bluuebunny/crossref_metadata_2025 huggingface dataset:
Idebenone prevents retinal pigmentepithelial cells from oxidative stress and apoptotic cell death by stabilizing BAX/Bcl‐2 ratio
Authors: AREND N , LAUBICHLER P , WOLF A , HARITOGLOU C , ULBIG MW , KAMPIK A , KERNT M
Published: December 2011

Purpose Age related macular degeneration is one of the leading causes of blindness. Oxidative stress plays an important role in the pathogenesis of this disease. This study investigates the possible anti‐apoptotic and cytoprotective effects of idebenone on retinal pigmentepithelial cells (ARPE19) under oxidative stress.

Methods ARPE19 were treated with 1 to 100 µM idebenone. Cell viability (tetrazolium dye‐reduction assay and live‐dead assay) and expression of BAX and Bcl‐2, two key modulators of apoptosis, and their mRNA were determined after 48 h and after H2O2 treatment.

Results Idebenone concentrations from 1 to 20 µM showed no toxic effects ARPE19. Doses of 5 and 7.5 µM were most effective in increasing cell viability after H2O2 treatment. Further more RT‐PCR and Western blot analysis yielded an increased expression of Bcl‐2 and a decrease of BAX compared to those cells that were treated with H2O2 only.

Conclusion In this study idebenone reduced oxidative stress and apoptotic cell death in cultured ARPE19 in vitro. Our results suggest that idebenone may help to protect these cells in vivo, and therefore might be helpful in preventing the progression of geographic atrophy in age related macular degeneration.
Definition, clinical aspects and new imaging of small melanocytic lesions of the choroid
Authors: CASSOUX N
Published: December 2011

Abstract not provided
Genetic findings in small melanocytic lesions
Authors: COUPLAND SE , DAMATO BE
Published: December 2011

Purpose The management of patients with small melanocytic choroidal tumour is controversial. The aim of this presentation is to inform the current debate on patient care by reporting on histological grade of malignancy and genetic type of such tumours.

Methods We reviewed our database and selected patients with: a melanocytic tumour having dimensions conforming to the TNM size category 1 (i.e., ‘small’); tumour involving choroid; and clinical and/or histological features of malignancy. Patients with such a ‘small choroidal melanoma’ were excluded if not resident in the British Isles, if the tumour was not treated at our centre between 1993 and 2010 or if they had bilateral uveal melanoma.

Results 3132 patients with a choroidal melanoma were identified, of which 1001 (32.2%) were ‘small’. Chromosome 3 status was known in 102 of such small choroidal melanomas. Chromosome 3 loss was detected in 40% of these. Approximately 63% of tumours with chromosome 3 loss showed chromosome 8q gain (cf. 85% of tumours of TNM size category 4). Approximately 70% (i.e., 16 tumours) of small choroidal melanomas with both these genetic abnormalities also showed epithelioid cells. Metastatic death occurred in 4 patients, all of whom had a tumour with chromosome 3 loss, chromosome 8q gain and epithelioid cells.

Conclusion Our data suggest that uveal melanomas show ‘crescendo malignancy’ with cumulative genetic abnormalities ultimately resulting in a lethal ‘double‐hit’ of chromosome 3 loss and chromosome 8q gain. We hypothesize that treatment of small choroidal melanomas showing either chromosome 3 loss or chromosome 8q gain prevents such a lethal double hit and hence the onset of metastatic spread. Delayed treatment of small choroidal melanomas may therefore be dangerous. Prognostication is greatly enhanced by multivariate analysis combining TNM staging with histological grading and genetic typing also taking account of the patient’s age and sex. There would seem to be scope for greater use of biopsy so as to provide better counselling of patients and plans for systemic screening and other aspects of care.
Metastasis from small melanocytic lesions: OOG experience and review of the literature
Authors: KIVELÄ T
Published: December 2011

Abstract not provided
Practical management of small melanocytic lesions
Authors: ZOGRAFOS L
Published: December 2011

Purpose To present the spectrum of various therapeutic options in the practical management of small melanocytic tumors

Methods The therapeutic decision is influenced by: • The cumulative risk factors. • The presence or absence of documented tumor growth. • The localisation and the volume of the tumor. • The personal data of the patient. • The expected functional results following a conservative management.

Results The predictions established by the statistical evaluation of the various risk factors, in the majority of the cases are confirmed by the therapeutic outcome. However, an unpredictable evolution which may occur in selected cases has to be taken in account in global therapeutic strategies which are used for the management of small melanocytic tumors.

Conclusion Successful management of small melanocytic tumors depends on a correct interpretation of risk factors and careful observation of all individual cases.
Practical management of small melanocytic lesions
Authors: DAMATO BE , HEIMANN H
Published: December 2011

Purpose The purpose of this presentation is to describe the authors' current approach to the treatment of small melanocytic uveal tumours of indeterminate malignancy.

Methods The tumours are assessed by binocular ophthalmoscopy, ultrasonography, ocular coherence tomography and autofluorescence imaging, according to the location of the tumour. Patients are advised on the likelihood of malignancy and the risk of metastasis. They are given the choice between observation, treatment and biopsy.

Results In most patients it is possible to distinguish small melanoma from large naevus. When the diagnosis remains uncertain, the management is decided by the size and location of the tumour, the chances of visual loss following treatment and the patient's attitude to risk.

Conclusion The practical management of small melanocytic tumours is based on the size and location of the tumour and the patient's fears and wishes.
Practical management of small melanocytic lesions
Authors: DESJARDINS L
Published: December 2011

Purpose In 2009 we have performed a retrospective study of 368 small uveal melanoma ( diameter less than 12 thickness less than 3 mm) Overall survival at 5 years was 92%and at 10 years 78% survival without metastasis at 5 years was 96% and at 10 years 93%. According to our data the smallest tumor associated with metastatic death was 5mm in diameter and 1,5 mm in thickness and 14 of the tumors had a diameter of less than 10 mm developed. Half of the metastatic patients developed metastasis 5 years or more after treatment.

Methods According to the study performed by Gass and Shields the risk factors for growth of small melanocytic lesions are the presence of symptoms, subretinal fluid,proximity of ON , orange pigment , thickness of more than 2mm and diameter of more than 7 mm. Performing genetic test on small melanocytic lesions is not always usefull , as it has been shown that a good prognosis lesion can grow and change in a bad prognosis.

Results Ophthalmologists are always trying to preserve vision as a rule. Nevertheless with possibly malignant lesions, the metastatic risk has to be considered before a therapeutic approach is decided. Factors like age of the patient, number of risk factors for growth and location of the tumor should be taken in account. Thus the practician should advise the patient and discuss and explain the decision.

Conclusion We usually recommend treatment if there are at least two risk factors and if the patient is young and the lesion away from the posterior pole.In all different situations we usually recommend close follow up for suspicious lesions and treatment in case of documented growth.
Long – term results of intravitreal bevacizumab (Avastin) injection for choroidal neovascularisation secondary to angioid streaks
Authors: LEVINAITE G , CIMBALAS A , SVALBONAITE E , ASOKLIS R
Published: December 2011

Purpose To evaluate the efficacy of long term intravitreal bevacizumab (Avastin) treatment for choroidal neovascularisation (CNV) associated with angioid streaks.

Methods 65 year old woman with bilateral active CNV secondary to angioid streaks was treated since October 2006. Photodynamic therapy (PDT) was used for primary treatment, after – intravitreal bevacizumab (1,25mg) was injected 20 times in each eye, average 1,4 months interval was between each session. Treatment efficacy assesment based on VA (visual acuity) (Snellen chart), fluorescence angiography (FA) and optical coherence tomography (OCT) was performed pre‐ and post‐ treatment before and after each injection.

Results The follow‐up of the patient lasts for 55 months. BCVA (best corrected visual acuity) of both eyes before treatment was 0,6. The patient received 3 PDT with verteporfin (Visudyne) into left eye and later 40 intravitreal bevacizumab injections (20 into each eye) for 41 months. During the whole follow‐up BCVA of the right eye decreased from 0,6 to 0,3 and left eye improved from 0,6 to 0,8. The CNV size remains stabile, low activity of FA was observed in both eyes. Central retinal thickness (CRT) decreased from 351 µm to 324 µm in the right eye and from 191 µm to 166 µm in the left eye. At the last follow‐up on FA no further leakage was observed. No injection‐related complications or drug‐related side effects were observed.

Conclusion CNV associated with angioid streaks can respond to treatment with PDT and bevacizumab. CRT reduced and stabilisation of visual acuity was achieved.
From lab to limbus and back to the lab!
Authors: AHMADI‐LARI S
Published: December 2011

Abstract not provided
Association between retinal vessel diameters and different types of diet
Authors: DROBNJAK D , VEIBY N , KESSEL L , JORGENSEN T , TOFT U , LARSEN M
Published: December 2011

Purpose To study the relationship between retinal vessel diameters and different types of diet.

Methods The Inter99 study comprised an age‐ and sex‐stratified sample of 13,016 participants residing in 11 suburban municipalities of the south‐western part of Copenhagen County. Of 6784 subjects aged 30‐60 years who volunteered to participate in the main study, a subgroup of 970 subjects participated in the eye study. We investigated the relation between fundus photographic retinal vessel diameters and different types of diet (represented in scales, range 1‐9) as a risk factor for cardiovascular disease and diabetes. Vessel diameters were expressed as central retinal artery equivalent diameter (CRAE), central retinal vein equivalent diameter (CRVE), and artery‐to‐vein diameter ratio (AVR). Data were analysed using multiple regression analysis.

Results A significant association was found between CRAE and different types of diet (p=0.026), and between CRVE and different types of diet (p=0.001). After adjusting for age and blood pressure, which influence retinal vessel diameters, significant association between CRVE and different type of diet persisted, which was not the case in association between CRAE and different type of diet (p=0.234).

Conclusion In the Inter99 study, retinal vessel diameters are associated with risk factors for cardiovascular disease and diabetes, such are different types of diet.
Clinical manifestations of reticular pseudodrusen in Korean patients
Authors: KIM SM , LEE MY , HAM DI
Published: December 2011

Purpose To clarify the clinical characteristics of reticular pseudodrusen(RPD) in Korean patients.

Methods The study was designed as retrospective, observational, consecutive case series. A total of 255 eyes of 130 patients diagnosed with RPD were evaluated. RPD were diagnosed by characteristic fundus findings, using multimodal imaging tests. Age related macular degeneration(AMD) was determined by the International Classification and Grading System.

Results The mean age of the patients was 72.6±9.0 years(range, 43‐92). Most of the RPD patients had the disease in both eyes(97.7%), with a female preponderance(86.2%). All of the 3 patients with unilateral RPD had shown neovascular AMD in the eye without RPD. AMD was found in 183 eyes(71.8%); early AMD in 115 eyes(45.1%), geographic atrophy(GA) in 41 eyes(16.1%), and neovasuclar AMD in 27 eyes(10.6%). The mean age was 73.7±9.2 years(range, 58‐92) in the RPD group and 69.9±11.7 years(range, 43‐90) in the control group repectively, and there was a statistically significant difference between these two groups(p<0.05). Classic choroidal neovascularization (CNV) was found in 13 eyes (48.1%), and occult CNV was found in 14 eyes (51.9%) in the neovascular AMD group.

Conclusion Clinical manifestation of RPD in Koreans did not differ significantly from those described in Caucasians. However, our study demonstrated a higher rate of bilaterality, lower prevalence of AMD, and higher prevalence of GA in RPD patients than those previously reported. Ethnical differences may be associated with these findings and further studies are required.
Correlation between exudative age‐related macular degeneration and pseudoexfoliation syndrome
Authors: SIRTAUTIENE R , ASOKLIS R , LIUTVINAITE R , BABRAUSKAITE E
Published: December 2011

Purpose To evaluate the correlation between exudative age related macular degeneration (AMD) and pseudoexfoliation syndrome (PEX) in patients receiving Bevacizumab therapy for AMD.

Methods Consecutive 200 patients with exudative AMD treated with Bevacizumab at Vilnius University Hospital between December 2010 and March 2011 were included into the study. Each patient’s data was recorded only once. Those with retinal occlusive disease were excluded. The results were statistically analysed by SPSS 19.0 program.

Results 135 (67.5%) females and 65 (32.5%) males were studied. The mean age was 73.9 (SD=0.6) years. The difference between the mean age of female and male patients was statistically not different (74 and 73.3 years respectively). The prevalence of PEX in the treated as well as in the controlateral eye was 15.5% (31 patients), binocular PEX was in 32% of the eyes, in all there were 15.0% eyes with PEX. There was no statistically significant correlation between the type of AMD and frequency of PEX, but the frequency of PEX in eyes with AMD was twice larger than in controlateral eyes without AMD: Odds ratio was 1.96 (95% CI: 0.4‐8.6). No correlation was found between sex, AMD type and PEX.

Conclusion In our study exudative AMD was found more often in female patients. PEX was found more often in eyes with AMD. No statistically significant differences between frequency of PEX and type of AMD were found. Further studies are necessary to achieve statistically significant results.
Subtenon injection of natural leucocytic interferon‐α for treatment of diabetic macular edema
Authors: CELLINI M , STROBBE E , BALDUCCI N , CAMPOS E
Published: December 2011

Purpose To report the effect of subtenon injection of natural leucocytic interferon‐α (IFN‐α) on visual acuity (VA) and macular thickness (MT) in diabetic macular edema (DME).

Methods 3 patients affected by diabetic macular edema refractory to intravitreal injection of bevacizumab received a complete ophthalmic examination including best‐corrected visual acuity (BCVA )and spectral domain ocular coherence tomography (SD‐OCT) before and after 1 week, 1 month and 4 months of a cycle of 3 parabulbar subtenonian injections in a week of IFN‐α (1x106 UL/ml, Alfaferone, AlfaWassermann).

Results BCVA and MT significantly improved after a week in patient 2 (male, age 66): 20/50 vs 20/30 and 498μm vs 237μm. The result was stable during the third and fourth visits (299μm and 254 μm). BCVA and MT improved after a week in patient 1 (male, age 64): 20/40 vs 20/32 and 467μm vs 244μm, respectively; BCVA was stable during the follow up period, but MT increased significantly (610 μm and 603μm during the third and fourth visits). BCVA improved in patient 3 (female, age 75) after one week (20/50 vs 20/32) and was stable during the follow up period, but she had only a little improvement in MT (533μm, 483μm, 498μm and 493μm during the 4 visits).

Conclusion BCVA improved in all the patients, and was stable after 4 months. MT greatly improved in two patients after 1 week but only in one patient was the result stable. IFN‐α, with its immunomodulatory, antiproliferative and antiangiogenic actions, was effective in improving VA and reducing macular thickness in DME. Randomized controlled studies will be useful to understand how long the effect of IFN‐α lasts, how many injections are needed and which patients might have the best results.
Increased IL‐6 levels in the vitreous of proliferative diabetic retinopathy (PDR)
Authors: ARJAMAA O , PÖLLÖNEN M
Published: December 2011

Purpose To assess the activity of HIF‐1alpha and NF‐kappaB transcription factors and inflammation markers (IL‐6 and IL‐8) in the vitreous of patients suffering from proliferative diabetic retinopathy.

Methods Twenty seven patients were enrolled for the study. The severity of retinopathy was classified (0, 1, 2, 3, 4) and the activity of neovascularization was graded (0, 1, 2, 3, 4) intraoperatively. Samples were collected during surgery and the NF‐κB and HIF‐1alpha and transcription factors activity and expression levels of IL‐6 and IL‐8 were measured.

Results The majority of samples fell into the retinopathy classes 3 (n=12) or 4 (n=13). Neither the level of IL‐6 increased from 68.9 + 46.8 pg/ml to 102.7 + 94.1 pg/ml and IL‐8 from 165.1 + 136.0 pg/ml to 521.0 + 870.9 pg/ml (mean + SD, non‐significant change: normality test followed with Mann‐Whitney Rank Sum Test). According to the neovascularization activity the samples fell into the grades 1 (n=7), 2 (n=12) or 3 (n=7). In IL‐6 there was a statistically significant increase (p<0.05) from grade 2 to 3: 58.6 + 40.3 pg/ml and 158.4 + 102.5 pg/ml, respectively (Kruskal‐Wallis One Way ANOVA on Ranks followed with Dunn’s Method). The level of IL‐8 was in grade 1: 118.0 + 62,4 pg/ml, in grade 2: 192.3 + 127.1 pg/ml and in grade 3: 884.3 + 1161.0 pg/ml (statistically non‐significant change). There was a statistically significant Linear Regression between IL‐6 and IL‐8 (P <0.001): IL‐6 = 51.88 pg/ml + (0.092 * IL‐8), r=0.772. Increased activity of the HIF‐1alpha and NF‐κB transcription factors were not observed.

Conclusion IL‐6 is a candidate to indicate activity of neovascularization process in PDR. It might be a new molecular therapeutic target to regulate innate immunity response in vitreous.
Diabetic retinopathy screening with computational support
Authors: CSUTAK A , ANTAL B , LAZAR I , PETO T , TOROK Z , BIRO A , HAJDU A
Published: December 2011

Purpose Diabetic retinopathy (DR) is among the most common causes of blindness in the developed world. Since many patients retain normal vision and may experience only minimal reduction despite the presence of a severe, sight‐threatening disease, screening and early detection of DR is highly recommended. Our purpose was to develop an automated DR screening system to gain computational support for high throughput screening activities.

Methods Detection of microaneurysms (MA) ‐ the most important indicators and the earliest signs of DR ‐ and of other lesions (exudates, vascular structures, etc.) have been assembled in an ensemble‐learning based framework, which has been tested on 1200 images of the Messidor database.

Results Images were classified as having DR or non by the MA detector only with 95% sensitivity, 51% specificity and 76% accuracy. By including other lesions, our system reached 89% sensitivity, 82% specificity and 85% accuracy.

Conclusion Our system has sensitivity/specificity values for the MA step comparable to or better then other automated systems available, as tested in the Retinopathy Online Challenge, where it is currently ranked as first. MA detection remains a key component in automated DR screening, but detection of other DR lesions can lead to further improvement. This work was supported in part by NKTH, TECH08‐2, Hungary DRSCREEN project and the NIHR BMRC in Ophthalmology (TP).
Changes in the retinal vessel diameter, retinal nerve fiver layer thickness, and optic disc after vitrectomy
Authors: LEE SU , KIM SJ , LEE JE , KIM SY , LEE SJ
Published: December 2011

Purpose To investigate the retinal vascular caliber, retinal nerve fiver layer thickness, and optic disc changes in patients after pars plana vitrectomy.

Methods We examined 40 eyes in 40 patients who had undergone unilateral pars plana vitrectomy at before and 3 months, 6 months after operation. The diameters of central retinal arteries and veins were measured on retinal photographs. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated using the revised Parr‐Hubbard formula. Retinal nerve fiver layer thickness was obtained using Stratus optical coherence tomography. Cup‐to‐disc vertical ratios of optic disc was evaluated using stereo optic disc photo

Results There were no significant differences between both eyes before operation. Cup‐to‐disc vertical ratios of optic disc significantly increased for 3 months and 6 months post‐operatively (p<0.01, p<0.01) and there was significant difference between operation eye and fellow eye at the same period (p<0.01, p<0.01). The changes of CRAE and CRVE in operation eye were significantly larger than fellow eye at 6 months post‐operatively (p<0.01, p<0.01). The retinal nerve fiver layer thickness showed no significant changes.

Conclusion Whereas no retinal nerve fiver layer thickness decrease was observed, vitrectomy induced changes in Cup‐to‐disc vertical ratios of optic disc and retinal vessel diameter for significant periods following surgery.
Aspirin is not a risk factor of haemorrhagic complications during or after surgery of primary rhegmatogenous retinal detachment
Authors: ZARATZIAN BRILLAT ZB , ALBALADEJO A , ROMANET R , CHIQUET C
Published: December 2011

Purpose To evaluate the hemorrhagic risk of treatment by acetylsalicylic acid, during the management of primary rhegmatogenous retinal detachment(RD).

Methods This comparative prospective case control study included a cohort of 322 patients from a prospective cohort of 835 patients with primary rhegmatogenous RD. After exclusion of patients with RD secondary,74 patients were included in the hemorrhagic group and patients without hemorrhagic complications were randomly selected in order to reach a 1:3 case (control population, n=248). Univariate and multivariate analyses were performed to identify risk factors of perioperative bleeding.

Results Univariate analysis showed that the presence of initial vitreous hemorrhage, size of breaks, number of breaks, pars plana vitrectomy (PPV) and the number of cryotherapy impacts were significantly associated with perioperative bleeding. Independent risk factors of perioperative hemorrhage were the number of cryotherapy sessions (odds ratio =1.12 [1.06; 1.20], 95% CI), transscleral drainage (OR =4.22 [1.62; 10.98]), and PPV (OR =3.39 [1.36; 8.47]). The occurrence of bleeding complications was associated with a lower single‐operation anatomical success rate. There was also a trend toward an association between bleeding complications, the total number of RD recurrences, and final visual acuity.

Conclusion Aspirin was not an independent risk factor of hemorrhagic complications during and after surgery of primary rhegmatogenous RD. The bleeding risk is instead associated with surgical factors such as PPV, cryotherapy, and subretinal fluid drainage.
OCT as sensitive indicator of geometric fundus deformities
Authors: KRASTEL H , BEUTELSPACHER SC , STEINMETZ PH , DRINGS A , ZAHN TH , JONAS JB
Published: December 2011

Purpose To emphasize the contribution of optical coherence tomography in detecting geometric fundus deformities

Methods Seven cases of geometric fundus deformities are evaluated retrospectively with regard to OCT (Heidelberg Spectralis), B‐scan ultrasound, fundus imaging, direct ophthalmoscopy and functional examinations, among them acuity, color vision and various perimetric techniques.

Results Patients were referred to our hospital because of unexplained reduction in visual acuity or loss within their visual fields, or were identified as being affected from geometric fundus deformity on routine exam. OCT provided the first‐at‐hand finding leading towards the explanation of abnormal visual function, or was the first to point incidentally to a geometric fundus deformity. Ophthalmoscopy (incl. an estimate of paraxial optic path length) and fundus imaging ranked next, whereas B scan ultrasound provided affirmative data. Among functions, visual fields were more often affected than acuity. There were no defects in color vision.

Conclusion OCT profiles of the posterior pole of the eye provide a sensitive indicator of geometric fundus deformities, thus leading to an understanding of otherwise unexplained defects of visual function.
Reproducibility and differences between cirrus and spectralis fourier‐domain OCT in epiretinal membranes
Authors: PINILLA I , GARCIA‐MARTIN E , IDOIPE M , PEREZ‐GARCIA D , JIMENEZ B , RAMIRO P , PEIRO C , ASCASO J , ABECIA E
Published: December 2011

Purpose To evaluate the ability of Fourier‐domain (FD) OCT to detect retinal alterations in epiretinal membrane (ERM) eyes. To test the intra‐session reproducibility of macular thickness measurements in ERM and healthy subjects using Cirrus and Spectralis OCT.

Methods Two hundred and nine of 209 subjects (87 ERM patients and 122 healthy subjects) underwent three macular scans by the same experienced examiner using Cirrus and Spectralis OCT . Differences between healthy and ERM eyes were studied. The relationship between average thicknesses with both instruments was evaluated. Repeatability was studied by intra‐class correlation coefficients and coefficients of variation (COV) for the nine areas corresponding to the ETDRS.

Results Macular thickness increase was detected in ERM eyes for all OCT parameters (p<0.05). Macular average thickness was 338.45 and 431.99 µm in ERM eyes using Cirrus and Spectralis, respectively. Changes in the morphology of the retinal layers were detected using both OCTs. Macular average thickness in ERM eyes as determined by both OCTs was correlated (r= 0.678; p<0.001), but differences were statistically significant (p=0.044). In ERM eyes, measurements showed a mean COV of 2.96% using Cirrus, 2.21% using Spectralis and 0.99% using Spectralis progression feature. Intra‐class correlation coefficients were higher than 0.919.

Conclusion Significant differences exist in macular thickness measurements between Cirrus and Spectralis despite the high correlation of measurements between the two instruments. Fourier‐domain OCT can be considered a valid device to detect alterations in ERM patients.
Reproducibility of retinal thikness measurements in patients with age‐related macular degeneration using fourier –domain optical coherence tomography
Authors: RAMIRO P , PINILLA I , CABEZON L , PEREZ D , IBANEZ J , MATEO A , CRISTOBAL JA
Published: December 2011

Purpose To assess the reproducibility intraoperative macular thickness measurements using optical coherence tomography, spectral domain (spectralis, Heidelberg Engineering, Germany) in patients with wet AMD and to evaluate differences in reproducibility with optical coherence tomography (Stratus, Carl Zeiss Meditect Inc, USA).

Methods prospective observational study and cross‐sectional study included 30 eyes of 30 patients with exudative AMD. All of them were dealt with macular status by fast‐track protocol posterior pole with spectral domain OCT (Spectralis OCT) and time domain OCT (Stratus OCT). Each patient underwent 3 consecutive scans each of the scanners and performed by the same observer to compare the reproducibility of both devices. We evaluated the central macular thickness in macular different areas described in the ETDRS (Early Treatment Diabetic Retinopathy Study).Statistics was performed descriptive analysis of variance and calculated the intraclass coefficient of correlation (ICC) and coefficients of variation

Results The thickness of the retina was highly reproducible for all ETDRS areas with OCT Spectralis with values of ICC and VOC better than the Stratus OCT. VOCs spectralis were obtained with less than 5% indicating a high reproducibility and the ICC greater than 0.9.

Conclusion Reproducibility of retinal thickness measurements with optical coherence tomography spectral domain is almost perfect, there are few differences in intraobserver assessments. The values ​​are higher than getting with time‐domain OCT .Fourier domain OCT is a valid and highly reliable device for diagnosis and monitoring of retinal diseases such as wet AMD.
Presence of contracting cellular elements at the border of stage III and IV macular holes
Authors: MENDRINOS E , BOCHATON‐PIALLAT ML , GILODI N , TSILIMBARIS MK , POURNARAS CJ
Published: December 2011

Purpose Myofibroblasts play a major role in the production of retractile phenomena causing contraction or shrinkage of the epiretinal membranes (ERM) in proliferative vitreoretinopathy, diabetic retinopathy or idiopathic macular epiretinal membranes. The presence of a‐smooth muscle actin (a‐SMA)‐positive myofibroblasts and of ED‐A fibronectin (FN), one of the main inducers of myofibroblastic differentiation was studied in internal limiting membranes (ILM) removed during macular hole surgery.

Methods Samples of ILMs following macular hole surgery in 9 eyes were collected. Double immunofluorescence staining with antibodies recognizing a‐SMA and ED‐A FN followed by confocal microscopy analysis as well as electronic microscopy were performed.

Results a‐SMA and ED‐A FN were detected in ILM removed in stage III and IV macular holes. ED‐A FN was expressed in close relation with a‐SMA‐positive myofibroblasts predominately located close to the border of the macular hole area. Distally to the hole area the ILM specimens were a‐SMA and ED‐A FN negative. No a‐SMA staining was observed in ILM specimens of stage II macular hole specimens.

Conclusion Scanning electron microscopy indicated that cellular migration was not apparent around the macular hole in the early stage of the development of this pathology.Cellular elements expressing contractile properties related to a‐SMA, typical of myofibroblasts differentiation, appear to be present at late stage macular holes.
Road to fulfillment (not perdition): taming immune response to restore vision
Authors: DICK A
Published: December 2011

Understanding immune regulation that maintains retinal function whilst interrogating immune responses during retinal inflammation has illuminated avenues to harness for future therapy of many disorders including uveitis and neovascular age‐related macular degeneration. The retina is endowed with a network of a continual turnover of myeloid derived cells. The default response is to regulate inflammation, however during inflammation the over burdening infiltration of activated T cells or macrophages generates damage and homeostasis is difficult to refirm. By harnessing approaches of suppressing infiltration via inhibiting trafficking of cells into the tissue, or inhibiting activation of cell infiltrate and then restoring homeostasis via recapitulating natural mechanisms of control will prevent damage, facilitate healing and regeneration and maintain immunoregulation.

Commercial interest
Late‐Onset Diffuse Lamellar Keratitis associated with cataract phacoemulsification
Authors: PRIETO CALVO E , IDOIPE CORTA M , EGEA ESTOPINAN C , SANCHEZ PEREZ A
Published: December 2011

Purpose Diffuse lamellar keratitis (DLK) is characterized by the presence of a diffuse inflammatory infiltrate localized at the laser in situ keratomileusis interface, with a non‐infectious etiology. Most cases of DLK occur within the first week following surgery but late‐onset DLK has been associated with inflammatory conditions such as iritis, viral keratoconjunctivitis or interstitial keratitis; and it can occur even years after LASIK.

Methods Prospective, interventional, single case report. A 67‐year‐old male patient, who had undergone bilateral LASIK 13 years earlier, developed an episode of DLK on the third day of the postoperative‐cataract surgery on his left eye (LE). Slit‐lamp biomicroscopy and optical coherence tomography (anterior segment mode) were performed to demonstrate the presence of highly‐reflective multifocal infiltrates and the absence of fluid at the flap interface. The patient was treated with intensive topical corticosteroids.

Results Treatment with topical 1.0% prednisolone acetate was instituted and continued for months, with improvement in patient symptoms and visual acuity.

Conclusion This is a case of DLK with an extremely delayed onset, which emphasizes the importance of following‐up of these patients not only in the early postoperative period.
Topical treatment with 0.05% cyclosporine for subepithelial infiltrates secondary to adenoviral keratoconjunctivitis
Authors: KONTADAKIS G , PLAKA A , LIMNOPOULOU A , DIAKONIS V , KYMIONIS G
Published: December 2011

Purpose To evaluate the treatment with topical 0,05% cyclosporine A (CsA) in patients with subepithelial corneal infiltrates secondary to adenoviral keratoconjunctivitis.

Methods 4 patients (8 eyes) before and after treatment with CsA 0.05% eyedrops twice daily were prospectively examined. All patients had been treated with topical corticosteroids previously without improvement. The objective data recorded included best‐corrected decimal visual acuity, intraocular pressure and evaluation of severity of SEIs (improved, stable, or worse).

Results 1 male and 3 females, mean age of 45 +/‐ 10 years, were included. Mean follow‐up on CsA was 12 months +/‐ 4 months. The mean best‐corrected decimal visual acuity before and after treatment was 0.8 +/‐ 0.25 and 1.0 +/‐ 0.28, respectively. 3 patients showed clinical improvement, and 1 was stable during the treatment period. Patients reported reduction in the severity of symptoms before and after the treatment. Most of the patients reported no foreign body sensation, glare, or other side effects with topical CsA treatment. Overall, patients noted an improvement in vision and satisfaction with CsA treatment.

Conclusion Topical CsA 0.05% is a safe and effective alternative treatment in patients with SEIs who do not respond to other treatment modalities or have unwanted side effects from topical steroids.
Corneal biomechanical properties in myopic LASIK
Authors: DEL BUEY MA , LAVILLA L , CRISTOBAL JA , LANCHARES E , MATEO J , ASCASO FJ , RODRIGUEZ A , PEIRO C , MATEO A , RUIZ DE GOPEGUI E
Published: December 2011

Purpose Describe and quantify the effect of myopic LASIK on corneal biomechanics considering the preoperative hysteresis

Methods In 126 eyes with myopia and myopic astigmatism the Ocular Response Analyzer (ORA) was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldman‐correlated intraocular pressure (IOPg), and corneal‐compensated IOP (IOPcc) before and 3 months after LASIK. We divided the sample into three groups based on the values of CH (mmHg) preoperative: G1 (30 eyes) CH 7.5‐9.5, G2 (66 eyes) 9.5‐11.5, G3 (30 eyes) >11.5.

Results After LASIK, there was a reduction in mean CH (ΔCH; G1:0.98 G2:1.51 G3: 1.81), CRF (ΔCRF; G1:2.35 G2:2.46 G3:2.83), IOPcc (ΔIOPcc; G1: 3.26 G2:1.74 G3: 1.75) and IOPg (ΔIOPg; G1: 5.01 G2:3.92 G3: 4.31) in three groups. However, there was no statistically significant difference between the groups in the percentage change of CH (G1: 13% G2: 14.6% G3: 15%) and CRF (G1: 25% G2: 23% G3: 24%). While the percentage decrease in IOPcc (G1: 18% G2: 10.5% G3: 11.5%) and IOPg (G1: 31% G2: 25% G3: 27%) was statistically different. Was find a significant correlation between ΔCH and ΔCRF with microns of ablation (r =‐ 0.406, r =‐ 0.616) and spherical equivalent (r = 0.405, r =‐ 0.599).

Conclusion LASIK surgery decreases the corneal hysteresis and corneal resistance factor. The percentage decline of corneal hysteresis and corneal resistance factor after LASIK surgery was no different between the three groups based on the preoperative hysteresis. Although there is a correlation between variations of the CH and CRF, with microns of ablation and the refractive error corrected.
Adaptive optics imaging in age‐related macular degeneration
Authors: GOCHO‐NAKASHIMA K , BENCHABOUNE M , ULLERN M , LAMORY B , CHATEAU N , SAHEL JA , PAQUES M
Published: December 2011

Purpose To document cases of drusen and age‐related geographic atrophy(GA) at the microscopic scale using adaptive optics(AO).

Methods Four cases of age‐related drusens, 2 cases of familial drusen and 7 patients of GA underwent en face retinal imaging by AO retinal camera(rtx1, Imagine Eyes, Orsay, France). AO images were confronted to high‐resolution spectral‐domain optical coherence tomography(OCT) and scanning laser ophthalmoscopy(SLO) examinations.

Results In AO images, most drusen appeared as doughnut‐shaped highly reflective zones, and were better delineated than by color fundus photograph. The overlying cone mosaic could be detected over most of them, including their top. Between drusen, the cone photoreceptor mosaic appeared normal. In GA cases, AO images revealed irregular patches of multiple cone‐like bright spots as well as larger dark disks in atrophic areas.

Conclusion AO provided images of microscopic structures in various types of AMD, including GA. Local losses in cone contrast at the drusen slopes confirmed a strong relation between cone visibility and their orientation. There was no evidence of cone loss in association to drusen. In GA patients, our findings suggest that photoreceptors with shortened outer segments may survive within atrophic areas, which may lead to the development of novel therapeutic strategies aimed at restoring the function of surviving cones. These results demonstrate that AO retinal camera can detect isolated residual photoreceptors, and hence that it will be a powerful tool for quantifying spontaneous or therapeutic changes in AMD patients. Supported by ANR through Tecsan Program (project iPhot n° ANR‐09‐TECS‐009)
Peripheral corneal ulceration associated with rheumatoid arthritis
Authors: ALMALIOTIS D , KONIDARIS V , STAMOULAS K , GEORGALA A , KARAMPATAKIS V
Published: December 2011

Purpose To report a case of a patient with rheumatoid arthritis (RA) and associated peripheral corneal ulceration.

Methods A 60 year old woman with RA diagnosed 15 years ago, and under immunosuppressive therapy (IV abatacept 250 mg / month), demonstrated blurring of vision in her right eye. Visual acuity was 6 / 10 in the right eye and 10 / 10 in the left eye. Slitlamp examination revealed a paracentral superior corneal melt in the right eye. Anterior chamber reaction was 2+. Laboratory investigations revealed negative Extractable Nuclear Antigens (ENA) Screen ELISA Test, negative anti‐Sm antibodies, positive serum IgG and IgA reactivities, and IgE and IgM within normal levels. Evaluation for the underlying connective tissue disease revealed highly elevated Rheumatoid Factor and C‐reactive protein (CRP) (955 IU/ml, normal range: 0‐20 IU/ml, and 1.59 mg/dl, normal range: 0‐0.8 respectively). The patient underwent extensive treatment with topical tobramycin and lubricants and oral prednisolone 60 mg/day with tapering doses, and methotrexate p.os. 15 mg / week was added.

Results The condition was improved within a few days after the initiation of prednisolone treatment. Re‐epithelization occurred one week after the onset of the treatment and only punctate fluorescein dye uptake was detected in the margins of the lesion.

Conclusion The effective control of the underlying disease and early diagnosis of the dry eye syndrome in RA patients may prevent serious corneal complications, such as corneal ulceration, which are difficult to treat. The initiation of treatment with steroids and immunosuppresants was found to halt the progression of keratolysis and assist re‐epithelization.
Effects of increased neutrophile count on ET1 – induced changes in erythrocyte and leukocyte movements
Authors: TOLD R , FUCHSJAGER‐MAYRL G , GARHOFER G , SCHMETTERER L
Published: December 2011

Purpose It is known that granulocyte‐colony stimulating factor (G‐CSF) increases white blood cell (WBC) count. There is evidence from other vascular beds that an increase in WBC count impairs blood flow regulation in the microcirculation. Whether this also holds true for the ocular circulation is yet unknown. In the following trial we investigated whether an increase in WBC count alters the endothelin‐1 (ET‐1) induced vasoconstriction.

Methods 24 healthy male subjects entered this randomized, placebo‐controlled, double masked, two‐way cross over study. 300µg G‐CSF or placebo were applied intravenously to increase WBC count on two study days. Thereafter, ET‐1 (5ng/kg/min) was infused for 30 minutes. Ocular hemodynamic variables were measured before and after G‐CSF treatment and during the last 10 minutes of ET‐1 infusion. Measurements of retinal WBC flux were performed with the blue‐field entoptic technique, blood flow (BF) velocity using a laser Doppler velocimeter and retinal vessel diameter using a Retinal Vessel Analyzer.

Results Neither G‐CSF nor ET‐1 had any consistent effect on blood pressure, pulse rate or IOP. G‐CSF induced an increase in retinal WBC density (p<.01). As expected ET‐1 lowered choroidal BF (p<.01), retinal BF (p<.01)and WBC velocity (p=.01). Changes in choroidal BF and WBC velocity in response to ET‐1 were not altered by pre‐treatment with G‐CSF. Contrary, the decrease in retinal BF was more pronounced during leukocytosis (p=.02) as compared to placebo.

Conclusion During vasoconstriction, induced by ET‐1, vascular regulation can be altered by the number of circulating leukocytes. Whether this is caused by an interaction of red and white blood cells or by another mechanism is yet unknown.
A randomized, placebo‐controlled study investigating the effects of moxaverine on ocular blood flow after oral administration in healthy subjects
Authors: LASTA M , SCHMIDL D , BOLTZ A , PALKOVITS S , TOLD R , KAYA S , GARHOFER G , SCHMETTERER L
Published: December 2011

Purpose We know that several eye diseases such as glaucoma, diabetic retinopathy and AMD are associated with ocular perfusion abnormalities. In recent studies we have shown that intravenous administration of moxaverine is capable of increasing ocular blood flow in healthy subjects compared to placebo as well as in elderly people with healthy eyes and in patients with eye diseases associated with hypoperfusion. In the present study we hypothesized that oral moxaverine may increase ocular blood flow.

Methods In this placebo‐controlled, two‐way crossover study 16 healthy subjects received 900 mg moxaverine‐hydrochloride, administrated per os in 3 equal doses, and placebo. Outcome variables were measured at BL and 5 hours after first drug administration. Choroidal and optic nerve head blood flow (ONHBF) were assessed with laser Doppler flowmetry and blood velocities in the retrobulbar vessels were measured with color Doppler imaging.

Results No parameter showed any difference between moxaverine and placebo. The p‐values of ANOVA testing between moxaverine and placebo were as follows: Choroidal blood flow (p=0.52), ONHBF (p=0.54), peak systolic velocity (PSV) in the ophthalmic artery (p=0.33), end diastolic velocity (EDV) in the ophthalmic artery (p=0.58), PSV in the posterior ciliary arteries (p=0.38), EDV in the posterior ciliary arteries (p=0.26), PSV in the central retinal artery (p=0.35), EDV in the central retinal artery (p=0.51).

Conclusion Our results indicate that oral moxaverine, in contrast to systemic moxaverine, does not increase ocular blood flow. This may be related to the relatively low bioavailability of moxaverine after oral administration.
Characterization of retinal blood flow in healthy subjects
Authors: FUCHSJAGER‐MAYRL G , SCHMETTERER L
Published: December 2011

Purpose Here we present by far the largest study in healthy subjects in an effort to characterize the physiology of retinal blood flow.

Methods In the present study 64 healthy subjects aged between 18 and 45 years were included. Bi‐directional laser Doppler velocimetry (Oculix, Arbaz, Switzerland) was used to measure retinal blood velocities. Venous vessel diameters were measured using the Retinal Vessel Analyzer (Imedos, Jena, Germany). Retinal blood flow was calculated by measuring all visible veins entering the optic nerve head. The perfusion values in the 4 quadrants were evaluated. In addition, the correlation between vessel diameters and red blood cell velocities was studied.

Results Total retinal blood flow was 46.2 ± 6.4 µl/min. The range of total retinal blood flow values was very high (29.0 – 70.8 µl/min). Blood flow was highest in the temporal inferior quadrant (17.9 ± 6.1 µl/min), followed by the temporal superior quadrant (12.2 ± 6.0 µl/min), the nasal inferior quadrant (7.3 ± 2.0 µl/min) and the nasal superior quadrant (6.5 ± 2.2 µl/min). In all four quadrants a highly significant linear correlation was found between blood velocities and vessel diameters (r‐values between 0.55 and 0.89). The regression line was, however, considerably steeper in superior than in inferior vessels. Whereas, within the confidence limits, the regression line included the point 0,0 in the velocity‐diameter graph in inferior veins, this was not the case in superior veins.

Conclusion The present data indicate that retinal blood flow shows a wide range in healthy subjects. In addition, differences were seen between the flow characteristics of the vessels in the inferior and the superior parts of the retina. The reason for these differences is hitherto unknown.
Technical principles of optical coherence tomography and basic differences among time‐domain, spectral‐domain and swept‐source OCT
Authors: WYLEGALA E
Published: December 2011

Abstract not provided
Important factors determining reliability and reproducibility of OCT scans; Advantages and disadvantages of commercially available OCT devices
Authors: WYLEGALA E
Published: December 2011

Abstract not provided
Corneal dystrophies and hereditary anterior eye segment disorders
Authors: NOWINSKA A
Published: December 2011

Abstract not provided
Cataract, refractive and glaucoma surgery
Authors: WYLEGALA E
Published: December 2011

Abstract not provided
Risk factors in JIA associated Uveitis
Authors: MACKENSEN F , HEILIGENHAUS A
Published: December 2011

Purpose to show from different studies from the literature (including published and new data from a German population based registry (Heiligenhaus et al Rheumatology 2007)) which are the special traits and risk factors in patients with juvenile idiopathic arthritis (JIA) associated uveitis.

Methods literature review and risk factor analysis. Comparison of different populations. Analysing predictors of longterm outcome.

Results young age of JIA onset, ANA positivity and the oligoarthritis subtype are risk factors for the development of uveitis. Patients with complications at first visit fare worse in terms of visual acuity than those without. Especially cataract development is of concern in this age group prone to amblyopia. Screening intervals of every three months in the first year after arthritis diagnosis may be insufficient. Patients with uveitis that stays active into adulthood frequently showed complications at time of first uveitis detection as cataract, glaucoma and synechiae.

Conclusion Ophthalmological screening is of utmost importance in patients with JIA and should be initiated as early as possible after the diagnosis and repeated regularly, the timing of intervals has to be further investigated. Complications present at first uveitis diagnosis may predict longterm uveitis activity into adulthood.