bluuebunny/crossref_metadata_2025 huggingface dataset:
Unilateral ischemic optic neuropathy by tacrolimus after liver transplantation
Authors: RAMIRO P , MATEO J , CABEZON L , IBANEZ J , PEIRO C , JIMENEZ B , PADGETT E , CRISTOBAL JA
Published: December 2011

Purpose To report a case of unilateral optic neuropathy in a patient on treatment with tacrolimus (Prograf®) after liver transplantation.

Methods Case report in a 53‐years old woman receiving tacrolimus after liver transplantation, serial neuroophtalmologic exams were performed.

Results 53 years‐ old woman treated with tacrolimus (Progra®f) after liver transplantation, seen in our clinic concerned by the loss of vision in left eye after several previous chapters of amurosis fugax.She was made a carotid doppler (unaltered) and vertebrobasilar (also normal).We ask that RMN detected mild variable Dandy‐Walker, subcortical atrophy, sylvian gaps in deep white matter of probable vascular origin (would microbleeds) and possible osmotic myelinolysis. PCR was elevated and VSG, consistent with pathology data accompanying the patient. Blood analysis showed alterations also be explained by what was happening.Vitamin B12 and folic acid were normal.Serologic tests for Brucella, Borrelia, syphilis, Epstein‐Barr virus, cytomegalovirus, herpes simplex and zoster were negative.Normal coagulation. Following these studies was diagnosed by non‐arteritic NOIA and tacrolimus treatment was added to adiro® 100 mg.The vision was 20/20 in right eye and amaurosis (no light perception) in OI. Had a pupillary afferent deffect in left eye. PIO of 15 mmHg in both eyes. Camera anterior large and transparent crystal. Fundus slight optic nerve pallor in the left eye.OCT with great thinning of the RNFL in the left eye and normal right eye

Conclusion Tacrolimus is an immunosuppressive agent useful in hepatic transplantation which may be associated with ischemic optic atrophy.
Conjunctival Autografts: indications and techniques
Authors: GICQUEL JJ
Published: December 2011

In conjunctival autograft an autologous free conjunctival graft is obtained from the superior bulbar conjunctiva. It is then sutured to the sclera bed. This technique is widely used in pterygium surgery. In this case the graft is obtained from the same eye. It may also be obtained from an healthy fellow eye if previous surgery, limbal stem cell deficiency or scarring is present. With this common procedure, a very low rate of recurrence is observed in the treatment of pterygium. However a lack of understanding of the basic principles of this surgery can result in a poor outcome and frequent recurrences. In this presentation we will review together all the important steps required for a successful conjunctival autograft.
Corneal epithelial limbal stem cell transplantation for ocular surface reconstruction
Authors: DUA H
Published: December 2011

Abstract not provided
Amniotic membrane transplantation
Authors: LANZINI M , CALIENNO R , CURCIO C , CIAFRè M , COLASANTE M , NUBILE M , MASTROPASQUA L
Published: December 2011

Purpose Aim of this presentation is to indicate current applications of amniotic membrane transplantation in corneal diseases and to describe, by means of in vivo imaging techniques, postoperative modifications of corneal tissue.

Methods Different indications for Amniotic Membrane Transplantation will be presented as clinical cases and literature review including corneal ulcers and perforations, persistent epithelial defect, bullous keratopathy. Surgical techniques and adverse events will be described and morphological changes of transplanted tissue and corneal profile will be analyzes by means of anterior segment OCT and in vivo confocal microscopy.

Results Amniotic membrane transplantation allows to obtain epithelial restoring, corneal sealing and stromal thickness recovery together with an antinflammatory effect on corneal tissue and reduction of pain. Transplanted tissue may be differently oriented and composed to obtain different effects on recipient cornea.

Conclusion Amniotic membrane transplantation is an useful surgical technique for managing of ulcerative corneal pathologies with or without perforation and epithelial defects. In vivo imaging diagnostic devices enable to visualize postoperative effects of transplanted tissue on recipient cornea in terms of morphology and tissutal modifications.
Loss of visual acuity following bariatric surgery for morbid obesity in three sisters
Authors: PEIRO C , PINILLA I , PEIRO B , AVENTIN MP , ASCASO J , PEREZ‐GARCIA D , IBANEZ J , CARAMELLO C , DEL BUEY MA , ZABADANI K
Published: December 2011

Purpose Bariatric surgery are various weight loss surgery options, that can originate deficiencies of Vitamin A, D and K as well as iron‐deficiency anemia and diminution of calcium and zinc. These nutricional changes can generate a loss of visual acuity after the surgical treatment. The purpose of this study is to describe three cases of visual acuity loss after bariatric surgery.

Methods Three sisters underwent a bariatric surgery for morbid obesity. All of them complained visual acuity loss months after surgery.

Results All the patients shown optic nerve atrophy. Biochemical alterations were presented in all of them, showing diminution of both liposoluble and hydrosoluble vitamins..

Conclusion Bariatric surgery could generate visual acuity loss. Vitamin deficiency must be controlled to avoid retinal and optic nerve changes and atrophy.
Is tractography coupled with the retinotopy obtained by functional magnetic resonance imaging feasible at 1,5 tesla to study the optic radiations?
Authors: GEORGET M , DESTRIEUX C , ANDERSSON F , ZEMMOURA I , COTTIER JP , PISELLA PJ
Published: December 2011

Purpose to evaluate the feasibility and to compare the results of different algorithms of tractography by diffusion weighted (DWI) magnetic resonance imaging (MRI) coupled with retinotopy by functional MRI (fMRI) at 1,5 tesla, to study the optic radiations.

Methods one healthy subject had: (1) a fMRI with visual stimulations by sectorial contrast alternating checkerboard patterns (2) a DWI MRI and (3) anatomical acquisitions. Optic radiations were tracked by both deterministic and probabilistic algorithms, using anatomical and functional data.

Results the optic radiations reconstructions agreed with literature data. The deterministic reconstruction algorithm is conceivable in current practice, and can correctly tracked the optic radiations with a good view of the Meyer loop, unlike the probabilistic reconstruction algorithm, whose post treatment is long and results disappointing.

Conclusion tractography coupled with the retinotopy is feasible at 1,5 tesla to study the optic radiations with deterministic reconstruction algorithm but not with probabilistic algorithm.
Isolation and structural studies of native RPE and BM fluorophores
Authors: GAILLARD E , DILLON JP , MURDAUGH L
Published: December 2011

Purpose To determine the chemical structure, fluorescence spectra and lifetimes and spatial distribution of the major retinal lipofuscin and Bruch’s membrane fluorophores and to correlate their relative amounts with disease.

Methods Human RPE lipofuscin granules and Bruch’s membrane explants were isolated from donor globes (Midwest Eye Banks and Transplantation Centers). The organic soluble portion was obtained by extraction with equal amounts of CHCl3:CH3OH:H2O, and the extract was analyzed by LC‐MS (Thermo Finnigan, LCQ Advantage, Surveyor; Surveyor LC with fluorescence and PDA detectors, quadrupole ion trap mass analyzer, electrospray ion source). Fluorescence lifetimes were measured with a PTI Timemaster Lifetime analyzer. MALDI spatial distribution maps were imaged with an Applied Biosystems Voyager‐DE Biospectrometry workstation.

Results Several derivatives, including higher molecular weight condensation products, of A2E have been isolated and structurally and spectroscopically characterized. A Bruch’s membrane specific biomarker, nitro‐A2E, has also been characterized and found to increase in concentration with both age and progression of AMD. These materials have unique fluorescence emission maxima and lifetimes and can be used with non‐invasive diagnostic methods. The spatial distribution of these molecules yields information as to their origin.

Conclusion Knowledge of the fluorescence maxima and lifetimes of identified retinal fluorophores may allow for a more detailed interpretation of fundus autofluorescence. Of particular importance are the trends in concentration as a function of disease state.
Spectral properties of the anterior segment of primates
Authors: DILLON JP , MERRIAM JC , GAILLARD E
Published: December 2011

Purpose To determine the age related spectral properties of the anterior segment such as transmission and fluorescence and relate those changes to aging mechanisms and retinal imaging

Methods A simple method has been developed to determine the optical properties of the anterior segment of the intact eye. This consists of a probe which is inserted into the posterior sclera and detects light passing through the anterior segment. The probe is connected to a CCD spectrophotometer via a fiber optic bundle. Using this the absorptive properties of primate cadaver eyes were determined

Results A young primate anterior segment has a maximum absorption of 365 nm due to the beta‐glucoside of 3‐hydroxykynurenine (3‐HKG) in the lens. This has a small transmission window to the retina centered at 320 nm, which closes up at around puberty. There is also a steep increase in transmission at wavelengths longer than 400 nm. With aging there is an increase in absorption throughout the visible (up to 550 nm)such that by the 6th decade only 20% of blue light is transmitted to the retina compared to the young primate eye. The increase in absorption is paralleled by an increase in fluorescence.

Conclusion Yellowing of the lens seems to be related to reactions of 3‐HKG. The window of transmission at 320 nm in the young primate may explain the early increased rate of production of lipofuscin in the retina. The rate of lenticular yellowing is similar to the rate of lipofuscin formation in the retina from 20‐70 years, suggesting that the amount of light absorbed by lipofuscin is constant over that span. The role of age related lenticular changes in retinal imaging will be discussed.
Dual‐wavelength "color" autofluorescence
Authors: HAMMER M
Published: December 2011

Purpose To distinguish fluorophores at the human ocular fundus by their different emission spectra.

Methods Autofluorescence images were taken from 62 eyes (78.3±6.3 years) with age‐related macular degeneration (AMD), 65 eyes (71.2±8.4 years) with diabetic retinopathy (RD), and 19 eyes (60.7±18.3 years) without any ophthalmic or systemic pathology (control group) by a fundus camera. All eyes were pseudophacic. A 3‐chip color CCD camera was used as detector, recording the fluorescence in two separate spectral bands: Upon excitation at 475‐515 nm, fluorescence was observed at 530‐570 nm and 570‐675 nm. For a global estimation of the fluorescence characteristics, the ratio of the green vs. the red emission (g/r) was calculated in a 70 by 70 pixel area temporal to the macula and apart from pathologic lesions and retinal vessels. Local changes of fluorescence emission spectra were assessed.

Results An orange fluorescence was found in the control group. Compared to that group (g/r=0.869±0.073), the global fundus fluorescence of AMD‐patients (g/r=0.906±0.105) and diabetics (g/r=0.974±0.119) was green‐shifted. This shift was statistically significant (t‐test, p=0.001) for the RD and the control group. The optic disc, hypo‐fluorescent atrophic areas (geographic atrophy, laser scars), hyper‐fluorescent drusen, and lipid exudates appeared greenish.

Conclusion The ocular fundus autofluorescence is dominated by the orange fluorescence of lipofuscin. The green‐shift of the fluorescence in AMD and RD may indicate protein glycation since advanced glycation end products show green fluorescence. Greenish fluorescence of drusen and exudates reveal non‐lipofuscin fluorescence which needs further clarification. Color autofluorescence visualizes different fluorophores and, thus, may be of diagnostic merit.
Differences in fundus autofluorescence in clinical practice
Authors: BARBAZETTO I
Published: December 2011

Purpose Fundus autofluorescence (AF) has become a standard imaging test for evaluating retinal disorders such as age‐related macular degeneration, hereditary, and inflammatory conditions. Little attention has been given to the influence of technical specifications of individual imaging devices and their potential influence on the studies obtained.

Methods AF was recorded using a Heidelberg confocal scanning laser ophthalmoscope (cSLO) with 488 nm laser exciter (488 nm‐AF), and a conventional Topcon fundus camera with halogen lamp exciter and 580 nm band‐pass filter (580 nm‐AF). Images of patients with various macular conditions were obtained and compared.

Results The autofluorescent signal is largely believed to derive from lipofuscein in the retinal pigment epithelium (RPE) and to represent a correlate of cellular metabolic activity. However, while images of geographic atrophy appeared to be rather comparable, significant differences were noted in patients with central serous chorioretinopathy, rip of the RPE and cystoids macular edema. It has been hypothesized that macular pigments (MPs) and more precisely changes of MPs density account in part for the differences, as MPs block 488nm‐AF more intensely than 580nm‐AF.

Conclusion Fundus autofluorescence images obtained with different imaging systems may not be interchangeable depending on the exciter and band‐pass filters used. Caution has to be taken when comparing diagnostic or therapeutic findings on AF from imaging devices with different specifications
DHEA Analogue Neuroprotection in an Experimental Model of Retinal Detachment
Authors: TSOKA PA , CHARALAMPOPOULOS I , GRAVANIS A , TSILIMBARIS MK
Published: December 2011

Purpose To evaluate the neuroprotective activity of a new synthetic analogue of Dehydroepiandrosterone (DHEA) in an experimental model of retinal detachment (RD).

Methods Sprague Dawley rats underwent a retinal detachment in their right eye under deep anesthesia while the left eye was served as a control. Animals were dived into three groups and injected with the synthetic DHEA analogue. The analogue can be detected in the rat retina after intraperitoneal injection. Animals received intraperitonealy 10 mg of the analogue diluted in 70 ul of ethanol in a total volume of 1 ml WFI per animal. In the first group the injections were administered after RD while in the other two groups (group 2 and 3) a pretreatment was utilized starting 7 days before RD (every day and every second day, respectively). The animals were sacrificed three days after RD, the eyes were enucleated and prepared for TUNEL labeling and confocal microscopy.

Results Morphological analysis revealed that the phenotype is rescued when the administration of the analogue begins before retinal detachment, with only a few cells labeled positive after TUNEL staining in groups 2 and 3. Administration of the drug only after the retinal detachment (group 1) seemed to have less anti‐apoptotic effect.

Conclusion Our results suggest that this molecule may prove to be anti‐apoptotic in retinal detachment induced apoptosis. Further investigation is required for the most efficient treatment and drug dosage in several time points of the apoptotic process.
Retinal bioavailability of a DHEA synthetic analog after intraperitoneal administration in the Sprague Dawley rat
Authors: TSIKA C , TSOKA PA , TZATZARAKIS M , CHARALAMPOPOULOS I , GRAVANIS A , TSILIMBARIS MK
Published: December 2011

Purpose To evaluate the retinal bioavailability of a synthetic Dehydroepiandrosterone (DHEA) analog, a molecule with potential anti‐apoptotic action, after systemic administration.

Methods 25 Sprague Dawley rats were injected intraperitoneally with 10 mg of the analog in1 ml of an ethanol/Water For Injection (WFI) solution. The synthetic neurosteroid was injected in 3‐5 rats at each time point at the same concentration every time. The animals were euthanized at 15, 30 min and 1, 2, 4, 6 & 24 hrs. The eyes were enucleated and the retina was isolated from the eye cup with an eye sponge with suitable handling. After appropriate preparation, the samples were measured with HPLC LC/MS.

Results The recovery of the method was 91.4%. The Limit Of Quantification (LOQ) was 0,05 ng/mg. The substance was detected at 30, 60, 120 and 240 min in mean concentrations of 0.10 ng/mg, 0.42 ng/mg, 0.91 ng/mg & 0.17 ng/mg respectively. No substance was detected with this method at 15 min, 6 & 24 hrs. No substance was detected in all blind samples

Conclusion The synthetic DHEA analog was successfully detected in the rat retina with an LC/MS HPLC method. The molecule seems to reach the retina in thirty minutes after systemic administration and is still detected there after four hours. Further investigation is obligatory for complete data of the pharmacokinetics of the substance in the rat retina.
Ghrelin and obestatin decreases the IOP in a acute glaucoma model
Authors: ROCHA DE SOUSA AA , TAVARES‐SILVA M , PEREIRA‐SILVA P , AZEVEDO‐ PINTO S , RODRIGUES‐ARAUJO J , LEITE‐MOREIRA AF
Published: December 2011

Purpose The aim of this study is to evaluate the effect of the pro‐ghrelin derived peptides in the intra‐ocular pressure in animal models of acute glaucoma.

Methods The first part of the experimental protocol was the calibration of the Tonovet® used to measure the IOP. In the second part of the protocol we studied, in a rabbit model of acute glaucoma, the effects of ghrelin (10‐4M, n=6), des‐acyl‐ghrelin (10‐4M, n=7) and obestatin (10‐4M, n=7), as well as the subcellular pathways involved. This model was achieved with an intra‐vitreal injection of 20% NaCl. Then, one of the three peptides was sub‐conjunctivally injected. Concerning the subcellular pathways, keterolac (a COX inhibitor; 30mg/ml; 500microl; n=7) and L‐NAME (a NO synthase inhibitor; 150mg/Kg; 500 microl; n=11) were sub‐conjunctivally injected previously to both NaCl and ghrelin injection. All the results were compared to a control group which did not receive ghrelin, des‐acyl‐ghrelin or obestatin.

Results There is a linear correlation between the IOP measured by the Tonovet (Y) and its real value (X), being that underestimated (Y= ‐0,331 + 0,750X). Our results show that the NaCl injection increases the IOP from 9.9 ± 1.9 to 44.9 ± 4.1. After that ghrelin promotes a decrease of 20,8 ± 5,0 mmHg (decrease of 47,9 ± 11,6%); obestatin promotes a maximal decrease of 15,8 ± 3,9 mmHg (decrease of 37,5 ± 9,4%), while des‐acyl‐ghrelin does not significantly change IOP. When keterolac or L‐NAME are added, ghrelin’s effect is completely blunted.

Conclusion Ghrelin showed to promote a decrease of the intra‐ocular pressure, independently from GHSR‐1a and dependently on NO and prostaglandins. Obestatin also promotes a decrease in the IOP.
Management of mild and moderate Graves' Orbitopathy
Authors: BOSCHI A
Published: December 2011

Purpose Management of Graves orbitopathy (GO) varies according to the level of its activity and its severity. For the activity evaluation, although no method is both specific and completely reliable, a simple office‐based tool is the Clinical Activity Score, which reflects the presence or absence of symptoms and signs that indicate inflammation. In addition, the severity of disease should be assessed by measuring exophthalmos, lid width, evaluating soft‐tissue involvement and extra‐ocular muscle function, and assessing corneal involvement and optic‐nerve involvement. Features of mild and moderate to severe GO will be presented.

Results Specific treatments for GO vary depending on the severity of the disease. Mild GO usually does not require any treatment except for local measures ( ex lubrificants, ointments, dark lenses, and prisms to to reduce diplopia).However, in some patient quality of life is so impaired that treatment such as that for more severe GO might be suggested. Regular follow‐up every 3‐6 months is recommended, since progression of GO is observed in about 25% of the pats. Patients with moderate to severe with active disease (CAS>/=3) should be treated with immunosuppressive treatment modalities, while those with inactive GO may benefit from rehabilitative surgery.

Conclusion The treatment of choice for moderate to severe GO is IV glucocorticoids +/‐ orbital radiation therapy, if GO is inactive, surgery as orbital decompression and /or squint surgery and/or eyelid surgery
Glaucoma of the brain: a disease model for the study of transsynaptic neural degeneration
Authors: GUPTA N
Published: December 2011

Abstract not provided
Abnormal retinal vascular function and cognitive loss in Alzheimer's Disease patients
Authors: GHERGHEL DOINA , BENAVENTE‐PEREZ A , MROCZKOWSKA S
Published: December 2011

Purpose To identify signs of abnormal retinal vascular function and their relationship to cognition deficits in newly diagnosed mild AD patients

Methods Retinal arterial and venous reaction times to flickering light were assessed in 10 AD patients and 28 age‐matched healthy individuals by means of Dynamic Vessels Analysis (DVA). Minimental state examination (MMSE) and Addenbrooke's Cognitive Examination‐Revised (ACE‐R), as well as blood pressure measurements and blood analyses for lipid metabolism markers were also performed in patients and controls.

Results AD patients demonstrated differences in their vascular reaction times to repeated cycles of flicker exposure at the retinal arterial level compared with healthy controls, which correlated with the degree of the patients’ cognitive impairment at the time of the test

Conclusion It proposed that a simple screening of the retinal vascular function could offer valuable information about risk for future vascular complications as well as progressive cognitive decline in newly diagnosed patients suffering from mild AD.
Quantitative assessment of the visual pathway by MRI‐DTI
Authors: ENGELHORN T
Published: December 2011

Abstract not provided
Impairment of 4th neuron‐ axons correlates with retinal nerve fiber loss in glaucoma
Authors: MICHELSON G , WAERNTGES S , ENGELHORN T , EL‐RAFEI A , HORNEGGER J , DOERFLER A
Published: December 2011

Purpose In glaucoma damage of retinal ganglion cells may continue to the linked optic radiations (OR). This damage may concern the axonal integrity as well as demyelination or glia cell impairment. This study investigated measures of axonal demyelination, i.e. radial diffusivity (RD), in the optic radiation of glaucoma patients. The results were correlated with the homonymous retinal nerve fiber layer thickness (RNFL).

Methods Fourteen control subjects (mean age, 52.0±11.7 years) were age‐adjusted to 12 patients with normal tension glaucoma (NTG, mean age, 58.3±9.5 years; p=0.157) and 18 patients with primary open angle glaucoma (POAG, mean age, 55.7±7.3 years; p=0.296). The control subjects had eye diseases without neuronal participation. All subjects underwent magnetic resonance (MR) tomography‐based diffusion tensor imaging (DTI) of the optic radiation and eye examination by the Spectralis optical coherence tomography. MR images did not show cerebral space occupying lesions along the visual pathway. The optic radiations in the DTI were outlined semi‐automatically and the mean values of FA and RD of both OR’s were measured. The homonymous RNFL thickness corresponding to the respective OR was calculated.

Results If corrected for age, gender, and diagnosis groups (control, NTG, POAG) partial correlation analysis disclosed a correlation between RD and the RNFL thickness (right OR: r=‐0.350, p=0.025; left OR: r=‐0.478, p=0.002).

Conclusion In glaucoma DTI‐derived parameters of axonal integrity and demyelination of the optic radiation (4th neuron) are suggested to change with decreasing retinal nerve fiber layer thickness (3rd neuron), i.e. with increasing glaucoma severity.
Neuroprotection of the visual pathway in glaucoma ‐ Is there a future role?
Authors: CORDEIRO MF
Published: December 2011

Abstract not provided
C‐Met signaling and preclinical analysis of Crizotinib in uveal melanoma
Authors: VAN DER VELDEN PA , DE LANGE M , DA SILVA CG , VERSLUIS M , LUYTEN GPM , JAGER MJ
Published: December 2011

Purpose Uveal melanoma (UM) is the most common intra‐ocular tumor in adults that often leads to metastases for which no effective treatment is available. The aim of this study was to analyze molecular mechanisms in UM in order to reveal treatment targets.

Methods Efficacy of kinase inhibitors and molecular mechanisms are analyzed in preclinical models of UM. Focus in this study was on the kinases and pathways that are associated with metastasis.

Results Based on c‐Met expression in UM with a bad prognosis (monosomy 3) and activation of c‐Met in all metastasis cell lines c‐Met was chosen as treatment target and Crizotinib was chosen as candidate drug. Crizotinib is a dual kinase inhibitor that inhibits both ALK and c‐Met. Molecular analysis revealed that Crizotinib was able to inhibit c‐Met in UM effectively at nano‐molar range. Proliferation was however not affected by Crizotinib treatment when cells were grown attached to culture dishes. To achieve growth inhibition with Crizotinib cells had to be grown non‐attached. Moreover, only tumor cells that contained activated c‐Met were affected by Crizotinib while c‐Met negative cells continued to grow in the presence of the drug. Molecular analysis furthermore revealed that focal adhesion kinase (FAK) is a downstream target that was also inactivated in response to Crizotinib treatment. FAK is involved in tumor cell motility and tumor cell extravasation that are both crucial processes in metastasis.

Conclusion We propose Crizotinib as a possible treatment option for metastasizing UM. As c‐Met expression is highly correlated with monosomy 3, both c‐Met and monosomy 3 may be evaluated as biomarker for Crizotinib treatment.
Immunosuppressive inflammation is an inherent characteristic of prognostically‐bad uveal melanoma.
Authors: BRONKHORST IHG , VU THK , JORDANOVA ES , ONKEN MD , VERSLUIS M , VAN DER VELDEN PA , LUYTEN GPM , HARBOUR JW , VAN DER BURG SH , JAGER MJ
Published: December 2011

Purpose The presence of infiltrating immune cells in uveal melanoma is associated with poor prognosis. An analysis of the different functional phenotypes of the tumor‐infiltrating leukocytes (TIL) may help to gain insight in the role of these infiltrating immune cells.

Methods The density of CD8+ (CD3+CD8+ T cells) and CD4+ (CD3+CD8− T cells) T lymphocytes, CD4+ regulatory T cells (Tregs; CD3+CD8‐Foxp3+ cells), CD68+ and CD68+CD163+ macrophages was evaluated by immunofluorescence histochemistry in 43 cases of uveal melanoma. The correlations between different parameters were analyzed and their presence compared to known morphologic, immunologic, cytogenetic and molecular prognostic variables.

Results The presence of increased numbers of all T cell subsets was associated with an epithelioid cell type, monosomy 3, and the class 2 gene expression profile (GEP). The presence of TIL was very variable, but strong correlations were observed between the different types of TIL. The presence of Tregs was correlated with the presence of M2 macrophages.

Conclusion Uveal melanoma with more malignant characteristics such as monosomy 3 and the class 2 GEP contained more TILs, which included Tregs. These data suggest that tumor‐intrinsic factors distinguishing bad from good melanoma probably control the initiation of inflammation, which involves infiltration of tumors by different lymphocytic and myeloid immune cell subtypes, and support the notion that immunosuppressive inflammation contributes to increased malignancy in high risk uveal melanoma cases.
Inflammation in primarily and secondarily‐enucleated eyes with uveal melanoma
Authors: VU THK , BRONKHORST IHG , VERSLUIS M , MARINKOVIC M , VAN DUINEN SG , VROLIJK J , LUYTEN GPM , JAGER MJ
Published: December 2011

Purpose Uveal melanoma with a bad prognosis contain high numbers of infiltrating macrophages, especially of the M2 phenotype, and different subsets of lymphocytes. The aim of this study is to determine the presence of inflammatory cells in uveal melanoma‐containing eyes enucleated after different types of irradiation, i.e. ruthenium‐106 brachytherapy, sandwich therapy, or proton beam irradiation.

Methods We analyzed 46 eyes enucleated due to tumor recurrence, non‐responsiveness, or complications after irradiation. Immunofluorescence staining was performed to determine the presence of CD68+ and CD68+CD163+macrophages, CD3+, CD8+ and Foxp3+ regulatory T lymphocytes. Outcomes were compared with known clinical and histological prognostic parameters.

Results Numbers of CD68+ and CD68+CD163+ macrophages in secondarily‐enucleated eyes varied widely, but was not related to the reason for enucleation. The median of CD3, CD8, FoxP3+ lymphocyte counts was 55, 99 and 9 cells/mm2, respectively. When compared to primarily‐enucleated eyes, the lymphocytic infiltration was significantly (p<.02) higher in irradiated eyes.

Conclusion Numbers of T‐lymphocytes and macrophages varied widely. Irradiation has no clear effect on the number and type of macrophages in uveal melanoma. However, there were higher numbers of lymphocytes in previously irradiated uveal melanoma.
Preclinical study of a glycoengineered anti‐human CD20 antibody in murine models of primary cerebral and intraocular B‐cell lymphomas
Authors: BAGGA RYM
Published: December 2011

Purpose Primary cerebral lymphomas (PCL) and primary intraocular lymphomas (PIOL), related to the systemic diffuse large B‐cell lymphoma family, are highly aggressive tumors, with poor prognosis and any specific therapy. Despite good results obtained with chemotherapy, many patients relapse and new therapeutic strategies are needed. PCL and PIOL are characterized by the presence of CD20+ lymphomatous B‐cells and as such are eligible for therapy with anti human CD20 antibodies.

Methods In this study, we evaluated the efficiency of LFB‐R603, a promising glycoengineered anti‐hCD20 monoclonal antibody that displays a high affinity for FcgRIIIa (CD16) receptors, when injected intumoraly. We used a murine lymphomatous B cell line transfected with the human CD20 gene to generate two syngeneic murine models of PCL and PIOL

Results After a single therapeutic injection of LFB‐R603 mAb, a strong anti‐tumor response was noted against the PCL and a less pronounced response in the PIOL model. This was linked to an inhibition of tumor growth and infiltration with CD8+ T‐cells in both models. Interestingly, therapeutic effects were much better than those obtained with the Rituximab used as a reference.

Conclusion These in vivo results confirm the potential of the LFB‐R603 mAb as an innovative therapeutic approach for the treatment of PCNSL tumors.
Intravitreal bevacizumab (Avastin) in treating macular oedema associated with central retinal vein occlusion
Authors: ADEPEGBA O , GEORGE S
Published: December 2011

Purpose To report the response following intravitreal bevacizumab(IVB) therapy in macula oedema associated with central retinal vein occlusion(CRVO).

Methods Clinic charts of consecutive patients with macula oedema secondary to CRVO were retrospectively reviewed. Data from ophthalmological examination, Visual acuity, OCT (optical coherence tomography) fundus fluorescein angiography were recorded. All patient received one intravitreal bevacizumab 1.25mg/0.05ml at baseline and retreatment was on prn (pro re nata ) basis.

Results Twenty‐five eyes of 25 eyes of 25 patients with a mean age of 73.1±12.1 were reviewed. Average time between diagnosis and initiation of IVB was 9.3±8.2weeks(range=0‐52weeks). Follow up was 12 months. All patients were treatment naïve. Mean baseline visual acuity and central retinal thickness(CRT) was 32.5±7.2ETDRS letters and 625±240µ respectively. The mean change in in vision at month 1, 3, 6 and 12 was + 4.5(p=0.10), +9.6(0.051), +11(p=0.062) and 13.6(p=0.049) ETDRS letters respectively. The mean change in CRT from baseline at month one was ‐209µ(p=0.056) and ‐335µ(p=0.009), ‐263µ(p=0.03) and ‐258µ(p=0.022) at month 3, 6 and 12 respectively. Mean number of injection was 3.4 at month 6 and 5.2 at month 12. There were no complications recorded.

Conclusion Treatment of macula oedema secondary to CRVO with IVB resulted in improvement of visual acuity and significant decrease in macula oedema over 12 follow up.
Corneal Stromal Mesenchymal Stem Cells for Corneal Stroma Reconstruction
Authors: GRIFFITH M , RAFAT M
Published: December 2011

Purpose To date, corneal epithelial reconstruction has been very successful. However, in a number of cases of injury or disease, the stromal layer is affected. Our goal is to develop biomaterials that will enable the regeneration of the corneal stroma. In this study, we compare endogenous vs exogenous stem cell courses for corneal stromal regeneration.

Methods We have previously developed collagen‐based corneal stromal extracellular matrix substitutes based on EDC crosslinked collagen, and have shown that they promote ingrowth of stromal cells from the host cornea (Merrett et al. 2009; Fagerholm et al. 2010). For cases where stromal progenitors are depleted, we developed a non‐toxic collagen‐based hydrogel system where a macromolecular photoinitiator (Dex‐BBA)was used to form the hydrogel around cells. The feasibility of Dex‐BBA as a photoinitiator to initiate the gelation of aminoethylmethacylate‐modified collagen (Coll‐AEMA) was examined with or without the presence of stroma cells.

Results The Dex‐BBA crosslinked hydrogels were weaker than the EDC crosslinked constructs. However, they were fairly robust and no apparent toxicity of the hydrogel system to mesenchymal stroma (or stem) cells (MSCs)were observed during the culture of 7 days, which indicated that Dex‐BBA based macrophotoinitiator and our collagen‐based hydrogel system may have potential in corneal stromal regeneration applications.

Conclusion We show that corneal stromal regeneration can be achieved by endogenous stimulation of existing corneal progenitor cells. Where the host cells may be depleted, our results show that hydrogel encapsulated stem cells may be used in the future.

Commercial interest
The dexamethasone drug delivery system for the treatment of retinal venous occlusion with cystoid macular edema
Authors: EGEA ESTOPINAN C , IDOIPE M , PRIETO CALVO E , FERNANDEZ LARRIPA S , FERRERAS A , PABLO L , ABECIA MARTINEZ E
Published: December 2011

Purpose To report our case report with sustained‐release dexamethasone 0.7 mg intravitreal implant (Ozurdex®; Allergan, Inc., Irvine, CA) in retinal vein occlusion with macular edema.

Methods A 67‐years old female patient with recent retinal vein occlusion with macular edema treated with sustained‐release dexamethasone 0.7 mg intravitreal implant was performed. On initial examination, the right best‐corrected visual acuity (BCVA) was 0,3. Right fundoscopy revealed dilatation and tortuosity of the retinal veins and retinal hemorrhage in the superior quadrant of the retina. The fluorescein retinal angiography showed a delay of filling time and spectral domain optical coherence tomography (Spectralis SD‐OCT; Heidelberg Engineering, Heidelberg, Germany) showed macular edema.

Results The patient was treated with two intravitreal ranibizumab injections but two moths later the visual acuity was 0,2 and then we treated with sustained‐release dexamethasone 0.7 mg intravitreal implant and six moths later the right BCVA was improved to 0.7. Funduscopy and optical coherence tomography confirmed reduction of edema and tolerability of the implant was assessed.

Conclusion The dexamethasone drug delivery system is one of the most recent additions to the armamentarium against macular edema, and is intriguing for its potency, dose consistency, potential for extended duration of action, and favorable safety profile. In patients with macular edema in retinal vein occlusion, sustained‐release dexamethasone 0.7 mg intravitreal implant may be an effective treatment option to control macular edema
Retinal Vein Occlusion : Treatment by series of 3 Ranibizumab IVT
Authors: GONZALEZ C
Published: December 2011

Purpose To evaluate the functional, anatomical, vascular flow, anti‐ exudative effects of intravitreal injections(IVT) for Retinal Vein Occlusion ,by a protocol with 3 Ranibizumab IVT series, and the recurrences frequency at 3 years evolution.

Methods 17 eyes of 17 patients with Retinal Vein Occlusion received intravitreous Ranibizumab, 3 times, every 4 weeks in an inductive treatment. The next injections depended on the follow‐up results and were done by series of 3. First and 2 months’ interval follow‐up exams included ETDRS visual acuity (VA), complete ophthalmic examination, optical coherence tomography (OCT), and fluorescein angiography (FA).VA and OCT were done before each IVT. We want to evaluate the incidence of this protocol on the exudation and frequency of recurrence and so on the number of IVT needed.

Results VA improved in 16 eyes, stabilized in 1. Diffuse edema was 53% normalised ,total thickness was 60% less in the average follow‐up, cysts 100% disappeared in 75% cases, in 60% were diminished in size , volume and number, by OCT. At Angiography, no leakage in 65% cases, cystoids macular edema disappeared, vascular abnormalities diminished. Most of patients had good functional, anatomical results, with few IVT needed, no scars in the retina. Inductive treatment was sufficient in 5 cases, needed 2 IVT Series in 27% cases, failed in no cases. This protocol was compared ,discussed .

Conclusion The results with improved visual acuity, reduction of exudation at OCT, vessel’s leakage and structure normalized at FA, suggest this protocol, with series of 3 Ranibizumab IVT, seems effective, more retinal protective. This protocol seems attractive, specific indication criteria and its indication must be optimized.
Design and rationale of COMO, a 12‐month study that compares the safety and efficacy of dexamethasone intravitreal implant versus ranibizumab in branch retinal vein occlusion
Authors: LOEWENSTEIN A , BANDELLO F , KAMPIK A , SOUIED E , FIGUEROA M , TUFAIL A , HEYWOOD A , FULFORD‐SMITH A
Published: December 2011

Purpose The DEX implant 0.7 mg and ranibizumab have not been directly compared in a randomized trial in branch retinal vein occlusion (BRVO). Inclusion of different patient populations in the GENEVA[1] and BRAVO[2] trials also prevents an indirect comparison. Duration of disease and visual acuity at baseline have been shown to impact outcomes following treatment. BRAVO recruited patients with a shorter duration of macular oedema (ME) and lower best corrected visual acuity (BCVA) at baseline than GENEVA. Sub‐analysis of GENEVA showed a greater BCVA improvement which peaked at day 60 (17.8 letters, p=0.002) and was sustained out to day 180 (14.4 letters, p=0.138).[3]

Methods This Phase IV, multinational, randomized, 12 month study directly compares DEX implant 0.7 mg with ranibizumab in BRVO with ME for <90 days. Recruitment will begin in 2011 and circa 400 patients will be enrolled and randomized (1:1). Stratification will be according to BCVA.

Results The primary endpoint is the mean change in BCVA from baseline to month 12 in the intention‐to‐treat population using a non‐inferiority analysis. Secondary endpoints include other measures of visual acuity and quality of life.

Conclusion The results of this first head‐to‐head comparison of DEX implant 0.7 mg with ranibizumab will have implications for future practice. References 1.Haller JA, et al. Ophthalmol 2010;117(6):1134‐46. 2.Campochiaro PA, et al. Ophthalmol 2010;117(6):1102‐1112. 3.Allergan data on file. GENEVA sub‐analysis.
The effect of intravitreal ranibizumab on retinal oxygenation in central retinal vein occlusion
Authors: TRAUSTASON S , LA COUR M , LARSEN M
Published: December 2011

Purpose To investigate the effect of intravitreal anti‐VEGF on retinal oxygenation in patients with central retinal vein occlusion. Intravitreal anti‐VEGF injections have recently become an approved method of treatment for retinal vein occlusions, as several studies have shown a beneficial effect on visual acuity and retinal thickness. However, there are indications that intravitreal anti‐VEGF may cause constrictions of the retinal vessels, leading to a reduction in retinal blood flow.

Methods Retinal oxygen saturation in patients with CRVO was analysed, using the Oxymap Retinal Oximeter P3, before and during 6 months of treatment with intravitreal injections of ranibizumab.

Results Our preliminary results indicate that retinal oxygen saturation is not decreased by intravitreal anti‐VEGF injections.

Commercial interest
Central retina vein occlusion: visual acuity correlate with focal electroretinogram, but not with optical coherence tomography
Authors: RUBERTO G , TINELLI C , LIZZANO M , PICCININI P , CALMA F , DISPINSERI J
Published: December 2011

Purpose central retina vein occlusion(CRVO) is a retinal vascular disorder associated with various degrees of retinal ischemia leading to macular oedema and visual acuity loss. The standard method to detect and measure the macular oedema is the Optical Coherence Tomography(OCT). The focal electroretinogram (FERG) is a part of the electroretinography that investigate functionally the macula.The aim of our study was to investigate the relationship between visual acuity, morphologic aspects and functional results in CRVO.

Methods we examined 24 eyes affected by CRVO. All the patients had complete survey comprehending ETDRS visual acuity(VA), FERG, OCT. The FERG was performed via ERG dome, using a background light of 300 cd/m2 and a led stimulus alternating at 5,1 hz. The OCT values of macular volume and thickness, the a and b wave values of latency and amplitude were collected and analyzed. The results were matched with 19 eyes not affected of the same sample and with 20 eyes of healthy subjects. Multiple statistical relationship analysis of the r and p were done by mean of Kruskal‐Wallis test. The sensitivity and specificity were analyzed with Roc curve.

Results we do not found correlations between VA and OCT macular volume and thickness. A significant correlation with VA was found in a and b FERG amplitudes between the CRVO group, healthy subjects and the healthy eyes of CRVO group and also between the healthy eyes of CRVO and healthy subjects.Significant sensitivity and specificity (72.1 and 80 respectively) were found in Roc curve

Conclusion in our study functional alterations of the FERG correlate and probably precede VA loss
Immune modulation in ocular allergy: Update and future directions
Authors: LEONARDI A
Published: December 2011

Purpose In the presence of active severe allergic reaction, steroids are preferred over anti‐allegic drugs since the former is more effective in inhibiting rapidly the inflammatory component of corneal damage, i.e., eosinophil‐ and neutrophil‐ liberated epithelial toxic mediators. However, one often finds steroid‐resistant forms of VKC and AKC that necessitate an alternative therapy.

Methods In poor responders, or when only prolonged steroids are effective, topical cyclosporine 0.5% to 2% ameliorates the signs and symptoms of severe VKC and AKC without significant side effects. New formulations of topical cyclosporine at 0.05% may be further available for the treatment of severe VKC and AKC.

Results Topical cyclosporine A (CsA) 1% or 2% emulsion in castor or olive oil has been considered for years the primary alternative to steroids for treatment of severe VKC and AKC. CsA 1% was reported to be the minimum effective concentration in the treatment of vernal shield ulcer, with recurrence observed at lower concentrations.Lower concentrations of CsA have been suggested as a steroid sparing agent with moderate to good effectiveness.

Conclusion Newer alternatives to the use of topical mast cell stabilizing drugs, topical steroids and topical cyclosporine are other immunosuppressive drugs and biological agents that are able to specifically target different elements of the immune response.
Immune modulation in optic neuritis: “Good news?”
Authors: LAGREZE W
Published: December 2011

Abstract not provided
Glaucoma after vitreoretinal surgery
Authors: DETRY‐MOREL M
Published: December 2011

With the important advances in the microsurgical techniques during the past three decades, various and complex eye diseases involving retina and vitreous are currently accessible to vitreoretinal surgery. Most current vitreoretinal surgical procedures have major relationships with glaucoma and potential devastating consequences on the optic nerve head. In a pre‐existing glaucoma patient having history of filtering surgery, maintenance of the patency of the filtering bleb requires a vitreoretinal approach for conjunctival preservation with techniques (pneumatic retinopexy or small gauge vitrectomy). Whether coming after intravitreal triamcinolone acetonide injection or associated with panretinal photocoagulation, scleral buckling, pars plana vitrectomy, intraocular gases or silicone oil tamponade, transient or sustained elevation of intraocular pressure and open‐ or closed‐angle secondary glaucomas of a multifactorial nature are a common occurrence following vitreoretinal surgery. Adequate and successful therapeutic intervention should be tailored to the individual patient based on the early identification of the underlying mechanism of the pressure elevation. Patients with or suspect for glaucoma or those who may at risk to develop postoperative ocular hypertension and secondary glaucoma should be carefully screened before any vitreoretinal procedure. This presentation will focus on the different mechanisms, frequency, risk factors, clinical diagnosis and prognosis of ocular hypertension and glaucoma resulting from the different vitreoretinal procedures with their respective available therapeutical options.
Secondary glaucoma associated with congenital corneal abnormalities
Authors: CLAERHOUT I
Published: December 2011

Purpose To present an overview of developmental glaucomas associated with congenital corneal abnormalities.

Results This overview will discuss the different underlying congenital abnormalities causing secondary glaucoma including aniridia, Peters anomaly, Axenfeld‐Rieger syndrome and micro and megalocornea.
Management of secondary glaucoma
Authors: LIM KS
Published: December 2011

Purpose To summarised the current medical and surgical treatment options for patients with secondary glaucoma.

Methods Identify causes of the secondary glaucoma. Understand the mechanism of raised intraocular pressure.Option 1: Medical/drops treatment; Option 2:Laser Trabeculoplasty; Option 3: Trabeculectomy; Option 4: Non‐penetrating surgery; Option 4: Diode laser; Option 5: Tube surgery

Results Pros and cons for each option will be discussed.

Conclusion Depending on the underlying cause of the raised intraocular pressure and the status of the conjunctival, surgical option may be best in preserving long term vision for patient.