bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraocular rubella virus detection as a diagnostic tool for atypical forms of Fuchs cyclitis
Authors: BOUILLOT A , FEL A , TOUITOU V , LE HOANG P , LABETOULLE M , ROZENBERG F , BODAGHI B
Published: November 2013

Purpose Since 2004, different studies have reported on the pathophysiology of Fuchs cyclitis, which may be due to rubella virus infection. The purpose of this study is to investigate clinical profile and prognosis of rubella virus associated uveitis. Retrospective, observational, bicentric study.

Methods All patients managed between January 2009 & march 2013 for an atypical form of Fuchs cyclitis were included. Clinical features for these patients were assessed. An extensive work‐up of anterior or intermediate uveitis was performed in all cases. An anterior chamber tap was done for molecular detection of herpesviruses and intraocular anti‐rubella virus antibody synthesis. Treatment was adapted to the results of ocular fluids analysis.

Results The series included 17 patients (M/F : 11/6) with a proven diagnosis of rubella virus‐associated uveitis. The mean age was 43.3years (27‐70)). All patients had a positive outcome for intraocular antibody production against rubella virus with a Goldmann‐Witmer coefficient > 3. Only 3 patients (15%) fulfilled the classical Fuchs cyclitis criteria with stellar keratic precipitates + heterochromia/iris atrophy + cataract + vitritis. Uveitis was bilateral in 3 patients (20%) and 7 patients (35%) had an uncontrolled IOP requiring glaucoma surgery.

Conclusion For most of these patients, intraocular rubella virus serology allowed the final diagnosis of Fuchs cyclitis despite incomplete clinical criteria. Intraocular rubella virus detection can help for the diagnosis of atypical forms of Fuchs cyclitis. This avoids unnecessary additional tests and prescription of local or systemic corticosteroids. Secondary glaucoma remains a major complication and needs a close monitoring.
3 months results of intravitreal dexamethasone implant in non infectious uveitis
Authors: DARUGAR A , CHAMPION E , TOUITOU V , FARDEAU C , LE HOANG P , BODAGHI B
Published: November 2013

Purpose To evaluate efficacy and safety of dexamethasone implant in patients with non infectious uveitis.

Methods Retrospective study. Charts of 30 patients with non infectious uveitis treated with dexamethasone implant between September 2012 from April 2013 were reviewed. Best corrected visual acuity (BCVA), intra‐ocular pressure (IOP), laser flare meter and retinal central mean thickness (CMT) were followed up initially, at 1 and 3 months in each patient.

Results 29 patients of 30 were treated for a macular edema. 1 patient was treated to improve the anti‐inflammatory control for a Behçet disease refractory to immunosupressive therapy. Intravitreal dexamethasone injection was effective in improving BCVA : preoperative mean BCVA was 0.57 logMAR units and improved to 0.45 and 0.43 logMAR units at month 1 and 3. Mean CMT also improved in all patients : the pre‐operative mean CMT was 455 μm and improved to 300 and 312 μm at months 1 and 3, respectively. Macular edema began to relapse in 23 patients at 3 months. Mean anterior chamber flare measured by laser decreased from 250 photons/ms to 60 photons/ms. Safety was good with 3 cases of IOP increase resolved by medical treatment only, 1 case of intravitreal hemorrhage treated by vitrectomy.

Conclusion OZURDEX(®) appeared effective in management of uveitis macular edema but its action was short with frequent relapse at 3 months. Its safety seemed to be good. Further studies are needed to evaluate its place in the treatment strategy.
Three‐dimensional analysis of HSV colour space to distinguish small retinal haemorrhages, hard exudates and photocoagulation marks from dust artefacts
Authors: SUZUKI N , YAMANE K
Published: November 2013

Purpose To detect early diabetic retinopathy, we employed three‐dimensional analysis of HSV colour spaces.

Methods Six patients with diabetic retinopathy and small haemorrhages, hard exudates and photocoagulation marks were evaluated using fundus photography, which revealed dust artefacts in the fundi of some patients. We constructed an experimental device similar to the optical system of a fundus camera and made the artificial eyes of the fundus painted four kinds of colours: khaki, sunset, rose and sunflower.　The dust 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, which changed the RGB colour space into an HSV colour space. The software interpreted each value of HSV colour space as a three‐dimensional graph, which was modified using a Gaussian filter.

Results We calculated the difference between manifestation and perimanifestation areas and dust artefact and periartefact areas using average HSV values. V values for the manifestations were haemorrhage, 0.06±0.03; hard exudate, −0.12±0.06 and photocoagulation marks, 0.07±0.02. V values for the dust artefacts, visualized under the human eye and the artificial eyes, were human eye, 0.19±0.03; khaki, 0.41±0.02; sunset, 0.43±0.04; rose, 0.47±0.11 and sunflower, 0.59±0.07. Ratios of the dust artefact to manifestation areas in the human eye were haemorrhage, 3.17; hard exudate, −1.58 and photocoagulation, 2.71.

Conclusion The HSV colour space displayed good capability to distinguish small retinal haemorrhages, hard exudates and photocoagulation marks from dust artefacts.
Autofluorescence patterns and visual acuity in macular telangiectasia type 2
Authors: BALASKAS K , LEUNG I , SALLO FB , CLEMONS TE , BIRD AC , PETO T
Published: November 2013

Purpose An analysis was performed with a view of determining potential associations between typical patterns seen on autofluorescence (AF) imaging in patients with Macular Telangiectesia (MacTel) type 2 and distance visual acuity at presentation as well as visual change over a 2‐year follow‐up period, thus ascribing predictive value to AF patterns in MacTel.

Methods A subgroup of 135 patients (229 eyes) enrolled in the MacTel study underwent AF imaging. Images were graded at the Moorfields Eye Hospital Reading Centre. Recorded AF patterns at baseline and at two years included the typical pattern of increased central AF due to loss of foveal masking, localized decreased AF at the end of a retinal vessel and a large area of decreased AF. Best‐corrected visual acuity (BCVA) was measured by means of the Early Treatment for Diabetic Retinopathy Study charts at baseline and after two years. Statistical associations were derived by means of a generalized linear model.

Results Presence of increased macular AF (p=0.004), a large area of decreased AF (p<0.001) or decreased AF at the end of a retinal vessel (p<0.001) at baseline were significantly associated with worse BCVA. Presence of increased macular AF (p<0.001) or of localized decreased AF at the end of a retinal vessel (p<0.001) and the absence of a large area of decreased AF (p<0.001) were predictive of a subtle, but statistically significant drop in BCVA at 2 years.

Conclusion The typical pattern of increased central AF at baseline is encountered in patients with worse BCVA in MacTel type 2 and is also predictive of further subtle visual loss in a period of two years. Decreased AF is found in patients with worse baseline BCVA though no further visual loss at two years is observed.
How to perform confrontational visual fields, tangent screen and manuel kinetic perimetry
Authors: KAWASAKI A , BORRUAT FX
Published: November 2013

Non‐automated visual field testing remains an important clinical skill. Confrontational testing is an important bedside test that can detect subtle hemianopic defects , paticularly when using a red test object. Confrontational and kinetic perimetry are also excellent ways to document a non‐organic origin of severely constricted visual fields. Tangent screen testing and kinetic perimetry are capable of identifying small central defects, particularly those missed on standard automated threshold tests and can delineate thier pattern of defect for purposes of localization. This lecture will review and provide tips on how to perform and interpret these non‐automated forms of perimetry in the appropriate clinical situation.
Cases and visual field examples and discussion
Authors: KAWASAKI A , BORRUAT FX , SZATZMARY G
Published: November 2013

cases for audience
Clinical results on the anti‐oxidative effect of oral vitamin and mineral supplementation (on impaired retinal vascular reactivity)
Authors: GARHOFER G
Published: November 2013

Abstract not provided
Psychophysical effects of RGC damage: What tests could we use clinically?
Authors: REDMOND T
Published: November 2013

Visual field sensitivity is measured clinically in the investigation of retinal conditions such as glaucoma. It is also the primary functional endpoint in many clinical trials in ophthalmology. Since the introduction of the gold standard visual field test, Static Automated Perimetry (SAP), over 30 years ago, a great deal more has been learned about biological changes in the retina in eye disease, particularly in the retinal ganglion cells (RGCs) from cat, primate and rodent models, with many recent studies pointing towards pre‐morbid degenerative events in these cells. There is also growing psychophysical evidence of enlarged RGC receptive fields in conditions such as glaucoma, before detection of damage by SAP. This has renewed interest in the design of functional tests that are capable of detecting subtle changes in the retina in early disease, in the hope that early visual loss can be halted or even reversed. The optimum visual field test is one that is sensitive to pre‐morbid biological changes in the retina with minimal measurement variability and a large measurement range. This test should be applicable to a wide range of diseases that are characterised by RGC damage.
Genetics of the posterior corneal dystrophies
Authors: DOBROWOLSKI D
Published: November 2013

Abstract not provided
Diagnosis FNAB for orbital and intraocular tumors from a cytologist point of view
Authors: KLIJANIENKO J
Published: November 2013

Abstract not provided
Minocycline as a new neuroprotective agent in a rodent model of NAION
Authors: FEL A , SIMONUTTI M , FROGER N , IVKOVIC I , LEHOANG P , BERNSTEIN SL , BODAGHI B , SAHEL JA , PAQUES M , PICAUD S , TOUITOU V
Published: November 2013

Purpose To study the neuroprotective properties of minocycline in a rodent model of NAION.

Methods 6 weeks old Long Evans male rats had induction of NAION in the right eye after intravenous injection of rose bengale and laser‐induced photothrombosis of the head of optic nerve. Treated animals were injected intraperitonealy with minocycline 22mg/kg/day, 3 days before induction and until sacrifice. Controls were treated by PBS during the same period of time. SLO, fluorescein angiography, and OCT were performed at day 1, 8, 15 and 30 to monitor fiber loss. At day 30, all animals were sacrified and flatmounted retina were stained with BRn3a. Retinal ganglion cells (RGC) were counted by manual method per field on stereology.

Results Sixteen rats had induction of NAION in the right eye, while the left eye was used as an internal control. In the PBS‐treated group, fiber loss was observed on SLO from the day 8 post‐induction. In this group, RGC loss in the NAION eye was 47.9% compared to control eyes (p<0.05). In the minocyclin‐treated group, RGC loss could not be observed on SLO, and stereology demonstrated a 9.58% loss compared to control eyes (not statistically significant).

Conclusion Minocycline seems to be an effective neuro protective agent in a rodent model of NAION, when administered before and after induction of NAION. The mechanisms involved in this neuroprotective effect are still to be further evaluated. This molecule could thus be a promising candidate, both in the treatment of NAION but also in the prevention of involvement of the fellow eye.
incidence of Diabetic Macular Edema in type 1 Diabetes
Authors: LUJAIN I
Published: November 2013

Purpose Diabetic retinopathy is a serious vision threatening complication which can be prevented if detected early.Since diabetic retinopathy has been reported to occur only rarely before the end of pubertal development , children and adolescents are seldom included in screening programmes.. Our main goal is to screen for early retinal changes and review the risk factors involved in the development of diabetic retinopathy in children.

Methods We prospectively enrolled 200 children and adolescents with insulin‐dependent type 1 diabetes mellitus diagnosed before the age of15.0years(disease duration of < 12 years)and who were older than 5.0 years at the time of examination from our pediatric endocrinology clinics at 2 tertiary care hospitals(king abdulaziz university hospital and king faisal specialist hospital) in Jeddah,Saudia Arabia. all patients recived full eye examination including Best Corrected Visual Acuity,Retinal examination was performed with stereoscopic fundus examination by indirect ophthalmoscope for peripheral retinal changes and slit lamp exam with 75 D lens for macular edema.Ocular coherence tography(OCT)was performed for all patients to evaluate sub‐clinical macular edema

Results Non of our patients had proliferative diabetic retinopathy changes,we also did not see evidence of diabetic macular edema Mean diabetes duration was 3years and mean HbA1c was 6.5%.Mild non proliferative DR was diagnosed in 30 children (15 %), those with DR were significantly older(P < 10−3),had a longer duration of diabetes (P = 0.001),and had higher HbA1c(P = 0.15). After adjustment for age, only longer duration remained significantly associated with DR (P = 0.01).

Conclusion mainstay of prevention is tight glycemic control with regular screening and fundus examination,with OCT if suspension
Refractive error after intravitreal bevazicumab for threshold disease in retinopathy of prematurity: Two‐years follow‐up
Authors: JONAS J , HARDER B , SCHLICHTENBREDE F , VON BALTZ S
Published: November 2013

Purpose To examine the association between myopic refractive error at two years of life in infants who postnatally received an intravitreal bevacizumab injection or standard laser therapy for threshold retinopathy of prematurity (ROP) in fundus zone I or zone II.

Methods In the retrospective non‐randomized interventional comparative study, infants who consecutively received a single intravitreal bevacizumab (0.375 mg) injection (study group) were compared with infants who had previously undergone standardized retinal argon laser therapy (control group). The follow‐up examination included cylcoplegic refractometry.

Results The study group consisted of 7 children (13 eyes) and the control group included 14 children (27 eyes). Both groups did not differ significantly in gestational age and follow‐up. At the end of follow‐up of 24 months, refractive error (median:+1.00 diopters (D) (+4.0D to ‐10.00D) versus median:‐7.50D (+2.50D to ‐15.0D);P=0.001)), astigmatism (median:0.25D (0D to 2D) versus median:1.25 D (0D to 5.75D);P=0.001)) and prevalence of high myopia (≤‐6D) (15±10% versus 52±10%;P=0.04) were significantly less in the study group than control group. After adjusting for gestational age, follow‐up time, gender and birth weight, refractive error (P=0.007), astigmatism (P=0.01) and prevalence of high myopia (P=0.03; Odds Ratio:0.13) were significantly associated only with laser therapy versus bevacizumab therapy.

Conclusion A single intravitreal bevacizumab injection as compared to conventional retinal laser coagulation was associated with a lower degree of myopization and less astigmatism at two year follow‐up.
Wide field imaging in patients treated with vigabatrin
Authors: ARNDT C , BRUGNIART C , BURSTZYN J , MOTTE J , DUCASSE A , BENISTY D
Published: November 2013

Purpose Vigabatrin is an active treatment for epilepsia in children particularily for West’s syndrome. In children when visual field testing cannot be performed, regular ERG recording is mandatory to screen for retinal toxicity. Some peripheral retinal changes have been described with ophthalmoscopy. The purpose of this study was to evaluate the occurrence of retinal changes wide field imaging and to compare the results with ERG recordings.

Methods Five consecutive patients treated with vigabatrin were followed up with Flicker ERG and wide field imaging using scanning laser ophthalmoscopy (Optomap, Optos). Flicker ERG amplitude was considered as abnormal below 50µV.

Results Two patients had abnormal ERG recordings and presented with peripheral pigmentary changes. One patient presented with abnormal flicker ERG and normal retinal imaging. Two patients had normal ERG recordings with no peripheral changes on wide field imaging.

Conclusion The follow‐up with ERG in children treated with vigabatrin is complicated because the recordings are regularly repeated. A follow‐up protocol combining electrophysiological recordings and wide field imaging could simplify screening for retinal toxicity but the remains to be demonstrated with a prospective study.
Quality of life among children with severe and chronic ophthalmic conditions
Authors: AZIZ A , MATONTI F , FAKHOURY O , DENIS D
Published: November 2013

Purpose To evaluate the impact on the quality of life of children from 8 to 18 years‐old of a rare and serious ophthalmological condition (cataract and congenital glaucoma).

Methods Analysis of the answers obtained between May and November,2012 by autoquestionnaire( KIDSCREEN‐10) among children from 8 to 18 years‐old and from their parents and approaching their physical, social, moral and educational wellness. The children are patients of a department of pediatric ophthalmology of the South of France and followed‐up on the long term for chronic and severe ophthalmological conditions.

Results 50 children (mean age 12 years) and 45 parents participated in this study. We register a lack of energy and an impression to be decreased to the everyday life to 32% of the children according to their parents(n: 14) and 27%(n: 13) according to the children. A feeling of sadness is present according to the parents for 43% of the staff(n: 19) and to 36% of the children according to their statements(n: 18). The solitude is felt at 64 %(n: 28)of children according to their parents against 30% (n: 15) according to the children. The school life is affected according to the parents for 82% of the children(n: 37) and 70% when we question the children (n: 35). The global appreciation of the child's health is degraded at 30 % of the children (n: 13) according to their parents against 22% according to the children (n:11).

Conclusion Chronic ophthalmological conditions have certain noxious impact on the quality of life of the children and particularly in their social relationships and their school life. This study shows a good correlation between the felt of the parents on the real‐life experience of their children and the appreciation which make the children themselves.
Experience with straylight in the cataract clinic
Authors: COCHENER B
Published: November 2013

We know that there are many sources of physiologic scatters such modified cornea (after refractive surgery, haze, dystrophies, ocular surface disease) , vitreous alterations and lens changes with the aging process inducing progressive cataract and impairing light diffusion. Nowadays, thanks to the access to scatter measurement, we might be able to assess tear film quality dynamics (with an increase in ocular surface desiccation commonly observed in old patients), but moreover we could detect early cataract at the stage of no induced visual acuity decrease but quality of vision degradation. We will present the preliminary results of a multicenter French study based on the use of the Double Pass Image Analyser (OQAS) for the potential diagnosis of cataract, on a standardized questionnaire of life and taking also account the integrity of ocular surface in addition to visual performances. The key parameter provided by this platform is the OSI (Ocular Surface that increases when scatters are in elevation (superior to 4). Our preliminary pilot results show a significant correlation between quality of life and OSI changes, suggesting that the objective measurement of light scatter might be of interest for detection of early cataract and that the consideration of quality of life (based on a basic questionnaire) should be considered in the modern new definition of cataract.
Inclusion effects if straylight is added to the indication for cataract surgery
Authors: VAN DEN BERG TJTP
Published: November 2013

In several European countries, criteria for cataract surgery (CE) are being debated. Within the ophthalmological profession, but also from other sides it is sometimes thought that more transparent choices are in order. Health insurances and governments may exert pressure for other than quality of care motives. With the high levels of safety nowadays achieved, CE can be offered much earlier, but to which patients precisely? Whatever the motives, it is of relevance to discuss potential improvements in targeting CE, making use of new instruments for evaluation of cataract related losses of visual function. As studies by Pesudovs and others show questionnaire assessment to be unreliable on individual basis, the focus must be on functional assessment. This presentation will focus on the CE inclusion effects if straylight assessment (log(s)) would be combined with visual acuity (logMAR). As one dimensional model for disease severity logMAR+log(s) (JCRS2012;38:840‐848) is applied to population studies (5000 general population eyes AJO2007;144:358‐363. 420 CE eyes JCRS2012;38:840‐848. 160 refractive lens exchange eyes, Lapid et al. paper in preparation). In all studies straylight would add strongly to the number of CE inclusions.

Commercial interest
Lithium increases p63 levels in cultured human limbal epithelial stem cells
Authors: MOE MC , JOHNSEN E , NESS CH , SHAHDADFAR A , NICOLAISSEN B , NOER A
Published: November 2013

Purpose p63 (isoform ΔNp63α) is a putative stemness marker for limbal epithelial stem cells (LESCs), and is essential for the proliferative potential of stem cells in stratified epithelia. The niche for LESCs is the limbus, located between the clear cornea and bulbar conjunctiva. LESCs are responsible for and able to renew and repair the corneal epithelium throughout life. In a number of disorders and after trauma, limbal stem cell deficiency (LSCD) may occur, and this can be treated by isolation and cultivation of LESCs from a healthy eye followed by transplantation to the affected eye. It is known that the percentage of p63‐bright cells affect the success rate of the transplantation. Thus, we wanted to reveal whether lithium, a known Wnt signaling inducing agent, may increase the expression of p63 in human LESC cultures.

Methods Small limbal biopsies (1x1‐2mm) were dissected from donor corneas and cultured in a standard medium at 37 oC and 5% CO2 under different concentrations of lithium (LiCl2). The cells were cultured for 3‐6 weeks and medium was changed every 2‐3 days.

Results The epithelial cells migrated from the limbal biopsy to form an epithelial sheet. Lithium enhanced the expression of p63 compared to controls, and this was confirmed by qRTPCR. Further studies mapping epigenetic alterations of the lithium treatment are currently conducted.

Conclusion Lithium induced upregulation of p63 in LESC could be clinically important by increasing the long term success of limbal stem cell therapy.
Identification of infected corneal epithelial cells using an innovative in vivo fluorescent multilaser confocal microscope: Proofs of concept
Authors: NAIGEON N , VERHOEVEN P , BOURLET T , SOULIER H , POZZETTO B , HE Z , CAMPOLMI N , CINOTTI E , PISELLI S , GAIN P , THURET G
Published: November 2013

Purpose To make the proof of concept of using fluorescent markers specific of certain bacteria or viruses (Herpes simplex virus, HSV) to make the aetiologic diagnosis of infectious keratitis directly at patient bedside, using fluorescent in vivo confocal microscopy (FIVCM)

Methods We fully adapted for ophthalmology, the dermatology multilaser FIVCM vivascope 1500ML (Lucid Inc, NY, MAVIG GmbH, Germany) equipped with 488, 658, and 785nm class IB lasers. Human corneas unsuitable for graft were infected with either a specific bacteria species or HSV suspensions after mechanichal superficial central wound to mimick a superficial infectious keratitis. They were incubated with the suspension during 2h, rinsed, and returned to storage medium for 24h at 31°C. For controls, bacteria or viruses were replaced by balanced salt solution. Corneas were incubated with the corresponding fluorescent marker, one for HSV, the other for bacteria during 1h at 37°C. After meticulous rinsing, corneas were mounted on an anterior artificial chamber and observed with the FIVCM

Results Control corneas showed little to no fluorescence, whereas numerous epithelial cells were fluorescent using the corresponding couple marker/wavelength

Conclusion For the first time we obtained the POCs, on ex vivo human corneas, of specific diagnosis of bacteria or HSV keratitis using FIVCM. Animal experiments are ongoing in our laboratory on infectious keratitis models to confirm the feasibility and safety of this new promising diagnosis method. Grant: Appel à projet jeune chercheur GIRCI Rhone Alpes Auvergne 2012
Various epithelial manifestation of herpetic keratitis in corneal confocal microscopy imaging
Authors: WOJCIK L , WYLEGALA E , SMEDOWSKI A
Published: November 2013

Purpose To present different variants of epithelial changes observed in patients with herpetic keratitis in corneal confocal microscopy in vivo images.

Methods In 19 patients with diagnosed herpetic keratitis of typical clinical course, we performed the following: basic slit lamp examination, corneal scans using Scheimpflug camera and corneal confocal microscopy in vivo. Full thickness corneal scans were made and compared with corresponding images from healthy objects. Additional imaging of epithelial layer with higher magnification was made to compare detailed changes within all components of epithelial layer.

Results On a slit lamp examination we described different size and surface ulceration of typical dendritic shape. In the image from Scheimpflug camera – local turbidity of stroma and lack of superficial layers in place of ulceration. The corneal confocal microscopy images showed different severity of stromal changes in form of hazing, turbidity, keratocytes activation, inflammatory cells infiltration or fibrosis. In epithelial layer scans except mostly diffused inflammatory infiltration, we described changes involving: epithelial cells‐intracellular inclusions, abnormal cells shape and size, degeneration; intercellular matrix‐hazing, inclusions; superficial nerve plexus‐thinning or lack of nerves, mace expand of nerves, nerve fibers proliferation; Bowman membrane and anterior stroma‐epithelial hernias into deeper layers.

Conclusion Herpetic corneal inflammations have no typical image in corneal confocal microscopy; however can show repeatable features in epithelial layer, which are helpful in diagnosis. Corneal confocal microscopy is useful tool for recognizing viral keratitis.
Regeneration of lymphatic vessels after lymphatic‐specific photodynamic therapy is not dependent on lymphangiogenesis and tissue remodeling by myofibroblast
Authors: KILARSKI W
Published: November 2013

Photodynamic therapy (PDT) is a clinically used therapeutic procedure based on the administration of a non‐toxic photosensitizer followed by sub‐thermal light exposure for treatment of pathologic cornea neovascularization. However, this approach does not target pre‐existing lymphatics at the cornea limbus and sustained antigen drainage can lead to rejection of allogenic cornea grafts. Our PDT protocol aim at specific destruction of lymphatic vessels leaving blood circulation intact. Collecting lymphatic vessels remain occluded for 9 days and then the drainage is restored. Interestingly, lymphatic regeneration occurs not by lymphangiogenesis and wound healing but by true, epimorphic regeneration. We found that myofibroblasts were present in the tissue even though the tissue injury was limited to the lymphatic endothelial cells of collecting lymphatics and their pericyte coverage. Even though myofibroblasts were recruited and persisted in the tissue for the whole period of lymphatic regeneration no scaring in other tissue structures was observed, i.e. remodeling of blood vessels, nerve fibers or adipocytes. Limited tissue remodeling and scarification after lymphatic‐specific PDT should alleviate potential clinical translation of this method for temporal occlusion of collecting lymphatics e.g. before cornea grafting.
Role of myofibroblasts in epiretinal membrane development
Authors: BOCHATON‐PIALLAT ML
Published: November 2013

Purpose: Fibrous epiretinal membranes (ERMs) result from inappropriate proliferation, migration and differentiation of several cell types including myofibroblasts. They occur at the endstage of proliferative and idiopathic vitreoretinopathy, and proliferative diabetic retinopathy. Myofibroblasts exhibit contractile features that are typical of granulation tissue during wound healing and fibrocontractive diseases and are responsible for granulation tissue remodeling and retraction. The marker of myofibroblasts is the expression of alpha‐smooth muscle actin (alpha‐SMA). Transforming growth factor‐beta1 (TGF‐beta1) and ED‐A fibronectin are key players of the complex process of myofibroblast differentiation. Methods: Samples of ERM were studied by electron microscopy, immunohistochemistry, and confocal microscopy with antibodies specific for alpha‐SMA, vimentin, TGF‐beta1, TGF‐beta receptor II and EDA‐ fibronectin. Results: The presence of alpha‐SM actin‐positive myofibroblasts was associated with the expression of vimentin, TGF‐beta1, TGF‐beta receptor II, and ED‐A fibronectin in all types of ERMs. Conclusions: The results furnish new data on the mechanism of alpha‐SM actin stimulation in fibroblasts in a human pathologic setting.
Glaucoma surgery
Authors: BARRAQUER J
Published: November 2013

Purpose Discussion of surgical management of different types of glaucoma.

Methods In congenital glaucoma early surgical management is indicated (goniotomy). In acute angle‐closure glaucoma immediate treatment is imperative (laser iridotomy or surgical iridectomy). In chronic angle‐closure glaucoma management depends on the evolution and duration of the process:a) Peripheral iridectomy. b) Non‐perforating trabeculectomy. c) Perforating trabeculectomy.d) YAG laser cyclocoagulation. In chronic simple glaucoma medical therapy is indicated if permanent (24 hours) response of the pressure is obtained. If not lamellar trabeculectomy with peripheral iridectomy and application of mitomycine is attempted. In severe chronic simple glaucoma perforating trabeculectomy with mytomycine is indicated.

Results In case of flat anterior chamber, with hypertension, malignant angle closure glaucoma is suspected. Management: a) Posterior sclerotomy. b) Vitreous aspiration. c) Reformation of the anterior chamber with air and Healon. d) Application of atropine 4%. If an incipient cataract is present simultaneous sonophako with IOL implantation is indicated. In case of flat anterior chamber with ocular hypotension instillation of 4% atropine and posterior sclerotomy for evacuation of the choroidal detachment, followed by restauration of the anterior chamber with air, is indicated.

Conclusion The main symptom of glaucoma is persistent increase of intraocular pressure which generally requires surgical intervention. The individual management has to be carefully selected according to the different types of the disease.
Trabeculectomy revision surgery with Ologen biodegradable collagen matrix implant
Authors: PELOSINI L , ANSARI E
Published: November 2013

Purpose To investigate the safety and efficacy of Ologen (OLO) implant (Kestrel Medical Ltd, Broadstone, Dorset) for trabeculectomy revision surgery versus trabeculectomy revision with Mitomycin C 0.3mg/ml.

Methods This study was a prospective pilot trial with 6‐months follow‐up. Fourteen glaucoma patients underwent trabeculectomy revision with OLO. Primary outcome measures included postoperative target intraocular pressure (IOP), with or without medications. Secondary outcome measures included bleb evaluation, OCT imaging, number of medications, number of postoperative interventions and adverse events. All patients were reviewed postoperatively at day 1, 7, week 3, 7, 12 and 24.

Results The mean pre‐operative IOP was 22.3 (±4.1 mmHg), mean postoperative IOP was 14 (±5.8 mmHg). IOP reduction from baseline was statistically significant (p<0.05). The bleb remained well formed and functioning in all patient at all postoperative reviews. OCT imaging allowed monitoring of the position of OLO implant and showed a progressive decrease in thickness from week 1 to week 7. No serious events were observed.

Conclusion The trial showed that trabeculectomy revision with OLO implant was safe and achieved a success rate similar to trabeculectomy revision with MMC.
The limbal stem cell niche
Authors: SHORTT AJ
Published: November 2013

Stem cells contain intrinsic mechanisms that control their behaviour but the environment immediately surrounding them, known as the niche, also plays a fundamental role. In a host of tissues and organisms the stem cell niche has been shown to maintain stem cells in an undifferentiated state and to regulate their behaviour. This stem cell – niche principle is typified by the corneal limbus. When limbal epithelial stem cells (LESC) are dissociated from their niche in the limbal palisades of Vogt they rapidly differentiate and cease to function as stem cells. It might be imagined that an understanding of the LESC niche would be of the highest priority for researchers in this field but the existence of a surrogate niche, in the form of growth arrested 3T3 fibroblast feeder layers, has allowed research on LESC biology to progress in the absence of a thorough understanding of their native niche. Thankfully LESC niche research has been gathering momentum and several exciting developments hold promise for limbal stem cell deficient patients. Amongst these are the characterisation of the physical structure of the niche and the identification of mesenchymal niche cells, which themselves displaying stem cell properties.
Assessment of the limbal condition
Authors: GICQUEL JJ
Published: November 2013

New sources of autologous tissue that can functionally replace the corneal epithelium; have recently been considered as an alternative to allogenous limbal transplants for limbal stem cells deficiency (LSCD). Nevertheless, regardless of the cell expansion technique (in vivo or ex vivo), the assessment of the limbal condition is crucial. It goes from the initial staging at the acute phase of a severe chemical burn; using the right classification, to the evaluation of the remaining ocular surface inflammation, during the chronic phase. We will review all the aspects of the evaluation of the limbal condition, that help the clinician, build his therapeutic strategy.
Animal models for ocular melanoma
Authors: CAO J , JAGER M
Published: November 2013

Animal models play an important role in understanding tumor growth and studying novel therapies in human cancer research. The significance of results from animal experiments relies on the selection of the proper animal model. Many attempts have been made to create appropriate models for uveal melanoma and its characteristic metastatic route. Ocular models have used Greene melanoma, murine B16 melanoma and human uveal melanoma cells, among others, in hamsters, rats, rabbits and mice. Various effective inoculation techniques, including subcutaneous, anterior chamber and posterior compartment injections have been developed to obtain tumor growth and mimic the pathological process of uveal melanoma. Metastatic models by subcutaneous, intraperitoneal, intravenous, intrahepatic, intrasplenic and intracardiac injection of tumor cells are able to induce tumor spread and simulate the human metastatic behavior to some extent. However, when we choose animal models, we must be conscious that the disadvantages, such as more aggressive tumor growth, the need for immune suppression in xenogeneic grafts and unreliable spreading sites should be taken into account.
Use of xenografts for preclinical drug testing
Authors: DE LANGE MJ , NéMATI F , VERSLUIS M , JAGER MJ , LUYTEN GPM , DECAUDIN D , VAN DER VELDEN PA
Published: November 2013

Uveal melanoma(UM) originates from melanocytes just like cutaneous melanoma (CM) and similar to CM, the MAPK pathway is involved in the development of UM. However, in vitro we showed an inverse correlation between MAPK and c‐Met activation with increasing metastatic potential of UM. In this study, we aimed to target both Src and c‐Met with repectively Dasatinib and Crizotinib in an experimental xenograft model. We used tissue derived from three different human primary tumours which were subcutaneously transplanted in mice. We used the c‐Met inhibitor Crizotinib to inhibit c‐Met function and Dasatinib to inhibit MAPK via Src. We monitored pharmacodynamics and analysed treatment efficacy with kinase assays. Growth inhibition was seen after treatment with Dasatinib in all three tumours. Crizotinib treatment had no marked effect on tumour size but showed, like Dasatinib, substantial effects on kinase activity. Src and c‐Met show susceptibility towards their inhibitors in vivo. Dasatinib showed an effect on both tumour growth and MAPK activity where Crizotinib effects remained limited to c‐Met inhibition. Combined, these results support our in vitro pathway analysis and warrants for clinical trials with these compounds in UM.
Stem cells in conjunctival melanoma xenografts
Authors: KSANDER B
Published: November 2013

Abstract not provided
Molecular Imaging of Protein and RNA Biomarkers in Retinal Vascular Disease
Authors: JAYAGOPAL A
Published: November 2013

Approaches for imaging disease biomarkers in the retina are needed to improve early detection, monitoring of disease progression, and assessment of therapeutic response. We will discuss our recent efforts toward in vivo imaging of protein, messenger RNA (mRNA), and microRNA (miRNA) biomarkers in animal models of retinal vascular diseases, including diabetic retinopathy and choroidal neovascularization.
Glutathione and Ascorbate: The balance between oxidant and carbonyl stress in the aging human lens
Authors: MONNIER VM , FAN XJ
Published: November 2013

Background: Two major processes appear to be at play in formation of ARNC. On the one hand advanced glycation end products (AGEs) modify lens crystallins, increasing thereby their susceptibility to oxidation via unfolding, exposure of SH‐groups and formation of UV‐photosensitizers, on the other hand SH groups form disulfides and high molecular weight aggregates that scatter light. In order to find out if there are critical SH residues in the latter process, we have generated a glutathione knockout(LEGSKO) mouse and an in vitro model of crystallin aggregation upon oxidation with H2O2.Methods: Crystallins from in vitro incubation or LEGSKO mouse were analyzed using ICAT labeling methods and 2D gel electrophoresis (2D‐PAGE) for disulfide analysis. Incubation of mouse lens homogenate (LH) with 5 mM H2O2 led to opacification within a few hours. Results: Analysis of LEGSKO crystallins by 2D‐PAGE revealed an age‐related shift from mostly intramolecular to intermolecular disulfide crosslinks which mimicked the pattern observed at 20 months in wild type lenses. All oxidation‐related disulfide forming sites in 13 crystallins were identified in vitro and found quasi concordant with those forming in the LEGSKO lens.
Antioxidative properties of glutaredoxin 2 in the lens
Authors: LOU MF , WU HL
Published: November 2013

Glutaredoxin (Grx) belongs to the oxidoreductase family that controls cellular redox homeostasis. The glutathione‐dependent Grx has a typical CXXC motif at its active site for efficient antioxidative function, and contains cytosolic Grx1 and mitochondrial Grx2 isoforms found in the lens and other ocular tissues. Both Grx1 and Grx2 have dethiolase activity that can reduce oxidized thiols in proteins/enzymes and restore enzymes/proteins activities/functions. Grx2 has additional peroxidase activity that can eliminate reactive oxygen species to maintain redox balance in cells. Its ability to protect the mitochondrial function makes it an effective molecule in preventing cell apoptosis. Our studies have shown that knockout (KO) Grx2 gene in lens epithelial cells causes the cells to be less viable with high sensitivity to oxidative stress, leakage in mitochondrial membrane, low ability to detoxify H2O2, and apoptotic. Enrich Grx2 KO cells with native recombinant Grx2 protein can rescue the cells from oxidative damage and apoptosis. Grx2 KO cells show impaired complex I and complex IV functions with low ATP pool. Mice with Grx2 gene deletion develop age‐related cataract much faster than that of the wild type control mice.
Age‐related human nuclear cataract. Blindness due to inexorable protein deterioration
Authors: TRUSCOTT R
Published: November 2013

Nuclear cataract stems from the inexorable breakdown of long‐lived macromolecules in the human lens. Although this realization is new, the overall framework is now quite clear. Racemisation, deamidation and truncation are the main drivers of protein denaturation and some amino acids are particularly susceptible to age‐related decomposition. Understanding these processes leads to a conclusion that the prospects for reversing lens opacification are remote. Since age‐related cataract appears to be inevitable, future strategies for slowing cataract formation may depend on a detailed examination of people who retain clear lenses into their eighth and ninth decades.
Pars Plana Vitrectomy alone vs Vitrectomy with scleral buckling for PRDs
Authors: ASTERIADIS S
Published: November 2013

Pseudophacik Retinal Detachment is a subgroup of Rhegmatogenous Retinal Retachments with some unique characteristics, such as the number and location of retinal breaks, certain intraoperative technical difficulties and possibly an increased risk of proliferative vitreoretinopathy. Recent evidence has established the role of pars plana vitrectomy as a primary method of managing these cases. The role of using scleral buckling techniques in combination with vitrectomy as well as the types of buckling that could be used remains controversial. At this talk, the above issues will be discussed in full, and a review of the literature as well as the personal experience of the speaker will attempt to clarify the role of using combined techniques in managing those cases.
Macular problems in PsRD
Authors: PAPPAS G
Published: November 2013

Phseudophakic retinal detachments can lead in various macular problems. Post retinal detachment ERM, macular holes, folds involving the macula, submacular heavy liquid droplets and functional problems have published. A presentation of these complications as well as techniques how to avoid them or to resolve is the aim of this presentation.
Comparative study of the IOP‐lowering effect of Xalatan vs generic latanoprost in normal subjects
Authors: YUWEI (VINCENT) Q , POURJAVAN S
Published: November 2013

Purpose To compare the intraocular pressure (IOP)‐lowering efficacy of Xalatan with the generic latanoprost (Latanoprost EG) in normal healthy subjects.

Methods 20 normal subjects were recruited in this single‐center, randomized, prospective, open label, two‐period comparative study. At the baseline visit, subjects' baseline IOP was measured in both eyes at 8am in the morning. Subjects were then administered Xalatan in the right eye and Latanoprost EG in the left eye, both at 10pm, and IOP was controlled again the following morning at 8am. The student T‐test was used to assess the level of IOP decrease significance in both groups.

Results The basline IOP in all the 20 subjects was: . The IOP decrease in the first group administered with Xalatan was 3.74 + 1.9 mmHg (26.11+ 11.3 mmHg). The IOP pressure at baseline and 10 hours after Xalatan administration were respectively 14.33 + 2.1 mmHg and 10.59 + 3.9 mmHg. In the second group, eyes administered with Latanoprost EG showed a slighter IOP decrease from baseline 2.54 + 1.33 mmHg (18.18 + 4.03 mmHg) The IOP at baseline and 10 hours after Latanoprost EG were respectively 14.01 + 2.37 mmHg and 11.45 + 2.39 mmHg. This difference was significative. (p <0.05)

Conclusion This study showed that the magnitude of IOP lowering in normal healthy subjects with Xalatan and Latanoprost EG is different, a higher IOP lowering efficacy of Xalatan compared to Latanoprost EG. This is important in Glaucoma patients especially when they are treated with different topical drops and for whom the maximum IOP decrease, achieving of the target IOP rang, maintenance of the remaining visual field and quality of life is crucial.
Efficacy of a preservative‐free fixed combination of bimatoprost and timolol in treatment‐naïve versus previously treated patients
Authors: CORDEIRO MF , GOLDBERG I , SCHIFFMAN R , BERNSTEIN P , LIU C , BEJANIAN M
Published: November 2013

Purpose To evaluate the intraocular pressure (IOP)‐lowering efficacy of a preservative‐free formulation of fixed‐combination bimatoprost/timolol (FCBT PF) in treatment (tx)‐naïve vs previously treated patients.

Methods A double‐masked, randomized, parallel‐group study compared FCBT PF with preserved FCBT (Ganfort) in 561 patients diagnosed with glaucoma or ocular hypertension who were tx naïve or had inadequate IOP lowering with previous tx. IOP was measured at 0, 2, and 8 hours at baseline and weeks 2, 6, and 12. Subgroup analysis evaluated average IOP change from baseline in tx‐naïve vs previously treated, washed out patients.

Results FCBT PF was equivalent to Ganfort, producing numerically greater (0.2 to 0.5 mmHg) IOP lowering than Ganfort during follow‐up. With FCBT PF, IOP mean changes from baseline (mmHg) ranged from −8.7 to –9.8 in tx‐naïve patients (n=50) and –7.3 to –8.5 in previously treated patients (n=228). Baseline IOP, age, diagnosis, and corneal pachymetry were significant covariates of IOP lowering. In an analysis of covariance model with these factors as covariates, differences between tx‐naïve and previously treated patients ranged from 0.8 to 1.7 mm Hg favouring tx‐naive patients and were significant (p≤0.018) at 7 of 9 timepoints.

Conclusion FCBT PF had a favourable IOP‐lowering effect compared with Ganfort and reduced IOP more effectively in tx‐naïve than previously treated patients. This can be attributed in part to the removal of preservative (BAK) optimizing the efficacy of timolol in FCBT PF.

Commercial interest