bluuebunny/crossref_metadata_2025 huggingface dataset:
Accommodation and fusion in patients with constant and intermittent exotropia
Authors: Boychuk I. , Aloui T.
Published: September 2016

Purpose

To determine the characteristics of the accommodation and fusion in patients with constant and intermittent divergent strabismus

Methods

Under observation there were 59 patients: 33 with a constant form of strabismus (I) and 26 with intermittent form (II) aged 10–21 y.o. with visual acuity with correction (0.8 ± 0.3) and refraction (0.5 ± 2.8) dptr, the angle of deviation in group I was for distance (36.6 ± 2.8) dptr, and for near (16.6 ± 2.5) dptr; in the II group (26.6 ± 2.8 and 12.0 ± 2.3) dptr respectively, p >0.05. The nearest point of convergence was determined by proximeter, the AK/A ratio by heterophory method and the fusion was assessed using synoptophore, distance and near deviations were assessed using prism cover test.

Results

Data analysis showed that the nearest point of convergence did not differ significantly in patients of both groups (8.8 ± 0.9) cm and (8.6 ± 0.6) cm, respectively). Values of AK/A also did not differ significantly (−0.5 ± 2.5) and (1.02 ± 0.97), in the I and II group respectively, but values less than 0 were found in 53.5% of cases at the I and in 38% at the II. Fusion by synoptophore was significantly more frequently in patients of the II group – 53.8%, in comparison with the I – 24.4%, (χ2 = 6.2), p = 0.001.

Conclusions

It is noted that in cases with the permanent form of strabismus low values of AK/A are more common (53.5%) than in intermittent (38%), which may be associated with weakness of accommodative convergence in these patients. Found that the fusion exist significantly more common in patients with intermittent form of divergent strabismus (53.8%) in comparison with a constant (24.4%), χ2 = 6.2, p = 0.001.
Retinal structural changes before and after idiopahic epiretinal membrane peeling – a study using OCT segmentation
Authors: Sousa F. , Pinto J. , Marques‐Neves C.
Published: September 2016

Purpose

We aim to study the microstructural changes and thickness of inner retinal layers in patients with idiopathic epirretinal membranes treated with peeling.

Methods

Observational retrospective study that included patients treated for idiopathic epiretinal membrane. Visual acuity and central retinal layers thickness were recorded before and at the last follow up visit. The retinal layers thickness was given by automated segmentation of OCT Heidelberg Spectralis but the accuracy was verified and when in disagreement, manual correction of the segmentation was made and the new measured thickness was used. 33 patients were treated with combined fhacoemulsification.and peeling and 14 patients had only peeling of the epiretinal membrane with vitrectomy.

Results

47 eyes of 46 patients were included with a mean age of 73.44 years. There was a significant improvement of visual acuity from 0.3 ± 0.1 to 0.6 ± 0.2 (p < 0.0001). From the tomographic analysis,was noted a significant reduction in the mean central macular thickness (CMT) from 469.4 ± 97.74 to 397.8 ± 71.16 (p < 0.0001), in the retinal nerve fiber layer (RNFL) thickness from 51.2 ± 49.84 to 24.71 ± 23.21 (p < 0.0001), in the ganglion cell layer (GCL) thickness from 55.4 ± 25.22 to 39.2 ± 13.08 (p < 0.0001), in the internal plexiform layer (IPL) thickness from 46.31 ± 13.46 to 38.62 ± 13.62 (p = 0.0012), in the outer plexiform layer (OPL) thickness from 39.71 ± 9.04 to 34.38 ± 7.9 (p = 0.0016) and in the internal retinal layers (IRL) thickness from 384.5 ± 97.7 to 312.8 ± 70.8 (p < 0.0001). There was no statistical difference in the thickness of the outer retinal layer, outer nuclear layer and inner nuclear layer before and after membrane peeling.

Conclusions

The layers that most have changed and contributed to the reduction of central thickness treated with peeling were the Internal Retinal Layers: RNFL, GCL and IPL.
From perfect visual function to ‘legally’ blind in one year: new mutations in progressive cone dystrophy
Authors: Sousa Neves F. , Braga J. , Loureiro M. , Arede C. , Sequeira J. , Varandas R.
Published: September 2016

Purpose

We aim to report a case of a 15 year‐old patient with severe and rapid bilateral visual impairment due to progressive cone dystrophy and describe the associated mutations.

Methods

This is a case report of a patient with a rare disease who underwent full ophthalmologic evaluations including optical coherence tomography (OCT) of the posterior pole, fundus autofluorescence (FAF) and electroretinography (ERG).

Results

A 15‐year‐old girl was presented at our Department with progressive vision loss and poor colour vision complaints. The patient reported these complaints for a year, despite a full uneventful ophthalmic evaluation at that time. Best‐corrected visual acuity was 6/60 for each eye and Ishihara 24‐plates colour test was altered. Fundoscopic evaluation showed a maculopathy with spotty pigment changes in addition to temporal pallor of the optic disk. Posterior pole OCT showed a reduced outer nuclear layer and retinal pigment epithelium unspecific changes. FAF revealed a central dark area surrounded by a ring of increased autofluorescence. ERG was inconclusive due to poor collaboration, although it was hypothesised to have a slight cone dysfunction. Moreover, genetic analyses of ABCA4 and CDHR1 genes were found to be positive for multiple mutations. The c.6816 + 2T>A (p.Leu2035Pro) mutation was never described and the c.6104T>C (p.Leu2035Pro) mutation was only present in one patient with Stargardt disease. After a period of 2 years of follow‐up visual function and retinal disease remained stable.

Conclusions

Progressive cone dystrophy is a rare inherited ocular disorder characterized by the loss of cone cells. This case report emphasizes the need to reach a clear diagnosis when uncommon symptoms appear in an otherwise normal ophthalmic evaluation and also describe newer mutations in ABCA4 gene enhancing our knowledge about this disease.
Visual function response to ocriplasmin for the treatment of vitreomacular traction: results from the oasis study
Authors: Jackson T.L. , Lescrauwaet B. , Duchateau L. , Verstraeten T.
Published: September 2016

Purpose

The effect of an intravitreal ocriplasmin‐injection on vitreomacular adhesion (VMA) resolution was investigated in a phase 3b randomized, sham‐controlled, double‐masked, multicentre study. The objective of this analysis was to assess the effect of ocriplasmin on patient‐relevant visual function outcomes.

Methods

Prespecified analysis of secondary endpoints in the OASIS study. A total of 220 participants with symptomatic VMA/VMT were enrolled, of whom 146 received a single IVT‐injection of 125 μg ocriplasmin and 74 a sham‐injection. Visual function response (VFR) was defined as either a VA improvement of ≥2 lines or an improvement exceeding the minimal clinically important difference (MCID) in the composite score or the VFQ‐25 mental health subscale score of the Visual Function Questionnaire (VFQ‐25). The MCID was estimated using the standard error of measurement approach. The main outcome measure was the VFR at 6 months, with further assessments at month 12 and 24.

Results

The MCID was estimated at 3.71 points for the VFQ‐25 composite score and 10.71 for the VFQ‐25 mental health subscale score. VFR occurred in 51.0% of ocriplasmin vs. 23.3% of sham subjects (p = 0.0001). The VFR was maintained through months 12 and 24: 53.1% and 50.3% in ocriplasmin vs. 21.9% and 20.5% in sham subjects, respectively (p < 0.0001).

Conclusions

Treatment with ocriplasmin compared with sham resulted in a significant improvement in VFR. The 6‐month treatment effect was sustained at month 12 and 24.
Visual outcomes of fractionated radiotherapy in optic nerve sheath meningioma
Authors: Kheir V. , Borruat F.X.
Published: September 2016

Purpose

Optic nerve sheath meningioma (ONSM) is a rare benign tumor of the optic nerve sheath that can lead to blindness if untreated. We conducted a retrospective monocentric study to assess the effect of radiotherapy on tumor control and visual outcomes in patients with ONSM.

Methods

All patients diagnosed with ONSM at our centre were reviewed and data on: symptoms at presentation; visual acuity (VA), color vision and visual fields (VF); treatment type; visual outcome if treated with radiotherapy were recorded.

Results

There were 34 (26 female) patients reviewed. Presenting symptoms were decreasing vision (25 patients), subjective scotoma (4 patients), transient visual obscuration (4 patients), disturbance of color vision (1 patient), diplopia (4 patients), exophthalmia (3 patients), palpebral edema (2 patients), tearing (2 patients), conjunctival hyperaemia (2 patients), pain (8 patients) and headaches (3 patients). Median initial VA was 0.1 (interquartile range (IQR) 0–1) logMAR, color vision was 1 (13 plates) and VF mean defect was 7 dB. 16 patients were treated with fractionated radiotherapy (total 50.4 Gy/28 sessions) between 2002 and 2015. After radiotherapy, VA improved in 13 eyes, was unchanged in 1 eye and decreased in 2 eyes. Median best‐corrected VA improved from 0.1(IQR) (0–0.4) logMAR to 0 (−0.1 to 0) logMAR, color vision improved from 5 (0 to 12) to 12 (1 to 13), and median VF mean defect improved from 10 (5 to 19) dB to 4 (1 to 10) dB. Tumor size was reduced in 3 patients, and stable in 11 patients (not available in 2 patients). No adverse side‐effects were reported during the time of follow‐up.

Conclusions

Fractionated radiotherapy is a safe procedure and can be used to treat patients with ONSM. In our study, visual improvement was observed in 13 (81%) eyes and visual loss in 2 (12.5%) eyes.
Assessment of postoperative corneal healing after epithelium‐off cross‐linking with a regenerating agent in progressive keratoconus patients
Authors: Kymionis G. , Schmetterer L. , Garhöfer G. , Schmidl D. , Chiambaretta F. , Grouin J.M. , Gumus K.
Published: September 2016

Purpose

To evaluate and compare data on corneal healing from randomised clinical trials (RCTs) in adult patients with progressive keratoconus undergoing epithelium‐off corneal collagen cross‐linking (epi‐off CXL) and receiving a regenerating agent (RGTA).

Methods

An individual study review and a meta‐analysis were performed by searching RCTs assessing the effect of RGTA (Cacicol®) postoperatively used for keratoconus. We focused on the outcome related to corneal healing and epithelial defect size measured by slit lamp/photography with fluorescein staining or optical coherence tomography. Other endpoints related to symptoms included ocular pain, burning, stinging, tearing, photophobia, conjunctival hyperaemia, and postooperative consumption of analgesics.

Results

Three RCTs were identified for the meta‐analysis including 118 patients (136 eyes) in total. The individual review showed faster reepithelialisation after instillations of RGTA compared to standard postoperative treatment (respectively, 83.3 vs. 13.3% of patients healed at day 2 postoperatively, p < 0.001), to artificial tears (61.1 vs. 11.1% at day 3, p = 0.002) and to hyaluronic acid (4.4 ± 1.3 vs. 6.1 ± 2.3 days for complete healing, p = 0.008). The meta‐analysis showed that instantaneous chances of achieving complete healing over time were with RGTA twice as high as with control (Hazard ratio: 2.01; 95% confidence interval: [1.64; 2.47]; p < 0.001). The overall safety profile of RGTA was found to be satisfactory.

Conclusions

Instillation of RGTA facilitates corneal epithelial healing after epi‐off CXL in patients with progressive keratoconus.
Comparison of multifocal pattern ERG responses to luminance and chromatic contrast stimulations
Authors: Charlier J.
Published: September 2016

Purpose

To evaluate the relationship between ganglion cells properties and responses obtained with multifocal pattern ERG.

Methods

6 normal subjects were tested with 3 types of multifocal ERG stimulations: standard flash, pattern reversal with luminance contrast (black / white) and pattern reversal with chromatic contrast (red / green). The amplitude density and implicit times (ms) of responses were evaluated as a function of eccentricity with respect to fixation.

Results

The amplitude density of responses was much smaller for pattern reversal stimulations than for flash stimulations with a ratio of 2.5 at the fovea (57 nV/deg2 vs. 146 nV/deg2) and 13 at 15 degrees of eccentricity (3.2 nV/deg2 vs. 43 nV/deg2). The responses to chromatic contrast were significantly delayed in comparison with luminance contrast.

Conclusions

The variation of amplitude density of multifocal ERG responses with eccentricity was found similar to the variation in density of photoreceptors for flash stimulations and of ganglion cells for pattern stimulations.
A dual therapeutic approach for the reversal of cataracts
Authors: Beltz J. , Pfaff A. , Ercall N.
Published: September 2016

Purpose

Over 20 million people suffer from cataracts worldwide. Currently, surgery is the only effective treatment for this condition. Although cataract surgery is routine and generally considered safe, it is neither feasible nor accessible for much of the world's population. Thus, there is a high demand for an effective topical treatment that can reverse or prevent cataracts in those for whom surgery is not a viable option. Clouding of the lens is caused by the aggregation of water‐soluble crystallin proteins. Crystallins are a major component of the lens and allow it to refract light. Crystallins are rich in sulfur‐containing amino acids, which are susceptible to the formation of disulfide bonds upon oxidative damage. This damage results in protein misfolding and aggregation. Thiol antioxidants have the potential to protect these proteins from oxidative damage and to prevent the formation of cataracts. α‐Crystallins act as chaperons for other crystallin isoforms, binding damaged β‐ and γ‐crystallins and impeding aggregation. Recently, sterols such as lanosterol and 25‐hydroxycholesterol have demonstrated the ability to stabilize the healthy, functional α‐crystallin structure, which preserves the anti‐aggregation action of these chaperons. The objective of this study was to determine additive and/or synergistic effects of a thiol antioxidant in combination with 25‐hydroxycholesterol to combat crystallin aggregation in two ways: protecting crystallin thiol residues and bolstering α‐crystallin chaperon activity.

Methods

To investigate thiol antioxidant candidates for incorporation into a topical cataract treatment, an ex vivo model using Wistar rat pup lenses was employed. Various thiol antioxidants were examined for their ability to reverse cataracts when used in combination with 25‐hydroxycholesterol.

Results

To be discussed.

Conclusions

To be discussed.
Autophagy is affected by Mitf in mouse primary RPE cells
Authors: Garcia Llorca A. , Ogmundsdóttir M.H. , Steingrimsson E. , Eysteinsson T.
Published: September 2016

Purpose

Microphthalmia‐associated transcription factor (MITF) regulates the differentiation and development of the retinal pigment epithelium (RPE). Mice that lack functional MITF do not develop the RPE and have microphthalmia. Recent studies have involved MITF in autophagy regulation in other cell types. The purpose of this study was to examine if the Mitf gene plays a fundamental role in regulating autophagy in primary RPE cells using various mutations in the Mitf gene.

Methods

Primary RPE cells from wild type and MITF mutant mice Mitf mi‐enu122(398), Mitf Mi‐Wh/+ and Mitf Mi‐Wh/Mitf mi‐mi) were isolated by enzymatic dissociation. The levels of LC3 and MITF were measured and compared by western blot in the primary RPE cultures from wild type and mutant mice. Basal autophagy was also analysed with western blots and confocal imaging using same markers in primary RPE cells from C5BL/6J mice. Untreated cells were compared to cells treated with the mTOR inhibitor Torin1, cells incubated in starvation media and cells treated with the autophagy inhibitor, bafilomycin A1 (Baf A1).

Results

The treatment with starvation media and Torin1 increased the levels of LC3 in RPE cells. Furthermore, both starvation and Torin1treatment resulted in reduced MITF protein levels. Cotreatment of Torin1 or starvation with Baf A1 restored the protein levels of MITF and LC3. Only the LC3II protein was detected in RPE cells from MITF mutant whereas wild type RPE cells showed both LC3I and II, suggesting that the degradation pathway of LC3 is stalled in the RPE from Mitf mutant mice.

Conclusions

This study suggests that autophagy is affected in Mitf mutant mice. This is consistent with in vitro data showing that MITF regulates expression of genes involved in autophagy.
A 5‐min time interval between two different dilating eyedrops increases their combined effect
Authors: Saguet P. , Charlot F. , Mouriaux F. , Lux A.L. , Beraud G. , Denion E.
Published: September 2016

Purpose

Patients are usually advised to wait 5 min between eyedrops. This delay supposedly allows the first drop not to be washed out by the second one, thereby increasing the combined effect. However, in the only experimental study conducted in humans on the concurrent administration of two different eyedrops, the authors concluded that a 5‐min time interval between eyedrops did not increase their combined effect. Our study was designed to reassess this puzzling conclusion.

Methods

Using digital photographs shot in photopic conditions in 40 eyes of 20 healthy volunteers, we compared relative pupil surface (i.e. pupil to iris surface area ratios) before and after the administration of one drop of 10% phenylephrine and one drop of 0.5% tropicamide either immediately or after a 5‐min time interval.

Results

Waiting 5 min yielded a 5.6% relative pupil surface gain (p < 0.001) indicating an additional combined effect with a 5‐min time interval.

Conclusions

This prospective blind study is the first to show in humans that waiting 5 min between two different eyedrops increases their combined effect. This conclusion is probably the result of methodological refinements including challenging of the mydriasis by photopic conditions and use of pupil and iris surface areas, which may show differences that would be undetectable in terms of diameter.
Canaloplasty with Stegmann's Canal Expander® for open‐angle glaucoma
Authors: Stangos A. , Mameletzi E. , Sunaric Megevand G.
Published: September 2016

Purpose

To evaluate the surgical outcome of canaloplasty using Stegmann's canal expander in open‐angle glaucoma (OAG).

Methods

Prospective, non‐comparative, interventional study. We recruited patients with uncontrolled OAG. All cases were operated by the same surgeon using a standardized canaloplasty procedure with 360‐degrees dilatation of Schlemm's canal (SC) using a flexible ophthalmic microcannula followed by the insertion of the expander into both surgically created SC ostia. Primary outcomes: mean change in intraocular pressure (IOP) and number of glaucoma medications following surgery. Secondary outcomes: complication rates; percentage of eyes with successful insertion of the expander in SC.

Results

44 eyes of 42 consecutive patients included. 38 (86%) were Caucasians; 32 (73%) female; primary‐, pseudoexfoliative‐, pigmentary‐ OAG had 25 (57%), 17 (39%), 2 (4%) respectively; 30 (68%) were pseudophakic; mean age (±SD) was 77 ± 8 years. All patients reached month‐6 follow‐up visit (range: 6–24). Mean IOP decreased from 22.4 ± 7.8 mmHg before surgery to 8.4 ± 4.2, 12.05 ± 3.59, 11.07 ± 4.08, 11.3 ± 3.51, 11.2 ± 2.6, 11.1 ± 2.7, 11.6 ± 2.3 at day‐1, week‐1, month‐1, ‐3, ‐6, ‐12, ‐24 respectively (p < 0.01). Mean number of glaucoma medications reduced from 3.36 ± 0.74 before surgery to 0.15 ± 0.47 at the last recorded visit (p < 0.01, Wilcoxon). No complication was recorded in 20 eyes (45%); a spontaneously‐resolving hyphema in 14 (32%); a choroidal detachment in 4 eyes (9%); a Descemet's membrane detachment and anterior uveitis each in 3 eyes (7%). Uneventful insertion was achieved in 29 eyes (66%). The stent was trimmed in 2 eyes (4.5%) due to some resistance during insertion and it was inserted only in one side in 8 eyes (18%).

Conclusions

Canaloplasty with Stegmann's expander appears to reduce IOP in OAG with minor and self‐limited complications.
Association of polymorphic variants of miRNA processing genes DGCR8 and XPO5 with primary open‐angle glaucoma risk in a Polish population
Authors: Szaflik J.P. , Molasy M. , Walczak A. , Przybyłowska‐Sygut K. , Szymanek K. , Szaflik M. , Szaflik J. , Majsterek I.
Published: September 2016

Purpose

Many reports suggest the association between altered miRNA level and the pathogenesis of glaucoma. The single nucleotide polymorphisms in genes DGCR8 and XPO5, which are involved in microRNA biogenesis, may be the key factor in this process. The aim of this study was the analysis of the single nucleotide polymorphisms of DGCR8 and XPO5 genes, which are involved in miRNA processing pathway, in relations with primary open‐angle glaucoma (POAG).

Methods

The material used in the experiment was blood obtained from patients affected by primary open‐angle glaucoma and age matched controls. The control groups rs3757 DGCR8 and rs11077 XPO5 consisted of 135 and 140 subjects respectively. The rs3757 DGCR8 study group consisted of 137 patients, while rs11077 XPO5 number of patients was 138.The polymorphic variant frequencies of rs3757 and rs1107 were determined using DNA isolated from the peripheral blood lymphocytes in TaqMan® SNP Genotyping Assays.

Results

The statistical analysis revealed that the genotype AG of DGCR8 rs3757 occurred more frequently in healthy individuals (p = 0.001), while homozygote GG was present mostly in people affected by primary open‐angle glaucoma (p = 0.003). No association between the risk of POAG and AC/CC genotypes of XPO5 was found.

Conclusions

During the experiment it was evaluated that genotype AG in rs3757 DGCR8 exhibits protective effect, decreasing the risk of primary open angle glaucoma, while the homozygote GG probably is associated with increased risk of glaucoma. The analysis of polymorphic variants of the genes involved in miRNA biogenesis could enable people classification to high‐risk group. This work was supported by grant NCN no. 2012/05/B/NZ7/02502.
Stereo OCT angiography in macular diseases
Authors: Mauget‐Faysse M. , Wolff B. , De Bat F. , Vasseur V. , Alonso A.S.
Published: September 2016

Purpose

To present stereo optical coherence tomography angiography (SD OCT‐A) images of patients with different macular pathologies.

Methods

A series of patients with macular pathologies underwent OCT‐A imaging with the Heidelberg Engineering SPECTRALIS OCT2 device. In addition, these patients underwent OCT B and C scans, color fundus photographies and fluorescein and ICG angiographies. The OCT‐A images were then computerized in a manner to give stereo images. Slabs of different thicknesses were analyzed and are presented.

Results

Thirty seven eyes with different macular diseases (10 exsudative AMD, 16 diabetic retinopathies, 10 retinal venous occlusions, 1 acute macular placoid pigmented epitheliopathy) were included and analyzed.

Stereo OCT‐A allowed to show the vascular abnormality and its impact on the retina and the choroid. The swelling of the retina was highlighted in stereo viewing.

Conclusions

Stereo OCT‐A is a new additive technique to OCT imaging. It gives a global assessment of the central retina pathology highlighting retinal swelling.

This technique needs perfect segmentation to achieve good stereo images and improvements are currently needed.
Analysis of macular sensitivity using multifocal electroretinogram and microperimetry in central serous chorioretinopathy patients after half‐dose photodynamic therapy
Authors: Rocha de Sousa A. , Rosinha P. , Rodrigues‐Araújo J. , Alves‐Faria P. , Costa A. , Falcão‐Reis F. , Penas S.
Published: September 2016

Purpose

To evaluate macular functional changes using multifocal electroretinography and microperimetry after half‐dose photodynamic therapy with verteporfin (HD‐PDT) in acute and chronic central serous chorioretinopathy (CSC) patients

Methods

The charts of 101 CSC patients submitted to half‐dose PDT were reviewed. A total of 117 eyes with acute or chronic CSC underwent half‐dose PDT using 3 mg/m2 verteporfin infused over 10 min. Serial recordings of BCVA using the ETDRS charts, macular thickness using OCT and retinal sensitivity using both microperimetry (MP) and mfERG were performed at baseline and at 3, 6, 12, 18, 24, 36, 48, 60 and 72 months after treatment. A longitudinal assessment for each of these parameters and a Spearmen's correlation analysis between them was performed.

Results

Compared to baseline, a significant increase in N1, P1 and N2 mean amplitudes was registered after HD‐PDT, as well as a significant decrease in N1, P1 and N2 mean implicit times, both for central and peripheral rings. A correlation analysis showed significant correlations between BCVA and the first‐order component of retinal response for the most central ring (<2°). Significant correlations were also found between P1 implicit time and mean central macular thickness both at 36 (p = 0.030) and 72 months (p = 0.037). Central 4 degrees retinal sensitivity significantly correlated with N1 amplitude ratio at 72 months (p < 0.01) and P1 implicit time differences at 6 (p = 0.013) and 12 months (p = 0.014).

Conclusions

mfERG demonstrated an increased retinal sensitivity in PDT‐treated CSC patients. Changes in BCVA, central macular thickness and central retinal sensitivity significantly correlated with the mfERG responses. HD PDT treatment improved both structural and functional outcomes and mfERG is an important objective parameter to evaluate functional changes in follow‐up.
Changes in choroidal thickness and mean ocular perfusion pressure with hemodialysis
Authors: Cordeiro Sousa D. , Leal I. , Couceiro R. , Bigotte Vieira M. , Lopez N. , Resina C. , Neves F. , Gomes da Costa A. , Pinto F. , Marques‐Neves C. , Proença H.
Published: September 2016

Purpose

The goals of hemodialysis (HD) in end‐stage renal disease (ESRD) are to remove uremic substances and to control the composition and volume of body fluid. Several associated systemic and ocular hemodynamic changes occurring along with HD have already been described. Our goal was to evaluate the changes in subfoveal choroidal thickness (SFCT) and mean ocular pressure perfusion (MOPP) in HD.

Methods

Prospective cohort study including 16 eyes of 16 black patients (8 women) under chronic HD. Macular enhanced depth imaging spectral domain ocular coherence tomography (EDI‐OCT) cross scans were performed and IOP measurements obtained using Tonopen® 1 h before and 1 h after HD. Hemodynamic data was also obtained at both time points. MOPP was calculated as MOPP = 2/3(mean arterial pressure) – IOP. The same experienced operator manually measured SFCT using the EDI‐OCT built‐in caliper. STATA v.13.0 was used as statistical package.

Results

Mean age of ESRD patients was 46.81 ± 7.72 [range 28–60] years. The mean time under HD was 17.38 ± 14.67 months. After HD, SFCT increased from 245.38 ± 73.86 μm to 269.13 ± 69.74 μm (p < 0.001). Adjusting for age, a linear regression model revealed a strong relationship between SFCT and MOPP with hemodialysis (p < 0.01).

Conclusions

In our study of ESRD patients, SFCT increased with HD. Shifting of molecules and fluid between the blood and choroidal interstitium during HD may be involved in SFCT changes, which are correlated with MOPP fluctuations.
Erroneus measurement of the intraocular pressure with the goldmann aplanation tonometry in fuchs endothelial corneal dystrophy
Authors: Berniolles J. , Bartolomé I. , Del buey M.A. , Martinez M. , Esteban O. , Ascaso J. , Sánchez J.I. , Idoate A. , Almenara C. , Pérez I.
Published: September 2016

Purpose

Fuchs endothelial corneal dystrophy (FECD) is a bilateral, progressive, disease of the corneal endothelium. It's caused by an abnormal collagen deposition in Descemet membrane leading to progressive degeneration of endothelial cells. The loss of endothelial cells prevents the removal of water from the cornea, causing corneal edema. Later stages involve other layers corneal layers. It is most frequently a spontaneous disease although several autosomal dominant mutations have been reported.

It has been described that corneal thickness influences the corneal biomechanics properties, leading to an erroneous measurement of the intraocular pressure (IOP) with the Goldmannn aplanation tonometry.

Methods

We report a patient diagnosed with FECD and his IOP was measured with Goldamann applanation tonometry (GAT) and Ocular Response Analyser (ORA). As well as corneal hysteresis (CH), corneal resistance factor (CRF) were recorded with the ORA. We have followed this patient for several years we also carried out corneal topographic maps and spectral domain optical coherence tomography (SD‐OCT) to complete the study.

Results

The evolution of our patient showed a corneal edema related to an abnormal endothelium. We noticed that compensated IOP was significantly higher than GAT IOP and Goldmann IOP due to biomechanic changes secondary to corneal edema.

Conclusions

IOP in patients with FECD and edema should be measured with ORA so compensated IOP is registered avoiding the underestimation of only GAT.
Unexpected orbital swelling after injection of hydrogel self inflating expanders
Authors: Grivet D. , Ronin C. , Boutet C. , Thuret G. , Gain P.
Published: September 2016

Purpose

Hydrogel self‐inflating expanders are used since the beginning of the century in order to treat enophalmos that occur after enucleation or evisceration. They are inserted in a dry, contracted state, and expand gradually to reach 10‐fold increase in volume. This procedure is relatively simple and considered as safe. Short term complications are rarely reported. Aim: to report a case of orbital swelling after implantation in order to discuss differential diagnosis and treatment options and present a revue of literature.

Methods

We describe the case of a 55 years old woman who received intra orbital injection of self‐inflating expanders in order to treat post‐enucleation enophtalmos. This procedure was followed by unexpected orbital swelling one day after surgery. The patient described important pain but no infectious signs were found.

Results

Early CT scan showed intra orbital isodense mass which ruled out post operative bleedind. MRI allowed to find out oedema features in the mass on T2w‐STIR images. It showed also the expanders inside the mass. The patient underwent topical and oral steroid medication during 3 months allowing complete resolution of the event. With no recurrence after 6 months follow up. After 6 months the swelling totally disappeared and MRI showed only the expanders with a high signal in T2w‐STIR images.

Conclusions

Non‐infectious orbital swelling after hydrogel self‐inflating expanders had not been previously described. Reporting adverse effects may help oculoplastic physicians improving the management of such rare cases.
Alterations in proliferative activity in the corneal endothelial periphery after transcorneal freezing
Authors: Correll M. , Crouzet E. , Cabrerizo J. , Dornonville de la Cour M. , Gain P. , He Z. , Heegaard S. , Kiilgaard J. , Thuret G.
Published: September 2016

Purpose

To localise proliferating cells in the corneal endothelium after transcorneal freeze injury and detect possible progenitor cells.

Methods

Endothelial cells (ECs) were disrupted by transcorneal freezing in 5‐weeks‐old rabbits. Concomitantly 10 mg/kg 5‐Ethynyl‐2’‐deoxyuridine (EdU) was injected intraperitoneally and repeated after 24 and 48 h. Animals were euthanized after 3, 5 or 40 days. Corneoscleral buttons were flat‐mounted for immunohistochemical analysis of proliferation marker Ki‐67 and detection of EdU, which is incorporated into the DNA during cell cycle S‐phase. Ki‐67+ and EdU+ cells were detected by fluorescence microscopy.

Results

Transcorneal freezing induced a central endothelial lesion of approximately 5 × 5 mm. After three days the endothelial wound was almost completely repopulated by small ECs exhibiting strong Ki‐67 expression and EdU incorporation. Furthermore, ECs in close proximity to the edges of the initial wound were positive for Ki‐67 and EdU. In the control group no central Ki‐67+ nor EdU+ ECs were detected. In the peripheral endothelium of the lesion group Ki‐67+ and EdU+ ECs were often arranged in clusters of 100–400 cells, with 1–3 clusters per quadrant. This is opposed to the periphery of the control group where Ki‐67+ and EdU+ ECs were abundantly present in all quadrants in a widespread pattern.

Conclusions

The central ECs in 5‐weeks‐old rabbits do not proliferate when the cell layer is intact, but proliferates extensively in response to wounding and covers the defect within 3 days. In contrast to this, peripheral ECs are continuously cycling. After a central lesion, the pattern of proliferative cells in the periphery change from widespread cells to clustered cells. This specific cell pattern can be indicative of a stem/progenitor cell niche.
Variation of accommodative process and anterior chamber parameters in diabetic patients
Authors: Costa L. , Passos I. , Pires G. , Proença R. , Amado D. , Ferreira J.
Published: September 2016

Purpose

Chronic hyperglycemia is responsible for vascular and neurodegenerative retinal changes in diabetic patients. However, other eye structures have been also associated with changes, such as corneal biomechanics and lens thickness.

The author's objective was to analyze the accommodative process – crystalline structural change and pupillary diameter based on Anterior Segment Optical Coherence Tomography (AS‐OCT).

Methods

Prospective case‐control study. The anterior chamber parameters were studied using AS‐OCT. The monocular accommodative process was obtained with different Dioptric Powers (0 D, 2.5 D, 5 D and 7 D – lens integrated in the OCT software) in both controlled photopic and scotopic conditions. 2 groups have been analyzed: group 1 with type 2 diabetic patients and group 2 with healthy‐controls. Measurements of anterior chamber depth (ACD), lens vault (LV), pupillary diameter (PD) and iris thickness (IT) were obtained.

Results

A total of 71 patients were evaluated (group 1 − n = 36; group 2 – n = 35). The mean age was 69.15 ± 5.55 years. Diabetic patients have showed the basal highest LV and lowest ACD values, with statistically significance (p < 0.05). In highest accommodative power, group 2 has experimented a significant reduction in ACD, ACA and PD (p < 0.05). The LV change has not proved important in the process. Group 1 has showed a significant response in scotopic conditions, even with a lower response with the highest accommodative stimuli compared to group 2.

Conclusions

The accommodative process is impaired in diabetic patients, with a significant difference in pupillary response more than in lens vault. This could be important to explain the importance of the anterior segment of crystalline in accommodation. Further studies will be necessary to clarify the DM effects on these parameters.
Unravelling the potential of secreted frizzled related protein 3 as a vascular marker
Authors: Madigan M. , Gu R. , Gilan P. , Eamegdool S.
Published: September 2016

Purpose

Secreted Frizzled Related Protein (SFRP)‐3, is a member of the SFRP family of secreted glycoproteins involved in regulating the ubiquitous Wnt signalling pathways. We noted SFRP3 expression incidentally on blood vessels at the limbus, and there are limited reprots on vessles in tumours. We further explored this observation in a range of human eye tissues, comparing SFRP3 patterns with other established vascular markers, including Ulex europaeus agglutinin (UEA)‐1 lectin.

Methods

Human post‐mortem eyes (<18 h delay) [consent and Human Research Ethics Committe approval; Lions NSW Eye Bank and UNSW HREC), were fixed in 2% paraformaldehyde/0.1M PBS. Paraffin sections (n = 6)] and flat mounts (choroid and retina) (n = 6) were immunolabelled for SFRP3 and other markers [collagen IV (basement membrane), smooth muscle actin (SMA) (pericytes and smooth muscle cells), MHCII (microglia and macrophages)] and UEA‐1 (vascular endothelium). All immnuolabelling was visualised using confocal microscopy (Zeiss LSM700).

Results

We observed SFRP‐3 immunolabelling of blood vessels in different human eye tissues including limbus, choroid (and naevi, Madigan et al., EVER 2015) and retina. Both sections and flatmounts displayed obvious SFRP3 immunlabelling of endothelial cell membranes; SFRP3 co‐localised with UEA‐1 lectin and Collagen IV (basement membrane). We also noted SFRP3+ neuron‐like cell bodies and processes in peripheral retina, adjacent to the ora serrata.

Conclusions

SFRP3 consistently immunolabelled blood vessels in all ocular tissues examined. It does not appear to label pericytes or perivascular immune cells, but co‐localised with UEA‐1 lectin (blood vessel ‘gold standard’) and basement membrane collagen IV, indicating its potential as a novel blood vessel marker.
A vascular comparison between primary open‐angle glaucoma and normal‐tension glaucoma
Authors: Van Keer K. , Abegão Pinto L. , Barbosa Breda J. , Willekens K. , Vandewalle E. , Stalmans I.
Published: September 2016

Purpose

To contrast systemic and ocular vascular parameters in patients with normal‐tension glaucoma (NTG) versus primary open‐angle glaucoma (POAG).

Methods

Sub‐analysis of a prospective, cross‐sectional, case–control hospital‐based study investigating ocular blood flow in glaucoma patients (Leuven Eye Study). Systemic and ocular vascular parameters, including a questionnaire, blood pressure, dynamic contour tonometry, colour Doppler imaging, retinal oximetry and optical coherent tomography enhanced‐depth imaging, were compared between an age‐matched group of POAG and NTG patients.

Results

We included 192 NTG and 214 POAG patients. Patients with NTG presented with significantly lower diastolic blood pressure (p = 0.01), decreased acceleration in the central retinal artery (p = 0.02), increased resistive index in the ophthalmic artery and central retinal vein (both p = 0.04), thinner peripapillary choroidal thickness (p < 0.001) and higher retinal venous oxygen saturation (p < 0.001). The odds of suffering from hypotension, migraine and Raynaud were significantly higher for NTG patients [95% confidence interval (CI) 1.30–8.73, 1.13–4.42 and 1.36–3.95 respectively], as were the odds of taking systemic bèta‐blockers, calcium antagonists and angiotensin II receptors blockers (95% CI 1.04–2.67, 1.21–6.62 and 1.18–5.97 respectively).

Conclusions

Patients with NTG differ significantly on several ocular and systemic vascular parameters from POAG patients. These findings add further support to a higher weight for vascular‐driven neuropathy in NTG vascular etiology in NTG.
Vitreous and serum VEGF levels after intravitreal injection of bevacizumab, ranibizumab and triamcinolone acetonide in patients with proliferative diabetic retinopathy
Authors: Sozen‐Delil F.I. , Cekic O. , Haklar G.
Published: September 2016

Purpose

To compare ocular and systemic vascular endothelial growth factor (VEGF) antagonizing effect of bevacizumab (IVB), ranibizumab (IVR) and triamcinolone acetonide (IVT) following intravitreal injection in eyes with proliferative diabetic retinopathy (PDR).

Methods

Thirty‐one eyes of 28 patients with diabetic retinopathy and 21 eyes of 21 non‐diabetic patients having various vitreoretinal diseases underwent vitrectomy. Eyes with PDR were injected with IVB (n = 7), IVR (n = 10) or IVT (n = 6) 3 days prior to vitrectomy. The non PDR eyes (n = 8) was not injected. Vitreous and serum samples were obtained during vitrectomy. Serum and vitreous VEGF levels were analyzed using ELISA.

Results

Mean (±SD) vitreous VEGF level in diabetic eyes was higher than that of non‐diabetics (1,275.76 ± 3,441.63 pg/ml vs. 82.66 ± 100.71 pg/ml, p < 0.001) while serum VEGF level did not differ (630.17 ± 981.72 pg/ml vs. 506.51 ± 825.64 pg/ml, p = 0.89). In diabetic eyes, VEGF levels in serum and vitreous was similar (p > 0.05) while in non‐diabetics, serum VEGF level was higher than vitreous VEGF level (p < 0.001). In non‐diabetics, there was lower vitreous VEGF levels than that of IVB, IVR, IVT injected eyes with PDR or non‐injected eyes with non‐PDR (p = 0.002, p < 0.001, p = 0.003 and p = 0.002, respectively). There was no difference among serum VEGF levels within PDR subgroups (p > 0.05). IVT suppressed vitreous VEGF level more than IVR did (298.36 ± 442.14 pg/ml vs. 1,525.01 ± 2,605.95 pg/ml, p = 0.03), however after adjusting total protein level, no significance was remained (p = 0.193).

Conclusions

Vitreous VEGF level was similarly affected 3 days after injection of IVB, IVR and IVT.

Acknowledgement

This project was supported by Marmara University, Scientific Research Projects Committee.
Vasodilation by cell membrane permeable but not impermeable carbonic anhydrase inhibitors of precontracted retinal arteries
Authors: Eysteinsson T. , Hardarson A.O. , Carta F. , Supuran C.T.
Published: September 2016

Purpose

Carbonic anhydrase inhibitors (CAI's) are used to lower intraocular pressure in glaucoma. Some have also been found to elevate retinal and optic nerve PO2 and cause vasodilation of retinal arteries. But the mechanism causing the vasodilatation is unknown. The aim is to identify which carbonic anhydrase isoenzymes are involved in control of vascular tone, and whether located intracellularly or on the surface of cell membranes. Selective membrane permeable and impermeable CAI's were used for this purpose.

Methods

Dissected segments of porcine retinal arteries were mounted in a wire myograph for measurement of contractile activity and precontracted with 10−6 M U‐46619, a prostaglandin analog, added to the organ bath. With the vascular tone stabilized the CAI's tested were applied separately to the bath, and the effects of each on the tone recorded. Results are presented as mean ± SEM percentage of the maximum vasodilation, as compared to the prior vasoconstriction per mm, induced by 10−6 M U‐46619.

Results

The membrane permeable CAI dorzolamide (10−3 M) induced a mean relaxation of porcine retinal arteries by 76 ± 8% (p < 0.02) when precontracted with U‐46619. Benzolamide, considered a membrane impermeable CAI, induced a significant mean relaxation of 85 ± 8% (p < 0.01) at 10−3 M after U‐46629 induced vasoconstriction; this relaxation was dose‐dependent. The pyridinium derivative FC5‐207A (10−3 M), a membrane impermeable CAI, had no effects on the vascular tone of retinal arteries precontracted by U‐45519, at any dose tested.

Conclusions

Membrane permeable carbonic anhydrase inhibitors induce vasodilation in precontracted porcine retinal arteries, while membrane impermeable inhibitors do not, suggesting that cytosolic isoenzymes are involved in mediating the vasodilation. The results indicate that benzolamide is probably a membrane permeable CAI.
Tomographic analysis of the retinal layers in diabetic macular edema treated with dexamethasone intravitreal implant
Authors: Medeiros Pinto J. , Prates Canelas J. , Rosa R. , Coelho C. , Vaz‐Pereira S.
Published: September 2016

Purpose

To study the morphological alterations in the individual retinal layers of patients with diabetic macular edema (DME) treated with dexamethasone intravitreal implant.

Methods

Retrospective, observational study of patients with center‐involving DME treated with a single dexamethasone implant as primary or secondary treatment, and with at least two follow‐up visits. Central thickness of each retinal layer was obtained with optical coherence tomography automated segmentation (Heidelberg Spectralis Engineering, Germany), with manual correction as needed.

Results

Twenty one eyes of 18 type 2 diabetic patients were included (median HbA1c 7.1%). The median time of follow‐up after treatment was 8 weeks (visit 1) and 4 months (visit 2). At visit 1, a significant reduction in central macular thickness (CMT) (480 ± 24 to 325 ± 134), retinal nerve fibre layer (RNFL) (21 ± 1 to 18 ± 2), ganglion cell layer (GCL) (30 ± 2 to 22 ± 1), inner nuclear layer (94 ± 15 to 46 ± 6), outer plexiform layer (OPL) (35 ± 3 to 28 ± 1), outer nuclear layer (ONL) (176 ± 14 to 117 ± 18) and retinal pigment epithelium (RPE) (29 ± 7 to 15 ± 5) was noted (p < 0.05 for all layers). At visit 2 there was a significant increase in CMT, (424 ± 270), although still lower than the baseline; there was also a significant increase in RNFL (25 ± 3), GCL (30 ± 3), OPL (40 ± 3), ONL (146 ± 20) and RPE (24 ± 5) (p < 0.05). There was no difference in inner plexiform layer (IPL) or outer retinal layers thickness over time. Seven eyes had neurosensorial detachment (NSD) at baseline, versus 0 at visit 1 and 2 at visit 2.

Conclusions

The reduction in CMT noted in patients with diabetic macular edema treated with dexamethasone intravitreal implant is mostly due to resolution of NSD (which accounts to the automated RPE thickness) and the layers above external limiting membrane, except for IPL. This effect is highest at the first follow‐up visit.
Functional and anatomical changes after standard and half dose verteporfin PDT in central serous choroidopathy
Authors: Montero Moreno J.A. , Ruiz‐Moreno O. , Garcia‐Martinez J. , Sierra‐Rodríguez M.A. , Ruiz‐Moreno J.M. , Gonzalez Uruena C. , Calvo Perez P. , Ruiz del Tiempo P. , Lopez Gaona A.
Published: September 2016

Purpose

To report the anatomical and functional changes occurring in patients with central serous choroidopathy (CSC) treated by standard or half dose photodynamic therapy (PDT) with verteporfin.

Methods

Retrospective, interventional, multicenter study. The clinical files, optical coherence tomography (OCT) and autofluorescence (AF) images of patients with CSC treated by standard or half dose PDT were revised.

Results

A total of 152 patients were identified (111 males). Patient's mean age was 50 years (standard deviation 10, range 30–68) and the average follow‐up was 21 months (SD 12, range 3–54). Mean baseline corrected visual acuity (VA) was 64 ETDRS letters (SD 18, range 2–85) and final VA was 72 letters (SD 16, range 2–85). The average central macular thickness (CMT) determined by automated OCT software at baseline was 293 μm (SD 85, range 115–615) and 221 μm (SD 45, range 41–615) by the end of follow up. Eighty‐two patients were treated by standard, full dose PDT and 70 patients were treated by half dose verteporfin PDT. The average number of required PDT sessions was 1.13 (SD 0.47, range 1–4) for standard PDT vs. 1.30 (SD 0.52, range 1–3) for half dose PDT (p = 0.009; Student's t test for unpaired data). Both groups did not differ in terms of age, previous lapse since diagnosis, baseline VA, final VA, and final CMT (p = 0.72; p = 0.18; p = 0.41; p = 0.30; p = 0.85; Student's t test for unpaired data). However, they differed in terms of basal CMT (mean CMT in the standard PDT group was 320 vs. 262 μm for the half dose group). The PDT laser spot could not be observed in the AF images in any of the groups.

Conclusions

According to our findings, standard, full dose PDT provides similar visual outcomes as half dose verteporfin PDT with a lower rate of re treatments and no differences in CMT or AF patterns.