First Prehistoric Representations of the Ocular Surface
Juan Murube, MD, PhD
The Ocular Surface 2006;4:170-177©2006 Ethis Communications, Inc. Vol 4: No 4

Topical/Mucosal Delivery of Sub-Unit Vaccines That Stimulate the Ocular Mucosal Immune System
Anthony B. Nesburn, MD,^1,2 Ilham Bettahi, PhD,¹ Xiuli Zhang, MD, PhD,¹ Xiaoming Zhu, MD,¹ Winston Chamberlain, MD, PhD,¹ Rasha E. Afifi, MD,¹ Steven L. Wechsler, PhD,^1,2 and Lbachir BenMohamed, PhD^1,3
The Ocular Surface 2006;4:178-187©2006 Ethis Communications, Inc. Vol 4: No 4
Mucosal vaccination is proving to be one of the greatest challenges in modern vaccine development. Although ocular mucosal immunity is highly beneficial for achieving protective immunity, the induction of ocular mucosal immunity against ocular infectious pathogens, particularly herpes simplex virus type 1 (HSV-1), which is the leading cause of infectious corneal blindness, remains difficult. Recent developments in cellular and molecular immunology of the ocular mucosal immune system (OMIS) may help in the design of more effective and optimal immunization strategies against ocular pathogens. In this review, we highlight ocular mucosal immunoprophylactic and immunotherapeutic vaccine strategies that have been evaluated to control the many pathogens that attack the surface of the eye. Next, we describe the current understandings of the OMIS and elucidate the structure and the function of the humoral and cellular immune system that protects the surface of the eye. Results from our recent experiments using topical ocular delivery of peptides-CpG and lipopeptide-based vaccines against HSV-1 infection are presented. The future challenges and issues related to the ocular mucosal delivery of molecularly defined sub-unit vaccines are discussed.

Autologous Serum Therapy of the Ocular Surface with Novel Delivery by Platelet Concentrate Gel
Bruce H. Koffler, MD
The Ocular Surface 2006;4:188-195©2006 Ethis Communications, Inc. Vol 4: No 4
Application of autologous serum to treat a multitude of ocular surface diseases and conditions is a relatively new technique that has gained popularity over the past 10 years. This review focuses on the use of topical autologous serum and a new platelet gel delivery technique that utilizes autologous platelet concentrate mixed with calcium chloride and thrombin for gelling serum, which can then be applied easily to the corneal surface. Residual platelet serum concentrate can be mixed with artificial tears that are capable of gelling in a 25% concentrate, which is then used by the patient postoperatively. A review of the literature identifies various concentrations of autologous serum, frequency of application, and storage criteria.

Excimer Laser Phototherapeutic Keratectomy
Brandon D. Ayres, MD, and Christopher J. Rapuano, MD
The Ocular Surface 2006;4:196-206©2006 Ethis Communications, Inc. Vol 4: No 4
Anterior corneal pathology, such as corneal scars and corneal stromal dystrophies, can be visually devastating. Over the past decade, there was a shift in treatment of these conditions from corneal transplantation to phototherapeutic keratectomy (PTK) using the 193 nm excimer laser for visual restoration. We have reviewed the recent literature on techniques for performing and refining PTK and also on various pathologic conditions that can be treated with PTK. The primary indications for PTK include anterior corneal dystrophies, such as lattice, granular, and Reis-Bückler’s dystrophy. PTK can produce significant visual improvement in these patients, and corneal transplantation or retransplantation can be delayed. Corneal degenerations, such as Salzmann’s nodular degeneration, keratoconus nodules, and climatic droplet keratopathy, also can be successfully treated with PTK. Additionally, anterior corneal scars from such etiologies as trauma, corneal ulcers, and prior refractive surgery can have visual improvement with PTK. I n summary, PTK is a powerful tool for the management of anterior corneal pathology. I n a properly selected and well-counseled patient, PTK can significantly improve vision and quality of life.

Optical Aberrations and Visual Disturbances Associated with Dry Eye
Eiki Goto, MD,^1,2 Reiko Ishida, MD,² Minako Kaido, MD,^2,3 Murat Dogru, MD,^2,3 Yukihiro Matsumoto, MD,² Takashi Kojima, MD,^2,4 and Kazuo Tsubota, MD^2,3
The Ocular Surface 2006;4:207-213©2006 Ethis Communications, Inc. Vol 4: No 4
Optical aberrations and visual disturbances are associated with dry eye, although visual impairment is often not detected by conventional visual acuity testing. The newly developed functional visual acuity (FVA) device allows continuous dynamic evaluation of distance visual acuity and assessment of the effect of natural tear film status on dynamic visual function. Similarly, to detect corneal surface irregularities during sustained eye opening in dry eye subjects, a new tear stability analysis system (TSAS) has been developed. B oth FVA and TSAS measurement systems seem to be effective tools in the assessment of dynamic visual acuity changes in dry eye and normal subjects. B oth methods were also found to be helpful in the evaluation of the outcome of management of dry eye disease. FVA testing has been suggested to be an important indication of an individual’s performance in relation to certain daily activities, such as driving, reading and working at a video display terminal. This review provides illustrations of results obtained from FVA and TSAS systems.

Pipeline
Gary D. Novack, PhD, Features Editor, Pipeline
The Ocular Surface 2006;4:215-217©2006 Ethis Communications, Inc. Vol 4: No 4