bluuebunny/crossref_metadata_2025 huggingface dataset:
Riparian disturbance restricts in‐stream movement of salamanders
Authors: Cecala Kristen K. , Lowe Winsor H. , Maerz John C.
Published: August 2014

Long‐term population persistence or population rescue require dispersal from other source populations. Barriers to movement can effectively fragment and isolate populations, reducing persistence and recolonisation. For stream organisms that depend heavily on movement within dendritic networks, research is needed to identify and estimate the effects of such barriers on connectivity.

We used capture–mark–recapture of displaced larval and adult salamanders to estimate return rates across gaps (length 13–85 m) in the riparian canopy and thus to assess the fragmentation of salamander populations within otherwise fully forested catchments.

Relative to salamanders in fully forested reaches, displaced salamanders were 86% less likely to return to their capture location when required to cross gaps in the canopy as short as 13 m, and the likelihood of return declined with increasing gap length. The effects of gaps on return rates were consistent among life stages and for up‐ and downstream movement.

Our study suggests that riparian disturbance can reduce permeability to salamanders, even in the absence of additional land‐use change. Because anthropogenic features, such as roads and powerlines, frequently cross small streams, the accumulation of apparently small land‐cover changes has the potential to reduce continuous populations to small fragments with limited connectivity.
Strong topographic sheltering effects lead to spatially complex treeline advance and increased forest density in a subtropical mountain region
Authors: Greenwood Sarah , Chen Jan‐Chang , Chen Chaur‐Tzuhn , Jump Alistair S.
Published: August 2014

Altitudinal treelines are typically temperature limited such that increasing temperatures linked to global climate change are causing upslope shifts of treelines worldwide. While such elevational increases are readily predicted based on shifting isotherms, at the regional level the realized response is often much more complex, with topography and local environmental conditions playing an important modifying role. Here, we used repeated aerial photographs in combination with forest inventory data to investigate changes in treeline position in the Central Mountain Range of Taiwan over the last 60 years. A highly spatially variable upslope advance of treeline was identified in which topography is a major driver of both treeline form and advance. The changes in treeline position that we observed occurred alongside substantial increases in forest density, and lead to a large increase in overall forest area. These changes will have a significant impact on carbon stocking in the high altitude zone, while the concomitant decrease in alpine grassland area is likely to have negative implications for alpine species. The complex and spatially variable changes that we report highlight the necessity for considering local factors such as topography when attempting to predict species distributional responses to warming climate.
Negative, neutral, and positive interactions among nonnative plants: patterns, processes, and management implications
Authors: Kuebbing Sara E. , Nuñez Martin A.
Published: August 2014

The movement of species is one of the most pervasive forms of global change, and few ecosystems remain uninvaded by nonnative species. Studying species interactions is crucial for understanding their distribution and abundance, particularly for nonnative species because interactions may influence the probability of invasion and consequent ecological impact. Interactions among nonnatives are relatively understudied, though the likelihood of nonnative species co‐occurrence is high. We quantify and describe the types of interactions among nonnative plants and determine what factors affect interaction outcomes for ecosystems globally. We reviewed 65 studies comprising 201 observations and recorded the interaction type, traits of the interacting species, and study characteristics. We conducted a census of interaction types and a meta‐analysis of experiments that tested nonnative competition intensity. Both methods showed that negative and neutral interactions prevailed, and a number of studies reported that the removal of a dominant nonnative led to competitive release of other nonnatives. Positive interactions were less frequently reported and positive mean effect sizes were rare, but the plant characteristics nitrogen fixation, life cycle (annual or perennial), and functional group significantly influenced positive interactions. Positive interactions were three times more frequent when a neighboring nonnative was a nitrogen fixer and 3.5 times lower when a neighboring nonnative was an annual. Woody plants were two or four times more likely to have positive interactions relative to grasses or herbs, respectively. The prevalence of negative interactions suggests that managers should prepare for reinvasion of sites when treating dominant nonnatives. Though positive interactions were infrequent, managers may be able to anticipate positive interactions among nonnatives based upon traits of the co‐occurring invaders. Predicting positive nonnative interactions is an important tool for determining habitat susceptibility to a particular invasion and for prioritizing management of nonnatives with a higher likelihood of positive interactions.
Symptomatic hypercalcemia in a rabies survivor underwent hemodialysis
Authors: Chen Yu‐Guang , Kan Li‐Ping , Lee Chien‐Hsing , Lin Shih‐Hua , Chu Der‐Ming , Chang Feng‐Yee , Yang Ya‐Sung
Published: August 2014

Adrenal insufficiency is an uncommon and easily ignored cause among most etiologies of hypercalcemia because not all cases of adrenal insufficiency presented with hypercalcemia. In most cases of adrenal insufficiency, viral encephalitis‐related panhypopituitarism is a rare complication that is sporadically encountered in previous studies. However, this complication has never been reported in rabies encephalitis because of the extremely high rate of mortality. Rapid recovery from hypercalcemia state after glucocorticoid supplement is a direct hint of adrenal insufficiency related hypercalcemia.
Migrating ducks in inland North America ignore major rivers as leading lines
Authors: O'Neal Benjamin J. , Stafford Joshua D. , Larkin Ronald P.
Published: August 2014

A recently developed radar‐based technique permitted empirical re‐evaluation of the established but poorly supported theory that migrating North American waterfowl (Anatidae) use landscape features such as rivers as leading lines. Ducks departing the Illinois River Valley in the autumn of each of 15 years travelledSSEwith a mean track that was 68° different from the 220° course of the Illinois River (P ≤ 0.001). We conclude that leading lines were unimportant navigation aids for ducks leaving this major stopover site in autumn and suggest that rivers have less effect on the spatial course of duck migration than previously thought. Timing of departures was examined in a representative subset of 8 years and found to be consistent, with a mean start time of 44 min after civil sunset.
Long‐term quality of life after radical prostatectomy: 8‐Year longitudinal study in Japan
Authors: Namiki Shunichi , Kaiho Yasuhiro , Mitsuzuka Koji , Saito Hideo , Yamada Shigeyuki , Nakagawa Haruo , Ito Akihiro , Arai Yoichi
Published: August 2014

Objectives

To assess long‐term health‐related quality of life in patients undergoing radical prostatectomy.

Methods

A total of 120 patients with at least 5 years of follow up after radical prostatectomy were included in the present study. Health‐related quality of life outcomes were assessed using three questionnaires, the Short Form 36‐Item Health Survey, the University of California, Los Angeles Prostate Cancer Index and the International Prostate Symptom Score.

Results

A total of 91 patients (73%) responded at a median follow‐up time of 102 months (range 85–123 months). Among general health‐related quality of life domains, mental and role composite summary score remained stable throughout the follow‐up period. At the final survey, no significant differences were observed in any of the domains compared with the age‐matched average score of the Japanese population. Although the slight decrease in urinary function scores and International Prostate Symptom Score beyond 5 years postoperatively compared with 5 years, the differences were not significant. The sexual function summary score showed a substantially lower score just after radical prostatectomy and remained at a deteriorated level (P < 0.001). Responders at the final survey were more likely to report favorable general, urinary and sexual outcomes at 60 months compared with non‐responders.

Conclusions

When taking age‐related changes into account, general health‐related quality of life seems to remain stable in the long term after radical prostatectomy: patients with favorable health‐related quality of life outcomes during the first 5 years after radical prostatectomy maintain favorable outcomes thereafter.
Posterior corneal dystrophies
Authors: LISKOVA P
Published: August 2014

Posterior corneal dystrophies represent a clinically and genetically heterogeneous group of disorders. The International Committee for Classification of Corneal Dystrophies (IC3D) lists autosomal dominant congenital hereditary endothelial dystrophy (CHED1), autosomal recessive congenital hereditary endothelial dystrophy (CHED2), posterior polymorphous corneal dystrophy (PPCD) and Fuchs endothelial corneal dystrophy (FECD) as separate clinical entities​. The course will provide an overview of posterior corneal dystrophies with a focus on recent clinical and genetic findings and their possible implications for future classification.
Imaging in uveitis: techniques and indications
Authors: HERBORT C
Published: August 2014

This tutorial will address the main complementary imaging techniques used in the field of (posterior) uveitis. In case imaging work‐up is decided, fluorescein angiography (FA) is performed routinely since a few decades. FA gives information on the superficial structures and lesions of the fundus including pathology of the retina, retinal vessels, optic disc, and subretinal fluid collection, as well as the RPE for which it is the examination method of choice, and the choriocapillaris in the first seconds of angiography. Most of the time it only confirms and gives the precise extension of lesions already identified by the clinical examination. The choroid is however involved at least as often as the retina and often all or part of choroidal lesions are occult and not detected by the clinical exam or FA. Only indocyanine green angiography (ICGA) gives visual access to choroidal inflammatory pathology where it can distinguish stromal choroidits (birdshot, VKH) from choriocapillaritis (MEWDS, APMPPE, etc). So if angiography is deemed necessary during initial appraisal of a case dual FA/ICGA should be performed as choroiditis can not be excluded "à priori". Other methods addressed will be OCT, UBM, FAF as well as anterior segment OCT.
Evaluation of potential retinal toxicity after intravitreal administration of a novel neuroprotecive agent, synthetic analog of dehydroepinadrosterone (DHEA)
Authors: TSIKA C , NIAVI S , GRAVANIS A , TSILIMBARIS M
Published: August 2014

Purpose To investigate the effect of the intravitreal administration of a synthetic analog of DHEA on retinal anatomy and function of the rabbit eye.

Methods All experiments complied with the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research. We injected 0.6mg/0.1ml of a synthetic DHEA analog in the right eye of 9 pigmented rabbits. The left eye received 0.1ml of the solvent (6μl of ethylic alcohol in 94μl of WFI). Indirect fundoscopy and ERG was performed before injection (baseline) and one month post injection. This was the end time point of the study. Histological samples were prepared for photonic microscopy after euthanasia and enucleation. Additionally, fundoscopy was performed weekly to follow up any macroscopic changes.

Results At one month, no significant macroscopic retinal changes were observed. No significant difference in scotopic b‐wave amplitude of the ERG was recorded one month after injection of the neuroprotective solution (p=0.441) or the solvent alone(p=0.767). Histology revealed minor changes in retinal anatomy that were not attributed to any substance effect. Control eyes showed similar findings. Interocular differences in ERG were not significant at baseline (p=0.136) or at one month (p=0.666).

Conclusion BNN 93 exhibited no toxicity on retinal anatomy or function after intravitreal administration of a high concentration in the rabbit eye. This is a promising preliminary finding for potential use in ocular neurodegenerative disease.
Development of an ECM hydrogel for corneal tissue engineering
Authors: AHEARNE M
Published: August 2014

Purpose Tissue engineering has been proposed as a method of dealing with the shortage of suitable tissue available for transplants. Many biomaterials under investigation for engineering corneal tissue lack the native corneas biochemical composition. The aim of this study was to fabricate and test a biomimetic hydrogel derived from corneal extracellular matrix (ECM) to be used for corneal tissue engineering.

Methods Porcine corneas were decellularized using several different techniques. The corneas were then freeze dried and milled into a fine powder. This ECM powder was dissolved using an acidic pepsin digest solution for 72 hours. A crosslinked hydrogel was formed after neutralizing the pH of the solution. Human corneal stromal cells were mixed into the hydrogels prior to gelation and cultured over 14 days. Biochemical assays, mechanical and optical testing, RT‐PCR and immunohistochemical staining were performed on the cell seeded hydrogels. Rat‐tail collagen hydrogels were used as controls.

Results The hydrogels were highly transparent and able to maintain stromal cell viability. When compared to standard collagen hydrogels, the ECM hydrogels retained corneal GAGs and appeared to enhance the cells native keratocyte phenotype. The amount of GAG present was dependent on the decellularization technique used. The ECM hydrogels exhibited similar viscoelastic characteristics to collagen hydrogels.

Conclusion A new type of hydrogel has been demonstrated that could be used for engineering corneal tissue. We plan further develop these hydrogels by optimizing the stromal decellularization process and examining different crosslinking techniques to improve the hydrogels mechanical strength and stiffness.
White dot syndromes
Authors: HERBORT C
Published: August 2014

"White dot syndromes" (WDS)is a term introduced around 1995 to describe posterior uveitis syndromes that were poorly understood such as MEWDS, APMPPE, multifocal choroiditis (MFC), serpiginous choroiditis (SC), birdshot retinochoroiditis (BRC) and many others depending on the extension with which the term is used. Unfortunatelly the term is of no utility as it is purely based on the the white dots most posterior uveitis exhibit and as it emcompasses entities that look alike but have nothing in common as far as mechanism is concerned. Thanks to indocyanine green angiography (ICGA) it became possible to get away from this pot‐pourri terminology and allowed to sort out choroiditis entities according to the pathophysiological mechanism subdividing choroiditis into diseases of the choriocapillaris (primary choriocapillaritis) including MEWDS, APMPPE, MFC, SC and atypical and overlapping entities on one side and stromal choroiditis on the other side including Vogt‐Koxanangi‐Harada disease (VKH), BRC, sarcoid and tubercular choroiditis. The appraisal of these diseases and the rationale of their new classification will be explained and examples will be given to illustrate this new comprehensive approach that should make WDS obsolete.
Corneal infectious diseases in children
Authors: BREMOND‐GIGNAC D
Published: August 2014

Corneal infections in children can affect subjects of all ages with a high frequency in newborns and infants. Severe visual impairment can result from corneal infectious disease especially if late diagnosed with delayed treatment. In infant, children and teenagers the most common ocular pathogens, that differ from the adult, are Haemophilus Influenzae, Staphylococcus aureus, Streptococcus pneumonia and also Moraxella species. These infections infections could lead to ulcers and sight‐threatening complications. In children corneal infections can be difficult to diagnose because the pathology can develop without pain. In addition the examination may be difficult to perform. The treatment should be provided earlier and aims to eliminate the bacteria, virus or fungus pathogens. Specific epidemiology of pathogens will be detailed according to age. Risks of visual impairment and amblyopia must be integrated. An update on topical antibiotics and current options will be reviewed with practical aspects, diverse clinical cases and considering quality of life of children and parents.

Commercial interest
Investigating AMD mechanisms using primary RPE cultures and donor tissue
Authors: FERRINGTON D , TERLUK M , EBELING M , ROEHRICH H , MONTEZUMA S
Published: August 2014

Stimuli that activate inflammasomes include mitochondrial (mt) reactive oxygen species, release of damaged mtDNA into the cytosol, or disruption of cellular ionic balance. These stimuli can arise from mt dysfunction, which may be a key pathogenic event in age‐related macular degeneration (AMD). This hypothesis is consistent with increased mtDNA damage reported in macular retinal pigment epithelium (RPE) of human donors with AMD. To investigate inflammasome activation, we developed primary cultures of RPE from donors with or without AMD. Cells express the RPE‐specific proteins bestrophin, CRALBP, and RPE65, are pigmented, express ZO‐1 at cell margins and Na‐K ATPase apically. These results show our primary cultures phenocopy the RPE in vivo. To examine inflammasome activation, cells were stimulated with LPS as a priming event, then treated with either the proteasome inhibitor MG132 to initiate formation of protein aggregates or rotenone to generate reactive oxygen species. We observed differences between cells from control and AMD donors in IL‐18 and IL‐1beta production and also caspase‐1 cleavage, the prototypic marker of inflammasome activation. These results suggest AMD affects inflammasome activation in the RPE.

Commercial interest
NP in glaucoma – pitfalls and promises?
Authors: SCHMETTERER L
Published: August 2014

In the last 25 years the pharmacological spectrum for reducing intraocular pressure (IOP) has increased drastically. As such many patients have their IOP lowered using topical medications. Evidence has, however, accumulated that some patients show visual field deterioration despite low IOP values. As such there is a clinical need for neuroprotective strategies that rescue retinal ganglion cells. Implementation of this concept is, however, not easy. A variety of mechanisms that may contribute to ganglion cell death have been identified, but the interplay of these pathways is largely unknown. As such doubts have been raised whether targeting a single pathway can be successful, which is a major problem in terms of drug approval. In addition, it is not entirely clear which end points should be used in clinical trials focusing on neuroprotection. Nevertheless, the hope to treat progressive glaucoma at low IOPs comes for neuroprotective strategies.
An update on ocular surface reconctruction with the amniotic membrane
Authors: GICQUEL J
Published: August 2014

Cryopreserved and Dried amniotic membrane (AM) can be a useful therapeutic adjunct in ophthalmic surgery. Differences in preservation techniques can significantly improve biochemical composition and physical properties of AM, potentially affecting clinical efficacy. There is a considerable variation in growth factors content of the Amniotic Membrane, between and within donors. This is further affected by handling of the AM. Such variations could affect the clinical efficacy of tissue constructs. Current use of AM for ex vivo expansion or surgery is not standardized and remains an area of concern. In this session, through practical clinical cases, we will apprehend the various modern surgical techniques, involving the use of amniotic membrane in ophthalmology.
Irradiation treatment of choroidal hemangiomas
Authors: ZOGRAFOS L
Published: August 2014

The advanced course of radiotherapy in ophtalmology covers all the technical and medical details of irradiation treatment in occular oncology. Following an historical overview of the evolution of occular radiotherapy all the modern technics of occular radiotherapy are described. The Brachytherapy and Teletherapy with Proton beam of uvual melanomas the irradiation treatment of choroidal hemangiomas, the irradiation treatment of metastatic tumors and lymphomas as well as radiotherapy of pediatric tumors are clearly illustrated.
Performance of advanced technologies for community‐based glaucoma case‐finding
Authors: LAWRENSON J , DABASIA P , EDGAR D , GARWAY‐HEATH D
Published: August 2014

Purpose To identify if the Frequency Doubling Technology perimeter (FDT), Moorfields Motion Displacement Test (MDT), iVue Optical Coherence Tomographer (OCT) and Ocular Response Analyser (ORA), alone or in combination, improve case detection of primary open angle glaucoma (POAG) in a population aged over 59 years.

Methods 505 volunteers aged 60 to 92 years (median age 68) completed all 4 screening tests conducted without knowledge of subjects’ ocular status. FDT and MDT were used in suprathreshold mode. iVue OCT measured ganglion cell complex and retinal nerve fibre layer thickness. Each subject then received a full ophthalmic examination by an experienced clinician, masked to preceding test results. Based on this evaluation, subjects were classified as normal, glaucoma suspects or POAG (defined as an open drainage angle, glaucomatous optic neuropathy, and glaucomatous field defects).

Results Based on the reference standard examination, 26 (5.1%) subjects were classified as POAG, and 32 (6.4%) suspect glaucoma. Sensitivity at 90% specificity for detection of POAG was 63% (95% CI: 39 to 82) for FDT, 54% (33 to 74) for MDT, and 82% (64 to 95) for best performing OCT parameter (inferior RNFL thickness). Using these criteria, partial AUROC was significantly greater for inferior RNFL thickness than other tests (p=<0.01).The probability of having POAG increased substantially when best‐performing criteria were combined for perimetry, iVue OCT and ORA.

Conclusion Diagnostic performance of individual tests gave acceptable accuracy for POAG detection in a representative sample of elderly subjects. For case‐finding, our study supports combining retinal nerve fibre layer thickness analysis with performance on vision‐function tests.
Cataract surgery in infants: should I implant an IOL?
Authors: VANDERVEEN D
Published: August 2014

Implantation of an intraocular lens (IOL) in infancy remains controversial, and the decision about implantation may be driven by many factors. Some of these factors include age of the infant, unilateral vs bilateral status, presence of other ocular abnormalities, age at surgery, socioeconomic status of the family, environmental conditions, and surgeon preference and expertise. The risks and benefits of alternatives for correction of aphakia in infants will be reviewed, and current practice strategies in the United States discussed. The results of the Infant Aphakia Treatment Study, a randomized prospective multicenter study, can also help decision making in this context. This study showed, to age 5 years, similar visual outcomes for infants who had IOL vs. contact lens correction of unilateral aphakia. However, there was a higher rate of adverse events (81% vs 56% eyes) and additional intraocular surgeries (72% vs 21%) in the group receiving primary IOL implantation compared to the group treated with an aphakic contact lens. These risks should be weighed with regard to the other factors at play in each case of infantile cataract.
The initial consultation
Authors: SPILEERS W
Published: August 2014

A patient reporting flashing lights, shimmering, positive scotoma, hallucinations, .. .needs a full (neuro‐)ophthalmological work‐up. The ophthalmological work‐up includes visual acuity testing, biomicroscopy of the anterior segment, examination of the fundus. In selected cases, more specific ophthalmic testing such as visual electrophysiology is needed. Sometimes a general work up is indicated. The different neuro‐ophthalmological causes of reporting positive phenomena will be introduced.
Silencing HuR: a new potential pharmacological strategy to target VEGF
Authors: AMADIO M , PASCALE A , GOVONI S , DRAGO F , BUCOLO C
Published: August 2014

Purpose VEGF, a key element in the pathogenesis of proliferative diabetic retinopathy (DR), is regulated at post‐transcriptional level by HuR protein (mRNA‐stabilizing human Embryonic Lethal Abnormal Vision protein), which binds to VEGF mRNA and, following diabetes‐induction, positively affects its expression. We investigated the effect of the in vivo administration of a silencing RNA (siRNA) which down‐regulates HuR expression on the diabetes‐induced VEGF increase.

Methods Diabetes was induced in rats by streptozotocin (STZ) injection (Amadio et al., Biochem. Pharmacol. 80: 1230–1237, 2010). After 24 h from STZ injection, 2.5µM siRNA (commercially available) against HuR was intravitreally administered. Animals were sacrificed 48 h after siRNA injection and retinal tissues collected. HuR and VEGF retinal protein levels were analyzed by Western blotting and ELISA, respectively.

Results siRNA treatment blunts HuR protein increase in STZ rat retina (mean gray level ratio of HuR/α‐tubulin ± S.E.M.: CTR 100% ± 4.8; CTR+siRNA 99% ± 9.3; STZ 147% ± 7.5; STZ+siRNA 109% ± 7.3; p<0.0001 STZ+siRNA vs. STZ) and, as a consequence, dampened VEGF production (STZ+siRNA 9.5 pg/mg ± 3.5 vs. STZ 18.2 pg/mg ± 4.2; p<0.05).

Conclusion HuR protein represents a novel pharmacological target useful to counteract pathologies implicating VEGF deregulation, such as DR.
How to get your research published?
Authors: PLEYER U , STEFANSSON E , KIVELÄ T , DUA H
Published: August 2014

Researchers often face the challenge of getting their work published. The goal of this session will be to provide some keys to write a high quality paper that will help to transform your ideas and findings into a research article. The panelists will discuss major aspects of the editorial process including basic decisions,e.g. where to submit your work, how to organize and prepare a manuscript and how to deal with the review process. We will raise the discussion on issues like: ‐ How to choose a journal? ‐ How to organize your paper? ‐ What are the characteristics of a good manuscript? ‐ How to interpret the letter from the editor? ‐ How to write a good reply to the reviewers? ‐ What to do when your paper is rejected? In addition, the personal view from an authors and editors perspective will be given in a vivid discussion with the participants.
The invention of the contact lenses (1888)
Authors: HEITZ R
Published: August 2014

In March 1888 appeared in the Archiv für Augenheilkunde an article entitled "Eine Contactbrille" submitted by Adolf Eugen Fick, lecturer at the University of Zurich. This paper and his English translation, published the same month in the Archives of Ophthalmology as "A Contact‐lens", described the first clinical application of a contact lenses. The analyze of Fick's article, of a memo on June 1887 send in a sealed envelope of the Saxon Academy of Science, and of five letters send to Professor Ernst Karl Abbe in Jena between June and October 1887, permit to describe this innovative step in the history of both corneal refractive neutralization and contact lenses. Key‐words: Contact lenses, Invention, Adolf Eugen Fick, Year 1888.
Optics of light scattering in the human eye lens
Authors: VAN DEN BERG T
Published: August 2014

The visual phenomenon of radiation of light around a bright light source (“ciliary corona”, glare, quantified as straylight) is known as result of forward light scattering in the eye. The slitlamp image (or the Scheimpflug image) of the human eye lens, results from backward light scattering. Solid physical theory exists for the relation between characteristics of the scattering elements, and the angular and wavelength dependence of the scattered light. Reversely from angular and wavelength dependence predictions for the scattering elements can be derived. Optical bench study of human eye lenses will be presented. Backward scatter is found to contain two components; a wavelength independent and strongly localized component identified as “Wasserspalten”, and a Rayleigh type component diffusely localized throughout the lens, originating from the crystalline molecules. The degree of ordering of the crystallines is critical for the size of this component. Forward scatter is dominated by particles of around 1 micrometer size. So, different processes govern forward and backward scatter, explaining why the slit image is not an accurate predictor of forward scatter or straylight.

Commercial interest
Incidense of iris melanomas in Denmark from 1942‐2013
Authors: JøRGENSEN A , WADT K , HEEGAARD S , PRAUSE J , KIILGAARD J
Published: August 2014

Purpose To estimate the incidence of iris melanoma in Denmark from 1942‐2013 as well as the age distribution of the patients and specific location of the tumor.

Methods Retrospective, nonrandomized clinical case series including all patients with a clincal diagnosis of iris melanoma over 71 years. For all patients age, sex and specific location were registered.

Results From 1942‐2013 a total of 389 cases were registered and 353 cases were treated (173 males, 116 females). This means an average of 5.6 cases/year in an average population of 5 million. A significant increase in the number of cases was found during the study period. The mean age at presentation of the surgically removed iris melanoma was 56 years (range 7 – 92). There were 11 (3,12 %) tumours in children and teenagers (≤20 years), 58 (16,43 %) in young adults (21‐40 years), 117 (33,14 %) in mid adults (41‐60 years) and 167 (47,30 %) in seniors (> 61 years). Location was described in 167 cases with 143 cases (85 %) inferior and 24 (15 %) superior in the iris.

Conclusion An increase in the incidence of iris melanomas in Denmark has been observed. In 85% of all cases the iris melanoma was located in the inferior part of the iris.
Vascular optic neuropathies versus glaucomatous optic neuropathy
Authors: SCHMETTERER L
Published: August 2014

Glaucoma is a group of progressive optic neuropathies characterized by excavation of the optic nerve head and associated visual field changes. Elevated intraocular pressure (IOP) is the most important risk factor for glaucoma. The pathophysiology of glaucoma is not well understood, but mechanical compression of the optic nerve head (ONH) appears to play a role. Anterior ischemic optic neuropathy (AION) is the second most common cause of optic nerve‐related loss of vision and comprises non‐arteritic AION (NAION) and arteritic AION (AAION). Factors that help in separating AION cases from glaucoma cases are: IOP is typically in the normal range or reduced, ONH cupping does not involve the peripapillary zones, visual field loss usually occurs in the central or cecocentral visual field and disk pallor. Whereas AION is ischemic in nature, the vascular involvement in glaucoma is still a matter of debate. The difference in appearance of the two diseases does, however, not argue against the vascular component in glaucoma.
Does normal‐pressure glaucoma and high‐pressure glaucoma differ in the optic nerve head appearance?
Authors: BRON AM
Published: August 2014

Many studies have been published trying to find out some differences in the phenotype of normal‐pressure glaucoma (NPG) and high‐pressure glaucoma (HPG). The authors of these studies mainly focused on the “vascular signs”, the visual field and the optic nerve head (ONH) appearance of these 2 clinical presentations. However the debate is very controversial and several papers have reported that after all there is no difference in clinical presentation between NPG and HPG. In this review we will detail the pros and cons of each theory and we will provide the physician with useful practical tips leaving him/her with the following questions: Is the limit between NPG and HPG so tight? Can we find specific clinical characteristics of the ONH according to the clinical presentation? Should not we concentrate on the erroneous NPG diagnoses, i.e. the nonglaucomatous optic neuropathies?
Penetrating keratoplasty – long‐term follow‐up data in low and high risk keratoplasties
Authors: FUCHSLUGER T
Published: August 2014

The talk will present long‐term follow up data from the Dusseldorf Graft Registry on graft survival and outcome. Both low and high risk keratoplasty cases will be presented.
Human limbal epithelial cells cultured on dense fibrillated collagen I transparent matrices
Authors: BORDERIE V , GHOUBAY D , MOSSER G
Published: August 2014

Transparent (78 to 84% at 580nm) collagen I fibrillated matrices have been synthesized at different concentrations making use of liquid crystal properties of collagen. The 90 mg/mL scaffold presents an organization that resembles the ones found in corneal stroma. Although matrices present low mechanical properties (with Young’s modulus of 2kPa at most) they allow development of an epithelium presenting the main characteristics of the corneal epithelial cells (expression of cytokertin 3 and presence of desmosomes) and maintenance of stemness during culture (i.e. expression of Delta N p63α and formation of holoclones in colony formation assay). Matrices with cultured cells feature higher transparency compared with matrices with no cells.
Age‐related changes of ocular parameters in an emmetropic Spanish healthy population
Authors: ZABADANI K , ASCASO FJ , HERRERA L , ESTEBAN O , MARTINEZ M , CARAMELLO C , PEREZ NAVARRO I , ALMENARA C , CASAS P , CRUZ N , CABEZON L , CRISTOBAL J
Published: August 2014

Purpose To evaluate the age‐related variations of ocular parameters in an emmetropic Spanish healthy population.

Methods We investigated 117 eyes of 117 healthy and emmetropic subjects. All patients were evaluated in the Department of Ophthalmology at the “Lozano Blesa” University Clinic Hospital, Zaragoza, Spain, between January and October 2013. Axial length (AL), refractive error (RE), subfoveal choroidal thickness (SCT), foveal thickness (FT) and foveal volume (FV) were measured by using auto‐refractive keratometer, optical biometer and spectral domain optical coherence tomography (SD‐OCT), respectively.

Results The mean RE was 0.09 ± 0.97 diopters (range, from ‐1.5 to +1.5 diopters); the mean AL was 23.08 ± 0.90 mm (range, 20.9‐24.5 mm); the mean SCT was 278.9 ± 113.2 µm (range, 57‐ 527 µm), the mean FT was 266.6 ± 21.1 µm (range, 210‐342 µm) and the mean FV was 0.20 ± 0.01 mm3 (range, 0.17‐0.27 mm3). In correlation analysis, from 20 to 89 years, subjects showed a positive and statistically significant correlation between age and RE (r=0.262, p=0.004), a negative and statistically significant correlation between age an AL (r= ‐ 0.198, p=0.045) and a negative correlation between age and SCT ( r= ‐ 0.468, p<0.001). There were no significant correlations between age and FT (r= 0.006 p=0.972), and between age and FV (r= 0.046, p=0.773).

Conclusion SCT and AL decreased with aging RE increased with age. No correlation was found between age and either FT or FV.
Cilioretinal artery occlusion and protein S deficiency in pregnancy
Authors: CARAMELLO C , MATEO OROBIA AJ , HERRERA L , ZABADANI K , PINILLA I , PEREZ NAVARRO I , ALMENARA C , ESTEBAN O , ASCASO J , CASAS P
Published: August 2014

Purpose Protein S (PS) is a vitamin K‐dependent plasma protein that has antithrombotic effects. Congenital deficiency of PS is a relatively rare disorder characterized clinically by thrombosis in young people. Cilioretinal arteries are present in about 20% of individuals, supplying a variable territory of the inner retina and macula. To our knowledge, only three cases of branch retinal artery occlusion associated with PS deficiency have been reported.

Methods We report the case of a 25 year‐old woman, 38 weeks pregnant, who developed cilioretinal artery branch occlusion in her left eye and who was found to have a PS deficiency. Her best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/30 in the left one. Fundoscopic examination showed an area of retinal pallor located on the posterior pole. Visual field study demonstrated a paracentral scotoma. Spectral‐domain optical coherence tomography (SD‐OCT) showed retinal atrophy in the cilioretinal artery irrigation area. Retinal Nerve Fiber Layer thickness was decrease in the papillomacular bundle.

Results Blood analysis demonstrated that PS values recovered after childbirth. The BCVA was 20/20 in both eyes and the funduscopic exploration returned to normal.

Conclusion When cilioretinal occlusion occurs, the extent of visual loss depends on the precise area of macular supply. Protein S defiency is another factor that should be considered in young patients with unexplained retinal vascular occlusion, particularly if it occurs during pregnancy.
The impact of intravitreal aflibercept on pigment epithelial detachement morphology in eyes with persistent subretinal fluid despite a minimum of 14 previous treatments with ranibizumab in patients with neovascular age‐related macular degeneration
Authors: PASU S , LUK S , MITRY D , KURUMTHOTTICAL M , YOUNIS S
Published: August 2014

Purpose To assess the efficacy of intravitreal aflibercept (2.0 mg) in patients with treatment‐resistant neovascular age‐related macular degeneration.

Methods Retrospective analysis of eyes treated with aflibercept with persistent subretinal and/or intraretinal fluid despite a minimum of 14 previous treatments with intravitreal ranibizumab (0.5 mg). All patients were switched to intravitreal aflibercept (2.0 mg) and analyzed after 3 consecutive injections and at month 4 of treatment. Main outcome measures included change in visual acuity, central foveal thickness, and the height and diameter of the largest pigment epithelial detachment on spectral domain optical coherence tomography.

Results Fifteen eyes of fifteen patients were analysed. The median number of previous injections of ranibizumab was 19 (IQR 15‐22). At month four, the mean visual acuity and central retinal thickness (CRT) did not change significantly from baseline: logMAR 0.64 (95%CI‐ 0.45‐0.83) and 0.65 (0.44‐0.89; p=0.5); CRT 282 μm (233‐333 μm) and 247 μm (201‐293 μm; p=0.06). However, the maximum pigment epithelial detachment height improved significantly from 279 μm (95%CI 124‐434 μm) to 195 μm (95%CI 65‐326 μm) (p=0.03) and pigment epithelial detachment diameter decreased significantly from 2,515 μm (95%CI 1,705‐3,3324μm) to 1,833 μm (95%CI 256‐1,106 μm) (p = 0.002).

Conclusion Intravitreal injections of aflibercept resulted in a significant improvement in the maximum height and width of the PED in eyes with a minimum of 14 previous injections of ranibizumab.
Ophthalmologists play a key role in the management of syphilis presenting with ocular involvement
Authors: BONNIN N , LAURICHESSE H , BEYTOUT J , LESENS O , ANDRE M , AUMAITRE O , CHIAMBARETTA F
Published: August 2014

Purpose To provide the key role of ophthalmologists in the management of syphilis presenting with ocular involvement, describe the increase of patients diagnosed with syphilis infection presenting ophthalmological involvement and their clinical features.

Methods Retrospective, observational case series analysis: patients were selected retrospectively based on serological criteria: VDRL>1 and TPHA>80, with upper cut‐off limit TPHA<320 and VDRL<4 (cases with VDRL <4 were retained if TPHA> 1280). Among these patients, patients presenting ophthalmological involvement were analyzed further.

Results Over the 10‐year period, among 126 patients diagnosed with syphilis, 22 patients with various ocular involvements were treated. The resurgence of syphilis has also been registered in ophthalmology. Among the specialized departments, ophthalmology ranks second in number of cases of syphilis infection diagnosed: 77% of patients with ocular involvement are diagnosed in ophthalmology.

Conclusion This underlines the central diagnostic role of ophthalmologists, as in cases of eye involvement, if ophthalmologists ignore the infection, diagnosis will rarely be picked up in other care units, especially given that visual symptoms are isolated in 80% of cases.
Eye AIDS patholgy evaluation by using ultrasound examination
Authors: KRIAUCIUNIENE L , BARZDZIUKAS V , LIUTKEVICIENE R , GUMBELEVICIUS A
Published: August 2014

Purpose Ultrasound B scan is an important diagnostic method in eye pathology. We want to demonstrate the usefulness of ultrasound B scan in early diagnosis of AIDS symptoms and structural changes in the eyes. 30 years old female with bilateral uveitis was examined. Patient had suddenly unilateral loss of vision acuity.

Methods Patient undergo full ophthalmological examination and ultrasound B scan diagnostic examination.

Results During 2 weeks patient noticed sudden loss of vision acuity. Slit lamp examination revealed acute anterior uveitis. Fundus examination revealed hard changes in vitreous body. In right eye we diagnosed vitreitis and in left eye was more intensive changes of endophthalmitis. During systemic treatment of toxoplasmosis and AIDS in right eye we noticed full process stabilisation. Acute retinal necrosis and full loss vision we noticed in left eye. Ultrasound B scan revealed only structural changes of vitreous in right eye and vitreous hemorrhages and total retina detachment in left eye.

Conclusion We recommend early referral of cases of AIDS pathology in the eyes for baseline Ultrasound scan and follow up scan in 2 weeks, 4 weeks, 3 months and for later time to detect underlying pathology.
Mycophenolate mofetil and cyclophosphamide treatment suppress inflammation intensity in experimental model of autoimmune uveitis
Authors: KLIMOVA A , SEIDLER STANGOVA P , HEISSIGEROVA J , SVOZILKOVA P , KUCERA T
Published: August 2014

Purpose The research in experimental models of autoimmune uveitis helps to find new therapeutical strategies. The aim of this study is to compare the effect of cyclophosphamide (CPA), mycophenolate mofetil (MMF) and golimumab on inflammation intensity in mice model of experimental autoimmune uveitis (EAU).

Methods EAU was induced in C57BL/6 mice by subcutaneous application of IRBP (interphotoreceptor retinoid binding protein) in complete Freund’s adjuvant and pertussis toxin. CPA was injected intraperitoneally in a single dose of 100 mg/kg, MMF intraperitoneally daily in a dose of 30 and 50 mg/kg, golimumab subcutaneously weekly in a dose of 70 mg/kg. Mice with EAU without treatment and group with EAU with sham treatment served as controls. Histological grading of uveitis at day 35 post induction of EAU was used.

Results The comparison of intensity of inflammation in group of treated and untreated mice shows that MMF significantly suppressed the inflammation (p˂0,05). The absolute suppression of inflammation by CPA (p˂0,0001) was shown. On the contrary, golimumab enhanced the ocular inflammation.

Conclusion In this study, we have confirmed the efficacy of CPA and MMF in treatment of posterior uveitis, which supports its use in human medicine. This project was supported by grant IGA MZ NT/14017‐3/2013 and SVV‐266505/2013.
Fluorophotometry study of riboflavin in iontophoresis procedure and conventional cross linking
Authors: DANIEL E , CASSAGNE M , BONNIN N , BOREL A , VIENNET A , COULANGEON LM , MONNEYRON N , MALECAZE F , CHIAMBARETTA F
Published: August 2014

Purpose A longitudinal observational multicentric study is conducted in Ophthalmology departments of Gabriel Montpied Hospital in Clermont‐Ferrand and Purpan Hospital in Toulouse. The aim of our study is to evaluate and compare the variations of riboflavin concentration in vivo through fluorophotometry in the anterior segment, during iontophoresis procedure (I‐CXL) and conventional cross‐linking (C‐CXL) for keratoconus patients.

Methods Inclusion criteria are patients from 18 to 40 years old, with progressive keratoconus and a corneal pachymetry higher than 400μm at the thinnest point. Exclusion criteria are patients with central corneal opacities or patients with previous history of corneal disease or corneal surgery. The use of Fluorotron Master FM‐2® for anterior segment fluorophotometry allows us to study the concentration of fluorescent molecules in the cornea and in the anterior chamber, with an automated processing.

Results Corneal concentration of riboflavin increases during instillation until a plateau is reached for both procedures. Though, the measurements for I‐CXL show a lower corneal concentration of riboflavin, about 50% less than the concentration in C‐CXL. More results are to come and will be presented during the EVER meeting.

Conclusion This is the first in vivo study of riboflavin corneal concentration kinetics in keratoconus patients. This fluorophotometry study needs to be complemented by the results of current clinical studies.
Epidemiology of corneal ulceration and ocular surface disease among patients with Graves’orbitopathy
Authors: KLYSIK A
Published: August 2014

Purpose To determine the incidence of corneal ulceration and ocular surface disease among patients with active and inactive stage of Graves’ orbitopathy.

Methods 678 patients with clinical evidence of moderate or severe Graves’ orbitopathy remaining under the care of Department of Ophthalmology of the Medical University of Lodz from January 2004 to April 2014. Average duration of the disease was 6.8 years. Average duration of follow‐up was 6.6 years. Episodes of corneal ulceration and ocular surface symptoms were analyzed.

Results Corneal ulceration occurred in 2 patients with active stage of orbitopathy, and 6 patient in an inactive stage. One patient in active stage of the disease developed central corneal ulceration, and 7 patients ( 1 in the active stage, and 6 in an inactive stage) developed peripheral corneal ulceration. 5 patient developed ulceration at 9 o’clock in the right eye and 3 o’clock in the left and 2 patients developed inferior ulcer at 6 o’clock. The incidence rate of corneal ulceration in moderate to severe Graves’ orbitopathy is 0.174 %. Ocular surface symptoms were noted in 26%

Conclusion Corneal ulceration is a very rare complication of Graves’ orbitopathy, more commonly occurring in the inactive stage of the disease. Ocular surface disease occurs in about one fourth of patients in an inactive stage of moderate and severe disease.
In vivo and ex vivo confocal microscopy of eyelid melanoma: case report
Authors: HAOUAS M , GUILLEMOT C , GRIVET D , CINOTTI E , PERROT JL , LABEILLE B , CAMBAZARD F , FOREST F , DUMOLLARD JM , PEOC'H M , GAIN P , THURET G
Published: August 2014

Purpose We report the first description of a malignant melanoma (MM) of the eyelid margin examined by in vivo and ex vivo reflectance confocal microscopy (IVCM and EVCM).

Methods A 65‐year‐old patient with a pigmented cutaneous tumor of the left upper eyelid margin was evaluated by clinical, dermoscopical and IVCM examination which suggested the diagnosis of MM. IVCM was performed with the handheld vivascope 3000 (Caliber/Mavig). Excision of the tumor with lateral margins of 2 mm was performed.

Results The fresh excised tissue was examined by EVCM (vivascope 2500 ML) which found features of MM and showed that surgical margins were tumor‐free. The diagnosis of the MM was confirmed by the histopathological examination.

Conclusion In addition to the clinical examination and dermoscopy, IVCM added evidence to the MM diagnosis and EVCM allowed to evaluate the excision margins before the histopathological examinations. Therefore IVCM and EVCM can provide to the clinician important elements to improve the diagnosis of MM and the management of the eyelid cutaneous melanocytic tumors.