bluuebunny/crossref_metadata_2025 huggingface dataset:
Agreement between in vivo confocal scanning laser microscopy with a handheld microscope and histology in eyelid and conjunctival tumours
Authors: ESPINASSE M , GRIVET D , CAMPOLMI N , CINOTTI E , PERROT JL , LABEILLE B , CAMBAZARD F , FOREST F , DUMOLLARD JM , PEOC'H M , GAIN P , THURET G
Published: November 2013

Purpose By providing non‐invasive pseudo histology, in vivo confocal microscopy (IVCM) has been proven efficient in the diagnosis and treatment management of numerous diseases in dermatology and in ophthalmology for the ocular surface. Although it is only complementary to classical histology it allows quicker decisions. At present, both ophthalmology IVCM available are nevertheless not fully convenient for the exploration of the whole conjunctival surface nor for the entire eyelids, because of their bulk and their limited mobility. Aim: to study the reliability of a dermatological handheld IVCM for eyelid and conjunctival tumours

Methods Thirty‐one tumours were analysed using the handheld dermatological IVCM Vivascope 3000 (Lucid Inc, NY, MAVIG GmbH, Germany) equipped with 830nm class IB laser. IVCM diagnosis was made by an ophthalmologist and a dermatologist with a standardized reading grid. Whenever surgery was necessary, tumours were analysed by pathologists blind to the IVCM diagnosis. Agreement between both diagnoses was determined by an independent observer, who calculated sensitivity, specificity, predictive pos value, and predictive neg value

Results All tumours were accessible. Overall scores were Se=1, Sp=0.45, PPV=0.75, PNV=1, for conjunctiva Se=1, Sp=0.4, PPV=0.571, PNV=1, for eyelids Se=1, Sp=1, PPV=1, PNV=1, and for eyelid margin Se=1, Sp=0.67, PPV=0.75, PNV=1

Conclusion The handheld IVCM is perfectly adapted to the exploration of the entire conjunctival and eyelid system. Grant: GIRCI Rhone Alpes Auvergne 2012 No financial interest for all authors
A novel imaging approach to periocular basal cell carcinoma: In vivo optical coherence tomography and histological correlates
Authors: PELOSINI L , SMITH HB , SCHOFIELD J , DHITAL A , KHANDWALA M
Published: November 2013

Purpose Optical coherence tomography (OCT) is a non‐invasive imaging method widely used in ophthalmology. Recent developments have produced OCT devices for imaging the skin. The purpose of this study was to assess preoperative OCT of periocular basal cell carcinoma (BCC) and to correlate optical biopsies with histological features.

Methods Consecutive patients with periocular BCC were prospectively investigated with VivoSight OCT (Michelson Ltd) prior to surgical excision. OCT images were correlated to haematoxylin and eosin stained histology sections with regard to: epidermal changes, intralesional and perilesional features.

Results A total of 15 patients with periocular BCC were recruited. Epidermal changes over BCC lesions represented important landmarks for topographic correlation and consisted in epidermal thinning and hyper‐reflective signals from surface ulceration and crusting. Intralesional OCT features of BCC included: hyporeflective lobular patterns corresponding to BCC nests with high cellularity, hyporeflective cystic spaces of liquefactive necrosis and hyper‐reflective margins corresponding to collagen compression. Perilesional OCT features of BCC included: hyporeflective spaces corresponding to fluid clefts, hyper‐reflective bands of perilesional granulomatous inflammation secondary to tissue biopsy and hyporeflective lumens of blood vessels and hair follicles

Conclusion This study demonstrated a high correlation between OCT images and histological features. Further studies are necessary to investigate novel potential applications of in vivo OCT for BCC such as non‐invasive diagnosis, intraoperative OCT‐guided tumour excision and postoperative detection of recurrences.
Repair of orbital implants exposures using muller muscle flaps
Authors: ROBERT PY , DELMAS J , ADENIS JP
Published: November 2013

Purpose To evaluate a two‐stage technique of Müller muscle and conjunctival flap for treatment of orbital implant exposure defects.

Methods In this retrospective study, 19 patients with acquired anophthalmic socket presenting an exposure of orbital implant were included, between March 1999 and September 2012.

Results 13 women, 6 males were managed with this two‐stage procedure. Medium age was 57.5 years (9 to 90). The average follow‐up was 41 months (3 to 163). 16 patients underwent an evisceration and 3 patients an enucleation. All of them were implanted primarily with hydroxyapatite (HA) implants, except one of them who had an acrylic implant. Orbital implant exposure was note at an average of 94.4 months (2 to 240) after implantation. The average period between the first‐stage (Müller muscle flap) and the second‐stage (section of the flap) was 39.9 days. Success rate was 68.4% (13 patients) and the failure rate was 31.6% (6 patients) who required second surgery (one or two‐stage implant ablation followed by dermis fat graft, or temporalis fascia graft). Predisposing factors for exposure were noticed among patients with failed Müller muscle flaps: 2 underwent an enucleation for melanoma followed by radiation therapy, 1 patient had an acrylic non porous implant. 1 patient presented an early exposure probably due to suture under stress. But 2 others patients did not present predisposing factors for exposure. Once the exposure was treated, all of the patients were fitted with a prosthetic device successfully.

Conclusion Müller muscle flap 2‐stage procedure is a reliable technique, with a success rate superior to 68%, allowing preservation of the implant and successful equipment with prosthetic devices.
Inhibition of the DNA damage response blocks herpes simplex virus infection in corneal epithelium
Authors: ALEKSEEV O , AZIZKHAN‐CLIFFORD J
Published: November 2013

Purpose Herpes simplex keratitis (HSK) is the leading cause of cornea‐derived and infection‐associated blindness in the developed world. Many HSK cases are refractory to treatment with available drugs, leading to permanent corneal pathology. In addition, drug‐resistant viral strains are beginning to emerge and may present a major clinical problem in the future. Thus, our study focused on identifying and targeting critical virus‐host interactions to suppress herpes simplex virus (HSV) infection in corneal epithelium. Specifically, we investigated the role of ataxia telangiectasia mutated (ATM), a key protein in the mammalian DNA damage response pathway, in the molecular pathogenesis of HSK.

Methods We utilized three experimental models in our studies. The in vitro model (human corneal epithelial and keratinocyte cell lines) was used to dissect the molecular mechanisms of HSV‐ATM interactions. The ex vivo model (human and rabbit explanted corneas) was used to validate our tissue culture findings. And the in vivo model (young C57BL/6 mice) was used to test the antiviral potential of ATM inhibition in a physiologically‐relevant context of ocular infection.

Results ATM inhibition reduces HSV infection in corneal epithelial cells by blocking viral genome replication. Importantly, this inhibitory effect was observed not only with wild type HSV‐1, but also with two different drug‐resistant strains. The antiviral effects of Acyclovir and ATM inhibition were additive. We have also made progress into elucidating the molecular mechanisms underlying this phenomenon.

Conclusion We have shown that ATM is a new therapeutic target for the treatment of herpes simplex keratitis. ATM inhibitors could be used alone or as adjuvant therapy to combat HSK.
Pharmaceutical failure mechanism of the worldwide ReNu with MoistureLoc‐related fusarium keratitis epidemic of 2004‐2006
Authors: BULLOCK J
Published: November 2013

Purpose Between 2004‐2006, a worldwide epidemic of Fusarium keratitis occurred, traced to Bausch & Lomb’s ReNu with MoistureLoc contact lens solution (RML), containing the antimicrobial agent, alexidine dihydrochloride. Our previous studies indicated that heating RML (>42oC and ≤ 56oC) in its plastic (but not a glass) bottle resulted in decreased anti‐Fusarium capability. The present study was undertaken to determine the exact mechanism of this antimicrobial failure.

Methods We investigated if: microbiologically and/or analytically (using Raman spectroscopy), an alexidine‐neutralizing leachate emanates from heated ReNu bottles; the alexidine concentration (measured by liquid chromatography coupled with tandem mass spectroscopy) changes when stored in heated ReNu bottles; alexidine permeates into ReNu bottle walls and can be detected by Fourier transform infrared spectroscopy; non‐alexidine antimicrobials fail in heated ReNu bottles; and/or, alexidine fails in heated non‐ReNu bottles.

Results No leachates were identified microbiologically or analytically. The alexidine concentration was 2.8 times greater in room temperature‐ (vs. 56oC‐) stored ReNu bottles. Alexidine deposited into the ReNu bottle wall 3.1 times greater in the heated (vs. room temperature‐stored) container. Non‐alexidine antimicrobials retain their anti‐Fusarium capability after being heated in ReNu bottles and alexidine heated in non‐ReNu bottles did not lose its anti‐Fusarium activity.

Conclusion Alexidine permeates into the walls of heated ReNu plastic bottles, diminishing its concentration in solution and allowing Fusarium growth. This appears to be the mechanism of the RML‐related Fusarium keratitis epidemic.
Recurrence of toxoplasmic retinochoroiditis: Analysis of cases proven by initial analysis of aqueous humor
Authors: MATET A , FARDEAU C , TERRADA C , CASSOUX N , PARIS L , LEHOANG P , BODAGHI B
Published: November 2013

Purpose Factors explaining recurrences of toxoplasmic retinochoroiditis (TRC) and their frequency are not understood. The aim of this study is to analyze their recurrence patterns, and search for an association with their clinical and biological features.

Methods 40 consecutive cases of TRC with a positive aqueous humour (AH) tap for toxoplasmosis were retrospectively included. Inclusion criteria were: Goldman‐Witmer coefficient (GWC)>2.0, positive immunoblot (IB) or positive PCR for Toxoplasma gondii. Further episodes, their characteristics, disease‐free intervals, and treatments were collected. We performed a case‐control analysis of patients with and without recurrences during follow‐up.

Results Mean age was 41.5 years. 10% of patients were immunodeficient (n=4). Mean follow‐up was 7.3 years (5.8‐10.3). Forty‐three percent of patients (n=17) presented at least one recurrence, with a mean of 1.7 episodes (1‐4) per patient. Mean interval between episodes was 27 months (3‐73). For patients experiencing one recurrence or more, initial AH analysis showed a lower GWC, less additional bands on IB, and less positive PCRs, even though these trends did not reach statistical significance. Clinically, these patients had broader lesions, in more peripheral locations, and more intense vitritis than those with no recurrences. For the initial episode, durations of antibiotic and anti‐inflammatory treatments were superior in the recurrence group. Sex, ethnicity, or immune status were not associated with a change in recurrence risk.

Conclusion TRC recurrences seem to be influenced by clinical and biological features at baseline.
Raxone (idebenone) in LHON ‐ An update
Authors: MEIER T
Published: November 2013

Leber’s Hereditary Optic Neuropathy (LHON) is caused by mtDNA mutations affecting subunits of Complex I of the mitochondrial electron transport chain. Affected mutation carriers suffer from rapidly progressing and mostly irreversible bilateral vision loss. An increasing body of evidence indicates that idebenone has therapeutic potential for the treatment of LHON. Data from a randomized placebo‐controlled study (RHODOS) and from a number of case reports and retrospective cohort studies demonstrate that patients with established vision loss may benefit from idebenone treatment and recover visual acuity. Early treatment start (e.g. within one year from onset of symptoms) appears to be associated with better outcome, which is supported by the cellular pathology of LHON. Data from a currently on‐going named patient program (NPP), where LHON patients receive 900 mg/day Raxone® under routine clinical care, will be presented and an update on the regulatory status of Raxone® provided.

Commercial interest
Descemet's membrane preparation in eye banks for DMEK
Authors: BACHMANN B , KRUSE FE
Published: November 2013

Eventhough Descemet Membrane Endothelial Keratoplasty (DMEK) results in unsurpassed improvement of postoperative visual acuity the complexity of graft preparation in DMEK prevents the wide spread use of this technique. Precut tissue preparation in eye banks for DMEK would make this technique amenable to a larger group of surgeons. Precut preparation of organ cultured corneas was preformed as previously described resulting in incompletely stripped Descemet’s membranes where a small central part was still attached to the corneal stroma. After subsequent culture for up to 5 days the precut grafts were used for DMEK. Visual acuity, central corneal thickness and endothelial cell density were retrospectively analyzed. Stripping was successfully completed in all grafts directly prior to surgery. The average visual acuity (logMAR) improved from 0.47 + 0.11 preoperatively to 0.2 + 0.13 3 months after DMEK. Central preoperative corneal thickness decreased from 632 + 46 µm preoperatively to 471 + 7 µm 3 months after DMEK. Average endothelial cell density was 2326 + 119 cells /mm2 before and 2226 + 150 cells/mm2 3 days after precut preparation (2 days before DMEK). 3 months after DMEK endothelial cell density further decreased to 1519 + 57 cells/mm2. Precut preparation of DMEK tissue, generated by incomplete Descemet stripping, leads to minor endothelial cell loss during subsequent culture and results in a fast visual recovery, only minor additional endothelial cell loss and a rapid decrease of corneal thickness.
Revisiting corneal storage using an innovative bioreactor
Authors: THURET G , HE Z , BERNARD A , NAIGEON N , NANGOUM‐FOSSO T , NEFZAOUI C , PISELLI S , ACQUART S , GARRAUD O , CAMPOLMI N , FOREST F , DUMOLLARD JM , PEOC’H M , GAIN P
Published: November 2013

Be it at 4°C or in organ‐culture at 31°C, two techniques no revisited since 70’, corneal storage is mandatorily accompanied by a significant endothelial cell (EC) death (600x more than during lifetime and stromal swelling responsible for endothelial folds triggering EC apoptosis. The absence of intra ocular pressure that constitutes one of the main forces opposed to the naturally hydrophilic stroma may play an important role in this vicious circle that begins with donor death and is prolonged during storage. The restoration of pressure gradient with circulation of fluids during long term storage may improve EC survival and reduce stromal swelling. Review of the literature and of patents on methods available to achieve ex vivo restoration of the corneal physiology and personal works of our laboratory of bioengineering with a patented corneal bioreactor. Several devices have been published or patented previously but none with the aim of improving storage (generally for short‐term toxicologic studies) and none using the technical solutions that we developed. Restoration of an increased pressure at the endothelial side associated with a continuous renewal of storage medium allowed rapidly reduction of stromal swelling and improvement of EC viability, compared to the rustic immersion in a sealed flask. Our innovative bioreactor could be used for research studies as well as for corneal storage in a next future in eye banks. Grant: Agence de la BioMédecine appel à projet recherche et greffe 2012
Controversies in the pathogenesis of RVO – Local perspective
Authors: ASCASO F
Published: November 2013

BRVO usually occurs at an arteriovenous (AV) crossing site, where a common adventitial sheath binds the artery and vein together. Several findings seem to demonstrate that vitreoretinal traction might have a significant role in some cases of BRVO. This prospective observational case‐control study, with SD‐OCT directed to the occlusion site, analyzed the prevalence of vitreoretinal traction in twenty BRVO patients. The results showed a true vitreoretinal traction in 7 eyes (35%). 5 eyes (25%) were associated with an adherence of posterior hyaloids without signs of retinal traction, whereas 8 eyes (40%) had neither vitreoretinal adherence nor vitreous traction. Regarding the same vessel segment of the fellow eye, none of the cases (0%) revealed vitreoretinal traction in the correspondent AV crossing site; 9 cases (45%) presented vitreoretinal adherence; and the remaining 11 cases (55%) showed neither traction nor adhesion. Chi‐square analysis indicated that vitreovascular traction in the occlusion site was significantly associated with BRVO (p<0.05). In conclusion, a common firm vitreoretinal adhesion at the obstruction site is reported herein, pointing out the role of vitreovascular traction in the etiology of some cases of BRVO.
The role of autologous plasmin enzyme in the therapy of macular edema secondary to RVO
Authors: UDAONDO P
Published: November 2013

Abstract not provided
24 hour continuous ocular tonography Triggerfish and biorhythms of the cardiovascular system functional parameters in healthy and glaucoma populations
Authors: WASILEWICZ R , WASILEWICZ P , CZAPLICKA E , KOCIECKI J , BLASZCZYNSKI J , MAZUREK C , SLOWINSKI R
Published: November 2013

Purpose Rating circadian biorhythms of the eye‐wall tension and cardiovascular system functional parameters in normal subjects(N) and patients with primary open‐angle glaucoma(POAG), normal tension glaucoma(NTG), ocular hypertension(OH).

Methods Study population: 50 Ns, 30 POAGs, 10 NTGs and 7 OHs. Simultaneous, 24 hours continuous ocular tonography Triggerfish and ECG/Blood pressure Holter recordings. The comparison in 4 time intervals, set basing on time of falling asleep(F) and awakening(W). Data are compared within intervals (IN) 1:(F‐5hrs,F], 2:(F,F+3], 3:(F+3,W], 4:(W,W+5]

Results Similar eye‐wall tension profiles for N and OH were detected, both decreasing in IN4, OH shows higher values in IN3. POAG and NTG tension profiles are different in IN4 with noticeable change for POAG with its value increase in opposite to others. Cardiovascular parameters show the similar characteristics of SAP for all cases with the highest value for OH and the lowest for N. The recordings for DAP show the noticeable difference for NTG, where the profile is changing rapidly between the highest values in INs2 and 4 to the lowest one in IN3. Additionally, only for OH the IN3 value is higher than IN4 one. The comparison of heart rate profile shows a noticeable difference for POAG. All data will be presented

Conclusion The study showed specific, group dependent, biorhythms for 24‐hour circadian eye‐wall tension and functional parameters of cardiovascular system. These figures bring new insights into the pathogenesis of glaucomatous neuropathy and indicate the location of potential handle points for individual time‐dependent therapeutic options.
Intraocular pressure and central corneal thickness in an old French population: The MONTRACHET study
Authors: BRON AM , FRANCOZ A , FIET C , BONYTHON KOPP C , BINQUET C , TZOURIO C , ACAR N , BRETILLON L , CREUZOT‐GARCHER C
Published: November 2013

Purpose To describe the distribution of intraocular pressure (IOP) and central corneal thickness (CCT) in an old French population.

Methods 9294 individuals 65 years and older were included in the 3C cohort study since 1999 in 3 French cities (Bordeaux, Dijon and Montpellier). In Dijon, an additional ophthalmic examination was performed 10 years after the initial inclusions to assess the relation between systemic age‐related diseases and eye diseases in the MONTRACHET Study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases). In this population‐based study a thorough eye examination and a questionnaire were undertaken in each participant. Intraocular pressure (IOP) was measured with a noncontact pneumotonometer and central corneal thickness (CCT) was measured with an ultrasound pachymeter.

Results Among the 1153 participants of the MONTRACHET study only those without an ocular hypotensive treatment and those without evidence of glaucoma based on optic disc photography were considered. Among these individuals, 64% were female and the age was 82.2 ± 3.8 years. IOP in the right eye and the left eye was 14.6 ± 3.2 and 14.8 ± 3.2 mmHg, respectively, p = 0.06.IOP was lower in pseudophakic than in phakic participants 15.2 ± 3.2 and 15.4 ± 3.1 mmHg vs 13.9 ± 3.0 and 14.1 ± 3.1 mmHg for the right and the left eye, respectively, p < 0.01. CCT in the right eye and the left eye was 553.4 ± 34.4 μm and 555.7 ± 34.7 μm, respectively, p < 0.01. CCT was not influenced by the lens status and the refraction error.

Conclusion These preliminary results of the MONTRACHET study shed a new light on the relations between IOP and and the lens status in the elderly.
Why is a precise assessment of the quality of vision essential in dry eye patients?
Authors: PISELLA P
Published: November 2013

Abstract not provided
3D or not 3D: The binocular tolerance to higher order aberrations
Authors: GICQUEL JJ
Published: November 2013

For the last decade, thanks to the measurement of higher order wavefront aberrations, we have been able to precise the concept of quality of vision (a new frontier that goes beyond visual acuity). These techniques, first developed for astronomical applications and defense, gave the ophthalmologist new tools, to measure the quality of vision, in healthy subjects and patients. We will go thru the pros and cons of each of the devices, developed for this very purpose and show their current applications. We will finally present new techniques, studying the quality of vision dynamically, in 3D and giving the patient a “preview” of a potential surgical procedure on his quality of vision.
Spherical aberration: Friend or foe?
Authors: VANDERMEER G , NOCHEZ Y , PISELLA PJ
Published: November 2013

To determine the level of residual spherical aberration that gives the best objective and subjective quality of image after cataract surgery with intraocular lens (IOL) implantation. Six months after microincision (1.8 mm) cataract surgery with aspheric IOL implantation, total aberrations were computed using a Wavescan aberrometer. The modulation transfer function (MTF), Strehl ratio, and objective index of scattering were measured using the Objective Quality Analysis System. Objective depth of focus was computed as the focus range at which the Strehl ratio did not fall below 50% of maximum. Subjective depth of focus was calculated as the difference between the vergence of the punctum remotum and that of the punctum proximum. Thirty patients (54 eyes) were evaluated. The MTF cutoff values were higher with decreasing total ocular spherical aberration (r = 0.56; P<.05). Objective and subjective depth of focus were positively correlated with total spherical aberration (r = 0.26 and r = 0.46, respectively; P<.05). A final spherical aberration of zero obtained by compensation of IOL asphericity gave the greatest improvement in objective quality of vision and better MTF contrast. However, a final target ocular spherical aberration between 0.07 μm and 0.10 μm should be considered to be the best compromise between subjective depth of focus and objective contrast sensitivity.
Overview of conjunctival and eyelid tumours
Authors: VAN GINDERDEUREN R
Published: November 2013

In this part of the course an overview will be given of the most common and most important conjunctiva and eyelid tumors ( basal cell carcinoma, squamous cell carcinoma, sebaceous cell carcinoma, malignant melanoma). For each disease clinical‐pathologic correlations will be emphasized. Typical and atypical characteristics will be shown. In most cases the clinician finds the correct diagnosis, but even then it is important to investigate the section margins and the degree or details of the tumor. In rare cases a surprise in diagnosis is found and some important examples of these will be given, with also the useful consequences on the clinical follow‐up of these patients. Correct diagnosis can also be useful in non‐malignant processes and examples will be given. A short overview will be given of newer techniques and diagnostic possibilities.
Anterior to posterior “tour” of ocular disease processes
Authors: VAN GINDERDEUREN R
Published: November 2013

In this part of the course the most important pathology of the internal eye structures will be explained from front to back side of the eye. The malignant tumors of adults (melanoma, metastasis , lymphoma) and children (retinoblastoma) will be covered, but also the differential diagnosis and important consequences of non‐malignant diseases (sympathetic ophthalmia). Newer technologies can be incorporated in the pathologic examination which can have far reaching consequences for the patients. Enucleation and the difference with evisceration specimens will be discussed. Newer methods for fine needle aspiration biopsy (in solid tumors) and vitreal biopsies ( cells in the vitreal fluid) in malignant and inflammatory processes will be explained.
Overview of adult and paediatric orbital pathology
Authors: HEEGAARD S
Published: November 2013

An update of the most important orbital diseases both for adults and for children will be presented. Diagnostic hallmarks for the most important diseases will be shown and correlated to the clinical features.
Comparative ocular pathology and animal models used in eye research
Authors: HEEGAARD S
Published: November 2013

This lecture dealing with comparative eye pathology will present various interesting animal eyes seen from a basic anatomical point of view but also seen as a potential animal eye model used for research. Anatomical differences in different animal eyes will be presented and nature’s way of solving different eye problems is discussed.
Meningeal carcinomatosis
Authors: SZATMARY G
Published: November 2013

Neuro‐ophthalmologic disorders in the patient with cancer Meningeal carcinomatosis Background: Meningeal carcinomatosis may be the first sign of malignancy, although usually represents widespread disease, and occurs most frequently in association with lung, breast and gastrointestinal cancer. Objective: To review the ophthalmological symptoms, signs, imaging appearance and differential diagnosis of meningeal carcinomatosis. Methods: Retrospective literature review and case reports. Results: Ocular manifestations are reported in 91% of patients with meningeal carcinomatosis. These include visual loss, diplopia, papilloedema, optic atrophy, and pupillary abnormality. Conclusion: Ophthalmologists and other eye care providers play a crucial role in the early detection of meningeal carcinomatosis.
Analysis of mitochondrial sequences in patients with keratoconus
Authors: NOWAK DM , KAROLAK JA , MACHTEL P , POLAKOWSKI P , SZAFLIK JP , SZAFLIK J , GAJECKA M
Published: November 2013

Purpose Keratoconus (KTCN) is thinning and anterior protrusion of the cornea. The etiology of KTCN remains unknown. Both genetic and environmental factors are associated with the disorder. The purpose of this study was to identify novel genetic factors by analyzing mitochondrial sequences in cases and controls from Polish population. There are available only a few analyses of some mitochondrial sequences in KTCN studies.

Methods A total of 96 individuals from Polish population were included into this study. Chosen mtDNA fragments of all individuals were sequenced.

Results Sequencing analysis of chosen mitochondrial genome fragments have revealed numerous alterations including several novel polymorphisms. No sequence variants segregated significantly more frequent with KTCN have been identified.

Conclusion Analysis of chosen fragments of mitochondrial genome in Polish patients have revealed numerous sequence variants, however our results do not support involvement of mtDNA changes in KTCN in Polish patients. The KTCN development does not depend on a single change in the gene, but on the accumulation of numerous sequence variants. The complexity of the genetic basis of KTCN causes the need to find another approach to further investigate the etiology of KTCN. Support: National Science Centre (Poland), Grant 2011/03/N/NZ5/01470
Cell biological mechanisms of wound healing
Authors: JÄRVINEN T
Published: November 2013

Purpose Tissue repair is among the most complex biological processes that occur during human life. After an injury, multiple biological pathways become activated and are coordinated through three distinct phases of inflammation, proliferation and maturation to yield the reparative response. What distinguishes different tissues in their response to insult is that some tissues, such as bone, can regenerate and replace the injured tissue with tissue that is identical to one that existed there before, whereas most tissues, including human skin, heal by a repair process where the original tissue is replaced by non‐functioning tissue known as a scar. The purpose is to review the repair process here Methods Skin wound healing can be considered as a model organism on which to base on our understanding of cell and molecular biology of the tissue repair. Results Knowledge on the biology of wound healing might help us to unlock latent regenerative pathways and steer the reparative response towards regenerative. Conclusion The identification of regenerative pathways could potentially change our current medical practices on tissue injuries as much as the introduction of antibiotics did for infectious diseases in the twentieth century

Commercial interest
Confusing corneal ulcerations: Management of neurotrophic ulcers
Authors: MURAINE M
Published: November 2013

Abstract not provided
New therapy for persistent epithelial defects ‐ report of the first cases
Authors: UDZIELA M
Published: November 2013

Abstract not provided
Visual field testing in clinical practice ‐ The role of age, stage and follow‐up duration
Authors: JANSONIUS NM
Published: November 2013

Perimetry is the key diagnostic tool for monitoring glaucoma patients with an established visual field defect. As perimetry is demanding for both the patient and the organization, it is important to perform it as efficient as possible, that is, perform the right number of tests, schedule the tests at the right moments, and interpret the test results correctly. Practical guidelines will be given on optimal data acquisition and interpretation in clinical practice. The importance of an adequate monitoring depends on the risk of life‐time blindness – and thus on age, glaucoma stage, and treatment. An easily applicable tool that can be used to estimate this risk will be presented.
Is there any place for non‐standard automated perimetry in glaucoma monitoring?
Authors: CHAUHAN B
Published: November 2013

Several modes of non‐standard automated perimetry have been introduced for the detection and the follow‐up of glaucoma, with some techniques described over 30 years ago. The objective of these techniques was to allow clinicians to monitor glaucoma more effectively than standard automated perimetry. In spite of dozens of studies that report apparently favourable results with these techniques, their use has not become widespread, and arguably is decreasing. This presentation will review the evidence for the merit of non‐standard automated perimetry and argue that given that the frequency of standard automated perimetry is well below practice standards, non‐standard perimetric techniques have a limited role in glaucoma.
How imaging can be used for clinical decision‐making?
Authors: GARWAY‐HEATH D
Published: November 2013

Abstract not provided
Irido‐ciliary tumours of the pigmented and non‐pigmented ciliary epithelium
Authors: DAMATO B
Published: November 2013

Tumours of the pigmented and non‐pigmented ciliary epithelium include adenoma and adenocarcinoma, which can be pigmented or amelanotic according to whether they arise in the pigmented or the non‐pigmented ciliary epithelium. These tumours can invade the anterior chamber and corneal endothelium. They can be multinodular. Complications include pigment scatter, subluxation of the lens, cataract, vitreous seeding and haemorrhage. Necrosis can cause uveitis. Histological differentiation between adenoma and adenocarcinoma can be difficult. Malignant tumours can spread extraocularly to cause an epibulbar tumour or proptosis. Some tumours arise in blind, traumatized eyes. The differential diagnosis includes melanoma, melanocytoma, Fuch's adenoma, epibulbar squamous cell carcinoma and medullopithelioma. Diagnosis is best achieved by excision biopsy, which also provides a cure. Radiotherapy can be followed by persistent uveitis and glaucoma ('toxic tumour syndrome'). Treatment, if indicated, usually consists of excision, if possible conserving the eye with useful vision.
RVO: A complex disease
Authors: PAQUES M
Published: November 2013

The events following a venous obstruction are poorly known, at the fundamental as well as at the clinical level. Experimental studies are poorly contributive, due to the questionable pertinence relative to the clinical situation. Despite numerous epidemiological studies, there is no strong consensus on the risk factors of RVO, especially the role of coagulation abnormalities, which appear to be modest at best. High blood pressure and glaucoma appears to be involved, however their pathophysiological role remains obscure. Controversies regarding the role of diabetes may be due to the fact that diabetics do more severe forms of RVO, hence a recruitment bias. The natural history of RVO is highly unpredictable at an individual level. Such poor predictibility may arouse from the intertwining of several parameters such as degree and duration of flow obstruction, blood pressure, intensity of microvascular remodelling… The aim of this SIS is to adress some still unanswered questions about RVOs, to point controversies, and to propose new pathways for a better understanding and clinical management of these patients.
Methods used to measure patient perceptions
Authors: RUBIN GS
Published: November 2013

The number and popularity of patient‐reported outcome measures (PROMs) have increased dramatically over the past two decades. At last count there were over 100 vision‐specific PROMs covering all of the major eye diseases, including glaucoma. In this paper we discuss some of the main issues faced by developers and users of PROMs in glaucoma. Glaucoma‐specific PROMs have been developed for many levels of patient assessment ranging from multifactorial “quality of life” questionnaires (e.g. the Glau‐QoL and GQL‐15) to the more specific symptom scales (GSS) . The standard validation procedure for PROMs ensures that questionnaire scores are in fairly good agreement with measured performance of everyday visual tasks, at least for PROMs that are designed to measure activity limitation or functional ability. But they don’t always agree, and we will illustrate how this disagreement may be informative and help identify patients who are at risk for functional decline. Finally, we will explore how modern questionnaire design, especially Rasch analysis, has changed the way we think about questionnaire scores and the implications of these changes for improving the content (item banks) and efficiency (computer adaptive testing) of future PROMs.
Corneal refractive power after anterior lamellar versus penetrating keratoplasty
Authors: BORDERIE VM , SANDALI O , GEORGEON C , BORDERIE M , TOUZEAU O , BOUHERAOUA N , LAROCHE L
Published: November 2013

Purpose To analyze the influence of various factors on the post‐operative refractive power after anterior lamellar keratoplasty (ALK) and penetrating keratoplasty (PK) in eyes with corneal diseases not involving the corneal endothelium.

Methods Retrospective comparative case series. Two hundred and thirty‐eight consecutive eyes of 238 patients with clear graft and at least one post‐operative Orbscan examination performed after suture removal were retrospectively analyzed. Multivariate analysis of recipient and surgical parameters was performed by multivariate regression.

Results The average Orbscan 3‐mm corneal power was 47.1 D with a wide 95%‐confidence interval [40.3 D; 53.9 D]. It was 47.9 D for ALKs and 46.2 D for PKs (p<0.01). In eyes with anterior lamellar keratoplasty, this figure was 48.2 D for oversized grafts and 44.0 D for non‐oversized grafts (p<0.001). It was significantly higher for eyes with keratoconus (48.2 D) or stromal scar after infectious keratitis (47.8 D) compared with stromal scar after trauma (43.6 D) or stromal dystrophies (41.3 D). The average Orbscan 3‐mm SimK cylinder was 4.7 D [0.0 D; 10.7 D] for ALKs and 5.2 D [0.0 D; 10.9 D] for PKs (p>0.5).

Conclusion The post‐operative, suture‐out, corneal refractive power is higher after ALK compared with PK and it features important variability. In ALK eyes, non‐oversized grafts result in post‐operative corneal power close to normal values and corneal diseases associated with stromal thinning result in higher post‐operative corneal power. Taking into account these parameters at the time of surgery may help decreasing the post‐operative spherical refractive error.
Recurrence of anterior corneal dystrophies after keratoplasty
Authors: DE LA PAZ M , BARRAQUER RI , ALVAREZ DE TOLEDO JP , BUIGUES A , MICHAEL R , BARRAQUER JI
Published: November 2013

Purpose To describe the rates of simple recurrence (SR) and clinically significant recurrence (CSR) of anterior dystrophies in donor corneas after penetrating or lamellar keratoplasty.

Methods Retrospective case series of patients who underwent keratoplasty for anterior dystrophies from 1954 to 2008 with a minimum follow‐up time of three years. Kaplan Meier survival curves were calculated for both parameters (SR and CR) to demonstrate recurrence of the different dystrophies thru time.

Results A total of 109 eyes of 66 patients were included: 8 cases of Bowman´s dystrophy (6 eyes with CDRB/Reis Bucklers and 2 eyes with CDTB/Thiel Bhenke), 19 cases of CDG/Granular, 53 cases of CDL/Lattice and 29 cases of CDM/Macular. The median follow‐up time for each kind of dystrophy varied from 75 months (6.25 years) to 180 months (15 years). The survival function for simple recurrence was significantly higher (376.2 months/31 years) for cases of CDM, as compared to those dystrophies related to the keratoepithelin gene : CDRB =177.6 months, CDL=168 months and CDG =89.2 months. Clinically significant recurrence (CR) was noted predominantly in cases of CDL and CDG

Conclusion Keratoplasty (whether penetrating or lamellar) is an effective treatment for cases of anterior dystrophies, when visual axis is affected or when other less invasive treatment modalities fail. The statistically significant difference in survival time of recurrence after keratoplasty for the different kinds of anterior dystrophies coincides with literature and may help us in prognosticating the best treatment option for each individual case. Theme: DALK and PK Does one or more of the authors have any financial interest in the subject matter of this presentation?: No
Very low risk of light‐induced retinal damage during Boston Keratoprosthesis surgery
Authors: SALVADOR CULLA B , BEHLAU I , SAYEGH RR , STACY RC , DOHLMAN CH , DELORI F
Published: November 2013

Purpose To assess the possibility of light damage to the retina by a surgical microscope during implantation of a Boston Keratoprosthesis (B‐KPro) in rabbits.

Methods The retinal irradiance from a Zeiss OPMI Lumera S7 operating microscope was measured at its working distance (16.5 cm). Light transmittance through an isolated B‐KPro (made of PMMA) was measured. A B‐KPro was implanted into one eye of each of 12 rabbits with the optic of the device initially covered during the procedure. Retinoscopy was performed after the implantation, and external additional lenses were used when needed to focus the light on the retina. The operated eyes were then continuously exposed to a fixed light intensity under the microscope for 1 hour. After the exposure, the rabbits were monitored for 9 days and fluorescein angiography (FA) was carried out at days 2 and 9.

Results Light transmittance of the B‐KPro revealed blockage of short wavelengths (from 0.001% at 200nm to 42% at 390nm) and of long wavelengths (12‐35% at 1660‐1750nm). In addition, the surgical microscope blocked part of the blue, ultraviolet (UV), and infrared (IR) wavelengths of light. FA showed no leak of dye or other morphological changes. Histological examination with H&E staining showed no morphological retinal changes.

Conclusion Our results show that the PMMA of the B‐KPro has a very low transmittance of phototoxic wavelengths of light, mostly UV. In addition, modern surgical microscopes have filters for UV and IR wavelengths of the light spectrum. No morphologic damage to the retina from the light exposure from our microscope could be demonstrated. Thus, there should be very low risk of light damage to the retina during routine B‐KPro surgery.
Introduction to study design
Authors: DAMATO B
Published: November 2013

Much research is never published. The main cause of failure is the poor quality of the data, which does not allow valid conditions to be drawn. This problem can arise because of poor study design. The aims of this presentation are to discuss quality of data and the study designs developed to improve data validity. It is essential to be aware of the many sources of bias, which can fool the inexpert scientist at any stage of the project. These include selection bias, chanelling bias, interview bias, chronology bias, recall bias, citation bias, confounding, and others. These shortcomings can be avoided by proper study design. Different levels of evidence have been defined to categorize study designs. These levels include: 'expert opinion without critical appraisal'; case‐series; case control studies; cohort studies and randomized controlled trials, with systematic reviews in each category being superior to individual studies. Research should be undertaken only by individuals and teams who have a good understanding of study design. Adequate preparation before initiating the study should result in valid data and a good chance of publication in a high‐impact journal, if the research findings are indeed new and useful.
Matching analysis with your study design
Authors: KIVELÄ T
Published: November 2013

This talk will highlight some key issues in choosing statistical methods for ophthalmic research, based on personal experience of the author as a writer, reviewer and editorial board member of the EVER Journal, Acta Ophthalmologica. The items discussed, based on examples from recent literature, will include: 1. proper ways of summarising and comparing visual acuities; 2. proper ways of analysing data collected from both eyes of the patients, 3. proper ways of analysing longitudinal follow‐up data, and 4. proper ways of analysing contigency table data. Correct reporting and analysis of data related to the eye is not too difficult as long as one is aware of a few basic rules. Putting them into action helps to ensure that the conclusions you put forward and those that the readers draw from your study will be proper.
Pearls and pitfalls
Authors: KIVELÄ T
Published: November 2013

The instructor will highlight some pearls and pitfalls in statistics that both authors and readers benefit from knowing, based on his personal experience as a writer, reviewer and editorial board member of the EVER Journal, Acta Ophthalmologica. The items discussed, based on examples from recent literature, will include: 1. how to avoid giving a false impression of precision when reporting key results, 2. how to communicate effect size; 3. how to differentiate statistical from clinical significance, 4. how to communicate statistically non‐significant results, and 5. how to recognise multiple comparisons and adjust for them. Clear reporting of basic statistics is not difficult as long as one is aware of some basic rules. Putting them into action may improve your manuscripts and reading skills when scanning published evidence to base your practice on.
Retinal pigment epithelial (RPE) cells convert bone marrow derived macrophages into myeloid suppressor cells with novel phenotype
Authors: XU H , ZHAO J , LUO C , CHEN M
Published: November 2013

Purpose We have shown previously that macrophages/microglia accumulate in the subretinal space and express CD68 and Arginase‐1 in the aging eye. We hypothesize that Retinal Pigment Epithelial (RPE) cells may play an important role in regulating macrophage/microglial phenotype and function.

Methods Bone marrow derived macrophages (BMDMs) and RPE were cultured from C57BL/6J mice and the phenotype was confirmed by CD11b and F4/80 (for BMDMs) and RPE65 and cytokeratin (for RPE cells) stainings. BMDMs were co‐cultured with RPE cells for different times. Macrophages were then isolated for phenotypic and functional assays.

Results Co‐culture of BMDMs with RPE cells resulted in a time‐dependent down‐regulation of MHC‐II and the generation of CD11b+F4/80+Ly6G+ myeloid‐derived suppressor cells (MDSC). The MDSCs expressed high levels of IL‐6, IL‐1β, Arginase‐1, and complement inhibitor C1INH, but lower levels of IL‐12p40 and TNF‐a compared to naïve BMDMs. The expression levels of iNOS, TGF‐β and Ym1 did not change compared to naive BMDMs. Furthermore, MDSCs had reduced phagocytic activity and lower ability to stimulate T cell activation and proliferation. When RPE cells were pre‐treated with oxidized photoreceptor outer segments, the expression of IL‐1β and IL‐6 in BMDMs was increased and the expression of Arginase‐1 was decreased.

Conclusion Our results suggest that healthy RPE cells can convert BMDMs into myeloid‐derived suppressor cells under in vitro culture conditions. RPE‐induced myeloid‐derived suppressor cells are CD11b+F4/80+Ly6G+MHC‐IIlowIL‐6+IL‐1b+Arg‐1+. This ability of RPE cells is reduced when suffering from oxidative insults.
Ocular Syphilis: Beware of the great imitator!
Authors: VELDMAN E , MEENKEN C , HALABY T , KOOTSTRA G
Published: November 2013

Purpose Treatment of HIV with highly active antiretroviral therapy (HAART) has extended life expectancy with many years. There are signs that the better prognosis of this formerly deadly disease has a negative spin‐off, which is a frequent occurrence of the coexistence of HIV and ocular syphilis.

Methods We collected the cases of ocular syphilis in the last 7 years in a general hospital ( Medisch Spectrum Twente, the Netherlands). Furthermore, a literature search was performed to identify papers on the clinical manifestation of this disease, especially in relation to HIV‐infection.

Results We analysed the characteristics of 3 patients with ocular syphilis, 2 of these patients had co‐infection with HIV. Several different disease manifestations of Treponema Pallidum infection in the eye were observed, especially with regard to the optic nerve, the macular area and the retinal periphery. Treatment with intravenous Penicillin was successful in all patients, though some eyes developed irreversible loss of function.

Conclusion Especially in immune compromised patients ocular syphilis is an acute sight threatening disease, with specific diagnostic challenges, requiring immediate intravenous treatment.