bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the lamina crivosa thickness and depth, the prelaminar nerve tissue thickness and the Bruch's membrane opening‐based minimum rim width in eyes with and without primary open‐angle glaucoma: an enhanced depth imaging OCT study of the optic nerve head and the correlation between anatomy and function
Authors: Gama I. , Almeida L. , Gonçalves I. , Monteiro‐Grillo M.
Published: September 2015

Purpose

To evaluate the lamina crivosa (LC)thickness (LCT), depth (LCD), prelaminar thickness (PLTT) and Bruch's membrane opening‐based minimum rim width (BMO‐MRW) in primary open‐angle glaucoma (POAG) and normal eyes (NE) and their correlation with function (MD).

Methods

This observational study included 45 eyes (25 eyes with POAG; 20 normal eyes),which were evaluated clinically, by applanation tonometry, pachymetry, Octopus perimetry and by enhanced depth imaging‐optical coeherence tomography (EDI‐OCT). A grid scan of the optic herve head (ONH), averaged 80 scans, to image the LCT, LCD and PLTT in center, mid‐inferior (I‐ONH), and superior positions and a nerve fiber layer (NFL) scan were done. LCT was the distance between borders of the LC. LCD was the distance between BMO reference line‐anterior LC border. BMO‐MRW was the shortest distance between BMO and internal limiting membrane. All values were compared between both groups and correlations between variables were tested.

Results

Global LCT was lower in POAG (132.9 ± 40.1 µm) than in control group (235.9 ± 36.8 µm, p < 0.05). Mean LCD was higher in POAG (572.2 ± 195.2 µm). Mean PLTT was lower in POAG (91.9 ± 49.9 µm, p < 0.05), as occurred with BMOMRW. In all eyes, the global LCT was correlated to NFLT (R = 0.61) and BMOMRW (R = 0.67; p < 0.001). In POAG eyes, global NFL was correlated to BMOMRW (R = 0.67) and the PLTT (R = 0.386). In I‐ONH scan, PLTT was correlated with LCD (R = −0.502) and inferior‐temporal (IT)‐NFLT(R = 0.479, p = 0.015). MD was correlated with PLTT(R = −0.597) and MBOMRW (R = −0.670, p < 0.01).

Conclusions

Glaucoma can cause a decrease in LCT, PLTT, BMOMRW and increase in LCD, being potential markers of glaucomatous damage. Some ONH‐OCT parameters correlated with function, as measured by the MD. ONH EDI‐OCT imaging with automatic segmentation would be useful in glaucoma evaluation.
Efficacity and safety of TOXO KO vaccine to prevent ocular toxoplasmosis in congenital murine model
Authors: Tarfaoui N. , Morisse S. , Lemee G. , Dimier‐Poisson I. , Seche E. , Pisella P.J.
Published: September 2015

Purpose

Toxoplasmosis is a worldwide zoonotic disease caused by the protozoa Toxoplasma gondii and is a major cause of abortions but also of ocular lesions. Thus, ocular toxoplasmosis is a major health issue in certain parts of the world, especially in South America and Africa.

Methods

We have studied the efficacy of a live attenuated strain of T. gondii (i.e. Toxo mic1‐3 KO mutant) as a vaccine against ocular toxoplasmosis in a congenital toxoplasmosis model in mice. Mice were vaccinated with Toxo mic1‐3 KO strain, mated and infected during pregnancy. Nonvaccinated mice infected at mid gestation with T. gondii were used as control. One month after delivery, pups were sacrificed and ocular fundus, cytokine production in intra‐camerular tissue and cysts formation in eye and in brain were analysed.

Results

We have demonstrated that: Retinal T. gondii cysts were detected in 71% of pups born to nonvaccinated dams (2.54 ± 4.10). A significantly smaller number of cysts in retinal tissue was seen in pups born to vaccinated dams 0.56 ± 1.18 (>86% reduction in cysts in ocular tissue). Clinical signs of ocular infection were detected in 73.2% of pups born to non vaccinated dams against 19% of pups born to vaccinated dams.

Conclusions

In conclusion, Toxo mic1‐3 KO is an effective vaccine against ocular toxoplasmosis in a congenital mice model. This strain could be a promizing vaccine.
A pilot study of survey on patient satisfaction and its meaning in an Glaucoma outpatient
Authors: Pourjavan S. , Vanhaecht K.
Published: September 2015

Purpose

To assess the degree of patient satisfaction and its correlation with the subjective satisfactory score of the ophthalmologist.

Outcomes:

The % of satisfied patients.

The correlation between doctor‐patient perception of care.

The impact of the interpersonal chemistry and the mood of care provider.

Methods

A prospective, blind study. A simple and short questionnaire is given to the patients. Patients were asked to fill in the questionnaire including 4 questions with a 1 (lowest) to 5 (highest satisfaction) scores.

The score the “care”?

the ophthalmologist?

Recommend of the outpatient?

Recommend of the specialist?

The ophthalmologist gives her subjective score in three fields:

The quality of consultation (QoC).

The interpersonal “click” with the patient.

Her “mood”

The consented patients will be called for more spontaneous explanation.

Results

Patient's score: 98% gave high scores >3.

Ophthalmologists score: neg. click with 15%, natural: 48% and good click: 36%, her mood was 33% each in 3 scores (bad, natural and hyper), Her objective QoC was 95% high scores.

The click was significantly related with her mood and her mood was significantly related with QoC. The only correlation was between click & the high score on Q3.

On telephonic enquete were good outcome of the surgery, optimal care, location and their “like” for the specialist, important.

Conclusions

All patients had a high satisfaction score & not influenced “Mood” or “QoC”. Upon spontaneously explaining of the patients, the most important factors for their satisfaction were; good operation outcome, optimal care, correct diagnosis but the geographical location (nearby, parking space) and their affection for the specialist were also very important reason for their satisfaction.
Reproducibility of intraocular pressure self‐measurement by ICare Home rebound tonometer and comparison with Goldman applanation tonometer
Authors: Gaillard R. , Fenolland J.R. , Bonnel S. , Rosenberg R. , Marill A.F. , Bostanci K. , Giraud J.M. , Renard J.P.
Published: September 2015

Purpose

To compare the intraocular pressure (IOP) measurements and reproducibility of the new ICare Home® rebound tonometer (RT) with Goldman applanation tonometer.

Methods

36 healthy eyes of 36 patients were enrolled. Three IOP measurements were performed with ICare Home by an ophthalmologist (RT‐O) then by the patient (RT‐P), and with GAT and non‐contact tonometry (AIR). All of the subjects underwent an examination including: slit lamp examination, keratometry, and optical measurements of ocular axial length and central corneal thickness.

Results

Results of mean IOPs were 16.3 ± 4.8 mmHg (RT‐O), 16.2 ± 4.7 mmHg (RT‐P), 15.1 ± 2.6 mmHg (GAT) and 16.0 ± 2.9 mmHg (AIR). There was no statistically difference between the 4 methods with random one‐way ANOVA or repeated measures (P = 0.09) and no difference between each couple of methods after Bonferroni correction for multiple comparisons. Correlation between the tonometers were: r = 87.4% between RT‐O and RT‐P, r = 63.4% between RT‐O and GAT and r = 65.0% between RT‐P and GAT. The intraclass correlation coefficients (ICC) were 0.924 for RT‐O, 0.854 for RT‐P and 0.887 for GAT. Bland Altman plots showed a good agreement between the different methods.

Conclusions

IOP measurements with ICare Home by the patient or the ophthalmologist were well correlated to GAT without statistically significant differences. Reproducibility was good and with a good agreement between the differents methods of measures.
The effect of glucose and insulin on the susceptibility of cultured photoreceptor‐like cells to hypoxia
Authors: Layton C. , De Moraes G.
Published: September 2015

Purpose

Diabetes causes a retinal neuropathy, however whether glucose itself is beneficial to stressed retinal neurons is controversial. This investigation aimed to assess the effect of glucose on the resilience of cultured photoreceptor‐like cells to hypoxia.

Methods

661W cells were cultured in serum free media and 5 mM glucose. Cellular insult and damage after CoCl2 induced hypoxia was measured by caspase 3/7 activation, annexin V binding and propridium iodide marking on flow cytometry and confirmed by immunofluorescence. hif 1α, VEGF expression and akt phosphorylation were assessed with primary conjugated antibodies and flow cytometry.

Results

In 5 mM glucose, hypoxia increased hif 1α activation and led to cell death by both apoptosis and necrosis in a dose dependent manner. Higher glucose levels increased hypoxia induced apoptosis and cell death. Photoreceptor‐like cells expressed the insulin receptor, and the increase in apoptosis associated with 25 mM glucose was blocked by insulin treatment, which increased intracellular levels of phosphorylated akt, decreased VEGF production and decreased caspase 3 activation and Annexin binding. However in increased necrosis resulted in no significant difference in hypoxic cell death compared with 5 mM glucose. These effects of insulin were partially blocked by the PI3K inhibitor wortmannin, but not by PKC inhibition with chelerythrine.

Conclusions

661W photoreceptor‐like cells were less resilient to hypoxia in “diabetic” glucose conditions. Insulin decreased apoptosis to levels equivalent to “non‐diabetic” hypoxic cells, but increased necrosis led to no change in the percentage of dead cells. An insulin induced shift to cell death by necrosis in hypoxic photoreceptors may be one mechanism of the initial exacerbation of diabetic retinopathy with intensive treatment.
Intravitreal chemotherapy in advanced retinoblastoma: results and complications
Authors: Hadjistilianou T. , Borri M. , De Francesco S. , Sparagna C.
Published: September 2015

Purpose

To describe the technique and evaluate the efficacy of intravitreal melphalan in advanced retinoblastoma with focal or diffuse vitreous seeding

Methods

This is a retrospective non‐comparative study. Our analysis was conducted at our referral center of retinoblastoma, Siena, Italy. The study included 19 eyes of 19 patients with naïve, persistent or recurrent vitreous seeding in advanced retinoblastoma. All eyes received intravitreal injection (20 μg) of melphalan under general anaesthesia .Outcome measures included vitreous seeding control and eyeball preservation, treatment complications and drug toxicity

Results

We used concomitant therapy, including systemic chemotherapy, intra‐arterial chemotherapy and peribulbar chemotherapy. All patients are alive without evidence of extraocular dissemination and global salvage was attained in 83% of cases. Complications included central vein thrombosis

Conclusions

This study suggests that intravitreal melphalan injection for naïve, persistent and recurrent vitreous seeding can provide seeding control and avoid enucleation with minimal toxicity and complications.
OCT angiography for the evaluation of macular ischemic micro‐angiopathies
Authors: Pournaras C.J. , Frountzou E. , Donati G.
Published: September 2015

The management of maculopathies related to the retinal vascular micro‐angiopathies, has been significantly improved since the initiation of intravitreal therapeutical approaches. A detailed evaluation of the vascular abnormalities by Optical coherence tomography (OCT) angiography offers an accurate evaluation of the therapeutical indications and their beneficial anatomical effects. OCT angiography has several advantages, such as 3D visualization of retinal and choroidal circulations (including the choriocapillaris). Using this non‐invasive alternative method, ischemia, microaneurysms, intraretinal microvascular abnormalities and the detection of neovascularization can be clearly visualized by a closer observation of each layer of the retinal capillaries. As an alternative to dye‐based angiography, in addition to the 3D tomographic macular imaging, OCT angiography may be clinically useful to evaluate the microvascular status and therapeutic effect of treatments for macular ischemic microangiopathies.
Surgical aspects of toric lens implantation, from perioperative marking to axis re‐adjustment
Authors: Barraquer R.I.
Published: September 2015

Which toric lens model is suitable for my patient? Which marking methods are available, what are the differences and which ones are suitable for toric lenses? How to assure that the lens will be properly implanted (centration, rotation and complication management)? A short overview on latest technology in surgical guidance systems.
Effects of smoking during pregnancy on retinopathy of prematurity
Authors: Rodrigo M.J. , Fernández S. , De la Mata G. , Ara M. , Prieto E. , González‐Viejo I. , Ferrer C. , Pueyo V.
Published: September 2015

Purpose

Background: Tobacco smoking during pregnancy is the first preventable cause of adverse birth outcomes such as vascular and neurodevelopment disturbation.

Aims: To asses how smoking during pregnancy would affect retinal vascularization causing retinopathy of prematurity.

Design: An observational cross‐sectional study.

Methods

Records of preterm newborns (n = 293) and tobacco expossure were reviewed. Retinopathy of prematurity (ROP) grading was evaluated in accordance with the International Classification of Retinopathy of Prematurity. Factors were evaluated using a multivariate logistic regression analysis

Results

Although most children did not develop ROP (74.1%), 10.9% has mild, 9.6% severe and 5.5% aggressive posterior retinopathy. Twenty percent of mothers smoked during pregnancy and 10.2% smoked ≥5 cigarettes per day. Children of smoking mothers showed higher rate of Anterior Progressive ROP (6.9%) than those who were not expossed (5.1%), and as much severe as higher number of cigarettes (10.9% vs 5.1%). However, these results were not statsically significative (p > 0.05).

Conclusions

A tendency to higher severity grades of ROP in connection with heavy tobacco exposure during pregnancy was observed.
Suprachoroidal pocket to collect drugs for treatment of ocular diseases
Authors: Rodrigo M.J. , Prieto E. , Idiope M. , García‐Martin E. , Otin S. , Polo V.
Published: September 2015

Purpose

We present the progressive improvement of a surgical procedure for suprachoroidal (sc) administration of drug, as an alternative route for drug administration to the posterior segment of the eye.

Methods

25 New Zealand albino rabbit eyes were used in the study. Fifty microliters volume of different increasing viscosity formulations were tested: balanced saline solution (BSS), 0.5% sodium hyaluronate solution (SH) and a formulation with patent to be register. Catheters of several gauges (25Gs, 27 Gs and 22 Gs) and different materials: metal cannula or flexible intravenous catheter were tested. Different architecture of the scleral‐sc pocket were assayed: large quadrangular area with sutures, rectangular area with small port without stitch and conic with small entrance without stitch.

Results

Following items were analyzed: (1) Reflux post‐administration: depending on the formulation; BSS and SH 0.5% (100%) versus Formulation (73.33%), on the surgical instrument for administration; 25G and 27G (100%) vs 22G (20%), and on different pocket architecture; quadrangular and rectangular (100%) vs conic pockets (73.33%). (2) Signs of ocular irritation: higher grades of hiperemia and secretion were observed in pockets with stitches (3) Ocular perforation: 1 eye in quadrangular pocket with stitch. (4) Surgical time: longer in sutured pockets.

Conclusions

The possibility of perform a sc pocket with a large conic area, small port and without stitches, permits us to use it as a receptacle for high viscosity formulations or implants for sustained drug delivery, avoiding the risks of intravitreal devices and allowing an easier removal of the implant in case of adverse reactions.
Three dimensional meibography for diagnosis of dry eye syndrome
Authors: Byun Y.S. , Yoo Y.S. , Eom T.J. , Na K.S. , Joo C.K.
Published: September 2015

Purpose

The dysfunction of meibomian glands which secrete components of lipid layer in tears is currently pointed out as one of the main causes occurring dry eye. The distribution of that is more than 70% in Asian, especially. This brought out the importance for the dysfunction of meibomian glands. Our study was aimed to confirm the efficacy of 3D meibography to evaluate the structures of meibomian glands.

Methods

This study is a cross sectional study for patients who had diagnosed as dry eye disease associated with the dysfunction of meibomian glands at Seoul Saint Mary's Hospital from July to October, 2014. To confirm the structure of dry eye patients, 3D images using 3D OCT (optical coherence tomography) and 2D images using infrared camera were obtained. Patients who had the drop‐out lesion in 3D and 2D images were divided as two groups, and differences between them were analyzed. At the same time, to find the clinical signification for structural changes of meibomian glands, all patients had an ocular surface and a tear function examination to define the degree of dry eye.

Results

As compared between 3D and 2D images for dry eye patients who had the drop‐out lesion on meibomian glands, 3D images was more useful for diagnosis of dry eye than 2D, especially in dry eye related with mild meibomian gland disease.

Conclusions

Our study confirmed that the structural change of meibomian glands was reflected in optical coherence tomography 3D images. Especially, 3D meibography was more powerful than 2D infrared camera to find out the real state of drop‐out lesion on meibomian glands. But, there was no statistical significance between the location of drop‐out lesions; such as near lid margin, middle area, near superior conjunctival fornix, and clinical features in these study.
Biomechanical properties of eyes with asymmetrical glaucoma defect
Authors: Cellini M. , Gizzi C. , Finzi A. , Campos E.C.
Published: September 2015

Purpose

To evaluate biomechanical properties in eyes of patients affected by primary open angle glaucoma (POAG) with marked asymmetrical defects by means of Ocular Response Analyzer (ORA) and Spectral Domain OCT with Enhanced Depth Imaging (EDI SD‐OCT) function.

Methods

We studied 20 patients (mean age: 56 ± 12) with asymmetrical POAG. One eye was classified as mild glaucoma (MG) and the sound eye as severe glaucoma (SG) by visual field indexes: MD −4.21 ± 1.51 vs −16.56 ± 5.76 dB; p = 0.011 and PSD 3.54 ± 0.87 vs 10.95 ± 3.51 dB; p = 0.007. An EDI SD‐OCT centered on the optic nerve head and an ORA examination were performed on each eye of every subject before and during a IOP increase of 12.5 ± 2.1 mm/Hg induced by a compression of the globe with an ophthalmodinamometer. Corneal histeresis (CH), corneal resistence factor (CRF) and laminar displacement (LD) were statistically analyzed by Wilcoxon's rank sum test and Spearman's correlation test considering significant a p < 0.05.

Results

After IOP increase we found a decrease of CH: 9.3 ± 3.66 vs 6.92 ± 3.04 mm/Hg; p = 0.012 in SG and 8.62 ± 2.16 vs 7.23 ± 2.29 mm/Hg; p = 0.176 in MG. CRF instead increase: 8.61 ± 2.31 vs 12.38 ± 3.65 mm/Hg; p = 0.016 in SG and 9.02 ± 1.48 vs 12.22 ± 5.68 mm/Hg; p = 0.041 in MG. LD was positive in MD: 29.08 ± 19.28 μm and negative in AG‐ 6.58 ± 16.09 μm. In AG eyes we found a correlation between LD and CRF (r = −0.658; p = 0.019) and between LD and Scleral Rigidity (r = −0.693; p = 0.012).

Conclusions

This study demonstrates that in asymmetrical glaucoma the IOP increase changes the eye biomechanics with stiffening of the eye structures that involves not only the lamina cribrosa but also the corneal tissue.
Automatic method to distinguish manifestation areas of early diabetic retinopathy from image artefacts by using L*u*v* colour space
Authors: Suzuki N. , Yamane K.
Published: September 2015

Purpose

The RGB colour space was converted into seven different colour spaces: XYZ, CMY, HSL, HSV, HSI, L*a*b* and L*u*v*. The L*u*v* colour space presented optimal results, with the highest sensitivity and best reproducibility. We employed three‐dimensional analysis of L*u*v* colour spaces to detect early diabetic retinopathy.

Methods

Six patients with small haemorrhages, hard exudates and photocoagulation marks were evaluated using fundus photography, which revealed image artefacts in the fundi of some patients. We constructed an experimental device similar to the optical system of a fundus camera, and created artificial eyes of the fundus, which were painted with four different colours. The image artefacts were photographed under each artificial eye using the experimental device. We analysed all images using Scilab 5.4.0 and SIVP 0.5.3 software. The software interpreted the values of the L*u*v* colour space as a three‐dimensional graph, which was modified using a Gaussian filter.

Results

We calculated the difference between the manifestation and perimanifestation areas and image artefact and periartefact areas using the L*u*v* values. The L*u*v* values’ ratios of the image artefact to manifestation areas in the human eye were as follows: haemorrhage (6.2, 11.4, 7.4); hard exudate (3.2, 7.7, 2.5) and photocoagulation mark (8.1, 3.9, 6.2).

Conclusions

L*u*v* colour space is an effective mean of differentiating between small haemorrhages, hard exudates and photocoagulation marks from image artefacts.
Intratarsal injection of kenacort in the treatment of severe cases of VKC
Authors: Lazreg S.
Published: September 2015

Purpose

To treat refractory cases of Vkc with intratarsal injections of trialcinolone.

Methods

We treated Severe cases of Vkc that have already experienced different anti allergic treatments and topical steroids with frequent relapses and dependancies to steroids with intratarsal injection of 40 mg of dexametasone, the follow up visits were performed at D0, D3, D7 and D30 (slit lamp examination, corneal staining, ocular pressure).

Results

87 severe cases of Vkc 63 males, mean age 10.4±3.5 years, 90% bilateral, and 100% of corneal involvement. 70% mixed forms and 15% of tarsal forms, the mean follow up was 20 ± 7 months. at D3 we had a decrease of all ocular signs (photophobia, redness and pruritis) at D7 decrease of corneal staining and trantas nods, and at d30, total remission of the Vkc, the mean duration of the efficacy of the treatment was 10.4 ± 2.6 months, no adverse event was observed.

Conclusions

Intratarsal injection of steroids is very effective in severe and resistant cases of Vkc, especially in our countries where this disease is very severe, frequent and when topical cyclosporine is not available.
Comparison of preservative‐free latanoprost and bimatoprost in a multicenter, randomized, investigator‐masked cross‐over clinical trial
Authors: Stalmans I. , Cordeiro F. , Hommer A. , Oddone F. , Ribeiro L. , Sunaric Mégevand G. , Rossetti L.
Published: September 2015

Purpose

To investigate the efficacy and safety of Bimatoprost Unit Dose Preservative Free (BUDPF) and Latanoprost Unit Dose Preservative Free (LUDPF) in a clinical setting.

Methods

Prospective, randomized, investigator‐masked, cross‐over comparison. Patients with ocular hypertension or open angle glaucoma (OAG) with an IOP ≤21 mmHg with a preserved prostaglandin monotherapy at screening were washed out and randomized to receive BUDPF or LUDPF for 3 months and were then switched to the other respective treatment for another 3 months. IOP curves were performed at baseline and after each treatment period, and safety and tolerability were assessed at the two latter timepoints.

Results

Both drugs were effective in lowering IOP, both at 3 and at 6 months (estimated differences compared to baseline pressures: −4.0 ± 0.5 for both BUDPF and LUDPF, p < 0.01 at 3 months; −5.2 ± 0.5 for BUDPF, −3.4 ± 0.5 for LUDPF, both p < 0.01 at 6 months). Analysis at 6 months (primary endpoint) showed a difference of 1.6 ± 0.5 mmHg between the two groups, favoring BUDPF (p < 0.01). An intra‐subject IOP difference of 0.9 ± 0.2 mmHg in favor of BUDPF was observed (p < 0.01).

Conclusions

This study demonstrate a superior efficacy of BUDPF over LUDPF in lowering IOP.
Immunohistochemical characterization of a retinal hamartoma
Authors: Van Ginderdeuren R. , Stalmans P.
Published: September 2015

Purpose

To describe the immunohistochemical features of a retinal hamartoma.

Methods

A 38 year old man was referred for preretinal fibrosis on his right eye. There was loss of vision for more than 8 years with metamorphopsia. The left eye was normal. Oct imaging showed an epiretinal fibrosis with extensive macular oedema. A 27Gauge vitrectomy was performed. The lamina limitans interna (ilm) was peeled after staining with Membrane Blue Dual and sent for histopathology.

Results

After removal the epiretinal membrane was immediately fixed with PreservCyt® in a ThinPrep® container. The specimen was routinely processed by the Cellient® embedding system. Microscopy showed a folded Pas positive membrane, recognized as ilm with on one side some glial remnants and on the other side a cuboidal non‐pigmented epithelium. The glial remnants stained with glial fibrillar protein (gfap), the epithelium with prekeratin AE1/AE3. CD 34 stain was positive in preretinal capillaries.

Conclusions

A strange retinal fibrosis consisted of glial tissue and a row of superficial cuboidal non‐pigmented epithelium cells. This kind of hamartoma with immunohistological description was never investigated or published.
Leuven Eye Study – Baseline and Methods
Authors: Abegao Pinto L. , Willekens K. , Van Keer K. , Shibesh A. , Vandewalle E. , Molenberghs G. , Stalmans I.
Published: September 2015

Purpose

Glaucoma is known to be associated with vascular dysfunction. However, integrating this knowledge in the clinical setting has been limited, considering the majority of vascular oriented studies have been either underpowered or only addressed a small segment of the vascular parameters in strictly selected patients. The Leuven Eye Study aims at bridging this gap by prospectively collecting the largest amount of vascular oriented data in a large real‐life glaucoma clinic setting.

Methods

Prospective, cross‐sectional, case–control hospital‐based study. Patients with primary open‐angle glaucoma (POAG), normal tension glaucoma (NTG), glaucoma suspect or ocular hypertension (OHT) and healthy volunteers were recruited. In addition to an ophthalmological examination, a vascular‐oriented questionnaire was completed and ocular blood flow assessment (color Doppler imaging of retrobulbar vessels, retinal oximetry, dynamic contour tonometry, optical coherent tomography enhanced depth imaging of the choroid) was performed in each subject.

Results

620 subjects (297 male) were recruited between March and December 2013 (POAG: 214, NTG: 192; glaucoma suspect: 41; OHT: 27; healthy controls: 146). Mean age was 68.4 ± 12.9 years. Other than IOP, there was no difference in demographic variables between glaucoma groups and healthy volunteers. Values for the ocular blood flow parameters are in line with the current literature.

Conclusions

The Leuven Eye study stands as the largest clinical trial on ocular blood flow in glaucoma. The creation of this vast database may help integrate the vascular aspects of glaucoma into the clinical practice of glaucoma.
Relapsing Polychondritis and its Orbital Manifestations
Authors: Teo L. , Choo C.T.
Published: September 2015

Purpose

We describe a 73 year old Chinese Gentleman with bilateral relapsing, remitting orbital inflammatory disease associated with Relapsing Polychondritis (RP).

Methods

We reviewed the current literature available on the diagnosis and management of orbital inflamamtory disease in RP.

Results

Our patient first presented with right orbital inflammation that did not improve despite antibiotic treatment. Computer tomography (CT) of the orbits showed a soft tissue mass along the roof of the orbit, which was biopsied, revealing acute on chronic inflammation. There was complete resolution of his orbital inflammation within 2 weeks of initiating systemic steroid treatment. He subsequently developed recurrent bouts of left orbital inflammation. One year later, he was diagnosed with relapsing polychondritis and subsequently developed multiple myeloma 7 years later.

Conclusions

In summary, recurrent orbital inflammatory disease should prompt the Oculoplastics surgeon to exclude a systemic autoimmune disease and hematological malignancy. The course of orbital inflammation in RP can be relapsing and remitting. Co–management with a rheumatologist will be helpful to achieve control of the disease with judicious use of immunosuppression. Long‐term follow‐up of the patient will be necessary to monitor for malignant transformation of the orbital lesion, as well as the development of hematologic malignancies.
The diameter regulation of retinal arterioles during systemic hypoxia is impaired in diabetic patients without retinopathy
Authors: Petersen L. , Bek T.
Published: September 2015

Purpose

Diabetic retinopathy (DR) is characterized by retinal lesions related to disturbances in retinal vascular supply that may lead to retinal hypoxia. Additionally, the metabolic activity of cyclooxygenase (COX) and nitric oxide synthase (NOS) have been found to be changed in patients with diabetes mellitus. Therefore, the purpose of the present study was to investigate the effects of inhibiting the COX and the NOS enzymes during hypoxia.

Methods

Twenty patients with type 1 diabetes mellitus and no visible diabetic retinopathy were studied. Using the Dynamic Vessel Analyzer the diameters of retinal arterioles at rest and during isometric exercise and flicker stimulation were studied before and during systemic hypoxia induced by breathing a hypoxic gas mixture. The examinations were performed before and during i.v. infusion of the NOS inhibitor L‐NMMA and all examinations were repeated on a second day after topical administration of the COX‐inhibitor diclofenac.

Results

Hypoxia reduced the vasodilatation induced by flicker stimulation (p = 0.0003) and the vasocontraction induced by both isometric exercise (p = 0.001) and NO synthesis inhibition (p < 0.0001), whereas COX inhibition had no significant effects on the diameter responses.

Conclusions

In diabetic patients, hypoxia reduces the diameter response of retinal arterioles secondary to changes in blood pressure and retinal metabolism, and the response depends on nitric oxide synthesis. This may potentially point to targets for intervention on retinal flow disturbances in patients with diabetic retinopathy.
3D model of pterygium and corneal limbus: Investigating histopathology and stem cell distribution
Authors: Blom N. , Andreasen A. , Heegaard S. , Hjortdal J. , Nielsen K.
Published: September 2015

Purpose

This study aims to create a complete histological 3D computer model of pterygium in situ, mapping the anatomy of the disease tissue, its relation to the corneal limbus and the distribution of limbal stem cells.

Methods

One human eye affected with pterygium was obtained from a cornea donor post mortem. The anterior part of the eye was cut into 900 consecutive horizontal sections. Every other section was stained with HE to be digitized, aligned and 3D reconstructed using interactive 3D visualization software. Immunohistochemistry targeting CK19, MMP‐1, p63 and VEGF was performed on the remaining sections alternating across the structure so as to create evenly distributed overlaying models.

Results

Using the sections a high‐resolution model of the pterygium and limbus was created, and in aligning the immunostained sections to the model, a spatial map of the staining was created. Analyzsing the model we found a mostly normal temporal limbus with intact architecture, however nasally the limbus was found to be buried under the pterygial mass and only partly intact, showing a number of pathological changes.

Conclusions

The limbal degeneration underneath the pterygium appears to be a precondition for a consequence of the pterygial growth.
The Protective Effect of Anti‐blue Lens Against Photo‐induced Cell Death
Authors: Yu W.Y. , Shan S.W. , To C.H. , Chan H.H.L.
Published: September 2015

Purpose

Anti‐blue lenses that selectively block the harmful portion of the blue light spectrum become commercially available recently. This study aimed to evaluate the protective effect of anti‐blue lens on cultured porcine primary retinal pigmented epithelial (RPE) cells against photo‐irradiation.

Methods

Primary RPE cells were isolated from porcine eyes and cultured to confluence. The cells were characterised by RPE65 using Western Blot. White and blue light emitting diode (LED) light sources as well as the transmittance of the anti‐blue and anti‐UV lenses were characterised by a spectroradiometer. The RPE cells were exposed to ~1.8 × 104 cd/m2 white (peak wavelength at 443 and 533 nm) or blue (peak wavelength at 448 and 523 nm) LED light for 16 hours, with anti‐blue, anti‐UV lens or without lens. Control cells were incubated in the dark. Cellular viability under the different lighting conditions with the anti‐blue or anti‐UV lenses were compared using trypan blue staining and MTT assay.

Results

Trypan blue staining showed that the RPE cellular viability under no light, white light and blue light conditions without any lenses were 94.8 ± 0.4%, 93.7 ± 1.1% and 88.7 ± 2.0% respectively. Blue light irradiation significantly induced more cell death when compared to no light (p = 0.001) and white light (p = 0.005) conditions. MTT assay also revealed significant difference under blue light when compared to no light (p = 0.002) and white light (p = 0.014) conditions. When comparing the effect of anti‐blue and anti‐UV lenses on cell survival, we found that anti‐blue lens showed significantly elevated viability (93.4 ± 1.4% vs 90.6 ± 1.4%) using trypan blue (p = 0.022) and MTT assay (p = 0.029).

Conclusions

Blue light exposure induced significant cytotoxicity on RPE cells. The anti‐blue lens significantly reduced the harmful blue spectrum and showed protective effect on RPE cell survival.
Randomised, controlled study of the efficacy and safety of a new eye‐drop formulation for moderate to severe dry eye syndrome
Authors: Doan S. , Baudouin C. , Khairallah M.
Published: September 2015

Purpose

The aim of this study was to compare the efficacy and safety in Dry Eye Disease (DED) of T2762, a new product containing an innovative bioprotective molecule trehalose (molecule finds in plants resistant to dissication with osmoprotectant properties) and hyaluronic acid, to Vismed®

Methods

Phase III, randomized, active‐controlled, Investigator‐masked, multicentric study in France and Tunisia. 105 Adult patients (≥18 years) with moderate to severe DED were included and received one drop of either T2762 (N = 52) or Vismed® (N = 53) 3–6 times per day for 84 days. The primary efficacy variable was the Oxford grading score at Day 35. Ocular Surface Disease Index (OSDI), dry eye symptoms, Schirmer test, TBUT, conjunctival hyperaemia, and global performance were assessed as secondary efficacy criteria at baseline, Day 35 and Day 84. Safety assessments were standard

Results

Non‐inferiority of T2762 to Vismed® for Oxford grading score was demonstrated at Day 35. For secondary efficacy parameters, reductions in OSDI, dry eye symptoms and investigator/patient assessments of global performance were better for T2762. There were no clinically meaningful between‐group differences for the other secondary criteria. Both treatments were well tolerated. Interestingly, there were fewer ocular symptoms upon instillation and fewer AEs with T2762

Conclusions

T2762 is effective and safe, with better patient satisfaction than existing hyaluronate‐only eye drops, and offers a therapeutic advancement in the treatment of moderate to severe DED.
Contribution of Optical Coherence Tomography (OCT) with real‐time OCT of the Femtosecond laser, and per operative OCT of the microscope in deep anterior lamellar keratoplasty (DALK) for keratoconus: a new technique
Authors: Nguyen D.T. , Stephan S. , Gleize S. , Cochereau I. , Gabison E.
Published: September 2015

Purpose

Deep anterior lamellar keratoplasty (DALK) is a treatment of choice for keratoconus. We evaluate the contribution of a new technique associating femtosecond laser with real‐time OCT, and per‐operative OCT on the microscope, in DALK surgeries for keratoconus.

Methods

After training on artificial anterior chambers of corneal grafts to evaluate the reproducibility of cuts, pre‐cuts of human anterior corneal lamellae during DALK of keratoconus were realized using the femtosecond laser (Victus, Bausch and Lomb) with real‐time OCT and a curved applanation's surface. The depth was caculated around 60% of the thinnest pachymetry. Surgeries were realized using the per‐operative OCT with the Rescan system of the microscope (Lumera 700, Zeiss).

Results

Curved applanation and visualization with real‐time OCT of the cuts’ depth enabled the realization of reproducible lamellar cuts on 200 µ thick corneas, without modifying the laser‐cornea interface neither using masking agents. Femtosecond laser cuts allowed the big‐bubble formation on 10/10 ex‐vivo corneas. In human surgeries, real‐time OCT visualization allowed controlling non‐penetrating cuts, and the curved applanation limited folds formation on the residual stroma. Each surgical step was controlled by per‐operative OCT, with visibility of tissues’ structure and thickness, and instruments in cross section. The Anwar‐air dissection technique permitted the “big‐bubble” formation in 7/7 case, clearly visible on OCT, with only 1 or 2 injections of air. Residual posterior stroma was resected realizing pre‐descemetic lamellar grafts.

Conclusions

This new technique, femtosecond laser associated with per‐operative OCT, appears to be safe, effective, reproducible and time‐saving in DALK surgeries, facilitating the “big‐bubble” formation. It may be proposed for the management of keratoconus and other indications.
Optic disc swelling: Prospective study of sixty‐seven patients
Authors: Sitbon C. , Fel A. , Bodaghi B. , Le Hoang P. , Touitou V.
Published: September 2015

Purpose

To assess the clinical features and etiologic work‐up of patients presenting with optic disc swelling (ODS) in the emergency room.

Methods

Patients seen in the ophthalmology emergency department of a single tertiary center between November 2014 and October 2015 were prospectively included. Each patient underwent an etiologic work‐up including a brain‐MRI, blood work, fluorescein angiography, and visual evoked potential.

Results

67 patients (39 female and 28 male) were included in this study. Average age was 46 years (17–86 years). ODS was unilateral in 45% of cases and bilateral in 55% of cases. The average time between the onset of symptoms and diagnosis of papillary edema was 80 days (3 days to 8 months). The mean initial visual acuity was 0.2 logMAR, and the mean final VA was 0.1 logMAR. Final diagnosis was intracranial idiopathic hypertension (43%), anterior ischemic optic neuropathy (25%), inflammatory or infectious papillitis (22%), compressive optic neuropathy (2%) and unknown in 3 cases (8%). The etiologic work‐up was contributive for the final diagnosis in 10% of cases for fluorescein angiography; 35% for MRI of the optical nerve; 32% for laboratory tests; 67% for visual evoked potentials; 90% for the visual field of Goldman. Findings of Goldman's visual field included central or caecocentral scotoma (32%), exclusion or enlarged blind spot (41%), inferior altitudinal scotoma (19%), and bitemporal quadrantanopia (5%).

Conclusions

Our results demonstrate that causes of ODS could be identified in 92% of patients presenting with ODS. According to the clinical features at presentation, the etiologic work‐up can be further adjusted but a standard minimal etiologic work‐up is usually efficient to state the diagnosis.
Two Sisters with Congenital Blindness caused by Osteoporosis‐pseudoglioma Syndrome due to new Mutations in the LPR5 Gene
Authors: Welinder L. , Robitaille J.M. , Boerkoel C.F. , Rupps R. , Lyons C.
Published: September 2015

Purpose

To discover the reason behind two sisters being born blind with retinal detachment and microphthalmia with later findings of severe osteoporosis with low impact fractures

Methods

Molecular testing identified biallelic lipoprotein receptor‐related protein 5 (LRP5) mutations (NM_002335.3:c. [889dupA]; [2827 + 1G4A]) confirming a diagnosis of osteoporosis–pseudoglioma (OPPG) syndrome.

Results

Two new mutations in the LPR5 gene were each found in the unrelated parents of the girls and were found heterozygote in the girls. Both parents were then discovered to have osteopenia, as did several relatives, who all started preventive treatment.

Conclusions

OPPG is a autosomal recessive disease almost uniformly causing blindness from very early age with severe osteoporosis and low impact fractures, which was also the case of our two sisters. The diagnosis of OPPG was confirmed by sequencing the LPR5 gene, where two new mutations were found.
The use of intraoperative spectral domain optic coherence tomography in vitreoretinal surgery: The evaluation of efficacy
Authors: Lytvynchuk L. , Glittenberg C. , Binder S.
Published: September 2015

Purpose

To evaluate the feasibility of intraoperative spectral domain optic coherence tomography (iSD‐OCT) in challenging cases during pars plana vitrectomy (PPV).

Methods

Intraoperative imaging was performed using the first commercially available iSD‐OCT system Rescan 700, fully integrated into the surgical microscope OPMI Lumera 700 (Zeiss, Oberkochen, Germany). The feasibility of iSD‐OCT was assessed during three 23‐gauge PPV cases: large macular hole (MH) with inverted internal limiting membrane (ILM) flap technique (Case #1), vitrectomy for asteroid hyalosis with age‐related macular degeneration (Case #2), vitrectomy for morning glory syndrome with retinoschisis and exudative retinal detachment (Case #3).

Results

Case #1. The use of iSD‐OCT facilitated to safely initiate ILM flap, to form inverted flap, to invert the flap into the MH, to control position of the forceps concerning retinal layers, and to confirm the MH covering with the ILM remnants at the end of the surgery. Case #2. Standard OCT was not available before the surgery due to opaque vitreous. Intraoperative SD‐OCT imaging assisted to reveal epiretinal membrane (ERM), retinal pigment epithelium detachment, intraretinal fluid and drusen. These findings required additional surgical steps: ERM removal and injection of anti‐VEGF at the end of the surgery. Case #3. In the case of morning glory syndrome iSD‐OCT facilitated to remove the strongly adherent posterior hyaloid, to control ILM flap initiation, to perform the peeling over the detached retina, to aspirate residual fluid after fluid/air exchange.

Conclusions

The use of iSD‐OCT facilitates real‐time simultaneous to surgical workflow visualisation of tissue behaviour and surgical manoeuvres during pars plans vitrectomy. The obtained information can improve surgical technique and influence the decision making in difficult cases.
Efficacy of Dry Eye Disease Treatment based on the 2007 Report of the International Dry Eye WorkShop (DEWS)
Authors: Utheim O. , Ræder S. , Utheim T.P. , Eidet J.R. , Badian R. , Stojanovic A. , Chen X.
Published: September 2015

Purpose

To assess the effect of dry eye disease (DED) treatment according to the guidelines reported by the International Dry Eye WorkShop (DEWS) in 2007.

Methods

Dry eye disease patients with or without meibomian gland dysfunction (MGD), treated at the Norwegian Dry Eye Clinic, with at least 6 months follow‐up time were consecutively included in the study. The choice of treatment for DED was based on the dry eye severity level (DESL), according to the 2007 Report of the International Dry Eye WorkShop (DEWS). The values of tear film break‐up time (TBUT), Schirmer I test, ocular surface staining (Oxford scale), and dry eye severity level (DESL) on the right eye at 1, 3, 6, 12, and 24 months after the treatment were compared with those prior to treatment.

Results

A total of 237 eyes were included. At 6 months follow‐up, TBUT increased from 5.07 ± 3.63s to 8.54 ± 5.12s (p < 0.001); Schirmer I test did not show significant change; ocular surface staining decreased from 1.64 ± 2.13 to 0.76 ± 1.20; and DESL decreased from 2.08 ± 0.47 to 1.72 ± 0.54 (p < 0.001). The improvement of TBUT, ocular surface staining, and DESL remained significant at 24 months follow‐up.

Conclusions

Treatment based on the 2007 Report of the International Dry Eye WorkShop (DEWS) was effective in a Norwegian cohort of DED patients with significant improvement in key parameters for assessing DED.
Reinforcement of a Magnesium‐Ammonium‐Phosphate Cement with Calcium Phosphate Whiskers
Authors: Zorn Katharina , Vorndran Elke , Gbureck Uwe , Müller Frank A.
Published: September 2015

Self‐setting resorbable phosphate cements are characterized by an excellent biocompatibility and bioactivity. However, poor mechanical properties restrict their application. Most studies which characterize phosphate cements mechanically focus on strength measurements. Examinations of mechanical reliability and facture toughness were hardly performed. In this study, calcium phosphate whisker‐reinforced magnesium‐ammonium‐phosphate (struvite) cements were examined at the whisker–matrix interface and the measured strength, reliability and toughness values were correlated to these observations. Moreover, the toughening mechanisms were evaluated. It was shown that whisker incorporation is not beneficial for material strength. It led to a strength decrease from 29.8 to 21.8 MPa by the incorporation of 15 vol% calcium‐deficient hydroxyapatite (CDHA) whiskers compared to the pure struvite cement. Weibull statistics and microstructural observations revealed that this is caused by the whisker–matrix interface, which acts as a flaw. In contrast with that, the reliability increases upon whisker incorporation. Furthermore, the critical stress intensity factor KIC as well as the work‐of‐fracture γwof increase from 0.52 to 0.60 MPam1/2 and from 9.5 to 12.9 J/m² by the addition of 15 vol% CDHA whiskers compared to the original struvite cement. It was shown that whisker pull‐out and crack deflection are the main mechanisms responsible for this increase.
Tolerance to deer herbivory and resistance to insect herbivores in the common evening primrose (Oenothera biennis)
Authors: Puentes A. , Johnson M. T. J.
Published: September 2015

The evolution of plant defence in response to herbivory will depend on the fitness effects of damage, availability of genetic variation and potential ecological and genetic constraints on defence. Here, we examine the potential for evolution of tolerance to deer herbivory in Oenothera biennis while simultaneously considering resistance to natural insect herbivores. We examined (i) the effects of deer damage on fitness, (ii) the presence of genetic variation in tolerance and resistance, (iii) selection on tolerance, (iv) genetic correlations with resistance that could constrain evolution of tolerance and (v) plant traits that might predict defence. In a field experiment, we simulated deer damage occurring early and late in the season, recorded arthropod abundances, flowering phenology and measured growth rate and lifetime reproduction. Our study showed that deer herbivory has a negative effect on fitness, with effects being more pronounced for late‐season damage. Selection acted to increase tolerance to deer damage, yet there was low and nonsignificant genetic variation in this trait. In contrast, there was substantial genetic variation in resistance to insect herbivores. Resistance was genetically uncorrelated with tolerance, whereas positive genetic correlations in resistance to insect herbivores suggest there exists diffuse selection on resistance traits. In addition, growth rate and flowering time did not predict variation in tolerance, but flowering phenology was genetically correlated with resistance. Our results suggest that deer damage has the potential to exert selection because browsing reduces plant fitness, but limited standing genetic variation in tolerance is expected to constrain adaptive evolution in O. biennis.