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Optometry & Vision Science - Published Ahead-of-Print
Sat, 13 Mar 2010 16:42:27 -0600
Sight-threatening microbial keratitis associated with contact lens wear remains a serious concern for patients, eye-care practitioners, and the contact lens industry. Several decades of research and some major advances in lens and solution technology have not resulted in a decline in disease incidence. Here, we offer a perspective on the complex pathogenesis of microbial keratitis, the factors that have prevented a better understanding of this disease, and new approaches being used to tackle this important clinical problem. (C) 2010 American Academy of Optometry
Adaptive optics (AO) describes a set of tools to correct or control aberrations in any optical system. In the eye, AO allows for precise control of the ocular aberrations. If used to correct aberrations over a large pupil, for example, cellular level resolution in retinal images can be achieved. AO systems have been demonstrated for advanced ophthalmoscopy as well as for testing and/or improving vision. In fact, AO can be integrated to any ophthalmic instrument where the optics of the eye is involved, with a scope of applications ranging from phoropters to optical coherence tomography systems. In this article, I discuss the applications and advantages of using AO in a specific system, the AO scanning laser ophthalmoscope. Since the Borish award was, in part, awarded to me because of this effort, I felt it appropriate to select this as the topic for this article. Furthermore, users of AO scanning laser ophthalmoscope continue to appreciate the benefits of the technology, some of which were not anticipated at the time of development, and so it is time to revisit this topic and summarize them in a single article. (C) 2010 American Academy of Optometry
The corneal endothelium maintains stromal deturgescence, which is a prerequisite for corneal transparency. The principal challenge to stromal deturgescence is the swelling pressure associated with the hydrophilic glycosaminoglycans in the stroma. This negative pressure induces fluid leak into the stroma from the anterior chamber, but the rate of leak is restrained by the tight junctions of the endothelium. This role of the endothelium represents its barrier function. In healthy cornea, the fluid leak is counterbalanced by an active fluid pump mechanism associated with the endothelium itself. Although this pump-leak hypothesis was postulated several decades ago, the mechanisms underlying regulation of the balance between the pump and leak functions remain largely unknown. In the last couple of decades, the ion transport systems that support the fluid pump activity have been discovered. In contrast, despite significant evidence for corneal edema secondary to endothelial barrier dysfunction, the molecular aspects underlying its regulation are relatively unknown. Recent findings in our laboratory, however, indicate that barrier integrity (i.e., structural and functional integrity of the tight junctions) of the endothelium is sensitive to remodeling of its peri-junctional actomyosin ring, which is located at the apical junctional complex. This review provides a focused perspective on dynamic regulation of the barrier integrity of endothelium vis-a-vis plasticity of the peri-junctional actomyosin ring and its association with cell signaling downstream of small GTPases of the Rho family. Based on findings to date, it appears that development of specific pharmacological strategies to treat corneal edema in response to inflammatory stress would be possible in the near future. (C) 2010 American Academy of Optometry
Purpose. Patient-reported outcomes are traditionally measured with questionnaires and many have been developed to measure Vision-Related Activity Limitation (VRAL; visual disability or visual functioning), Symptoms, and Quality Of Life (QOL). These vary in quality and can be classified as First or Second Generation instruments. First generation instruments are characterized by simple summary scoring of ordinal responses, which precludes interval measurement. This problem is solved in second generation instruments where Rasch analysis is used to optimize psychometric properties. However, second generation instruments retain limitations; difficulties in comparing scores across instruments, limited applicability to populations and inability to adapt to change. A third generation approach to patient-reported outcomes measurement, item banking, can solve these problems. The aim of this project was to use Rasch analysis to calibrate all items from all instruments to form VRAL, Symptoms, and QOL Item Banks. Methods. Six hundred twenty-four people on the waiting list for cataract surgery were recruited. Each participant completed, by self-administration, a number of the 19 instruments. A total of 353 items were calibrated using Rasch analysis (Winsteps v3.67). The psychometric properties of each item bank were optimized; items fitting the Rasch model were retained (Infit and Outfit range, 0.50 to 1.50). Results. Items were sorted into the three traits; 226 tapped VRAL, 22 symptoms, and 60 QOL. Satisfactory measurement of each latent trait occurred with person separation of 8.11 for VRAL, 2.33 for Symptoms, and 3.20 for QOL. Rasch estimates of item difficulty were highly stable with an average standard error of 0.11 logits. Conclusions. Item banks for the measurement of the latent traits of VRAL, symptoms, and QOL have been formed. New items can be added to enable evolution of measurement. Item banking facilitates accurate and precise measurement through computer adaptive testing. This approach provides common measurement scales, facilitating worldwide comparison of results. (C) 2010 American Academy of Optometry
Twenty years of investigation into emmetropization and the development of myopia has led to several recent insights. Accommodation appears to be an important visual signal for emmetropization. Lens thinning during emmetropization and its cessation at the onset of myopia suggest that interruption of lens stretch during growth is an important part of the process of developing myopia. The ciliary muscle may play a greater role in emmetropization and myopia than previously thought. Time spent outdoors, not near work, may be the more important environmental variable in myopia. The effect of time outdoors shows an important interaction with a substantial genetic contribution to the risk of myopia. (C) 2010 American Academy of Optometry
The development of treatments that slow photoreceptor death could profoundly improve patient wellbeing in those with inherited retinal degenerations. Over recent years, it has emerged that extracellular adenosine-tri-phosphate (ATP) regulates the function of photoreceptors in rodents and primates. Moreover, when the retina is exposed to high levels of ATP, rapid death of photoreceptors occurs, which can be blocked by pretreatment with antagonists to P2X receptors. Compounds that inhibit the action of extracellular ATP slow photoreceptor loss in an animal model of inherited retinal degeneration. In this article, I provide an overview of our work in relation to other research in this area and suggest a model by which ATP contributes to photoreceptor death in inherited retinal degenerations. (C) 2010 American Academy of Optometry
People with central vision loss must use peripheral vision for visual tasks. It is well known that performance for almost all spatial tasks is worse in the normal periphery than in the normal fovea. The primary goal of my ongoing research is to understand the limiting factors and the potential for enhancing vision for people with central vision loss. Here I review my previous work related to understanding the limiting factors on reading, a task that is the primary complaint of many patients with age-related macular degeneration, the leading cause of visual impairment in the elderly. I also review my work related to enhancing visual functions in the normal periphery and how it may be applied to people with central vision loss. (C) 2010 American Academy of Optometry
A devastating consequence of autoimmune-mediated, aqueous tear deficiency is pathological keratinization of the ocular surface. It is setoff by an aberrant immune response that promotes a program of altered mucosal epithelial cell differentiation. The management of keratinizing ocular surface disease is challenging. Topical therapies are largely inadequate for acute exacerbations, and progressive disease often requires systemic immunosuppression. A combination of translational and basic science research is necessary to understand the link between aberrant immunity and pathological keratinization. I review recent research and future directions aimed to develop targeted therapies that control or prevent ocular surface keratinization. (C) 2010 American Academy of Optometry

Published monthly, Optometry and Vision Science (OVS) is the official journal of the American Academy of Optometry. It is an authoritative source for current developments in optometry, physiological optics, and vision science. Ranked 19th, and the top ranked optometry journal internationally of the top 45 journals in the Ophthalmology (eye/vision research, ophthalmology, optometry) category (JCR, 2007) with an Impact Factor of 1.638, this frequently cited scientific journal has served primary eye care practitioners for almost 80 years, promoting vital interdisciplinary exchange among optometrists, ophthalmologists and vision scientists worldwide. Anthony J. Adams, OD, PhD, FAAO is the Editor-in-Chief, Optometry and Vision Science.


Open Access

AAO members and subscribers, as always, are able to access all issues, and all content of the journal online. For others, each issue of OVS has one lead article that is immediately open access and free ("Editors Choice"). In addition, there is free open access to all Optometry and Vision Science content published prior to the last 12 months.


Table of Contents

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Citability Information for Papers and Posters at Academy Meetings

This is a PDF document list of all of the Program Numbers for Academy 2005 San Diego. The format of the program numbers is described below.

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The Academy's scientific papers and posters can be cited using a program number in which the first two digits are the year (i.e. "05", for 2005). The next digit is either "0" (for papers), or "5" (for posters). The next three digits are the placement of the papers or posters in the meeting. The 2005 meeting includes the numbers 001 to 103 for papers, and 001 to 436 for posters.


Example:

Before 2005:
Omlor RA, Mutti DO. Differences in axial length using A-scan ultrasonography and IOL Master: effects of anterior chamber depth. Optom Vis Sci 2003;80(suppl.):120.

Beginning 2005:
Author, VS. The effect of all-work and no-play on peripheral vision. Optom Vis Sci 2005;82:E-abstract 050437.
[The OVS volume changes each year with year 2005 being 82; hence "Optom Vis Sci 2005;82" in the citation.]

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