Timo Tervo

University of Helsinki | HY · Department of Ophthalmology

Purpose: To evaluate the significance of vision-related problems in fatal motor vehicle accidents (FMVAs) based on a systematic investigation process by multidisciplinary road accident investigation teams (RAITs). Methods: Retrospective registry-based study of all FMVAs during the years 2012-2016 in Finland in which driver causing the accident h...

Objective: We studied which current fatal at-fault crashes would occur despite the most advanced current active safety devices (up to SAE level 2 of driving automation) and how frequent these crashes would be. Methods: We carried out a cross-sectional study of passenger cars that were first registered during the period 1st January 2010 to 31st D...

Objective: Road traffic suicides typically involve a passenger car driver crashing his or her vehicle into a heavy vehicle, because death is almost certain due to the large mass difference between these vehicles. For the same reason, heavy-vehicle drivers typically suffer minor injuries, if any, and have thus received little attention in the resear...

Objective: The aim of the present study was twofold. The first aim was to explore how frequently physicians evaluate driving fitness when a patient has a serious alcohol problem, which is accomplished by examining differences in physicians' compliance with their intervention/notification obligation among different alcohol-related ICD-10 diagnoses....

Objective: We examined both fatal and injury at-fault crashes of a population of passenger cars fitted with electronic stability control (ESC). Crash rates were calculated in relation to both registration years and mileage. Crash rates were also calculated for a non-ESC car population and crash rate ratios were calculated to compare the crash risk...

Objective: To study different factors that are associated with fatal sleepiness-related motor vehicle accidents (FSMVA) and in other types of fatal motor vehicle accidents (FMVA) in Finland. Methods: All FMVA that were caused by falling asleep at the wheel (FSMVA) during the years 2005-2014 were investigated using OTI (Finnish Crash Data Institu...

OBJECTIVE: The purpose of this study was to explore the relationship between annual alcohol consumption per capita/alcohol price index and the number of alcohol-related fatal motor vehicle accidents (AFMVAs). We were particularly interested in whether a tax reduction in 2004 increased the number of alcohol-related accidents. METHOD: The data consis...

OBJECTIVE We studied the correlation between airbag deployment and eye injuries using two different data sets. METHODS The registry of the Finnish Road Accident (FRA) Investigation Teams (RAIT) was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009–12 (4 years) w...

Background Fatal single vehicle accidents (SVA) which involved ESC fitted passenger cars were examined in order to disclose the immediate and background risk factors for the accidents as well as the validity of ESC function. Methods The registry of Finnish Road Accident (FRA) Investigation Teams (RAIT) was analysed and all fatal passenger car acci...

Small nerve fiber loss and damage, a neuropathy of the sensory and autonomic nervous systems, often appears after chemotherapy or develops following a number of genetic, degenerative, or metabolic diseases, with diabetes being its primary cause. Because of the different etiologies of small fiber neuropathy (SFN) and the variety of organs that can b...

Objective: The purpose of this study was to investigate whether individuals with attention deficit-hyperactivity disorder (ADHD) followed up to age 40 have a higher mortality, more involvement in criminal behavior, increased traffic accidents, and frequency or registered violations against traffic rules or whether they have been more frequently vi...

Objective: Longitudinal follow-up of ADHD suggests a poorer outcome in those affected. Studies extending to 30 years however are rare. We investigated the adult outcome of ADHD associated with perinatal risks (PRs), treated non-pharmacologically. Method: A study group of 122 participants (86 men, 36 women) with PR-associated ADHD was followed-up...

PurposeTo refine the diagnostic criteria for peripheral hypertrophic subepithelial corneal degeneration (PHSD) and characterize its clinical phenotype, histopathology and immunohistochemical features.Methods Diagnostic criteria were refined on the basis of literature data. Fourteen patients (13 women and one man; median age 52 years, range 33–66) w...

Purpose: To evaluate the efficacy of keratectomy in treating irregular astigmatism caused by peripheral hypertrophic subepithelial corneal degeneration (PHSD) and to study the possible underlying immunological risk factors. Materials and methods: Patients (14 eyes) with diagnosed PHSD were treated with superficial keratectomy with or without the as...

Purpose: To (1) examine the prevalence of fatal disease attacks while driving, (2) evaluate the potential risk of a driver's acute incapacity to drive, (3) compare the risks related to the driver's incapacity to drive with other major risks related to fatal motor vehicle accidents (fMVAs), and (4) assess how these accidents are reported in officia...

To describe long-term postoperative results of 5 eyes that had central toxic keratopathy after photorefractive keratectomy (PRK). In a period of 2 months, 74 eyes were subjected to refractive surgery (21 by PRK and 53 by laser in situ keratomileusis) in 2006. Laser ablations were performed with a VISX S4 (VISX, Santa Ana, CA) excimer laser. Five ey...

Purpose: To prospectively study the effect of refractive surgery in the primary visual cortex of adult anisometropic and isometropic myopic patients. Methods: Two anisometropic and two isometropic myopic patients were examined with multifocal functional magnetic resonance imaging technique (mffMRI) before refractive surgery and at 3, 6, 9 and 12 mo...

To determine the changes in corneal sensitivity to different stimulus modalities in diabetes mellitus (DM)1 and DM2 patients with retinopathy, and to explore whether argon laser photocoagulation exacerbates sensitivity loss in diabetic patients. Corneal sensitivity to different modalities of stimulus was determined in one randomized eye in 52 patie...

Fatal motor vehicle accidents (fMVAs) as well as accidents involving pedestrians or bicyclists in Uusimaa county in 2008 were reviewed. Of the fMVAs, acute disease attacks while driving caused 26.5% (9/34) of the drivers' deaths. This equalled with the number of alcohol-related fatal accidents. Heart attack was the main cause (7/9 disease attacks)....

To compare the long-term results of photorefractive keratectomy (PRK) for low to moderate myopia performed using a broad-beam laser system or a scanning-slit laser system. Department of Ophthalmology, University of Helsinki, Helsinki, Finland. Case-control study. This follow-up study comprised eyes with myopia (-1.25 to -7.00 diopters [D]) or myopi...

To compare the global gene expression profile of stratified epithelia generated in vitro using simian virus 40 (SV40) immortalized human corneal epithelial cells with the previously reported gene expression of normal human corneal epithelia. Immortalized cells expanded in submerged culture were grown in an air-liquid interface of liquid permeable c...

The aim of this study was to describe the morphology, corneal topography and sensitivity in individuals with Dystrophia Helsinglandica. This autosomal dominant corneal disease is characterized by recurrent corneal erosive episodes and progressive subepithelial fibrosis not significantly affecting visual acuity. The corneas of nine affected and nine...

Models showing locations of Loops 1–3 containing clusters of SCD mutations. See also Figure 3B for comparison, to identify SCD mutations in each loop. Two views are shown, a side view (left side) and top view (right side). These highlight the loop regions containing amino acids implicated in SCD. Loop 1 (containing amino acids A97 to R132) is shown...

Structures of potential substrates successfully docked with the UBIAD1 model. (A) Farneslydiphosphate (C15H25O7P2-3). (B) Menaquinone (C11H8O2). (C) Naphthalenediol (C10H8O2). (0.93 MB TIF)

Key enzymatic prenylation reaction catalyzed by UbiA during biosynthesis of ubiquinone [16], [17]. Prenylation of 4-hydroxybenzoic acid by oligoprenyl diphosphates are shown (n>1). A two substrate reaction is shown similar to that proposed for human UBIAD1 (see Discussion). (1.19 MB TIF)

Docking simulation with naphthalinediol as a putative substrate. Tertiary protein structure model of human UBIAD1 with eight transmembrane helices and a putative naphthalinediol substrate docked (shown as a spacefill atom representation). (2.99 MB TIF)

Mutations in a novel gene, UBIAD1, were recently found to cause the autosomal dominant eye disease Schnyder corneal dystrophy (SCD). SCD is characterized by an abnormal deposition of cholesterol and phospholipids in the cornea resulting in progressive corneal opacification and visual loss. We characterized lesions in the UBIAD1 gene in new SCD fami...

To determine corneal sensitivity to selective mechanical, chemical, and thermal (heat and cold) stimulation in patients with a history of herpes simplex virus (HSV) keratitis. Corneal sensitivity to different modalities of stimulus was determined in both eyes of 16 patients with unilateral HSV keratitis diagnosed 1 to 12 months before the study. On...

Monocarboxylate transporters (MCTs) are transmembrane proteins capable of transferring lactate and other endogenous and exogenous monocarboxylates across the cell membrane. The aim of the present study was to assess the expression and transporter role of human MCT1, MCT3 and MCT4 in the corneal epithelium, corneal epithelial cell lines (primary HCE...

Climatic droplet keratopathy (CDK) is an acquired corneal disease characterized by progressive scarring of the cornea. In several corneal diseases, matrix metalloproteinases (MMPs) are upregulated during the degradation of epithelial and stromal tissues. We investigated the levels, degree of activation and molecular forms of MMP-2, MMP-9, MMP-8 and...

To retrospectively evaluate the visual and refractive outcome of visually impaired adults treated with refractive surgery (photorefractive keratectomy or laser-assisted in situ keratomileusis). We searched a refractive surgery database comprising 1716 mildly visually impaired patients [best spectacle-corrected visual acuity (BSCVA) on a logMAR scal...

Familial dysautonomia (Riley-Day syndrome) is characterized by both sensory and autonomic dysfunction. The authors describe Finnish twins without Jewish ancestry displaying all the criteria for the Riley-Day syndrome. The twins also had cardiological findings which have not been reported previously in connection with the Riley-Day syndrome.

PURPOSE. To study the presence and release of tear fluid transforming growth factor-ß1 (TGF-ß1) and vasoendothelial growth factor (VEGF) of 19 patients undergoing excimer laser photorefractive keratectomy. METHODS. Tear fluid samples were collected with scaled micro-capillary tubes preoperatively (Day 0) and on the first or second (Day 1–2) and sev...

To evaluate long-term results of LASIK in the correction of high myopia. Preoperative and early postoperative data, including uncorrected and best spectacle-corrected visual acuity and refraction, were collected retrospectively from 77 eyes of 47 patients who underwent LASIK for myopia of at least -9.00 diopters (D) performed with the VISX STAR S2...

To assess the long-term refractive results, subjective parameters, and late sequelae of LASIK. A retrospective follow-up study was conducted on 38 eyes of 21 patients (17 with bilateral treatment and 4 with unilateral treatment) who had LASIK surgery between 1999 and 2000. Laser ablations were done with an excimer laser (VISX STAR and STAR S2). Fol...

Previous work in type-I pollen allergies has mainly focused on lymphocytes and immune responses. Here, we begin to analyse with a systems biology view the differences in conjunctival epithelium obtained from healthy and allergic subjects. Transcriptomics analysis combined with light and electron microscopic analysis of birch pollen allergen Bet v 1...

Integrin complex α6β4 is a component of the hemidesmosome. In the unwounded cornea both the integrin subunits face the laminin-containing basement membrane, but the α6 subunit is also located between the basal cells. While the migrating epithelium is known to be without hemidesmosomes, we investigated the distribution of α6β4 during epithelial heal...

ATP-binding cassette (ABC) transporters are able to efflux their substrate drugs from the cells. We compared expression of efflux proteins in normal human corneal epithelial tissue, primary human corneal epithelial cells (HCEpiC), and corneal epithelial cell culture model (HCE model) based on human immortal cell line. Expression of multidrug resist...

Acanthamoebae are protists causing opportunistic infections to immunocompromised patients, and refractory keratitis also to others. Factors predisposing to Acanthamoebae keratitis include conditions that impair corneal defence mechanisms, such as traumas or use of contact lenses combined with exposure to contaminated water, for example. Delays in d...

To study the results of late photorefractive keratectomy (PRK) in corneas originally subjected to LASIK. Seven eyes of seven patients who had LASIK for myopia were retreated with PRK at least 2 years after LASIK. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, and haze were evaluated before and after LA...

To quantify human corneal recovery after moderate to high myopic laser in situ keratomileusis (LASIK) in a 2-year prospective follow-up study. Fifteen eyes of 15 patients (mean refraction -10.1 (SD 2.4) D) were examined preoperatively and postoperatively at day 1, 5 days, 2 weeks, 1, 3 and 6 months and 2 years. Biomicroscopy, visual acuity and refr...

Abstract During re-epithelialization of corneal erosions, the epithelial cells are attached and migrate on a fibronectin-containing substratum. In earlier studies we found that topical application of the plasmin inhibitor aprotinin promoted healing of corneal epithelial defects, presumably inhibiting proteolytic degradation of fibronectin and relat...

Purpose To assess changes in morphology, corneal topography and sensitivity in a family with inherited recurrent corneal erosion syndrome. Methods Eighteen family members, 9 affected and 9 unaffected eyes were examined. The affected members represented the different stages of corneal pathology from a nearly normal cor‐nea to anterior stromal fibros...

The aim of the study was to assess subjective symptoms and objective clinical signs of dry eye in relation to corneal nerve morphology and sensitivity in primary Sjögren's syndrome. Twenty eyes of 20 primary Sjögren's syndrome patients and ten eyes of 10 healthy age- and sex-matched controls were included in the study. Ocular surface disease index...

To review the pathophysiology of LASIK-associated dry eye conditions and provide insights into prophylaxis to decrease the incidence of dry eye after LASIK and to treat the condition when it occurs. A review of the literature was performed on LASIK-associated dry eye and the experience of the authors was summarized. LASIK has a neurotrophic effect...

To study the incidence of health-related conditions and observational failures/distraction (OFD) as an immediate cause for fatal motor vehicle accidents (FMVA) and to correlate them with driver's age. Retrospective study of all FMVA in Finland secondary to OFD from January 1995 to December 2005 and FMVA secondary to a disease attack/incapacity (DA)...

To evaluate the long-term effects of excimer laser treatment for ametropia after surgical treatment of rhegmatogenous retinal detachment (RRD) with scleral buckles. Helsinki University Eye Hospital, Helsinki, Finland. Ten patients (10 eyes) who had 1 or more surgeries for RRD followed by refractive surgery for myopia were retrospectively enrolled i...

Purpose: LASIK is widely used in the correction of moderate and high myopia, even though reports on long‐term results are few. We carried out this study to evaluate long‐term results, stability and patient satisfaction after LASIK for high myopia. Methods: The study included 77 eyes of 47 patients who underwent LASIK for myopia of over ‐10 D in our...

To test the hypothesis that anisometropic adults without significant amblyopia suffer from mild visual impairment probably due to aniseikonia, which might be improved by corneal refractive surgery. Fifty-seven patients presenting with myopic anisometropia > or = 3.25 diopters (D) and 174 myopic controls appropriate for refractive surgery were inclu...

To assess subjective symptoms and objective clinical signs of dry eye and investigate corneal sensitivity after high myopic LASIK. Twenty eyes of 20 patients with a mean age of 34 +/- 7.5 years who had undergone high myopic LASIK 2 to 5 years previously and 10 eyes of 10 controls with a mean age of 39.8 +/- 10.4 years were enrolled in the study. Cl...

To study the changes in irregular astigmatism in patients with recurrent corneal erosion syndrome due to map-dot-fingerprint degeneration and to demonstrate that both symptomatic and asymptomatic map-dot-fingerprint degeneration/recurrent corneal erosion syndrome may be related to irregular astigmatism, which can effectively be corrected by phototh...

The repair of corneal wounds requires both epithelial cell adhesion and migration. We have studied the early adhesion process of immortalized human corneal epithelial (HCE) cells and show by field emission scanning electron microscopy (FESEM) that the cells first adhere via foot-like process to the growth substratum and later present lamellar sprea...

To study the proteolytic phenomena contributing to the pathogenesis of keratoconus, corneal enzymes with potential to cleave fibrillar collagen were studied. Immunohistochemical labeling was undertaken of conventional and novel mammalian collagenases (MMP-1, -2, -8, -13, and -14) of the matrix metalloproteinase (MMP) family and other collagenolytic...

Type XIII collagen (ColXIII) is a transmembrane protein thought to be involved in cell-cell and cell-matrix interactions. We report here on its presence in the normal human cornea and compare the results for keratoconus and scarred corneas. Immunohistochemistry and in situ hybridization were applied to human corneal samples obtained by penetrating...

This study was conducted to determine the eventual presence and activity of EMMPRIN (extracellular matrix metalloproteinase inducer CD147) and interstitial collagenase MMP-1 in the cornea of keratoconus patients and their eventual interrelationship. MMP-1 was chosen because it is able to degrade fibrillar corneal collagens type I and III and might...

This study was designed to clarify the expression of 2 closely related collagen (Col) types XVIII and XV, and the proteolytically derived endostatin fragment of ColXVIII in normal, keratoconus, and scarred human corneas. Immunohistochemistry, in situ hybridization, immunoelectron microscopy, and Western immunoblotting were used for human corneal sa...

We studied the adhesion characteristics of immortalized human corneal epithelial (HCE) cells on purified human laminin (Ln)-10 (alpha5beta1gamma1). Immunofluorescence studies with monoclonal antibodies (MAb) revealed the presence of laminin alpha5 chain receptor Lutheran (Lu) in vivo on the basal cells of cornea and as punctate cell surface-confine...

The principal lipid-interacting protein in human tears has been reported to be tear lipocalin (Tlc). Tlc has been suggested to scavenge harmful lipophilic substances from the corneal epithelium and to maintain the integrity of the anterior tear film lipid layer by binding and releasing lipid(s) that are accommodated within the protein. Although lip...

To report a method of treatment for through-the-flap multibacterial ulcerative keratitis after laser in situ keratomileusis (LASIK). Bacterial ulcerative keratitis after LASIK was treated with topical and systemic antibiotics followed by flap lifting, cleaning, and phototherapeutic keratectomy (PTK). Follow-up examinations included in vivo confocal...

Nordic ophthalmologists and vision scientists are active in many fields of eye research. This is most evident at the biannual Nordic Congress of Ophthalmology, most recently held in Malmö in June 2004. The authors here review some of the research in vision and ophthalmology presented at this meeting or published recently by Nordic scientists. This...

The human tear fluid film consists of a superficial lipid layer, an aqueous middle layer, and a hydrated mucin layer located next to the corneal epithelium. The superficial lipid layer protects the eye from drying and is composed of polar and neutral lipids provided by the meibomian glands. Excess accumulation of lipids in the tear film may lead to...

To describe a patient with a long disease history who was finally diagnosed with neurosarcoidosis and to discuss the reasons behind the delayed diagnosis. A 58-year-old man with sick sinus syndrome and bradycardia, which was treated with a pacemaker, developed first right and then left facial palsy. Subsequently, multiple cranial nerve palsies deve...

Leukocyte traffic from blood to sites of inflammation has been elaborately studied in animal models and in vitro. However, to date, little understanding has accumulated on the process in humans in vivo. A noninvasive light confocal microscopy technique has enabled us to image leukocyte rolling, arrest and transmigrated cells in vivo in human tissue...

To evaluate visual performance after unilateral photorefractive keratectomy (PRK) performed for >/=2.75-diopter (D) myopic anisometropia. Prospective observational case series. Eleven patients exhibiting >/=2.75-D myopic anisometropia appropriate for PRK. Photorefractive keratectomy was performed on 11 eyes of 11 patients for myopic anisometropia r...

Schnyder's crystalline corneal dystrophy (SCCD) is a rare autosomal dominant eye disease with a spectrum of clinical manifestations that may include bilateral corneal clouding, arcus lipoides, and anterior corneal crystalline cholesterol deposition. We have previously performed a genome-wide linkage analysis on two large Swede-Finn families and map...

Immediate allergic reactions are initiated by allergen-induced, specific IgE-mediated mast cell degranulation and involve leukocyte recruitment into the inflamed site. We compared conjunctival signs, symptoms, and in vivo leukocyte rolling and extravasation into sites of inflammation in five patients allergic to birch pollen and in 10 nonallergic c...

To evaluate the time course of changes in corneal sensitivity to mechanical and chemical stimuli produced by laser in situ keratomileusis (LASIK) in humans. We performed a cross-sectional study of 17 LASIK-operated eyes (VisX S2, equipped with version 2.50-3.10 software) and 15 control eyes of 17 individuals to evaluate regeneration of corneal sens...

To examine the inflammatory reaction in acute or late-onset post-laser in situ keratomileusis (LASIK) diffuse lamellar keratitis (DLK) associated with an epithelial defect. Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland. Six consecutive LASIK patients presented with stage 2 to 3 unilateral DLK 1 to 4 days after...

We present 2 patients with late traumatic laser in situ keratomileusis flap dislocation 8 months and 17 months after surgery. One patient had a sharp trauma that caused a partial laceration and the second patient had a blunt trauma that caused a dislocation of the flap. The corneas were examined with slitlamp microscopy, computed corneal topography...

To establish whether features of environmental lighting in far northern latitudes might be associated with prevalence of myopia. Using both questionnaires and military medical examinations, this cross-sectional survey of Finnish conscripts assessed both light exposure and conventional risk factors for myopia. While myopia was not associated with th...

To study the effect of photorefractive keratectomy (PRK) on the concentration of group IIA phospholipase A(2) (GIIAPLA(2)) in tears. Departments of Ophthalmology and Pathology, University of Turku, Turku, and Helsinki University Eye Hospital, Helsinki, Finland. Tear samples were collected from 25 eyes of 23 patients (mean age 32.3 years +/- 8.6 [SD...

A 52-year-old woman had bilateral LASIK for myopia. Visual acuity in the left eye dropped to 20/400 3 weeks postoperatively as a result of an infection.

A 32-year-old woman was scheduled for myopic laser in situ keratomileusis (LASIK) because of myopia and anisometropia caused by retinal detachment surgery. During surgery, a sudden malfunction of the microkeratome during the forward pass was experienced. It was not possible to reverse the blade manually along the suction ring. Moreover, disconnecti...

Acute inflammations main characteristics are exudation of fluid and plasma proteins and emigration of leukocytes, predominantly neutrophils into inflamed tissue. We have previously demonstrated that leukocyte extravasation can be directly monitored in human patients in vivo after tunnel cataract operation, but at the same time we noticed that only...

To study the production and deposition of fibronectin (Fn) isoforms and tenascin-C (Tn-C) by immortalized human corneal epithelial (HCE) cells and their integrin-dependent adhesion characteristics. Indirect immunofluorescence with isoform-specific monoclonal antibodies (mAbs) was used to study extracellular matrix (ECM) protein composition and thei...

This study was undertaken to evaluate the risk of eye injury in motor vehicle accidents in which airbags deploy. An attempt was made to assess the possible associations between eye injuries and eyewear in these accidents. Retrospective observational case series and literature review with analysis. We conducted a literature review of 62 case reports...

To analyze the in vivo morphology of the different corneal sublayers and corneal nerves in primary Sjögren's syndrome (SS). Ten eyes of 10 patients with primary SS and 10 eyes of 10 sex- and age-matched control subjects were investigated. Diagnosis was based on American-European consensus criteria. In vivo confocal microscopy with through-focusing...

Matrix metalloproteinases (MMPs) play a central role in the wound-healing process. The objective of this study was to identify and characterize the levels and molecular forms of human tear fluid collagenase-2 (MMP-8) and membrane type 1-MMP (MT1-MMP or MMP-14) in patients who had undergone excimer laser photorefractive keratectomy (PRK) and in heal...

Understanding of corneal wound healing plays an important role, not only in management of corneal infections, but especially in refractive surgery. A better control of wound healing mechanisms might improve the results of such resculpturing techniques and help to avoid complications arising from these procedures. While studies have been focused in...

This review provides a comprehensive analysis of the structure, neurochemical content, and functions of corneal nerves, with special emphasis on human corneal nerves. A revised interpretation of human corneal nerve architecture is presented based on recent observations obtained by in vivo confocal microscopy (IVCM), immunohistochemistry, and ultras...

Understanding of corneal wound healing plays an important role, not only in management of corneal infections, but especially in refractive surgery. A better control of wound healing mechanisms might improve the results of such resculpturing techniques and help to avoid complications arising from these procedures. While studies have been focused in...