bluuebunny/crossref_metadata_2025 huggingface dataset:
Refractive changes after anti‐VEGF injections for diabetic macular edema
Authors: Chatziralli I. , Chatzipantelis A. , Dimitriou E. , Mpourouki E. , Saitakis G. , Theodossiadis P.
Published: September 2017

Purpose

To evaluate refractive changes after anti‐vascular endothelial growth factor (anti‐VEGF) injections for the treatment of diabetic macular edema (DME).

Methods

Participants in this retrospective study were 37 patients (37 eyes) with DME, who received intravitreal anti‐VEGF injections with either ranibizumab or aflibercept. Spherical equivalent refractive power was evaluated before treatment and at least one month after the last injection where no fluid existed. Demographic characteristics, visual acuity, central retinal thickness and the number of injections were recorded and analyzed.

Results

Changes in visual acuity and central retinal thickness were statistically significant before and after injections. The spherical equivalent refractive power did not differ significantly pre‐ and post‐ injections.

Conclusions

Intravitreal anti‐VEGF injections did not seem to affect the refractive power of patients with DME. Therefore, appropriate spectacle correction can be prescribed any time during ongoing treatment with anti‐VEGF agents.
Long‐term reproducibility of axial length in eyes undergoing combined phacovitrectomy for macular‐sparing rhegmatogenous retinal detachment
Authors: Kang T.S. , Shin Y.I. , Kim J.Y.
Published: September 2017

Purpose

To evaluate the change of axial length (AL) and the long‐term reproducibility measured by optical biometry and ultrasound A‐scan (US) after combined phacovitrectomy for macular‐on retinal detachment (RD).

Methods

Thirty‐seven eyes that underwent combined phacovitrectomy with intraocular lens implantation were analyzed, prospectively. The ALs were measured before surgery, after 1 year and 2 years, using optical biometry (IOL Master®, Carl Zeiss, Jena, Germany) and US. Intraclass correlation coefficient (ICC), coefficient of variation (CV), and test–retest standard deviation (TRTSD) were assessed.

Results

The mean age of patients was 56.5 ± 6.2 years, and 20 (54.1%) of the 37 were men. The mean preoperative AL measured by optical biometry was 25.03 ± 1.69 mm in vitrectomized eyes and 24.96 ± 1.70 mm in fellow eyes. The ICC, CV, and TRTSD were 0.97, 0.45 and 0.114 in vitrectomized eyes and 0.98, 0.66, 0.167 in fellow eyes, respectively. These parameters exhibit excellent long‐term reproducibility. Refractive prediction error by optical biometry and US were ‐0.41 ± 0.67 D (p = 0.001), and ‐0.49 ± 0.68 D (p = 0.000) respectively, which shows myopic shift. Correlation analysis showed significant relationships between myopic shift with shallow anterior chamber and thick lens.

Conclusions

After combined phacovitrectomy for macular on RD, the AL showed excellent long‐term intervisit reproducibility for two years. Regardless of AL, combined phacovitrectomy and gas tamponade resulted in significant myopic shift of postoperative refraction, for both optical biometry and US.
The impact of epiretinal membrane on neovascular age‐related macular degeneration treatment: A spectral‐domain optical coherence tomography study
Authors: Chatziralli I. , Stavrakas P. , Ananikas K. , Dimitriou E. , Theodossiadis G. , Theodossiadis P.
Published: September 2017

Purpose

The purpose of this prospective study was to evaluate the impact of epiretinal membrane (ERM) on anatomical and functional results in patients with wet age‐related macular degeneration (AMD) treated with intravitreal anti‐vascular endothelial growth (anti‐VEGF) injections.

Methods

Participants in the study were 48 patients with either wet AMD alone (n = 27) or AMD and ERM (n = 21). All patients received intravitreal anti‐VEGF injections (3 monthly injections and PRN thereafter) and were followed‐up for at least 12 months. All participants had best corrected visual acuity (BCVA) measurement and optical coherence tomography (OCT) at each visit, while fluorescein angiography was performed at baseline and then at the discretion of the physician. The main outcomes were the change in BCVA and central retinal thickness (CRT) along with the presence of fluid in the two groups.

Results

There was a statistically significant improvement in BCVA in both groups, while the two groups did not differ significantly regarding BCVA at the end of the follow‐up. Accordingly, there was a statistically significant reduction in CRT in both groups, which did not have any difference in between. Patients with AMD alone presented subretinal fluid in a lower percentage than patients with AMD/ERM at the end of the follow‐up. In addition, patients with coexistence of AMD and ERM needed more injections than patients with AMD alone.

Conclusions

Patients with AMD combined with ERM seemed to need more injections for the treatment of AMD, while they presented higher percentage of subretinal fluid at the 12‐month follow‐up, although there was no significant difference in BCVA and CRT in comparison with patients having AMD alone.
Clinical application of enhanced retinal vasculature visualization using hemoglobin absorbance
Authors: Kim Y.T.
Published: September 2017

Purpose

To develop a digital filter for better visualization of retinal blood vessels and verify its clinical usefulness

Methods

Four‐hundred 24‐bit color fundus images were analyzed and properties of red, green, and blue channels were extracted. Then, using hemoglobin absorption coefficients, the relevant weights for gray‐scale conversion that emphasizes retinal vessels were calculated. To evaluate images, edges were detected via convolutional 2D Laplacian kernel from the processed images, and the number of edges, number of effective edges, and sum of intensities of edges were evaluated. The values of weights for red, green, and blue channels were calculated to be ‐0.0572, 0.7335, and 2.2079, respectively. The number of edges, effective edges, and sum of intensities of edges were all found to be significantly higher in the images processed with the new filter (P < 10‐16). To evaluate the clinical usefulness of the digital filter, 2 individual observers graded 100 photographs from subjects with diabetes mellitus before and after application of newly developed digital filter. Grading was compared with FA findings.

Results

Correspondence of diabetic retinopathy grading from 2 independent observers were 0.36 and 0.29 before application of digital filter and 0.61 and 0.65 after application of digital filter(kappa value, respectively). Correspondence of presence of diabetic retinopathy from 2 independent observers were 0.69 and 0.69 before application of digital filter and 0.86 and 0.84 after application of digital filter(kappa value, respectively).

Conclusions

The hemoglobin absorbance reinforced the edges of retinal blood vessels, verifying that the new RGB filter can enhance the visualization of retinal vasculature and increase the accuracy of diagnosis.
Relation between cardiovascular conditions and macular and retinal nerve fiber layer thickness evaluated with Spectral‐Domain OCT
Authors: Obis J. , Garcia‐Martin E. , Orduna E. , Vilades E. , Cipres M. , Rodrigo M.J. , Satue M.
Published: September 2017

Purpose

To detect changes in the macular and Retinal Nerve fiber Layer (RNFL) thickness in subjects with cardiovascular risk factors or subclinical ischemia

Methods

152 healthy men were evaluated. They underwent cardiovascular examination (including quantification of classic major risk factors, blood analysis and quantification of subclinical atheroma plaques by ultrasound scans) and a complete ophthalmic evaluation including evaluation with spectral‐domain optical coherence tomography (SD‐OCT) registering macular and RNFL thickness

Results

Subjects without cardiovascular risk factors did not show higher macular or RNFL thicknesses than subjects with at least one risk factor. Subjects with subclinical atheroma plaques in the carotid artery showed significantly lower central macular thickness in the left eye compared to the right eye (p = 0.016). Subjects with atheroma plaques showed significantly reduced RNFL thickness in the superior quadrant (p = 0.044) and in the 2 o'clock sector (p = 0.014) compared to subjects without atheroma plaques. Smokers showed significant thinning in central macular thickness (p = 0.034), and also in the nasal RNFL quadrant (p = 0.006) and the 3 and 5 o'clock RNFL sectors (p = 0.016 and 0.009), compared to non‐smokers

Conclusions

Subjects with subclinical atherosclerosis assessed by ultrasound scans showed reduced RNFL thickness in the superior quadrant. Smokers showed reduced central macular thickness and reduced RNFL thickness in the nasal quadrant. Macular and RNFL analysis with SD‐OCT could be a good biomarker of early axonal damage in subjects with cardiovascular conditions
The SRPK1 inhibitor SPHINX31 prevents increased retinal permeability in a rodent model of diabetes
Authors: Allen C. , Horton K. , Malhi N. , Batson J. , Bates D.
Published: September 2017

Purpose

In diabetic retinopathy (DR) microvascular damage results from ischaemia driven production of pro‐angiogenic vascular endothelial growth factor (VEGF) inducing angiogenesis and increased permeability in the retina. Small molecule inhibitors of serine‐rich protein kinase‐1 (SRPK1), with good penetration properties to the retina, have been shown to inhibit choroidal neovascularisation in mice as eye drops by decreasing pro‐angiogenic and increasing anti‐angiogenic VEGF isoforms. SRPK1 inhibitors such as SPHINX31 may therefore switch splicing in DR and prevent increased vascular permeability.

Methods

FFA was performed in Norway Brown rats on day 0 and 7, using the Micron IV retinal microscope (Phoenix Research). Animals received twice daily topical eye drops with eye formulation only control buffer (n = 5) or SPHINX31 (200 μg/ml, n = 6). On day 1 animals received a single dose of streptozotocin (50 mg/kg, i.p.) to induce type I diabetes and maintained for 1 week without insulin. The ratio of interstitial to vascular fluorescence was calculated and plotted against time to determine an estimate of permeability.

Results

Retinal permeability (12.67 ± 1.09 × 10−4 cms−1) was shown to significantly increase (p < 0.01) in diabetics compared to before diabetes (8.85 ± 1.29 × 10−4 cms−1) in the eye formulation control group. Following a weekly regimen of twice daily topical eye drop treatment with SPHINX31 retinal permeability was no greater in the diabetics than (7.92 ± 1.65 × 10−4 cms−1) than before induction of diabetes, (8.15 ± 2.33 × 10−4 cms−1) and in the control group.

Conclusions

SPHINX31 protected the retinal endothelial permeability barrier from diabetes‐associated loss of integrity. SPHINX31 may therefore be a potential alternative and more specific topical therapeutic for DR.
Melatonin and epigallocatechin gallate reduce the loss of visual function in an animal model of retinal degeneration, P23H rat
Authors: Perdices L. , Orduna E. , Sánchez A.I. , Segura F. , Insa G. , Fuentes L. , Cuenca N. , Pinilla I.
Published: September 2017

Purpose

Retinitis Pigmentosa (RP) is a heterogeneous group of retinal degenerative disorders which represent a major cause of blindness in adult people with no effective therapy found.

Most RP cases are due to rhodopsin mutations, which cause retinal disorganization due to rod degeneration and oxidative stress. Melatonin and epigallocatechin gallate (EGCG) have been reported to exhibit anti‐apoptosis, antioxidant and neuroprotective effects. The aim of this study was to evaluate the synergistic effects of these two natural antioxidants in the P23H rat.

Methods

20 P23H rats crossed with Long Evans (LE) rats, were used and compared to 20 SD (P23H background) crossed with LE rats. Vehicle, or 10 mg/kg/day of Melatonin and/or 10 mg/kg/day of EGCG were orally administered for 6 months. Visual acuity and contrast sensitivity was evaluated by a monthly optomotor test.

Results

P23HxLE rats showed lower values than SDxLE rats in all optomotor parameters studied. SDxLE rats treated with melatonin or EGCG increased, after 60 days of treatment, visual function parameters even higher than young animals. P23HxLE rats treated with melatonin or EGCG showed better visual acuity and contrast sensitivity than those treated with vehicle in all measurements done after 30 days of treatment, slowing the disease progression. In all animal groups, treatment with melatonin and EGCG simultaneously obtained better visual acuity and contrast sensitivity values than treatment with any of those compounds alone.

Conclusions

In conclusion, oral treatment of melatonin or EGCG improved vision in wild type animals and delayed vision loss in P23H rats. Furthermore, combination of both compounds had a better effect than any of those treatments alone, suggesting different mechanisms of action.
THR‐687, a potent small molecule integrin antagonist, holds promise as a therapeutic approach for back‐of‐the‐eye vascular pathologies
Authors: Van Hove I. , Vanhove M. , Porcu M. , Barbeaux P. , Feyen J.H.M. , Vermassen E.
Published: September 2017

Purpose

Pathologic neovascularization and vessel leakage are key drivers for vision loss in several back‐of‐the‐eye diseases, such as diabetic retinopathy and age‐related macular degeneration. In the eye, integrin receptors play an important role in (pathological) angiogenesis and vascular leakage. Blocking integrin receptors has the potential to inhibit these processes, independent of anti‐VEGF responsiveness. In this study, we evaluated the integrin‐blocking and anti‐angiogenic properties of THR‐687, a novel small molecule integrin antagonist.

Methods

Competition ELISA assays were used to assess the ability of THR‐687 to compete with the binding of integrin receptors to their natural ligands. The inhibitory effect of THR‐687 on the migration of human umbilical vein endothelial cells (HUVECs) was evaluated in the ORIS cell migration assay. The effect of THR‐687 on blood vessel outgrowth was evaluated in an ex vivo mouse choroidal explant model. Cytotoxicity of THR‐687 on human retinal microvascular endothelial cells (HRMVECs) was evaluated using the CellTox Green assay. The safety profile of THR‐687 was further evaluated using hERG and genotoxicity assays.

Results

THR‐687 was found to inhibit multiple integrin receptors belonging to the RGD class with IC50 values in the low nanomolar range, including, but not limited to, αvβ3, αvβ5 and α5β1. THR‐687 potently inhibited the migration of HUVECs in the ORIS system (IC50 of 82 ± 11 nM). Ex vivo choroidal vessel sprouting was dose‐dependently inhibited by THR‐687 (IC50 of 1.50 ± 0.27 μM). No relevant cytotoxicity signal was observed on HRMVECs at concentrations ranging from 0.25 nM to 20 μM, and in vitro pharmacological profiling studies indicated a good safety profile.

Conclusions

THR‐687 is a potent drug candidate for the treatment of diabetic eye disease.
Use of sodium hyaluronate in combination with a blood derivative in the re‐epithelialization of rabbit corneas
Authors: Andollo N. , Suarez‐Barrio C. , Hernáez‐Moya R. , Vicario M. , Herrero‐Vanrell R. , Molina‐Martínez I.T. , Durán J.A. , Etxebarria J.
Published: September 2017

Purpose

To analyze if using a bioadhesive (sodium hyaluronate or HaNa) in combination with a blood derivative (s‐PRGF) improves the healing rate and quality of corneal epithelial ulcers.

Methods

Rabbit corneas removed 7 and 30 days after an in vivo re‐epithelialization assay were include in paraffin and processed for haematoxylin–eosin staining or cryopreserved for immunofluorescent staining. In vitro proliferation and wound healing experiments were performed using the human corneal epithelial HCE cell line and rabbit primary corneal epithelial cultures. We studied the following treatments: 1) 90% s‐PRGF 2) 0.22% NaHa 3) s‐PRGF + NaHa 4) PBS as control treatment for the in vivo assay. All components in treatments 1, 2 and 3 were half the concentration for the in vitro assays, being 1% BSA the control treatment (4). To manufacture s‐PRGF whole blood was collected by venipuncture from healthy volunteers or New Zealand rabbits, respectively.

Results

Healing rate was higher in cultures and in eyes under s‐PRGF treatment than in those treated with HaNa or the combination of both. H‐E sections at 30 days showed more cells in the anterior stroma in eyes under HaNa treatments. In agreement with it, Ki67 staining as well as in vitro proliferation assays demonstrated that HaNa stimulated cell proliferation. All treatments produced stratified and mature epithelia (CK3 positiveness) with barrier function (ZO‐1 staining) and activation of limbal stem cells (CK15 staining), although the HaNa treated epithelia were the less organized. Moreover, eyes treated with only s‐PRGF showed the best integrin β4 staining.

Conclusions

HaNa bioadhesive promotes epithelial and stromal cell proliferation, but does not improve the corneal healing capacity of s‐PRGF. s‐PRGF shows a better healing quality in terms of epithelial‐stromal adhesion.
Progressive changes in visual function after Descemet membrane endotelial keratoplasty
Authors: Romero Sanz M. , Gavín Sancho A. , Satué Palacián M. , Mateo Orobia A. , Sánchez Pérez‐Borbujo A. , García Martín E. , Blasco Martínez A. , Idoipe Corta M.
Published: September 2017

Purpose

Objectives: To evaluate progressive changes in visual function parameters in patients with Fuchs endotelial dystrophy (FED) who underwent Descemet membrane endotelial keratoplasty (DMEK) and to compare visual results after DMEK with visual function parameters in healthy subjects without corneal pathology.

Methods

Methods: Fourteen patients (14 eyes) with FED who underwent DMEK surgery were included in the study. All subjects underwent best corrected visual acuity (BCVA) evaluation using the ETDRS optotype in photopic and scotopic conditions, and contrast sensitivity (CS) assessment using the CSV 1000 and the Pelli Robson tests in different lighting conditions, preoperatively, at 1 and 6 months after surgery. Fourteen eyes of 14 healthy controls were evaluated using the same protocol and compared with the patients’ final postsurgery data.

Results

Results: A significant improvement in all visual function parameters was observed in patients 1 month (p < 0.05) and 6 months (p < 0.05) after DMEK, compared with preoperative levels. Healthy controls had significantly higher BCVA in photopic and scotopic conditions (p = 0.02, p = 0.044, respectively), better CS in spatial frequencies of 6 cpd (p < 0.001); 12 cpd (p = 0.006) and 18 cpd (p = 0.006) measured with the CSV 1000 test, and CS as measured with the Pelli Robson test (p = 0.002). No significant differences were observed between patients and healthy controls in the spatial frequency of 3 cpd (photopic, p = 0.704; mesopic, p = 0.596; mesopic with glare, p = 0.989).

Conclusions

Conclusions: DMEK improves visual function parameters in patients with FED in the first month after surgery. Patients who underwent DMEK present similar CS to healthy subjects in lower frequencies. However, BCVA and CS in medium and high frequencies remain significantly lower than those values found in healthy corneas.
Exploratory ocular surface distribution studies of Azithromycin formulations based on semifluorinated alkanes
Authors: Fischer K. , Grillenberger R. , Amar T. , Krösser S.
Published: September 2017

Purpose

Azithromycin is an antimicrobial agent with broad spectrum activity and anti‐inflammatory properties. The aim of this study was to investigate the ocular distribution of azithromycin after a single topical instillation of a new semifluorinated alkane (SFA) based formulation in rabbits.

Methods

Rabbits were treated with either a single administration of 1.5% or 3% SFA‐azithromycin suspensions. Due to the low surface and interface tension of the SFA, and its excellent spreading properties, droplet size is smaller compared to other ophthalmic formulations which lead to a low instillation volume of ~11 μL. Tears (T), aqueous humor (AH), cornea (C), bulbar conjunctiva (BCJ), and eyelids (EL) from individual eyes were collected up to 144 h post dosing and drug concentrations were measured using a validated LC‐MS/MS method.

Results

Following a single topical instillation of SFA‐azithromycin in rabbit eyes, both formulations were macroscopically well tolerated. The highest exposure was found in the general order of EL > T > C > BCJ > AH. The obtained values were compared with data from a similar experiment of a marketed 1.5% azithromycin formulation in medium‐chain triglycerides1, with a single instillation of 25 μL. The comparison showed that azithromycin exposure after administration of 1.5% SFA‐azithromycin formulation was similar to the marketed formulation despite the lower absolute dose.

Amar et al, Current Eye Research, 33: 149‐158, 2008

Conclusions

The preservative‐free, multi‐dose SFA‐azithromycin formulation was well tolerated. Both concentrations resulted in adequate and long‐lasting azithromycin levels in T and EL, C and BCJ. Based on these results this azithromycin formulation may lead to a new therapeutic well‐tolerated option in treating ocular surface bacterial infections.
Clinical manifestations of reverse pupillary block after scleral‐fixated intraocular lens implantation: Pre‐ and post‐laser peripheral iridotomy
Authors: Kim J.M. , Lee K.B. , Han J.I. , Jung J.J.
Published: September 2017

Purpose

To present the clinical features and intraocular pressure (IOP) changes of patients with reverse pupillary block (RPB) after scleral fixated intraocular lens (IOL) implantation treated with laser peripheral iridotomy (LPI).

Methods

A chart review of patients presenting with elevated IOP and RPB after sclera fixated IOL implantation was carried out. LPI was performed in 5 eyes of total 6 eyes included in the study. Ultrasound biomicroscopy (UBM) and Goldmann applanation tonometry (GAT) was also performed before and after laser treatment.

Results

Five men who underwent LPI at a mean of 38.2 months (range 9 to 75 months) after scleral‐fixated PC IOL implantation were included. Two patients had history of retinal detachment, one subject had a history of trauma, and one patient was previously diagnosed with open angle glaucoma. Angle recession was not observed in all cases. The mean axial length was 24.24 ± 1.14 mm (range 22.86 to 25.44). Scleral fixated IOL implantation with pars plana vitrectomy was performed in all cases. All eyes showed extremely deep anterior chamber with pigment (trace to 1 + ), a concave iris configuration and angle pigmentation before LPI. On UBM, all eyes showed RPB. After LPI, RPB was resolved on slit lamp examination and UBM in all cases. IOP decreased within normal range (from 29.00 ± 12.37 to 13.40 ± 2.88 mmHg, p = 0.043) temporarily, but IOP elevated again (to 30.20 ± 15.39 mmHg, p = 0.068) few weeks after LPI and all patients needed IOP lowering medications.

Conclusions

LPI is effective for relieving the RPB. But, in some patients, IOP was still elevated and IOP lowering eye drops were needed persistently. Even though RPB is reloved, regular check up of IOP after LPI is recommended. Also it is necessary to consider the possibility of previously decreased TM function.
Positional and shape changes of lamina cribrosa after trabeculectomy in pseudoexfoliative and primary open angle glaucoma
Authors: Kadziauskiene A. , Strelkauskaitė E. , Ašoklis R. , Girard M.J.A. , Schmetterer L.
Published: September 2017

Purpose

To evaluate positional and shape changes of anterior lamina cribrosa (LC) after trabeculectomy and compare them between eyes with pseudoexfoliative (PEXG) and primary open angle glaucoma (POAG).

Methods

The prospective study included 99 eyes (78 PEXG and 21 POAG) planned for trabeculectomy. The morphological parameters of LC and intraocular pressure (IOP) were measured pre‐ and postoperatively (1 week and 1, 3, 6 and 9 months after the surgery). LC was imaged using enhanced depth imaging spectral domain optical coherence tomography. The mean and sectoral LC depth (LCD), global shape index (GSI), curvedness and curvatures in main meridians were calculated using Morphology 1.0 software. LC parameters were compared across the follow‐up visits and in‐between PEXG and POAG groups.

Results

The mean IOP reduced in PEXG and POAG eyes after the trabeculectomy at all follow‐up visits (p < 0.001). There was a decrease in mean and sectoral LCD (p < 0.001), curvedness (p < 0.001), nasal‐temporal (N‐T) and superior‐inferior (S‐I) curvatures (p < 0.001, p = 0.045, respectively) during whole postoperative period. LC GSI did not change significantly postoperatively and stayed in‐between a trough and rut shape (p = 0.065). There were no differences in the changes of LC morphology between PEXG and POAG eyes (p > 0.05); however a tendency of greater reduction in LCD and curvature was observed. The decrease in LCD, N‐T and S‐I curvatures correlated positively with IOP reduction(ρ = 0.326, ρ = 0.3, ρ = 0.261, p < 0.01 after 1 week, respectively).

Conclusions

Trabeculectomy induced a long term mean and sectoral anterior displacement as well as flattening of LC. However, the overall shape of LC was not affected postoperatively. Despite a potential elastinopathy of pseudoexfoliative syndrome PEXG and POAG eyes did not show differences in positional and shape behaviour of LC after the surgery.
Application of 3D‐ASL technique in observation on cerebral blood flow changes in early and mid‐stage primary open angle glaucoma
Authors: Qing Z.
Published: September 2017

Purpose

Based on Three Dimensional Arterial Spin Labeling (3D‐ASL) was used to examine the cerebral blood flow(CBF)changes of cerebrum for patients with early and middle stage primary open‐angle glaucoma (POAG) and to explore the characters of CBF changes and Central nervous system injury in early and middle stage POAG in order to providing a new thinking of preventing POAG.

Methods

According to the inclusion and exclusion criteria of POAG, Seventeen POAG patients and seventeen gengder‐age‐matched healthy control were enrolled in the study. For each participant high‐resolution structural brain image was acquired on a 3.0 scanner. CBF images were obtained after being preprocessed by SPM8. REST were used to analyze CBF changes of whole brain and correlation analysis between CBF changes and RNFL and MD.

Results

1) whole brain CBF analysis:compared with control group,CBF is mainly decreased in POAG. The area include:right cerebellum, left superior occipital gyrus, right precentral gyrus, left cerebellum, right superior frontal gyrus, left fusiform gyrus, corpus callosum, left calcarine, the left parahippocampal. Increased CBF area:inferior frontal gyrus, caudate nucleus, orbitofrontal. 2) correlation analysis:RNFL was shown positive correlation with right inferior temporal gyrus, left calcarine, right cerebellum and right occipital gyrus. It has positive correlation between MD and right superior frontal, right calcarine and left middle frontal.

Conclusions

POAG in early and middle stage POAG could cause cerebral blood flow decrease,and these changes were positive correlation to RNFL and MD. Cerebral blood flow may be a potential biomarker for the brain involvement in glaucoma.
Prescription pattern of ocular hypotensive drugs in Portugal and its comparison with the European guidelines – PEM study
Authors: Pimenta G. , Sousa D.C. , Leal I. , Marques‐Neves C. , Abegão Pinto L.
Published: September 2017

Purpose

There are few studies in Europe addressing the adherence to antiglaucomatous prescription guidelines. This study aims to describe the nationwide yearlong analysis of the prescription patterns of these drugs in Portugal, discussing how guidelines are being applied and identifying opportunities for improvement.

Methods

Cross‐sectional study including all patients who were prescribed at least one IOP‐lowering medication in Portugal, in 2015. Data was obtained from the common electronic drug prescription system used by all hospitals and clinics in the country. Current National and European Guidelines on Glaucoma Management were used as a reference. Statistical analyses were performed using STATA.

Results

A total of 833 871 prescriptions were provided to 231 634 patients (57% women). Over half of them were under monotherapy, but only 76% complied with first‐line treatment choices (prostaglandin analogues or beta blockers). Among patients who were prescribed two IOP‐lowering drugs, only two thirds adhered to the treatment strategy of using them as a fixed combination (FC). The guidelines orientation to use FC treatments was more likely to be followed by the ophthalmologist than the patient's General Practitioner. Nationwide, this topical IOP‐lowering therapy accounted for a total of 26 million euros (M€) in costs, shared between patients and the national health system. The prescription rate per 100 000 people ranged from 13 180 to 2 257 among the seven Portuguese regions.

Conclusions

Guidelines for glaucoma treatment seem to apply to the majority of Portuguese patients taking IOP‐lowering medication. However, a significant number of treated patients are not being prescribed first line IOP‐lowering drugs. Non‐ophthalmologist may be less aware of the preferred practice patterns in the management of this disease.
Nature‐inspired Nrf2 activators in retinal pigment epithelial cells: a source for therapeutics in age‐related macular degeneration
Authors: AMADIO M. , Serafini M.M. , Marchesi N. , Catanzaro M. , Fagiani F. , Simoni E. , Pascale A. , Rosini M. , Lanni C.
Published: September 2017

Purpose

Age‐related Macular Degeneration (AMD) is a severe neurodegenerative disease and a major cause of blindness in the elderly worldwide. Oxidative stress is a common feature of AMD pathogenesis, and a positive modulation of Nrf2 activity has been demonstrated to be protective. Natural products are generally a rich source of therapeutics; we recently combined polyphenols from curcumin and diallyl sulfide in new chemical entities to produce hybrids with anti‐oxidant activity. To confirm Nrf2 pathway as a valuable therapeutic target, we studied the modulation of this cascade by our new hybrids.

Methods

The human retinal pigment epithelium cell line ARPE‐19 was exposed to increasing concentrations of the new nature‐inspired hybrids. Cell viability was evaluated by MTT assay. Nrf2 nuclear translocation and target gene expression were measured by Western blotting.

Results

New nature‐inspired hybrids induce Nrf2 nuclear translocation and modulation of its target genes involved in phase II response in ARPE‐19 cells. These molecules show a potency on Nrf2 activation profile comparable to that induced by the reference compounds curcumin and dimethylfumarate, the latter being currently used in clinic for multiple sclerosis.

Conclusions

The new nature‐inspired hybrids show to be promising to counteract some features related to AMD pathogenesis, thus suggesting the potential use of Nrf2 activators as therapeutics.
Reduction in subfoveal choroidal thickness and peripapillary retinal thickness after high‐dose melphalan therapy followed by autologous peripheral blood stem cell transplantation in a patient with POEMS syndrome
Authors: Hirotaka Y. , Toshiyuki O. , Takayuki B. , Shuichi Y.
Published: September 2017

Purpose

To determine whether high‐dose melphalan therapy followed by autologous peripheral blood stem cell transplantation can reduce the serum level of vascular endothelial growth factor (VEGF), the peripapillary retinal thickness (pRT), and the choroidal thickness (CT) in a patient with the polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome.

Methods

A 39‐year‐old man with POEMS syndrome was given high‐dose melphalan therapy followed by autologous peripheral blood stem cell transplantation. The peripapillary retinal thickness (pRT) and subfoveal CT was determined by spectral‐domain optical coherence tomography (SD‐OCT) to quantify the degree of optic disc edema and choroidal thickness. The pRT thickness was measured at the baseline and at 6 months after the treatment. The serum level of VEGF was also determined by enzyme‐linked immunosorbent assays (ELISAs) at the baseline and at 6 months after beginning the treatment.

Results

At the baseline, the serum level of VEGF was 9960 pg/ml and the pRT was 1062 μm in the right eye and 963 μm in the left eye. At 6 months after the treatment, the serum level of VEGF was reduced to 333 pg/ml, the ODE was reduced bilaterally, and the pRT was decreased to 406 μm in his right eye and 358 μm in his left eye. The subfoveal CT was 439 μm in the right eye and 409 μm in the left eye at the baseline. Six months after the treatment, the subfoveal CT was decreased to 368 μm in the right eye and 364 μm in the left eye.

Conclusions

Our result showed that the peripapillary retinal thickness and subfoveal choroidal thickness were reduced in the optical coherence tomographic (OCT) images along with a decrease of the serum VEGF levels. We recommend OCT to monitor the changes in the signs of POEMS syndrome after treatments.
Clinical applications of a visual field perimeter with binocular video imaging
Authors: Charlier J.
Published: September 2017

Purpose

The majority of visual field testing equipment is designed for monocular tests only: most instruments do not have the capability to visualize both eyes simultaneously and many do not have a head rest position suitable for binocular testing. This presentation will focus on the clinical applications of the binocular visual field tests available on the MonCvONE perimeter.

Methods

Binocular testing is very important for functional evaluations. Extrapolation from monocular tests is inaccurate as phenomenons such as integration, suppression, ocular deviation, cyclotorsion, … affect differently monocular and binocular vision. The MonCvONE perimeter combines a binocular video sensor with the possibility of video recording to the possibility of controlling the exam with an interactive mode similar to the Goldmann perimeter.

Results

Clinical examples of binocular perimetry will be presented including ‐ the evaluation of ptosis with a documentation of the gain in visual field area in relationship with the opening of the eye lids. ‐ the assessment of low vision with the Esterman technique ‐ the evaluation of drivers’ visual field in agreement with the European Community directive ‐ the evaluation of the field of single vision with the determination of a diplopia score‐ the test of the visual field in young infants when eye occlusion and head immobility are not easily obtained

Conclusions

These examples demonstrate the clinical usefulness of binocular visual field testing with video recording
Enhanced visual attentional modulation in patients with inherited peripheral retinal degeneration in the absence of cortical degeneration
Authors: Ferreira S. , Andreia P. , Quendera B. , Silva E. , Reis A. , Castelo‐Branco M.
Published: September 2017

Purpose

Studies concerning the effects of peripheral retinal degeneration on visual cortical structure and function are scarce. Our work aimed to determine the effect of peripheral retinal dystrophy caused by Retinitis Pigmentosa on brain function and structure using magnetic resonance imaging, taking into account the effect of the preserved visual field extent and the disease onset age.

Methods

We included thirteen patients and twenty‐two matched controls. We analyzed cortical responses under attentional demands and passive viewing conditions while presenting a visual stimulus covering the central and paracentral visual field. Responses were studied in the visual cortical areas (V1, V2 and V3) and also in two cortical regions of interest corresponding to the preserved and the damaged visual field. The cortical thickness of visual areas was also measured

Results

We found that cortical visual responses under attentional demands were increased in patients with larger degeneration of visual field. Moreover, activation during the task condition was increased for patients in both cortical regions corresponding to the preserved and the damaged visual field, specifically in patients with severe visual field loss. These findings were observed in presence of preserved visual cortical structure.

Conclusions

We conclude that Retinitis Pigmentosa patients have enhanced visual attentional modulation despite their retinal degeneration, while cortical structure remains intact (with an relative increase in V2 thickness in patients with RP in early stages). The unmasking of feedback signals from higher level visual regions involved in attentional processes may explain the increased cortical responses. These findings are relevant in the context of the design of strategies for treating retinal diseases.
An intraocular foreign body detection using swept‐source OCT
Authors: Berniolles J. , Marco Monzon S. , Ascaso Puyuelo A. , Bartolomé Sesé M.I. , Martínez Vélez M. , Esteban Floria O. , Sánchez J.I. , Idoate Domench A. , López Sangrós I. , Ibáñez Alperte J.
Published: September 2017

Purpose

To describe a case report of a 35 years old metal worker with a corneal ulcer in his right eye treated with an antibiotics ointment by a primary care doctor that presented blurry vision two days later.

Methods

Examination of the anterior chamber by slit lamp, tonometry was used to determine intraocular pressure, funduscopy, Swept‐Source OCT and CT scan were performed.

Results

The patient right eye presented intense epibulbar and tarsal hyperemia, and it had a 1x1 mm corneal ulcer, positive in the fluorescent test, and an iridium hole below. Tyndall 2+ and IOP of 18 mmHg. No cataract was detected. Funduscopy examination showed a moderate amount of vitreous hemorrhage. A CT scan, retinography and a Swept‐Source OCT were performed and they revealed an intraocular foreign body located in the optic nerve area. The foreign body was removed via pars plana vitrectomy 23G surgery, requiring a magnet a demarcating laser. After four months the patient has a 20/20 visual acuity with no cataract.

Conclusions

This case underlines that although CT scan is considered the “gold standard” for the detection, localization and characterization of intraocular foreign bodies, new image techniques as Swept‐Source OCT can be a non invasive and accurate search tool in cases of intraocular foreign body.
Changes in the electromyography of the lateral and medial muscles after the electrostimulation treatment of lateral muscles in children with convergent concomitant strabismus
Authors: Boychuk I. , Mazur V.
Published: September 2017

Purpose

It is known that physiotherapeutic treatment of convergent concomitant strabismus with electrostimulation of extraocular rectus muscles is applied. Assessment of changes in the electromyography of the muscles after the course of treatment was not carried out, due to absence of a method of surface electromyography (SEMG) of the rectus muscles.To identify changes in the SEMG before and after electrostimulation of the external rectus muscles in children with concomitant strabismus the work was done

Methods

Electrostimulation of the lateral rectus muscles of both eyes was performed using the Amplipulse‐5 apparatus in a standard procedure in 12 children (24 eyes) with convergent concomitant strabismus with deviation 12‐ 24pr.dptr. SEMG was done with the M‐TEST‐2 electromyograph, according to the method developed by us earlier. Patients were examined before and after treatment.

Results

Amplitudes of the biopotentials of the SEMG of the lateral rectus muscle decreased slightly after treatment (11,55 ± 2,3 mV ÷ 10,64 ± 0,7 mV, p> 0.05), while the frequency increased significantly (49, 7 ± 3,6Hz ÷ 63,18 ± 8,2Hz, p <0.05). Ranges of the SEMG biopotential amplitudes and frequency of the medial rectus muscle decreased slightly after treatment (11.48 ± 0.5 mV ÷ 10.2 ± 0.9 mV, 101.96 ± 5.6 Hz ÷ 94.7 ± 19, 5 Hz, p> 0.05).Deviation became less in average on 12,2±4,6 pr.dptr. en with concomitant strabismus.

Conclusions

The method of surface electromyography allows estimating changes in the biopotentials of the external rectus of the eye before and after electrostimulation (amplitude, frequency). Electrostimulation treatment decrease the imbalance between the lateral and medial rectus muscles biopotentials of SEMG in children with a convergent concomitant strabismus.
AMD drusenoid deposits “P”, protein‐cellular type: volume, morphology, evolution analysis with morphology‐structural software
Authors: Gonzalez C.
Published: September 2017

Purpose

To study AMD Drusenoid deposits “P” with morphology‐structural software and see all the input of this software on their morphology, evolution knowledge and understanding

Methods

310 eyes of 155 patients, 61 men, 94 women, with AMD Drusenoid Deposits “P”, Protein‐Cellular Type (Pseudovitellifom AMD,Cuticular drusen,Subretinal drusenoid deposits(SDD),Drusenoid PED,”P”). Deposits were evaluated by Autofluorescence, IR imaging, OCT(Spectralis HRA‐OCT,spectral domain OCT) and Morphology‐Structural software (M‐S software). ETDRS visual acuity(VA), complete ophthalmic examination with Fundus exam were added. M‐S software let: grading (semi‐automatized drusenoid deposit volume and contours analyze,3D deposit reconstruction); measurements (volume(in μm3), density(grey levels of deposits)(Statistic moments of pixel intensities: mean,median,minimum,maximum,average,standard deviation,skewness and kurtosis), structure (structural measures, texture parameters),(Haralick texture measurements for distances of 1 to 10 pixels), composition(differential density calculation). Grading, measurements(volume,density) let analyze Drusenoid deposit “P”, their evolution,4 years follow‐up

Results

M‐S software allows AMD Drusenoid Deposits “P”,Protein‐Cellular Type (Pseudovitellifom AMD,Cuticular drusen,Subretinal drusenoid deposits(SDD),Drusenoid PED,”P”) analyze, follow‐up: topography,volume,density,evolution, for each cut,layer,eye,patient and patient to patient. Therefore M‐S software enable Drusenoid Deposits comparison, evolution for each patient and patient to patient. So M‐S let assay AMD progression, assess evolution Drusenoid deposits “P” to Neovascular complication and its intensity and occurrence period

Conclusions

Morphology‐Structural Software contribute to and improve AMD Drusenoid deposits “P”,Protein‐Cellular type, study and knowledge and so AMD understanding.
Towards a new therapy concept for acute microbial karatides, including Acanthamoebae
Authors: Storsberg J. , Schmidt C. , Plog C. , Höfer P. , Klöpzig S. , Rehfeldt S. , Sel S.
Published: September 2017

Purpose

The purpose of this study was to develop novel therapeutic approaches for the management and treatment of microbial keratitides, especially pathologies resulting from Acantamoeba castellanii inoculations.

Methods

Growth inhibitory effects of plasma‐induced reactive species on cultures of Staphylococcus aureus, Pseudomonas aeruginosa, Acantamoeba castellanii, and MRSA were assayed for in in an in‐vitro setting. Human donor corneas were inoculated and cultured with cultures of above pathogens, followed by staining of cells and microscopic analysis.

Results

Our results show a substantial inhibitory effect of plasma‐induced reactive species on the growth and migration of the pathogens tested.

Conclusions

The effects observed provide foundation for the development of new avenues for the management and therapy of microbial keratitides.
Adalimumab as an alternative treatment in Serpiginous Choroiditis
Authors: Sánchez Marín J.I. , Idoate Domench A. , Pérez Navarro I. , Bartolomé Sesé I. , Berniolles Alcalde J. , Marco Monzón S. , López Sangrós I. , Ibáñez Alperte J. , Ascaso Puyuel F.J.
Published: September 2017

Purpose

Serpiginous Choroiditis is a type of chronic bilateral posterior uveitis, with a geographical pattern that begins in the juxtapapillary zone and spreads in an intermittent and centrifugal manner. The purpose is to describe an alternative treatment for SC based on Adalimumab monotherapy.

Methods

A female patient with decreased visual acuity in the last 6 months of the left eye and characteristic lesions in the ocular fundus of SC with juxtapapillary and paramacular involvement. The disease continued its course despite treatment with Prednisone at high doses, and affected the contralateral eye with small foci. Disease control was achieved by triple therapy of Prednisone, Azatriopine and Cyclosporin but the patient started with side effects derived from the treatment. Due to the immunological basis and supported on the literature, treatment with Adalimumab and decreasing doses of Prednisone was instituted.

Results

After 8 months of follow up, the patient presents a good control of the disease, besides the improvement of the secondary effects derived from the previous treatment.

Conclusions

Adalimumab may be a good alternative in cases of CS that are not controlled despite the maximum treatment with triple therapy, or in which the treatment can not be continued due to side effects or poor compliance.
Inflammatory choroidal neovascularization imaged by optical coherence tomography – angiography
Authors: Diwo E. , Coscas F. , Massamba N. , Bodaghi B.
Published: September 2017

Purpose

To describe the optical coherence tomography ‐ angiography (OCT‐ A) findings in patients with uveitis related neovascularization.

Methods

We included all patients diagnosed with inflammatory neovascularization (CNV) at the Pitie Salpetriere hospital between 2016/09/01 and 2016/11/15. All patients were assessed including best corrected visual acuity, clinical inflammatory parameters, multimodality imaging, fluorescein angiography, ICG and SD‐OCT or SS‐OCT. All patients underwent OCT angiography with SS‐OCT DRI Triton (Topcon, Japan) or/and Spectralis Angiography OCT (HRA, Heidelberg, Germany). OCT‐A images were analyzed and compared with en face and B‐OCT.

Results

Six patients (7 eyes), 3 women and 3 men, with a mean age of 55 years, were included. Three patients were diagnosed with ocular sarcoidosis and the rest of the patients with Birdshot chorioretinopathy, HSV‐2 uveitis and ocular tuberculosis. OCT‐A revealed inflammatory pre retinal pigment epithelial CNV in all cases. Three lesions were localized in the papillo‐macular region and four close to the vascular arcades. The main length of the major axis was 2.806 microns. All lesions presented a sea fan pattern with an anastomotic network and a thin capillaries network surrounded by a dark halo. They were attached to a single or to multiple thick branches. Two patients had a follow‐up of one month after the anti‐VEGF therapy confirming the rapid fibrosis of these vessels. The characteristics of inflammatory CNV seem to differ from those of CNV in neovascular age related macular degeneration scanned with OCT‐A. The branching seems to be less important, and capillaries thinner and pedicles thicker.

Conclusions

OCT‐A is a new complementary imaging method for the diagnosis of inflammatory CNV. The features and the evolution of these lesions need to be investigated in further studies.