Corneal biomechanics, refractive error, and axial length in Chinese primary school children.

PURPOSE: Low corneal hysteresis is associated with longer axial length in Chinese secondary school children. The authors sought to explore this association in primary school children. METHODS: LogMAR presenting visual acuity, cycloplegic refractive error, ocular biometry, central corneal thickness (CCT), and corneal hysteresis (CH) was assessed for children in grades 1 to 3 at an academically competitive urban school in Shantou, China. RESULTS: Among 872 eligible children (mean age, 8.6 ± 2.1 years), 651 (74.7%) completed the examination. Among 1299 examined eyes, 111 (8.5%) had uncorrected vision ≤6/12. Mean spherical equivalent refractive error for all eyes was +0.26 ± 1.41 D, and axial length (AL) was 22.7 ± 0.90 mm. CH for the lowest (mean AL, 21.7 ± 0.39 mm), two middle (mean AL, 22.4 ± 0.15 and 22.9 ± 0.15 mm), and highest quartiles (mean AL, 23.7 ± 0.74 mm) of AL were 10.6 ± 2.1 mm Hg, 10.4 ± 2.1 mm Hg, 10.3 ± 2.3 mm Hg, and 10.2 ± 2.3 mm Hg respectively (age- and gender-adjusted Pearson's correlation coefficient r = -0.052; P = 0.001). In generalized estimating equation models adjusting for age, gender, and CCT, lower CH was significantly associated with longer AL (P < 0.001) and more myopic refractive error (P = 0.001). CONCLUSIONS: CH measurement is practical in young children because this is when myopia undergoes its most rapid progression. Prospective follow-up of this cohort at high risk for myopia is under way to determine whether low CH is predictive, or a consequence, of long AL.

Determinants of postoperative corneal edema and impact on goldmann intraocular pressure.

PURPOSE: Recent studies report that increased corneal edema because of contact lens wear under closed lids is associated with elevated Goldmann intraocular pressure (GAT IOP). We sought to assess whether the impact of postoperative corneal edema on GAT IOP would be similar and to determine the differential effect of different amounts of edema. METHODS: The setting is a tertiary level cataract clinic in Shantou, China. Pre- and postoperative (day 1) GAT IOP, central corneal thickness (CCT), corneal hysteresis, corneal resistance factor, and radius of corneal curvature were measured for consecutive patients undergoing phacoemulsification surgery by 2 experienced surgeons. Corneal edema was calculated as the percentage increase in CCT. RESULTS: Among 136 subjects (mean age, 62.5 ± 15.4 years; 53.7% women), the mean increase in CCT was 10.3% postoperatively. Greater corneal edema was associated with lower GAT IOP in unadjusted analyses (P < 0.03) and in linear regression models (P < 0.01). In the model, higher corneal resistance factor (P < 0.001), lower corneal hysteresis (P < 0.001), and steeper radius of corneal curvature (P < 0.001) were associated with higher GAT IOP. Among subjects with edema < the median, edema was associated with lower GAT IOP (P = 0.004), whereas among those with edema ≥ the median, edema was not associated with GAT IOP. An increase in CCT of 7% was associated with an 8 mm Hg underestimation of GAT IOP in our models. CONCLUSIONS: The effect of postoperative edema on GAT IOP seems to be the opposite of contact lens-induced edema. The magnitude of the effect is potentially relevant to patient management.

Intraocular pressure, central corneal thickness, and glaucoma in chinese adults: the liwan eye study.

PURPOSE: To describe the distribution of central corneal thickness (CCT), intraocular pressure (IOP), and their determinants and association with glaucoma in Chinese adults.DESIGN: Population-based cross-sectional study.METHODS: Chinese adults aged 50 years and older were identified using cluster random sampling in Liwan District, Guangzhou. CCT (both optical [OCCT] and ultrasound [UCCT]), intraocular pressure (by Tonopen, IOP), refractive error (by autorefractor, RE), radius of corneal curvature (RCC), axial length (AL), and body mass index (BMI) were measured, and history of hypertension and diabetes (DM) was collected by questionnaire. Right eye data were analyzed.RESULTS: The mean values of OCCT, UCCT, and IOP were 512 ± 29.0 μm, 542 ± 31.4 μm, and 15.2 ± 3.1 mm Hg, respectively. In multiple regression models, CCT declined with age (P < .001) and increased with greater RCC (P < .001) and DM (P = .037). IOP was positively associated with greater CCT (P < .001), BMI (P < .001), and hypertension (P < .001). All 25 persons with open-angle glaucoma had IOP <21 mm Hg. CCT did not differ significantly between persons with and without open- or closed-angle glaucoma. Among 65 persons with ocular hypertension (IOP >97.5th percentile), CCT (555 ± 29 μm) was significantly (P = .01) higher than for normal persons.CONCLUSIONS: The distributions of CCT and IOP in this study are similar to that for other Chinese populations, though IOP was lower than for European populations, possibly due to lower BMI and blood pressure. Glaucoma with IOP <21 mm Hg is common in this population. We found no association between glaucoma and CCT, though power (0.3) for this analysis was low.

Corneal hysteresis is correlated with reduction in axial length after trabeculectomy.

BACKGROUND: We sought to determine whether corneal biomechanical parameters are predictive of reduction in axial length after anti-metabolite trabeculectomy. METHODS: Chinese subjects undergoing trabeculectomy with mitomycin C by a single experienced surgeon underwent the following measurements: Corneal hysteresis (CH, Ocular Response Analyzer, Reichert Ophthalmic Instruments), Goldmann intra-ocular pressure (IOP), central corneal thickness (CCT) and axial length (AL, IOLMaster, Carl Zeiss Meditec, Dublin, CA) were measured pre-operatively, and AL, CH and IOP were measured 1 day and 1 week post-operatively. RESULTS: Mean age of 31 subjects was 52.0 ± 15.2 years, and 15 (48.4%) were female. The mean pre-operative IOP of 21.4 ± 9.3 mmHg was reduced to 8.2 ± 4.6 mmHg 1 day and 11.0 ± 4.4 mmHg 1 week post-operatively (p < 0.001). AL declined from 22.99 ± 0.90 to 22.76 ± 0.87 mm at 1 day and 22.74 ± 0.9 mm at 1 week; 30/31 (%) eyes had a decline in AL (p < 0.001, sign test). In multivariate linear regression models including post-operative data from 1 day and 1 week, greater decline in Goldmann IOP (p < 0.0001, greater pre-op axial length (p < 0.001) and lower pre-operative CH (p = 0.03), were all associated with greater decline in post-operative axial length. CONCLUSIONS: Eyes with lesser ability of the ocular coat to absorb energy (lower CH) had significantly greater decrease in axial length after trabeculectomy-induced IOP-lowering.

Attitudes and Knowledge Concerning Corneal Donation in a Population-Based Sample of Urban Chinese Adults.

PURPOSE: To better understand knowledge and attitudes concerning corneal donation among Chinese adults.
METHODS: Randomly selected residents in predetermined age strata 20 to 60+ years completed home-based questionnaires in each of 12 randomly chosen communities in Guangzhou, southern China.
RESULTS: Among 1217 selected persons, 430 (35.3%) completed the questionnaires (mean age 40.4 yrs, 57.9% female). Refusers were older (44.8 yrs, P < 0.001), but sex did not differ (52.2% female, P = 0.07). Among participants, 175 (40.7%) were willing to donate their corneas (WTD). Differences between WTD and not WTD included donation knowledge score (range, 1-12) [WTD (SD) 6.91 ± 2.21, not WTD 5.62 ± 2.43, P < 0.001]; having discussed donation (WTD 26.3%, not WTD 8.63%, P < 0.001); viewing donation as unpopular (WTD 88.0%, not WTD 96.5%, P = 0.001); and feeling donation "damages the body" (WTD 15.4%, not WTD 25.7%, P = 0.013). Associated significantly with WTD in multiple regression models were higher knowledge score [odds ratio (OR) = 1.18, 95% confidence interval (CI), 1.04-1.32, P = 0.008]; not feeling donation "damages the body" (OR = 1.91, 95% CI, 1.07-3.43, P = 0.030); and willingness to discuss donation (OR = 10.6, 95% CI, 3.35-33.9, P < 0.001). WTD did not differ by age (>60 yrs: 22/51, 43.1%; ≤60 yrs: 153/379, 40.4%, P = 0.706). Assuming all those refusing the survey would not donate, 14.4% (175/1217) were WTD for themselves, though only 7.1% (86/1217) would do so on behalf of a family member if they did not know the deceased's preference.
CONCLUSIONS: Interventions to increase knowledge and promote discussions about donation, and policies allowing widespread expression of donation preference, are needed in this setting.

Enhancement of optically thick to thin line intensities in solar and stellar coronal plasmas through radiative transfer effects: an angularly resolved study.

An analysis of radiative transfer effects present in the Fe XV ion stage of solar and stellar coronal plasmas provides a general explanation of line radiation intensity enhancement above the optically thin limit. Full linearization radiation transfer is compared with the escape factor method and found to be in good agreement at the lower column densities. An angular study of the enhancement shows that symmetry factors are of great importance. This gives a possible reason for the indeterminate status of opacity in relation to coronal lines of distant stellar sources, where only emission integrated across the whole surface is detected.

An analytic geometry-variant approach to line ratio enhancement above the optically thin limit

We describe a simple theoretical model to investigate the anomalous effects of opacity on spectral line ratios, as previously studied in elements such as Fe XV and Fe XVII. The model developed is general: it is not specific to a particular atomic system, thus giving applicability to a number of coronal and chromospheric plasmas; furthermore, it may be applied to a variety of astrophysically relevant geometries. The analysis is underpinned by geometrical arguments, and we outline a technique for it to be used as a tool for the explicit diagnosis of plasma geometry in distant astrophysical objects.

X-ray and extreme-ultraviolet emission from the coronae of Capella

The primary objective of this work is the analysis and interpretation of coronal observations of Capella obtained in 1999 September with the High Energy Transmission Grating Spectrometer on the Chandra X-ray Observatory and the Extreme Ultraviolet Explorer (EUVE). He-like lines of O (O vii) are used to derive a density of 1.7 x 10(10) cm(-3) for the coronae of the binary, consistent with the upper limits derived from Fe xxi, Ne ix and Mg xi line ratios. Previous estimates of the electron density based on Fe xxi should be considered as upper limits. We construct emission measure distributions and compare the theoretical and observed spectra to conclude that the coronal material has a temperature distribution that peaks around 4-6 MK, implying that the coronae of Capella were significantly cooler than in the previous years. In addition, we present an extended line list with over 100 features in the 5-24 Angstrom wavelength range, and find that the X-ray spectrum is very similar to that of a solar flare observed with SMM. The observed to theoretical Fe xvii 15.012-Angstrom line intensity reveals that opacity has no significant effect on the line flux. We derive an upper limit to the optical depth, which we combine with the electron density to derive an upper limit of 3000 km for the size of the Fe xvii emitting region. In the same context, we use the Si iv transition region lines of Capella from HST/Goddard High-Resolution Spectrometer observations to show that opacity can be significant at T = 10(5) K, and derive a path-length of approximate to 75 kin for the transition region. Both the coronal and transition region observations are consistent with very small emitting regions, which could be explained by small loops over the stellar surfaces.

Transparency Proposals for European Sovereign Bond Markets

The debate over the possible extension of transparency regulation in Europe to include sovereign bonds has opened up a number of other issues in need of serious consideration. One such issue is the appropriateness of the entire infrastructure supporting the trading of European sovereign bonds. In recent years sovereign issuers have supported the development of an electronic inter-dealer market but have remained unconcerned with the opacity of dealer-to-customer trading. The degree of segmentation in this market is high relative to what exists in nearly all other financial markets. This paper explores why European sovereign bond markets have developed in such a segmented way and considers how this structure could be altered to improve transparency without adversely affecting liquidity, efficiency or the benefits enjoyed by primary dealers and issuers. It is suggested that the structure of the market could be improved greatly if the largest and most active investors were permitted access to the inter-dealer electronic trading platforms. This would solve a number of market imperfections and increase the proportion of market activity that is conducted in a transparent way. The paper argues that sovereign issuers in Europe have the means to provide incentives that would influence dealers to support reduced segmentation. Some practical examples of how this could be achieved are provided and the potential benefits are outlined.

Key biological issues in contact lens development

A contact lens is a medical device widely used as an alternative to spectacles in order to correct refractive vision problems. The evolution of polymeric biomaterials has heralded a continuous development in the materials used to produce contact lenses and maximize patient comfort and limit adverse events. Microbial keratitis (MK) is a relatively rare but potentially devastating condition associated with contact lens use, particularly with the extended wear of hydrogel lenses. It is the principal complication related to contact lens wear and the large population at risk make it a public health concern. Bacterial binding to the contact lens material is a precursor to the development of MK and is influenced by properties of the material and the bacteria. In order for bacteria to infiltrate the cornea there must be some degree of corneal damage, usually caused by trauma or hypoxia. The most recent materials available aim to allow the continuous wear of lenses while limiting corneal hypoxia, thus helping to prevent the development of MK. Limitations to the treatment of MK require that novel approaches may be necessary in order to limit bacterial adhesion to contact lens materials.

Short pulse pumped X-ray lasers

Double laser pulses of duration similar to 75 ps and short laser pulses similar to 1 ps superimposed on longer duration background pulses have been shown to efficiently pump lasing in Ne-like and Ni-like ions. For the 75 ps pumping, X-ray laser output without travelling wave pumping is shown to be well-described by a model of ASE output. With I ps pumping, the X-ray laser output with different velocity travelling wave pumping is well-fitted with an extension to the ASE model allowing for travelling wave excitation of the gain along the plasma line. The model is used to investigate the production of short (<1 ps) x-ray laser pulses and the effects of non-ideal travelling wave velocities on the X-ray laser output. Resonance line spectra of emission perpendicular to the plasma line are measured and simulated. It is shown that an accurate opacity model for the more intense Ne-like ions is needed to correctly simulate the spectra.

Absolute photoionization cross sections for Xe4+, Xe5+, and Xe6+ near 13.5 nm: Experiment and theory

Absolute photoionization cross-section measurements for a mixture of ground and metastable states of Xe4+, Xe5+, and Xe6+ are reported in the photon energy range of 4d -> nf transitions, which occur within or adjacent to the 13.5 nm window for extreme ultraviolet lithography light source development. The reported values allow the quantification of opacity effects in xenon plasmas due to these 4d -> nf autoionizing states. The oscillator strengths for the 4d -> 4f and 4d -> 5f transitions in Xeq+ (q=1-6) ions are calculated using nonrelativistic Hartree-Fock and random phase approximations. These are compared with published experimental values for Xe+ to Xe3+ and with the values obtained from the present experimental cross-section measurements for Xe4+ to Xe6+. The calculations assisted in the determination of the metastable content in the ion beams for Xe5+ and Xe6+. The experiments were performed by merging a synchrotron photon beam generated by an undulator beamline of the Advanced Light Source with an ion beam produced by an electron cyclotron resonance ion source.

Mutations in sodium-borate cotransporter SLC4A11 cause recessive congenital hereditary endothelial dystrophy (CHED2)

Congenital hereditary endothelial dystrophy ( CHED) is a heritable, bilateral corneal dystrophy characterized by corneal opacification and nystagmus. We describe seven different mutations in the SLC4A11 gene in ten families with autosomal recessive CHED. Mutations in SLC4A11, which encodes a membrane-bound sodium-borate cotransporter, cause loss of function of the protein either by blocking its membrane targeting or nonsense-mediated decay.

Limbal stem cell deficiency and ocular phenotype in ectrodactyly-ectodermal dysplasia-clefting syndrome caused by p63 mutations

Objective: To describe the ocular phenotype in patients with ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome (MIM#604292) and to determine the pathogenic basis of visual morbidity. Design: Retrospective case series. Participants: Nineteen families (23 patients) affected by EEC syndrome from the United Kingdom, Ireland, and Italy. Methods: General medical examination to fulfill the diagnostic criteria for EEC syndrome and determine the phenotypic severity. Mutational analysis of p63 was performed by polymerase chain reaction-based bidirectional Sanger sequencing. All patients with EEC syndrome underwent a complete ophthalmic examination and ocular surface assessment. Limbal stem cell deficiency (LSCD) was diagnosed clinically on the basis of corneal conjunctivalization and anatomy of the limbal palisades of Vogt. Impression cytology using immunofluorescent antibodies was performed in 1 individual. Histologic and immunohistochemical analyses were performed on a corneal button and corneal pannus from 2 EEC patients. Main Outcome Measures: The EEC syndrome phenotypic severity (EEC score), best-corrected Snellen visual acuity (decimal fraction), slit-lamp biomicroscopy, tear function index, tear breakup time, LSCD, p63 DNA sequence variants, impression cytology, and corneal histopathology. Results: Eleven heterozygous missense mutations in the DNA binding domain of p63 were identified in all patients with EEC syndrome. All patients had ocular involvement and the commonest was an anomaly of the meibomian glands and lacrimal drainage system defects. The major cause of visual morbidity was progressive LSCD, which was detected in 61% (14/23). Limbal stem cell deficiency was related to advancing age and caused a progressive keratopathy, resulting in a dense vascularized corneal pannus, and eventually leading to visual impairment. Histologic analysis and impression cytology confirmed LSCD. Conclusions: Heterozygous p63 mutations cause the EEC syndrome and result in visual impairment owing to progressive LSCD. There was no relationship of limbal stem cell failure with the severity of EEC syndrome, as classified by the EEC score, or the underlying molecular defect in p63. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. © 2012 American Academy of Ophthalmology.

COLORIMETRIC POLYMER FILM SENSORS FOR DISSOLVED CARBON-DIOXIDE

Plasticized and unplasticized polymer colorimetric film sensors for gaseous CO2, containing the dye m-cresol purple, are tested as sensors for dissolved CO2. The plasticized polymer m-cresol purple film sensor develops a measurable degree of opacity when exposed to aqueous solution, especially in neutral, compared with alkaline, solution. However, it is shown that a presoaked, fogged plasticized polymer m-cresol purple film does function as a quantitative sensor for dissolved CO2 over the range 0-4% CO2. An unplasticized polymer m-cresol purple film remains largely dear upon exposure to aqueous solution and also functions as a quantitative sensor for dissolved CO2 over the range 0-4% CO2. However, in both types of films the dye interacts with electrolytes present in solution; invariably the dye appears to be converted from its initial deprotonated form (blue) to its protonated form (yellow) and the rate of this process appears to increase with increasing ionic strength, anionic charge and decreasing pH. The 90% response and recovery times for an unplasticized film are determined as 19 s(CO2:0-->5%) and 21 s (CO2:5-->3.6%), respectively.