bluuebunny/crossref_metadata_2025 huggingface dataset:
Circulation of avian influenza viruses in wild birds in Inner Niger Delta, Mali
Authors: Cappelle Julien , Servan de Almeida Renata , Fofana Bouba , Dakouo Martin , Balança Gilles , Gil Patricia , Albina Emmanuel , Gaidet Nicolas
Published: December 2011

Please cite this paper as: Cappelle et al. (2012) Circulation of avian influenza viruses in wild birds in Inner Niger Delta, Mali. Influenza and Other Respiratory Viruses 6(4), 240–244.

Background  Avian influenza viruses (AIV) have been detected in wild birds in West Africa during the northern winter, but no information is available on a potential year‐round circulation of AIV in West Africa. Such year‐round circulation would allow reassortment opportunities between strains circulating in Afro‐tropical birds and strains imported by migratory birds wintering in West Africa.

Objective and Method  A 2‐year longitudinal survey was conducted in the largest continental wetland of West Africa, the Inner Niger Delta in Mali, to determine the year‐round circulation of AIV in wild birds.

Results and Conclusions  Avian influenza virus RNA was detected during all periods of the year. Very low prevalence was detected during the absence of the migratory wild birds. However, a year‐round circulation of AIV seems possible in West Africa, as shown in other African regions. West Africa may hence be another potential site of reassortment between AIV strains originating from both Afro‐tropical and Eurasian regions.
mTHPC‐mediated Photodynamic Treatment Up‐regulates the Cytokines VEGF and IL‐1alpha
Authors: Dabkeviciene Daiva , Sasnauskiene Ausra , Leman Eva , Kvietkauskaite Raimonda , Daugelaviciene Neringa , Stankevicius Vaidotas , Jurgelevicius Vaclovas , Juodka Benediktas , Kirveliene Vida
Published: December 2011

Photodynamic therapy (PDT) of cancer induces oxidative stress, which intervenes in the expression of cytokines by tumor cells. The cytokines might have either a positive or a negative impact on tumor eradication. Here, we studied the expression of cytokines vascular endothelial growth factor (VEGF) and interleukin‐1alpha (IL‐1alpha) in the human epidermoid carcinoma A‐431 cells following m‐tetra(3‐hydroxyphenyl)‐chlorin (mTHPC)‐mediated PDT in vitro and assessed the IL‐1alpha effect on VEGF expression. Quantitative polymerase chain reaction and enzyme‐linked immunosorbent assay revealed the enhanced production of VEGF and IL‐1alpha both on mRNA and protein levels by mTHPC‐loaded cells after light exposure. The silencing of IL1A by small interfering RNA resulted in decreased production of IL‐1alpha and a reduced amount of VEGF. Furthermore, exogenous recombinant IL‐1alpha stimulated the VEGF expression after PDT. Thus, in addition to the cytotoxic action on the A‐431 cells, mTHPC‐mediated PDT stimulated the production of VEGF and IL‐1alpha, and IL‐1alpha contributed to the VEGF overexpression. These data establish IL‐1alpha as a possible target of combined cancer treatment.
Las cuestiones del cambio climático en las prácticas de inversión de los fondos
Authors: Sørensen Ole Beier , Pfeifer Stephanie
Published: December 2011

La forma en que los inversores institucionales afrontan las cuestiones ambientales, sociales y de gobernanza empresarial (ASG) en sus prácticas de inversión ha experimentado un gran cambio. Para los inversores públicos y privados, estas cuestiones se han convertido en parte de las prácticas corrientes de inversión que reflejan un mejor entendimiento de los importantes riesgos y oportunidades que representan y que deben ser examinados como parte de sus obligaciones fiduciarias. Algunos criterios ASG requieren un enfoque que va mucho más allá de las orientaciones tradicionales de simple selección que utilizaban los antiguos fondos especializados. Para ilustrarlo, hemos procedido a realizar un análisis detallado de las prácticas de los inversores en materia de cambio climático, que deben incluir una evaluación de riesgos y oportunidades a largo plazo, y de las estrategias que se han acometido para afrontarlos. También argumentamos que, dado que el papel de la política y la regulación es fundamental para modificar los intereses económicos a favor de inversiones encaminadas a reducir las emisiones de carbono, es fundamental entablar un diálogo estructurado entre los inversores y los responsables de la toma de decisiones para garantizar que se movilice el capital institucional necesario para apoyar los objetivos políticos encaminados a limitar el cambio climático, al mismo tiempo que se establece un marco en el que los inversores puedan realizar sus actividades de conformidad con su responsabilidad fiduciaria.
Migrants' Associations and Their Attempts to Gain Recognition: The Case of Milan
Authors: Camozzi Ilenya
Published: December 2011

In the late 1970s, Italy switched from being a source of émigrés to becoming a recipient of immigrants. The city of Milan and its surrounding region led the way. A multitude of migrant associations sprang up as migrants pursued their quest for recognition as subjects and citizens. This study draws on the author's interviews with members of Milan's migrant associations to examine the inner dynamics both between migrants within associations, and between migrant members and those volunteers, both Italian and of other nationalities, who work with the associations. This study shows that the forms of solidarity and engagement offered by Italian activists represent a platform where the process of identity construction occurs and (mis)recognition practices are played out. As the article will point out, migrants are sometimes quite critical of the activities of Italian activists. In short, the study suggests that the consideration of two dimensions – identity and recognition – as they arise within everyday social practices, could make a useful contribution to the further study of the social phenomena of migrants' associations and political participation.
Classification of Uveitis
Authors: ANDROUDI S
Published: December 2011

Purpose Classification and standardization of uveitis is important, as it enhances the precision and comparability of clinical research from different centers and assists in the development of a complete picture of the course of the disorders and their response to treatment.

Methods Attempts have been made to standardize some aspects of uveitis, and various classification criteria, inflammation grading schema, and outcomes criteria have been described.

Results The most widely used classification of uveitis is the one devised by the International Uveitis Study Group (IUSG) in 1987, based on the anatomical location of the inflammation. This classification includes anterior uveitis (iritis, iridocyclitis, and anterior cyclitis), intermediate uveitis (pars planitis, posterior cyclitis, and hyalitis), posterior uveitis (focal, multifocal, or diffuse choroiditis, chorioretinitis, retinitis, and neuroretinitis) or panuveitis (anterior chamber, vitreous, retina, and choroid). In 2005, the Standardization of Uveitis Nomenclature (SUN) Working Group standardized a grading schema for aspects of intraocular intraocular inflammation, that is, anterior chamber cells, anterior chamber flare, and vitreous haze, was developed. Standardized definitions of outcomes, including reporting visual acuity outcomes, were approved.

Conclusion Today’s uveitis nomenclature has been revised regarding the anatomical location and the grade of inflammation, and supplemented by the inclusion of definitions for onset, duration and course.
Laboratory work‐up and specialized investigations
Authors: PLEYER U
Published: December 2011

Abstract not provided
Fungal Infections
Authors: KESTELYN P
Published: December 2011

Abstract not provided
Infectious crystalline keratopathy and its management
Authors: DUA H
Published: December 2011

Abstract not provided
Boston Type 1 KPro ‐ patient selection
Authors: LAKE D
Published: December 2011

Abstract not provided
Boston Type 1 KPro ‐ surgical technique
Authors: CORTINA S
Published: December 2011

Abstract not provided
Infectious posterior uveitis
Authors: MARKOMICHELAKIS N
Published: December 2011

Abstract not provided
Pediatric uveitis
Authors: BODAGHI B
Published: December 2011

The etiology and treatment of uveitis in children remains different from adults. Infectious and auto‐immune conditions must be identified. Juvenile idiopathic arthritis‐associated uveitis is the main etiology of chronic anterior uveitis. Pars planitis is another frequent etiology of bilateral auto‐immune uveitis. On the other hand, toxoplasmic retinochoroiditis, ocular toxocariasis and cat scratch disease should be excluded in children with unilateral posterior uveitis. Case reports will be presented in order to illustrate th management of different pediatric uveitis entities.
B27‐associated uveitis
Authors: WILLERMAIN F
Published: December 2011

B27 associated uveitis is a very frequent form of intraocular inflammation which account for approximately 50 % of acute anterior uveitis. Its main clinical features, natural history and association with seronegative arthritis are well known. B27 associated uveitis are thus often considered as an easy diagnosis. However, several aspects of the disease remain challenging and debated. This interactive course will be mostly based on clinical cases and focused on the most controversial aspects of the work up, treatment, and complications of B27 associated uveitis.
Complications of uveitis and their management
Authors: NERI P , ARAPI I
Published: December 2011

Purpose To review the uveitis complications and their management.

Methods The current literature is reviewed and the experience of a tertiary referral centre is reported.

Results Visual recovery in uveitis is hampered all too often by the onset of complications arising from the frequent, recurrent episodes of inflammation. The most frequent complications in uveitis are: cataract, cystoid macular edema (CMO), glaucoma, neovascularization, and vitreous opacities. Moreover, these sequela may progress, despite an apparent good control of the ocular inflammatory disease. An early recognition, as well as an appropriate and timely management are mandatory for a successful outcome. In addition, the treatment alternatives for these entities should be considered, depending on the severity of the condition.

Conclusion Several sequela have been described in uveitis. A prompt recognition may orient correctly the ophthalmologist towards the best treatment option, lowering the risks of severe and irreversible ocular damages.
Immunosuppression and biologic agents
Authors: DICK A
Published: December 2011

Purpose To overview the contemporary therapeutic approaches to treatment of non‐infectious non‐infective ocular inflammatory disease. Treatment of non‐infectious uveitis has over past 15 years expanded from the use of traditional therapies including corticosteroids and immunosuppressants to the deployment of targetting the immune response with biologic therapies with monoclonal antibodies and immunoadhesins.Such use will be exemplified with case reports during the talk.

Methods The talk will overview the evidence of effect of immunosuppressants in the treatment of uveitis, the role of predicting steroid responsiveness, the use of monotherapy with immunosuppression and finally the pathways and evidence of success of biologic therapy.

Results The concommitant use of immunosuppression is an important aspect to the adequate treatment of uveitis. This ensures adequate control of inflammation whilst reducing the need for comcomitant steroids thereapy. Moreover, monotherapy is equally efficacious in the control of some forms of uveitis.Neverthless there are patients who remain refractory to therapy, and in particular treatment of sight threatening Cystoid macular oedema. The use of targetted biologic therapy has gained increasing evidence to now lead to clinical trials in the use of anti‐TNF and anti‐IL17 agents

Conclusion There is now a recognised algorithm to treat aggressively and early patients with sight threatening disease. The appropriately timed use of immunosuppression and moreover increasingly earlier intervention with biologics has the promise to alter prognosis and outcome of such blinding disorders.
Optic vesicle‐like neurospheres derived from the H9 and H1 human ES cell lines
Authors: PINILLA I , WRIGHT LS , VERHOEVEN AD , WALLACE KA , CAPOWSKI EE , MEYER J , CUENCA N , GARCIA MARTIN E , GAMM DM
Published: December 2011

Purpose To compare cell fate and differentiation potential of retinal cultures derived from two commonly used human embryonic stem cell (hESC) lines over time.

Methods H1 and H9 hESC lines of similar passage were differentiated toward a retinal lineage using a previously published protocol. Highly enriched populations of optic vesicle (OV) stage retinal progenitors from each line were manually separated and allowed to differentiate for up to an additional 120 days. The sequence and timing of expression of markers indicative of retinal development were determined via RT‐PCR and immunocytochemistry.

Results A greater number of OV‐like neurospheres were obtained from H1 hESCs than H9 hESCs at day 20 of differentiation. By contrast, the appearance of pigmented RPE within OV‐like neurospheres occurred earlier and more frequently in H9 cultures. However, beginning at approximately day 50 of differentiation and throughout the remainder of the study, a similar pattern of neuroretinal marker expression was observed between both hESC lines. More specifically, markers of ganglion cell differentiation were observed initially, followed by the appearance of photoreceptor and retinal interneuron markers.

Conclusion RPE and neuroretinal cell types can be obtained from differentiating H1 and H9 hESCs in a sequence reminiscent of normal human retinal development. However, differences were seen in the proclivity of these lines to produce multipotent retinal progenitors and RPE, as well as the timing of differentiation of certain retinal cell types. Therefore, caution should be used when directly comparing results obtained from different hESC lines.
Functional aspects of hyperautofluorescent ring in retinal dystrophies
Authors: HAWLINA M , LENASSI E , FAKIN A , JARC VIDMAR M , BRECELJ J
Published: December 2011

Purpose To further investigate functional aspects of hyperautofluorescent ring, seen in retinal dystrophies.

Methods Full ophthalmologic examination was performed, autofluorescence imaging was done by Heidelberg Engineering Spectralis/OCT, microperimetry with MP1 and electrophysiology.

Results Hzperautofluorescent ring exhibited different characteristics in RP‐related diseases and very heterogenous characteristics in cone dystrophies, cone/rod dystrophies and macular dystrophies such as Stargardt disease, Best's disease and other dystrophies affecting central retina.

Conclusion Hyperautofluorescent ring is a specific feature that represents boundary between functioning and disfunctional retina and its origin is at present unknown. Different forms of ring are seen in different diseases and its functional correlations are important to understand the underlying mechanisms.
From persistent epithelial defect to corneal ulceration : induction of proteases and epithelial‐stromal interactions
Authors: MENASHI S
Published: December 2011

Abstract not provided
Infectious corneal ulcers : pathogenesis and management
Authors: BOURCIER T
Published: December 2011

Abstract not provided
Therapeutic approachs in sterile corneal melts
Authors: GABISON EE
Published: December 2011

Purpose The aim of this instruction course is to present the medical and surgical management of chronic corneal melts.

Methods Interactive clinical cases.

Results Modulation of epithelial wound healing using different technics such as epihelial debridement, inlay and overlay amniotic membrane transplatation, lamellar or penetrating keratoplaty are presented.

Conclusion Delayed epithelial wound closure is the main risk factor of sterile corneal melts. Early diagnosis for the medical and surgical management of corneal ulcerations
Occupational Cataracts and Lens Opacities in interventional Cardiology (O’CLOC Study)
Authors: JACOB S , LAURIER D , JOURDAIN JR , BERNIER MO
Published: December 2011

Purpose Interventional cardiologists ‐ ICs, are exposed to ionizing radiations (X‐rays), which may induce early cataracts known as radiation‐induced cataracts. To test the existence of an increased risk of cataracts among ICs, the O'CLOC study was performed in France.

Methods This study is a cross‐sectional study including an exposed group of ICs and a comparable unexposed group of non medical workers. Individual information on risk factors of cataracts (age, diabetes, myopia, etc. ...) and catheterization laboratory activity for ICs, were collected during a phone interview. Clinical eye examination including papillary dilatation and slit lamp examination was performed. LOCS III classification was used to detect lens opacities (nuclear, cortical or posterior subcapsular)

Results The study included 106 ICs (mean age=51.1±7.3 yrs.) and 99 unexposed people (mean age =49.6±6.7 yrs.). There was no significant difference between both groups in terms of sex ratio, BMI, smoking status, diabetes, myopia, corticosteroids use. Regarding nuclear and cortical lens opacities, no significant difference was observed: 61% for ICs vs. 69% for unexposed group, p=0.23, and 23% for ICs vs. 29% for unexposed group, p=0.29, respectively. In contrast, posterior subcapsular lens opacities were significantly more frequent among ICs (17% vs. 5%, p = 0.006), corresponding to a crude OR=3.89 [1.39–10.93] which remained significant even after adjustment for age, sex, BMI, smoking status, diabetes, myopia and corticosteroids use (OR=3.85 [1.30–11.40], p=0.015).

Conclusion In order to limit the exposure to the eyes and the risk of radiation‐induced cataract, we recommend ICs to wear lead glasses and use protective equipment against X‐rays.
I‐LASIK retreatment of residual refractive errors after microkeratome and femtosecond assisted LASIK
Authors: MENICACCI F , FRUSCHELLI M , MENICACCI C , SANGIUOLO M , HADIJSTILIANOU T
Published: December 2011

Purpose To evaluate the efficacy and safety of femtosecond‐assisted sub‐bowman keratomileusis (I‐LASIK) retreatment for residual refractive errors after either I‐LASIK or microkeratome assisted LASIK.

Methods We performed i‐lasik retreatment in 14 eyes of 10 patients (mean age 37) for residual myopic and astigmatic refractive errors after previous both i‐lasik and lasik procedures. All patients had stable residual refractive errors for at least 2 years. I‐lasik was performed in all cases with AMO's IntraLase™ FS and STAR S4 IR™ Excimer Laser System, corneal flap thickness was 100µm and hinge position was 90 degrees with reverse 120° side cut. The optical zone of the ablation was from 6.5 to 7 mm, transition zone from 8 to 9 mm.

Results Controls were made at 1day, 1 and 3 months. Anterior segment OCT and corneal confocal microscopy were performed in every case. No flap decentration was observed in any case, we had 2 cases of epithelial ingrowth, 4 cases of dry eye, no cases of corneal ectasia and no retinal complications. All spherical equivalent results were within 0.50 diopters.

Conclusion In our experience I‐lasik procedure demonstrated itself to be safe and effective also in patients with residual refractive errors from previous i‐lasik and lasik treatments.
Long‐term results of simultaneous topo‐guided photorefractive keratectomy followed by corneal collagen cross‐linking for keratoconus
Authors: DIAKONIS V , GRENTZELOS M , PORTALIOU D , KOUNIS G , LIMNOPOULOU A , KYMIONIS G
Published: December 2011

Purpose To present the long‐term results after simultaneous photorefractive keratectomy (PRK) followed by corneal collagen cross linking (CXL) for keratoconus

Methods In this prospective case series, 26 patients (31 eyes) with progressive keratoconus were included. All patients underwent customized topography guided photorefractive keratectomy (PRK) immediately followed by corneal collagen cross linking with the use of riboflavin and ultraviolet‐A irradiation. Epithelium was removed by transepithelial phototherapeutic keratectomy (t‐PTK) in all cases

Results Mean follow‐up was 19.53 +/‐ 3.97 months (range 12 to 25 months). Mean preoperative spherical equivalent (SE) was –2.3 +/‐ 2.8 diopters (D) while at the last follow up examination was significantly (p<0.001) reduced to ‐1.08 +/‐ 2.41 D. LogMAR uncorrected (UDVA) and corrected distance visual acuity (CDVA) were significantly reduced by 0.46 and 0.084 LogMAR units, (p<0.001) at the last follow up examination. Mean steep and flat keratometry readings were reduced by 2.35 D (p<0.001) and 1.18 D (p=0.013) at the last follow‐up examination

Conclusion Simultaneous topo‐guided PRK followed by CXL seems to be an effective and safe treatment without any complications in our series of keratoconic patients
The distribution of retinal thickness in healthy eyes and its use in the objective analysis of optical coherence tomography (OCT) scans
Authors: HALDAR S , DAVIES N
Published: December 2011

Purpose OCT provides quantitative data but interpretation remains subjective. We have developed a statistical method to detect abnormal retinal thickness in OCT scans.

Methods High resolution macula topography maps, which were identified as normal by a retinal specialist, were exported from a spectral domain OCT/SLO machine. A Matlab® algorithm was written to perform image registration to a model macula. A reference map was constructed for each eye consisting of mean thickness and standard deviation at each point. Kurtosis and skewness were calculated. To analyse pathological scans areas > 2 SD from the mean were deemed abnormal.

Results 151 left eye scans and 112 right eye scans were analysed. The mean foveal thickness was 190.7 microns (SD 1.8) for the left and 189.2 microns (SD 1.6) for the right. Skewness and kurtosis were assessed over the macula. The mean skewness was 0.34 (‐0.39 to 0.39) for the left and ‐0.0154 (‐0.45 to +0.45) for the right. The mean kurtosis was 0.95 (SE 0.39, range ‐0.8 to 0.8) for the left and ‐0.0324 (SE 0.45, range ‐0.90 to 0.90) for the right. 20 abnormal scans from patients with diabetes were aligned with the reference maps. The mean percentage area of abnormality >2 SD was 28%, 2‐3 SD was 8%, 3‐5 SD was 7%, 5‐10 SD was 8% and >10 SD 5%. There was a linear correlation of area >2 SD with areas 3‐5 SD (R2 = 0.65) and 5‐10 SD (R2 = 0.73) indicating that larger lesion area is associated with greater oedema.

Conclusion The data show a normal distribution of retinal thickness in healthy eyes. A quantified image of statistical abnormality in a diseased eye can be generated which is helpful for standardising interpretation.
A Meta‐analysis of stydies on the hetitability of myopia
Authors: MORGAN I
Published: December 2011

Purpose Recently there has been considerable interest in the issue of mssing heritability ‐ the quite common problem of difficulty in matching the high heritability for some complex diseases with associated genomic variation. The aim of this analysis was to determine whether the heritability values for myopia and ocular biometry dervied from twin studies, broader family studies and population‐based studies were similar or different.

Methods Relevant studies were collected by using as search words "myopia","refractive error", "axial length","corneal curvature", "corneal power" and "heritability" in the PubMed database. Reference lists of the papers identified were also searched to identify additional references. Studies on populations enriched in myopia or refractive error due to the selection criteria for inclusion were excluded from the analysis,

Results The heritabilites determined for myopia from twin studies were significantly higher than those from family studies and population‐based studies. Fewer studies were availalbe on the heritability of axial length, but there appeared to be a similar trend in the data. Studies on the heritability of corneal power were even fewer in number, and the results were inconsistent.

Conclusion The decline in the heritability of myopia with broader population base to the study suggests that the high heritability determined in twin studies is not generalisable, and may be associated with the low level of environmental variation within twin pairs. The heritability of axial length also depends on study design, although not as markedly as for myopia. Despite the high heritability determined in twin studies, evidence for major environmental effects is obtained with a broader population base.
Congenital Glaucoma: from the diagnosis up to the surgery. About a case
Authors: IBANEZ J , PEREZ GARCIA D , REMON L , JIMENEZ DEL RIO B , PEIRO C , CABEZON L , RAMIRO P , CRISTOBAL JA
Published: December 2011

Purpose The surgical treatment is, at present, universally accepted as treatment of choice in the congenital primary glaucoma. However, sometimes at the time of diagnosis, the conditions of the eye disable to carry out the surgery in safety conditions.

Methods We present the case of a baby of 8 months, who was referred to our department for pain and corneous opaqueness of 48 hours of evolution. Exploration shows the presence of edematous cornea, with increase of the horizontal diameter (12 mm, opposite to 10 mm of the contralateral eye). With the possible diagnostic of congenital glaucoma, ultrasound scan was performed to confirm the increase in the axial length, and determination of the intraocular pressure(Perkins tonometry and Tono‐Pen, under topical anesthesia), which confirmed numbers abnormally high (38 and 42 mmHg respectively).

Results Confirmed the diagnosis, and given the inability to carry out the goniotomy due to the corneal edema, began treatment with fixed combination dorzolamida/timolol 2 times a day for 5 days. The improvement of the corneous condition after the guideline of medical treatment, allowed the angular exploration and the surgery in safety conditions 7 days later.

Conclusion In the managing of the congenital glaucoma, given the special characteristics of the patient, in many cases is necessary to delay the surgery in time. It is important to perform a thorough ophthalmological and systemic exploration in newborn patients to optimize the conditions of the eye before the surgery, allowing that this one should carry out, and making it less difficult, as far as possible.
Rates of visual field progression before and after trabeculectomy
Authors: BERTRAND V , FIEUWS S , STALMANS I , ZEYEN T
Published: December 2011

Purpose To compare the rates of change in the visual field (VF) in patients with glaucoma before and after trabeculectomy.

Methods 52 eyes of 52 patients over 35 years of age with different types of chronic glaucoma who underwent primary trabeculectomy were evaluated retrospectively. Pre‐ and postoperative automated visual fields measured by the same technique were compared to detect differences in rates of progression. Rates of VF loss before and after trabeculectomy were calculated using global indices, mean defect (MD) and pattern standard deviation (PSD) and linear regression analysis per cluster. Linear mixed models were used to compare the evolution of the VF before and after trabeculectomy.

Results The mean follow‐up period pre‐trabeculectomy was 3.88 years (min 0.92, max 10.72) and post‐trabeculectomy 3.82 years (min 2.03, max 8.02). The intraocular pressure (IOP) decreased significantly from 18.12 ± 4.71 mmHg before trabeculectomy to 11 ± 2.87 mmHg at the last follow‐up after trabeculectomy (P < 0.0001). The rate of progression of MD decreased with 55%, from –0.36 dB/year before surgery to –0.16 dB/year after surgery (P = 0.15). The rates of progression of PSD decreased from –1.69 dB/year before to –0.018 dB/year after surgery (P = 0.03). Of the 10 predefined clusters, only in cluster 10, situated infero‐temporally, the difference between the slopes was statistically significant (0.64 dB/year, P = 0.0021).

Conclusion Trabeculectomy significantly decreased the rates of glaucomatous VF progression.
Correlation of the rate of progression of visual field loss between Guided Progression Analysis (GPA II) and PeriDataTM program in glaucoma patients: Pilot study
Authors: POURJAVAN S , PEETERS H , DETRY‐MOREL M
Published: December 2011

Purpose To assess the correlation of progression rate measured by GPAII using visual field index (VFI%) and PeriDataTM employing functional equivalent score (FES) in glaucoma patients.

Methods Retrospective, observational study including 54 eyes of 37 medically treated glaucoma patients with at least 5 reliable visual field examinations in minimum 2 years. Only patients with a negative rate of progression with VFI were taken into account to calculate their rate of progression and loss of FES. Patients who underwent filtering surgery or laser trabeculoplasty during the follow‐up period were excluded.

Results Mean age was 75.7 ±13.4 yrs. the patients performed their visual field with Humphrey standard automated perimeter (Sita Standard 24‐2). The mean follow‐up was 7.5 ± 2.5 yrs. The mean of progression by GPA (%/year) and PeriData FES index (%/year) were: ‐2.0 ± 2.2 (range= ‐10.6 to ‐0.2 per year) and ‐3.18 ± 2.5 (range: ‐9.3 to 2.8 per year) respectively. There was an excellent correlation between GPAII index VFI% loss per year and PeriData FES loss per year (<0.001) for the total group. In contrary when the group was limited to low‐ moderate progressors (VFI% loss per year ≥ ‐2), there was no correlation between the two different indexes.

Conclusion In this study we couldn't find any correlation between VFI% and FES% in the clinically low to moderate visual field progression.
Mitigation of the IOP elevation associated with non‐supine sleep positions
Authors: FLATAU A
Published: December 2011

Purpose When a person sleeps in a non‐supine position, the load path through which the weight of the head is transferred to a supporting surface (a pillow, the mattress, an arm, etc.) generally includes one eye. This research quantifies the forces that act on the eye and the potential for extended periods of intraocular pressure (IOP) elevation when the eye is a load bearing element in the "head‐to‐bed" load path.

Methods An engineering model of the load path is used to quantify nominal loads on the eye when in side‐ and face‐down sleep positions. The eye is modeled as a fluid filled, thin walled pressure vessel and is included as a load‐bearing structural element in the head‐to‐bed load path. The model is used to simulate a device that provides as alternative load path to mitigate sleep position related elevation of IOP.

Results Predictions from a lumped parameter model indicate that individuals who sleep in non‐supine positions will experience elevation of IOP of 3‐5 mmHg. A more sophisticated eye model is used to incorporate deformation of the eye and to show the lumped parameter model estimates of IOP elevation are conservative. This result is supported by a recently published experimental study of measured IOP elevation in dogs during eye manipulation [Keing et al., 2011] which suggests that relatively modest deformations of the eye can nearly double measured IOP levels. A non‐invasive method for alleviation of the external forces that act on the eye during non‐supine sleep is described as a means for altering this load path.

Conclusion These results suggest that patients with normal IOP levels during the day may experience significant elevation of IOP levels due to sleeping in non‐supine positions. An approach to mitigate this mechanism of IOP elevation is presented.
Retinal nerve fiber layer thickness measured by optical coherence tomography correlates with Expanded Disability Status Scale (EDSS) in multiple sclerosis (MS)
Authors: CARZOLI A , LATARCHE C , BERROD JP , DEBOUVERIE M , ANGIOI K
Published: December 2011

Purpose To determinate if retinal nerve fiber layer (RNFL) thickness was correlated with Expanded Disability Status Scale (EDSS) score in patients with definite multiple sclerosis (MS)

Methods 74 consecutive patients (extracted from the prospective Lorraine Multiple Sclerosis Registry) were included. A neurological examination with determination of the EDSS score and an ophthalmological examination with visual acuity, visual field testing, and RNFL measurements with optical coherence tomography (OCT3‐Carl Zeiss Meditec, Dublin California USA) were performed.

Results Mean age was 44,5 years and 66% were women. EDSS average score was 3. Prior optic neuritis was present in 83% OD and 41% OS. EDSS score was negatively correlated with RNFL thickness (‐0,28 p=0.04 OD and ‐0.2 p<0,1 OS). There were no correlation between RNFL thickness and MS subtype or any of other ophthalmological tests. At the opposite, RNLF thickness was significantly lower among eyes with prior optic neuritis (74 vs 90 OD and 76.8 vs 90.3 micrometers, p<0.01). In addition we did not find any correlation between EDSS and other ophthalmological tests.

Conclusion Our study demonstrates that RNFL thickness is statistically correlated with EDSS score. RNFL thickness measured by OCT appears to be an interesting structural biomarker to detect global axonal loss in MS patients. Larger studies are warranted to confirm if RNFL thickness could serve as a surrogate of EDSS score.
Wavefront guided or topo‐link ? Which one and when ?
Authors: GICQUEL JJ
Published: December 2011

Based on the refractive outcomes and postoperative wavefront aberrations measurements, in large series of patients who underwent photorefractive keratectomy with topography‐guided, or wavefront‐guided ablation, we will help you decide when to use each of these "premium" refractive surgery techniques.
Morphology and function of the inner lid margin – History and recent findings
Authors: KNOP E , KNOP N
Published: December 2011

Purpose The eyelid margin is a region that often receives little interest but, in contrast, is of utmost importance for ocular surface health and disease. The posterior lid border is a pre‐requisite for perfect distribution of a thin pre‐ocular tear film that is reformed with every blink.

Methods Own findings on the zonal differentiation of the normal lid margin and observations in pathology are presented in the context of the literature on this region.

Results The lid margin is not a homogenous entity but composed of different sub‐zones which comprise at least the anterior and posterior lid borders as opposed to the free lid margin. The posterior lid border is again subdivided into three zones that are all characterized by a specific epithelial structure. The termination of the cornified epidermis posterior to the orifices of the Meibomian glands (MG) explains hyperkeratinization as the main pathology of the MG. The mucocutaneous junction (MCJ) has a parakeratinized surface that represents the natural stainable line of Marx. The inner aspect of the posterior lid border is covered by the epithelial lip of the lid wiper with conjunctival structure and goblet cells. The line of Marx, proposed as the bottom of the tear meniscus, has occasionally been suggested as the area wiping over the globe but several lines of evidence point to the lid wiper as the contact interface between lid and globe.

Conclusion Better knowledge of the structure and function of the eyelid margin will provide better tools for the understanding of its function, clinical diagnosis and therapy of frequent diseases at the ocular surface, namely dry eye disease. Support DFG KN 317‐11
The relation of lipid layer structure to meibum ‐ Results from a new high resolution microscope
Authors: KING‐SMITH PE , BRAUN RJ , NICHOLS JJ , NICHOLS KK
Published: December 2011

Purpose Evaporative dry eye is a common disorder, in which the lipid layer of the tear film is a poor barrier to evaporation. We therefore developed a high resolution microscope as an aid in understanding the properties of the lipid layer.

Methods The microscope has a resolution of about 1 um, and uses a stroboscopic light source to prevent blurring from eye movements. Over 10,000 images of a least "fair" quality have been obtained from 375 subjects, including dry eyes and normals.

Results Two characteristics of the images are described here. 1. In some dry eye patients, irregular "islands" and circular "lenses" of lipid are seen within an apparently bare surrounding area. 2. In most images, "droplets" of lipid are observed which may be circular or irregular, and are surrounded by lipid of irregular thickness. Droplets do not appear to change in the inter‐blink interval.

Conclusion 1. Rapid evaporation is to be expected through the bare surface between islands and lenses. This pattern may be due to insufficient surfactant (e.g., polar lipid) to help spread lipid over the aqueous layer. 2. "Droplets" do not seem to be generated in the inter‐blink interval and it is not obvious how they could be generated by blinks, so their origin may be the "fat droplets" which are observed histologically in meibomian glands (Sirigu et al., 1992, IOVS 33, 2284). It is suggested that meibum is an emulsion of these droplets.
CSF pressure and glaucoma: Contra
Authors: GRZYBOWSKI A
Published: December 2011

Purpose The concept that the low cerebrospinal fluid (CSF) pressure might influence optic nerve neuropathy in glaucoma was recently reappraised. This is to discuss the possible relevance of this concept.

Methods Analysis of the previous clinical and experimental studies, including their results and limitations.

Results The pathogenesis of optic nerve neuropathy in glaucoma is multifactorial and not well understood, thus different new concepts appear to explain the heterogeneity and complexity of the disease. The concept arguing that CSF pressure directly influences the intraocular pressure and is linked to the glaucoma pathogenesis has its proponents and opponents. Evidence based discussion is limited, however, by the fact that the only prospective clinical study raised some ethical concerns and have not been verified yet by any other research center. Moreover, the same ethical concerns might restrain the similar studies in future, what make the scientific discussion of the subject difficult.
Trend versus Event analysis in glaucoma progression
Authors: VISWANATHAN A
Published: December 2011

Analysis of visual field series in order to detect and measure progression may be performed either by event analysis or trend analysis. Event analysis constructs a baseline and compares subsequent tests to the baseline. Trend analysis models the behaviour of the whole series, for example by linear regression.This talk will give examples of how each technique has been used in clinical research and will also present evidence from studies comparing the two.
Ocular temperature rise and light scattering development in the lens correlating with exposure time after in vivo exposure to 1090 nm infrared radiation
Authors: YU Z , SCHULMEISTER K , GALICHANIN K , SÖDERBERG P
Published: December 2011

Purpose To investigate the relationship between light scattering development in the lens and ocular temperature rise after in vivo exposure to high intensity 1090 nm radiation with exposure time up to 60 minutes.

Methods 80 six‐weeks‐old albino SD rats were anesthetized and the pupils were bilaterally dilated prior to exposure. The animals were randomly divided into four groups of 20 each. All animals were unilaterally exposed to 3.0 W coherent infrared radiation at 1090 nm with a spot size of 2 mm within the pupil for 10, 18, 33, 60 minutes respectively. During exposure, temperature was recorded at the limbus of exposed eye.7 days after the exposure and both lenses were extracted for light scattering measurements and macroscopic photographing.

Results The maximum temperature increase for exposure time of 10, 18, 33, 60 minutes was 7.0, 6.8, 7.6, 7.4 ºC at the limbus of exposed eye. 7 days after the exposure, in all the groups there was no statistical difference of light scattering in the lenses between exposed and non‐exposed contralateral eyes and no significant lens opacities from the exposed eyes were observed.

Conclusion An irradiance of 96 W/cm2 of 1090 nm projected on the cornea in vivo induces a constant temperature increase of about 7 ºCin the anterior segment of the eye. At a temperature increase of 7ºC in the anterior segment, no light scattering development and opacity formation in the lens occurs one week after exposure, indicating that there is no direct either photochemical or thermal effect in the lens under the conditions of the irradiance less than 96 W/cm2 on the cornea and temperature rise below 7ºC in the anterior segment for at least 1 hour.
Age‐specific changes of the crystalline lens's physical characteristics
Authors: KUDRYAVTSEVA YV , CHUPROV AD
Published: December 2011

Purpose to study changes of a crystalline lens’s physical properties with the years

Methods Patients at the age from 57 to 90. 73 crystalline lens’s nuclei with a cataract of the various maturities, received by a method of the extracapsular extraction were investigated. Before operation we determined relative acoustic density of a crystalline lens by an original technique, also we estimated color of a crystalline lens and weight of a lens’ nucleus.

Results We revealed that brown color of a crystalline lens’s nucleus a little intensify with the years ‐ the correlation factor is equal 0.4 (р <0.05). Average value of relative acoustic density was 0.59 ± 0.01. Average weight of a lens’ nuclei was 98.3 ± 1.0 mg. The average density of a lens’ nuclei was 1312 ± 12 mg m2. It’s revealed that the mature cataract isn’t always rigid: the correlation factor is equal ‐0.4 (р <0.05). If density of a crystalline lens increases, a mechanical hardness increases too– the correlation factor is equal 0.4 (р <0.05). At the same time, a mechanical hardness of a crystalline lens’s nucleus reinforces with the years, factor of correlation is 0.74 (р <0.05). It’s revealed that the age isn't a determining factor in appearance and cataract progressing.

Conclusion Mechanical properties of a crystalline lens depend on change of its chemical compound, at ageing there is a increasing of brown coloring of a crystalline lens and mechanical hardness of a crystalline lens’s nucleus, visual acuity thus can change slightly. Processes of maturing of a cataract and increase in hardness of a crystalline lens are chemically different and go not in parallel each other.
Corneal biomechanical characterization from in‐vitro eye inflation, optical coherence tomography and finite element modeling
Authors: KLING S , PEREZ P , ORTIZ S , MARCOS S
Published: December 2011

Purpose Absolute changes in corneal surface area, volume, apex displacement and limbus deformation during in‐vitro inflation were used to determine biomechanical properties of the corneal tissue

Methods Whole‐globe and corneal button inflation experiments were performed on porcine eyes placed in a temperature and humidity controlled chamber. IOP was increased and decreased (15‐55‐15 mmHg) at 5mmHg steps, each time acquiring a 3‐D imaging with a customized spectral anterior segment OCT imaging system. Raw images were corrected from optical and fan distortion. Limbus and apex were detected and the corneal volume and surface area were calculated. The experimental data served as input to optimize a 2D‐axis‐symmetric, viscoelastic finite‐element‐model (with cornea‐limbus‐sclera geometry) written in ANSYS to retrieve elastic (Young’s modulus) and viscoelastic (Prony and retardation time constants) corneal biomechanical properties.

Results The experimental corneal response upon inflation was well predicted by the FEM simulations. The central cornea deformed more (the apex raised by 60.8 μm at maximum IOP) than the limbal region (factor 3/4 in radial expansion). The limbus expansion caused a flattening of the angle between cornea and sclera. Mean corneal surface was 226 mm2 and changed less than 1% Poisson’s ratio was found to be 0.49 and Young’s modulus 1.24 MPa

Conclusion Measuring and understanding corneal biomechanical parameters is important to predict the outcome of different surgical treatments and could be useful to early detection of several corneal pathologies. Quantitative high resolution OCT imaging in combination with FEM simulation allows to accurately determine meaningful mechanical parameters.
Theoretical basis for estimating the elastic characteristics of individual living human eyes
Authors: STEIN AA , MOISEEVA IN
Published: December 2011

Purpose To develop a method for estimating the effective elastic parameters of an individual eye from the data obtainable in various clinical tests with a static load applied.

Methods Our mathematical model that represents the fibrous coat as a system consisting of a soft elastic shell (cornea) and an elastic element characterized by a single elastic constant (sclera and tissues surrounding it) is used for calculating the mechanical behavior of the eyeball during different loading procedures. The calculations were performed for two types of external mechanical loading corresponding to applanation and impression tonometry, as well as for inflating the eye by liquid. The presence in the model of only two important mechanical constants makes it possible to identify them by comparing the data of different tests and then to find the effective elastic characteristics important in diagnostics.

Results A technique of determining the elastic constants of the model from the standard diagnostic tests is developed. This technique is applied to estimating the average elastic characteristics of the human eyeball in vivo basing on the data available from the literature.

Conclusion Our results form a basis for obtaining in standard clinical tests representative individual mechanical characteristics of the living eye. This makes it possible to calculate effective (integral) elastic parameters needed in processing a specific test from the data obtained from other tests, for example, to estimate the volume rigidity from elastometry data. We can now correctly interpret the term “rigidity”: in different tests it is commonly used for characteristics that may differ substantially.
The effect of cataract on spatial and temporal contrast sensitivity tests in glaucoma
Authors: KLEIN JO , ZLATKOVA M , PIERSCIONEK B , LAURITZEN JS
Published: December 2011

Purpose To investigate the efficacy of spatial and temporal contrast sensitivity (CS) tests for detecting early glaucoma in the presence of cataract

Methods Twenty‐seven early glaucoma patients (mean age 60 ±10.2 years) with early cataractous signs were selected together with twenty‐seven control subjects matched for age and cataract type. Cataracts were graded using the grading scheme of Casser et al (1997). Measurements of grating spatial and temporal CS at 20 HZ in central vision were performed in each group for spatial frequencies (SF) 0.5, 1.5 and 3 c/d with and without glare. Visual acuity, visual fields sensitivity measurements and structural tests using Heidelberg Retina Tomograph (HRT) were also performed.

Results Overall reduction in both spatial and temporal CS at all SF was found for glaucoma patients compared with cataract patients with a significant mean difference of 0.2 log units (p < 0.01). This difference correlated well with measurements of visual fields or and HRT parameters. The effect of the glare on CS was significant (p < 0.01) and was similar for both groups. A significant correlation (p< 0.05) was found between the glare factor and the glaucomatous damage assessed by HRT.

Conclusion Our results indicate that both spatial and temporal CS tests can distinguish glaucomatous vision loss from vision loss resulting from cataracts, the temporal test providing better separation at higher SF. The CS reduction due to the presence of glare increased with the glaucomatous damage, suggesting that there maybe an increase in intraocular straylight in glaucoma. References: 1.Casser L, Fingeret M, and Woodcome T. Atlas of Primary Eyecare Procedures, ed 2, 1997