Analysis of the pathogenic factors and management of dry eye in ocular surface disorders

The tear film represents the interface between the eye and the environment. The alteration of the delicate balance that regulates the secretion and distribution of the tear film determines the dry eye (DE) syndrome. Despite having a multifactorial origin, the main risk factors are female gender and advanced age. Likewise, morphological changes in several glands and in the chemical composition of their secretions, such as proteins, mucins, lipidics, aqueous tears, and salinity, are highly relevant factors that maintain a steady ocular surface. Another key factor of recurrence and onset of the disease is the presence of local and/or systemic inflammation that involves the ocular surface. DE syndrome is one of the most commonly encountered diseases in clinical practice, and many other causes related to daily life and the increase in average life expectancy will contribute to its onset. This review will consider the disorders of the ocular surface that give rise to such a widespread pathology. At the end, the most recent therapeutic options for the management of DE will be briefly discussed according to the specific underlying pathology

Alcance de los estudios sobre la pesca deportiva de los istiophoridae en Venezuela

On effectue l'analyse historique (1961-89) de la CPUE des poissons porte-épée capturés par la pêche sportive dans le principal port de plaisance du pays (Playa Grande Yatching Club). Bien qu'il existe une variabilité interannuelle accusée de la production, on peut observer que l'indice d'abondance du Makaire blanc (#Tetrapturus albidus) a baissé de façon continue ces dernières années, presqu'à son plus faible niveau historique. En ce qui concerne le Makaire bleu (#Makaira nigricans), la hausse de la CPUE, qui avait commencé au début des années quatre-vingt, s'est interrompue, et montrait déjà ces dernières années une tendance décroissante. Bien qu'encore faible, la CPUE du voilier (#Istiophorus albicans$) s'est stabilisée dans le courant de la décennie en cours. Exception faite de cette dernière espèce, on n'a pas observé d'individus sexuellement matures dans les échantillons. Chez les deux espèces de Makaires, les femelles atteignent une taille supérieure à celle des mâles, contrairement au voilier chez lequel il ne semble pas exister de différentiation sexuelle à cet égar

Fifteen years follow-up of photorefractive keratectomy up to 10 D of myopia: outcomes and analysis of the refractive regression

PURPOSE: To evaluate outcomes of photorefractive keratectomy up to -10.00 D of myopia and -4.50 of astigmatism and to develop a predictive model for the refractive changes in the long term. SETTING: Vissum Corporation and Miguel Hernandez University (Alicante, Spain). DESIGN: Retrospective-prospective observational series of cases. METHODS: This study included 33 eyes of 33 patients aged 46.79±7.04 years (range 40-57) operated with the VISX 20/20 excimer laser with optical zones of 6 mm. No mitomycin C was used in any of these cases. The minimum follow-up was 15 years. The main outcome measures were: uncorrected and corrected distance visual acuity, manifest refraction and corneal topography. Linear regression models were developed from the observed refractive changes over time. RESULTS: Safety and efficacy indexes at 15 years were 1.18 and 0.83, respectively. No statistically significant differences were detected for any keratometric variable during the follow-up (p≥0.103). 15 years after the surgery 54.55% of the eyes were within ±1.00 D of spherical equivalent and 84.85% within ±2.00 D. The uncorrected distance visual acuity at 15 years was 20/25 or better in 60.6% of the eyes and 20/40 or better in 72.73% of the eyes. The correlation between the attempted and the achieved refractions was r=0.948 (p<0.001) at 1 year, and r=0.821 (p<0.001) at 15 years. No corneal ectasia was detected in any case during the follow-up. CONCLUSIONS: Photorefractive keratectomy is a safe refractive procedure in the long term within the range of myopia currently considered suitable for its use, although its efficacy decreases with time, especially, in high myopia. The model developed predicts a myopic regression of 2.00 D at 15 years for an ablation depth of 130 µm

Multifocal versus monofocal intraocular lenses after cataract extraction.

BACKGROUND: Good unaided distance visual acuity is now a realistic expectation following cataract surgery and intraocular lens (IOL) implantation. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal) IOLs are available which claim to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal IOLs. OBJECTIVES: The objective of this review was to assess the effects of multifocal IOLs, including effects on visual acuity, subjective visual satisfaction, spectacle dependence, glare and contrast sensitivity, compared to standard monofocal lenses in people undergoing cataract surgery. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 2), MEDLINE (January 1946 to March 2012), EMBASE (January 1980 to March 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 6 March 2012. We searched the reference lists of relevant articles and contacted investigators of included studies and manufacturers of multifocal IOLs for information about additional published and unpublished studies. SELECTION CRITERIA: All randomised controlled trials comparing a multifocal IOL of any type with a monofocal IOL as control were included. Both unilateral and bilateral implantation trials were included. DATA COLLECTION AND ANALYSIS: Two authors collected data and assessed trial quality. Where possible, we pooled data from the individual studies using a random-effects model, otherwise we tabulated data. MAIN RESULTS: Sixteen completed trials (1608 participants) and two ongoing trials were identified. All included trials compared multifocal and monofocal lenses but there was considerable variety in the make and model of lenses implanted. Overall we considered the trials at risk of performance and detection bias because it was difficult to mask patients and outcome assessors. It was also difficult to assess the role of reporting bias. There was moderate quality evidence that similar distance acuity is achieved with both types of lenses (pooled risk ratio (RR) for unaided visual acuity worse than 6/6: 0.98, 95% confidence interval (CI) 0.91 to 1.05). There was also evidence that people with multifocal lenses had better near vision but methodological and statistical heterogeneity meant that we did not calculate a pooled estimate for effect on near vision. Total freedom from use of glasses was achieved more frequently with multifocal than monofocal IOLs. Adverse subjective visual phenomena, particularly haloes, or rings around lights, were more prevalent and more troublesome in participants with the multifocal IOL and there was evidence of reduced contrast sensitivity with the multifocal lenses. AUTHORS' CONCLUSIONS: Multifocal IOLs are effective at improving near vision relative to monofocal IOLs. Whether that improvement outweighs the adverse effects of multifocal IOLs will vary between patients. Motivation to achieve spectacle independence is likely to be the deciding factor

Seasonal changes in planktonic bacterivory rates under the ice-covered coastal Arctic Ocean

Bacterivory was determined in surface waters of Franklin Bay, western Arctic, over a seasonal ice-covered period (winter-spring, 2003-2004). The objectives were to obtain information on the functioning of the microbial food web under the ice, during winter (from 21 December 2003 to 21 March 2004) and during spring (from 22 March 2004 to 29 May 2004), and to test whether bacterial losses would increase after the increase in bacterial production following the spring phytoplankton bloom. Chl a concentrations ranged from 0.04 to 0.36 mu g L(-1), increasing in March and reaching a peak in April. Bacterial biomass showed no consistent trend for the whole period, and protist biomass followed a pattern similar to that of Chl a. Bacterial production increased 1 week after Chl a concentrations started to increase, while bacterivory rates increased very slightly. Average bacterivory rates in winter (0.16 +/- 0.07 mu g C L(-1) d(-1)) were not significantly different from those in spring (0.29 +/- 0.24 mu g C L(-1) d(-1)). Average bacterial production, on the other hand, was similar to bacterivory rates in winter (0.19 +/- 0.38 mu g C L(-1) d(-1)), but higher than bacterivory in spring (0.93 +/- 0.28 mu g C L(-1) d(-1)). Therefore, bacterial production was controlled by grazers during winter and by substrate concentration in spring