract
•
Lyophilisates for drug delivery in ophthalmology: pharmacokinetics of fluorescein in the human anterior segment. Author(s): Dinslage S, Diestelhorst M, Weichselbaum A, Suverkrup R. Source: The British Journal of Ophthalmology. 2002 October; 86(10): 1114-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12234889&dopt=Abstract
Studies
69
•
Measuring surgical skill and proclivity in ophthalmology residency training program applicants using the American Dental Association Dental Admission (Sample) Test (DAT). Author(s): Romano PE. Source: Binocul Vis Strabismus Q. 2002 Summer; 17(2): 143-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12067272&dopt=Abstract
•
Medical imaging in pediatric ophthalmology. Author(s): Mafee MF, Mafee RF, Malik M, Pierce J. Source: Pediatric Clinics of North America. 2003 February; 50(1): 259-86. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12713117&dopt=Abstract
•
Medicine in Malaysia: ophthalmology. Author(s): Selvarajah S. Source: Med J Malaysia. 1995 May; 50 Suppl A: S79-85. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10968023&dopt=Abstract
•
Methicillin-resistant Staphylococcus aureus in ophthalmology, occurrence, sanitation measures and hygienic precautions. Author(s): Wagenvoort JH. Source: Dev Ophthalmol. 2002; 33: 199-206. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236110&dopt=Abstract
•
Mitochondrial diseases in pediatric ophthalmology. Author(s): Phillips PH, Newman NJ. Source: J Aapos. 1997 June; 1(2): 115-22. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10875089&dopt=Abstract
•
Modelling bivariate ordinal responses smoothly with examples from ophthalmology and genetics. Author(s): Bustami R, Lesaffre E, Molenberghs G, Loos R, Danckaerts M, Vlietinck R. Source: Statistics in Medicine. 2001 June 30; 20(12): 1825-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11406844&dopt=Abstract
•
Neuroimaging contrast agents in ophthalmology. Author(s): Lee AG, Hayman LA, Ross AW. Source: Survey of Ophthalmology. 2000 November-December; 45(3): 237-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11094248&dopt=Abstract
70
Ophthalmology
•
Neuro-ophthalmology of mitochondrial diseases. Author(s): Biousse V, Newman NJ. Source: Current Opinion in Neurology. 2003 February; 16(1): 35-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544855&dopt=Abstract
•
Neuro-ophthalmology of mitochondrial diseases. Author(s): Biousse V, Newman NJ. Source: Seminars in Neurology. 2001 September; 21(3): 275-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11641818&dopt=Abstract
•
Neuro-ophthalmology of mitochondrial diseases. Author(s): Riordan-Eva P. Source: Current Opinion in Ophthalmology. 2000 December; 11(6): 408-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11141634&dopt=Abstract
•
Neuro-ophthalmology of movement disorders. Author(s): Hamilton SR. Source: Current Opinion in Ophthalmology. 2000 December; 11(6): 403-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11141633&dopt=Abstract
•
Neuro-ophthalmology of the phacomatoses. Author(s): Kerrison JB. Source: Current Opinion in Ophthalmology. 2000 December; 11(6): 413-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11141635&dopt=Abstract
•
Neuro-ophthalmology of the pregeniculate afferent visual system: January-December 1999. Author(s): Balcer LJ, Galetta SL. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2000 September; 20(3): 173-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11001194&dopt=Abstract
•
New American Academy of Ophthalmology recommendations on screening for hydroxychloroquine retinopathy. Author(s): Marmor MF. Source: Arthritis and Rheumatism. 2003 June; 48(6): 1764. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12794848&dopt=Abstract
•
New antifungal therapy in ophthalmology. Author(s): Lieberman TW, Leopold IH. Source: Trans Am Ophthalmol Soc. 1973; 71: 233-42. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10949601&dopt=Abstract
Studies
71
•
Now we number 33: women in ophthalmology at the Massachusetts Eye and Ear Infirmary in 2002. Author(s): Colby K. Source: Archives of Ophthalmology. 2002 December; 120(12): 1738-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12470151&dopt=Abstract
•
Open drops in ophthalmology offices: expiration and contamination. Author(s): Wessels IF, Bekendam P, Calvin WS, Zimmerman GJ. Source: Ophthalmic Surgery and Lasers. 1999 July-August; 30(7): 540-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10929977&dopt=Abstract
•
Ophthalmology and general medicine. Author(s): Karseras A. Source: Postgraduate Medical Journal. 2000 September; 76(899): 551-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10964117&dopt=Abstract
•
Ophthalmology in Australia. Author(s): Mitchell P. Source: Archives of Ophthalmology. 2002 October; 120(10): 1375-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365919&dopt=Abstract
•
Ophthalmology in Finland. Author(s): Kivela T. Source: Archives of Ophthalmology. 2003 October; 121(10): 1471-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14557186&dopt=Abstract
•
Ophthalmology in Hong Kong. Author(s): Lam DS, Tham CC. Source: The British Journal of Ophthalmology. 2003 February; 87(2): 130-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543735&dopt=Abstract
•
Ophthalmology in Iceland. Author(s): Alsbirk PH. Source: Acta Ophthalmologica Scandinavica. Supplement. 2002 April; 234: 45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12082976&dopt=Abstract
•
Ophthalmology in India. Author(s): Rao GN. Source: Archives of Ophthalmology. 2000 October; 118(10): 1431-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11030829&dopt=Abstract
72
Ophthalmology
•
Ophthalmology in Israel. Author(s): Melamed S. Source: Archives of Ophthalmology. 2001 October; 119(10): 1535-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594958&dopt=Abstract
•
Ophthalmology in Peru. Author(s): Gleiser-Boiko J. Source: Archives of Ophthalmology. 2002 October; 120(10): 1373-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12365918&dopt=Abstract
•
Ophthalmology in Portugal. Author(s): Cunha-Vaz JG. Source: Archives of Ophthalmology. 2000 October; 118(10): 1435-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11030831&dopt=Abstract
•
Ophthalmology in Russia. Author(s): Babich G. Source: Archives of Ophthalmology. 2001 October; 119(10): 1537-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594959&dopt=Abstract
•
Ophthalmology in Spain. Author(s): Saornil MA. Source: Archives of Ophthalmology. 2000 October; 118(10): 1433-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11030830&dopt=Abstract
•
Ophthalmology in Sweden. Author(s): Alm A. Source: Archives of Ophthalmology. 2003 October; 121(10): 1469-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14557185&dopt=Abstract
•
Ophthalmology in the European Union at the beginning of the 21st century and its opening towards Eastern Europe. Author(s): Grewe R. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 2000 October; 238(10): 812-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11127566&dopt=Abstract
•
Ophthalmology in the Kingdom of Saudi Arabia. Author(s): Wagoner MD, al-Rajhi AA. Source: Archives of Ophthalmology. 2001 October; 119(10): 1539-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594960&dopt=Abstract
Studies
73
•
Ophthalmology inpatient consultation. Author(s): Carter K, Miller KM. Source: Ophthalmology. 2001 August; 108(8): 1505-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11470711&dopt=Abstract
•
Ophthalmology of shaken baby syndrome. Author(s): Levin AV. Source: Neurosurg Clin N Am. 2002 April; 13(2): 201-11, Vi. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12391704&dopt=Abstract
•
Ophthalmology resident training in refractive surgery. Author(s): Aaron MM, Aaberg TM. Source: American Journal of Ophthalmology. 2001 February; 131(2): 241-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11228302&dopt=Abstract
•
Ophthalmology update for primary practitioners. Part I. Update on optic neuritis. Author(s): Granadier RJ. Source: Disease-A-Month : Dm. 2000 August; 46(8): 508-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10969715&dopt=Abstract
•
Ophthalmology update for the primary practitioner. Part II. Therapeutic management of age-related macular degeneration. Author(s): Sarrafizadeh R, Trese MT. Source: Disease-A-Month : Dm. 2000 August; 46(8): 533-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10969716&dopt=Abstract
•
Ophthalmology. Author(s): Formanek R Jr. Source: Hosp Pract (Off Ed). 2000 May 15; 35(5): Suppl 44. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10866543&dopt=Abstract
•
Ophthalmology. Coming soon: 'wavefront eye surgery'? Author(s): Mackenzie D. Source: Science. 2003 March 14; 299(5613): 1655. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637718&dopt=Abstract
•
Ophthalmology. Screening and treatment of age-related and pathologic vision changes. Author(s): Rosenthal BP. Source: Geriatrics. 2001 December; 56(12): 27-31; Quiz 32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11766560&dopt=Abstract
74
Ophthalmology
•
Ophthalmology. Tailor-made vision descends to the eye of the beholder. Author(s): Mackenzie D. Source: Science. 2003 March 14; 299(5613): 1654-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637717&dopt=Abstract
•
Optometry and ophthalmology: the Internet connection--assessing consumer health web sites. Author(s): Soroka M, Schachne E, Saludes I. Source: Optometry. 2001 November; 72(11): 713-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12363259&dopt=Abstract
•
Orbital implants in enucleation surgery: a report by the American Academy of Ophthalmology. Author(s): Custer PL, Kennedy RH, Woog JJ, Kaltreider SA, Meyer DR. Source: Ophthalmology. 2003 October; 110(10): 2054-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14522788&dopt=Abstract
•
Overview. Predictive DNA testing in ophthalmology. Author(s): Mackey DA. Source: The British Journal of Ophthalmology. 2003 May; 87(5): 637-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714413&dopt=Abstract
•
Patient-focused urban tele-ophthalmology services. Author(s): Blomdahl S, Calissendorff B, Jacobsson U. Source: Journal of Telemedicine and Telecare. 2002; 8 Suppl 2: 43-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217130&dopt=Abstract
•
Patterns of prescription and drug use in ophthalmology in a tertiary hospital in Delhi. Author(s): Biswas NR, Jindal S, Siddiquei MM, Maini R. Source: British Journal of Clinical Pharmacology. 2001 March; 51(3): 267-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11298073&dopt=Abstract
•
Pediatric ophthalmology and strabismus in France. Author(s): Spielmann AC. Source: J Aapos. 2003 June; 7(3): 156-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825053&dopt=Abstract
•
Pediatric ophthalmology in the new millennium. Author(s): Kushner BJ. Source: Archives of Ophthalmology. 2000 September; 118(9): 1277-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10980775&dopt=Abstract
Studies
75
•
Physicians' liability in ophthalmology practice. Author(s): Mavroforou A, Michalodimitrakis E. Source: Acta Ophthalmologica Scandinavica. 2003 August; 81(4): 321-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12859256&dopt=Abstract
•
Predictive DNA testing in ophthalmology. Author(s): Mackey DA, Heon E, Webster AR. Source: The British Journal of Ophthalmology. 2003 May; 87(5): 633. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714411&dopt=Abstract
•
Predictive DNA testing in ophthalmology: view 1. Author(s): Heon E. Source: The British Journal of Ophthalmology. 2003 May; 87(5): 633-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714410&dopt=Abstract
•
Predictive DNA testing in ophthalmology: View 2. Author(s): Webster AR. Source: The British Journal of Ophthalmology. 2003 May; 87(5): 635-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714412&dopt=Abstract
•
Primary care and ophthalmology in the United Kingdom. Author(s): Riad SF, Dart JK, Cooling RJ. Source: The British Journal of Ophthalmology. 2003 April; 87(4): 493-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12642317&dopt=Abstract
•
Primary care in ophthalmology. Author(s): Thompson J. Source: The British Journal of Ophthalmology. 2003 April; 87(4): 380-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12642291&dopt=Abstract
•
Raman spectroscopy in ophthalmology: from experimental tool to applications in vivo. Author(s): Erckens RJ, Jongsma FH, Wicksted JP, Hendrikse F, March WF, Motamedi M. Source: Lasers in Medical Science. 2001; 16(4): 236-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11702629&dopt=Abstract
•
Random comments: neurologists and neuro-ophthalmology; the “ocular motor” system; and update on ophthalmoplegic migraine. Author(s): Daroff RB. Source: Seminars in Neurology. 2000; 20(1): 145-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10874784&dopt=Abstract
76
Ophthalmology
•
Randomized clinical trials in ophthalmology in 2001: twenty-fifth anniversary of the first publication from the Diabetic Retinopathy Study. Author(s): Bressler SB, Bressler NM. Source: American Journal of Ophthalmology. 2001 April; 131(4): 503-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11292415&dopt=Abstract
•
Recommendations on screening for chloroquine and hydroxychloroquine retinopathy: a report by the American Academy of Ophthalmology. Author(s): Marmor MF, Carr RE, Easterbrook M, Farjo AA, Mieler WF; American Academy of Ophthalmology. Source: Ophthalmology. 2002 July; 109(7): 1377-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12093666&dopt=Abstract
•
Recycling in ophthalmology. Author(s): Boyd-Monk H. Source: J Ophthalmic Nurs Technol. 1999 September-October; 18(5): 192-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10847044&dopt=Abstract
•
Report of the meeting of the American Academy of Pediatrics Section on Ophthalmology. “Why Can't EYE Learn?'. Author(s): Romano PE. Source: Binocul Vis Strabismus Q. 2001; 16(3): 217-21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11515565&dopt=Abstract
•
Requirements concerning antiseptics for periorbital, orbital and intraorbital application. Systemic tolerance of antiseptics used in ophthalmology. Author(s): Siegmund W, Giessmann T. Source: Dev Ophthalmol. 2002; 33: 57-65. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236128&dopt=Abstract
•
Research contributions in ophthalmology: Australia's productivity. Author(s): Davis M, Wilson CS. Source: Clinical & Experimental Ophthalmology. 2003 August; 31(4): 286-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880451&dopt=Abstract
•
Revolutions in ophthalmology. Author(s): Adhikari T, Sarkar K, Datta H, Biswas MC, Chatterjee PR. Source: J Indian Med Assoc. 2000 December; 98(12): 770-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11394476&dopt=Abstract
Studies
77
•
Rheopheresis for age-related macular degeneration: a novel indication for therapeutic apheresis in ophthalmology. Author(s): Klingel R, Fassbender C, Fischer I, Hattenbach L, Gumbel H, Pulido J, Koch F. Source: Therapeutic Apheresis : Official Journal of the International Society for Apheresis and the Japanese Society for Apheresis. 2002 August; 6(4): 271-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12164796&dopt=Abstract
•
Sample size for ophthalmology studies. Author(s): Naduvilath TJ, John RK, Dandona L. Source: Indian J Ophthalmol. 2000 September; 48(3): 245-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11217261&dopt=Abstract
•
Screening elderly patients in an outpatient ophthalmology clinic for dementia, depression, and functional impairment. Author(s): Lee AG, Beaver HA, Jogerst G, Daly JM. Source: Ophthalmology. 2003 April; 110(4): 651-7; Discussion 657. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12689881&dopt=Abstract
•
Segmentation techniques for tissue differentiation in MRI of ophthalmology using fuzzy clustering algorithms. Author(s): Yang MS, Hu YJ, Lin KC, Lin CC. Source: Magnetic Resonance Imaging. 2002 February; 20(2): 173-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034338&dopt=Abstract
•
Semifluorinated alkanes--a new class of compounds with outstanding properties for use in ophthalmology. Author(s): Meinert H, Roy T. Source: Eur J Ophthalmol. 2000 July-September; 10(3): 189-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11071025&dopt=Abstract
•
Signs and symptoms in ophthalmology. Author(s): Boyd-Monk H. Source: J Ophthalmic Nurs Technol. 2000 September-October; 19(5): 212-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11933313&dopt=Abstract
•
Stem cells in ophthalmology. Author(s): Pantcheva MB, Mukai S. Source: International Ophthalmology Clinics. 2001 Fall; 41(4): 241-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11698752&dopt=Abstract
78
Ophthalmology
•
Strabology report of the 26th annual meeting of the American Association for Pediatric Ophthalmology and Strabismus. Author(s): Mims JL. Source: Binocul Vis Strabismus Q. 2000 Summer; 15(2): 155-62. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10950619&dopt=Abstract
•
Strabology report of the 28th annual meeting of the American Association for Pediatric Ophthalmology and Strabismus. Author(s): Mims JL 3rd. Source: Binocul Vis Strabismus Q. 2002 Summer; 17(2): 148-57. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075604&dopt=Abstract
•
Strabology Report of the 29th Annual Meeting of the American Association for Pediatric Ophthalmology and Strabismus. The Hilton Waikoloa Village, Waikoloa, Hawaii, March 23-27, 2003. Author(s): Mims JL 3rd. Source: Binocul Vis Strabismus Q. 2003 Spring-Summer; 18(2): 104-14. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785320&dopt=Abstract
•
Surgical management of macular holes: a report by the American Academy of Ophthalmology. Author(s): Benson WE, Cruickshanks KC, Fong DS, Williams GA, Bloome MA, Frambach DA, Kreiger AE, Murphy RP. Source: Ophthalmology. 2001 July; 108(7): 1328-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11425696&dopt=Abstract
•
Surgical training in ophthalmology. Author(s): Gibson A, Boulton M, Watson M, Fielder A. Source: Lancet. 2002 November 23; 360(9346): 1702. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457834&dopt=Abstract
•
Systemic disease and neuro-ophthalmology: annual update 2000 (Part I). Author(s): Arnold AC, Lee AG. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2001 March; 21(1): 46-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11315984&dopt=Abstract
•
Systemic disease and neuro-ophthalmology: annual update 2000 (Part II). Author(s): Frohman LP. Source: Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 2001 June; 21(2): 74-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11450905&dopt=Abstract
Studies
79
•
Telemedicine and tele-ophthalmology. Author(s): Burnier MN Jr. Source: Can J Ophthalmol. 2003 August; 38(5): 343, 345. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956273&dopt=Abstract
•
Telemedicine framework and applications in dermatology and ophthalmology. Author(s): Lamminen H, Voipio V, Ruohonen K. Source: Annals of Medicine. 2001 May; 33(4): 222-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11405542&dopt=Abstract
•
Telemedicine in ophthalmology. Author(s): Hammack GG. Source: Current Problems in Dermatology. 2003; 32: 127-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472001&dopt=Abstract
•
Telemedicine in ophthalmology. Author(s): Lamminen H, Voipio V, Ruohonen K, Uusitalo H. Source: Acta Ophthalmologica Scandinavica. 2003 April; 81(2): 105-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752046&dopt=Abstract
•
Telemedicine in ophthalmology. Author(s): Prasad S, Verma D, Nagpal M. Source: J Indian Med Assoc. 2001 October; 99(10): 567, 570-1, 574-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018542&dopt=Abstract
•
Tele-ophthalmology for the treatment in primary care of disorders in the anterior part of the eye. Author(s): Blomdahl S, Maren N, Lof R. Source: Journal of Telemedicine and Telecare. 2001; 7 Suppl 1: 25-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11576480&dopt=Abstract
•
Teleophthalmology link between a primary health care centre and a reference hospital. Author(s): Gonzalez F, Iglesias R, Suarez A, Gomez-Ulla F, Perez R. Source: Medical Informatics and the Internet in Medicine. 2001 October-December; 26(4): 251-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11783710&dopt=Abstract
80
Ophthalmology
•
Tele-ophthalmology screening for retinal and anterior segment diseases. Author(s): Yogesan K, Cuypers M, Barry CJ, Constable IJ, Jitskaia L. Source: Journal of Telemedicine and Telecare. 2000; 6 Suppl 1: S96-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10793986&dopt=Abstract
•
Tele-ophthalmology via stereoscopic digital imaging: a pilot project. Author(s): Tennant MT, Rudnisky CJ, Hinz BJ, MacDonald IM, Greve MD. Source: Diabetes Technology & Therapeutics. 2000 Winter; 2(4): 583-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11469622&dopt=Abstract
•
Texas Society for Pediatric Ophthalmology. Author(s): Mims JL. Source: Binocul Vis Strabismus Q. 2000 Winter; 15(4): 364-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11187155&dopt=Abstract
•
The American Journal of Ophthalmology announces online submission and peer review process. Author(s): Liesegang TJ. Source: American Journal of Ophthalmology. 2002 November; 134(5): 744-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12429252&dopt=Abstract
•
The American Journal of Ophthalmology: electronic augmentation on the Internet. Author(s): Prasad S. Source: American Journal of Ophthalmology. 2000 July; 130(1): 138-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11185715&dopt=Abstract
•
The Association of Vision Science Librarians' citation analysis of Duane's Clinical Ophthalmology. Author(s): Watson MM. Source: Journal of the Medical Library Association : Jmla. 2003 January; 91(1): 83-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568162&dopt=Abstract
•
The bedside and office neuro-ophthalmology examination. Author(s): Corbett JJ. Source: Seminars in Neurology. 2003 March; 23(1): 63-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870107&dopt=Abstract
•
The challenge of teaching ophthalmology: a Residency Review Committee perspective. Author(s): Sadun AA. Source: Ophthalmology. 2000 November; 107(11): 1971-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054314&dopt=Abstract
Studies
81
•
The changing of the guard in ophthalmology. Author(s): Boyd-Monk H. Source: J Ophthalmic Nurs Technol. 2000 November-December; 19(6): 264-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11933515&dopt=Abstract
•
The delivery of ophthalmic care: the practitioner, community ophthalmic teams, and contract ophthalmology. Author(s): Blach R. Source: The British Journal of Ophthalmology. 2001 November; 85(11): 1274-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11673286&dopt=Abstract
•
The determination of sample size in controlled clinical trials in ophthalmology. Author(s): Krummenauer F, Dick B, Schwenn O, Pfeiffer N. Source: The British Journal of Ophthalmology. 2002 September; 86(9): 946-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12185110&dopt=Abstract
•
The future of Clinical and Experimental Ophthalmology. Author(s): McGhee CN. Source: Clinical & Experimental Ophthalmology. 2003 February; 31(1): 1-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580885&dopt=Abstract
•
The future of paediatric ophthalmology. Author(s): Billson F. Source: Clinical & Experimental Ophthalmology. 2000 October; 28(5): 334-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11097276&dopt=Abstract
•
The impact of information technology on the practice of ophthalmology. Author(s): Prasad S, Nagpal M, Sharma OP, Nagpal PN. Source: Indian J Ophthalmol. 2000 September; 48(3): 237-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11217260&dopt=Abstract
•
The interface between ophthalmology and optometric vision therapy. Author(s): Press LJ. Source: Binocul Vis Strabismus Q. 2002 Summer; 17(2): 81. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12067261&dopt=Abstract
•
The interface between ophthalmology and optometric vision therapy. Author(s): Press LJ. Source: Binocul Vis Strabismus Q. 2002 Spring; 17(1): 6-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874377&dopt=Abstract
82
Ophthalmology
•
The man behind the syndrome: Argyll Robertson, Scotland's ambassador extraordinary in the realm of ophthalmology. Author(s): Hornsten G. Source: Journal of the History of the Neurosciences. 1994 January; 3(1): 61-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11618808&dopt=Abstract
•
The mechanisms of apoptosis in biology and medicine: a new focus for ophthalmology. Author(s): Tempestini A, Schiavone N, Papucci L, Witort E, Lapucci A, Cutri M, Donnini M, Capaccioli S. Source: Eur J Ophthalmol. 2003 April; 13 Suppl 3: S11-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749672&dopt=Abstract
•
The Moldova logs. A second report of international ophthalmology in Moldova. Author(s): Freedman H. Source: Binocul Vis Strabismus Q. 2002 Winter; 17(4): 319-24. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12470295&dopt=Abstract
•
The monthly variation in acute anterior uveitis in a community-based ophthalmology practice. Author(s): Levinson RD, Greenhill LH. Source: Ocular Immunology and Inflammation. 2002 June; 10(2): 133-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778349&dopt=Abstract
•
The ophthalmology patient's pain. Author(s): Boyd-Monk H. Source: J Ophthalmic Nurs Technol. 1999 July-August; 18(4): 136-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10847035&dopt=Abstract
•
The opportunity for international ophthalmology in treating blindness. Author(s): Spivey B. Source: Trans Am Ophthalmol Soc. 2001; 99: 73-6; Discussion 76-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11797322&dopt=Abstract
•
The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics. Author(s): Ghanem VC, Mehra N, Wong S, Mannis MJ. Source: Cornea. 2003 April; 22(3): 230-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658088&dopt=Abstract
Studies
83
•
The quality of reporting of randomized clinical trials published in Ophthalmology. Author(s): Sanchez-Thorin JC, Cortes MC, Montenegro M, Villate N. Source: Ophthalmology. 2001 February; 108(2): 410-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11158822&dopt=Abstract
•
The reliability of clinical methods in ophthalmology. Author(s): Margo CE, Harman LE, Mulla ZD. Source: Survey of Ophthalmology. 2002 July-August; 47(4): 375-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161213&dopt=Abstract
•
The use of antimicrobial peptides in ophthalmology: an experimental study in corneal preservation and the management of bacterial keratitis. Author(s): Mannis MJ. Source: Trans Am Ophthalmol Soc. 2002; 100: 243-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12545697&dopt=Abstract
•
The use of botulinum toxin in ophthalmology. Author(s): Denniston A, Reuser T. Source: Hosp Med. 2001 August; 62(8): 477-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530585&dopt=Abstract
•
The use of cycloplegic agents. Results of a 1999 survey of German-speaking centers for pediatric ophthalmology and strabology. Author(s): Loewen N, Barry JC. Source: Strabismus. 2000 June; 8(2): 91-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10980690&dopt=Abstract
•
The utility of ranking ophthalmology centers. The ranking of ophthalmology centers in ophthalmology and lay publications is appropriate for medicine in today's business world. Author(s): Guyer DR. Source: Archives of Ophthalmology. 2000 November; 118(11): 1580. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11074818&dopt=Abstract
•
The utility of ranking ophthalmology centers. The ranking of ophthalmology centers in ophthalmology and lay publications is not appropriate for medicine in today's business world. Author(s): Finkelstein D. Source: Archives of Ophthalmology. 2000 November; 118(11): 1579-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11074817&dopt=Abstract
84
Ophthalmology
•
The value of clinicopathological correlation in patient care, teaching and research in ophthalmology. Author(s): Burnier MN Jr. Source: Can J Ophthalmol. 2003 February; 38(1): 19-22. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608512&dopt=Abstract
•
Topical nonsteroidal antiinflammatory drugs in ophthalmology. Author(s): Flach AJ. Source: International Ophthalmology Clinics. 2002 Winter; 42(1): 1-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12189605&dopt=Abstract
•
Topical nonsteroidal anti-inflammatory therapy in ophthalmology. Author(s): Schalnus R. Source: Ophthalmologica. Journal International D'ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde. 2003 March-April; 217(2): 89-98. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12592044&dopt=Abstract
•
Training in ophthalmology is critical for all physicians. Author(s): Clarkson JG. Source: Archives of Ophthalmology. 2003 September; 121(9): 1327. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12963618&dopt=Abstract
•
Translational research in ophthalmology. Author(s): Ryan SJ, Hinton DR, Ogden TE, Rao N. Source: Archives of Ophthalmology. 2002 March; 120(3): 389-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11879146&dopt=Abstract
•
Two ophthalmology departments financed by compulsory health insurance: what is it that makes a difference in costs and clinical effectiveness? Author(s): Nasic M, Oreskovic S. Source: Croatian Medical Journal. 2002 August; 43(4): 433-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187521&dopt=Abstract
•
Undergraduate ophthalmology education survey of New Zealand ophthalmologists, general practitioners and optometrists. Author(s): Ah-Chan JJ, Sanderson G, Vote BJ, Molteno AC. Source: Clinical & Experimental Ophthalmology. 2001 December; 29(6): 416-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11778814&dopt=Abstract
Studies
85
•
Use of botulinum toxin in neuro-ophthalmology. Author(s): O'Day J. Source: Current Opinion in Ophthalmology. 2001 December; 12(6): 419-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11734681&dopt=Abstract
•
Usefulness of teleconsultations in neuro-ophthalmology. Author(s): Bremner F, Kennedy C, Rees A, Acheson J, Murdoch I. Source: Journal of Telemedicine and Telecare. 2002; 8(5): 305-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396861&dopt=Abstract
•
Utilization and practical aspects of tele-ophthalmology between South Africa and the UK. Author(s): Kennedy C, Van Heerden A, Cook C, Murdoch I. Source: Journal of Telemedicine and Telecare. 2001; 7 Suppl 1: 20-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11576478&dopt=Abstract
•
Viagra (sildenafil citrate) and ophthalmology. Author(s): Laties A, Zrenner E. Source: Progress in Retinal and Eye Research. 2002 September; 21(5): 485-506. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12207947&dopt=Abstract
•
Wavefront technology in ophthalmology. Author(s): Maeda N. Source: Current Opinion in Ophthalmology. 2001 August; 12(4): 294-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11507343&dopt=Abstract
•
Why choose ophthalmology? Author(s): Anderson D, Romanchuk K. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 May 27; 168(11): 1396. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771066&dopt=Abstract
•
Women in ophthalmology at Wills Eye Hospital. Author(s): Cohen EJ. Source: Archives of Ophthalmology. 2001 October; 119(10): 1562. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594970&dopt=Abstract
87
CHAPTER 2. NUTRITION AND OPHTHALMOLOGY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and ophthalmology.
Finding Nutrition Studies on Ophthalmology The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “ophthalmology” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
88
Ophthalmology
The following is a typical result when searching for recently indexed consumer information on ophthalmology: •
Archives of ophthalmology, Volume 8, 1932: Experimental cataract in vitamin G deficiency. Source: O'Brien, C S Nutr-Revolume 1989 August; 47(8): 235-7 0029-6643
The following information is typical of that found when using the “Full IBIDS Database” to search for “ophthalmology” (or a synonym): •
Clinical research in pediatric ophthalmology: the Pediatric Eye Disease Investigator Group. Author(s): Jaeb Center for Health Research, 3010 E. 138th Avenue, Suite 9, Tampa, FL 33613, U.S.A.
[email protected] Source: Beck, R W Curr-Opin-Ophthalmol. 2002 October; 13(5): 337-40 1040-8738
•
Diagnostic ophthalmology. Melting corneal ulcer. Author(s): Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4. Source: Grahn, B H Cullen, C L Can-Vet-J. 2001 August; 42(8): 656-7 0008-5286
•
Overview on community ophthalmology. Author(s): Institute of Ophthalmology, University College, London. Source: Johnson, G J J-Indian-Med-Assoc. 1999 August; 97(8): 305-8 0019-5847
•
The general development of Chinese ophthalmology. Source: Chen, Y Z Yan-Ke-Xue-Bao. 1987 September; 3(3): 139-42 1000-4432
•
The use of antimicrobial peptides in ophthalmology: an experimental study in corneal preservation and the management of bacterial keratitis. Author(s): Cornea Research Laboratory, Department of Ophthalmology, University of California, Davis, USA. Source: Mannis, M J Trans-Am-Ophthalmol-Soc. 2002; 100: 243-71 0065-9533
•
Topical use of chitosan in ophthalmology: tolerance assessment and evaluation of precorneal retention. Author(s): School of Pharmacy, University of Geneva, 30, Quai Ernest-Ansermet, CH1211, Geneva 4, Switzerland. Source: Felt, O Furrer, P Mayer, J M Plazonnet, B Buri, P Gurny, R Int-J-Pharm. 1999 April 15; 180(2): 185-93 0378-5173
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
•
The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
•
The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
Nutrition
89
•
The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
•
The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
•
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
•
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
•
Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
•
Google: http://directory.google.com/Top/Health/Nutrition/
•
Healthnotes: http://www.healthnotes.com/
•
Open Directory Project: http://dmoz.org/Health/Nutrition/
•
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
•
WebMDHealth: http://my.webmd.com/nutrition
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to ophthalmology; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Vitamin E Alternative names: Alpha-Tocopherol, Beta-Tocopherol, D-Alpha-Tocopherol, Delta-Tocopherol, Gamma-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Vitamin E Source: Prima Communications, Inc.www.personalhealthzone.com
90
Ophthalmology
•
Minerals Alpha-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Beta-tocopherol Source: Integrative Medicine Communications; www.drkoop.com D-alpha-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Delta-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Gamma-tocopherol Source: Integrative Medicine Communications; www.drkoop.com
•
Food and Diet Diabetes Source: Healthnotes, Inc.; www.healthnotes.com
91
CHAPTER 3. ALTERNATIVE OPHTHALMOLOGY
MEDICINE
AND
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to ophthalmology. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to ophthalmology and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “ophthalmology” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to ophthalmology: •
“Professor” Charles Tyrrell and his ideal sight restorer. Author(s): Ferry AP. Source: Ophthalmology. 1986 September; 93(9): 1246-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3543791&dopt=Abstract
•
A brief review of the development of ophthalmology in Croatia. Author(s): Gabric N, Henc-Petrinovic L. Source: Acta Med Croatica. 1993; 47(1): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7693078&dopt=Abstract
•
A practical application of hypnosis in the practice of ophthalmology. Author(s): Goode FH.
92
Ophthalmology
Source: J Tenn Med Assoc. 1971 February; 64(2): 119-21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5545941&dopt=Abstract •
Assessment of the existing state of ophthalmology in India. Ways and means for improvement. Author(s): Sinha RP. Source: Int Surg. 1968 December; 50(6): 533-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5698651&dopt=Abstract
•
Cardiac arrest in ophthalmology: its diagnosis and management. Author(s): MAGOON RC, NORTON EW. Source: Southern Medical Journal. 1964 July; 57: 836-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14175449&dopt=Abstract
•
Clinical application of acupuncture in ophthalmology. Author(s): Dabov S, Goutoranov G, Ivanova R, Petkova N. Source: Acupuncture & Electro-Therapeutics Research. 1985; 10(1-2): 79-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2861724&dopt=Abstract
•
Clinical research in pediatric ophthalmology: the Pediatric Eye Disease Investigator Group. Author(s): Beck RW. Source: Current Opinion in Ophthalmology. 2002 October; 13(5): 337-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218466&dopt=Abstract
•
Educational program on ophthalmology. Author(s): Lee JM, Koide MM, Salvador EM, Moura J, Ramos MP, Uras R, Matos RB Jr, Ancao MS, Sigulem D. Source: Medinfo. 1995; 8 Pt 2: 1241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8591417&dopt=Abstract
•
Ethno-ophthalmology in the Egyptian delta: an historical systems approach to ethnomedicine in the Middle East. Author(s): Millar MI, Lane SD. Source: Social Science & Medicine (1982). 1988; 26(6): 651-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3283948&dopt=Abstract
•
Exchange program glimpses of soviet ophthalmology. Author(s): HEATH SA. Source: American Journal of Ophthalmology. 1965 January; 59: 69-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14259944&dopt=Abstract
Alternative Medicine 93
•
Hypnosis as an anesthetic in ophthalmology. Author(s): GOMEZ RUIZ OR, FERNANDEZ A. Source: American Journal of Ophthalmology. 1960 July; 50: 163. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13850895&dopt=Abstract
•
Hypnosis as an anesthetic in pediatric ophthalmology. Author(s): Lewenstein LN. Source: Anesthesiology. 1978 August; 49(2): 144-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=686423&dopt=Abstract
•
Is acupuncture an useful tool for pain-treatment in ophthalmology? Author(s): Nepp J, Jandrasits K, Schauersberger J, Schild G, Wedrich A, Sabine GL, Spacek A. Source: Acupuncture & Electro-Therapeutics Research. 2002; 27(3-4): 171-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638737&dopt=Abstract
•
Ophthalmology and magic. Author(s): Young MN. Source: Bull N Y Acad Med. 1990 November-December; 66(6): 638-46. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2282444&dopt=Abstract
•
Ophthalmology in traditional Chinese medicine. Author(s): PI HT, LEE T. Source: Chin Med J. 1958 September; 77(3): 264-74. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13608746&dopt=Abstract
•
Ophthalmology manpower: a general profile, United States--1968. Author(s): Koch HK. Source: Vital Health Stat 1. 1972 December; 14(5): 1-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4539611&dopt=Abstract
•
Ophthalmology's botanical heritage. Author(s): Packer M, Brandt JD. Source: Survey of Ophthalmology. 1992 March-April; 36(5): 357-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1566238&dopt=Abstract
•
Overt behavior manifested in bilaterally patched patients; a comparative study of observations on an ophthalmology unit. Author(s): DAYTON GO Jr, TRABER WJ, KAUFMANN MA, GUNTER LM.
94
Ophthalmology
Source: American Journal of Ophthalmology. 1965 May; 59: 864-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14288928&dopt=Abstract •
Proceedings: Hemp in connection with ophthalmology. Author(s): Valk LE. Source: Ophthalmologica. Journal International D'ophtalmologie. International Journal of Ophthalmology. Zeitschrift Fur Augenheilkunde. 1973; 167(5): 413-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4771489&dopt=Abstract
•
The Charles Bonnet syndrome: a large prospective study in The Netherlands. A study of the prevalence of the Charles Bonnet syndrome and associated factors in 500 patients attending the University Department of Ophthalmology at Nijmegen. Author(s): Teunisse RJ, Cruysberg JR, Verbeek A, Zitman FG. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1995 February; 166(2): 254-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7728372&dopt=Abstract
•
The general development of Chinese ophthalmology. Author(s): Chen YZ. Source: Yan Ke Xue Bao. 1987 September; 3(3): 139-42. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3334134&dopt=Abstract
•
The pupula duplex and other tokens of an “evil eye” in the light of ophthalmology. Author(s): McDaniel WB. Source: Perspectives in Biology and Medicine. 1971 Fall; 15(1): 72-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4946353&dopt=Abstract
•
The role of traditional medicine in ophthalmology in Kenya. Author(s): Kimani V, Klauss V. Source: Social Science & Medicine (1982). 1983; 17(22): 1827-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6648606&dopt=Abstract
•
The use of acupuncture in ophthalmology. Author(s): Wong S, Ching R. Source: The American Journal of Chinese Medicine. 1980 Spring-Summer; 8(1-2): 104-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7395794&dopt=Abstract
•
The use of antimicrobial peptides in ophthalmology: an experimental study in corneal preservation and the management of bacterial keratitis. Author(s): Mannis MJ.
Alternative Medicine 95
Source: Trans Am Ophthalmol Soc. 2002; 100: 243-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12545697&dopt=Abstract •
Use of cavinton drip infusion in ophthalmology. Effect of cavinton drip infusion on the peripheral resistance of internal carotid artery. Author(s): Imre G. Source: Ther Hung. 1985; 33(4): 186-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3842015&dopt=Abstract
•
Use of Cavinton drip infusion in ophthalmology. II. Effect of Cavinton drip infusion in eye diseases caused by vascular occlusion or stenosis. Author(s): Imre G. Source: Ther Hung. 1986; 34(2): 84-6. No Abstract Available. Erratum In: Ther Hung 1987; 35(1): 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3449973&dopt=Abstract
•
Visual fields in glaucoma and neuro-ophthalmology. Author(s): Best SJ. Source: J Ophthalmic Nurs Technol. 1992 March-April; 11(2): 46-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1564737&dopt=Abstract
•
Visual hallucinations in ophthalmology. Author(s): Olbrich HM, Engelmeier MP, Pauleikhoff D, Waubke T. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 1987; 225(3): 217-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3609761&dopt=Abstract
•
William H. Bates: the originator of astigmatic keratotomy and psycho-ophthalmology. Author(s): Waring GO 3rd. Source: Refract Corneal Surg. 1989 January-February; 5(1): 56-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2488783&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
•
AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
•
Chinese Medicine: http://www.newcenturynutrition.com/
•
drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
96
Ophthalmology
•
Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
•
Google: http://directory.google.com/Top/Health/Alternative/
•
Healthnotes: http://www.healthnotes.com/
•
MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
•
Open Directory Project: http://dmoz.org/Health/Alternative/
•
HealthGate: http://www.tnp.com/
•
WebMDHealth: http://my.webmd.com/drugs_and_herbs
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to ophthalmology; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Cataracts Source: Healthnotes, Inc.; www.healthnotes.com Cataracts Source: Integrative Medicine Communications; www.drkoop.com Macular Degeneration Source: Healthnotes, Inc.; www.healthnotes.com Macular Degeneration Source: Integrative Medicine Communications; www.drkoop.com
•
Herbs and Supplements Eleuthero Alternative names: Siberian Ginseng, Eleuthero; Acanthopanax/Eleutherococcus senticosus Rupr. & Maxim. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
97
CHAPTER 4. DISSERTATIONS ON OPHTHALMOLOGY Overview In this chapter, we will give you a bibliography on recent dissertations relating to ophthalmology. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “ophthalmology” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on ophthalmology, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Ophthalmology ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to ophthalmology. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
Basic Instruction in Ophthalmology for Medical Students: a Prototype for Instructional Development in Medical Education by Arsham, Gary Martin, PhD from University of Illinois at Urbana-Champaign, 1971, 124 pages http://wwwlib.umi.com/dissertations/fullcit/7212075
•
The Control over Visual Refractive Technology by the Professions of Ophthalmology and Optometry and Its Implications for Public Policy by Levinson, Richard Alan, DPA from The George Washington University, 1983, 247 pages http://wwwlib.umi.com/dissertations/fullcit/8310228
98
Ophthalmology
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
99
CHAPTER 5. PATENTS ON OPHTHALMOLOGY Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “ophthalmology” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on ophthalmology, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Ophthalmology By performing a patent search focusing on ophthalmology, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
100 Ophthalmology
example of the type of information that you can expect to obtain from a patent search on ophthalmology: •
Collagen treatment apparatus Inventor(s): Sand; Bruce J. (Hidden Hills, CA) Assignee(s): Sunrise Technologies (Fremont, CA) Patent Number: 5,618,284 Date filed: June 7, 1995 Abstract: A method and apparatus for controlled thermal shrinkage of collagen tissue by irradiation with coherent energy in the wavelength band of 1.80 to 2.55 microns as generated by a laser. A specific application to ophthalmological corneal reshaping is described. A method for shrinkage of collagen tissue by application of coherent infrared energy, in which the threshold shrinkage temperature is substantially reduced by application of a reagent such as lysozyme to the tissue prior to heating. The method is especially useful in ophthalmology for shape modification of a cornea, and is enhanced by using a corneal collagen shield as a carrier and delivery agent for the reagent and an admixed anaesthetic. Excerpt(s): Collagen connective tissue is ubiquitous in the human body and demonstrates several unique characteristics not found in other tissues. It provides the cohesiveness and tenacity of the musculo-skeletal system, the structural integrity of the viscera, as well as the elasticity of the integument. Most endothelial-lined structures of the body have collagen cores for specific functional purposes. Collagen cores are found in structure as diverse as the trabecular meshwork of the aqueous filtration system of the eye, and the valves of the heart. The walls of the great vessels share their collagen integrity with the ligamentous bony attachments and the tendinous or sinewy muscular attachments to the long bones. The cornea of the eye is a unique example of collagen connective tissue with the cornea stroma (accounting for about 90% of the total thickness of the cornea) demonstrating a high transparency of cross-oriented individual sheets or lamellae of collagen with a high (about 70%) water content and lesser (about 8%) amounts of protein and muco-polysaccharides. Intermolecular cross-links provide collagen connective tissue with unique physical properties of high tensile strength and substantial elasticity. The extracellular matrix of this tissue consists of complex macromolecules, the biosynthesis of which involves several specific reactions that are often under stringent enzymatic control. The cross-linking is mediated, for example, by the copper-dependent enzyme lysyloxidase, and can be inhibited by chemicals such as B-aminoproprionitrile, as well as by various types of energy such as heat and photonic radiation. The net accumulation of collagen connective tissue is then dependent upon the precise balance between the synthesis and degradation of the connective tissue components. Web site: http://www.delphion.com/details?pn=US05618284__
Patents 101
•
Composition for ophthalmological use Inventor(s): Malson; Tomas (Uppsala, SE) Assignee(s): Pharmacia AB (Uppsala, SE) Patent Number: 4,764,360 Date filed: April 30, 1986 Abstract: A composition to be used in ophthalmology and containing an aqueous solution of a high molecular polymer to which has been added a polymeric dye having a molecular weight higher than 10,000. Excerpt(s): This invention is concerned with a colored composition to be used in ophthalmology and consisting of an aqueous solution of a high molecular polymer to which a polymeric dyestuff has been added. Viscoelastic solutions of highly purified hyaluronic acid (Healon.RTM., Pharmacia AB, Uppsala, Sweden) are nowadays commonly employed in eye surgery practice. Examples of such surgical operations are corneal transplantations, cataract surgery and glaucoma surgery, the Healon.RTM. being injected into the anterior eye chamber in order to maintain that chamber in its correct shape during the operation. For vitrectomy and in cases of retinal detachment the substance is similarly injected into the vitreous chamber (i.e. the space normally occupied by the vitreous humor) so that then the injected substance, in cooperation with residual vitreous humor, will retain the retina in a properly fixed position. Healon.RTM. is a solution that is entirely clear and colorless. These properties while being excellent-in themselves nevertheless do have the drawback that the substance is not readily observable during the operation and cannot be clearly distinguished from e.g. natural vitreous humor and aqueous humor inasmuch as both of these have approximately the same optical properties as Healon.RTM. Therefore, in order to facilitate inspection during the operation, Zirm (Klin. Mbl. Augenheilk. 181 (1982), 426-428) has reported a series of tests employing fluorescein additions to Healon.RTM. Web site: http://www.delphion.com/details?pn=US04764360__
•
Control arrangement for an apparatus for ophthalmological treatment Inventor(s): Batscher; Paul (Munsingen, CH), Lawniczak; Michel (Steffisburg, CH), Meerstetter; Robert (Thun, CH) Assignee(s): Lasag AG (Thun, CH) Patent Number: 5,000,561 Date filed: October 5, 1989 Abstract: The control arrangement (13) of this invention includes a casing on which the hand (22) of a medical practitioner may rest when the position of the point of focus of a laser beam onto a place to be surgically treated is sought. The arrangement includes a roller (20) operated by the thumb (21) and a ball (23) operated by the index finger (24), the roller and the ball respectively displacing the point of focus along a first coordinate axis (Z) and along second and third coordinate axes (X Y). A push button (25) operated by the middle finger (26) controls firing of the laser beam. The arrangement is used in ophthalmology. Excerpt(s): This invention concerns an arrangement for controlling an apparatus for ophthalmological treatment, said apparatus including at least one laser power beam having a focal point of concentration of said beam capable of acting when fired by a
102 Ophthalmology
practitioner on a predetermined location within the eye of a patient, said location being defined by first, second and third dimensional orthogonal coordinates. An apparatus for ophthalmological treatment for which it is necessary to assure control is described for instance in the European patent document EP-B-0 030 210. The apparatus includes essentially a first light source which emits a laser power beam intended for treatment, and a second light source which emits a visible coherent light beam of low power arranged to envelop the power beam. Such beams then pass through a converging lens which concentrates them at a focal point, this being the point of treatment, the visible light beam being present in order to permit localization with precision of the place where the point of focus of the power beam is to be found. The point of focus is observed by a medical practitioner through an eye piece (or binocular) while the ocular cavity is illuminated by an auxiliary source of light. When the place sought for treatment is reached, the practitioner may fire the power beam. In order to displace the beams coming out of the optical system 8 and to direct them to a precise point within the ocular cavity, the practitioner employs a contact lens 10 which is held on the eye of the patient. In this case his left hand 11 is occupied. The right hand 12 of the practitioner must thus be capable of alone operating the control arrangement 13 which is not described in the document cited hereinabove and which must permit control of at least four functions: that of displacement of the column 7 according to three coordinates X, Y and Z and that of firing the laser at the moment when the three coordinates which have been sought are attained. It can be readily imagined without any particular inventive activity that the control arrangement 13 includes four distinct elements controlling respectively the displacements X, Y and Z of the laser beam, the first three elements being rollers which may be operated in both senses and the fourth element being a simple push-button. Such an arrangement is awkward since it obliges the practitioner to memorize the location of the rollers and the functions which are attached to them with risks of error or loss of time that such a system may cause, since the eyesight of the practitioner is entirely occupied in observing the eye cavity to be cared for and must not be distracted to check for instance if the correct control element has been operated. Web site: http://www.delphion.com/details?pn=US05000561__ •
Corneal incision marker Inventor(s): Degtev; Evgeny I. (Moscow, SU), Fedorov; Svyatoslav N. (Moscow, SU), Golubev; Vladimir N. (Moscow, SU), Karavaev; Alexandr A. (Moscow, SU), Khromov; Sergei V. (Moscow, SU), Yatsenko; Igor A. (Moscow, SU) Assignee(s): Moskovsky Nauchno-Issledovatelsky Institut Mikrokhirurgii Glaza (Moscow, SU) Patent Number: 4,515,157 Date filed: January 18, 1983 Abstract: The invention relates to ophthalmology and, more particularly, to a corneal ncision marker adapted for use in surgical treatment, notably that of myopia.An instrument of this invention comprises a case in the form of a bush accommodating a sight, and plates in planar arrangement at right angles to the plane of the sight. The plates are brought into contact with the cornea leaving indentations which serve as guidelines to perform incisions. According to the invention, each plate is mounted on a separate holder, the latter being attached movably radially with respect to the bush, the holders being rigidly secured in their entirety to said bush, and provision is made for a drive to effect smooth synchronized movement of the plate holders.
Patents 103
Excerpt(s): The invention herein disclosed relates to opthalmology and, more particularly, to a corneal incision marker suitable for use in surgical removal of myopia, astigmatism and compound myopic astigmatism. Over the recent years much interest was generated in a novel surgical procedure employed in the treatment of such conditions as myopia, astigmatism and compound myopic astigmatism. In performing such an operation, the ophthalmologist makes a series of external partial thickness incisions of the corneal periphery. Arrangement of the incisions varies depending upon the condition to be treated and state of the patient's eye. Initially, the incisions were made free-hand with the choice of their arrangement and placement reserved to the surgeon. It stands to reason that the resultant incisions are subject to considerable variation affecting their position both relative to each other and to the optical center and central optical zone of the cornea. Web site: http://www.delphion.com/details?pn=US04515157__ •
Determining and marking apparatus and method for use in optometry and ophthalmology Inventor(s): Marshall; Forrest A. (P.O. Box 649, Dublin, GA 31021) Assignee(s): none reported Patent Number: 5,036,592 Date filed: January 19, 1990 Abstract: An apparatus and method for subjectively determining the proper positioning of progressive power or other corrective lenses are disclosed. The apparatus includes a target such as a small fiber optic or other light source and one or more marking rods which may be activated by the patient. While wearing prefitted frames and fixating on a remote target, the patient places the light source against or immediately adjacent the exterior surface of the simulated or other lens within either of the frames and positions the light so that it is centered in his or her line or sight. Once the light is centered the patient activates the marking rod which contacts, and marks, the exterior surface of the lens. Because the light source and marking rod or rods are designed to obstruct very little of the patient's vision, his or her peripheral vision remains intact during the process, thereby allowing binocular fusion to occur and avoiding introduction of phoria errors into the positioning process. Excerpt(s): This invention relates to apparatus and techniques for subjectively determining relationships between patients' pupils and locations on corresponding multi-focal spectacle lenses. Multi-focal lenses, frequently used for remedying presbyopia, contain two or more regions of differing corrective power. An early attempt at constructing multi-focal lenses involved joining pieces of two separate lenses, one positioned above the other, within the eyewires of each of a patient's left and right spectacle frames. Called "Franklin Bifocals," these lenses included distinct horizontal lines demarcating the boundary between the joined lens pieces in each frame. The sharp dividing lines were cosmetically unattractive, however, and the lenses themselves were mechanically weak. More modern bifocal designs provide far- and near-viewing correction for each eye using a single lens fitted into the eyewire of the corresponding spectacle frame. Typically designed to correct the distance vision of the patient, the single lens includes a cavity or countersink ground into either its front or rear surface. A separate segment button is fused to the countersink to provide the appropriate additive power for near vision correction. Alternatively, the distance prescription may be ground on one surface of a single lens and the power of the addition ground on the other. Each
104 Ophthalmology
of these designs supplies PG,3 lenses mechanically stronger than the Franklin bifocal; the designs do not, however, eliminate the unattractive boundary visible between the two prescriptive surfaces. Use of these conventional bifocals also causes patients to experience blurriness in zones corresponding to the demarcation lines as the patients move their eyes vertically. Web site: http://www.delphion.com/details?pn=US05036592__ •
Fluoroalkyl hydrocarbons for administering water insoluble or unstable drugs Inventor(s): Lang; John C. (Arlington, TX), Maniar; Manoj L. (San Diego, CA) Assignee(s): Alcon Laboratories, Inc. (Fort Worth, TX) Patent Number: 5,874,469 Date filed: January 5, 1996 Abstract: Fluoroalkyl hydrocarbons as vehicles for pharmaceutical drugs are disclosed. These vehicles are particularly well-suited for delivering drugs which are insoluble in water or chemically unstable in aqueous media. Pharmaceutical solution compositions based on these vehicles have long shelf lives and provide improved drug bioavailability. In addition, the pharmaceutical compositions of the present invention are nonaqueous, and therefore do not require preservatives or tonicity agents. The invention is particularly useful in the field of ophthalmology. Excerpt(s): The present invention relates to the field of ophthalmic drug formulation and delivery. More particularly, this invention relates to an improved method for formulating and administering pharmaceutical drugs which are insoluble or unstable in aqueous solutions. Biologically active and/or diagnostic agents are conventionally formulated as solutions, suspensions, ointments, or gels (responsive or non-responsive to the ophthalmic environment); or are incorporated into (or absorbed onto) carriers such as solvated polymers, inclusion complexes, microspheres (monolithic or encapsulated), nanospheres, liposomes, ion exchange resins, or combinations of the above. These formulations typically contain water as one of the major components. Unfortunately, not all biologically active agents are chemically stable in an aqueous environment. Many classes of drugs include compounds which are therapeutically effective, but which are hydrolytically unstable. In particular, biologically active ergoline derivatives, such as cabergoline, are highly unstable when placed in an aqueous environment. More generally, prodrugs and soft drugs, which are becoming increasingly important due to improved delivery and targeting, are often subject to hydrolytic degradation, especially on prolonged storage in aqueous environments. In view of the relative instability of such compounds, it is not possible to incorporate these compounds in aqueous solutions, or other types of aqueous compositions which may be stored for relatively long periods (i.e., several months or more) prior to use. Compounds which are insoluble in water are frequently soluble in hydrocarbon or silicone oils, triglycerides (such as the medium-chain triglycerides commercially available as Miglyols.RTM.), waxes, etc. or in stabilized emulsions (utilizing lipids or surfactants) of these solvents. However, formulations which utilize oils as the vehicle for the active drug are not ideal. This is particularly true with respect to ophthalmic compositions. Among other disadvantages, oils may obscure vision of patients, thereby adversely affecting patient compliance, and high oil/water partition coefficients of compounds may reduce bioavailability. Web site: http://www.delphion.com/details?pn=US05874469__
Patents 105
•
Gel, especially for ophthalmology Inventor(s): Lobering; Hans-Georg (Munchen, DE), Polzer; Heinz (Taufkirchen, DE) Assignee(s): Medproject Pharma Entwicklungs und Vertriebs Gesellschaft (Sauerlack, DE) Patent Number: 5,397,567 Date filed: March 25, 1993 Abstract: An ophthalmologic gel is disclosed having a viscosity in the range of about 10,000 to about 50,000 mPa.s and comprising (1) about 0.05 to about 3% by weight of one or more polyacrylates and (2) about 0.1 to about 10% by weight one or more watersoluble, physiologically compatible polymers selected from the group consisting of polyvinyl alcohol, dextran, and mixtures thereof. Excerpt(s): This invention pertains to new medications, namely gels, especially for use on the eye. Generally, active ingredients for use in the eye are supplied in the form of salves, drops, inserts, or even gels. Each of these forms of administration has its advantages and disadvantages. The form of treatment most pleasant for the eye is still the aqueous drop. In contrast to the other forms mentioned, however, it has the shortest residence time on the eye, which means that the treatment frequency is correspondingly higher and the systemic stress thus greater. The development of gels which reside for a longer period of time on the surface of the eye has therefore been attracting greater attention. These gels frequently have a salve-like consistency and are therefore packaged in tubes. The handling of tubes for the administration of a drop to the eye has disadvantages in many respects, for which reason physicians and patients prefer eye medications in plastic bottles. So far there is no product which logically combines the advantages of aqueous drops, namely, their compatibility and ease of handling, with the advantage of a prolonged residence time on the eye. Although several patents on gels and gel formulations have appeared, the special requirements associated with the use of a gel on the eye have not yet been worked out in them. Web site: http://www.delphion.com/details?pn=US05397567__
•
High-frequency surgical apparatus Inventor(s): Farin; Gunter (Tubingen-Hirshau, DE) Assignee(s): Erbe Elektromedizin GmbH & Co. KG (Tubingen, DE) Patent Number: 4,244,371 Date filed: March 20, 1979 Abstract: In a high-frequency surgical apparatus having a number of electrodeconnections for a neutral electrode and a number of electrodes, respectively, for monopolar and bipolar operation, a single high-frequency generator operating through a transformer with monopolar and bipolar secondaries designed to work into different impedance loads is provided in combination with a multipole switch for switching over between bipolar and monopolar use. A warning signal is produced only if the switch is set for a monopolar use, even if the neutral electrode is not properly connected. The bipolar output may be used independently of whether a neutral electrode is connected to the apparatus or not. In this manner unintended injuries or damage by a contact with an electrode are avoided. Examples for the field of use of such electrosurgery units are
106 Ophthalmology
Dermatology, Gynaecology, Ophthalmology, Dental Surgery, ENT and Cosmetic Surgery. Excerpt(s): The present invention relates to a high-frequency surgical apparatus, e.g., for use in producing coagulation of body tissues in high-frequency electro-surgery. Such surgical apparatus is normally provided with a neutral electrode and activatable electrodes for monopolar and bipolar operation, and is provided with a protective circuit, which in the case of an interruption of the electrical circuit between the neutral electrode and its connections at the apparatus also interrupts the supply of energy from the high-frequency generator to the active electrode or electrodes and indicates the interruption by an alarm signal. In the case of known high-frequency surgical apparatus of this type, which are provided with electrode contacts for a monopolar as well as for a bipolar use, the high-frequency current for the monopolar as well as for the bipolar use is supplied from a single high-frequency generator. Though it is possible in the case of such known surgical apparatus to adjust the output power for the monopolar use and the bipolar use, respectively, independently from each other at the apparatus, still a number of problems are involved in the practical use of such surgical apparatus. During the activation of the high-frequency generator, high-frequency electrical voltage is present simultaneously on all connections, this voltage being applied to the connections of both the monopolar and the bipolar electrodes. Web site: http://www.delphion.com/details?pn=US04244371__ •
Laser system Inventor(s): Yessik; Michael (San Francisco, CA) Assignee(s): Bausch & Lomb Incorporated (Rochester, NY) Patent Number: 4,862,888 Date filed: September 9, 1988 Abstract: A laser system which is compact, requires no cooling means and can produce either substantially continuous output or narrow single pulses of high intensity or pulse bursts comprises a closed spherical pumping cavity having a diffuse reflecting surface and a laser rod and a flashlamp mounted in non-parallel relationship in the cavity. The system is especially useful in ophthalmology. Excerpt(s): In recent years laser instruments have gained wide acceptance in the field of ophthalmological surgery, due primarily to the ability of laser systems to accomplish surgical tasks within the eye while causing little or no unwanted residual surgical trauma. Surgical laser systems are used for such diverse purposes as photocoagulation of tissue to cutting and removal of tissue within the eye. In the former case, the procedure requires a relatively long laser illumination at a relatively low power intensity. In the latter case, it is necessary to use pulses of light energy of extremely short duration and high peak energy. Such pulses are capable of destroying the tissue at and around the focal point without causing undesirable thermal effects. It is generally true that systems capable of long-term laser illumination are not capable of generating the short, high intensity pulses required for some procedures. A prior art system which exemplifies the state of the art of the latter case systems is disclosed in U.S. Pat. No. 4,309,998. This system is a Q-switched, mode-locked laser employing a YAG crystal to produce pulses of sufficient brevity and intensity to permit surgical cutting by optical puncture. Such a system, however, produces a series of closely spaced pulses in relatively uncontrolled fashion It is difficult to select precisely the desired output energy
Patents 107
or number of pulses produced. Furthermore, this laser cannot be operated to produce the thermal effects which are necessary in some ophthalmological surgical procedures. Web site: http://www.delphion.com/details?pn=US04862888__ •
Low yellow index polymer compositions, polymerizable compositions and lenses using said compositions Inventor(s): Keita; Gabriel (Courbevoie, FR), Renaudineau; Joel (Creteil, FR), Yean; Leanirith (Largo, FL) Assignee(s): Essilor International (Compagnie Generale d'Optique) (Charenton Cedex, FR) Patent Number: 5,702,825 Date filed: August 12, 1996 Abstract: The present invention relates to a new polymer compositions for use in the manufacture of ophthalmic lenses, to their use in ophthalmology and to apparatus using these lenses, such as eyepieces and film/video camera optics. Excerpt(s): The present invention relates to new polymer compositions for use in the manufacture of ophthalmic lenses, to their use in ophthalmology and to apparatus using these lenses, such as eyepieces and film/video camera optics. Ophthalmic plastics obtained from acrylic bisphenol A derivatives are in general too yellow for use. The use of additives which reduce yellowness is well know, but usually at the cost of the degree of polymerisation and thermomechanical properties. Web site: http://www.delphion.com/details?pn=US05702825__
•
Medicament which is utilizable in ophthalmology Inventor(s): Bigou; Alphonse (Paris, FR) Assignee(s): Societe B.F.B. (Champigny, FR) Patent Number: 4,002,758 Date filed: July 2, 1975 Abstract: A method of treating ophthalmological disorders is disclosed. The method comprises the oral administration from one to four times a day of a composition comprising:A. from 200 to 1,000 mg of a compound selected from the group consisting of cystine and cysteineB. from 50 to 300 mg of pyridoxine in the form of a base or a salt. Excerpt(s): The present invention relates to a novel medicament which is utilisable in ophthalmology and which comprises a combination of cystine and pyridoxine. Cystine and/or cysteine or their derivatives are known sulphur-containing amino acids, which have found a certain number of uses as anticollagenasic agents. It it also known that pyridoxine (vitamin B.sub.6) in the form of the base or a salt has useful pharmacological properties. This vitamin has already been utilised in numerous medicaments. Web site: http://www.delphion.com/details?pn=US04002758__
108 Ophthalmology
•
Method and arrangement for determining an at least approximately circular contacting surface using incoherent light and a film waveguide Inventor(s): Goerlich; Steffen (Jena, DE), Klose; Norbert (Graitschen, DE), Merker; Wolfgang (Jena, DE), Moehr; Klaus (Eisenberg, DE), Voigt; Peter (Jena, DE), Wieser; Joachim (Jena, DE) Assignee(s): Jenoptik GmbH (Jena, DE) Patent Number: 5,440,140 Date filed: April 4, 1994 Abstract: A method and arrangements for determining an at least approximately circular contacting surface is disclosed. The primary object of finding a simple way of objectively determining the contacting surface of a deformable medium on a plane surface with high accuracy and at a low technical expense is met according to the invention in that a film waveguide is used as a plane surface. An incoherent, parallel, homogeneous bundle of light whose width widens one-dimensionally is coupled into this film waveguide and the decoupled light is fed to a photoreceiver array for recording one-dimensional intensity distributions. An evaluating unit generates a difference curve from a normal curve without contacting medium and from a measurement curve with contacting medium and the exact diameter of the contacting surface is determined from the distance of two associated extremes of the difference curve. The method and arrangements are preferably used in ophthalmology for the measurement of the applanation circle at the tonometer and for measuring liquid drops for the purpose of analysis. Excerpt(s): The invention is directed to a method and arrangements for determining an at least approximately circular contacting surface of a deformed medium on a plane surface, in particular for verifying an applanation circle in an applanation tonometer. The change in the optical characteristics of a waveguide when contacting a medium is the subject of various publications, e.g. on substance analysis (EP 403 468, GB 2 156 970, DE 37 23 159). These arrangements, which are constructed as chemo-sensors, are concerned only with detecting or verifying various substances in the adjacent media, wherein a selective, permeable waveguide layer or film in which the substances to be verified are diffused or bonded to this film undergo changes in optical density or in the index of refraction so that changes in the phase, polarity or intensity of the penetrating light can be detected. Further, a known solution is concerned with the change in the above-mentioned physical characteristics brought about by a contacting surface of varying magnitude and is applied in ophthalmology for measuring the intraocular pressure of the human eye. It makes use of the same effective mechanism as that used in EP-OS 40 34 68 in that two vibrational modes which are oriented vertically to one another and in which different effective refractive indices act along the contacting surface with the aplanatic cornea of the eye are excited by coherent, linearly polarized light in a film waveguide. Phase differences accordingly result between the two modes and can be determined in various ways, e.g. in the form of a change in intensity when using a (linear) polarizer prior to a receiver. However, a disadvantage in the known working principle consists in that the expenditure for determining the phase difference is still relatively high (lasers, polarizers and analysis of the change in intensity, costly adjustment of the polarizers), particularly for accurately determining the magnitude of the contact area. Web site: http://www.delphion.com/details?pn=US05440140__
Patents 109
•
Method and composition for ophthalmic anesthesia using rodocaine Inventor(s): Chan; Peter W. K. (Culver City, CA) Assignee(s): Iolab Corporation (Claremont, CA) Patent Number: 4,902,692 Date filed: March 18, 1988 Abstract: Rodocaine or a pharmaceutically-acceptable salt thereof has been found to be an effective anesthetic in ophthalmology. Topical and injectable formulations are disclosed. Excerpt(s): Local topical anesthetics for the eye are generally used with caution since the decrease in blinking and subsequent dehydration may cause damage to the corneal epithelium. For non-surgical situations, the eye care professional would want anesthesia in the eye which would last only as long as the desired procedure. Such a procedure may be quite short, and there is thus a need for a fast acting and yet transient topical anesthetic for the eye. Such an anesthetic would minimize the keratitis caused by the lack of or decreased rate of blinking. Injectable anesthetics are used in the eye by retrobulbar injection to prevent the eye muscles of the patient from moving during sugery. For example, during cataract surgery, the lens of the eye is replaced, and the ophthalmologist will normally anesthetize the retro-bulbar muscles and nerves to keep the eye still during the delicate procedure. Many such surgeons use a combination of drugs to achieve the proper anesthetic profile. For example, lidocaine may have a quick inset while bupivacaine provides a longer action. However, such mixing is an obvious disadvantage. An ophthalmic anesthetic, particularly for topical use, has been found in rodocaine. Also part of the invention are ophthalmic pharmaceuticals which contain rodocaine. Web site: http://www.delphion.com/details?pn=US04902692__
•
Method for apparatus for a defined serumfree medical solution useful for corneal preservation Inventor(s): Lindstrom; Richard L. (1065 W. Ferndale Rd., Wayzata, MN 55391), Skelnik; Debra (P.O. Box 1758, Rte. 3, Cambridge, MN 55008) Assignee(s): none reported Patent Number: 5,104,787 Date filed: March 5, 1990 Abstract: A defined serumfree medical solution for applications in Ophthalmology, that contains one or more cell nutrient supplements which maintains and enhances the preservation of eye tissues, including human corneal tissues at low temperatures (2.degree. C. to 15.degree. C.). This solution is composed of a defined aqueous nutrient and electrolyte solution, supplemented with a glycosaminoglycan(s), a deturgescent agent(s), an energy source(s), a buffer system(s), an antioxidant(s), membrane stabilizing components, antibiotic(s), ATP precursors and nutrient cell supplements. Excerpt(s): The present invention relates to the preservation of eye tissue in a defined nutritive, aqueous medical solution, and more particularly, relates to the preservation and enhancement of human corneal tissue, specified as the time between removal from the donor and transplantation. Keratoplasty, or transplantation of the cornea, has been effective in providing visual rehabilitation to many who suffer from corneal disorders.
110 Ophthalmology
This procedure has gained widespread acceptance but has been severely hampered by the universally inconsistent availability of donor tissue. This problem made the development of a storage solution imperative. The development of MK.TM.preservation medium, and subsequent chondroitin sulfate-containing media, has positively impacted the availability of quality donor tissue. Much research in this area has been undertaken with a view towards prolonging donor storage time and yet maintaining a viable endothelium, which is crucial to successful transplantation. Storage of the cornea for up to 14 days at 4.degree. C. has been reported, although the current technology does not permit adequate tissue preservation beyond a few days. Storage longer than 96 hours is attended by epithelial decomposition and loss of corneal clarity, as demonstrated by increased swelling of the corneal stroma. This stromal edema is attributed to the decreased maintenance of the barrier pump function of the corneal endothelium, a specific cell layer lining the corneal stroma. The functional status of the endothelium and sustained corneal deturgescence after corneal preservation are of great clinical importance, and contribute primarily to the success of the surgical outcome. The ability of the cornea to maintain a relatively dehydrated state is essential to the maintenance of corneal transparency. Corneal deturgescence is an energy-dependent phenomenon performed primarily by the endothelial cells. In order for the cornea to remain viable, various enzymatic reactions must occur to carry out energy-dependent functions, maintained by high levels of ATP. Web site: http://www.delphion.com/details?pn=US05104787__ •
Method for collagen shrinkage Inventor(s): Sand; Bruce J. (Hidden Hills, CA) Assignee(s): Laser Biotech, Inc. (Los Angeles, CA) Patent Number: 5,304,169 Date filed: August 17, 1992 Abstract: A method for shrinkage of collagen tissue by application of coherent infrared energy, in which the threshold shrinkage temperature is substantially reduced by application of a reagent such as lysozyme to the tissue prior to heating. The method is especially useful in ophthalmology for shape modification of a cornea, and is enhanced by using a corneal collagen shield as a carrier and delivery agent for the reagent and an admixed anaesthetic. Excerpt(s): My U.S. patent application Ser. No. 07/546,252 and U.S. Pat. No. 4,976,709, the entire disclosures of which are incorporated herein by reference, describe methods and apparatus for achieving controlled shrinkage of collagen tissue. These prior inventions have application to collagen shrinkage in many parts of the body, and are particularly useful in an ophthalmological procedure for achieving controlled shape changes in the cornea of the eye for correction of refractive errors. As described in detail in the application and patent which are incorporated by reference, a presently preferred collagen-shrinkage technique involves use of laser coherent energy in a wavelength range of about 1.80 to about 2.55 microns, or of such coherent infrared energy of wavelengths corresponding to collagen absorption coefficients in the range of about 15 to 120 cm.sup.-1. Irradiation of collagen with such energy is controlled to elevate the collagen temperature to at least 23.degree. C. above normal body temperature to achieve collagen shrinkage. As explained in my referenced prior disclosures, a critical factor in shrinkage of corneal collagen of the eye is avoidance of excessive tissue-destructive temperature increases throughout the corneal stroma, and especially in the outer
Patents 111
epithelial and inner endothelial layers of the cornea. A lowering of the threshold temperature at which collagen shrinkage occurs will provide an added measure of safety in avoiding tissue-destructive temperature increases, and it is to this goal that the present invention is directed. Web site: http://www.delphion.com/details?pn=US05304169__ •
Method of preparing a biological material for use in ophthalmology Inventor(s): Bagrov; Sergei Nikolayevich (Moscow, RU), Fedorov; Svyatoslav Nikolayevich (Moscow, RU), Larionov; Yevgeny Viktorovich (Moscow, RU), Malyshev; Vladimir Borisovich (Moscow, RU) Assignee(s): Staar Surgical Company, Inc. (Monrovia, CA) Patent Number: 5,856,120 Date filed: January 29, 1997 Abstract: A collagen containing substrate comprising cattle basal membrane is conditioned by incubating the membranes in a mixture of pepsin, hyaluronidase and acetic acid and separating the collagen from the mixture. The mixture can include pepsin, hyaluronidase and a 0.5M solution of acetic acid in 1:1:10 proportions. The incubation is conducted for about 10 hours at about 45.degree. C. After incubation, collagen is separated from the mixture by centrifuging at a speed of 5000 to 30000 rpms for about 30 minutes. The collagen is mixed with polymerizable monomer and polymerized to form a gel that can be ground to form an intraocular or contact lens. Excerpt(s): The invention relates to a method for conditioning a collagen containing substrate to produce a biological material for use in ophthalmology. A polymeric biological material can be prepared by initial conditioning steps of enzyme treatment of animal raw material, such as pig sclera. Collagen is extracted from the raw material and is mixed with monomers for polymerization to ophthalmological materials, such as intraocular and contact lenses. The lenses are used for surgical or conservative treatment of myopia. The ophthalmological materials are also used to form collagen solutions for treating mild myopia and solutions to prepare external forms of medication. There are a number of major deficiencies associated with this method. First, enzyme treatment with trypsin results in irreversible breakdown of the primary structure of pig sclera collagen. It is difficult to achieve high collagen concentrations in ophthalmological products manufactured from this collagen. Products manufactured from lower collagen concentrations are brittle. Web site: http://www.delphion.com/details?pn=US05856120__
•
Ophthalmological photographing apparatus Inventor(s): Kato; Takeyuki (Tokyo, JP), Ohtsuka; Hiroyuki (Tokyo, JP), Okashita; Toshihiro (Tokyo, JP) Assignee(s): Kabushiki Kaisha TOPCON (Tokyo, JP) Patent Number: 6,082,859 Date filed: May 17, 1999 Abstract: A photographic instrument for ophthalmology permits easily recognizing which portion of an eye E to be examined a position of a photographed portion of the
112 Ophthalmology
eye E corresponds to. The instrument comprises a display means 8 for displaying a portion to be photographed as a part of the entire eye E as an alignment image when the eye E is photographed and for displaying a recognition pattern for recognizing the position of the portion to be photographed. Excerpt(s): The present invention relates to an improvement of a photographic instrument for ophthalmology for photographing various portions of an eye to be examined, such as its fundus, corneal endothelium, and cornea cross section. A photographic instrument for ophthalmology for photographing various portions of an eye to be examined, such as its fundus, corneal endothelium and cornea cross section has heretofore been known. In a photographic instrument for ophthalmology of this type, e.g., a fundus camera for photographing the fundus of the eye, a portion of the fundus to be photographed, as a part of the entire fundus, is displayed on a monitor screen as an alignment image, and then the portion is photographed. After that, the photographed portion is recorded in, for example, a still video recorder as a recording means. In the fundus photography of this type, sometimes performed is a so-called "panoramic photography" in which different portions of a fundus are photographed, respectively, to obtain a plurality of photographed portions, thereby obtaining the entire image of the fundus. Web site: http://www.delphion.com/details?pn=US06082859__ •
Ophthalmology apparatus Inventor(s): Takai; Motoya (Utsunomiya, JP) Assignee(s): Canon Kabushiki Kaisha (Tokyo, JP) Patent Number: 6,334,682 Date filed: June 27, 2000 Abstract: An ophthalmology apparatus has an illuminating system which illuminates an eye to be examined, an imaging system which takes images of the eye to be examined illuminated by the illuminating system, and a controller capable of controlling the imaging system so as to obtain the plurality of images sequentially while changing focusing states. Excerpt(s): The present invention relates to an ophthalmology apparatus, such as a retinal camera or the like, used in ophthalmic hospitals, in health screening, and so on. Based on a projection image of this split chart 17, an operator moves the taking lens 8 along the optical path so as to align left and right bright lines with each other, thereby bringing the eye to be examined E into focus. After completion of focusing, the operator manipulates a fixation target moving switch, not illustrated, in order to photograph a predetermined portion of the eye to be examined E, and then moves an opening portion of liquid-crystal shutter 19 to guide the desired portion of the eye to be examined E into the field by a fixation target 20. Unless there is any defocus at this time, the operator depresses a photograph switch 21 to light a photograph light source 22 in the illumination optical system, thereby illuminating the eyeground Er. The reflected light from the eyeground Er is guided through the objective 7, the aperture of the bored mirror 6, the taking lens 8, a field lens 23, a field stop 24, and an imaging lens 25 to form an image on an image pickup device 26. The output of the image pickup device 26 is supplied through a controller 27 to an image recording device 28 to record a still image and to a television monitor 29 to display a dynamic picture. In the above-stated example, however, since the target projected for focusing of the eye to be examined E is
Patents 113
only one meridian of the eye to be examined E, there will exist in-focus and out-of-focus portions in a single image if the eye to be examined E suffers an ametropia such as astigmatism or the like. The human eye also has spherical aberrations which cause the existence of in-focus and out-of-focus portions. Therefore, the operator needs to adjust the focus position again before photography and these operations require some time and labor. Problems which are troublesome. Web site: http://www.delphion.com/details?pn=US06334682__ •
Peptide antagonists of substance P Inventor(s): Folkers; Karl (Austin, TX), Jie-cheng; Xu (Shanghai, CN) Assignee(s): Board of Regents, The University of Texas System (Austin, TX) Patent Number: 4,481,139 Date filed: April 13, 1983 Abstract: Undecapeptides retaining the amino acids in positions 2, 3, 4, 5, 6, 8 and 10 of substance P (Arg.sup.1 -Pro.sup.2 -Lys.sup.3 -Pro.sup.4 -Gln.sup.5 -Gln.sup.6 -Phe.sup.7 -Phe.sup.8 -Gly.sup.9 -Leu.sup.10 -Met.sup.11 -NH.sub.2), but having substitutions in positions 1, 7, 9 and 11 of substance P have been discovered to have high antagonistic activity to block substance P in biological systems. Exemplifying these potent antagonists is D-Arg.sup.1,D-Trp.sup.7,D-Trp.sup.9 -Leu.sup.11 -Substance P, which is an effective inhibitor and has high potency. These antagonists of substance P are useful to elucidate some biological mechanisms of substance P, and to treat inflammatory responses in the eye for medical practice in ophthalmology, and to be novel analgesic agents for medical applications. Excerpt(s): The sequence-biological activities of the luteinizing hormone releasing hormone (LHRH) (Glp-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH.sub.2) and substance P (SP) (Arg-Pro-Lys-Pro-Gln-Gln-Phe-Phe-Gly-Leu-Met-NH.sub.2) differ in an important structural aspect. No truncated analog of LHRH is known which has activity equal to that of LHRH. Although LHRH is a decapeptide and SP is an undecapeptide, the removal of the N-terminal four or five amino acids of SP gives truncated hexa- and heptapeptides which show biological activities essentially equivalent ot that of SP itself. For example, the studies of Yanaihara et al. ["Substance P Nobel Symposium 37", U.S. von Euler and B. Pernow, eds., Raven Press, New York (1977) p. 27] exemplify data on sequence-activity of truncated analogs of SP, which showed that the hexapeptide, GlpPhe-Phe-Gly-Leu-Met, and the heptapeptide, Glp-Gln-Phe-Phe-Gly-Leu-Met-NH.sub.2, showed 2.0 and 1.7 relative activities, respectively, in comparison with SP as 1. It is generally believed in the field of SP that the N-terminal Arg.sup.1 -Pro.sup.2 -Lys.sup.3 Pro.sup.4 - or Arg.sup.1 -Pro.sup.2 -Lys.sup.3 -Pro.sup.4 -Gln.sup.5 - of SP are not needed for biological activity and such statements imply the concept that these Nterminals four or five amino acids have no biological role whatsoever. This concept may not be entirely correct, because it is possible that these four or five N-terminal amino acids of SP have a role in binding at one or more receptors, particularly when one considers the strong functionality of Arg.sup.1 and Lys.sup.3 in these units. Also, the presence of Pro.sup.2 and Pro.sup.4 indicate a unique conformational contribution from the N-terminal portion of SP. Therefore, the presence of Arg.sup.1 -Pro.sup.2 -Lys.sup.3 -Pro.sup.4 - and Arg.sup.1 -Pro.sup.2 -Lys.sup.3 -Pro.sup.4 -Gln.sup.5 - should not be summarily dismissed from consideration of some nature of a biological role. Doubtless, peptide chemists, in general, were attracted to synthesize truncated analogs of SP not only because the N-terminal moiety does not contribute to agonist mechanisms, but
114 Ophthalmology
because truncated analogs can be more quickly synthesized, and at less expense, and probably be purified to a high state of purity more readily than the corresponding undecapeptides. Web site: http://www.delphion.com/details?pn=US04481139__ •
Pharmaceutical compositions and their use as mydriatics Inventor(s): Carenzi; Angelo (Via Rossini, 9, 21051 Busto Arsizio, IT), Casagrande; Cesare (Via Campo Gallo, 21/67, 20020 Arese, IT), Cerri; Oreste (Viale Campania, 21, 20133 Milano, IT), Miragoli; Giovanna (Corso Italia, 1, 20122 Milano, IT), Pozzi; Franco (Via Jacopo Rezia, 11, 22100 Como, IT), Virno; Michele (Via Papiniano, 29, 00137 Roma, IT) Assignee(s): none reported Patent Number: 4,764,530 Date filed: August 26, 1986 Abstract: Pharmaceutical compositions and their use in ophthalmology. Said compositions comprise ibopamine (epinine 3, 4-0-diisobutyrate and are used mainly as mydriatics. Excerpt(s): This invention relates to new pharmaceutical compositions and their use in ophthalmology. More particularly this invention relates to new pharmaceutical compositions comprising ibopamine or a pharmaceutically acceptable addition salt thereof, and to their use as mydriatics. Ibopamine (epinine 3,4-O-diisobutyrate) is a drug useful for systemic use in cardiovascular therapy (U.S. Pat. No. 4,218,470). Web site: http://www.delphion.com/details?pn=US04764530__
•
Pharmaceutical compsition of herpes simplex virus type-1 (HSV-1), glycoproteins Inventor(s): Ghiasi; Homayan (Los Angeles, CA), Nesburn; Anthony B. (Malibu, CA), Wechsler; Steven L. (Westlake Village, CA) Assignee(s): Cedars-Sinai Medical Center (Los Angeles, CA) Patent Number: 5,955,088 Date filed: June 7, 1995 Abstract: The present invention relates to the field of infectious diseases and ophthalmology. More particularly, the invention relates to compositions and methods for vaccination against Herpes Simplex Virus which rely on preparations comprising a mixture of five, six, or seven HSV glycoproteins selected from the group consisting of gB, gC, gD, gE, gG, gH, and gI. Excerpt(s): Herpes Simplex Virus (HSV), also known as herpesvirus hominis, is classified into two (2) types, 1 and 2. HSV-1 is transmitted by physical contact, such as kissing, and is thus spread among family members and friends. About half of all babies in the United States are born with IgG antibodies to this agent which is transmitted across the placenta. As this immunity dissipates, new infections are acquired until, by age 45, close to 70% of people have become serologically positive--most without ever experiencing signs of disease, others after one or several episodes of fever blisters or cold sores. In contrast, HSV-2, also called genital herpes, is transmitted during birth or
Patents 115
by sexual contact. The latter's incidence rises with the number of sexual partners and has therefore greatly increased in today's society. Compared with HSV-1, genital herpes is less prevalent overall but is likewise cumulative with age. In addition, genital herpes has engendered considerable anxiety because there is tenuous evidence that it may contribute to the causation of cervical cancer, and because of the risk of vertical transmission during childbirth inducing serious disease. Infections with both causative agents are difficult to prevent; and there is as yet no proven vaccine for the prophylaxis of genital herpes. Moreover, an ocular vaccine for the prophylaxis of ocular HSV has not been tried in humans. Web site: http://www.delphion.com/details?pn=US05955088__ •
Semi-synthetic material usable in medicine and surgery Inventor(s): Camprasse; Georges (Villenauxe la Petite, FR), Camprasse; Serge (Chelles, FR) Assignee(s): Pearl Ventures, Inc. (Ridgefield, CT) Patent Number: 5,755,787 Date filed: September 15, 1995 Abstract: A semi-synthetic material for producing shaped elements for use in orthopaedic surgery, bone stabilizing and regenerating materials and biological cement, made from the mother-of-pearl of aquatic molluscs which is subjected to a specific mechanical, thermal or chemical treatment in order to alter its physical and chemical structure. The material may be powdered, mixed with calcium hydroxide, any other calcium salt, collagen or starch, dried and shaped into prosthetic members. Said material may be combined with methyl or acrylic derivatives, antibiotics or antimitotic agents, and is suitable for use in orthopaedic surgery, dentistry, carcinology, ear, nose and throat medicine, gynaecology and ophthalmology. Excerpt(s): The present invention relates to a semi-synthetic product obtained after a specific mechanical, thermal and chemical treatment of mother of pearl intended to modify the structure and the properties in such a manner that it may be used for the manufacture of shaped parts for the orthopaedic, craniofacial surgery, for the preparation of biological cements for the sealing of prostheses, of a bone regenerating material and of a stabilizing material in carcinology and in intervening imagery. The basic material, mother of pearl, originates from the nacreous test of aquatic mollusca, the physical-chemical structure of which comprises in addition to a mineral fraction representing 90% to 98% of the total mass in the shape of biocrystals, an organic fraction composed of fibers and non fibers, soluble or non-soluble proteins having a genic specificity making its use unsuitable in the actual state on the animal and on the man. In effect, the biomaterial used as such would behave as a xenograft and would exhibit within a variable time its antigenic character with an unfavourable immunological reaction which could cause the rejection thereof. Web site: http://www.delphion.com/details?pn=US05755787__
116 Ophthalmology
•
Single-mode laser Inventor(s): Kazic; Marko (Tolmin, YU), Trost; Stojan (Kranj, YU), Vedlin; Boris (Ljubljana, YU) Assignee(s): Iskra-Sozd elektrokovinske industrije n.sol.o. (Ljubljana, YU) Patent Number: 4,672,616 Date filed: January 27, 1986 Abstract: The invention relates to a single-mode laser provided with a folded optical resonator, comprising a laser rod 1, resonator mirrors 3A, 3B deposited by evaporation on a single mirror plate 3, a stop 6 provided with two separate apertures 6A, 6B which are overlapped by the laser rod 1 when they are viewed along it and which are located so that the rays traversing the aperture 6A or 6B towards the resonator mirrors 3A, 3B, respectively, completely impinge only on the high reflecting resonator mirror 3A or on the semitransparent resonator mirror 3B, a foil Q-switch 5 and a reversing prism 4.The device according to the invention is compact, of moderate price and is provided with a dynamically stable optical resonator, it generating single-mode laser pulses with a divergence below 2 mrad, but with an energy about 15 mJ and with a width about 10 nsec.The device according to the invention is intended for use e.g. in ophthalmology or elsewhere where the laser pulses characterized above are required. Excerpt(s): Present invention relates to lasers and in particular to ophthalmic laser systems. Object of the invention is a single-mode laser in which a stop provided with two separate apertures is placed into the optical resonator in such manner that the apertures are located in front of one end face of a laser rod. The energy and the divergence of a single-mode output pulse generated by the laser according to the invention are comparable to the output pulse originating from several times larger lasers belonging to the prior art. The laser device proposed by the invention is dynamically stable. Ihe invention is generally applicable in lasers. The single-mode laser according to the invention is intended to be used e.g. in ophthalmology where in a combination with a slit lamp it is used in surgical operations, or elsewhere where a compact laser device with set demands on laser pulse quality is required. The problem solved by the present invention lies in providing a laser which should be as compact and of as moderate price as possible and which should have a dynamically stable optical resonator and the divergence of the singlemode laser pulse generated by it should not exceed 2 mrad, but on the other hand the laser output pulses should have an energy about 15 mJ and a pulse width about 10 nsec. In the published patent application DE-OS No. 28 04 046 a laser provided with a folded optical resonator is described, in which resonator mirrors are mounted on a common holder. Thereby a dynamic stability of the optical resonator is intended to be increased. Disadvantageously, in this laser rays traverse the laser rod in only one branch of their path inside the optical resonator, while the path of the rays in the second branch of the optical resonator is not exploited for an amplification of the laser ray. As another disadvantage displayed in said laser the fact may be considered that an optical wedge is required to compensate wedge errors inherent to individual optical components which are traversed by rays, especially to both resonator mirrors. Web site: http://www.delphion.com/details?pn=US04672616__
Patents 117
•
Stereoscopic microscope including a field-magnifying lens in front of the objective lens Inventor(s): Kirchhuebel; Rainer (Asslar, DE), Spitznas; Manfred (Bonn, DE), Volkert; Heinz (Wetzlar, DE) Assignee(s): Oculus Optikgeraete GmbH (Wetzlar-Dutenhofen, DE) Patent Number: 5,282,085 Date filed: May 8, 1992 Abstract: The invention relates to a stereoscopic microscope, which is suited both for pure observation and also for support during surgical procedures in ophthalmology. It can be adapted to both uses through an inversion optics arrangement, which can be removed from the beam path of the microscope. The inversion optics arrangement is arranged in an attachment containing a field-magnifying lens, which attachment is needed in most cases, and is located between the field-magnifying lens and the objective lens of the microscope such that it is movable within the attachment. Thus, the fieldmagnifying lens does not need to be moved in the case of sight defects of a patient, but the correction is carried out with the inversion optics arrangement, and this means an inside focussing occurs. The inversion optics arrangement can also be removed with the attachment so that the microscope can then be used as a normal viewing microscope. In place of the field-magnifying lens, it is also possible to provide a prism system for the image inversion. Excerpt(s): The invention relates to a stereoscopic microscope, which can be used in ophthalmology both as a viewing microscope with relatively small image sections and also during eye surgeries for contact-free observation of a relatively large image section of a freely movable eye of a patient, in particular of the background of the eye, essentially including an objective lens arrangement, preferably an enlargement changer, an eyepiece arrangement, for example in the form of a telescopetube eyepiece for each eye of the observer, a prism and lens system between the lens arrangement and the eyepiece arrangement for the inversion and parallel alignment of two beam paths coming from the eyepiece arrangement, a housing for receiving all operating elements and operating devices, and a removable field-magnifying lens along the optical axis of the microscope in an attachment between the lens arrangement and the eye of the patient. German Offenlegungsschrift 38 26 069 discloses already a stereoscopic microscope for the same purpose. An inversion system of a number of stereoscopically connected prisms, which system can be selectively moved into the microscope between the lens and the eyepiece arrangement in the stereoscopic beam path, ensures that a laterally inverted image standing on its head and made available by the microscope is inverted such that an upright, stereoscopically correct image reaches the eyes of the observer. Such a prism arrangement does guarantee a compact structural length of the entire microscope; however, it is disadvantageous that the inversion system is arranged inside of the microscope; this requires significant structure and creates also technical manufacturing problems, because it must be assured that the inversion system is arranged in the beam path and is precisely oriented with respect to this beam path. Web site: http://www.delphion.com/details?pn=US05282085__
118 Ophthalmology
•
Surface topographer Inventor(s): Adachi; Yoshi (16241 Watson Cir., Westminster, CA 92683) Assignee(s): none reported Patent Number: 5,080,477 Date filed: November 8, 1990 Abstract: A computer assisted optical instrument analyzes a differential wave front developed by subtracting the wave front due to a circular grating reticle only in the optical path, from the wave front due to a reflecting surface being analyzed in the optical path including the reticle, to obtain a Foucault shadow fringe pattern indicating the surface curvature. The differential wave front is analyzed by the circular grating and a CCD camera, in polar coordinates, to obtain polynomial coefficients defining the wave front. The polynomial is then plotted and displayed as the topographic shadow fringe pattern of the reflected surface. Dedicated lens and reflector combinations adapt the instrument to specific embodiments in ophthalmology and metrology. Excerpt(s): This invention is related to measuring instruments for the measurement of electromagnetic radiation flux fields for the purpose of inferring characteristics of an illuminated surface, and more particularly to optical and near-optical measurement of physical characteristics of a surface and examining its topography, with special applications in measurement of curvature for ophthalmology, and precision measurement for inspection and manufacturing. A prior patent issued to the same inventor, Adachi, U.S. Pat. No. 4,692,003, teaches the use of real-time analysis of optically generated patterns using circular gratings, and a Moire pattern that indicates transverse aberration from an ideal curvature for an object such as the cornea of a human eye. The invention differs from this patent in that Moire is not used and a different optical system, as well as a different data analysis and processing method using Zernike polynomials, is used. Only the use of the circular grating is common to both. In accordance with the invention, the use of a circular grating reticle in the optical path, lends itself to mathematical identification of points on the wave front, in polar coordinates. A radiated wave front is received by a photometric detector such as a CCD camera, from an illuminated surface through the circular grating reticle, such that the identified points have an intensity value assigned to them. When digitized and processed by a computer and display device, the coordinate and intensity data in the wave front image will produce a shadow fringe pattern if the grating reticle is placed in front of the focus point of the reflective optics, that is, the image of the grating is slightly defocused. The shadow fringe pattern with no reflective surface in the optical path is a series of concentric bands whose number depends on the period (resolution) of the particular grating used. When a surface to be tested is placed in the reflective optical path, the fringes may become distorted and locally spaced further apart in accordance with the contour of the reflective surface. In analyzing curved surfaces such as spheres, one or a series of equally spaced rings are expected for a well formed sphere. The period of the grating reticle establishes the resolution of the analysis; however, interpolation by computer program can display any number of fringes desired for analysis of the topography. Web site: http://www.delphion.com/details?pn=US05080477__
Patents 119
•
Surgical needle configuration with spatula geometry Inventor(s): Maurer; Thomas (San Angelo, TX), McGregor; Walter (Flemington, NJ) Assignee(s): Ethicon, Inc. (Somerville, NJ) Patent Number: 5,002,564 Date filed: June 19, 1989 Abstract: A spatulated needle is provided wherein a six-sided cross-sectional portion results from a parallel or tapered pair of upper and lower surfaces connected by needle walls and a pair of fluted edges. At the tapered end of the needle, the upper surface alternates resulting in a five-sided cross-section. This improved configuration results in ease of tissue penetration, minimized tissue distortion, and minimized wound trauma. The resultant needle therefore is desirable for usage with refined surgery such as ophthalmology, microsurgery and plastic surgery. Excerpt(s): The present invention relates generally to improved surgical needles. More specifically, the present invention relates to surgical needles which have improved sharpness and reduced penetration resistance between needle and tissue during surgery. Most specifically, the present invention relates to a surgical needle whereby the wound opening area is reduced in order to better perform sensitive surgeries by minimizing tissue distortion and improving tissue apposition. The performance criteria of surgical needles can be measured in three interrelated ways. First, needle sharpness is necessary to reduce penetration resistance between needle and tissue. Greater sharpness lessens the external force required to embed the needle into tissue during surgery. Second, it is desirable to improve the needle cross-section so that the tissue opening, more commonly referred to as the wound opening site, is also reduced. As suspected, with improved penetration, the wound opening is also reduced. Third, when wound opening size is reduced, this will generally minimize the amount of tissue distortion and trauma during penetration of the needle. With improved penetration, reduced wound opening and minimized tissue distortion, tissue apposition is generally improved As a result, finer and more approximate surgery is possible. Thus, with improved needle sharpness, it is increasingly possible to perform more specialized surgery, especially in such highly refined areas as ophthalmology, microsurgery or plastic surgery. Web site: http://www.delphion.com/details?pn=US05002564__
•
Synchronous vitreous lavage device for ophthalmology and an ophthalmologic lavaging system using the same Inventor(s): Lin; Po-Kang (2F, No.283-1, Chang Tsun Road, Taipei, TW) Assignee(s): none reported Patent Number: 5,957,883 Date filed: September 30, 1997 Abstract: A synchronous vitreous lavage device for ophthalmology an includes a platform, a pair of main supporters, an auxiliary supporter, a pair of gears, a pair of movable seats, a pair of screw rods, and a clamp. When the screw rods rotate in different directions, the two movable seats move in opposite direction. Thus, the lavage device simultaneously drains bloody water from the eyeball, and injects lavage water into the eyeball by means of two syringes. The bloody water in the eyeball can be easily removed from the eyeball at a cheap cost. An ophthalmologic lavaging system is formed
120 Ophthalmology
by connecting two regulating syringes through two three-way valves to the lavage device. Excerpt(s): After a patient has been performed an ophthalmological surgical operation, such as retina surgical operation, some bloody water remains within the patient eyeball and should be removed from the eyeball. Conventional method of removing the bloody water is to perform an additional ophthalmological surgical operation. The conventional method is costly, dangerous and time-consuming. It is an object of the Present invention to provide a synchronous vitreous lavage device for ophthalmology. The synchronous vitreous lavage device of this invention comprises a platform, a pair of main supporters, an auxiliary supporter, a pair of gears, a pair of movable seats, a pair of screw rods and a clamp for holding and controlling two lavage syringes. After two syringes are mounted on the lavage device, the finger flanges of the syringes are fixed to the main supporters by means of the engagement of the finger flanges to the main supporters. The thumb rests of the pistons of the syringes are fixed to the movable seats by means of the engagement of the thumb rests to the movable seats. When the handle affixed to the gear is rotated by the turning of the hand, the first screw rod is rotated in one direction and the second screw rod is rotated in the opposite direction. The first movable seat and the second movable seat move in opposite directions. Then, one of the syringes absorbs the bloody water from the eyeball into it, and the other syringe simultaneously injects lavaging water into the eyeball. The absorption and injection of the two syringes are synchronously and isovolemicaly. Thus in the present invention it becomes easy, accurate and convenient to remove the bloody water. Please see FIGS. 1-3, a synchronous vitreous lavage device for ophthalmology 1 of the present invention comprises a platform 11, two main supporters 121,123 and an auxiliary supporter 122, two gears 161,162, two movable seats 131,132, two screw rods 151,152, and a clamp 14. Web site: http://www.delphion.com/details?pn=US05957883__ •
Ultrasonic diagnostic apparatus and method for ophthalmology Inventor(s): Kajino; Tadashi (Okazaki, JP), Nakao; Munehiro (Toyokawa, JP) Assignee(s): Nidek Co., Ltd. (Gamagori, JP) Patent Number: 5,125,409 Date filed: March 5, 1991 Abstract: An ultrasonic diagnostic apparatus for ophthalmology according to the present invention includes a card connector into and from which a memory card is to be inserted and removed, a microcomputer incorporated in the apparatus, and a card interface for data transfer between the memory card and the microcomputer therethrough. Diagnosis data is obtained based on data of the memory card and data in the microcomputer, whereby even when a new program or data necessary for diagnosis is developed, the apparatus can immediately used the new program or data while eliminating the need for being modified. The apparatus thus can readily reproduce patient data and efficiently diagnose many patients. Excerpt(s): The present invention generally relates to ultrasonic diagnostic apparatuses for ophthalmology and more particularly, to an ultrasonic diagnostic apparatus and method for ophthalmology which use ultrasonic waves suitably for measurement of the axial length and for diagnosis of the intraocular tissue. When comparison is made between diagnostic apparatuses for ophthalmology and medical ultrasonic diagnostic apparatuses for applications other than ophthalmology (such latter apparatuses are
Patents 121
sometimes referred to merely as the non-ophthalmic apparatuses), the ophthalmic apparatuses require probes to be contacted with the eye to be examined. For that reason, the structure and arrangement of the probes are devised in various ways but how ophthalmic apparatuses transmit and receive ultrasonic waves is not especially different from how non-ophthalmic apparatuses operate. In ultrasonic diagnostic apparatuses for ophthalmology, it is not very helpful to only receive the ultrasonic waves reflected by the respective intraocular tissue, process the received ultrasonic signal by a known processing technique, and then indicate the signal on a display in the form of an Amode waveform or a B-mode image. It is when the measurement data thus obtained is added to the data base on the ophthalmologist's experience that the measurement data can become helpful. of an intraocular iens (an "IOL") inserted after cataract surgery. The calculation of IOL power is carried out by substituting into a power calculation formula the axial length obtained by the ultrasonic diagnostic apparatus. Such IOL power calculations have been formulated based on the ophthalmologist's long-term experience; there now exist 5 such typical formulas. Each of these formulas has merits and demerits. In this way, no single IOL power calculation formula has yet been recognized by a majority of ophthalmologists for its validity. Since the existing formulas have been established based on the individual ophthalmologist's experiences, the formulas tend to vary as the individual opthalmologist's experience is added thereto. The same applicant as the present application has proposed an ultrasonic diagnostic apparatus for ophthalmology suitable for differential diagnostics in U.S. patent application Ser. No. 313,203 filed on Feb. 21, 1989. This apparatus comprising a means for storing therein a plurality of reflected-echo images having a dynamic range larger than a display image is arranged to retrieve an image of a given condition, which corresponds to the obtained image by adjusting its dynamic range, from the reflection echo images stored in said means. Even in this apparatus, it is impossible to determine what condition is proper for retrieving an image from the storage memory. In other words, the individual ophthalmologist's continual clinical experience is heavily relied upon in using the apparatus for diagnosis, and must be dependable. Web site: http://www.delphion.com/details?pn=US05125409__ •
Ultrasonic diagnostic apparatus for ophthalmology Inventor(s): Baba; Yukio (Hiroshima, JP), Kajino; Tadashi (Okazaki, JP) Assignee(s): Nidek Co., Ltd. (Gamagori, JP) Patent Number: 5,029,587 Date filed: February 21, 1989 Abstract: A novel ultrasonic diagnostic apparatus for ophthalmology is disclosed in which a plurality of reflection echo images having a dynamic range larger than a display are stored, an image of a given condition is retrieved from the reflection echo images thus stored, and the image thus retrieved is displayed. As many diagnostic data as possible are obtained from a single frozen image thereby to produce acoustic information on a biological tissue. Excerpt(s): The present invention relates to an ultrasonic diagnostic apparatus for ophthalmology in which an ultrasonic wave is transmitted from an ultrasonic transducer and an echo, reflected from the tissue at each part within an organism, is received so that the ultrasonic signal thus received is processed with waveforms or the like displayed. The present invention also relates to an ultrasonic diagnostic apparatus for ophthalmology suitable for precision diagnosis of a biological tissue with a fine
122 Ophthalmology
structure such as the eye. The use of a diagnostic apparatus using and ultrasonic wave for obtaining information on the internal parts of organs of a person is rapidly advancing. The marked progress of the image processing technique has permitted the utilization of an economical ultrasonic wave with low invasiveness and other superior characteristics as compared with the existing ones for diagnosis. The ultrasonic diagnostic apparatus is widely known in either 1) A mode type method in which a wave reflected from an object is displayed as a waveform (i.e., a single position) on a cathode ray tube or 2) B mode type method in which a single, obtained by an A mode method and subjected to intensity modulation, is used to scan a transducer thereby to display a section (i.e., a plurality of single positions from the A mode method) as an image. Web site: http://www.delphion.com/details?pn=US05029587__ •
Uncrosslinked hydrogel, process for its preparation and its uses as an article for medical and/or surgical purposes such as tubes, films, joints, implants and the like, particularly in ophthalmology Inventor(s): Homiger; Jiri (Villejuif, FR), Laroche; Laurent (Paris, FR) Assignee(s): Institute National de la Sante et de la Recherche Medicale- Inserm (Paris, FR) Patent Number: 5,273,750 Date filed: November 21, 1990 Abstract: The invention relates to an uncrosslinked hydrogel, its process of preparon as well as its uses as an article for medical and/or surgical purposes such as tubes, filaments, films, joints, implants and the like, especially in ophthalmology. The uncrosslinked hydrogel has a relatively high water content and is constituted from a liquid starting composition which comprises 2 to 50% of a copolymer of acrylonitrile and an olefinically unsaturated comonomer bearing aninic groups, possible salified, the molar ratio arcylonitrile-comonomer being comprised between 90:10 and 100:0, a suitable solvent and a suitable non-solvent of said copolymer. The ratio solvent/nonsolvent is comprised between 500:1 and 0.5:1 by weight, said hydrogel having a microporous structure, an ionic capacity comprised between 0 and 500 mEq/kg of gel, a hydric content compressed between 50 and 98% and having an aptitude for permanent deformation under stress, even at a temperature below 40.degree. C. Excerpt(s): The present invention relates to an uncrosslinked hydrogel, to its process of preparation as well as to its applications as an article for medical and/or surgical purposes such as tubes, filaments, films, joints, implants and the like, particularly in ophthalmology. It has already been proposed, to employ polymers in hydrogel form having a relatively high water content whilst having improved mechanical and optical properties (European patent No. 188 110 and U.S. Pat. Nos. 4,379,864 and 4,543,371), for ophthalmic purposes. However, the product described in U.S. Pat. Nos. 4,379,864 and 4,543,371 do not show a high water content; these polymers lose, in fact, the required mechanical properties, particularly for their use as an implant, when the water content is high. Web site: http://www.delphion.com/details?pn=US05273750__
Patents 123
Patent Applications on Ophthalmology As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to ophthalmology: •
Biological material, method of preparing such materials, uses thereof and products made therefrom Inventor(s): Bagrov, Sergei Nikolayevich; (Moscow, RU), Fedorov, Svyatoslav Nikolayevich; (Moscow, RU), Larionov, Yevgeny Viktorovich; (Moscow, RU) Correspondence: Law Offices OF William L. Klima, P.L.C.; P.O. Box 2855; Stafford; VA; 22555-2855; US Patent Application Number: 20010038847 Date filed: December 26, 2000 Abstract: A biological material is prepared for use in ophthalmology by steps of providing animal pericardium, subjecting the animal pericardium to multiple steps of freezing and thawing in a salt solution and incubating the animal pericardium in a solution of ammonia and ethyl alcohol. The multiple steps of freezing and thawing are conducted in a mixture of about 0.9% sodium chloride solution and distilled water in about 1:1 proportions of sodium chloride solution to distilled water. The incubating step is conducted in a mixture of 1% ammonia solution and 1% ethyl alcohol solution in about 1:1 proportions of ammonia solution to ethyl alcohol solution over a period of 48 to 72 hours. Excerpt(s): This application is a continuation-in-part application of Ser. No. 08/628,379, filed Apr. 5, 1995. The invention relates to biological materials, methods of preparing such biological materials and uses thereof for example in ophthalmology. The invention may be used to produce anti-glaucoma drainage tubes for the surgical treatment of glaucoma, to produce collagen solutions to treat mild myopia and to produce pharmaceuticals for external use. Biological materials have been extracted from raw material of animal origin, such as pig eye sclera, by treatment with alkali and acetic acid solutions as shown in Soviet Inventor's Certificate No. 1747075, Cl. A 61 K 37/12. The material synthesized by this prior art method can be used in ophthalmological applications only after very lengthy and complex treatment. The material is characterized by extremely high solubility and low enzyme resistance. Hence, the material is not suitable for use in ophthalmology. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
9
This has been a common practice outside the United States prior to December 2000.
124 Ophthalmology
•
Ectocornea extension promoters Inventor(s): Fujihara, Tsutomu; (Kadoma-shi, JP), Fujita, Hiromi; (Osaka-shi, JP), Nakamura, Masatsugu; (Nara-shi, JP), Nakata, Katsuhiko; (Sakurai-shi, JP) Correspondence: Albert P Halluin; Howrey Simon Arnold & White; Box 34; 301 Ravenswood Avenue; Menlo Park; CA; 94025; US Patent Application Number: 20030186927 Date filed: May 20, 2003 Abstract: Based on research for compounds that can display a corneal epithelial migration promoting effect in ophthalmology, the present invention provides P2Y receptor agonist corneal epithelial migration promoters, such as phosphoric acid compounds having an adenosyl group, uridyl group, xanthosyl group, guanosyl group, or thymidyl group, or their salts, with excellent corneal epithelial migration promoting effects. Excerpt(s): The present invention pertains to a type of corneal epithelial migration promoter that contains P2Y receptor agonist as the effective component. The cornea is transparent tissue with no blood vessels, a diameter of about 1 cm and a thickness of about 1 mm. The transparency of a cornea has an important influence on visual function. Various physiological and biochemical phenomena of the cornea mainly function to maintain this transparency. Corneal epithelial defects caused by corneal ulcers, exfoliation of corneal epithelium, keratitis, dry eyes, and various other diseases can be repaired naturally if no mixed infection occurs. However, if repair is delayed or not made for certain reasons, corneal epithelial migration takes place, such that the normal epithelium construction is adversely affected, and the structure and function of the parenchyma and endothelium are also harmed. In prior art, the principal therapy was the so-called passive method, in which the surface of the cornea is protected from external stimulation so that the epithelium again extends naturally to cover the damaged portion. In recent years, with developments in cell biology, factors pertaining to split, movement, fusion, migration, etc., have been clarified, and it has been reported that compounds that can promote corneal epithelial migration play an important role (Ringan, 46, 738-743 (1992); Ganka Shujutsu, 5, 719-727 (1992)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Histochrome and its therapeutic use in ophthalmology Inventor(s): Artjukov, Alexander Alexeevich; (Vladivostok, RU), Elyakov, Georgy Borisovich; (Vladivostok, RU), Fedoreev, Sergei Alexandrovich; (Vladivostock, RU), Glebko, Ljutsia Ignatievna; (Vladivostok, RU), Koltsova, Evgenia Alexandrovna; (Vladivostok, RU), Krasovskaya, Natalya Petrovna; (Vladivostok, RU), Maximov, Oleg Borisovich; (Vladivostok, RU), Mischenko, Natalya Petrovna; (Vladivostok, RU) Correspondence: Pennie & Edmonds Llp; 1667 K Street NW; Suite 1000; Washington; DC; 20006 Patent Application Number: 20010021723 Date filed: April 12, 2001 Abstract: A pharmaceutical composition is provided which comprises an isotonic solution of an 0.02% mixture of di- and trisodim salts of echinochrome (Histochrome). It meets the requirements that apply to injectable formulations. Histochrome
Patents 125
administration to human patients normalizes metabolic processes and eliminates inflammation in the retina, vascular membrane and cornea of the eye, improves trophic functions, reduces edema and accelerates epithelization. Excerpt(s): The present invention relates to medicine and, more specifically, to a novel pharma-ceutical composition useful in the treatment of ophthalmic diseases. At present, the role of free-radical peroxidation in the development of various diseases of the retina, optic nerve and other structures of the eye is well appreciated. For this reason, antioxidants are used increasingly in the treatment of ocular diseases. These compounds are able to alleviate inflammatory resorptive phenomena, to accelerate epithelization of the cornea and to reduce the incidence of dangerous complications that may result in the death of the eye. The synthetic antioxidant Emoxipin (2-ethyl-6-methyl-4-oxypyridine) is known by its ability to reduce the capillary permeability and to inhibit blood coagulation. Injection of a 1% solution of this compound facilitates the resorption of intraocular hemorrhages. Emoxipin is clinically used in the treatment of chemical and thermal burns of the eye and in the keratoplasty of burn-related leukomas. However, monitoring of the blood coagulation system is required in the course of Emoxipin therapy, since this compound is liable to cause reccurrent hemorrhages (Egorov E. A., Shvedova A. A., Obraztsova I. S. Results of a clinical study of the antioxidant Emoxipin in the treatment of eye diseases. Vestnik Oftalmologii, 1989, No. 5, pp. 52-55, in Russian). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
LOW-OXYGEN FLUOROCARBON AS AN AGENT FOR OPHTHALMOLOGY Inventor(s): DRESP, JOACHIM; (MUNCHEN, DE), GABEL, VIET-PETER; (REGENSBURG, DE), KOBUCH, KARIN; (PENTLING, DE), MENZ, DIRK-HENNING; (DIEDORF, DE) Correspondence: Thomas P. Sarro; Larson & Taylor; Suite 900; 1199 North Fairfax Street; Alexandria; VA; 22314 Patent Application Number: 20020001607 Date filed: March 16, 1999 Abstract: The present invention concerns fluorocarbons for use in ophthalmology. Fluorocarbons disclosed in the prior art can only be left in the eye for a limited period of time because they cause damage to the retina or intraocular structure. The present invention provides an oxygen-fluorocarbon mixture having a dissolved oxygen content of less than 6% by volume, which can be used as an ophthalmological agent for longer periods of time than conventional fluorocarbons, with little or no damage to the retina or intraocular structures. The invention also provides a process for preparing the oxygen-fluorocarbon mixture. In one embodiment, up to 20% by volume of a second gas, such as carbon dioxide or nitric oxide, is combined with the oxygen-fluorocarbon mixtures. Excerpt(s): The invention concerns the use of a fluorocarbon as an agent for ophthalmology. Within the meaning of this description, the term "fluorocarbon" either refers to compounds from the class of saturated, perfluorinated hydrocarbons in which all of the hydrogen atoms are replaced by fluorinated atoms, or partially fluorinated alkanes having the general formula R.sub.FR.sub.H or R.sub.FR.sub.HR.sub.F that can be present in a liquid or gel-like state. In this case, R.sub.F is a perfluorinated alkyl group and R.sub.H an alkyl group. Substances of this type, as well as their possible
126 Ophthalmology
applications in medicine and technology are, for example, described in DE 42 05 341 A1, U.S. Pat. Nos. 5,275,669, 4,490,351, EP 493 677 A2 and DE 195 36 504 A1. These fluorocarbons are almost always saturated with oxygen in a highly concentrated manner, whereby the oxygen is present in a physical solution. When increasing the partial pressure of the oxygen, fluorocarbons can store up to 50% by volume of oxygen. This compound-typical property was the basis for the development of numerous technical applications of these compounds (see the article by B. Cornils "Fluorous biphasic systems" in Angew. Chemie [Applied chemistry] 1997, 109, 2147), as well as medical applications, e.g. as blood substitutes, as means for liquid artificial respiration, as oxygen carriers in ointments, etc. Fluorocarbons having a low content of dissolved oxygen spontaneously and very quickly absorb oxygen in contact with air until a balance between dissolved oxygen and the oxygen content of the ambient atmosphere is reached. These medical applications of fluorocarbons as oxygen carriers were described, for example, in the aforementioned publications and in the paper by K. C. Lowe "Properties and Biomedical Applications of PFC and their Emulsions", in Org. Fluorine Chem.: Principles and Commercial Appl., Plenum Press, N.Y. 1994. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Medical laser therapy device Inventor(s): Gerlach, Mario; (Eisenberg, DE), Kalies, Alexander; (Frauenpriessnitz, DE), Kempe, Michael; (Kunitz, DE), Kittelmann, Olaf; (Kleinmachnow, DE), Muehlhoff, Dirk; (Kunitz, DE), Wiechmann, Martin; (Jena, DE), Zimare, Diegeo; (Jena, DE) Correspondence: Reed Smith Llp; 375 Park Avenue; New York; NY; 10152; US Patent Application Number: 20020177844 Date filed: January 10, 2002 Abstract: A medical laser therapy device, particularly for use in ophthalmology and surgery, comprises a controllable pump module with a coupling element for a waveguide, a beam control device in the form of a waveguide for supplying the pumping radiation delivered by the pump module to the applicator which is provided with a coupling element for the waveguide for introducing a target beam and/or treatment beam into the eye to be treated. The device is primarily characterized in that the pump module has laser diodes whose electromagnetic pumping radiation is in the spectral range from 800 nm to 815 nm, and in that an optics module is provided which couples the pumping radiation into the waveguide, in that the beam control device is an Nd-doped waveguide laser with a double core or single core and a suitable reflecting coating of the fiber end faces, the waveguide forming a laser cavity with radiation in a frequency range between 1050 nm and 1070 nm, in that the applicator is a laser slit lamp with zoom system having a device for frequency doubling which preferably comprises nonlinear optical material or periodically poled nonlinear optical material, in that the applicator has a device for power monitoring and a device for illuminating and observing the operating field, and in that the applicator has a target beam device whose radiation is coupled collinearly into the beam path for the therapy radiation by a suitable beamsplitter. The medical therapy device is constructed in a modular manner. Excerpt(s): This application claims priority of German Application No. 101 00 859.7, filed Jan. 11, 2001, the complete disclosure of which is hereby incorporated by reference. The invention is directed to a medical laser therapy device, particularly for use in surgery and ophthalmology. In scarcely any other medical discipline is the use of lasers so established as in ophthalmology, where patients have the very considerable advantage
Patents 127
of noninvasive treatment which can usually be performed on an outpatient basis. Alternative methods are often unavailable or involve invasive procedures in the eye. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for preparing a latex with photochromic properties and uses thereof, particularly in Ophthalmology Inventor(s): Cano, Jean-Paul; (Chennevieres sur Marne, FR), Charleux, Bernadette; (Vincennes, FR), Maisonnier, Sylvette; (Moisselles, FR), Tardieu, Pascale; (Paris, FR), Vairon, Jean-Pierre; (Bourg la Reine, FR), Wajs, Georges; (Ivry sur Seine, FR) Correspondence: Mark B. Wilson; Fulbright & Jaworski L.L.P.; Suite 2400; 600 Congress Avenue; Austin; TX; 78701; US Patent Application Number: 20020128339 Date filed: August 24, 2001 Abstract: This invention relates to a method for preparing a photochromic latex, photochromic thin films obtained therefrom, and articles coated with such thin films, in particular photochromic ophthalmic lenses. Excerpt(s): The object of the present invention is a method for preparing a photochromic latex, photochromic thin films obtained from the latter, and articles coated with such thin films, in particular photochromic ophthalmic lenses. The phenomenon of photochromism has been known for many years. A compound is described as photochromic when, for example, this compound, irradiated with a light beam containing some wavelengths in the ultraviolet region, changes colour and returns to its original colour when the irradiation ceases. There are many applications of this phenomenon, but one of the most useful known applications is in the ophthalmic optics field, in the manufacture of lenses or spectacle glasses, so as to filter the light radiation as a function of its intensity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Method for preventing deterioration of the sense of sight and/or for mending the sense of sight of users of display facilities Inventor(s): Turovetsky, Vladimir Naumovich; (Moskovskaya Obl, RU) Correspondence: William Collard; Collard & Roe, P.C.; 1077 Northern Boulevard; Roslyn; NY; 11576; US Patent Application Number: 20030156254 Date filed: February 26, 2003 Abstract: The invention relates to medicine, more precisely to hygieology and ophthalmology, and can be used for preventing deterioration of the sense of sight and also for improving the sense of sight of users reading off a screen. The invention increases the level of comfort and the reliability of the inventive method. The inventive method consists in influencing the user's eyes by additional pictures on screen, whereby an image is formed whose shape and color have a relaxing effect on a visual analyzer. The duration of exposure of the additional pictures is organized in such a way that makes it possible to restore the content of adenosine triphosphate and oxygen in the eye tissue; time intervals between exposures is less than time needed for acidulation of
128 Ophthalmology
tissues and for the occurrence of a lack of oxygen. In the beginning the user watches such additional pictures whose shape and color range have a relaxing reflect on the visual analyzer region in the central nervous system (CNS). The shape and the color range of the additional pictures which have a relaxing effect on the visual analyzer are selected in such a way that they perform a relaxing effect on lateral and transversal eye muscles. The time interval between the images ranges from 20 to 150 min, the duration of exposure is selected within a range of 1.0 to 6.0 min. Together with the relaxing effect on a visual organ, said relaxing action is also exerted on an organ of hearing and muscles of the neck. The shape of at least a part of the additional pictures is smooth and roundish without distinct lines and boundaries. Excerpt(s): The invention relates to medicine, more precisely to hygieology and ophthalmology, and can be used for preventing deterioration of the sense of sight and improving the sense of sight of a person reading images off the screen of a video device, such as a computer, television set and the like. Numerous studies have shown that prolonged viewing of a video device screen can cause such changes in the visual organ as onset or progress of existing myopia. Such changes are related to the specifics of screen images (self-luminous, low contrast, discrete and flickering), which are very tense and even stressful for the human eye to read off, and during computer operation requiring the eye to continually shift from the screen to the keyboard and the text printout. Efforts to prevent deterioration of eyesight are to be, therefore, applied to the refraction system, that is, optical adjustment of the eye to direction of light, and accommodation, that is, adjustment of the eye to different distances. Besides, it has been confirmed that screen images affect the central nervous system (CNS) through the visual organ and produce excitation foci in the CNS. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method of restoring endothelium of cornea Inventor(s): Bagrov, Sergei Nikolaevich; (Moscow, RU), Maklakova, Irina Alexandrovna; (Moscow, RU), Ronkina, Tamara Ilinichna; (Moscow, RU), Zolotorevsky, Andrei Valentinovich; (Moscow, RU) Correspondence: Oblon Spivak Mcclelland Maier & Neustadt PC; Fourth Floor; 1755 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20020017305 Date filed: July 5, 2001 Abstract: The invention relates to the field of medicine, in particular, to ophthalmology. The technical result of the invention is reduction of the loss of endothelium in the postoperation period, and during post-operation keratopathy and the initial stage of secondary endothelium-epithelium dystrophy--reduction of the edema and normalization of the thickness of the cornea. The technical result is achieved in that in a method of restoring the endothelium of the cornea, including administration of an activating solution into the anterior segment of the eye, in accordance with the invention, restoration of the endothelium of the cornea is effected with the aid of an activating solution having the following composition:carnosine 0.1-20.0 mga complex of glycosaminoglycans with cations of at least one metal of the group consisting of calcium, magnesium, zinc, aluminum, copper, iron, manganese 0.005-0.15 mgin 1 ml of a balanced salt solution.
Patents 129
Excerpt(s): The invention relates to the field of medicine, in particular, to ophthalmology. It is known that under normal physiological conditions, the mitotic capability of cornea endothelium is limited. Regeneration of the endothelium takes place, as a rule, as a result of hypertrophy and migration of endothelium cells. With age, there is a constant reduction of the number of endothelium cells, and any damage, including surgical trauma, increases the percentage of their loss. A reduction of the density of endothelium cells to below the critical level (less than 1000 cells per mm.sup.2) results in the development of endothelium-epithelium dystrophy (EED) of the cornea, which means a sharp loss of eyesight and capability of working. A method of restoring damaged endothelium is known, this method consisting in administering a purified fibroblastic growth factor into the anterior chamber of the eye (Exp. Eye Res., 1987, 45, 805-807). However, the author has only achieved favorable results in experiments. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Methods for producing epithelial flaps on the cornea and for placement of ocular devices and lenses beneath an epithelial flap or membrane, epithelial delaminating devices, and structures of epithelium and ocular devices and lenses Inventor(s): Perez, Edward; (Redwood City, CA) Correspondence: E. Thomas Wheelock; Morrison & Foerster Llp; 755 Page Mill Road; Palo Alto; CA; 94304-1018; US Patent Application Number: 20030220653 Date filed: January 17, 2003 Abstract: These methods, devices, and structures are useful in the field of ophthalmology; the devices and methods relate variously to separating or lifting corneal epithelium from the eye preferably in a substantially continuous layer, placing a lens or other suitable ocular or medical device beneath the epithelial membrane, and to the resulting structures formed by those procedures. The de-epilthelialization devices generally utilize a non-cutting separator or dissector that is configured to separate the epithelium at a naturally occurring cleavage surface in the eye between the epithelium and the corneal stroma (Bowman's membrane), specifically separating in the region of the lamina lucida. The separator or dissector may have a structure that rolls or vibrates (or both) at that cleavage surface or interface during the dissection step. The separated epithelium may be lifted or peeled from the surface of the eye to form an epithelial flap or a pocket. The epithelium may then be replaced on the cornea after a refractive procedure or after placement of an ocular lens (or other subepithelial device) on the eye. The subepithelial device may comprise a wide variety of synthetic, natural, or composite polymeric materials. The step of replacing epithelial tissue upon the subepithelial device or upon the anterior corneal surface promotes epithelial healing. Excerpt(s): This is a continuation-in-part of PCT Application No. PCT/US01/22633, having an International Filing Date of Jul. 18, 2001 and a continuation-in-part of pending U.S. patent application Ser. No. 09/618,580, filed Jul. 18, 2000 and derives benefit under 35 USC 119 from each of U.S. Provisional Application No. 60/350,003 entitled "EPITHELIAL DELAMINATING DEVICE" filed Jan. 17, 2002; U.S. Provisional Application Serial No. 60/393,305 entitled "EPITHELIAL DELAMINATING DEVICE (II)" filed Jul. 1, 2002; and U.S. Provisional Application Serial No. 60/408,226 entitled "EPITHELIAL DELAMINATING DEVICE (III) filed Oct. 3, 2002, each of which are specifically incorporated in their entirety by reference. Refractive surgery refers to a set
130 Ophthalmology
of surgical procedures that change the native optical or focusing power of the eye. These changes alleviate the need for glasses or contact lenses that an individual might otherwise be dependent on for clear sight. The majority of the focusing power in the human eye is dictated by the curvature of the air-liquid interface, where there is the greatest change in the index of refraction. This curved interface is the outer surface of the cornea. The refractive power of this interface accounts for approximately 70% of the total magnification of the eye. Light rays that make up the images we see pass through the cornea, the anterior chamber, the crystalline lens, and the vitreous humor before they are focused on the retina to form an image. It is the magnifying power of this curved, air-corneal interface that provided the field of refractive surgery with the opportunity to surgically correct visual deficiencies. Initial refractive surgical procedures corrected nearsightedness by flattening of the curvature of the cornea. The first largely successful procedure was called radial keratotomy (RK). RK was widely used during the 1970's and early 1980's where radially oriented incisions were made in the periphery of the cornea. These incisions allowed the peripheral cornea to bow outwards, consequently flattening the central optical zone of the cornea. This was fairly easy and thus, popular, but it rarely did more than lessen one's dependency on glasses or contract lenses. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Optical lens furler and injector Inventor(s): Nadel, Bernard A.; (Irvington, VA) Correspondence: Bernard A Nadel; 49 Reynold's Landing; P.O. Box 499; Irvington; VA; 22480; US Patent Application Number: 20020156486 Date filed: May 9, 2002 Abstract: In ophthalmology a cataracted lens is removed from the eye and replaced with an artificial one. Presently, an artificial lens, packaged in a clean room is shipped in a sterile package. The surgeon, after excising the cataracted lens, removes the artificial lens from the package and inserts it into the eye. The success of the operation done in this manner is subject to the skill of the surgeon, and possible contamination. A large incision requiring stitching is necessary unless the lens is folded. Folding tends to exceed the modulus of elasticity of the lens and a lens folded in this manner unfolds uncontrollably in the eye and needs adjustment.The Furler & Injector, which curls or furls the lens, is also the package and the lens is never exposed to the air. A curled or furled lens uncurls gradually and stays put. Further, using elements of this invention, the entire operation including excision may be done mechanically independent of the surgeon's dexterity and not one stitch is required. Excerpt(s): The benefit of the filing date of provisional application number 60/284,808, filing date Apr. 19, 2001 entitled Optical Lens Furler and Injector is hereby claimed. The present invention relates to the methods of and apparatus for preparing and inserting flexible intra ocular lenses used in the field of ophthalmology. In cataract surgery, a cataractous human lens is removed through a 3 mm or larger incision. A prosthetic intra ocular lens is then substituted for the human lens. The intra ocular lens' transparency improves the patient's or restores the patient's vision. In practice, a smaller incision is necessary if the prosthetic lens is folded prior to insertion. obviating the need for additional vision correction after surgery, which would otherwise be necessary.
Patents 131
Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Systems and methods for tele-ophthalmology Inventor(s): Bhasin, Sanjay; (Ambler, PA), Sinclair, Stephen H.; (Gladwyne, PA) Correspondence: Pennie And Edmonds; 1155 Avenue OF The Americas; New York; NY; 100362711 Patent Application Number: 20020052551 Date filed: August 23, 2001 Abstract: The present invention provides systems and methods for screening and tracking ophthalmic disease in a plurality of patients. The invention includes a screening subsystem comprising a non-mydriatic camera for obtaining digital images of eyes of the patients, a central database for storing the digital images of the eyes of patients as well as patient demographic data and related health data, and a central server comprising a computer which executes retinopathy grading algorithms, wherein the retinopathy grading algorithms recognize and assign a grade to ophthalmic disease present in the digital eye image and store the results in the central database. The invention also provides a method for screening and tracking ophthalmic disease in a patient with the steps of obtaining digital images of eyes of the patient by means of a screening subsystem comprising a camera, transmitting the obtained digital image to a central database and to a central server, executing retinopathy grading algorithms that recognize and assign a grade to ophthalmic disease present in the digital eye images, and storing the transmitted digital images and the results of the retinopathy grading algorithms in the central database. Excerpt(s): The present application claims priority to and all benefits of U.S. provisional patent application serial No. 60/227,192 filed Aug. 23, 2000. The present invention relates to systems and methods for providing ophthalmology services; in particular this invention relates to networked computer systems which provide for acquiring and screening retinal images for evidence of diabetic retinopathy and other ophthalmic diseases and for providing a database for tracking and analyzing ocular disease onset and progression. Retinal screening is an important ocular service. Many ocular diseases are progressive, and although their progress may be impeded or arrested, ocular damage once done cannot be reversed. Further, because slowly progressive vision impairment can be adapted to, vision problems may not be sufficiently perceptible to cause a patient to seek medical attention until the underlying disease is considerably advanced. Thus, early detection of ocular disease can be vitally important for preserving vision, and retinal screening of at least those at risk is key to early detection. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with ophthalmology, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type
132 Ophthalmology
“ophthalmology” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on ophthalmology. You can also use this procedure to view pending patent applications concerning ophthalmology. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
133
CHAPTER 6. BOOKS ON OPHTHALMOLOGY Overview This chapter provides bibliographic book references relating to ophthalmology. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on ophthalmology include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “ophthalmology” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on ophthalmology: •
Current Medical Diagnosis and Treatment 1999. 38th ed Source: Stamford, CT: Appleton and Lange. 1999. 1672 p. Contact: Available from McGraw-Hill Companies. 1221 Avenue of the Americas, New York, NY 10020. (800) 352-3566 or (212) 512-4100. Fax (212) 512-4105. Website: www.mcgraw-hill.com. PRICE: $47.50 plus shipping and handling. ISBN: 0838515509. Summary: This general medical textbook is designed as a single source reference for practitioners in both hospital and ambulatory settings. The textbook offers extensive coverage of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, and urology. Chapter 1 presents general information on patient care, including health maintenance and disease prevention and management of pain and other common symptoms. Chapter 2 presents information on preoperative assessment and perioperative management and Chapter 3
134 Ophthalmology
addresses special problems of the older patient. Chapter 4 discusses medical management of cancer and Chapter 5 addresses care at the end of life. Chapters 6 through 28 describe diseases and disorders of various organ systems and their treatment. Chapter 29 sets forth the basic concepts of nutrition in modern medical practice. Chapters 30 to 37 cover infectious diseases and antimicrobial therapy. Chapters 38 and 39 cover disorders due to physical agents and poisoning; Chapter 40 discusses the principles of genetics as applied to medical disorders; and Chapter 41 discusses laboratory tests and the diagnostic process. The appendix provides information about therapeutic drug levels and reference ranges for the commonly used laboratory tests. A detailed subject index concludes the volume.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “ophthalmology” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “ophthalmology” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “ophthalmology” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Advances in Ophthalmology by H. Sautter (Editor), et al (1979); ISBN: 3805530307; http://www.amazon.com/exec/obidos/ASIN/3805530307/icongroupinterna
•
An Illustrated Colour Text: Ophthalmology by Mark Batterbury, Brad Bowling; ISBN: 0443055378; http://www.amazon.com/exec/obidos/ASIN/0443055378/icongroupinterna
•
Atlas of Clinical Ophthalmology by Daniel M. Albert, Frederick a. Jakobiec (1996); ISBN: 0721634176; http://www.amazon.com/exec/obidos/ASIN/0721634176/icongroupinterna
•
Atlas of Feline Ophthalmology by Kerry L. Ketring, Mary B. Glaze; ISBN: 1884254136; http://www.amazon.com/exec/obidos/ASIN/1884254136/icongroupinterna
•
Basic and Clinical Science Course 1997-1998: Fundamentals and Principles of Ophthalmology; ISBN: 1560550767; http://www.amazon.com/exec/obidos/ASIN/1560550767/icongroupinterna
•
Basic Ophthalmology for Medical Students and Primary Care Residents by Cynthia A. Bradford (Editor) (1999); ISBN: 1560550988; http://www.amazon.com/exec/obidos/ASIN/1560550988/icongroupinterna
•
Breaking the Color Line in Medicine: African Americans in Ophthalmology by Lenworth N., Md Johnson, O. C. Bobby Daniels (2002); ISBN: 1556426089; http://www.amazon.com/exec/obidos/ASIN/1556426089/icongroupinterna
•
Clinical Decisions in Neuro-Ophthalmology by Ronald M. Burde, et al (2002); ISBN: 032301707X; http://www.amazon.com/exec/obidos/ASIN/032301707X/icongroupinterna
Books
135
•
Clinical Ophthalmology: A Test Yourself Atlas by Jack J., Md, MS, Frcs, Frcophth Kanski, Jack J. Kanski; ISBN: 0750649380; http://www.amazon.com/exec/obidos/ASIN/0750649380/icongroupinterna
•
Clinical Pathways in Neuro-Ophthalmology: An Evidence-Based Approach by Andrew G. Lee, Paul W., MD Brazis (2003); ISBN: 158890136X; http://www.amazon.com/exec/obidos/ASIN/158890136X/icongroupinterna
•
Clinical Trials in Ophthalmology: A Summary and Practice Guide by Peter Kertes (Editor), Mandi D. Conway (Editor); ISBN: 0683302051; http://www.amazon.com/exec/obidos/ASIN/0683302051/icongroupinterna
•
Codelink: Ophthalmology, A Comprehensive Guide to CPT and ICD-9-CM Code Linkages, 2002 by Practice Management Information Corporation (2002); ISBN: 1570662401; http://www.amazon.com/exec/obidos/ASIN/1570662401/icongroupinterna
•
Color Atlas and Synopsis of Clinical Ophthalmology (Wills Eye Series) 5-Volume Library by Christopher J. Rapuano; ISBN: 0071375880; http://www.amazon.com/exec/obidos/ASIN/0071375880/icongroupinterna
•
Color Atlas of Ophthalmology: the Manhattan Eye, Ear, & Throat Hospital Pocket Guide by Suresh Mandava (Editor), et al; ISBN: 0865776857; http://www.amazon.com/exec/obidos/ASIN/0865776857/icongroupinterna
•
Color Atlas of Veterinary Ophthalmology by Kirk N. Gelatt (2001); ISBN: 078172998X; http://www.amazon.com/exec/obidos/ASIN/078172998X/icongroupinterna
•
Cornea: Color Atlas and Synopsis of Clinical Ophthalmology (Wills Eye Series) by Christopher J. Rapuano, Wee-Jin Heng; ISBN: 0071375899; http://www.amazon.com/exec/obidos/ASIN/0071375899/icongroupinterna
•
Cpt 2003 With Guidelines, Ama Express Reference Coding Card Ophthalmology by American Medical Association, et al (2003); ISBN: 1579473814; http://www.amazon.com/exec/obidos/ASIN/1579473814/icongroupinterna
•
Current Neuro-Ophthalmology by Simmons Lessell, J.T.W. Van Dalen (Editor); ISBN: 0815153880; http://www.amazon.com/exec/obidos/ASIN/0815153880/icongroupinterna
•
Dates in Ophthalmology: A Chronological Record of Progress in Ophthalmology over the Last Millennium by Daniel M. Albert; ISBN: 1842141139; http://www.amazon.com/exec/obidos/ASIN/1842141139/icongroupinterna
•
Decision Making in Ophthalmology by W. A. J. Van Heuven, Johan Zwaan; ISBN: 155664454X; http://www.amazon.com/exec/obidos/ASIN/155664454X/icongroupinterna
•
Diagnostic Procedures in Ophthalmology by H. V. Nema (Editor), N. Nema (Editor) (2003); ISBN: 1842651374; http://www.amazon.com/exec/obidos/ASIN/1842651374/icongroupinterna
•
Dictionary of Ophthalmology by Michel, Ph.D. Millodot, Daniel, MD Laby; ISBN: 0750647973; http://www.amazon.com/exec/obidos/ASIN/0750647973/icongroupinterna
•
Differential Diagnosis in Ophthalmology by Stephen A. Vernon; ISBN: 0838517072; http://www.amazon.com/exec/obidos/ASIN/0838517072/icongroupinterna
136 Ophthalmology
•
Duane's Clinical Ophthalmology on Cd-Rom 2004 by William, Md. Tasman, Edward A., Md. Jaeger (2003); ISBN: 0781752574; http://www.amazon.com/exec/obidos/ASIN/0781752574/icongroupinterna
•
Emergency Ophthalmology: A Rapid Treatment Guide by Kenneth C., MD Chern (Editor); ISBN: 007137325X; http://www.amazon.com/exec/obidos/ASIN/007137325X/icongroupinterna
•
Emergency Ophthalmology: A Symptom Based Guide to Diagnosis and Early Management by Hung Cheng, et al (1998); ISBN: 0727908618; http://www.amazon.com/exec/obidos/ASIN/0727908618/icongroupinterna
•
Endoscopic Surgery in Ophthalmology by Tommy Graef (Illustrator), Martin, Md Uram (2003); ISBN: 078173651X; http://www.amazon.com/exec/obidos/ASIN/078173651X/icongroupinterna
•
Essential Subtleties on the Silver Sea: The Yin-Hai Jing-Wei: A Chinese Classic on Ophthalmology (Comparative Studies of Health Systems and Medical Care, 38) by Ssu-Miao Sun, et al (1999); ISBN: 0520080580; http://www.amazon.com/exec/obidos/ASIN/0520080580/icongroupinterna
•
Essentials of Veterinary Ophthalmology by Kirk N. Gelatt; ISBN: 0683300776; http://www.amazon.com/exec/obidos/ASIN/0683300776/icongroupinterna
•
Evolution of Microsurgery (Developments in Ophthalmology, Vol 22) by Ph. Sourdille (1991); ISBN: 3805553331; http://www.amazon.com/exec/obidos/ASIN/3805553331/icongroupinterna
•
Feline Ophthalmology: An Atlas & Text by Barnett, Crispin (1998); ISBN: 0702016624; http://www.amazon.com/exec/obidos/ASIN/0702016624/icongroupinterna
•
Fluorescein Angiography: Technique and Interpretation (Ophthalmology Monographs, 5) by Joseph W. Berkow, et al; ISBN: 1560550090; http://www.amazon.com/exec/obidos/ASIN/1560550090/icongroupinterna
•
Fundamentals and Principles of Ophthalmology 1995-1996: Section Two; ISBN: 1560551151; http://www.amazon.com/exec/obidos/ASIN/1560551151/icongroupinterna
•
Fundamentals of Veterinary Ophthalmology by WB Saunders Company, Douglas H. Slatter; ISBN: 0721627056; http://www.amazon.com/exec/obidos/ASIN/0721627056/icongroupinterna
•
General Ophthalmology by Daniel G. Vaughan; ISBN: 083853127X; http://www.amazon.com/exec/obidos/ASIN/083853127X/icongroupinterna
•
Genetics in Ophthalmology (Developments in Ophthalmology, 37) by B. Wissinger (Editor), et al (2003); ISBN: 3805575785; http://www.amazon.com/exec/obidos/ASIN/3805575785/icongroupinterna
•
Glaucoma Surgery: Principles and Techniques (Ophthalmology Monographs, 4) by Robert N. Weinreb (Editor), Richard P. Mills (Editor) (1998); ISBN: 1560660465; http://www.amazon.com/exec/obidos/ASIN/1560660465/icongroupinterna
•
Gotta Get'Em Fixed: Spiritual Ophthalmology 101 by Twila M. Belk (2002); ISBN: 1579214290; http://www.amazon.com/exec/obidos/ASIN/1579214290/icongroupinterna
Books
137
•
ICD-9-CM 2003 Express Reference Coding Card: Ophthalmology by Terence Johnson, Betty Johnson (2002); ISBN: 1579473709; http://www.amazon.com/exec/obidos/ASIN/1579473709/icongroupinterna
•
Illustrated Tutorials in Clinical Ophthalmology (Book with CD-ROM) by Jack J. Kanski, Anne Bolton; ISBN: 0750652721; http://www.amazon.com/exec/obidos/ASIN/0750652721/icongroupinterna
•
Laser Photocoagulation of the Retina and Choroid (Ophthalmology Monograph) by James C. Folk, Jose S. Pulido; ISBN: 1560550457; http://www.amazon.com/exec/obidos/ASIN/1560550457/icongroupinterna
•
Magnetic Resonance Imaging and Computed Tomography: Clinical Neuro-Orbital Anatomy (Ophthalmology Monographs, No. 6) by Jonathan D. Wirtschafter, et al (1992); ISBN: 1560550104; http://www.amazon.com/exec/obidos/ASIN/1560550104/icongroupinterna
•
Mycosis of the Eye and Its Adnexa (Developments in Ophthalmology, Vol. 32) by Wolfgang Behrens-Baumann, R. Ruchel (1999); ISBN: 3805569157; http://www.amazon.com/exec/obidos/ASIN/3805569157/icongroupinterna
•
Neuro Ophthalmology by Wjk Cumming, et al (1998); ISBN: 0723419647; http://www.amazon.com/exec/obidos/ASIN/0723419647/icongroupinterna
•
Neuro-Ophthalmology (Textbook of Ophthalmology, Vol 6) by Thomas L. Slamovits, Ronald M. Burde; ISBN: 1563750996; http://www.amazon.com/exec/obidos/ASIN/1563750996/icongroupinterna
•
Neuro-Ophthalmology: Color Atlas and Synopsis of Clinical Ophthalmology (Wills Eye Series) by Peter J. Savino, Helen V. Danesh-Meyer; ISBN: 0071375953; http://www.amazon.com/exec/obidos/ASIN/0071375953/icongroupinterna
•
Neuro-Ophthalmology: Diagnosis and Management by Grant T. Liu, et al (2001); ISBN: 0721665330; http://www.amazon.com/exec/obidos/ASIN/0721665330/icongroupinterna
•
Neuro-Ophthalmology: Review Manual by Lanning B., Md Kline, Frank J., Md. Bajandas (2004); ISBN: 1556426720; http://www.amazon.com/exec/obidos/ASIN/1556426720/icongroupinterna
•
Neuro-Ophthalmology: The Requisites in Ophthalmology by Timothy J., Md Martin, James J., MD Corbett (2000); ISBN: 0323001823; http://www.amazon.com/exec/obidos/ASIN/0323001823/icongroupinterna
•
Oculoplastic Surgery: The Requisites in Ophthalmology by Jeffrey A., Md Nerad, et al; ISBN: 0323001742; http://www.amazon.com/exec/obidos/ASIN/0323001742/icongroupinterna
•
Oculoplastics: Color Atlas and Synopsis of Clinical Ophthalmology (Wills Eye Series) by Robert B. Penne; ISBN: 0071375945; http://www.amazon.com/exec/obidos/ASIN/0071375945/icongroupinterna
•
Ophthalmology by Katharine A. Phillips (1997); ISBN: 0702016098; http://www.amazon.com/exec/obidos/ASIN/0702016098/icongroupinterna
•
Ophthalmology by Fritz Hollwich, Frederick C. Blodi (Translator) (1985); ISBN: 0865771847; http://www.amazon.com/exec/obidos/ASIN/0865771847/icongroupinterna
138 Ophthalmology
•
Ophthalmology by Jack J. Kanski; ISBN: 0443060371; http://www.amazon.com/exec/obidos/ASIN/0443060371/icongroupinterna
•
Ophthalmology by Myron Yanoff (Editor), Jay S. Duker (Editor); ISBN: 0723425000; http://www.amazon.com/exec/obidos/ASIN/0723425000/icongroupinterna
•
Ophthalmology and Otolaryngology for the Boards and Wards: Usmle Steps 1, 2, & 3 (Boards and Wards) by Brad, Md. Spellberg, Carlos, Md. Ayala (2001); ISBN: 0632045825; http://www.amazon.com/exec/obidos/ASIN/0632045825/icongroupinterna
•
Ophthalmology Annual, 1985 by Robert D. Reinecke (Editor) (1984); ISBN: 0838574300; http://www.amazon.com/exec/obidos/ASIN/0838574300/icongroupinterna
•
Ophthalmology for the Equine Practitioner by Dennis E. Brooks (2002); ISBN: 1893441512; http://www.amazon.com/exec/obidos/ASIN/1893441512/icongroupinterna
•
Ophthalmology for the Primary Care Physician by Jay H., MD Krachmer (Editor), David A., MD Palay (Editor); ISBN: 0815188986; http://www.amazon.com/exec/obidos/ASIN/0815188986/icongroupinterna
•
Ophthalmology for the Veterinary Practitioner by Frans C. Stades, et al (2000); ISBN: 3877064884; http://www.amazon.com/exec/obidos/ASIN/3877064884/icongroupinterna
•
Ophthalmology in Medicine: An Illustrated Clinical Guide by David Abrams (1990); ISBN: 0801600286; http://www.amazon.com/exec/obidos/ASIN/0801600286/icongroupinterna
•
Ophthalmology Made Ridiculously Simple (MedMaster Series, 2001 Edition) by Stephen Goldberg, S. Goldberg (2001); ISBN: 0940780518; http://www.amazon.com/exec/obidos/ASIN/0940780518/icongroupinterna
•
Ophthalmology Pearls by Janice A. Gault (Editor) (2003); ISBN: 1560534982; http://www.amazon.com/exec/obidos/ASIN/1560534982/icongroupinterna
•
Ophthalmology Reveiw: A Case Study Approach by Kuldev Singh (Editor), et al; ISBN: 0865779821; http://www.amazon.com/exec/obidos/ASIN/0865779821/icongroupinterna
•
Ophthalmology Review Manual by Kenneth C. Chern (Editor), et al; ISBN: 0683303643; http://www.amazon.com/exec/obidos/ASIN/0683303643/icongroupinterna
•
Ophthalmology Secrets: Questions You Will Be Asked on Rounds, in the Clinic, on Oral Exams by James F. Vander (Editor), et al; ISBN: 156053429X; http://www.amazon.com/exec/obidos/ASIN/156053429X/icongroupinterna
•
Ophthalmology-Book and Cd-Rom Package by Myron Yanoff (2004); ISBN: 0323016596; http://www.amazon.com/exec/obidos/ASIN/0323016596/icongroupinterna
•
Optics and Refraction: A User-Friendly Guide (Textbook of Ophthalmology, Vol. 1) by David Miller, Mosby-Wolfe; ISBN: 1563750112; http://www.amazon.com/exec/obidos/ASIN/1563750112/icongroupinterna
•
Orbit and Oculoplastics (Textbook of Ophthalmology, Vol 4) by Richard R. Tenzel (Editor); ISBN: 1563750961; http://www.amazon.com/exec/obidos/ASIN/1563750961/icongroupinterna
Books
139
•
Pediatric Ophthalmology by David Taylor (Editor); ISBN: 086542831X; http://www.amazon.com/exec/obidos/ASIN/086542831X/icongroupinterna
•
Pediatric Ophthalmology and Strabismus by Kenneth W. Wright (Editor), Peter H. Spiegel (Editor); ISBN: 0387954783; http://www.amazon.com/exec/obidos/ASIN/0387954783/icongroupinterna
•
Pediatric Ophthalmology for Primary Care by Rob Mattison, Kenneth W. Wright (2002); ISBN: 1581100876; http://www.amazon.com/exec/obidos/ASIN/1581100876/icongroupinterna
•
Perimetric Standards and Perimetric Glossary of the International Council of Ophthalmology by International Council Of Ophthalmology (1979); ISBN: 9061936004; http://www.amazon.com/exec/obidos/ASIN/9061936004/icongroupinterna
•
Physicians' Desk Reference for Ophthalmology, 2000 by Medical Economics (Editor); ISBN: 1563633396; http://www.amazon.com/exec/obidos/ASIN/1563633396/icongroupinterna
•
Practice Management: Cumulative Index for Textbook of Ophthalmology Vols 1-10 by Steven Podos, et al; ISBN: 1563751585; http://www.amazon.com/exec/obidos/ASIN/1563751585/icongroupinterna
•
Principles and Practice of Ophthalmology (6-Volume Set) by Daniel M. Albert (Editor), et al; ISBN: 072167500X; http://www.amazon.com/exec/obidos/ASIN/072167500X/icongroupinterna
•
Requisites in Ophthalmology: Retina, Choroid, and Vitreous by Jose S., MD Pulido, Mosby; ISBN: 0323002374; http://www.amazon.com/exec/obidos/ASIN/0323002374/icongroupinterna
•
Retina: Color Atlas and Synopsis of Clinical Ophthalmology (Wills Eye Series) by Allen Ho (Editor), et al; ISBN: 0071375961; http://www.amazon.com/exec/obidos/ASIN/0071375961/icongroupinterna
•
Review of Ophthalmology: A Question and Answer Book by Kenneth C. Chern (Editor), et al; ISBN: 0683182390; http://www.amazon.com/exec/obidos/ASIN/0683182390/icongroupinterna
•
Revision in Sciences Basic to Ophthalmology (Arnold's Self-Assessment) by Raman Malhotra, et al (1998); ISBN: 0340676787; http://www.amazon.com/exec/obidos/ASIN/0340676787/icongroupinterna
•
Small Animal Ophthalmology Secrets by Ronald C. Riis (Editor), A Hanley & Belfus Publication; ISBN: 1560534079; http://www.amazon.com/exec/obidos/ASIN/1560534079/icongroupinterna
•
Small Animal Ophthalmology: A Problem-Oriented Approach by Robert L. Peiffer (Editor), et al; ISBN: 0702025704; http://www.amazon.com/exec/obidos/ASIN/0702025704/icongroupinterna
•
Stedman's Ophthalmology Words by Thomas Lathrop Stedman, Stedmans; ISBN: 0683307762; http://www.amazon.com/exec/obidos/ASIN/0683307762/icongroupinterna
•
Strabismus Surgery: Basic and Advanced Techniques (Ophthalmology Monographs) by David A. Plager (Editor), et al (2003); ISBN: 0195170237; http://www.amazon.com/exec/obidos/ASIN/0195170237/icongroupinterna
140 Ophthalmology
•
Textbook of Ophthalmology by Sunita Agarwal (Editor), et al (2002); ISBN: 8171798845; http://www.amazon.com/exec/obidos/ASIN/8171798845/icongroupinterna
•
The Atlas of Ophthalmology by Alfredo Gomez Leal, et al (2002); ISBN: 1556425740; http://www.amazon.com/exec/obidos/ASIN/1556425740/icongroupinterna
•
The Bernard Becker Collection in Ophthalmology: An Annotated Catalog by Lilla Wechsler (Compiler), Washington University (1996); ISBN: 0912260130; http://www.amazon.com/exec/obidos/ASIN/0912260130/icongroupinterna
•
The Essentials: Walsh & Hoyt's Clinical Neuro-Ophthalmology, Companion to 5th Edition by Neil R. Miller (Editor), Nancy J. Newman (Editor); ISBN: 0683306820; http://www.amazon.com/exec/obidos/ASIN/0683306820/icongroupinterna
•
The Massachusetts Eye & Ear Infirmary Illustrated Manual of Ophthalmology by Neil Friedman, et al; ISBN: 0721670253; http://www.amazon.com/exec/obidos/ASIN/0721670253/icongroupinterna
•
The Massachusetts Eye and Ear Infirmary Review Manual for Ophthalmology by Jeffrey C., Md. Lamkin, Frederick A. Jakobiec; ISBN: 0781717639; http://www.amazon.com/exec/obidos/ASIN/0781717639/icongroupinterna
•
The Ultrastructure of the Conjunctival Epithelium (Developments in Ophthalmology, Vol 19) by Klaus-Peter Steuhl (1989); ISBN: 3805549431; http://www.amazon.com/exec/obidos/ASIN/3805549431/icongroupinterna
•
The Wills Eye Hospital Atlas of Clinical Ophthalmology by William, Md. Tasman (Editor), et al; ISBN: 078172774X; http://www.amazon.com/exec/obidos/ASIN/078172774X/icongroupinterna
•
The Wills Eye Hospital Atlas of Clinical Ophthalmology: Review of Clinical Ophthalmology on CD-ROM by Dan, Md. Montzka (Editor), Daniel P. Montzka (Editor); ISBN: 0781727758; http://www.amazon.com/exec/obidos/ASIN/0781727758/icongroupinterna
•
Update on Strabismus and Pediatric OphthalmologyProceedings of the June, 1994 Joint ISA and AAPO&S Meeting, Vancouver, C by Gunnar Lennerstrand (Editor), International Strabismological Associati; ISBN: 0849389615; http://www.amazon.com/exec/obidos/ASIN/0849389615/icongroupinterna
•
Uveitis Update (Developments in Ophthalmology, Vol. 31) by David Benezra (Editor) (1999); ISBN: 3805568916; http://www.amazon.com/exec/obidos/ASIN/3805568916/icongroupinterna
•
Veterinary Ophthalmology Essentials by Bruce H. Grahn, et al; ISBN: 0750673966; http://www.amazon.com/exec/obidos/ASIN/0750673966/icongroupinterna
•
Visual Field in Glaucoma Cellular Proliferation (Developments in Ophthalmology Vol 12) by W. Straub (Editor), B.P. Gloor (Editor) (1985); ISBN: 3805540221; http://www.amazon.com/exec/obidos/ASIN/3805540221/icongroupinterna
•
Visual Fields: Examination and Interpretation (Ophthalmology Monographs, 3) by Thomas J. Walsh (Editor) (1991); ISBN: 1560550066; http://www.amazon.com/exec/obidos/ASIN/1560550066/icongroupinterna
•
Walsh and Hoyt's Clinical Neuro-Ophthalmology by Neil R., M.D. Miller; ISBN: 0683060201; http://www.amazon.com/exec/obidos/ASIN/0683060201/icongroupinterna
Books
•
141
Year Book of Ophthalmology, 1987 by J. Terry Ernest (Editor), Thomas A. Deutsch (Editor); ISBN: 0815131410; http://www.amazon.com/exec/obidos/ASIN/0815131410/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “ophthalmology” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •
A history of ophthalmology at the University of Pennsylvania, by Daniel M. Albert and Harold G. Scheie. Author: Albert, Daniel M.; Year: 1964; Springfield, Ill., Thomas [c1965]
•
Canine ophthalmology. Author: Magrane, William G.; Year: 1962; Philadelphia, Lea; Febiger, 1965
•
Coding system for disorders of the eye; recommended by the International Council of Ophthalmology and the International Federation of Ophthalmological Societies [by] J. Schappert-Kimmijser, A. Colenbrander [and] S. Franken. Author: SchappertKimmijser, J. (Johanna); Year: 1963; Basel, New York, Karger, 1968
•
Essentials of ophthalmology [by] M. el-Arabi [and] F. Hosni. Author: El-Arabi, M.; Year: 1940; Cairo, El-Nasr Modern Bookshop, 1962
•
Focus on ophthalmology. Author: Luntz, Maurice H.; Year: 1965; Johannesburg, Witwatersrand Univ. Press, 1965
•
Modern ophthalmology. Butterworth, 1963-64
•
Ophthalmology; principles and concepts. Author: Newell, Frank W.; Year: 1965; St. Louis, Mosby, 1965
•
Some of the practical relations of ophthalmology and otology to the general practice of medicine. Author: McKay, Read J.; Year: 1963; Wilmington, Del., 1879
Author:
Sorsby,
Arnold,;
Year:
1903;
Washington,
Chapters on Ophthalmology In order to find chapters that specifically relate to ophthalmology, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and ophthalmology using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the 10
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
142 Ophthalmology
drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “ophthalmology” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on ophthalmology: •
Management of Cleft Lip and Palate Source: in Cameron, A.C. and Widmer, R.P., eds. Handbook of Pediatric Dentistry. London, England: Mosby. 1997. p. 289-306. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. PRICE: $44.95. ISBN: 0723430683. Summary: Children with clefting conditions will require extensive interdisciplinary medical treatments, involving plastic surgery, maxillofacial or craniofacial surgery, dentistry, ear nose and throat surgery, audiology, speech therapy, psychology, and in some cases ophthalmology and neurosurgery. This chapter on management of cleft lip and palate is from a resource book that presents the essentials of the contemporary dental care of children, including behavior management and treatment of oral and dental trauma, dental caries, and oral infections. A special focus on pediatric dental preventive strategies, risk assessment, fluoridation, and restorative techniques is provided. The authors of this chapter cover the anatomy of the facial skeleton in cleft lip and palate, dental anomalies, current concepts of cleft management, the importance of dental care in overall management, surgical management, orthodontic management, and speech therapy. Dental care topics include patient referral, initial consultation, the role of the pediatric dentist (coordination), preventive dental care, dental extractions and minor oral surgery, and cosmetic restoration of malformed anterior teeth and alveolar cleft. 9 figures. 1 table. 9 references.
•
Ear, Nose, and Throat: Otolaryngologic Manifestations of HIV Infection Source: in Tierney, L.M.; McPhee,S.J.; Papadakis, M.A., eds. Current Medical Diagnosis and Treatment 1999. 38th ed. Stamford, CT: Appleton and Lange. 1999. p. 252-254. Contact: Available from McGraw-Hill Companies. 1221 Avenue of the Americas, New York, NY 10020. (800) 352-3566 or (212) 512-4100. Fax (212) 512-4105. Website: www.mcgraw-hill.com. PRICE: $47.50 plus shipping and handling. ISBN: 0838515509. Summary: Gingivitis (infection of the gums) and stomatitis (oral lesions) are frequent presenting symptoms in HIV infected patients. This chapter on the otolaryngologic manifestations of HIV infection is from a general medical textbook that is designed as a single source reference for practitioners in both hospital and ambulatory settings. The textbook offers extensive coverage of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, and urology. This chapter covers the oral cavity and pharynx, the neck, and the paranasal sinuses. For each topic, the author reviews the symptoms, diagnostic methods, classification, prevention, treatment, and prognosis in patients with HIV infection. Each section offers relevant references for that particular topic and the chapter concludes with a list of general references for otolaryngologic manifestations of HIV infection and a list of relevant World Wide Web sites. 25 references.
•
Ear, Nose, and Throat: Diseases of the Salivary Glands Source: in Tierney, L.M.; McPhee,S.J.; Papadakis, M.A., eds. Current Medical Diagnosis and Treatment 1999. 38th ed. Stamford, CT: Appleton and Lange. 1999. p. 243-244.
Books
143
Contact: Available from McGraw-Hill Companies. 1221 Avenue of the Americas, New York, NY 10020. (800) 352-3566 or (212) 512-4100. Fax (212) 512-4105. Website: www.mcgraw-hill.com. PRICE: $47.50 plus shipping and handling. ISBN: 0838515509. Summary: The salivary glands are divided into the two large parotid glands, two submandibular glands, several sublingual glands, and 600 to 1000 minor salivary glands located throughout the upper aerodigestive tract. This chapter on the diseases of the salivary glands is from a general medical textbook that is designed as a single source reference for practitioners in both hospital and ambulatory settings. The textbook offers extensive coverage of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, and urology. This chapter covers acute inflammatory salivary gland disorders, including sialadenitis (salivary gland infection) and sialolithiasis (salivary gland stones, or calculus formation); chronic inflammatory and infiltrative disorders of the salivary glands; and salivary gland tumors. For each topic, the author briefly reviews the symptoms, diagnostic methods, classification, prevention, treatment, and prognosis in patients with HIV infection. Each section offers relevant references for that particular topic. 10 references. •
Pemphigus and Pemphigoid Source: in Bottomley, W.K. and Rosenberg, S.W., eds. Clinician's Guide to Treatment of Common Oral Conditions. 4th ed. Baltimore, MD: American Academy of Oral Medicine (AAOM). 1997. p. 21. Contact: Available from American Academy of Oral Medicine (AAOM). 2910 Lightfoot Drive, Baltimore, MD 21209-1452. (410) 602-8585. Website: www.aaom.com. PRICE: $21.00 plus shipping and handling. Summary: This chapter is from a quick reference guide to the management of some common oral conditions. This brief chapter discusses pemphigus and pemphigoid, a type of oral lesion. The authors provide a summary of the etiology, clinical description, and rationale for the treatment recommended. They indicate that the potentially serious nature of this disease warrants referrals to specialists in oral medicine, ophthalmology, dermatology, or rheumatology.
•
Ear, Nose, and Throat: Diseases of the Oral Cavity and Pharynx Source: in Tierney, L.M.; McPhee,S.J.; Papadakis, M.A., eds. Current Medical Diagnosis and Treatment 1999. 38th ed. Stamford, CT: Appleton and Lange. 1999. p. 237-243. Contact: Available from McGraw-Hill Companies. 1221 Avenue of the Americas, New York, NY 10020. (800) 352-3566 or (212) 512-4100. Fax (212) 512-4105. Website: www.mcgraw-hill.com. PRICE: $47.50 plus shipping and handling. ISBN: 0838515509. Summary: This chapter on diseases of the oral cavity and pharynx is from a general medical textbook that is designed as a single source reference for practitioners in both hospital and ambulatory settings. The textbook offers extensive coverage of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, and urology. This chapter covers leukoplakia, erythroplakia, and oral cancer; oral candidiasis (thrush); glossitis (inflammation of the tongue) and glossodynia (burning and pain of the tongue); intraoral ulcerative lesions, including necrotizing ulcerative gingivitis (trench mouth), aphthous ulcer (canker sore), and herpetic stomatitis; pharyngitis and tonsillitis; peritonsillar abscess and cellulitis; tonsillectomy (removal of the tonsils); and deep neck infections. For each topic, the
144 Ophthalmology
author discusses the symptoms, diagnostic methods, classification, prevention, treatment, prognosis. Each section offers relevant references for that particular topic. 45 references. •
Kidney Source: in Tierney, L.M.; McPhee, S.J.; Papadakis, M.A., eds. Current Medical Diagnosis and Treatment 1999. 38th ed. Stamford, CT: Appleton and Lange. 1999. p. 863-893. Contact: Available from McGraw-Hill Companies. 1221 Avenue of the Americas, New York, NY 10020. (800) 352-3566 or (212) 512-4100. Fax (212) 512-4105. Website: www.mcgraw-hill.com. PRICE: $47.50 plus shipping and handling. ISBN: 0838515509. Summary: This chapter on the kidney is from a general medical textbook designed as a single source reference for practitioners in both hospital and ambulatory settings. The textbook offers extensive coverage of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, and urology. The chapter begins with a review of the approach to renal disease. The authors note that a patient will present with renal disease in one of two ways: discovered incidentally during a routine medical evaluation or with evidence of renal dysfunction such as hypertension, edema, nausea, and hematuria. The initial approach in both situations should be to assess the cause and severity of renal abnormalities. In all cases, this evaluation includes an estimation of disease duration, a careful urinalysis, and an assessment of the glomerular filtration rate (GFR). The authors discuss urinalysis findings, including proteinuria (protein in the urine), and hematuria (blood in the urine); estimation of GFR; imaging studies, including radionuclide studies, ultrasonography, intravenous urography, computed tomography (CT scan), magnetic resonance imaging (MRI), and arteriography and venography; and renal biopsy. The authors then discuss different kidney diseases, including acute renal failure, acute tubular necrosis, interstitial nephritis, glomerulonephritis, chronic renal disease, nephritic syndrome, postinfectious glomerulonephritis, IgA nephropathy and Henoch Schonlein purpura, Pauci immune glomerulonephritis, anti GBM glomerulonephritis and Goodpasture's syndrome, cryoglobulin associated glomerulonephritis, nephrotic syndrome, minimal change disease, membranous nephropathy, focal segmental glomerular sclerosis, and nephrotic diseases associated with systemic disorders, including amyloidosis, diabetic nephropathy, HIV associated nephropathy, systemic lupus erythematosus (SLE), and membranoproliferative glomerulonephritis. The chapter concludes with a discussion of tubulointerstitial diseases, cystic diseases of the kidney, medullary sponge kidney, and multisystem diseases with variable kidney involvement. For each condition, the authors discuss the essentials of diagnosis, general considerations (including etiology), clinical findings, treatment course, and prognosis. Each section offers relevant references, and the chapter concludes with a brief list of relevant World Wide Web sites. 2 figures. 10 tables. 38 references.
•
Liver, Biliary Tract, and Pancreas Source: in Tierney, L.M.; McPhee, S.J.; Papadakis, M.A., eds. Current Medical Diagnosis and Treatment 1999. 38th ed. Stamford, CT: Appleton and Lange. 1999. p. 638-677. Contact: Available from McGraw-Hill Companies. 1221 Avenue of the Americas, New York, NY 10020. (800) 352-3566 or (212) 512-4100. Fax (212) 512-4105. Website: www.mcgraw-hill.com. PRICE: $47.50 plus shipping and handling. ISBN: 0838515509. Summary: This chapter on the liver, biliary tract, and pancreas is from a general medical textbook that is designed as a single source reference for practitioners in both hospital
Books
145
and ambulatory settings. The textbook offers extensive coverage of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, and urology. This chapter covers jaundice, viral hepatitis (all types), chronic hepatitis, alcoholic hepatitis, drug and toxin induced liver disease, fatty liver and nonalcoholic steatohepatitis, cirrhosis, primary biliary cirrhosis, hemochromatosis, Wilson's disease, hepatic vein obstruction (Budd Chiari syndrome), the liver in heart failure, noncirrhotic portal hypertension, hepatic abscess (amebic and pyogenic), hepatocellular carcinoma, benign liver neoplasms, cholelithiasis, acute cholecystitis, cystic duct syndromes, choledocholithiasis and cholangitis, biliary stricture, primary sclerosing cholangitis, carcinoma of the biliary tract, acute pancreatitis, chronic pancreatitis, and carcinoma of the pancreas and the periampullary area. For each topic, the author discusses the symptoms, diagnostic methods, classification, prevention, treatment, prognosis. Each section offers relevant references for that particular topic. The chapter concludes with a list of relevant World Wide Web sites. 3 figures. 7 tables. 97 references. •
Urology Source: in Tierney, L.M.; McPhee, S.J.; Papadakis, M.A., eds. Current Medical Diagnosis and Treatment 1999. 38th ed. Stamford, CT: Appleton and Lange. 1999. p. 894-931. Contact: Available from McGraw-Hill Companies. 1221 Avenue of the Americas, New York, NY 10020. (800) 352-3566 or (212) 512-4100. Fax (212) 512-4105. Website: www.mcgraw-hill.com. PRICE: $47.50 plus shipping and handling. ISBN: 0838515509. Summary: This chapter on urology is from a general medical textbook designed as a single source reference for practitioners in both hospital and ambulatory settings. The textbook offers extensive coverage of all primary care topics, including gynecology, obstetrics, dermatology, ophthalmology, otolaryngology, psychiatry, neurology, and urology. The chapter begins with a review of urologic evaluation. The first section covers diagnostic issues: the patient history, including systemic manifestations, pain, hematuria (blood in the urine), irritative voiding symptoms, obstructive voiding symptoms, and incontinence; physical examination; and urinalysis, including collection of specimens, dipstick urinalysis, and microscopic urinalysis. The chapter then addresses the evaluation of hematuria, and discusses genitourinary tract infections, including acute cystitis, acute pyelonephritis, acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, prostatodynia, and acute epididymitis. The reminder of the chapter covers urinary stone disease, urinary incontinence, male erectile dysfunction (impotence) and sexual dysfunction, male infertility, benign prostatic hyperplasia (BPH), malignant genitourinary tract disorders, bladder cancer, cancers of the ureter and renal pelvis, and primary and secondary tumors of the kidney. For each condition, the authors discuss the essentials of diagnosis, general considerations (including etiology), clinical findings, treatment course, and prognosis. Each section offers relevant references, and some sections conclude with a brief list of relevant World Wide Web sites. 1 figure. 13 tables. 49 references.
Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to ophthalmology have been published that consolidate information
146 Ophthalmology
across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:11 •
Medical and Surgical Eye Care Services to the Medically Underserved: 1996 Resource Directory Source: San Francisco, CA: American Academy of Ophthalmology. 1996. 30 p. Contact: Available from American Academy of Ophthalmology. P.O. Box 429098 San Francisco, CA 94142-9098. (415) 561-8500. Instant fax on demand: (908) 935-2761; when prompted for document number, enter code 777 plus your own fax number. PRICE: Single copy free. Summary: This resource directory lists a sampling of medical and surgical eye care services available to the medically underserved. After a brief listing of national organizations, the directory lists resources alphabetically by state. Each entry lists the contact information, the contact person, the types of services provided, and eligibility requirements. Sample services provided include eye examinations, eyeglasses, eye surgery, provision of low vision devices, vocational training, pediatric ophthalmology, and hospitalization for eye diseases.
11
You will need to limit your search to “Directory” and “ophthalmology” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “ophthalmology” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.
147
CHAPTER 7. MULTIMEDIA ON OPHTHALMOLOGY Overview In this chapter, we show you how to keep current on multimedia sources of information on ophthalmology. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Bibliography: Multimedia on Ophthalmology The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in ophthalmology (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on ophthalmology: •
Audio journal review in ophthalmology. [sound recording]. Format: Sound recording; New York, Grune & Stratton
•
Audio-digest. Ophthalmology. [sound recording]. Year: 9999; Format: Sound recording; Glendale, Calif., Audio-Digest Foundation
•
Comprehensive ophthalmology update. Year: 9999; Brookline, MA: Comprehensive
•
Online journal of ophthalmology [electronic resource]. Year: 9999; Format: Electronic resource; [Erlangen, Germany?: OnJOph,
•
Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift für Augenheilkunde. Year: 9999; Basel
•
Ophthalmology [videorecording] Source: University of Texas System Cancer Center M. D. Anderson Hospital and Tumor Institute; Year: 1976; Format: Videorecording; Houston: The Institute, 1976
•
Scientific exhibits in ophthalmology AAOO 1975 [videorecording] Source: American Academy of Ophthalmology and Otolaryngology; Year: 1975; Format: Videorecording; Rochester, Minn.: The Academy, c1975
148 Ophthalmology
•
The American Academy of Ophthalmology code of ethics & you [videorecording] Source: presented by the AAO Ethics Committee; Year: 1987; Format: Videorecording; San Francisco, CA: American Academy of
•
The Use of genetic principles in clinical ophthalmology [videorecording] Source: Video Digest, inc; Year: 1972; Format: Videorecording; Cincinnati: Video Digest, 1972
•
Veterinary ophthalmology essentials Source: Bruce H. Grahn, Cheryl L. Cullen, Robert L. Peiffer; Year: 2004; Philadelphia: Butterworth-Heinemann, c2004
•
Video journal of ophthalmology [videorecording]: VJO. Year: 9999; Format: Videorecording; St. Louis, MO: Medical Video Productions,
149
CHAPTER 8. PERIODICALS OPHTHALMOLOGY
AND
NEWS
ON
Overview In this chapter, we suggest a number of news sources and present various periodicals that cover ophthalmology.
News Services and Press Releases One of the simplest ways of tracking press releases on ophthalmology is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “ophthalmology” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to ophthalmology. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “ophthalmology” (or synonyms).
150 Ophthalmology
The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “ophthalmology” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “ophthalmology” (or synonyms). If you know the name of a company that is relevant to ophthalmology, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “ophthalmology” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly
Periodicals and News
151
to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “ophthalmology” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on ophthalmology: •
Laser Surgery: Sometimes the Right Choice, Sometimes Not Source: Mayo Clinic Health Letter. 18(4): 1-3. April 2000. Contact: Available from Mayo Clinic Health Letter. 200 First Street SW, Rochester, MN 55905. (800) 333-9037 or (303) 604-1465. E-mail:
[email protected]. Summary: This newsletter article provides people who may need a surgical procedure with information on laser surgery. Laser is a acronym that stands for light amplification by stimulated emission of radiation. Laser beams are strong beams of light produced by electrically simulating a solid, liquid, or gas. Lasers are usually named for the substances that produce them. Uses include cutting or destroying abnormal or diseased tissue, shrinking or destroying tumors or lesions, burning off or vaporizing tissue, sculpting tissue, and sealing bleeding blood vessels. Lasers have some distinct advantages over traditional methods, such as causing minimal bleeding, posing less risk of infection, causing minimal scarring, and being faster than traditional surgery. However, in many cases, conventional surgery is more effective than laser surgery, and laser surgery is not necessarily pain free or risk free. The article discusses common uses of laser surgery in dermatology, plastic surgery, ophthalmology, gastroenterology, gynecology, urology, cardiology, neurosurgery, dentistry, otorhinolaryngology, and orthopedics.
Academic Periodicals covering Ophthalmology Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to ophthalmology. In addition to these sources, you can search for articles covering ophthalmology that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
153
APPENDICES
155
APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
12
These publications are typically written by one or more of the various NIH Institutes.
156 Ophthalmology
•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
•
National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
•
National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources
157
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
13 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.
158 Ophthalmology
•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “ophthalmology” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “ophthalmology” (or synonyms) into the “For these words:” box. The following is a sample result: •
Clinical Alert 2/4: Updated Recommendations for Ophthalmic Practice in Relation to the Human Immunodeficiency Virus Contact: American Academy Ophthalmology, Clinical Alert Program, PO Box 7424, San Francisco, CA, 94120-7424, (415) 561-8555, http://www.eyenet.org. Summary: This policy statement outlines precautionary procedures for reducing the risks of Human immunodeficiency virus (HIV) infection and Acquired immunodeficiency syndrome (AIDS) to patients and ophthalmology staff. Office, diagnostic, and surgery precautions are discussed.
The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “ophthalmology” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category.
15 16
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).
Physician Resources
159
Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 17851 3860 822 44 4 22581
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “ophthalmology” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
17
Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
18
The HSTAT URL is http://hstat.nlm.nih.gov/.
19
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 20 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 21 The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
160 Ophthalmology
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
161
APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on ophthalmology can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to ophthalmology. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to ophthalmology. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “ophthalmology”:
162 Ophthalmology
•
Other guides Cataract http://www.nlm.nih.gov/medlineplus/cataract.html Eye Diseases http://www.nlm.nih.gov/medlineplus/eyediseases.html Eye Injuries http://www.nlm.nih.gov/medlineplus/eyeinjuries.html Eye Wear http://www.nlm.nih.gov/medlineplus/eyewear.html Refractive Errors http://www.nlm.nih.gov/medlineplus/refractiveerrors.html
Within the health topic page dedicated to ophthalmology, the following was listed: •
General/Overviews Eye Injury Prevention Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZFDIAP3SC&s ub_cat=2015 Saving Your Sight--Early Detection Is Critical Source: Food and Drug Administration http://www.fda.gov/fdac/features/2002/202_eyes.html
•
Diagnosis/Symptoms Eye Problems: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/505.html Signs of Possible Eye Trouble in Adults Source: Prevent Blindness America http://www.preventblindness.org/eye_problems/signsadults.html
•
Treatment Eye Drops to Treat Childhood Eye Disorder Work As Well As Patching the Eye Source: National Eye Institute http://www.nih.gov/news/pr/mar2002/nei-13.htm
•
Specific Conditions/Aspects Allergic Conjunctivitis Source: American Academy of Family Physicians http://familydoctor.org/678.xml Benign Essential Blepharospasm Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/blepharospasm.htm
Patient Resources
163
Blepharitis Source: National Eye Institute http://www.nei.nih.gov/health/blepharitis/index.htm Conjunctivitis Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/1900/1951.asp?index=8614 Cornea and Corneal Disease Source: National Eye Institute http://www.nei.nih.gov/health/cornealdisease/index.htm Dry Eyes Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00463 Ectropion Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/ectropion.html Entropion Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/entropion.html Excessive Watering Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00054 Eye Donation and Corneal Transplantation: Frequently Asked Questions and Answers Source: Eye Bank Association of America http://www.restoresight.org/general/faqs.htm Floaters Source: Prevent Blindness America http://www.preventblindness.org/eye_problems/floatersFAQ.html Histoplasmosis Source: National Eye Institute http://www.nei.nih.gov/health/histoplasmosis/index.htm Optic Neuritis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00227 Orbital Tumors Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/tumors.html Thyroid Disease and the Eye Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/thyroid.html Uveitis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00610
164 Ophthalmology
Wet Eye: Excessive Tearing Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/weteye.html •
Children Amblyopia Source: National Eye Institute http://www.nei.nih.gov/health/amblyopia/index.htm Anophthalmia and Microphthalmia Source: National Eye Institute http://www.nei.nih.gov/health/anoph/index.htm Big Look at the Eye Source: Nemours Foundation http://kidshealth.org/kid/body/eye_noSW.html Congenital Ptosis: Upper Eyelid Drooping Present Since Birth Source: American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/Pages/congenital.html Conjunctivitis (Pinkeye) Source: Nemours Foundation http://kidshealth.org/parent/infections/bacterial_viral/conjunctivitis.html Cross-Eyes Source: American Optometric Association http://www.aoa.org/eweb/DynamicPage.aspx?site=AOAstage&WebCode=Cross Eyes Septo Optic Dysplasia Source: MAGIC Foundation http://www.magicfoundation.org/divisions/sod.htm Statement on the Success of Reduced Daily Eye Patching to Treat Severe Amblyopia Source: National Eye Institute http://www.nei.nih.gov/news/statements/amblyopia.htm Strabismus Source: Prevent Blindness America http://www.preventblindness.org/children/StrabismusFAQ.html Symptoms of Vision Problems Source: American Academy of Pediatrics http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=/ZZZ44DKVR7 C&sub_cat=105 Tear-Duct Obstruction and Surgery Source: Nemours Foundation http://kidshealth.org/parent/general/eyes/tear_duct_obstruct_surgery.html What Is a Pediatric Ophthalmologist? http://www.aap.org/sections/he3006.pdf
Patient Resources
•
165
From the National Institutes of Health Are You at Risk for Eye Disease? Source: National Eye Institute http://www.nei.nih.gov/health/risk.htm
•
Latest News Cord Blood Heals Persistent Cornea Defects Source: 11/28/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14886 .html
•
Law and Policy Healthy People 2010, the National Health Blueprint, Includes Vision Objectives for the First Time Source: National Eye Institute http://www.nei.nih.gov/news/pressreleases/060100.htm
•
Men Focus on Women's Eyes Source: Prevent Blindness America http://www.preventblindness.org/news/releases/women_0499.html
•
Organizations American Academy of Ophthalmology http://www.aao.org/ American Society of Ophthalmic Plastic and Reconstructive Surgery http://www.asoprs.org/ National Eye Institute http://www.nei.nih.gov/ Prevent Blindness America http://www.preventblindness.org/
•
Pictures/Diagrams Diagram of the Eye Source: National Eye Institute http://www.nei.nih.gov/health/eyediagram/index.htm Eye Disease Anatomy Source: National Eye Institute http://www.nei.nih.gov/photo/eyedis/index.htm Eye Disease Simulations Source: National Eye Institute http://www.nei.nih.gov/photo/sims/sims.htm
166 Ophthalmology
Eye Examinations Source: National Eye Institute http://www.nei.nih.gov/photo/eye_exam/eye_exam.htm •
Prevention/Screening Checklist for Your Eye Doctor Appointment Source: Prevent Blindness America http://www.preventblindness.org/eye_problems/doc_checklist.html How Often to Have an Eye Exam Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZAKCLP3SC& sub_cat=113 How to Protect and Care for Your Eyes Source: American Medical Women's Association http://www.amwa-doc.org/publications/WCHealthbook/eyesamwa-ch23.html Selecting the Right Sunglasses Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZLSXBLH4C& sub_cat=113
•
Research Botox Effective in Treating Upper Eyelid Retraction Associated with Thyroid Disease Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZM6LR552D& sub_cat=2 Damaged DNA Synthesis Enzyme Shown to Cause Progressive Muscle Weakening Source: National Institute of Environmental Health Sciences http://www.nih.gov/news/pr/may2002/niehs-06.htm LASIK for Farsightedness Effective in Correcting Cross-Eyes, but Predicting Outcomes Remains Problematic Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZHT5Q652D& sub_cat=2 Lutein and Eye Disease Prevention Source: National Eye Institute http://www.nei.nih.gov/news/statements/lutein.htm Macular Degeneration Treatment Also Effective for Treating Ocular Fungus Disease (Histoplasmosis) Source: American Academy of Ophthalmology http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZ8WQ30U4D &sub_cat=2
Patient Resources
167
Oxygen Restrictions Can Be Eased for Premature Infants with Blinding Eye Disease Source: National Eye Institute http://www.nei.nih.gov/news/pressreleases/020700.htm •
Statistics Vision Problems in the U.S. Source: National Eye Institute http://www.nei.nih.gov/eyedata/pdf/VPUS.pdf
•
Women Focus on Women's Eyes Source: Prevent Blindness America http://www.preventblindness.org/news/releases/women_0499.html
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on ophthalmology. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Identifying Hearing Loss in Children: Some Basic Evaluations Source: Omaha, NE: Center for Hearing Loss in Children, Boys Town National Research Hospital (BTNRH). 1994. 2 p. Contact: Available from Boys Town National Research Hospital (BTNRH). Information Dissemination Department, 555 North 30th Street, Omaha, NE 68131-2136. (402) 4986749. PRICE: 1-10 copies free; bulk orders available. Item Number A-6 (4-94). Summary: This fact sheet describes some of the hearing tests and evaluations that may be needed when a child seems to have a hearing problem. The fact sheet also discusses why the test information is important to understanding and managing a child's hearing loss. Audiologic and medical evaluations discussed include behavioral tests; auditory brainstem response evaluation; otoacoustic emissions; vestibular evaluation; otolaryngology; medical genetics; and ophthalmology. The fact sheet concludes with a brief description of communication and developmental evaluations.
168 Ophthalmology
Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Find an Eye M.D. Summary: The American Academy of Ophthalmology (AAO) offers Find an Eye M.D., an on-line listing of member ophthalmologists practicing in the United States and abroad. Source: American Academy of Ophthalmology http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6803
•
Journal of Neurosurgery Summary: A medical journal devoted to the publication of work relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, and pathology. Source: American Association of Neurological Surgeons/Congress of Neurological Surgeons http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1957
•
Ophthalmology (Journal) Summary: This journal is designed to provide opportunities for the free exchange of ideas and information among physicians and researchers in the field of ophthalmology. The publication is available on CD-ROM. Source: American Academy of Ophthalmology http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1951 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to ophthalmology. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.
Patient Resources
169
Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to ophthalmology. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with ophthalmology. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about ophthalmology. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “ophthalmology” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received
170 Ophthalmology
your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “ophthalmology”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “ophthalmology” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “ophthalmology” (or a synonym) into the search box, and click “Submit Query.”
171
APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
23
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
172 Ophthalmology
libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
24
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
173
•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
174 Ophthalmology
•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
175
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
176 Ophthalmology
•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
177
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
179
OPHTHALMOLOGY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acantholysis: Separation of the prickle cells of the stratum spinosum of the epidermis, resulting in atrophy of the prickle cell layer. It is seen in diseases such as pemphigus vulgaris (see pemphigus) and keratosis follicularis. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Rosacea: An acneiform eruption occurring mostly in middle-aged adults and appearing generally on the forehead, cheeks, nose, and chin. Three types are recognized: granulomatous, glandular hyperplastic with rhinophyma, and ocular. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Acute tubular: A severe form of acute renal failure that develops in people with severe illnesses like infections or with low blood pressure. Patients may need dialysis. Kidney function often improves if the underlying disease is successfully treated. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH]
180 Ophthalmology
Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adhesives: Substances that cause the adherence of two surfaces. They include glues (properly collagen-derived adhesives), mucilages, sticky pastes, gums, resins, or latex. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]
Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH]
Dictionary 181
Alkaline: Having the reactions of an alkali. [EU] Allografts: A graft of tissue obtained from the body of another animal of the same species but with genotype differing from that of the recipient; tissue graft from a donor of one genotype to a host of another genotype with host and donor being members of the same species. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Amblyopia: A nonspecific term referring to impaired vision. Major subcategories include stimulus deprivation-induced amblyopia and toxic amblyopia. Stimulus deprivationinduced amblopia is a developmental disorder of the visual cortex. A discrepancy between visual information received by the visual cortex from each eye results in abnormal cortical development. Strabismus and refractive errors may cause this condition. Toxic amblyopia is a disorder of the optic nerve which is associated with alcoholism, tobacco smoking, and other toxins and as an adverse effect of the use of some medications. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU]
182 Ophthalmology
Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]
Anomalies: Birth defects; abnormalities. [NIH] Anterior chamber: The space in front of the iris and behind the cornea. [NIH] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on
Dictionary 183
the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antimitotic: Inhibiting or preventing mitosis. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Aphakia: Absence of crystalline lens totally or partially from field of vision, from any cause except after cataract extraction. Aphakia is mainly congenital or as result of lens dislocation and subluxation. [NIH] Apheresis: Components plateletpheresis. [NIH]
being
separated
out,
as
leukapheresis,
plasmapheresis,
Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Approximate: Approximal [EU] Aptitude: The ability to acquire general or special types of knowledge or skill. [NIH] Aqueous: Having to do with water. [NIH] Aqueous humor: Clear, watery fluid that flows between and nourishes the lens and the
184 Ophthalmology
cornea; secreted by the ciliary processes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriography: A procedure to x-ray arteries. The arteries can be seen because of an injection of a dye that outlines the vessels on an x-ray. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteritis: Inflammation of an artery. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astigmatism: A condition in which the surface of the cornea is not spherical; causes a blurred image to be received at the retina. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Audiology: The study of hearing and hearing impairment. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Avian: A plasmodial infection in birds. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH]
Dictionary 185
Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Betaxolol: A cardioselective beta-1-adrenergic antagonist with no partial agonist activity. [NIH]
Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Stricture: A narrowing of the biliary tract from scar tissue. The scar tissue may result from injury, disease, pancreatitis, infection, or gallstones. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Binocular vision: The blending of the separate images seen by each eye into a single image; allows images to be seen with depth. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biochemical Phenomena: Biochemical functions, activities, and processes at organic and
186 Ophthalmology
molecular levels in humans, animals, microorganisms, and plants. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological Sciences: All of the divisions of the natural sciences dealing with the various aspects of the phenomena of life and vital processes. The concept includes anatomy and physiology, biochemistry and biophysics, and the biology of animals, plants, and microorganisms. It should be differentiated from biology, one of its subdivisions, concerned specifically with the origin and life processes of living organisms. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biometry: The use of statistical methods to analyze biological observations and phenomena. [NIH]
Biophysics: The science of physical phenomena and processes in living organisms. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Biphasic: Having two phases; having both a sporophytic and a gametophytic phase in the life cycle. [EU] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blepharitis: Inflammation of the eyelids. [NIH] Blepharospasm: Excessive winking; tonic or clonic spasm of the orbicularis oculi muscle. [NIH]
Blinking: Brief closing of the eyelids by involuntary normal periodic closing, as a protective measure, or by voluntary action. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in
Dictionary 187
the blood coagulation process. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood Substitutes: Substances that can carry oxygen to and carbon dioxide away from the tissues when introduced into the blood stream. They are used to replace hemoglobin in severe hemorrhage and also to perfuse isolated organs. The best known are perfluorocarbon emulsions and various hemoglobin solutions. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [EU] Bupivacaine: A widely used local anesthetic agent. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic
188 Ophthalmology
weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Hydroxide: Ca(OH)2. A white powder that has many therapeutic uses. Because of its ability to stimulate mineralization, it is found in many dental formulations. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]
Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capillary Fragility: The lack of resistance, or susceptibility, of capillaries to damage or disruption under conditions of increased stress. [NIH] Capillary Permeability: Property of blood capillary walls that allows for the selective exchange of substances. Small lipid-soluble molecules such as carbon dioxide and oxygen move freely by diffusion. Water and water-soluble molecules cannot pass through the endothelial walls and are dependent on microscopic pores. These pores show narrow areas (tight junctions) which may limit large molecule movement. [NIH] Capsular: Cataract which is initiated by an opacification at the surface of the lens. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiology: The study of the heart, its physiology, and its functions. [NIH] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual
Dictionary 189
patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH] Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH]
190 Ophthalmology
Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centromere: The clear constricted portion of the chromosome at which the chromatids are joined and by which the chromosome is attached to the spindle during cell division. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholangitis: Inflammation of a bile duct. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Choledocholithiasis: Gallstones in the bile ducts. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]
Chorioretinitis: Inflammation of the choroid in which the sensory retina becomes edematous and opaque. The inflammatory cells and exudate may burst through the sensory retina to cloud the vitreous body. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH]
Dictionary 191
Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Body: A ring of tissue extending from the scleral spur to the ora serrata of the retina. It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion. [NIH] Ciliary muscles: The muscles that relax the zonules to enable the lens to change shape for focusing. [NIH] Ciliary processes: The extensions or projections of the ciliary body that secrete aqueous humor. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]
Clonic: Pertaining to or of the nature of clonus. [EU] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the
192 Ophthalmology
high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Common Bile Duct: The largest biliary duct. It is formed by the junction of the cystic duct and the hepatic duct. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH]
Dictionary 193
Computer Systems: Systems composed of a computer or computers, peripheral equipment, such as disks, printers, and terminals, and telecommunications capabilities. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contrast Sensitivity: The ability to detect sharp boundaries (stimuli) and to detect slight changes in luminance at regions without distinct contours. Psychophysical measurements of this visual function are used to evaluate visual acuity and to detect eye disease. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to
194 Ophthalmology
enter the inside. [NIH] Corneal Diseases: Diseases of the cornea. [NIH] Corneal Stroma: The lamellated connective tissue constituting the thickest layer of the cornea between the Bowman and Descemet membranes. [NIH] Corneal Transplantation: Partial or total replacement of the cornea from one human or animal to another. [NIH] Corneal Ulcer: Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue; usually caused by bacterial, fungal, or viral infection. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Criterion: A standard by which something may be judged. [EU] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cryostat: A batchwise operating apparatus in which a cryogenic liquid or solid is used to maintain by evaporation a cryotemperature which needs not be constant but may vary in a predetermined fashion. [NIH] Crystallins: A heterogeneous family of water-soluble structural proteins found in cells of the vertebrate lens. The presence of these proteins accounts for the transparency of the lens. The family is composed of four major groups, alpha, beta, gamma, and delta, and several minor groups, which are classed on the basis of size, charge, immunological properties, and vertebrate source. Alpha, beta, and delta crystallins occur in avian and reptilian lenses, while alpha, beta, and gamma crystallins occur in all other lenses. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystic Duct: The tube that carries bile from the gallbladder into the common bile duct and the small intestine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine.
Dictionary 195
[NIH]
Cystitis: Inflammation of the urinary bladder. [EU] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Dacryocystorhinostomy: Surgical fistulization of the lacrimal sac for external drainage of an obstructed nasolacrimal duct. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Data Display: The visual display of data in a man-machine system. An example is a cathode ray tube display in which certain data can be called for from the computer and presented on the screen. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH]
196 Ophthalmology
Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
Dentists: Individuals licensed to practice dentistry. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Depth Perception: Perception of three-dimensionality. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dexterity: Ability to move the hands easily and skillfully. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diagnostic Services: Organized services for the purpose of providing diagnosis to promote and maintain health. [NIH]
Dictionary 197
Diastolic: Of or pertaining to the diastole. [EU] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfection: Rendering pathogens harmless through the use of heat, antiseptics, antibacterial agents, etc. [NIH] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Dissection: Cutting up of an organism for study. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Drip: The continuous slow introduction of a fluid containing nutrients or drugs. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH]
198 Ophthalmology
Dyskinesias: Abnormal involuntary movements which primarily affect the extremities, trunk, or jaw that occur as a manifestation of an underlying disease process. Conditions which feature recurrent or persistent episodes of dyskinesia as a primary manifestation of disease may be referred to as dyskinesia syndromes (movement disorders). Dyskinesias are also a relatively common manifestation of basal ganglia diseases. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electron microscope: A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscopes shows tiny details better than any other type of microscope. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Electroretinogram: The electrical effect recorded from the surface of the eyeball and originated by a pulse of light. [NIH] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or
Dictionary 199
aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endophthalmitis: Suppurative inflammation of the tissues of the internal structures of the eye; not all layers of the uvea are affected. Fungi, necrosis of intraocular tumors, and retained intraocular foreign bodies often cause a purulent endophthalmitis. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enteropeptidase: A specialized proteolytic enzyme secreted by intestinal cells. It converts trypsinogen into its active form trypsin by removing the N-terminal peptide. EC 3.4.21.9. [NIH]
Enucleation: Removal of the nucleus from an eucaryiotic cell. [NIH]
200 Ophthalmology
Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Equalization: The reduction of frequency and/or phase distortion, or modification of gain and or phase versus frequency characteristics of a transducer, by the use of attenuation circuits whose loss or delay is a function of frequency. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythroplakia: A reddened patch with a velvety surface found in the mouth. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Esotropia: A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze. [NIH] Estrogen: One of the two female sex hormones. [NIH] Ethmoid: An unpaired cranial bone which helps form the medial walls of the orbits and contains the themoidal air cells which drain into the nose. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excimer laser: An ultraviolet laser used in refractive surgery to remove corneal tissue. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU]
Dictionary 201
Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Excitotoxicity: Excessive exposure to glutamate or related compounds can kill brain neurons, presumably by overstimulating them. [NIH] Exfoliation: A falling off in scales or layers. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotropia: A form of ocular misalignment where the visual axes diverge inappropriately. For example, medial rectus muscle weakness may produce this condition as the affected eye will deviate laterally upon attempted forward gaze. An exotropia occurs due to the relatively unopposed force exerted on the eye by the lateral rectus muscle, which pulls the eye in an outward direction. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Eye Abnormalities: Congenital absence of or defects in structures of the eye; may also be hereditary. [NIH] Eye Injuries: Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries. [NIH] Eye socket: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
202 Ophthalmology
Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds
Dictionary 203
with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fluoridation: The addition of fluorine usually as a fluoride to something, as the adding of a fluoride to drinking water or public water supplies for prevention of tooth decay in children. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fundus of the Eye: The back or deep part of the eye, including the retina. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes
204 Ophthalmology
are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]
Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germanium: A rare metal element with a blue-gray appearance and atomic symbol Ge, atomic number 32, and atomic weight 72.59. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomerular Filtration Rate: The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to inulin clearance. [NIH] Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glossalgia: Painful sensations in the tongue, including a sensation of burning. [NIH] Glossitis: Inflammation of the tongue. [NIH] Glossodynia: Pain in the tongue; glossalgia. [EU] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH]
Dictionary 205
Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]
Grafting: The operation of transfer of tissue from one site to another. [NIH] Granule: A small pill made from sucrose. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynecology: A medical-surgical specialty concerned with the physiology and disorders primarily of the female genital tract, as well as female endocrinology and reproductive physiology. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of
206 Ophthalmology
health. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Hematuria: Presence of blood in the urine. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatitis, Alcoholic: An acute or chronic degenerative and inflammatory lesion of the liver in the alcoholic which is potentially progressive though sometimes reversible. It does not necessarily include steatosis, fibrosis, or cirrhosis of alcoholics, although it is frequently associated with these conditions. It is characterized by liver cell necrosis, infiltration by polymorphonuclear leukocytes and lymphocytes, and Mallory bodies. The morphologic changes of chronic alcoholic hepatitis are not likely to be confused with chronic hepatitis. [NIH]
Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU]
Dictionary 207
Herpes virus: A member of the herpes family of viruses. [NIH] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Heterotropia: One in which the angle of squint remains relatively unaltered on conjugate movement of the eyes. [NIH] Histocompatibility: The degree of antigenic similarity between the tissues of different individuals, which determines the acceptance or rejection of allografts. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hyaluronidase: An enzyme that splits hyaluronic acid and thus lowers the viscosity of the acid and facilitates the spreading of fluids through tissues either advantageously or disadvantageously. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydroxylamine: A colorless inorganic compound (HONH2) used in organic synthesis and as a reducing agent, due to its ability to donate nitric oxide. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH]
208 Ophthalmology
Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperaemia: An excess of blood in a part; engorgement. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hyperopia: Farsightedness; ability to see distant objects more clearly than close objects; may be corrected with glasses or contact lenses. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunotoxins: Semisynthetic conjugates of various toxic molecules, including radioactive isotopes and bacterial or plant toxins, with specific immune substances such as immunoglobulins, monoclonal antibodies, and antigens. The antitumor or antiviral immune substance carries the toxin to the tumor or infected cell where the toxin exerts its poisonous effect. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH]
Dictionary 209
Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Information Science: The field of knowledge, theory, and technology dealing with the collection of facts and figures, and the processes and methods involved in their manipulation, storage, dissemination, publication, and retrieval. It includes the fields of communication, publishing, library science and informatics. [NIH] Information Systems: Integrated set of files, procedures, and equipment for the storage, manipulation, and retrieval of information. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH]
210 Ophthalmology
Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Integrins: A family of transmembrane glycoproteins consisting of noncovalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement, and other cells, while their intracellular domains interact with the cytoskeleton. The integrins consist of at least three identified families: the cytoadhesin receptors, the leukocyte adhesion receptors, and the very-late-antigen receptors. Each family contains a common beta-subunit combined with one or more distinct alpha-subunits. These receptors participate in cell-matrix and cell-cell adhesion in many physiologically important processes, including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin
Dictionary 211
or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ion Exchange: Reversible chemical reaction between a solid, often an ION exchange resin, and a fluid whereby ions may be exchanged from one substance to another. This technique is used in water purification, in research, and in industry. [NIH] Ion Exchange Resins: High molecular weight, insoluble polymers which contain functional groups that are capable of undergoing exchange reactions (ion exchange) with either cations or anions. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isotonic: A biological term denoting a solution in which body cells can be bathed without a net flow of water across the semipermeable cell membrane. Also, denoting a solution having the same tonicity as some other solution with which it is compared, such as physiologic salt solution and the blood serum. [EU] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratitis: Inflammation of the cornea. [NIH] Keratoconus: A disorder characterized by an irregular corneal surface (cone-shaped) resulting in blurred and distorted images. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Keratomileusis: Carving of the cornea to reshape it. [NIH] Keratotomy: A surgical incision (cut) of the cornea. [NIH]
212 Ophthalmology
Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Pelvis: The flattened, funnel-shaped expansion connecting the ureter to the kidney calices. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laboratory Personnel: Those health care professionals, technicians, and assistants staffing a research or health care facility where specimens are grown, tested, or evaluated and the results of such measures are recorded. [NIH] Lacrimal: Pertaining to the tears. [EU] Lacrimal gland: The small almond-shaped structure that produces tears; located just above the outer corner of the eye. [NIH] Lactation: The period of the secretion of milk. [EU] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Laser therapy: The use of an intensely powerful beam of light to kill cancer cells. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lavage: A cleaning of the stomach and colon. Uses a special drink and enemas. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukapheresis: The preparation of leukocyte concentrates with the return of red cells and leukocyte-poor plasma to the donor. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH]
Dictionary 213
Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Light microscope: A microscope (device to magnify small objects) in which objects are lit directly by white light. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Liquor: 1. A liquid, especially an aqueous solution containing a medicinal substance. 2. A general term used in anatomical nomenclature for certain fluids of the body. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Neoplasms: Tumors or cancer of the liver. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups
214 Ophthalmology
that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low vision: Visual loss that cannot be corrected with eyeglasses or contact lenses and interferes with daily living activities. [NIH] Lucida: An instrument, invented by Wollaton, consisting essentially of a prism or a mirror through which an object can be viewed so as to appear on a plane surface seen in direct view and on which the outline of the object may be traced. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Macular Degeneration: Degenerative changes in the macula lutea of the retina. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU]
Dictionary 215
Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Medical Informatics: The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Membranoproliferative: A disease that occurs primarily in children and young adults. Over time, inflammation leads to scarring in the glomeruli, causing proteinuria, hematuria, and sometimes chronic renal failure or end-stage renal disease. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the
216 Ophthalmology
atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Metastasize: To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]
labeled
with
Microsurgery: Surgical procedures on the cellular level; a light microscope and miniaturized instruments are used. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU]
Dictionary 217
Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Mollusca: A phylum of the kingdom Metazoa. Mollusca have soft, unsegmented bodies with an anterior head, a dorsal visceral mass, and a ventral foot. Most are encased in a protective calcareous shell. It includes the classes Gastropoda, Bivalvia, Cephalopoda, Aplacophora, Scaphopoda, Polyplacophora, and Monoplacophora. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocular: Diplopia identified with one eye only; it may be induced with a double prism, or it may occur either as a result of double imagery due to an optical defect in the eye, or as a result of simultaneous use of normal and anomalous retinal correspondence. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculoskeletal System: Themuscles, bones, and cartilage of the body. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the
218 Ophthalmology
blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasolacrimal: Pertaining to the nose and lacrimal apparatus. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Nearsightedness: The common term for myopia. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH]
Dictionary 219
Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptides: Peptides released by neurons as intercellular messengers. Many neuropeptides are also hormones released by non-neuronal cells. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neuroprotective Agents: Drugs intended to prevent damage to the brain or spinal cord from ischemia, stroke, convulsions, or trauma. Some must be administered before the event, but others may be effective for some time after. They act by a variety of mechanisms, but often directly or indirectly minimize the damage produced by endogenous excitatory amino acids. [NIH] Neuroretinitis: Inflammation of the optic nerve head and adjacent retina. [NIH] Neurosciences: The scientific disciplines concerned with the embryology, anatomy, physiology, biochemistry, pharmacology, etc., of the nervous sytem. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. [NIH] Neurotrophins: A nerve growth factor. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Night Blindness: Anomaly of vision in which there is a pronounced inadequacy or complete absence of dark-adaptation. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH]
220 Ophthalmology
Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleolus: A small dense body (sub organelle) within the nucleus of eukaryotic cells, visible by phase contrast and interference microscopy in live cells throughout interphase. Contains RNA and protein and is the site of synthesis of ribosomal RNA. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Occipital Lobe: Posterior part of the cerebral hemisphere. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oculi: Globe or ball of the eye. [NIH] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Oncology: The study of cancer. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operating Rooms: Facilities equipped for performing surgery. [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmologic: Pertaining to ophthalmology (= the branch of medicine dealing with the eye). [EU] Ophthalmologist: A medical doctor specializing in the diagnosis and medical or surgical treatment of visual disorders and eye disease. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Ophthalmoscope: A lighted instrument used to examine the inside of the eye, including the retina and the optic nerve. [NIH] Ophthalmoscopy: Examination of the interior of the eye with an ophthalmoscope. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Opsin: A visual pigment protein found in the retinal rods. It combines with retinaldehyde to form rhodopsin. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each
Dictionary 221
half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Optic disc: The circular area (disc) where the optic nerve connects to the retina. [NIH] Optic Disk: The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. [NIH]
Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Optic Nerve Diseases: Conditions which produce injury or dysfunction of the second cranial or optic nerve, which is generally considered a component of the central nervous system. Damage to optic nerve fibers may occur at or near their origin in the retina, at the optic disk, or in the nerve, optic chiasm, optic tract, or lateral geniculate nuclei. Clinical manifestations may include decreased visual acuity and contrast sensitivity, impaired color vision, and an afferent pupillary defect. [NIH] Optic nerve head: The circular area (disc) where the optic nerve connects to the retina. [NIH] Optic Neuritis: Inflammation of the optic nerve. Commonly associated conditions include autoimmune disorders such as multiple sclerosis, infections, and granulomatous diseases. Clinical features include retro-orbital pain that is aggravated by eye movement, loss of color vision, and contrast sensitivity that may progress to severe visual loss, an afferent pupillary defect (Marcus-Gunn pupil), and in some instances optic disc hyperemia and swelling. Inflammation may occur in the portion of the nerve within the globe (neuropapillitis or anterior optic neuritis) or the portion behind the globe (retrobulbar neuritis or posterior optic neuritis). [NIH] Optometrist: A primary eye care provider who diagnoses, manages, and treats disorders of the visual system and eye diseases. [NIH] Optometry: The professional practice of primary eye and vision care that includes the measurement of visual refractive power and the correction of visual defects with lenses or glasses. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]
Orbicularis: A thin layer of fibers that originates at the posterior lacrimal crest and passes outward and forward, dividing into two slips which surround the canaliculi. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Orthopaedic: Pertaining to the correction of deformities of the musculoskeletal system; pertaining to orthopaedics. [EU] Orthopedics: A surgical specialty which utilizes medical, surgical, and physical methods to
222 Ophthalmology
treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures. [NIH] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Otology: The branch of medicine which deals with the diagnosis and treatment of the disorders and diseases of the ear. [NIH] Otorhinolaryngology: That branch of medicine concerned with medical and surgical treatment of the head and neck, including the ears, nose and throat. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidants: Oxidizing agents or electron-accepting molecules in chemical reactions in which electrons are transferred from one molecule to another (oxidation-reduction). In vivo, it appears that phagocyte-generated oxidants function as tumor promoters or cocarcinogens rather than as complete carcinogens perhaps because of the high levels of endogenous antioxidant defenses. It is also thought that oxidative damage in joints may trigger the autoimmune response that characterizes the persistence of the rheumatoid disease process. [NIH]
Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It
Dictionary 223
is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Papilledema: Swelling around the optic disk. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Parenchyma: The essential elements of an organ; used in anatomical nomenclature as a general term to designate the functional elements of an organ, as distinguished from its framework, or stroma. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Particle: A tiny mass of material. [EU] Partnership Practice: A voluntary contract between two or more doctors who may or may not share responsibility for the care of patients, with proportional sharing of profits and losses. [NIH] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Peer Review: An organized procedure carried out by a select committee of professionals in evaluating the performance of other professionals in meeting the standards of their specialty. Review by peers is used by editors in the evaluation of articles and other papers submitted for publication. Peer review is used also in the evaluation of grant applications. It is applied also in evaluating the quality of health care provided to patients. [NIH] Pemphigus: Group of chronic blistering diseases characterized histologically by acantholysis and blister formation within the epidermis. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH]
224 Ophthalmology
Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Perimetry: Determination of the extent of the visual field for various types and intensities of stimuli. [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Periorbital: Situated around the orbit, or eye socket. [EU] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral vision: Side vision; ability to see objects and movement outside of the direct line of vision. [NIH] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharyngitis: Inflammation of the throat. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Photoreceptor: Receptor capable of being activated by light stimuli, as a rod or cone cell of
Dictionary 225
the eye. [NIH] Phototransduction: The transducing of light energy to afferent nerve impulses, such as takes place in the retinal rods and cones. After light photons are absorbed by the photopigments, the signal is transmitted to the outer segment membrane by the cyclic GMP second messenger system, where it closes the sodium channels. This channel gating ultimately generates an action potential in the inner retina. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] Plasmids: Any extrachromosomal hereditary determinant. Plasmids are self-replicating circular molecules of DNA that are found in a variety of bacterial, archaeal, fungal, algal, and plant species. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the
226 Ophthalmology
platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Plateletpheresis: The preparation of platelet concentrates with the return of red cells and platelet-poor plasma to the donor. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Polyvinyl Alcohol: A polymer prepared from polyvinyl acetates by replacement of the acetate groups with hydroxyl groups. It is used as a pharmaceutic aid and ophthalmic lubricant as well as in the manufacture of surface coatings artificial sponges, cosmetics, and other products. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH]
Dictionary 227
Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Presbyopia: The normal decreasing elasticity of the crystalline lens that leads to loss of accommodation. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [NIH] Private Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care. [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should
228 Ophthalmology
fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Prostatitis: Inflammation of the prostate. [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU]
Dictionary 229
Pseudotumor Cerebri: A condition marked by raised intracranial pressure and characterized clinically by headaches; nausea; papilledema, peripheral constriction of the visual fields, transient visual obscurations, and pulsatile tinnitus. Obesity is frequently associated with this condition, which primarily affects women between 20 and 44 years of age. Chronic papilledema may lead to optic nerve injury (optic nerve diseases) and visual loss (blindness). [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychophysics: The science dealing with the correlation of the physical characteristics of a stimulus, e.g., frequency or intensity, with the response to the stimulus, in order to assess the psychologic factors involved in the relationship. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupil: The aperture in the iris through which light passes. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial infection. [EU] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radial Keratotomy: Commonly referred to as RK; a surgical procedure designed to correct myopia (nearsightedness) by flattening the cornea using radial cuts. [NIH]
230 Ophthalmology
Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiobiology: That part of biology which deals with the effects of radiation on living organisms. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Radius: The lateral bone of the forearm. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU]
Dictionary 231
Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflective: Capable of throwing back light, images, sound waves : reflecting. [EU] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Errors: Deviations from the average or standard indices of refraction of the eye through its dioptric or refractive apparatus. [NIH] Refractive Power: The ability of an object, such as the eye, to bend light as light passes through it. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Research Support: Financial support of research activities. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinae: A congenital notch or cleft of the retina, usually located inferiorly. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Detachment: Separation of the inner layers of the retina (neural retina) from the
232 Ophthalmology
pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). [NIH] Retinal Ganglion Cells: Cells of the innermost nuclear layer of the retina, the ganglion cell layer, which project axons through the optic nerve to the brain. They are quite variable in size and in the shapes of their dendritic arbors, which are generally confined to the inner plexiform layer. [NIH] Retinal Neovascularization: Formation of new blood vessels originating from the retinal veins and extending along the inner (vitreal) surface of the retina. [NIH] Retinal pigment epithelium: The pigment cell layer that nourishes the retinal cells; located just outside the retina and attached to the choroid. [NIH] Retinal Vein: Central retinal vein and its tributaries. It runs a short course within the optic nerve and then leaves and empties into the superior ophthalmic vein or cavernous sinus. [NIH]
Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retinitis Pigmentosa: Hereditary, progressive degeneration of the neuroepithelium of the retina characterized by night blindness and progressive contraction of the visual field. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrobulbar: Behind the pons. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Rhinophyma: A manifestation of severe Acne rosacea resulting in significant enlargement of the nose and occurring primarily in men. It is caused by hypertrophy of the sebaceous glands and surrounding connective tissue. The nose is reddened and marked with numerous telangiectasias. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the
Dictionary 233
cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rod: A reception for vision, located in the retina. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sanitation: The development and establishment of environmental conditions favorable to the health of the public. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH]
234 Ophthalmology
Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Semantics: The relationships between symbols and their meanings. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serrata: The serrated anterior border of the retina located approximately 8.5 mm from the limbus and adjacent to the pars plana of the ciliary body. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexual Partners: Married or single individuals who share sexual relations. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell
Dictionary 235
differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicone Oils: Organic siloxanes which are polymerized to the oily stage. The oils have low surface tension and density less than 1. They are used in industrial applications and in the treatment of retinal detachment, complicated by proliferative vitreoretinopathy. [NIH] Siloxanes: Silicon polymers that contain alternate silicon and oxygen atoms in linear or cyclic molecular structures. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH]
236 Ophthalmology
Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphenoid: An unpaired cranial bone with a body containing the sphenoid sinus and forming the posterior part of the medial walls of the orbits. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Standardize: To compare with or conform to a standard; to establish standards. [EU] Steatosis: Fatty degeneration. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stereoscopic: Accurate depth perception in the presence of binocular single vision, due to the slight disparity in the two retinal images of the same object. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other
Dictionary 237
excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]
Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strabismus: Deviation of the eye which the patient cannot overcome. The visual axes assume a position relative to each other different from that required by the physiological conditions. The various forms of strabismus are spoken of as tropias, their direction being indicated by the appropriate prefix, as cyclo tropia, esotropia, exotropia, hypertropia, and hypotropia. Called also cast, heterotropia, manifest deviation, and squint. [EU] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Sublingual: Located beneath the tongue. [EU] Submandibular: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH]
238 Ophthalmology
Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telecommunications: Transmission of information over distances via electronic means. [NIH]
Telemedicine: Delivery of health services via remote telecommunications. This includes interactive consultative and diagnostic services. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Timolol: A beta-adrenergic antagonist similar in action to propranolol. The levo-isomer is the more active. Timolol has been proposed as an antihypertensive, antiarrhythmic, antiangina, and antiglaucoma agent. It is also used in the treatment of migraine and tremor. [NIH]
Dictionary 239
Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tissue Preservation: The process by which a tissue or aggregate of cells is kept alive outside of the organism from which it was derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonometer: For testing the intra-ocular tension. [NIH] Tonsillitis: Inflammation of the tonsils, especially the palatine tonsils. It is often caused by a bacterium. Tonsillitis may be acute, chronic, or recurrent. [NIH] Tonsils: Small masses of lymphoid tissue on either side of the throat. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trabecular Meshwork: A porelike structure surrounding the entire circumference of the anterior chamber through which aqueous humor circulates to the canal of Schlemm. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH]
240 Ophthalmology
Training Support: Financial support for training including both student stipends and loans and training grants to institutions. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translating: Conversion from one language to another language. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]
Trophic: Of or pertaining to nutrition. [EU] Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH]
Dictionary 241
Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urography: Radiography of any part of the urinary tract. [NIH] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH]
242 Ophthalmology
Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Visual Cortex: Area of the occipital lobe concerned with vision. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH]
Dictionary 243
Visual Perception: The selecting and organizing of visual stimuli based on the individual's past experience. [NIH] Vitrectomy: Removal of the whole or part of the vitreous body in treating endophthalmitis, diabetic retinopathy, retinal detachment, intraocular foreign bodies, and some types of glaucoma. [NIH] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [NIH] Vitreous Hemorrhage: Hemorrhage into the vitreous body. [NIH] Vitreous Humor: The transparent, colorless mass of gel that lies behind the lens and in front of the retina and fills the center of the eyeball. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]
White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zonules: The fibers that hold the lens suspended in position and enable it to change shape during accommodation. [NIH]
245
INDEX A Abdominal, 179, 222, 223, 241 Abdominal Pain, 179, 241 Abscess, 143, 145, 179 Acantholysis, 179, 223 Accommodation, 54, 128, 179, 218, 227, 243 Acetylcholine, 179, 219 Acne, 82, 179, 232 Acne Rosacea, 82, 179 Acoustic, 54, 121, 179 Acrylonitrile, 122, 179, 233 Acuity, 26, 179 Acute renal, 144, 179 Acute tubular, 144, 179 Adaptability, 179, 189 Adaptation, 179, 219, 225 Adenine, 179, 180 Adenocarcinoma, 179, 206 Adenosine, 127, 180, 224 Adenosine Triphosphate, 127, 180, 224 Adhesives, 179, 180 Adjunctive Therapy, 35, 180 Adjustment, 108, 128, 130, 179, 180 Adolescence, 180, 223 Adrenal Glands, 180, 181 Adrenergic, 180, 185, 228, 238 Adverse Effect, 17, 180, 181, 234 Aerosol, 180, 238 Afferent, 70, 180, 201, 221, 225 Affinity, 6, 180, 235 Age Groups, 19, 180 Age of Onset, 180, 240 Aged, 80 and Over, 180 Agonist, 113, 124, 180, 185 Algorithms, 77, 131, 180, 186 Alkaline, 181, 187 Allografts, 181, 207 Alpha Particles, 181, 230 Alternative medicine, 150, 181 Aluminum, 128, 181 Alveolar Process, 181, 231 Amblyopia, 55, 164, 181 Amino Acid Sequence, 181, 182 Amino Acids, 107, 113, 181, 201, 223, 226, 228, 233, 234, 240, 241 Ammonia, 123, 181 Amplification, 12, 116, 151, 181
Ampulla, 181, 199 Amyloidosis, 144, 181 Anaesthesia, 68, 181, 182, 209 Anaesthetic, 100, 110, 182 Anal, 182, 202, 213 Analgesic, 113, 182, 212 Analog, 113, 182 Analogous, 19, 182, 240 Anaphylatoxins, 182, 192 Anatomical, 14, 182, 190, 199, 208, 213, 223, 233 Androgens, 37, 182 Anesthesia, 67, 109, 182, 227 Anesthetics, 109, 182 Animal model, 8, 18, 22, 34, 41, 46, 182 Anions, 182, 211 Annealing, 182, 226 Anomalies, 43, 142, 182 Anterior chamber, 53, 129, 130, 182, 211, 239 Antiarrhythmic, 182, 238 Antibacterial, 182, 197, 236 Antibiotic, 6, 35, 109, 182, 236 Antibodies, 23, 114, 182, 184, 205, 208, 214, 217, 225 Antibody, 23, 180, 182, 183, 192, 205, 207, 208, 209, 211, 217, 230, 236, 243 Antifungal, 70, 183 Antigen, 23, 24, 38, 43, 180, 182, 183, 192, 207, 208, 209, 210 Antigen-Antibody Complex, 183, 192 Antihypertensive, 183, 238 Anti-infective, 183, 207 Anti-inflammatory, 18, 84, 183, 184 Anti-Inflammatory Agents, 183, 184 Antimicrobial, 35, 83, 88, 94, 134, 183 Antimitotic, 115, 183 Antioxidant, 41, 109, 125, 183, 222 Antiviral, 183, 208 Anxiety, 115, 183, 228 Aperture, 22, 54, 112, 116, 183, 229 Aphakia, 183, 232 Apheresis, 77, 183 Aponeurosis, 183, 203 Apoptosis, 30, 67, 82, 183, 189 Approximate, 119, 183 Aptitude, 122, 183
246 Ophthalmology
Aqueous, 15, 61, 100, 101, 104, 105, 109, 183, 185, 191, 195, 198, 207, 212, 213, 239 Aqueous humor, 15, 61, 101, 183, 191, 239 Arginine, 182, 184, 219, 240 Arterial, 184, 208, 228, 238 Arteries, 4, 184, 187, 194, 216, 218 Arteriography, 144, 184 Arteriolar, 22, 184, 187 Arterioles, 22, 184, 187, 188 Arteritis, 4, 184 Aspirin, 26, 184 Assay, 54, 184 Astigmatism, 68, 103, 113, 184, 231 Asymptomatic, 184, 222 Atrophy, 37, 179, 184, 219 Attenuation, 184, 200 Audiology, 142, 184 Auditory, 25, 167, 184, 200 Autoantibodies, 184 Autoantigens, 23, 184 Autodigestion, 184, 222 Autoimmune disease, 24, 37, 184, 217 Autoimmunity, 24, 184 Autoradiography, 38, 184 Avian, 184, 194 Axonal, 18, 184 Axons, 184, 221, 232 B Bacteria, 14, 182, 183, 184, 185, 196, 199, 216, 236, 240, 241 Bacteriophage, 185, 240 Bacterium, 185, 239 Bacteriuria, 185, 241 Basal Ganglia, 185, 198, 203 Base, 11, 41, 48, 54, 107, 121, 179, 185, 196, 211, 238, 241 Basement Membrane, 31, 185, 201, 212 Benign, 145, 162, 185, 203, 205, 230 Benign prostatic hyperplasia, 145, 185 Betaxolol, 17, 19, 185 Bilateral, 46, 185, 232 Bile, 185, 190, 194, 203, 211, 213, 227, 236 Bile Ducts, 185, 190, 203, 227 Bile Pigments, 185, 211 Biliary, 144, 185, 192, 223 Biliary Stricture, 145, 185 Biliary Tract, 144, 185, 223 Binocular vision, 42, 185 Bioavailability, 104, 185 Biochemical, 15, 24, 48, 124, 185, 202 Biochemical Phenomena, 124, 185 Biological response modifier, 37, 186
Biological Sciences, 44, 55, 186 Biological therapy, 186, 205 Biometry, 14, 186 Biophysics, 36, 45, 186 Biopsy, 4, 19, 144, 186 Biosynthesis, 100, 186, 234 Biotechnology, 51, 57, 58, 141, 150, 157, 186 Biotransformation, 186 Biphasic, 126, 186 Bladder, 145, 185, 186, 195, 203, 209, 217, 228, 231, 241 Blastocyst, 186, 225 Blepharitis, 163, 186 Blepharospasm, 162, 186 Blinking, 109, 186 Blister, 186, 223 Blood Coagulation, 125, 186, 188 Blood Coagulation Factors, 186 Blood Glucose, 187, 206 Blood pressure, 179, 183, 187, 208, 217, 220, 235 Blood Substitutes, 126, 187 Body Fluids, 187, 197, 235 Bone Marrow, 187, 214, 237 Bone scan, 187, 233 Bowel, 182, 187, 197, 237, 241 Brachytherapy, 187, 210, 211, 230, 243 Bradykinin, 187, 219 Branch, 116, 175, 187, 195, 198, 204, 220, 222, 223, 229, 236, 238 Breakdown, 111, 187, 197, 203 Buccal, 187, 214, 237 Bulbar, 109, 187 Bupivacaine, 109, 187, 213 Burns, 125, 187 Burns, Electric, 187 C Calcium, 15, 115, 128, 187, 188, 192, 235 Calcium Hydroxide, 115, 188 Candidiasis, 143, 188 Candidosis, 188 Capillary, 3, 22, 125, 187, 188, 204, 242 Capillary Fragility, 3, 188 Capillary Permeability, 125, 187, 188 Capsular, 67, 188 Capsules, 188, 204 Carbon Dioxide, 125, 187, 188, 202, 225, 231 Carcinogenesis, 37, 188 Carcinogenic, 188, 210, 220, 228, 236 Carcinogens, 188, 222
Index 247
Carcinoma, 145, 188 Cardiac, 92, 182, 188, 198, 199, 213, 218, 236 Cardiology, 4, 19, 27, 29, 45, 151, 188 Cardioselective, 185, 188, 228 Cardiovascular, 45, 114, 188 Carotene, 188, 231 Case report, 4, 188, 189, 191 Case series, 189, 191 Caspase, 30, 189 Cataract, 7, 8, 9, 46, 55, 88, 101, 109, 121, 130, 162, 183, 188, 189, 232 Cathode, 122, 189, 195, 198 Cations, 128, 189, 211 Caudal, 189, 226 Cell Adhesion, 37, 189, 210 Cell Death, 28, 55, 183, 189, 218 Cell Differentiation, 189, 235 Cell Division, 184, 189, 190, 195, 205, 215, 216, 225, 228, 234 Cell membrane, 189, 196, 211, 235, 243 Cell proliferation, 189, 235 Cell Respiration, 189, 231 Cell Size, 189, 202 Cell Survival, 189, 205 Cellulitis, 143, 189 Central Nervous System, 128, 179, 189, 190, 200, 203, 205, 217, 221 Central Nervous System Infections, 190, 205 Centromere, 20, 190 Cervical, 115, 190 Cervix, 190 Character, 115, 190, 196 Chemotactic Factors, 190, 192 Chin, 93, 179, 190 Cholangitis, 145, 190 Cholecystitis, 145, 190 Choledocholithiasis, 145, 190 Cholelithiasis, 145, 190 Cholesterol, 185, 190, 203, 236 Chondroitin sulfate, 110, 190 Chorioretinitis, 190, 232 Choroid, 137, 139, 190, 231, 232, 241 Chromatin, 183, 190 Chromosomal, 30, 181, 190, 233 Chromosome, 20, 30, 190, 213, 233, 234, 240 Chronic renal, 144, 190, 215, 241 Ciliary, 15, 21, 22, 53, 184, 191, 234, 241 Ciliary Body, 21, 22, 54, 191, 234, 241 Ciliary muscles, 54, 191
Ciliary processes, 53, 184, 191 CIS, 191, 231 Clamp, 119, 120, 191 Clinical Medicine, 41, 191, 227 Clinical study, 14, 34, 125, 191, 193 Clinical trial, 5, 7, 9, 10, 11, 14, 17, 25, 27, 34, 37, 157, 191, 228, 230 Clone, 12, 191 Clonic, 186, 191 Cloning, 23, 186, 191 Coagulation, 106, 125, 187, 191, 206, 212 Cofactor, 191, 228 Cognition, 53, 191 Colitis, 191 Collagen, 28, 63, 100, 110, 111, 115, 123, 180, 185, 191, 226, 228 Collapse, 187, 192 Colloidal, 192, 238 Common Bile Duct, 192, 194 Complement, 8, 182, 192, 204, 210 Complementary and alternative medicine, 91, 96, 192 Complementary medicine, 91, 192 Computational Biology, 157, 192 Computed tomography, 144, 192, 193, 233 Computer Simulation, 15, 192 Computer Systems, 131, 193 Computerized axial tomography, 192, 193, 233 Computerized tomography, 192, 193 Concentric, 118, 193 Concomitant, 18, 193 Cone, 193, 211, 224 Conjunctiva, 39, 193 Conjunctivitis, 162, 163, 164, 193 Connective Tissue, 3, 100, 187, 189, 191, 193, 194, 202, 203, 214, 232, 238 Connective Tissue Cells, 193 Consciousness, 182, 193, 196, 197 Constitutional, 193, 232 Constriction, 22, 193, 211, 229, 233 Consultation, 10, 16, 51, 73, 142, 193 Contamination, 32, 71, 130, 193, 206 Contraindications, ii, 193 Contrast Sensitivity, 193, 221 Controlled clinical trial, 9, 17, 81, 193 Convulsions, 193, 219 Coordination, 55, 142, 193, 217 Corneal Diseases, 15, 55, 194 Corneal Stroma, 110, 129, 194 Corneal Transplantation, 16, 20, 101, 163, 194
248 Ophthalmology
Corneal Ulcer, 32, 88, 124, 194 Coronary, 20, 194, 216, 218 Coronary Thrombosis, 194, 216, 218 Cortex, 181, 194, 200, 227 Cortical, 46, 181, 194, 201 Cranial, 4, 194, 200, 201, 205, 210, 218, 220, 221, 223, 224, 236 Craniocerebral Trauma, 194, 205, 239 Criterion, 194 Crossing-over, 194, 231 Cryostat, 15, 194 Crystallins, 38, 194 Cues, 43, 194 Curative, 194, 238 Cutaneous, 63, 188, 194, 214 Cyclic, 194, 205, 219, 224, 225, 235 Cysteine, 107, 194 Cystic Duct, 145, 192, 194 Cystine, 107, 194 Cystitis, 145, 195 Cytogenetics, 195, 233 Cytomegalovirus, 5, 29, 195 Cytoplasm, 183, 189, 195, 205, 233 Cytoskeleton, 195, 210 Cytotoxic, 195, 230, 235 D Dacryocystorhinostomy, 64, 195 Data Collection, 17, 195 Data Display, 36, 195 Databases, Bibliographic, 157, 195 De novo, 6, 195 Decidua, 195, 225 Decision Making, 62, 135, 195 Decompression, 18, 195 Decompression Sickness, 195 Defense Mechanisms, 195, 210 Degenerative, 15, 21, 22, 196, 206, 214, 217, 232 Dehydration, 109, 196 Deletion, 48, 183, 196 Dementia, 77, 196 Denaturation, 28, 196, 226 Dendrites, 196, 219 Density, 22, 108, 129, 196, 202, 220, 235 Dental Care, 142, 196 Dental Caries, 142, 196, 203 Dentists, 4, 196 Depolarization, 196, 235 Deprivation, 181, 196 Depth Perception, 196, 236 Dermatology, 4, 24, 27, 35, 43, 45, 58, 79, 82, 106, 133, 142, 143, 144, 145, 151, 196
Deuterium, 196, 207 Dexterity, 130, 196 Diabetes Mellitus, 196, 206, 210 Diabetic Retinopathy, 4, 18, 22, 26, 27, 46, 47, 76, 131, 196, 224, 243 Diagnostic procedure, 99, 150, 196 Diagnostic Services, 196, 238 Diastolic, 197, 208 Diffusion, 188, 197, 209 Digestion, 185, 187, 197, 213, 237 Digestive system, 197, 203 Dilatation, 197, 227, 242 Diploid, 197, 225, 240 Direct, iii, 18, 35, 46, 102, 191, 197, 214, 224, 231 Disinfection, 32, 197 Disparity, 197, 236 Dissection, 129, 197 Dissociation, 180, 197 Distal, 20, 184, 197, 198, 228 Dorsal, 197, 217, 226 Dorsum, 197, 203 Drip, 95, 197 Drive, ii, vi, 3, 23, 87, 88, 102, 142, 143, 197, 212 Drug Interactions, 197 Drug Tolerance, 197, 239 Duct, 164, 181, 190, 192, 195, 197, 201, 233 Duodenum, 185, 197, 199, 237 Dyskinesias, 198, 217 Dystrophy, 53, 128, 129, 198 E Edema, 110, 125, 128, 144, 196, 198, 218, 241 Effector, 179, 192, 198, 224 Efficacy, 68, 198 Elasticity, 100, 130, 198, 227 Elastin, 191, 198 Elective, 50, 198 Electrocoagulation, 191, 198 Electrode, 105, 106, 189, 198 Electrolysis, 182, 189, 198 Electrolyte, 15, 109, 198, 235, 241 Electron microscope, 25, 198 Electrons, 183, 185, 189, 198, 211, 222, 230 Electrophysiological, 15, 36, 198 Electroretinogram, 15, 198 Embryology, 198, 219 Emollient, 198, 220 Emulsion, 184, 198, 202 Enamel, 196, 199 Encapsulated, 104, 199
Index 249
Endocarditis, 188, 199 Endocrine System, 199 Endocrinology, 29, 45, 199, 205 Endophthalmitis, 199, 243 Endoscope, 18, 199 Endoscopic, 18, 136, 199 Endothelial cell, 110, 199 Endothelium, 110, 112, 124, 128, 129, 199, 219, 225 Endothelium, Lymphatic, 199 Endothelium, Vascular, 199 Endothelium-derived, 199, 219 Endotoxin, 199, 240 End-stage renal, 190, 199, 215 Enteropeptidase, 199, 240 Enucleation, 74, 199 Environmental Health, 156, 158, 166, 200 Enzymatic, 100, 110, 188, 192, 196, 200, 226, 231 Enzyme, 100, 111, 123, 166, 189, 198, 199, 200, 205, 207, 223, 224, 225, 226, 228, 234, 237, 243 Epidemiological, 9, 35, 39, 47, 200 Epidermis, 179, 186, 200, 223, 229 Epigastric, 200, 222 Epithelial, 31, 38, 43, 110, 111, 124, 129, 179, 191, 194, 195, 200, 206, 212 Epithelial Cells, 31, 38, 43, 200, 206, 212 Epithelium, 15, 21, 109, 124, 128, 129, 140, 185, 199, 200, 211, 232 Equalization, 54, 200 Erectile, 145, 200 Erection, 200 Erythroplakia, 143, 200 Esophageal, 20, 200 Esophagus, 20, 197, 200, 203, 224, 237 Esotropia, 200, 237 Estrogen, 37, 200, 227 Ethmoid, 200, 223 Evoke, 200, 236 Evoked Potentials, 15, 200 Excimer laser, 60, 200 Excitation, 128, 200, 202 Excitatory, 201, 205, 219 Excitatory Amino Acids, 201, 219 Excitotoxicity, 15, 201 Exfoliation, 124, 201 Exocrine, 201, 222 Exogenous, 37, 186, 201, 240 Exotropia, 201, 237 Expiration, 71, 201, 231
External-beam radiation, 201, 211, 230, 243 Extracellular, 8, 55, 100, 193, 201, 210, 235 Extracellular Matrix, 55, 100, 193, 201, 210 Extracellular Space, 201 Extraction, 7, 183, 201, 232 Eye Abnormalities, 20, 201 Eye Injuries, 59, 162, 201 Eye socket, 201, 224 F Facial, 142, 201, 223 Facial Nerve, 201, 223 Family Planning, 157, 201 Fat, 187, 188, 201, 202, 213, 217, 232, 235 Fatigue, 201, 206 Fatty Liver, 145, 202 Ferritin, 8, 202 Fetus, 202, 225, 241 Fibrin, 186, 202, 225 Fibrinogen, 202, 225 Fibrosis, 202, 206, 233 Filtration, 100, 202 Fixation, 112, 202 Flatus, 202, 203 Flow Cytometry, 7, 12, 202 Fluorescence, 6, 12, 15, 202 Fluorescent Dyes, 202 Fluoridation, 142, 203 Fluorine, 126, 203 Fold, 20, 203 Forearm, 187, 203, 230 Fovea, 27, 202, 203 Fundus, 10, 18, 19, 23, 47, 112, 203, 221 Fundus of the Eye, 112, 203 Fungi, 183, 199, 203, 216, 243 Fungus, 166, 188, 203 G Gallbladder, 179, 185, 190, 194, 197, 203 Gallstones, 185, 190, 203 Ganglia, 179, 203, 218, 224, 238 Ganglion, 55, 203, 221, 232 Gas, 125, 151, 181, 188, 195, 197, 202, 203, 207, 219, 237, 238, 242 Gastrin, 203, 207 Gastroenterology, 37, 151, 203 Gels, 12, 104, 105, 203 Gene, 8, 12, 15, 20, 21, 25, 28, 30, 36, 38, 41, 47, 49, 55, 141, 186, 203, 204, 213, 225, 234 Gene Expression, 8, 30, 38, 41, 48, 49, 55, 204 General practitioner, 84, 204
250 Ophthalmology
Generator, 105, 106, 204 Genetic Engineering, 186, 191, 204 Genetic testing, 204, 226 Genital, 114, 204, 205, 241 Genitourinary, 37, 145, 204, 241 Genomics, 15, 204 Genotype, 8, 20, 41, 181, 204, 224 Germanium, 35, 204 Gestation, 204, 225 Gland, 37, 143, 204, 214, 222, 223, 228, 234, 236, 237, 238 Glomerular, 144, 204, 210 Glomerular Filtration Rate, 144, 204 Glomeruli, 204, 215, 229 Glomerulonephritis, 144, 204 Glomerulus, 204, 218 Glossalgia, 204 Glossitis, 143, 204 Glossodynia, 143, 204 Glucose, 187, 196, 204, 206, 210, 233 Glutamate, 15, 201, 205 Glycoprotein, 202, 205, 212, 240 Glycosaminoglycan, 109, 190, 205 Gonadal, 205, 236 Governing Board, 205, 227 Grade, 46, 131, 205 Grading, 39, 47, 131, 205 Grafting, 205, 209 Granule, 205, 232 Granulocytes, 205, 235, 243 Growth factors, 21, 25, 205 Guanylate Cyclase, 205, 219 Gynecology, 5, 16, 25, 27, 133, 142, 143, 144, 145, 151, 205 H Habitual, 190, 205 Haptens, 180, 205 Headache, 4, 205 Headache Disorders, 205 Health Services, 16, 205, 238 Heart failure, 145, 206 Hematology, 16, 37, 45, 206 Hematuria, 144, 145, 206, 215 Hemochromatosis, 145, 206 Hemoglobin, 18, 187, 206 Hemorrhage, 187, 194, 198, 205, 206, 229, 237, 243 Hemostasis, 206, 210 Hepatic, 145, 192, 206 Hepatitis, 26, 145, 206, 242 Hepatitis A, 206 Hepatitis, Alcoholic, 145, 206
Hepatocellular, 145, 206 Hepatocellular carcinoma, 145, 206 Hepatocytes, 206 Hereditary, 3, 201, 206, 217, 219, 225, 232 Heredity, 30, 203, 204, 206 Herpes, 5, 114, 206, 207 Herpes virus, 5, 207 Herpes Zoster, 206, 207 Heterodimers, 207, 210 Heterogeneity, 180, 207 Heterotropia, 207, 237 Histocompatibility, 38, 207 Histology, 12, 13, 15, 38, 41, 55, 207 Homeostasis, 30, 43, 207 Homogeneous, 108, 207 Homologous, 41, 48, 194, 207, 234, 238 Hormonal, 184, 207 Hormone, 48, 113, 203, 207, 210, 215, 227, 232, 234, 238 Host, 181, 185, 188, 207, 241 Hyaluronidase, 111, 207 Hybrid, 191, 207 Hydrogel, 122, 207 Hydrogen, 33, 125, 185, 196, 207, 213, 217, 219, 222, 228 Hydrogen Peroxide, 33, 207, 213 Hydrolysis, 186, 207, 224, 226, 228, 240 Hydrophilic, 207 Hydroxylamine, 6, 207 Hydroxylysine, 191, 207 Hydroxyproline, 191, 208 Hygienic, 69, 208 Hyperaemia, 193, 208 Hyperbilirubinemia, 208, 211 Hyperopia, 208, 231 Hypersensitivity, 208, 232 Hypertension, 33, 144, 145, 205, 208, 228, 239, 241 Hypertrophy, 129, 185, 208, 232 I Id, 89, 95, 163, 169, 174, 176, 208 Idiopathic, 49, 208 Immune function, 37, 208 Immune response, 23, 24, 183, 184, 205, 208, 237, 241, 242 Immune system, 24, 184, 186, 208, 214, 217, 224, 241, 243 Immunity, 114, 208 Immunodeficiency, 24, 158, 208 Immunodeficiency syndrome, 158, 208 Immunofluorescence, 23, 208 Immunoglobulin, 182, 208, 217
Index 251
Immunohistochemistry, 12, 21, 208 Immunologic, 24, 190, 208, 230 Immunology, 5, 6, 7, 14, 16, 23, 24, 25, 29, 37, 51, 52, 55, 60, 82, 180, 203, 208 Immunosuppressive, 18, 208 Immunotoxins, 24, 208 Impairment, 9, 77, 131, 184, 208, 215 Implant radiation, 209, 210, 211, 230, 243 Implantation, 7, 18, 67, 209 Impotence, 145, 200, 209 In situ, 68, 209 In vitro, 24, 34, 35, 37, 38, 43, 209, 226, 239 In vivo, 5, 24, 28, 34, 38, 39, 43, 75, 209, 222 Incision, 102, 103, 130, 209, 210, 211 Incontinence, 145, 209 Incubation, 111, 209 Indicative, 134, 209, 223, 242 Induction, 182, 209, 227 Infant, Newborn, 180, 209 Infarction, 209 Infertility, 145, 209, 241 Infiltration, 37, 204, 206, 209, 227 Information Science, 209, 215 Information Systems, 40, 49, 209 Infusion, 95, 209 Ingestion, 210, 226 Inhalation, 180, 210, 226 Initiation, 13, 210 Inlay, 210, 231 Inorganic, 207, 210, 217 Insight, 21, 28, 31, 64, 66, 210 Insulator, 210, 217 Insulin, 210, 240 Integrins, 31, 210 Intermittent, 210, 214 Internal Medicine, 9, 24, 25, 37, 45, 199, 203, 206, 210, 218, 232 Internal radiation, 210, 211, 230, 243 Interstitial, 38, 144, 187, 201, 210, 211, 218, 243 Intestines, 179, 197, 210, 234 Intracellular, 5, 43, 209, 210, 215, 219, 234 Intracranial Pressure, 210, 229 Intraocular, 7, 15, 17, 19, 26, 59, 67, 108, 111, 120, 125, 199, 201, 210, 243 Intraocular pressure, 15, 17, 19, 26, 59, 108, 210 Intravenous, 5, 144, 209, 210 Intrinsic, 180, 185, 210 Inulin, 204, 210 Invasive, 19, 22, 127, 208, 210, 214 Involuntary, 186, 198, 211, 218, 235
Ion Channels, 25, 211 Ion Exchange, 104, 211 Ion Exchange Resins, 104, 211 Ions, 185, 197, 198, 207, 211, 235 Iris, 182, 193, 211, 229, 241 Irradiation, 100, 110, 127, 211, 243 Ischemia, 184, 211, 219 Isotonic, 28, 124, 211, 216 J Jaundice, 145, 208, 211 Joint, 3, 38, 44, 140, 195, 211, 238 K Kb, 156, 211 Keratitis, 32, 35, 83, 88, 94, 109, 124, 211 Keratoconus, 20, 211 Keratolytic, 196, 211 Keratomileusis, 68, 211 Keratotomy, 95, 211 Kidney Disease, 144, 156, 212 Kidney Pelvis, 212, 241 Kinetic, 212 L Labile, 192, 212 Laboratory Personnel, 13, 212 Lacrimal, 37, 62, 195, 201, 212, 218, 221 Lacrimal gland, 37, 62, 212 Lactation, 212, 227 Lag, 23, 212 Laminin, 185, 212 Laryngeal, 25, 212 Larynx, 212, 239 Laser Surgery, 35, 46, 151, 212 Laser therapy, 126, 212 Latent, 26, 212 Lavage, 119, 120, 212 Lesion, 143, 206, 212, 213, 241 Leukapheresis, 183, 212 Leukocytes, 187, 190, 205, 206, 212, 240 Leukoplakia, 143, 212 Levo, 212, 238 Libido, 182, 212 Library Services, 174, 213 Lidocaine, 109, 213 Life cycle, 186, 203, 213 Ligaments, 194, 213 Ligands, 210, 213 Light microscope, 213, 216 Linkage, 30, 41, 213 Lip, 142, 213 Lipid, 188, 210, 213, 217, 222 Lipid Peroxidation, 213, 222 Liposomes, 104, 213
252 Ophthalmology
Liquor, 213, 229 Liver, 144, 179, 181, 185, 195, 197, 199, 202, 203, 206, 213, 227, 233 Liver Neoplasms, 145, 213 Liver scan, 213, 233 Localization, 25, 102, 208, 213 Localized, 43, 181, 196, 199, 202, 209, 212, 213, 225, 241 Logistic Models, 46, 213 Longitudinal study, 47, 213 Long-Term Care, 21, 214 Loop, 23, 214 Low vision, 10, 146, 214 Lucida, 129, 212, 214 Lupus, 24, 214, 238 Lutein Cells, 214, 227 Lymph, 190, 199, 214, 237 Lymph node, 190, 214 Lymphatic, 199, 209, 214, 236 Lymphocyte, 24, 183, 214 Lymphocytic, 37, 214 Lymphoid, 182, 214, 239 Lysine, 207, 214, 240 M Macula, 27, 203, 214 Macula Lutea, 214 Macular Degeneration, 22, 30, 41, 73, 77, 96, 166, 214 Magnetic Resonance Imaging, 77, 137, 144, 214, 233 Malignant, 22, 24, 145, 179, 214, 230 Malnutrition, 184, 214 Mandible, 181, 190, 214, 231 Manifest, 17, 19, 184, 214, 237 Maxillary, 215, 223 Medial, 11, 200, 201, 215, 220, 236 Medical Informatics, 48, 79, 215 Medicament, 107, 215 MEDLINE, 157, 215 Medullary, 144, 215 Meiosis, 215, 238 Melanocytes, 215 Melanoma, 22, 215 Membrane Glycoproteins, 215 Membrane Proteins, 213, 215 Membranoproliferative, 144, 215 Memory, 120, 121, 196, 215 Meninges, 189, 190, 194, 215 Menopause, 215, 226, 228 Mental Disorders, 215, 229 Mental Health, iv, 5, 156, 159, 215, 229 Mental Processes, 197, 215, 229
Mental Retardation, 28, 215 Mentors, 44, 49, 52, 56, 215 Mercury, 202, 215 Metastasize, 216, 233 Metastatic, 216, 233 MI, 92, 177, 216 Microbiology, 5, 6, 14, 16, 24, 35, 51, 52, 55, 179, 185, 216 Microorganism, 191, 216, 223, 243 Micro-organism, 196, 216 Microscopy, 12, 13, 14, 15, 21, 25, 54, 55, 185, 216, 220 Microspheres, 104, 216 Microsurgery, 119, 136, 216 Migration, 24, 124, 129, 216 Millimeter, 54, 216 Mineralization, 188, 216 Mitochondrial Swelling, 216, 218 Mitosis, 183, 216 Mitotic, 29, 129, 216 Modeling, 16, 216 Modification, 36, 100, 110, 200, 204, 216, 229 Modulator, 37, 216 Molecule, 6, 38, 183, 185, 188, 190, 192, 197, 198, 199, 200, 205, 207, 217, 222, 230, 234, 242 Mollusca, 115, 217 Monitor, 17, 112, 217, 220 Monoclonal, 23, 208, 211, 217, 230, 243 Monoclonal antibodies, 208, 217 Monocular, 43, 217 Mononuclear, 217, 240 Morphology, 36, 54, 55, 189, 206, 217 Motion Sickness, 217, 218 Motor nerve, 217, 220 Movement Disorders, 41, 70, 198, 217 Mucinous, 203, 217 Mucosa, 214, 217, 218, 227, 237 Mucus, 217, 241 Multiple sclerosis, 24, 53, 217, 221 Muscular Dystrophies, 198, 217 Musculoskeletal System, 217, 221 Mydriatic, 131, 217 Myelin, 217 Myocardial infarction, 20, 194, 216, 217, 228 Myocardium, 216, 217, 218 Myopia, 30, 67, 68, 102, 103, 111, 123, 128, 218, 229, 231, 232 N Nasal Cavity, 218, 223
Index 253
Nasolacrimal, 195, 218 Nausea, 144, 218, 229, 241 Nearsightedness, 30, 130, 218, 229 Necrosis, 144, 183, 194, 199, 206, 209, 216, 217, 218 Need, 3, 4, 7, 18, 20, 24, 27, 35, 38, 40, 109, 117, 120, 130, 133, 141, 146, 150, 151, 158, 170, 179, 190, 218, 239 Neonatal, 28, 218 Neoplasia, 20, 218 Nephritis, 144, 218 Nephrology, 45, 218 Nephropathy, 144, 212, 218 Nephrosis, 218 Nephrotic, 144, 218 Nephrotic Syndrome, 144, 218 Nerve, 18, 22, 25, 39, 180, 182, 184, 190, 196, 201, 203, 217, 218, 219, 220, 221, 225, 226, 227, 233, 236, 239, 240, 242 Nerve Growth Factor, 218, 219 Neural, 36, 50, 180, 218, 231, 235 Neuritis, 218, 221 Neurodegenerative Diseases, 30, 219 Neurologic, 5, 40, 219 Neuromuscular, 28, 40, 179, 219, 241 Neuronal, 29, 219 Neurons, 29, 196, 201, 203, 218, 219, 238 Neuropathy, 18, 219 Neuropeptides, 31, 219 Neurophysiology, 55, 168, 196, 219 Neuroprotective Agents, 18, 219 Neuroretinitis, 219, 232 Neurosciences, 11, 53, 82, 219 Neurosurgery, 29, 45, 53, 142, 151, 168, 219 Neurotrophins, 21, 219 Neutrons, 181, 211, 219, 230 Night Blindness, 219, 232 Nitric Oxide, 125, 207, 219 Nitrogen, 182, 195, 202, 219, 240 Normotensive, 54, 220 Nuclear, 46, 185, 198, 203, 218, 220, 232 Nuclei, 181, 198, 204, 214, 216, 219, 220, 221, 228 Nucleolus, 220, 232 Nucleus, 183, 190, 194, 195, 196, 199, 215, 217, 219, 220, 228, 237 O Obstetrics, 133, 142, 143, 144, 145, 220 Occipital Lobe, 220, 242 Oculi, 186, 220 Oculomotor, 15, 43, 220
Ointments, 104, 126, 220 Oncogenic, 210, 220 Oncology, 16, 27, 36, 37, 51, 220 On-line, 168, 177, 220 Opacity, 9, 189, 196, 220 Operating Rooms, 40, 220 Ophthalmologic, 26, 32, 46, 48, 105, 119, 220 Ophthalmologist, 20, 30, 39, 103, 109, 121, 164, 220 Ophthalmoscope, 220, 221 Ophthalmoscopy, 45, 220 Opportunistic Infections, 5, 220 Opsin, 220, 231 Optic Chiasm, 220, 221 Optic disc, 17, 27, 39, 221 Optic Disk, 196, 214, 221, 223 Optic Nerve, 18, 22, 39, 125, 181, 219, 220, 221, 229, 231, 232, 233 Optic Nerve Diseases, 18, 221, 229 Optic nerve head, 22, 219, 221 Optic Neuritis, 18, 33, 73, 163, 221 Optometrist, 39, 42, 221 Optometry, 15, 39, 42, 44, 74, 97, 103, 221 Oral Manifestations, 3, 221 Orbicularis, 186, 221 Orbit, 18, 138, 201, 221, 224 Orbital, 18, 74, 76, 137, 163, 221 Organ Culture, 16, 221, 239 Organ Transplantation, 7, 24, 221 Orthopaedic, 115, 221 Orthopedics, 27, 151, 221 Otolaryngology, 25, 133, 138, 142, 143, 144, 145, 147, 167, 222 Otology, 141, 222 Otorhinolaryngology, 151, 222 Outpatient, 34, 77, 127, 222 Ovum, 195, 204, 213, 222, 227 Oxidants, 9, 222 Oxidation, 183, 186, 194, 213, 222 Oxidation-Reduction, 186, 222 Oxidative Stress, 41, 222 Oxygen Consumption, 222, 231 P Paediatric, 68, 81, 222 Palate, 142, 222, 237 Palliative, 222, 238 Pancreas, 144, 179, 197, 203, 206, 210, 222, 240 Pancreatic, 222 Pancreatitis, 145, 185, 222 Papilledema, 223, 229
254 Ophthalmology
Paralysis, 187, 200, 223 Paranasal Sinuses, 142, 223 Parenchyma, 124, 223 Parotid, 143, 223 Particle, 223, 235, 240 Partnership Practice, 223, 227 Parturition, 220, 223, 227 Patch, 200, 212, 223 Pathogen, 209, 223 Pathogenesis, 23, 41, 49, 223 Pathologic, 8, 25, 38, 73, 183, 186, 188, 194, 208, 223, 231 Pathologic Processes, 183, 223 Patient Compliance, 32, 104, 223 Patient Education, 167, 172, 174, 177, 223 Pediatrics, 16, 28, 29, 41, 45, 51, 76, 164, 223 Peer Review, 13, 80, 87, 223 Pemphigus, 143, 179, 223 Pepsin, 111, 223 Peptide, 113, 199, 223, 226, 228 Perception, 42, 50, 193, 196, 224 Perforation, 183, 224 Perfusion, 22, 224 Pericardium, 123, 224, 238 Perimetry, 19, 33, 61, 224 Perioperative, 133, 224 Periorbital, 76, 224 Peripheral Nervous System, 219, 224, 237 Peripheral vision, 103, 224, 242 Phagocyte, 222, 224 Phallic, 202, 224 Pharmacokinetic, 224 Pharmacologic, 182, 224, 239 Pharyngitis, 143, 224 Pharynx, 142, 143, 218, 224 Phenotype, 20, 30, 41, 43, 224 Phosphodiesterase, 47, 224 Phospholipases, 224, 235 Phosphorus, 188, 224 Photocoagulation, 27, 106, 137, 191, 224 Photoreceptor, 16, 25, 29, 41, 48, 55, 224 Phototransduction, 16, 225 Physical Examination, 145, 225 Physiologic, 180, 186, 210, 211, 225, 230, 231, 240 Physiology, 14, 15, 45, 53, 55, 179, 186, 188, 198, 199, 203, 205, 206, 218, 219, 225 Pigment, 215, 220, 225, 232 Placenta, 114, 225, 227, 229 Plants, 186, 188, 204, 210, 217, 225, 233, 239
Plasma, 182, 189, 199, 202, 204, 206, 212, 225, 226 Plasma cells, 182, 225 Plasmapheresis, 183, 225 Plasmids, 14, 225 Plasmin, 225 Plasminogen, 43, 225 Plasminogen Activators, 225 Plasticity, 25, 225 Platelet Activation, 225, 235 Platelet Aggregation, 182, 219, 226 Plateletpheresis, 183, 226 Platelets, 219, 226 Platinum, 214, 226 Poisoning, 134, 216, 218, 226 Polymerase, 36, 226 Polymerase Chain Reaction, 36, 226 Polymers, 104, 105, 122, 211, 226, 228, 235 Polypeptide, 181, 191, 202, 225, 226, 227 Polysaccharide, 183, 205, 226, 228 Polyvinyl Alcohol, 105, 226 Posterior, 18, 42, 182, 190, 197, 211, 220, 221, 222, 226, 233, 236 Postmenopausal, 37, 226 Postsynaptic, 226, 235 Post-traumatic, 205, 217, 226 Potentiate, 54, 226 Potentiation, 227, 235 Practice Guidelines, 159, 227 Precursor, 198, 200, 225, 227, 240 Presbyopia, 103, 227 Prevalence, 10, 26, 32, 49, 82, 94, 227 Primary Biliary Cirrhosis, 145, 227 Private Practice, 34, 227 Probe, 35, 227 Procaine, 213, 227 Prodrug, 227 Professional Practice, 221, 227 Progeny, 12, 227 Progesterone, 227, 236 Progression, 9, 17, 20, 131, 182, 227 Progressive, 103, 131, 166, 189, 190, 194, 196, 197, 205, 206, 217, 218, 219, 225, 227, 232, 240 Projection, 112, 195, 221, 227 Prolactin, 37, 227 Proline, 191, 208, 228 Promoter, 21, 124, 228 Prophase, 228, 238 Prophylaxis, 115, 228, 241 Proportional, 35, 223, 228 Propranolol, 228, 238
Index 255
Prospective study, 94, 213, 228 Prostate, 185, 228 Prostatic Hyperplasia, 228 Prostatitis, 145, 228 Protein C, 181, 185, 202, 228 Protein S, 16, 141, 186, 228, 233 Proteinuria, 144, 215, 218, 228 Proteoglycans, 185, 228 Proteolytic, 43, 192, 199, 202, 225, 228 Protocol, 6, 8, 18, 19, 28, 33, 228 Protons, 181, 207, 228, 230 Proximal, 197, 218, 228 Pseudotumor Cerebri, 18, 229 Psychiatry, 16, 29, 94, 133, 142, 143, 144, 145, 202, 229 Psychology, 29, 44, 49, 50, 142, 197, 229 Psychophysics, 33, 49, 55, 229 Public Health, 9, 16, 29, 39, 42, 44, 45, 49, 52, 159, 229 Public Policy, 16, 97, 157, 229 Publishing, 4, 32, 57, 209, 229 Puerperium, 220, 229 Pulmonary, 45, 187, 229, 242 Pulse, 35, 46, 106, 116, 198, 217, 229 Pupil, 22, 193, 217, 221, 229 Purpura, 144, 229 Purulent, 179, 199, 229, 242 Pyelonephritis, 145, 229 Pyogenic, 145, 229 Q Quality of Life, 10, 18, 25, 35, 229 R Race, 18, 216, 229 Radial Keratotomy, 130, 229 Radiation, 35, 36, 37, 100, 118, 126, 127, 151, 184, 201, 202, 210, 211, 230, 233, 243 Radiation therapy, 201, 210, 211, 230, 243 Radioactive, 184, 187, 207, 208, 209, 210, 211, 213, 217, 220, 230, 233, 243 Radiobiology, 37, 230 Radiolabeled, 211, 230, 243 Radiology, 45, 168, 230 Radiopharmaceutical, 204, 230 Radiotherapy, 187, 211, 230, 243 Radius, 230 Random Allocation, 230 Randomization, 8, 17, 34, 230 Randomized, 8, 9, 17, 19, 42, 76, 83, 198, 230 Randomized clinical trial, 8, 17, 76, 83, 230 Reagent, 100, 110, 230
Receptor, 30, 31, 48, 53, 124, 179, 183, 193, 200, 224, 230, 234 Recombinant, 23, 230, 242 Recombination, 21, 41, 48, 231 Rectum, 197, 202, 203, 209, 228, 231 Refer, 1, 34, 187, 192, 202, 203, 206, 213, 214, 219, 231, 242 Reflective, 118, 231 Refraction, 108, 128, 130, 138, 218, 231, 236 Refractive Errors, 110, 162, 181, 231 Refractive Power, 130, 218, 221, 231 Refractory, 29, 198, 231 Regimen, 11, 198, 223, 231 Reliability, 8, 83, 127, 231 Renal pelvis, 145, 231 Research Design, 15, 41, 231 Research Support, 11, 25, 231 Resorption, 125, 231 Respiration, 126, 188, 217, 231 Restoration, 5, 128, 142, 231, 243 Retinae, 214, 231 Retinal Detachment, 30, 101, 196, 231, 235, 243 Retinal Ganglion Cells, 221, 232 Retinal Neovascularization, 16, 232 Retinal pigment epithelium, 16, 232 Retinal Vein, 232 Retinitis, 25, 29, 48, 232 Retinitis Pigmentosa, 29, 48, 232 Retinoid, 16, 232 Retinol, 231, 232 Retinopathy, 18, 48, 70, 76, 131, 196, 232 Retrobulbar, 221, 232 Retrospective, 35, 47, 232 Rheumatism, 70, 232 Rheumatoid, 24, 222, 232 Rheumatoid arthritis, 24, 232 Rheumatology, 24, 45, 143, 232 Rhinophyma, 179, 232 Ribose, 180, 232 Ribosome, 21, 232, 240 Risk factor, 32, 46, 213, 228, 233 Risk patient, 18, 233 Rod, 29, 103, 106, 116, 120, 185, 191, 224, 233 Rubber, 179, 233 S Saliva, 233 Salivary, 142, 143, 195, 197, 201, 233, 237 Salivary glands, 143, 195, 197, 201, 233 Sanitation, 69, 233 Saponins, 233, 236
256 Ophthalmology
Satellite, 5, 233 Scans, 54, 233 Sclera, 111, 123, 190, 193, 233, 241 Sclerosis, 144, 217, 233 Screening, 18, 19, 23, 27, 30, 47, 70, 73, 76, 77, 80, 112, 131, 191, 233, 241 Secondary tumor, 145, 216, 233 Secretion, 38, 61, 212, 217, 234 Secretory, 37, 234 Sediment, 234, 241 Segmental, 144, 234 Segmentation, 47, 77, 234 Segregation, 185, 231, 234 Semantics, 50, 234 Sensibility, 181, 234 Sensor, 22, 234 Sequencing, 12, 15, 36, 56, 226, 234 Serine, 234, 240 Serous, 199, 234 Serrata, 191, 234 Serum, 8, 182, 192, 211, 234, 240 Sex Characteristics, 180, 182, 234 Sexual Partners, 115, 234 Sharpness, 119, 234, 242 Shock, 234, 240 Side effect, 180, 186, 234, 239 Signal Transduction, 24, 38, 53, 234 Signs and Symptoms, 4, 235, 241 Silicone Oils, 104, 235 Siloxanes, 235 Skeletal, 100, 182, 191, 217, 222, 235 Skeleton, 142, 211, 235 Skull, 194, 201, 210, 221, 235, 238 Small intestine, 185, 194, 197, 207, 210, 235, 240 Social Environment, 229, 235 Sodium, 50, 123, 225, 235 Sodium Channels, 50, 225, 235 Soft tissue, 187, 235 Solvent, 122, 235 Soma, 235 Somatic, 28, 180, 215, 216, 224, 235 Sound wave, 231, 235 Spasm, 186, 235 Specialist, 18, 169, 236 Species, 43, 181, 207, 215, 216, 217, 221, 225, 229, 236, 237, 240, 243 Specificity, 6, 23, 115, 180, 236 Spectrum, 4, 28, 236 Sperm, 182, 190, 236 Sphenoid, 223, 236
Spinal cord, 53, 189, 190, 203, 215, 218, 219, 224, 236, 238 Spleen, 181, 195, 214, 236 Sporadic, 219, 236 Staging, 233, 236 Standard therapy, 19, 236 Standardize, 32, 236 Steatosis, 202, 206, 236 Steel, 191, 236, 240 Stereoscopic, 18, 80, 117, 236 Sterile, 130, 236 Sterility, 209, 236 Sterilization, 32, 236 Steroid, 48, 233, 236 Stimulus, 43, 181, 197, 198, 200, 211, 212, 229, 236, 238 Stomach, 179, 184, 197, 200, 203, 207, 210, 212, 218, 223, 224, 235, 236, 237 Stomatitis, 142, 143, 237 Stool, 209, 237 Strabismus, 43, 55, 60, 61, 65, 69, 74, 76, 78, 80, 81, 82, 83, 139, 140, 164, 181, 237 Strand, 226, 237 Stress, 28, 41, 105, 122, 188, 218, 222, 232, 233, 237 Stroke, 53, 156, 162, 219, 237 Stroma, 100, 110, 211, 223, 237 Stromal, 110, 237 Subacute, 209, 237 Subarachnoid, 205, 237 Subclinical, 209, 237 Subcutaneous, 189, 198, 237 Sublingual, 143, 237 Submandibular, 143, 237 Subspecies, 236, 237 Substance P, 113, 234, 237 Substrate, 111, 237 Suction, 202, 237 Supplementation, 9, 237 Suppression, 18, 54, 237 Suppurative, 189, 199, 237 Suspensions, 104, 238 Sympathetic Nervous System, 219, 238 Symptomatic, 222, 238 Synapsis, 238 Synaptic, 25, 235, 238 Synergistic, 227, 238 Systemic, 18, 24, 49, 76, 78, 105, 114, 144, 145, 181, 187, 188, 209, 211, 230, 237, 238, 243 Systemic disease, 49, 78, 238 Systemic lupus erythematosus, 144, 238
Index 257
Systolic, 208, 238 T Telecommunications, 193, 238 Telemedicine, 27, 49, 58, 64, 66, 74, 79, 80, 85, 238 Temporal, 4, 48, 205, 214, 238 Therapeutics, 67, 80, 92, 93, 238 Thermal, 27, 100, 106, 115, 125, 197, 219, 226, 238 Threshold, 100, 110, 111, 208, 238 Thrombolytic, 225, 238 Thrombosis, 210, 228, 237, 238 Thyroid, 163, 166, 238 Timolol, 34, 238 Tinnitus, 229, 239 Tissue Culture, 11, 13, 55, 239 Tissue Preservation, 110, 239 Tolerance, 76, 88, 179, 239 Tomography, 19, 137, 239 Tonic, 186, 239 Tonicity, 104, 211, 239 Tonometer, 108, 239 Tonsillitis, 143, 239 Tonsils, 143, 239 Topical, 18, 84, 88, 109, 207, 239 Toxic, iv, 181, 208, 219, 239 Toxicity, 197, 216, 239 Toxicokinetics, 239 Toxicology, 158, 239 Toxins, 181, 183, 208, 209, 217, 239 Trabecular Meshwork, 54, 100, 239 Trachea, 212, 224, 238, 239 Traction, 191, 239 Training Support, 44, 45, 240 Transduction, 50, 234, 240 Transfection, 12, 186, 240 Translating, 36, 240 Translation, 36, 240 Transmitter, 179, 201, 211, 240 Transplantation, 109, 190, 240 Trauma, 22, 42, 54, 59, 106, 119, 129, 142, 201, 218, 219, 223, 240 Tremor, 238, 240 Trisomy, 20, 240 Trophic, 125, 240 Trypsin, 111, 199, 240 Tryptophan, 191, 240 Tuberculosis, 25, 214, 240 Tumor Necrosis Factor, 30, 240 Tumour, 203, 240 Tungsten, 189, 240 Type 2 diabetes, 18, 240
U Ulcer, 143, 189, 241 Ulcerative colitis, 23, 241 Ultrasonography, 144, 241 Unconscious, 182, 195, 208, 241 Uraemia, 223, 241 Ureter, 145, 212, 231, 241 Urethra, 185, 228, 241 Urinalysis, 144, 145, 241 Urinary, 145, 185, 195, 204, 209, 241 Urinary tract, 185, 241 Urine, 144, 145, 185, 186, 206, 209, 228, 231, 241 Urogenital, 204, 241 Urography, 144, 241 Urology, 27, 37, 133, 142, 143, 144, 145, 151, 241 Uterus, 190, 195, 203, 227, 241, 242 Uvea, 199, 241 Uveitis, 23, 29, 82, 140, 163, 241 V Vaccination, 114, 241 Vaccine, 115, 228, 241 Vagina, 188, 190, 242 Vaginitis, 188, 242 Valves, 100, 120, 242 Vascular, 63, 95, 125, 190, 199, 205, 209, 219, 225, 241, 242 Vasculitis, 223, 242 Vasodilators, 219, 242 VE, 144, 242 Vector, 240, 242 Vein, 145, 210, 220, 223, 232, 233, 242 Venous, 228, 242 Ventral, 217, 220, 242 Ventricle, 229, 238, 242 Venules, 22, 187, 188, 199, 242 Vertebrae, 236, 242 Vestibular, 167, 242 Vestibule, 242 Veterinary Medicine, 30, 44, 88, 157, 242 Viral, 29, 41, 51, 145, 164, 194, 220, 240, 242 Viral Hepatitis, 145, 242 Virus, 5, 114, 158, 185, 190, 204, 240, 242 Viscera, 100, 235, 242 Visceral, 217, 242 Viscosity, 105, 207, 242 Visual Acuity, 19, 26, 39, 193, 221, 242 Visual Cortex, 36, 181, 242 Visual field, 17, 39, 46, 95, 221, 224, 229, 232, 242 Visual Perception, 44, 243
258 Ophthalmology
Vitrectomy, 101, 243 Vitreous Body, 190, 231, 243 Vitreous Hemorrhage, 196, 243 Vitreous Humor, 101, 130, 232, 243 Vitro, 34, 54, 243 Vivo, 34, 43, 54, 243 Voltage-gated, 50, 243 W White blood cell, 182, 212, 214, 217, 225, 243 Windpipe, 224, 238, 243
Wound Healing, 31, 55, 210, 243 X Xenograft, 115, 182, 243 X-ray, 184, 189, 192, 193, 202, 211, 220, 230, 233, 243 X-ray therapy, 211, 243 Y Yeasts, 188, 203, 224, 243 Z Zonules, 191, 243
Index 259
260 Ophthalmology