bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular pulsatility and Intraocular pressure
Authors: DASTIRIDOU A
Published: December 2011

Purpose To characterize the effect of intraocular pressure (IOP) on ocular pulsation parameters.

Methods Fifty cataract patients (50 eyes) were enrolled. After cannulation of the anterior chamber, a computer‐controlled device for the intraoperative measurement and control of IOP was used to increase the IOP in a stepping procedure from 15 to 40 mm Hg. Recordings of IOP were acquired after each infusion step. Ocular rigidity was computed from the pressure‐volume data. Ocular pulse amplitude (OPA), pulse volume (PV), and pulsatile ocular blood flow (POBF) were measured from continuous IOP recordings.

Results The average rigidity coefficient was 0.0224 μL‐1 (SD 0.0049). OPA increased by 91%, while PV and POBF decreased by 29% and 30%, respectively, when increasing the IOP from 15 to 40 mm Hg.

Conclusion An increase in IOP is associated with an increased mechanical resistance of the ocular wall, an increase in OPA and decreased POBF.
Morphological changes in peripapillary nerve fiber In multiple sclerosis patients
Authors: JANKOWSKA‐LECH I , GRABSKA‐ LIBEREK I , WASYLUK J , TERELAK‐BORYS B , PALASIK W
Published: December 2011

Purpose The aim of this study was to estimate the incidence of lesions in the peripapillary retinal nerve fiber layer in population of patients suffering from sclerosis multiplex

Methods Material of this study consists of 57 subjects (114 eyes) suffering from multiple sclerosis, in observation in our Department of Ophthalmology. In all patients spectral optical coherence tomography of the peripapillary retinal nerve fiber layer was performed by 3D‐ OCT 1000 (Topcon), glaucoma module, circular around the optical nerve head. Obtained data was analyzed, taking into consideration thickness of the nerve fiber layer in four sectors around the optic nerve head (ONH) and normative database classification (normal, borderline, outside normal limits). Outcomes were classified as borderline or outside normal limits when at least one eye was borderline or outside normal limits.

Results In the obtained OCT results the following data was collected: normal group: 36 (63.2%), borderline group: 15 (26.3%) and outside normal group: 6 (10.5%). The particular numerical data of nerve fiber layer thickness in specific groups will be presented.

Conclusion The percentage of patients with borderline or outside normal results of the nerve fiber layer thickness in the study group was significantly higher than in healthy population, e.g. in persons without glaucoma or sclerosis multiplex. This may suggest the common pathogenetical background of both diseases.
In Vitro Detection of UV‐Induced Damage of the Cornea, Lens and RPE
Authors: SIVAK JG , YOUN HY , MCCANNA DJ , JONES LW
Published: December 2011

Purpose UV‐A and UV‐B radiation from sunlight is a major source of ocular oxidative damage. This paper describes in vitro methods that can be used to detect ocular damage from UV radiation.

Methods Human corneal epithelial cells, lens epithelial cells, and RPE cells were cultured and Ultraviolet A/Ultraviolet B blocking filters and UVB‐only blocking filters were placed between the cells and a UV light source. Cells were irradiated with UV radiations at various energy levels, with and without filters. Cell viability after exposure was determined using the metabolic dye alamarBlue and by evaluating changes in nuclei, mitochondria, membrane permeability, and cell membranes using the fluorescent dyes Hoechst 33342, rhodamine 123, calcein AM, ethidium homodimer‐1, and annexin V. Images of the cells were taken with a Zeiss 510 confocal laser scanning microscope

Results The alamarBlue assay results of UV‐exposed cells without filters showed energy level‐dependent decreases in cellular viability. However, UV treated cells with 400 nm LP filter protection showed the equivalent viability to untreated cells at all energy levels. Also, UV irradiated cells with 320 nm LP filter showed lower cell viability than the unexposed control cells, yet higher viability than UV‐exposed cells without filters in an energy level‐dependent manner. The confocal microscopy results also showed that UV radiation can cause significant dose‐dependent degradations of nuclei and mitochondria in ocular cells. The annexin V staining also showed an increased number of apoptotic cells after UV irradiation.

Conclusion UV‐induced damage can be evaluated to test the effectiveness of UV‐absorbing contact lenses and intraocular lenses with bioassays that measure change in in vitro cells
Frequency of glaucomatous optic neuropathy (GON) in multiple sclerosis patients
Authors: JANKOWSKA‐LECH I , GRABSKA‐ LIBEREK I , TERELAK‐BORYS B , WASYLUK J , PALASIK W , TREDA A
Published: December 2011

Purpose The aim of this study was to estimate the incidence of structural glaucomatous optic neuropathy (GON) in multiple sclerosis patients.

Methods Material of this study consists of 49 subjects suffering from multiple sclerosis. In all patients scanning laser tomography – HRT (Heidelberg Retina Tomograph), spectral optical coherence tomography of the peripapillary retinal nerve fiber layer (OCT‐ 3D 1000, Topcon) and clinical stereoexamination was performed in purpose to GON discovering.

Results At least in one eye, GON was observed in 16 (32%) multiple sclerosis patients in HRT(according to Mickelberg classification). 9 patients (18%) with glaucomatous structural changes in HRT had borderline or outside normal results of the nerve fiber layer thickness in OCT. Between these, 4 patients (8%) was demonstrated of GON picture in clinical steroexamination.

Conclusion Outcomes of this study indicate higher frequency of incidence of structural glaucoma changes in multiple sclerosis patients than in normal population.
Wavefront aberration variations with multifocal intraocular lenses
Authors: PISELLA PJ
Published: December 2011

Abstract not provided
Professional sportsmen aiming for super vision
Authors: DIGHIERO P
Published: December 2011

Abstract not provided
The role of suppression in amblyopia
Authors: LI J , THOMPSON B , LAM CS , CHAN LY , MAEHARA G , WOO GC , YU M , HESS RF
Published: December 2011

Purpose This study had three main aims; to assess the degree of suppression in patients with strabismic, anisometropic and mixed amblyopia, to establish the relationship between suppression and the degree of amblyopia and to compare the degree of suppression across the clinical sub‐groups within our sample.

Methods Using both standard measures of suppression (Bagolini lenses and ND filters, Worth 4 dots) and a new approach involving the measurement of dichoptic motion thresholds under conditions of variable interocular contrast, we quantified the degree of suppression in 43 amblyopic patients with strabismus, anisometropia or a combination of both.

Results There was good agreement between the quantitative measures of suppression made using the new dichoptic motion threshold technique and measurements made using standard clinical techniques (Bagolini lenses and ND filters, Worth 4 dots). The degree of suppression was found to directly correlate with the degree of amblyopia within our clinical sample whereby stronger suppression was associated with a greater interocular acuity difference and poorer stereoacuity. Suppression was not related to the type or angle of strabismus when this was present or the previous treatment history.

Conclusion These results suggest that suppression may have a primary role in the amblyopia syndrome and therefore have implications for the treatment of amblyopia.
Prevalence and risk factors of near decompensated heterophoria in a population of university students
Authors: YEKTA AA , GHASEMI MOGHADDAM S , KHABAZKHOOB M , OSTADI MOGHADDAM H , DERAKHSHAN A , HERAVIAN J , AZIMI A , YEKTA R
Published: December 2011

Purpose The aim of this study was to determine the prevalence and risk factors of near decompensated heterophoria in a population of university students.

Methods In a randomized study, 406 students of six schools of Mashhad University of Medical Sciences were selected and classified into symptomatic and non symptomatic groups. Visual acuity (VA), near point of convergence (NPC), Near point of accommodation (NPA), dissociated and associated phoria, suppression, stereopsis, accommodative facility, relative accommodation, accommodative convergence/accommodation ( AC/A ratio and fusional reserves were measured in two groups. The data were analysed by using SPSS software, version 11.5o.

Results The prevalence of symptoms and binocular disorders in students were 41.6% and 21.8% respectively . Of the students,9.1% had near decompensated heterophoria (heterophoria with symptoms). The results of this study showed that VA, NPC, NPA, heterophoria, stereopsis, accommodative facility, relative accommodation, AC/A ratio and fusional reserves were different in symptomatic and asymptomatic subjects and were worsen in students with decompensated heterophoria (P<0.05).

Conclusion The results of this study indicated relatively high prevalence of symptomatic students, binocular dysfunction and decompensated heterophoria in university students. Students with decompensated heterophoria failed in more visual skills which can be risk factors for decompensating the heterophoria.
Association of Alzheimer's disease and age‐related macular degeneration
Authors: TOTH‐KOVACS K , PAMER Z , RIDEG O , KOVACS A , FEKETE S , BIRO Z , KOVACS GL
Published: December 2011

Purpose The pathomechanisms of age‐related macular degeneration (AMD) and Alzheimer dementia (AD) show several similarities. Allelic variations of apolipoprotein E (apoE) are associated with both diseases: apoE4 with increased risk of AD, whereas apoE2 with reduced susceptibility of AD, but increased risk of AMD. The AMD associated complement factor H (CFH) gene has also been shown to influence the risk of AD. We investigated, therefore, the occurrence of AMD in AD patients and compared their lipid profile, apoE and CFH polymorphisms.

Methods 96 AMD, 84 AD and 30 control patients were examined (visual acuity, biomicroscopy, fundoscopy). Measurements of triglyceride, total‐ and HDL cholesterol levels, as well as the analysis of apoE and CFH alleles were performed.

Results The prevalence of the apoE4 isoform in the AMD, AD and control patients was 6%, 34% and 27%, while that of apoE2 was 14%, 11% and 6%, respectively. The occurrence rate of CFH Y402H CC homozygote mutation was 35%, 19% and 16%, respectively. Triglyceride, total‐ and HDL cholesterol levels were in the reference range. Advanced AMD was found in 13% of the 68 cooperating AD patients, the early and intermediate form was seen in 17%.

Conclusion A higher frequency of apoE2 in AMD, and a higher frequency of apoE4 in Alzheimer's patients have been found. The CFH mutation is associated with AMD, but does not differ significantly between Alzheimer's patients and controls. The frequency of early and intermediate AMD in AD patients was lower than expected from the population‐based studies.
Evaluating the effectiveness of therapy with prospidin in patiens with age‐related macular degeneration
Authors: CHUPROV AD , KULIGINA NA
Published: December 2011

Purpose The current study was to follow the dynamics of the above medication within a year.

Methods Prospidium directly effects DNA, Ribonucleic acid (RNA), has an anti‐inflammatory, anti‐modulator, anti‐proliferative effects. This medication blocks messenger RNA and damages the synthesis vascular endothelial growth factor. In Kirov Ophthalmology Hospital, patients with wet form of age related macular degeneration were treated with Prospidium. The dose was 30 mg in peribulbar injections every week. 98 patients, 106 eyes were studied. The course of treatment included 5 injections. The age range was 44‐82 years. The evaluation included: check‐up of visual acuteness, examination of the eye fundus, photography of the eye fundus, fluorescent angiography of the retina, OCT.

Results 3 months later, stability of vision was noted in 56.2%. Visual functions improved in 21.6%. Worsening of visual functions was seen in 12.0%. Repeated decrease of visual acuteness after a one time infusion of Prospidium was noted in 56% of cases on an average 68 days. This fact explains the necessity of the next in‐time course of injections.

Conclusion Treatment for the wet form of age related macular degeneration with Prospidium is effective.
Long‐term visual acuity in patients with age‐related macular degeneration treated with ranibizumab and persistence of subretinal fluid
Authors: FERNANDEZ‐PEREZ S , TORRON C , RUIZ‐MORENO O , LECINENA J , PEREZ‐INIGO A , DE LA MATA G , HERRERO LATORRE R , PABLO L
Published: December 2011

Purpose To analyze the visual acuity (VA) in the long term in patients with age‐related macular degeneration (ARMD) treated with ranibizumab with persistent subretinal fluid after induction therapy and / or in the follow‐up.

Methods A retrospective study of all patients with ARMD treated with ranibizumab between January 2008 and April 2010 with persistent subretinal fluid for at least one year of follow‐up after the induction therapy with ranibizumab. We reviewed the medical records, optical coherence tomography and fluorescein angiography in all patients included in the study.

Results 36 eyes of 34 patients were included in the study of a total of 216 patients analyzed. 19 eyes (52.7%) had persistent and 17 (47.2%) recurrent sub‐retinal fluid during the follow‐up (mean 29.06 ± 9.28 months). The initial mean VA was 0.3 ± 0.2, at 3 months 0.43 ± 0.2 and at the end of the follow‐up 0.41 ± 0.22 (p> 0.05). The appearance of bleeding in the relapse was associated with poorer final VA (p = 0.004). There was no significant difference in final VA in the membrane type, lesion size, presence of pigment epithelial detachment or blood before treatment. 18 eyes (50%) remain on treatment with ranibizumab,16 eyes (44%) are observed and 2 patients died. We did not find differences in VA and central macular thickness between both groups.

Conclusion The persistence or recurrence of macular subretinal fluid in patients treated with ranibizumab did not significantly lower visual gain obtained after the induction therapy, despite the discontinuation of treatment during the follow‐up.
Association between hypovitaminosis D and age‐related macular degeneration: a case‐control study
Authors: MAUGET‐FAYSSE M , GRAFFE A , ANNWEILER C , BEAUCHET O , MILEA D
Published: December 2011

Purpose To examine the association of low serum 25‐hydroxyvitamin D (25OHD) concentration with age‐related macular degeneration (AMD). Based on a case–control study. 31 patients with AMD (i.e., early, intermediate and advanced AMD) and 34 control patients without AMD were prospectively recruited. Ophthalmological examination, and funduscopic analysis was performed to determine AMD stage and serum 25OHD concentration was measured for each patient.

Methods Hypovitaminosis D was defined by serum 25OHD concentration < 50nmol/L. Age, gender and season of blood collection were used as potential confounders.

Results Compared to 28 subjects with normal 25OHD status (i.e., ≥50nmol/mL), subjects with hypovitaminosis D (n=37) had more often AMD (P=0.029) all stages confused. Hypovitaminosis D was associated with AMD (unadjusted odds ratio (OR)=3.10 with P=0.031; adjusted OR=3.03 with P=0.041 for full model; adjusted OR=3.10 with P=0.031 for stepwise backward model).

Conclusion Hypovitaminosis D may be associated with AMD.
Ranibizumab for the treatment of exudative age‐related macular degeneration associated with retinal pigment epithelial detachment
Authors: ZIYATDINOVA O , SAFIULLINA L
Published: December 2011

Purpose To evaluate the efficacy of intravitreal ranibizumab in eyes with exudative age‐related macular degeneration associated with retinal pigment epithelial detachment.

Methods In this retrospective case series, patients with active exudative age‐related macular degeneration associated with retinal pigment epithelial detachment were treated by repeated injections of intravitreal ranibizumab. The outcome measures were best‐corrected visual acuity and the signs of lesion activity, as evaluated by optical coherence tomography.

Results Fifteen eyes of 15 patients were followed‐up for a median of 6 months (range, 3‐12 months). The median number of injections was 3 (range, 1‐6). The best‐corrected visual acuity improved in 8 eyes (53,4%), remained stable in 5 (33,3%), and decreased in 2 (13,3%).

Conclusion Intravitreal ranibizumab was effective in improving or stabilizing vision and resulting in a quiescent lesion in the majority of patients with exudative age‐related macular degeneration associated with retinal pigment epithelial detachment. The functional results were apparently better in eyes without foveal involvement by the retinal pigment epithelial detachment..
Vascular Reacitivty in Glaucoma
Authors: GARHOFER G
Published: December 2011

Today, several lines of evidence indicate that beside the classical risk factors such as increased intraocular pressure or family history, decreased ocular perfusion may contribute to the pathogenesis of the disease. In particular, a decrease in ocular blood flow may lead to ischemic events, which in turn may trigger ganglion cell loss and subsequent detoriation of visual field. Recent studies have indicated that instabilities of perfusion rather than a continuous decline of ocular perfusion may be an important factor in the pathogenesis of the disease. In healthy subjects, changes in ocular perfusion pressure are compensated for by an autoregulatory response of the ocular vasculature, in order to keep blood flow constant. This mechanism may be impaired in patients with glaucoma. Indeed several studies indicate that glaucoma patients show reduced vascular reactivity as induced for example by changes in ocular perfusion pressure or by increased metabolic demands. This talk aims to summarize different techniques to test vascular reactivity in humans and the data currently available for patients with glaucoma. In addition, possible pathomechanisms of impaired vascular reactivity will be discussed.
Replacement of Corneal Epithelium
Authors: ILMARINEN T , LAINE J , JUUTI‐UUSITALO K , NUMMINEN J , SUURONEN R , UUSITALO H , SKOTTMAN H
Published: December 2011

Purpose Ocular surface reconstruction with cultivated oral mucosal epithelial transplantation technique has potential in the treatment of patients with severe ocular surface injuries. Currently, this technique is mainly based on utilization of xenogenic/allogenic components such as murine feeders, serum and amniotic membrane. The use of animal‐derived materials possesses risk of pathogen transmission, immune reactions and graft rejection.

Methods The formation of stratified sheets by human oral mucosal epithelial cells under serum‐free culture environment both in the absence and presence of fibroblast‐conditioned culture medium and elevated epidermal growth factor concentration was examined. The integrity of the epithelium was measured by transepithelial electrical resistance. The tissue‐engineered cell sheets were also studied for histology and immunohistochemical markers for epithelial keratins (K), cell proliferation and cell adhesion.

Results In all examined culture conditions, the cultivated oral epithelial cells formed a stratified tissue positive for keratins K3/12, K4, and K13. The tissue‐engineered oral epithelia also expressed proliferation and progenitor markers Ki67 and p63 in the basal layer. The cultures presented expression of tight junction proteins ZO‐1 and occludin and high transepithelial electrical resistance values.

Conclusion Tight multi‐layered epithelium with proliferative potential can be produced from human oral mucosal epithelial cells under defined culture conditions and without the use of serum.
Development of Binocular Vision and Implications for Clinical Testing
Authors: MCGRAW P
Published: December 2011

Purpose It is now clear that newborn infants are not a tabula rasa as once thought. Instead, they are born with the cortical circuitry required to process rudimentary visual information already in place. Early in life, these circuits are shaped by experience‐dependent plasticity and a range of new visual abilities are brought on‐line. Any disruption to normal sensory input can, and often does, result in marked functional impairment of binocular vision. A comprehensive understanding of the neurodynamics of binocular visual development is critical to determining how and why certain functions deviate from the developmental plan and the most appropriate ages at which these problems can be detected.

Methods The essential components of binocular vision are simultaneous perception of monocular images, fusion, oculomotor control and stereopsis. Each of these aspects has a distinct developmental trajectory and sensory and motor function must develop in concert to provide the neural basis for normal binocular experience.

Results Early in life, infants superimpose dichoptic images rather than alternating perception between eyes. Stereopsis has a sudden onset around 3‐5 months of age and fusion develops at around the same time. Following the onset of stereopsis, disparity thresholds improve rapidly over a period of several weeks while at the same time inter‐ocular differences in acuity decline.

Conclusion This talk will summarise research relating to binocular vision in early life, with an emphasis on the methods used to assess visual function and the factors that constrain the development of normal binocular vision. The implications for clinical testing in children will also be discussed.
Assessment of BV & the more common anomalies of binocular vision
Authors: VAKROU C
Published: December 2011

Purpose Binocular vision is the co‐ordination and integration of what is received from the two eyes separately into a single binocular percept. Simultaneous macular perception is the most elementary type of binocularity and represents simple sensory fusion. It occurs when the visual cortex processes separate stimuli from the two eyes at the same time and perceives them as a single image. However, true fusion occurs when both two images are fused, and some effort is made to maintain this fusion by adding a motor response. Finally these fused images of the two eyes are blended to produce a stereoscopic effect. Thus stereopsis involves a perceptual synthesis at a higher level.

Methods When investigating binocular vision we should aim at assessing the presence or absence of 1) simultaneous perception, 2) fusion with some amplitude and 3) stereopsis.

Results Here we examine the mechanisms of these conditions and how they reflect increasing levels of binocularity. Additionally, we will discuss the different clinical tests available to assess these conditions and what is observed when abnormal binocular vision is present.

Conclusion Understanding binocular vision and how there are different levels of processing is of great importance. This talk will try to assist on the understanding of the mechanisms of binocular vision and stereopsis so we can be in better position to understand the clinical findings of our patients and what they mean in terms of cortical processing.
The impact of binocular vision disorders on 3D display viewing
Authors: STRANG NC
Published: December 2011

Purpose Recent advances in display technology have led to 3D display viewing becoming a commonplace activity. This exciting development has a number of implications for the vision science community. From a scientific point of view 3D displays allow us the opportunity to develop new types of tests to examine binocular function, while clinically a number of issues arise relating to visual symptoms and treatment.

Methods Here we review the range of methods employed to create a 3D viewing environment and discuss the advantages and disadvantages of these technologies from a binocular vision perspective.

Results We will summarise the recent research findings relating to the influence of 3D viewing on visual measures such as the AC/A and CA/C ratio and discuss how these changes may induce visual symptoms in certain patient groups. The impact of 3D viewing upon the visual system during the earlier stages of visual development will also be considered.

Conclusion Findings suggest that in the mature visual system 3D display technology may induce visual symptoms in patients with normally insignificant binocular anomalies. In the immature binocular vision system, consideration should be given to the possibility of developmental problems arising from prolonged 3D display viewing. However, continued advances in 3D display technology also offer great potential for the assessment and restoration of binocular vision in patients with binocular vision anomalies such as amblyopia and strabismus.
Unilateral mydriasis revealing a neurovascular conflict: a case report
Authors: TRECHOT F , LEGOU F , BRAUN M , ANGIOI K
Published: December 2011

Purpose To demonstrate a neuro‐vascular conflict between the right posterior communicating artery and oculomotor nerve (CN III) revealed by an isolated unilateral mydriasis.

Methods (patient): A right mydriasis without ophtalmoplegia or ptosis was discovered in a 41 years old patient complaining of blurred vision for 6 months. Direct, consensual and accommodation reflexes were absent in the right eye. Slit lamp and fundus examination were strictly normal in both eyes. Cerebral tomography was also normal. After complete ophthalmologic examination (excluding Adie's pupil, with pilocarpine diluted test) and neurological examination, we concluded to a partial CN III palsy reaching the intrinsic component and she underwent an MRI examination including FIESTA weighted images.

Results MRI demonstrated the compression of the right CN III by the right posterior communicating cerebral artery, on its superior median part. Imaging criteria of neuro‐vascular conflict were fullfilled: a direct contact, at right angle, at the level of the first millimetres of the nerve and displacing its course. The results of others clinic and paraclinic investigations did not revealed abnormalities, specifically no infectious or inflammatory diseases.

Conclusion We recommend performing an MRI in patients with an isolated and persistent mydriasis.
Neovascular glaucoma anti‐VEGF treatment
Authors: ZOGRAFOS L
Published: December 2011

Purpose To present the anti‐VEGF treatment in neovascular glaucoma following proton beam irradiation in uveal melanomas.

Methods Prospective evaluation on 69 cases of iris neovascularisation and neovascular glaucoma treated with anti‐VEGF intraocular injections.

Results Iris neovascularisation was classified as pupillary 26%, sectorial 16%, tuffts 15% and diffused 43%. A sectorial iris ischemia related to proton beam irradiation was present in 64% of the cases. Following an observation period of 6 months to 3 years a normalisation of the intraocular pressure (less than 20 mm Hg) was obtained in 84% of the cases. Regression of iris tortuosity was observed in 77% of the cases. Regression of the iris neovascularisation in 68 % of the cases and reduction of diffusion of the dye in 67% of the cases. A remodelling of the iris ischemia was observed in 32% of the cases.

Conclusion The intraocular injections of anti‐VEGF drugs in selected cases is a promising therapeutic approach for the treatment of iris neovascularisation and neovascular glaucoma related to proton beam irradiation of uveal melanomas.
Corneal collagen cross linking: traditional vs transepithelial results with histopathological analysis
Authors: MENCUCCI R , MARINI M , PALADINI I , FAVUZZA E , SARCHIELLI E , MENCHINI U , VANNELLI GB
Published: December 2011

Purpose To evaluate the effects of transepithelial corneal crosslinking (TE‐CXL) on epithelium and stroma in human corneas

Methods Fifteen corneal buttons were examined. Ten were from patients with keratoconus submitted to penetrating keratoplasty (PKP). Five of them were treated with TE‐CXL 2 hours before PKP, five of them were treated with TE‐CXL 3 months before PKP. Five normal corneal buttons from healthy donors were used as controls. TE‐CXL was performed with two different time of imbibition: 30 minutes and 2 hours.All samples were prepared for the detection of keratocyte apoptosis by TUNEL assay and for the morphological evaluation of epithelium and stroma by immunohistochemical analysis (Connexin 43, CD34).

Results Normal corneas exhibited no TUNEL positive keratocytes while keratoconus and crosslinked samples showed moderate apoptotic cells in the anterior part of the stroma. Moreover, the samples treated with TE‐CXL 2 hours before PKP showed also an almost completely deteriorated epithelium with TUNEL positive cells. The epithelial positivity for connexin43 (transmembrane protein that forms gap junction channels) was similar in the control and in the corneas with crosslinking 3 months before PKP, while seemed more scattered in the keratoconus. In the samples treated with TE‐CXL 2 hours before PKP the positivity was patchy in the few remained epithelial cells.

Conclusion The treatment with TE‐CXL leads to epithelial damage and a reduction of keratocytes in the sub‐epithelial region in the corneas treated 2 hours before PKP. In the samples treated with TE‐CXL 3 months before PKP the positivity of both CD34 keratocytes and connexin‐43 epithelial cells is similar to control.
New trends in endothelial transplantation: DSAEK vs DMEK
Authors: SCORCIA V
Published: December 2011

Abstract not provided
An unususal optic neuropathy: interest of imaging and conservative treatment
Authors: CRETU I , MILAZZO S , BREMOND‐GIGNAC D
Published: December 2011

Purpose Interest of imaging of an unusual optic neuropathy case report and to perform a conservative treatment.

Methods A 17 year‐old girl was referred for a 3 months progressive visual loss. No personal or family history was noticed. At ocular examination right VA was 3/10 P14 OR and 10/10 P2 OS. At fundus optic disc was discolored with optic neuropathy. At examination she showed a large unilateral visual field loss possibly mimicking ocular manifestation of multiple sclerosis. OCT was performed. MR Imaging revealed a high signal and a right optic nerve sheath meningioma, with unilateral optic disc mild atrophy. Stereotactic fractionated radiotherapy treatment was decided and applied twice at one month interval. After 3 years follow‐up tumor was non active with a visual improvement at 4/10 P5 OR.

Results This clinical presentation of an optic neuropathy can mimic ocular defect in multiple sclerosis but the imaging allow the diagnosis of the meningioma. Saeed study underlines the interest of stereotactic treatment in optic nerve sheath meningioma. A conservative treatment is of interest and visual improvement of our case was obtained with stable tumor.

Conclusion Unusual presentation of optic neuropathy systematically must benefit of an imaging with accurate definition. Primary radiotherapy for patients with optic nerve sheath meningioma is associated with long‐term improvement of visual acuity and few adverse effects.
Quantitative Autofluorescence Measurements
Authors: SMITH RT , GREENBERG J , DELORI F
Published: December 2011

Purpose Technology for quantitative measurement of fundus autofluorescence (AF).

Methods Scanning laser ophthalmoscopes (SLO’s, HRA2 and Spectralis, Heidelberg Eng.) were modified by insertion of an internal AF reference to account for variable laser power and detector sensitivity. 30° images (mean of 9 without histogram stretching) were acquired from normal test subjects (10‐60 y/o) after a 20 s bleaching period,.. Quantified AF (qAF) was calculated from the reference gray level (GL), the zero GL, the media and the magnification (refractive error). The linearity of the system, field uniformity, effect of refractive error, and reproducibility were tested. qAF measurements were then done on 22 patients with Stargardt disease (STGD ) and 11 patients with retinitis pigmentosa (RP).

Results The linear detection range extended to 175 GL. Field uniformity was better than 5% in a central 20°‐diameter circle. The recorded AF and the square of the image magnification were inversely related. Different day reproducibility was 4.1 % at the fovea. Median inter‐instrument reproducibility (Spectralis and the HRA2) was 7.4 %. Normals. qAF highly correlated with age (central qAF = 8.8+3.5*Age, p<0.00001). STGD. Background levels of qAF were elevated up to 4 times age‐matched controls; fleck levels were twice background. RP. HyperAF rings had significantly higher levels than controls and correlated with inner segment/outer segment junction loss.

Conclusion Modified SLO instrumentation and analytic methods that account for optical media density and refractive error allow non‐invasive, in vivo quantitative AF measurements (total lipofuscin fluorescence) relative to a fixed internal standard in normal subjects and patients with retinal degenerations to monitor disease progression and response to therapy.
Topical application of AMA0076, a locally acting rho kinase (ROCK) inhibitor, results in a robust IOP control in a hypertensive rabbit model
Authors: VAN DE VELDE S , VAN BERGEN T , VANDEWALLE E , SIJNAVE D , HOLLANDERS K , LEYSEN D , MOONS L , STALMANS I
Published: December 2011

Purpose To elucidate the IOP lowering effect of the local ROCK inhibitor, AMA0076, in the rabbit eye.

Methods An ocular hypertensive rabbit model, based on the intracameral injection of visco‐elastic material, has been developed to determine the IOP lowering effect of compounds acting to improve aqueous humor outflow. Using this model, the IOP lowering effect of AMA0076 was tested and compared to Y‐39983, Latanoprost and Bimatoprost (5 rabbits/compound).

Results Topical administration (TID) of AMA0076 prevented the IOP rise induced by the injection of visco‐elastics in a dose dependent manner (overall P<0.0001). Treatment with AMA0076 0.3% completely prevented the rise in IOP (overall P<0.0001). Administration of Y‐39983 0.3% significantly reduced (but did not completely abolish) IOP rise in the hypertensive model compared to the control eye (overall P<0.0001). A more subtle IOP decrease was also observed in the control eye with this non‐local ROCK inhibitor, presumably due to the systemic absorption of Y‐39983. AMA0076 was significantly more potent in blocking the IOP elevation in the hypertensive model compared to Latanoprost and Bimatoprost (respectively overall P=0.0004; P=0.0003).

Conclusion The local ROCK inhibitor AMA0076 lowers IOP in an efficient manner in an acute rabbit model for ocular hypertension, with a potency exceeding that of the non‐local ROCK inhibitor Y‐39983, as well as the prostaglandin analogues Latanoprost and Bimatoprost. In summary, the present data indicate that this new class of ROCK inhibitors has potential therapeutic value for the treatment of glaucoma through a novel IOP lowering strategy.
Effect of anti‐VEGF drugs and steroids on the inner blood‐retinal barrier, after experimental BRVO in rats: preliminary results
Authors: BOUZIKA PS , GILODI N , CONTI A , TSILIMBARIS MK , POURNARAS CJ
Published: December 2011

Purpose To evaluate the effect of anti‐VEGF drugs and steroids on the inner blood‐retinal barrier (BRB) function after experimental branch retinal vein occlusion (BRVO) in rats. The integrity of the barrier is related to the expression of occludins by retinal endothelial cells.

Methods Laser photocoagulation was applied to retinal veins of the right eye of 4 Long‐Evans rats, to induce BRVO. The left eye was used as control. One day after the occlusion, the right eye of each animal was injected intravitreally with either bevacizumab (n=2) or triamcinolone (n=2). The animals were sacrificed 7 days later; all retinas were harvested and prepared for indirect immunohistochemistry, using an anti‐ occluding primary antibody. The specimens were examined using a confocal microscope and images were acquired.

Results In normal retinas, occludins appeared as a dense, well‐organised, fluorescent reticulum along the vascular wall. In eyes with BRVO, the structure of occludins was disrupted; irregular linear fluorescence appeared along occluded veins, while absence of fluorescence suggested down‐regulation of occludin expression. Occludin distribution was improved in animals having received treatment post BRVO.

Conclusion The administration of bevacizumab and triamcinolone post BRVO seems to improve the function of the inner BRB. This could explain macular edema reduction after the use of these drugs. These preliminary results are part of an ongoing experiment, which will include the use of combination therapy in the management of BRVO.
Cytoarchitectonic and apoptotic consequences after intravitreal octreotide injection in an oxygen induced retinopathy mouse model
Authors: AKKOYUN I , KAYA S , HABERAL N , DAGDEVIREN A , YILMAZ G , OTO S , AKOVA YA
Published: December 2011

Purpose To evaluate the cytoarchitectonic and apoptotic consequences after intravitreal Octreotide acetate (OA) injection in different concentrations in an oxygen induced retinopathy (OIR) mouse model.

Methods A total of 26 of C57BL/J6 mice were exposed to 75±2% oxygen from postnatal day 7‐ 12. On day 12, 12 mice (group‐C) were injected with 0.1microg intravitreal Octreotide acetate (IVOA), 14 mice (group‐D) were injected with 0.05microg IVOA in right eye. The contralateral eyes were injected with isotonic saline (control group, group‐B). Four age‐matched mice, maintained in room air, were used as negative controls (group‐A). Neovascularization was quantified by counting the number of retinal vascular endothelial cell nuclei anterior to the inner limiting membrane. Cytoarchitectonic changes were examined by light and electron microscopy. Apoptosis was investigated using TUNEL technique.

Results Endothelial cell nuclei count was lower in groups C (p<0.0001) and D (p<0.0001) compared with group‐B. Light microscopy showed no retinal toxicity in any group. Electron microscopic cytoarchitectonic evaluation revealed mitochondrial damage in the inner segment of the photoreceptors in OIR mouse model without increasing in IVOA injected groups. There was no significant increasing apoptotic cell death in the IVOA injected groups.

Conclusion Intravitreal injection of OA may be a potential treatment of proliferative retinopathies.
Management of thyroid dysfunction in Graves’ Orbitopathy
Authors: ORGIAZZI J
Published: December 2011

Graves’Orbitopathy (GO), generally associated with hyperthyroidism, may develop also before or after the onset of hyperthyroidism, or even in hypothyroid Hashimoto’s patients. The course and treatment modalities/outcomes of the thyroid disease may alter GO expression and severity. Restoration of euthyroidism with antithyroid drug (ATD) usually improves ocular conditions. However, recurrence of hyperthyroidism after ATD withdrawal, may favour GO progression. Therefore, radical treatment with radioiodine (RAI) or thyroidectomy, should be considered in relapsing patients with GO. RAI leads to a progression of GO in 15‐37% of patients. Several factors are predictive: a) pre‐existing ‘active’ GO, b) severity of hyperthyroidism, c) high serum TSH‐R Ab levels, d) cigarette smoking and e) occurrence of uncorrected post‐radioiodine hypothyroidism with elevated serum TSH. Progression of GO can be prevented by glucocorticoid (GC) therapy, 0.5 mg/Kg BW initially gradually withdrawn over 10‐12 weeks. In patients with inactive GO nor other risk factors, GC coverage is not necessary. In patients with ‘moderate‐severe and active GO’, if radical treatment with RAI is indicated, GO should be treated concomitantly with iv GC and/or orbital radiotherapy. Thyroidectomy is ‘neutral’ for GO. Total thyroid ablation (total thyroidectomy + RAI) might even be beneficial for GO. Iatrogenic hypothyroidism, whatever the treatment, is a significant risk factor of occurrence or progression of GO which warrants close control, and prompt correction, of thyroid function during ATD or after radical treatment. In conclusion, learned treatment strategy and close management of thyroid function are mandatory in Graves’ disease patients. In patients with GO, the combined endocrinological‐ophthalmological approach is the prerequisite for efficient global management.
Radiologic features of inflammatory versus tumoral orbital diseases
Authors: DE POTTER P
Published: December 2011

To propose guidelines for analysis and interpretation of orbital imaging studies (CT and MRI) in order to help the ophtlamologist in the differential radiological approach between oncologic versus inflammatory orbital disorders.
Clinical Cases
Authors: KAWASAKI A
Published: December 2011

Clinical cases will be presented.

Commercial interest
Retinotopic organisation of primary visual cortex in glaucoma: a fMRI study
Authors: ZANGWILL L
Published: December 2011

Abstract not provided
Proteomic analysis of aqueous humor in retinoblastoma: a preliminary approach
Authors: MICHELI L , HADJISTILIANOU D , GIGLIONI S , VANNONI D , BROGI E , CEVENINI G , CORTELAZZO A , DE FRANCESCO S , MENICACCI F , LEONCINI R
Published: December 2011

Purpose Compare the basic protein composition of the aqueous humor from retinoblastoma (RTB) patients with aqueous humor from patients with cataract who served as controls.

Methods The study was carried out on 18 hospitalized RTB patients, who had undergone ocular enucleation (Reese‐Ellsworth stage V or ABC classification group E RB), and 10 cataract patients. Five out of 18 RTB patients presented with associated secondary glaucoma and 5 out of 13 with no secondary glaucoma received chemotherapeutical treatment with Melphalan. The total protein concentration and electrophoresis pattern (SDS PAGE) of the aqueous humor was analysed.

Results The aqueous humor from RTB patients had significantly higher total protein concentrations than controls (p<0.01); patients with secondary glaucoma presented with the highest total protein concentrations, and they were significantly different from controls (p<0.05), while those treated with Melphalan presented a 70% decreasing in protein concentration and, in respect to all non‐treated patients, were significantly different (p<0.01). Besides, the protein content of controls was not significantly different from treated patients. The SDS PAGE pattern of RTB patients was very different from controls; yet, after chemotherapeutical treatment, patterns were similar.

Conclusion This study represents a preliminary step towards a more accurate 2DE pattern, which will be combined with mass spectrometry analysis to clarify the potential role of specific proteins in tumor development and progression; although this results suggest that aqueous humor protein pattern in RTB is characteristic, several aspects of the study are still under investigation.
Mutations in the BAP1 gene in uveal melanoma
Authors: KOOPMANS AE , VAN DEN BOSCH T , VAARWATER J , KILIC E , PARIDAENS D , NAUS N , DE KLEIN A
Published: December 2011

Purpose Uveal melanoma (UM) is the most frequently occurring intraocular malignancy in adults. UM has a strong tendency to metastasize to the liver. There are no effective therapies for metastatic disease resulting in a tumour‐related death in about 45% of UM patients within 15 years after the initial diagnosis. Monosomy of chromosome 3 is the most frequent found chromosomal aberration in UM and is predominantly found in metastasizing tumours. Chromosome 3 losses can be detected by karyotyping, FISH or DNA based techniques as QPCR/MLPA and Array CGH. We use a combination of FISH and SNP arrays to select patients for a dendritic cell therapy trial. Recently, inactivating somatic mutations were identified in the gene encoding BRCA1‐associated protein 1 (BAP1) on chromosome 3p21.1 in metastasizing tumours. In a retrospective series of UMs we will determine the sensitivity and specificity of mutations in BAP1 and compare these with the currently used predictive standard of monosomy.

Methods We will use targeted multiplexed Next Generation Sequencing to determine mutations in the BAP1 gene.

Results Our results will follow shortly.

Conclusion Conclusions will be drawn when all the results are known.
Autologous and Allogeneic Limbal Stem Cell Therapy ‐ Where are the Limits?
Authors: DUA H
Published: December 2011

Abstract not provided
Nanoparticle‐mediated Transfer of Therapeutics to Corneal Cells
Authors: FUCHSLUGER T
Published: December 2011

Purpose Calcium phosphate nanoparticles (CaP‐NPs) are biodegradable and biocompatible as they dissolve in the cell in calcium and phosphate. Therefore they are an ideal tool for transfection with DNA or RNA. It has been demonstrated that the impact on intracellular levels of Ca2+ is low and therefore does not affect cell vitality. In this study, we determine the most efficient type of CaP‐NPs for transfer of DNA into in corneal endothelial cells (EC).

Methods CaP‐NPs with triple‐shell pcDNA3‐EGFP in different concentrations or coated by dispersions of polyethylenimine (PEI) were manufactured. Polyfect®‐pcDNA3‐EGFP served as positive control. Human and murine EC (suspensions and donor tissue) were transfected using various concentrations of CaP‐NPs and different times of transfection. Transfection efficacy was determined by measuring EGFP‐expression (flow cytometry, fluorescence microscopy). To evaluate toxicity, apoptosis was studied by TUNEL and propidium iodide staining.

Results The transfection efficacy of triple shell CaP‐NPs (EGFP expression up to 50% after transfection with triple shell CaP‐NPs) was significantly increased after coating with PEI. Cell viability in corneal tissue was not significantly impaired after treatment. As EC possess minimal proliferative capacity, there was no significant change of EGFP expression.

Conclusion CaP‐NPs seem to be an alternative to viral vectors and safe for application in patients. Therefore CaP‐NP may be a new and suitable tool for DNA transfer into EC. Further studies are necessary to carefully evaluate functional application and biosafety.
Analysis of gene expression in ischemic neuroretinas: genome‐wide screen discriminating occlusion versus laser effects in rats
Authors: GEKA A , OROPESA C , POURNARAS CJ
Published: December 2011

Purpose Identification of genes differentially expressed in rat neuroretinas submitted to experimental acute BRVO, to laser treatment, or to light exposure

Methods Using an in vivo experimental model of BRVO in rat retinas, we induced acute ischemia by argon laser photocoagulation of venous sites near the ONH in the right eye of one group of animals. In a second group, right eye retinas were exposed to laser treatment at sites located between major vessels. A third group of animals had their right eye exposed to light through a slit lamp. Untreated left eyes served as controls in each animal. Total RNA was extracted from neuroretinas, 30 min and 6 h post treatments, and processed for global gene analysis with Affymetrix microarrays. Genome‐wide comparison of transcriptomes was then performed

Results At 30 min, data did not reveal any sequence differentially expressed for the 3 treated groups. At 6 h, light exposure was definitively excluded as an impacting factor. However, the expression of 627 and 113 sequences changed, respectively post BRVO and post laser treatment. When comparing transcriptomes of both groups, we identified, respectively, 396 and 21 genes specifically modified. Interestingly, around 80 genes, all upregulated, were common to both groups. The majority of differentially regulated genes encode proteins involved in different aspects of a large number of complex pathways, among which we retained: inflammation, angiogenesis, apoptosis and neuroprotection

Conclusion Microarray analysis revealed changes in gene expression bearing similarities to results from other ischemia models. Furthermore, it revealed that laser treatment may have unreported and specific impacts on retina’s metabolism