bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of gender‐specific differences in corneal elasticity upon IOP measurements using vibration tonometry
Authors: Bitoun P. , Chapelle P. , Chambard J.P. , Lachkar Y. , Pean V. , Bouafia K. , Benzacken L.
Published: September 2016

Purpose

Vibration Tonometry enables precise non‐contact tonometry independently of CCT and post LASIK using induced corneal vibrations response to calculate IOP using different algorithms for men and women. This corneal vibrations response reflects different tissue elasticity between men and women. We calculate IOP error using gender‐inverted algorithms: female algorithm for men and vice versa

Methods

Vibration Tonometry IOP data from clinical trials in 324 subjects in 3 IOP groups and in 3 age groups. 1,040 and 1,031 measurements were used respectively in women and in men

Results

Using men algorithm for women mean IOP difference was −0.376 mm Hg; 0.07 mmHg; 1.937 mmHg respectively in the <16 mm; 16–23 mm and in the >23 mm Hg group significantly different p < 0.0001. In 3 age groups women showed IOP mean difference of −0.086 mm Hg, 0.077 and −0.224 mm Hg respectively in <50; 50–60 and >60 years old women. Kruskal Wallis test used showed all 3 groups differed significantly p < 0.001, when compared 2 to 2 the error in the 50–60 group differed significantly from that in >60 years old group. For Men mean IOP difference was −0.115 mm Hg in the <16 mm group versus 0.385 in the 16–26 mm Hg group and −1.002 in the >23 mm Hg group all significantly different (Ttest p < 0.0009). The 3 age groups in men showed IOP mean difference of −0.129 mmHg, 0.185 and 0.259 mmHg (SD = 1.286) respectively in <50; 50–60 and >60 years old men. Kruskal Wallis test non significant p < 0.056, when compared 2 to 2 the error in the <50 group differed nearly significantly from that in >60 years old p = 0.025

Conclusions

Gender related difference in IOP measurement is most significant in the higher IOP, >60 years old and most significantly in women with higher corneal elasticity. These analyses confirm the important need for gender specific tonometry as uniquely provided by Vibration Tonometry.
Comparison of the pattern of peripapillary retinal nerve fiber layer damage between open‐angle glaucoma and anterior ischemic optic neuropathy
Authors: Heo D.W. , Kim K.N. , Lee Y.H. , Kim C.S.
Published: September 2016

Purpose

To compare the pattern of peripapillary retinal nerve fiber layer (RNFL) damage in between primary open angle glaucoma (POAG) and nonarteritic anterior ischemic optic neuropathy (NAION).

Methods

Thirty‐two eyes of 32 patients with unilateral NAION and 60 eyes of 60 patients with POAG were consecutively enrolled in this study. The age, sex, and average RNFL thickness of the POAG were matched by those of the NAION. All of the patients underwent thorough eye examination including Cirrus HD optical coherence tomography (Carl Zeiss Meditec, Dublin, CA, USA). Peripapillary RNFL thickness in the 4 quadrants and 12 clock hours were compared in both groups.

Results

RNFL thickness of the nasal 1 o'clock area in NAION was significantly thinner compared to POAG (64.0 ± 18.9 and 75.8 ± 22.4 μm, p = 0.014). RNFL thickness of temporal 7 o'clock area in POAG was significantly thinner compared to NAION (78.7 ± 32.1 and 100.9 ± 42.1 μm, p = 0.006).

Conclusions

RNFL thickness of nasal quadrant and superonasal sector was thinner in NAION. RNFL thickness of the inferotemporal sector was thinner in POAG.
Management and treatment of contact lens keratitis
Authors: Perez Navarro I. , Ascaso F. , Sánchez Marín J.I. , Martínez Vélez M. , Estebán Floría O. , Almenara Michelena C. , Idoate A. , Bartolomé I. , Del Buey Sayas M.Á.
Published: September 2016

Purpose

Microbial keratitis is an infective process of the cornea with a potentially and serious visual impairments. Contact lenses are a major cause of microbial keratitis in the developed countries especially among young people. Therefore, the purpose of the present study was to evaluate the frequency and microbiological characteristic of contact lens keratitis (CLK) in patients referred to the emergency department of Hospital Clinico Lozano Blesa, Zaragoza

Methods

This is a cross‐sectional study of all patients with contact lens induced corneal ulcers who were reffered to the Hospital Clinico Lozano Blesa in the last 6 months. An ophthalmologist examined patients with the slit‐lamp and clinical features of them were noted and infectious corneal ulcers were scraped for microbial culture. The contact lenses and their liquid storage were analyzed by microbiology.

Results

A total of 18 patients were recuited into the study. The cultures were positive in 36.36% of corneal samples and 80% of culture contact lenses. The most common isolated organism in contact lenses was gram negative bacilli showing cleaning and manteinance system falilure of this type of lenses. Two case of contamination of liquid lenses by fungi were recorded, candida parapsilosis y acremonium spp and two case of contamination by acanthamoeba. The most microorganisms found from the corneal scrapes were gram positive cocci and Pseudomona aeruginosa was the most common gram negative.

Conclusions

Due to the percentage of positive results in the cultures of contact lenses is higher than the percentage of corneal scrapings its realization is useful, beacuse the microorganism isolated in the ulcer is also present in maintenance fluids. Due to the high sensitivity of the main microorganisms to quinolones, are recommended as initial empiric therapy in infectious keratitis.
Uveal melanoma clonogenic response to proton beam irradiation
Authors: Romanowska Dixon B. , Jasinska K. , Michalik M. , Madeja Z. , Urbańska K. , Elas M.
Published: September 2016

Purpose

The goal of this study was to compare the cellular clonogenic response to proton beam and X‐ray irradiation of uveal melanoma cell line Mel270 and human melanoma cell line BLM.

Methods

BLM line was derived from a skin melanoma metastasis to the lung, and Mel270 is a primary uveal melanoma cell line. Cells were irradiated with 1–5 Gy of X ray (300 kVp Phillips, 1 Gy/min) or proton beam (60 MeV) from Proteus C‐235. After irradiation cells were seeded for the clonogenic assay. Two weeks after seeding the number and type of clones were determined. Three types of clones were found: the largest in size holoclones (with the highest potential to proliferate), medium sized meroclones and the smallest paraclones (low potential to proliferate).

Results

The total number of clones were similar for both cell lines and both types of irradiation. The RBE values calculated for 37% of survival fraction were 1.11 and 1.13 for Mel270 and BLM cells, respectively. Three types of clones seen in untreated cultures imply the heterogeneity of cellular populations. After irradiation the proportion between the three types of clones was changed: the number of holoclones was drastically lower, and the number of paraclones increased. The number of paraclones was lower after proton bean irradiation in comparison to X‐rays in both cell lines.

Conclusions

Proton beam and X‐ray irradiation differently modify the proliferation potential of melanoma cells.
Optimization of storage of differentiated retinal pigment epithelial cells
Authors: Khan A.Z. , Utheim T.P. , Reppe S. , Sandvik L. , Lyberg T. , Roald B.B.H. , Eidet J.R.
Published: September 2016

Purpose

The advancement of human retinal pigment epithelial (HRPE) cell replacement therapy for retinal blindness is partly dependent on optimization of cell culture, cell preservation, and storage medium. This study aims at optimizing the storage temperature and storage medium for HRPE cells.

Methods

HRPE cells were cultured under standard conditions and randomized for storage at six temperatures (4°C, 16°C, 20°C, 24°C, 28°C, and 37°C) for seven days. After finding the optimal storage temperature, HRPE cells were subsequently stored at 4°C with and without the silk protein sericin added to the storage medium. Live dead assay was performed on all cell cultures including the unstored control cells. The phenotypic expression of premelanosomal protein‐17 (Pmel17), cellular retinaldehyde binding protein (CRALBP), tyrosinase, and proliferating cell nuclear antigen (PCNA) were objectively measured using quantitative immunofluorescence. Morphology was analyzed using light microscopy, phenotypic expression of the junctional protein zonula occludens (ZO‐1), and transmission electron microscopy (TEM).

Results

Viability was maintained at all storage temperatures, except 24°C. The lowest number of dead cells were observed at 4°C (60% ± 18%; p = 0.001, compared to control). Cultures stored at 4°C best resembled the morphology of the unstored control cultures. The addition of sericin to the storage medium maintained viability, improved pigmentation, and increased levels of tyrosinase (141% ± 1%; p = 0.026) and premelanosomal protein‐17 (252% ± 8%; p = 0.014) following storage at 4°C.

Conclusions

After seven days of storage, viability and morphology were best preserved at 4°C. Addition of the silk protein sericin to the storage medium maintained the characteristic HRPE morphology of the preserved cells, and improved pigmentation and phenotypic expression in cultured HRPE.
Mechanism of ‘Flap Closure’ after the inverted internal limiting membrane flap technique
Authors: Michalewska Z. , Bonińska K. , Michalewski J. , Nawrocki J.
Published: September 2016

Purpose

4 macular hole closure types are known: U‐type, V‐ type, irregular and flat open. After the inverted ILM flap technique some macular holes are covered only with a thin layer of the inverted ILM flap shortly after surgery (flap closure). The aim of this paper is to describe functional and anatomical results in eyes closed with ‘flap closure’.

Methods

Data of 190 eyes after vitrectomy with the inverted ILM flap technique were reviewed in order to spot eyes, in which the hole was open and covered only with a thin layer of the inverted ILM flap 1 week postoperatively. Swept Source OCT performed preoperatively and at 1 week, 1, 3, 6, and 12 months after surgery was anlyzed.

Results

Flap closure was noted in 50/190 eyes (26.3%) 1 week after surgery. Preoperatively, the minimum hole diameter was 544.04 μm and maximum diameter at the base was 1001.42 μm, in those eyes. Visual acuity improved from 0.91 logMAR to 0.54 logMAR 12 months after surgery. Final closure type of most eyes primarily closed with the inverted ILM flap technique was U‐type closure. Photoreceptor defects improved during the observation period (50 eyes – 1 week, 41 eyes – 1 month, 34 eyes – 3 months, 23 eyes – 6 months, 19 eyes – 12 months). Restoration of the external limiting membrane preceeded restoration of the photoreceptors. Retinal nerve fiber layer defects were noted in 16 eyes 1 month postoperatively. No new retinal nerve fiber layer defects were noted during the rest of follow‐up.

Conclusions

Macular holes closed only with a thin layer of the inverted ILM flap preopeartively, improve their architecture up to 12 months after surgery. Visual acuity improvement was noted in those cases. ‘Flap closure’ is a new closure type, which probably enables closure of large macular holes, which would remain open without the use of the inverted ILM flap technique.
Variations in normative foveal morphology SD‐OCT data: A study of White, South Asian and Black ethnicities
Authors: Ctori I. , Huntjens B.
Published: September 2016

Purpose

Foveal morphology shows significant inter‐individual variation and ethnicity may play a role. We investigated variations in specific retinal layer thickness and foveal pit shape in three ethnic groups.

Methods

We recruited 226 healthy volunteers age 18–39 years (76 white, 80 South Asian and 70 black; male to female ratio 1:2 per ethnic group). Foveal thickness including inner retinal layer (IRL), outer nuclear layer (ONL), photoreceptor layer (PRL), retinal pigment epithelium (RPE), foveal width and foveal pit depth (FPD) were taken from Spectralis (Heidelberg, Germany) SD‐OCT scans. Retinal layer thickness measurements were taken from 0° to 3.8° eccentricity from the fovea. Two‐way ANCOVA evaluated the impact of ethnicity and gender confounders on foveal morphology parameters, while controlling for refractive error.

Results

White subjects had thicker central IRL (130 ± 21 μm) than South Asian (123 ± 16 μm) and blacks (116 ± 14 μm; F (2) = 12.4, p < 0.0005). This was also true for ONL (p < 0.0005) and PRL (p = 0.03), but not for RPE (p = 0.31). We report similar findings for thickness comparisons up to 3.8° retinal eccentricity. Foveal width was narrower in whites (2,226 ± 261 μm) compared to South Asian (2,417 ± 273 μm) and blacks (2,300 ± 223 μm; F (2) = 10.0, p < 0.0005). Ethnicity explained around 12% of the variance in IRL and foveal width, while gender played no significant role (p > 0.05). The depth of the foveal pit was significantly shallower in white (120 ± 25 μm) and South Asian (121 ± 18 μm) than blacks (129 ± 17 μm, F (2) = 4.8, p < 0.009), with no significant effect of gender (p = 0.39).

Conclusions

The overall foveal pit profile significantly varies with ethnicity. Our results indicate that ethnicity explains more of the variation in foveal morphology than gender, and should be taken into account when interpreting OCT scans.
Diabetic maculopathy screening in England; are we seeing too much?
Authors: Begum S. , Macgregor C. , Meredith P. , Cansfield J. , Meredith S.
Published: September 2016

Purpose

The England screening service classification of diabetic retinopathy has strict, quality assured criteria to identify potential diabetic maculopathy termed ‘M1’. All new M1 cases identified by the screening service are referred to a hospital service. We aimed to evaluate the effectiveness of the England National Diabetic Eye Screening R1M1 classification of diabetic maculopathy as a criteria for secondary care referral in Portsmouth, UK.

Methods

Retrospective audit of all patients referred to Portsmouth Hospitals NHS Trust with R1M1 pathology from April 2013 to January 2014. The total number of referrals received for this period was noted as well as the number of patients followed up in subsequent care pathways. Follow‐up data on those who remained under hospital care is presented for three years.

Results

A total of 306 diabetic patients were referred to Portsmouth Hospitals NHS Trust for R1M1 pathology over a 10 month period. At the first hospital appointment 135 (44%) had no fluid present on macular SD OCT and were either referred back to screening if the M1 features had resolved (65) or followed up with retinal images (70). 115 (38%) patients were considered to require further follow‐up in secondary care. Of those patients remaining in secondary care 70 remained in active follow up 3 years later.

Conclusions

These results would suggest that 44% of those with M1 features have no evidence of diabetic maculopathy on OCT at the initial hospital appointment and were discharged to community screening. Follow‐up for over three years in a secondary care setting is required by 23%. Secondary service could be better utilised by streamlining referrals either by refining the R1M1 classification or developing community based OCT service.
Improvement of diabetic macular edema after micropulse laser therapy
Authors: El Matri L. , Falfoul Y. , Chebbi Z. , Kortli M. , El Matri K. , Chebil A.
Published: September 2016

Purpose

MicroPulse technology (MP) is a new technique using a subthreshold laser micropulse. The desired effect is to reduce the laser damage to ocular tissue; its application in the macular area is very promising in order to treat diabetic macular edema (DME) with the less retinal damage.

We present our 6 months experience with MicroPulse Laser Therapy in DME using a new multifunctional laser, the IRIDEX IQ577.

Methods

We used MP as first‐line therapy in cases of diffuse DME if central macular thickness (CMT) was <300 μm. However, if DME was diffuse and CMT was >400 μm, we began anti‐VEGF therapy to reduce CMT and improve vision as quickly as possible. We began with the laser set in traditional settings. We placed a test spot in a non‐edematous area of the retina and we increased the power up moving to a new area each time, until we note a thermal reaction (white burn). In the second step, we switch the laser to the micropulse setting and perform MP over the area of edema with a high‐density grid treatment.

Results

Ten eyes of 8 patients were included. Mean age at diagnosis was 63.5 years. Best‐corrected visual acuity was 0.88 logmar (range 1.7–0.3) before treatment. After three months of MP, it improved to 0.67 logmar (range 1.4–0.2), p: 0.002. CMT was 367 μm, and improved to 316.5 μm (p: 0.14) at 1 month after treatment and to 291.2 μm at 3 months (p: 0.04). OCT detected early retinal reflectivity changes after treatment. All patients reported subjective improvement. No adverse events were observed during follow‐up.

Conclusions

MP laser is an effective laser to treat DME. Moreover, the attractive safety profile of MP treatment allows clinicians to offer earlier treatment to prevent tissue damage and the development of visual disability.
Frequency doubling technology perimetry and retinal fiber layer correlation in type 2 diabetics without retinopathy
Authors: Aldaham S. , Martín‐Ridaura M.D.C. , Puell M.C.
Published: September 2016

Purpose

Alterations in visual field (VF) and retinal nerve fiber layer (RNFL) thickness were reported in diabetics. Little is known however about the extent to which VF and RNFL changes are affected and their correlations. The purpose was to assess the RNFL thickness and its correlation with VF parameters in type 2 diabetics without retinopathy with well controlled glucose level and good standard visual acuity.

Methods

A total of 28 controls and 16 type 2 diabetics without retinopathy were recruited. VF was assessed with the frequency doubling technology (FDT) perimeter using the full threshold C‐20 program. The RNFL thickness was acquired by the optical coherence tomography 200 × 200 optic disc cube scanning protocol. Forward stepwise multiple linear regression analysis was applied to rule out the independent association of the RNFL thickness with the FDT parameters.

Results

Compared to the controls, the diabetics showed a trend of decreased RNFL thickness but was not significant, lower sensitivities for some VF locations, no difference in the mean deviation, and worse mean pattern standard deviation (PSD) (3.89 ± 0.36 vs. 3.47 ± 0.58 dB, p < 0.05). The RNFL thickness was significantly negatively correlated with PSD (r = −0.6, p < 0.05).

Conclusions

Apparent VF changes precede RNFL thickness thinning in type 2 diabetics without retinopathy. Also, the RNFL thickness shows a negative correlation with the PSD of the FDT parameter.
Quantification of green fluorescent protein expression in mouse retinal ganglion cells following intravitreal injection of recombinant adeno‐associated virus
Authors: Khatib T. , Osborne A. , Widdowson P. , Martin K.
Published: September 2016

Purpose

To determine the transduction efficiency and spatial pattern of green fluorescent protein (GFP) expression in mouse retinal ganglion cells (RGCs) following intravitreal injection of recombinant adeno‐associated virus (rAAV2).

Methods

16 adult C57bL/6 mice received intravitreal injections of rAAV2‐CAG‐GFP at 3 different titres: 1 × 10E11, 1 × 10E12 or 1 × 10E13 genomic particles/ml. 2 μl of the virus was injected at each concentration. To determine the effect of volume on transduction efficiency, a subset of animals received 1 μl of the highest viral titre.

Animals were sacrificed 21 days after injection. Retinal wholemounts were immunostained with Brn3a to identify RGCs and quantification carried out using imageJ software. The percentage of GFP positive RGCs was measured at each titre using Volocity software at 20× magnification. A further 20–25 images at 10× magnification were captured for each titre and merged using to reconstruct the entire wholemount to assess the spatial pattern of expression.

Results

RGC transduction rate increased with viral titre; 10% at 1 × 10E11, 53% and 1 × 10E12 and 64% at 1 × 10E13 genomic particles/ml. The volume injected did not appear to affect the transduction efficiency, with 64% of RGCs transduced at the highest titre using either 1 or 2 ul injection. GFP intensity also increased with viral titre with the spatial pattern of GFP expression more extensive at the highest titre. GFP expression at lower titres tended to localise around the injection site.

Conclusions

GFP transduction efficiency of RGCs can be quantified efficiently using Volocity software. We have demonstrated an increase in GFP expression and spread at higher viral titres with similar transduction efficiency at a lower volume.
Mechanisms behind the protein aggregation‐related inflammasome activation in RPE cells
Authors: Kauppinen A. , Piippo N. , Korhonen E. , Hytti M. , Kinnunen K. , Kaarniranta K.
Published: September 2016

Purpose

Inflammasomes are intracellular protein complexes whose activation results in the caspase‐1‐mediated release of pro‐inflammatory cytokines IL‐1β and IL‐18. We and others have shown that activation of NLRP3 inflammasome is associated with the pathogenesis of age‐related macular degeneration (AMD). Declined proteasomal degradation with concurrent autophagy inhibition is among the risk factors activating the NLRP3 receptor in retinal pigment epithelial (RPE) cells. NLRP3 is known to have various activation mechanisms and in the present study, we have analyzed which of them contribute to the inflammasome activation when protein degradation systems in RPE cells fail.

Methods

Inflammasome activation was induced in human ARPE‐19 cells by the proteasome inhibitor MG‐132 and the lysosome neutralizer Bafilomycin A. Extracellular ATP was measured, and its receptors were inhibited using a P2X7 inhibitor. Potassium efflux was inhibited using high extracellular ion concentration, and glyburide was added to block the ATP‐mediated potassium efflux. APDC (ammonium pyrrolidine dithiocarbamate) and NAC (N‐acetylcysteine) were used to reduce oxidative stress.

Results

Despite increased extracellular ATP level, the inhibition of P2X7 receptors did not reduce the secretion of IL‐1β. Neither potassium efflux nor cathepsin B contributed to the inflammasome activation in our model, but ROS inhibitors alleviated the IL‐1β production.

Conclusions

Our results suggest that oxidative stress plays a role in the inflammasome activation in RPE cells upon declined intracellular clearance.
Incidence of retinal vein occlusions (RVO) in patients treated with oral anticoagulants or antiplatelet drugs for cardioembolic or atherothrombotic prevention
Authors: Fruschelli M. , Fazio S. , Capozzoli M. , Chimenti G. , Hadjistilianou T. , Sicuranza A. , Aprile L. , Puccetti L.
Published: September 2016

Purpose

It is still a matter of debate whether anticoagulant or antiplatelet therapy are useful for the prevention of retinal vein occlusions. In some cases, patients who are already under antiplatelet or anticoagulant therapy still develop retinal venous diseases. We analyzed the prevalence of RVO in patients treated yet with warfarin or aspirin for other clinical indications.

Methods

64 patients (30 CRVO and 34 BRVO) treated with warfarin for atrial fibrillation (n = 11) or aspirin for carotid stenosis (n = 53) were observed. Multivariate analysis was employed to detect any putative relation among treatments and CRVO or BRVO.

Results

The whole cohort analysis showed that aspirin was less effective than warfarin for prevention of RVO (H.R. 2.4, 95% C.I. 1.9–3.2 p < 0.01); 9 BRVO and 2 CRVO were in patients treated with warfarin whereas 25 BRVO and 28 CRVO in aspirin treated subjects. The confirmation test showed an H.R. of 2.1 (1.6–3.1 95% C.I.) p < 0.01, for the association between aspirin treatment and CRVO.

Conclusions

Such retrospective data indicate that aspirin could be less effective in RVO and particularly CRVO prevention with respect to anticoagulants. Planned large prospective observational studies are needed to study the efficacy of such treatments in RVO prevention and treatment. Our data could fit well with the previous observation that specific pro‐coagulative state as suggested by increased thrombin generation is a pattern of CRVO with respect to BRVO.
Increased intraocular pressure causes deficiency in the level of ELAVL1/HuR cytoplasmic fraction in the retina
Authors: Smedowski A. , Trzeciecka A. , Podracka L. , Pietrucha‐Dutczak M. , Lewin‐Kowalik J. , Akhtar S. , Kaarniranta K. , Amadio M.
Published: September 2016

Purpose

To evaluate impact of raised intraocular pressure on RNA binding protein ELAVL1/HuR expression in retina.

Methods

In order to induce glaucomatous damage, intraocular pressure was increased unilaterally using modified rat bead model and maintained for up to 8 weeks. Fellow eye was used as a healthy control. Animals were sacrificed, retina and optic nerves were collected and processed for western blot (WB) analysis or for immunostainings.

Results

Glaucomatous damage was confirmed in electron microscopy by the presence of axonal damage, myelin sheat dezintegration and glial cells proliferation within the optic nerve. Eight weeks glaucoma induced up to 36% loss of Retinal Ganglion Cells (RGCs) in the retina. In fractionated WB analysis of retinal homogenates, the level of active, cytoplasmic fraction of HuR was decreased approximately 3‐times when compared with healthy tissue (p < 0.05). Additionally, the cytoplasmic levels of cell cycle regulatory proteins (Hsp70, p53), whose expression is regulated by HuR, were also decreased. Stereological analysis of retinas revealed decrease in the number of double‐stained RGCs (positive for β3tubulin + HuR) below the number of total β3tubulin positive RGCs (1,960 ± 885 cells/mm2 vs. 2,136 ± 689 cells/mm2) what means that some of them lost visible HuR expression. Immunostaining of retinal and optic nerves cross sections showed decreased expression of HuR within RGCs and increased expression within optic nerve glia in glaucoma samples.

Conclusions

Increased intraocular pressure results in defect of active fraction of RNA binding HuR protein within retina and specifically within RGCs. This defect is linked with decreased expression of HuR‐dependent regulatory proteins (Hsp70, p53). This might be mechanism contributing to the development of glaucomatous degeneration.
Infectious keratitis after penetrating keratoplasty: predisposing risk factors and prognosis
Authors: Hassairi A. , Limaiem R. , Ben Mrad A. , Rayhan H. , Turki R. , El Matri L.
Published: September 2016

Purpose

To investigate prevalence, predisposing risk factors and prognosis of graft survival in patients who developed infectious keratitis following penetrating keratoplasty (PK).

Methods

we undertook a retrospective analysis of 16 patients hospitalized at the Institute of Ophthalmology of Tunis for the occurrence of infectious keratitis following PK over an seven‐year period (From March 2009 to March 2016). We excluded all herpetic keratitis secondary to PK. Efficacy of treatment was evaluated by anatomical (clarity of graft) and visual recovery.

Results

Principal indications for PK were corneal opacity (secondary to infectious keratitis in 2 cases and to trachoma in 2 cases), therapeutic penetrating keratoplasty for corneal perforation in 5 cases, keratoconus in 3 cases, pseudophakic bullous keratopathy in one case and penetrating keratoplasty in children in 3 cases. Principal predisposing risk factors were suture‐related problems (56.25%) followed by topical corticotherapy (43.75%) and persistant epithelial defect in (43.75%). The microbiological examinations were positive in 70.58% of the cases: bacillus Gram +: 66.66%, Bacillus Gram Négatif: 8.33%, amoeba: 8.33% of the cases. We noted two cases of polymicrobial infection. Four patients underwent PK. The infection was solved in 100% of the cases but with opacities of the transplant in 75% and a severe limitation of the visual acuity.

Conclusions

The development of infectious keratitis after PK is a serious complication that is associated with a high incidence of graft failure and poor visual outcome. Preventive measures are essential and include a regular follow‐up and education of the operated patients.
Phakic intraocular lens (Verisyse) implantation for correction of high anisometropia in pediatric patients
Authors: Autrata R. , Krejcirova I. , Griscikova L.
Published: September 2016

Purpose

Our study evaluated safety and efficacy of Verisyse™ (AMO) phakic anterior chamber intraocular lens (IOL) in the correction of significant myopic (>−9 D) or hyperopic anisometropia (>+6D) in children who are noncompliant to conventional treatment with spectacle correction or contact lenses.

Methods

28 children with myopic anisometropia (range −9.0 to −18.0 D, SE) and 7 patients with hyperopic anisometropia (range +6.0 to +9.5 D, SE) underwent unilateral Verisyse phakic IOL implantation under general anesthesia. All patients had chronic difficulties with spectacles due to aniseikonia or with contact lens intolerance. Pre‐ and post‐operative visual acuity, cycloplegic refraction, anterior and posterior segment examination, axial biometry measurements, endothelial cell counts, stereoacuity and aniseikonia examinations were performed in all patients. Target refraction was approximately 0 to −1 D. The mean age was 6.7 years; range 5–14 years. Mean follow‐up was 19.5 months (range, 10–36 months).

Results

The mean spherical equivalent cyloplegic refraction of myopic eyes changed from −15.2 D preoperatively to −0.73 D postoperatively. The mean hyperopia reduced from +7.65 D preop. to +0.94. 81% of treated eyes were in the range ±1.0 D of emetropia. The mean uncorrected visual acuity improved from 0.012 to 0.35 (logMAR 0.45 ± 0.22), t‐test; p = 0.0014. The mean best spectacles corrected visual acuity (BSCVA) changed from 0.23 (logMAR 0.58 ± 0.15) to 0.62 (log MAR 0.17 ± 0.13), t‐test; p = 0.0238. The mean Safety Index (BSCVA postop/preop) was 2.18. Improvement in stereoacuity was reached in all 35 patients.

Conclusions

Anterior chamber phakic IOLs may provide a safe and effective alternative in management of highly anisometropic myopic and hyperopic children, who are noncompliant with conventional treatment with spectacles or contact lenses.
Automatisation and improved repeatability of retinal oximetry
Authors: Hardarson S. , Karlsson R.A. , Olafsdottir O.B. , Eliasdottir T. , Bek T. , Stefánsson E.
Published: September 2016

Purpose

To develop and test an automatic method for analysing retinal oximetry images.

Methods

The dual‐wavelength Oxymap T1 oximeter captures images for calculation of oxygen saturation in retinal vessels. Images were taken of healthy subjects for testing of repeatability and sensitivity, the latter during 100% O2 breathing (n = 21). Images were also taken of patients with diabetes and no DR (n = 16) and patients with non‐proliferative DR (n = 24). The diabetic groups were compared with 54 healthy subjects.

Semi‐automatic and fully automatic computer programs were used for analysis. The main differences are: The automatic program automatically categorises vessel points into arterioles and venules and then gives averages for each retinal image. The automatic program uses all pixels on vessel cross‐sections for calculations.

Results

For arterioles in healthy, the standard deviation between repeated measurements was 0.98 percentage points (pp) with the semi‐automatic method but 0.66 pp with the automatic method. The corresponding values for venules were 1.99 pp (semi‐auto) and 1.50 pp (auto). The automatic program detected an increase of 5.1 pp in arteriolar saturation and 17.4 pp in venules when healthy subjects inhaled pure oxygen (p < 0.0001 in both cases). Similar values were found with the semi‐automatic software.

Higher venous saturation was detected in patients with non‐proliferative DR (p < 0.05 with both programs). Values (mean ± SD) from the automatic software were 68.5 ± 5.6% (NPDR), 63.3 ± 6.0% (DM but no DR) and 64.9 ± 4.7% (healthy).

Conclusions

Automatic analysis of retinal oximetry images yields good repeatability. The automatic method is sensitive to changes in saturation during 100% O2 breathing and detects higher venous saturation in diabetic retinopathy. Automatic analysis is much faster than the semi‐automatic approach and is less subjective.
Excimer laser correction for myopic anisometropic amblyopia in pediatric patients‐ Long term results
Authors: Autrata R. , Krejcirova I. , Griscikova L.
Published: September 2016

Purpose

To evaluate the efficacy, predictabilty, safety, stability, visual acuity and binocular vision results of laser‐assisted subepithelial keratectomy (LASEK) for the correction of high myopic anisometropia and amblyopia in children.

Methods

Our study comprised 195 eyes of 195 pediatric patients that had LASEK for high myopic anisometropia from −5.5 to −11.5 D operated between 1998 and 2012. All children were unable to use spectacles due to aniseikonia, and they were noncompliant with contact lenses. They were at 3–8 years of age in time of surgery, Children younger than 7 years were operated in general anesthesia. All patients were treated with LASEK multizonal ablation technique. In all children surgery was followed by a half‐day patching of the dominant eye. Main outcome measures were cycloplegic refraction, uncorrected and best spectacle‐corrected visual acuity (UCVA, BSCVA resp.), keratometry, biometry, ocular alignment, corneal clarity and grade of stereopsis over 2–12 years of follow‐up.

Results

The preoperative mean spherical equivalent (MSE) was −8.32 D. The postoperative MSE was −1.21D at the last visit. The mean preop UCVA 0.033 increased to 0.59 (p < 0.05) postop. The mean preop. BSCVA was 0.38 and changed to 0.89 postop. The safety index was 1.79. All the eyes had no line lost in BSCVA, 60 eyes had two lines gained, 56 and 79 eyes had 3 and 4 or more lines gained, resp. Preoperative spectacle aniseikonia decreased from 11.6 to 2.1% postop. Binocular vision was improved and saved in 86% of children. No postoperative complications were observed.

Conclusions

Pediatric LASEK was highly effective and safe methods to reduce myopic anisometropia up to −12D, decrease spectacle aniseikoina, improve visual acuity and stereopsis in children aged 3–8 years with amblyopia when contact lens intolerance.
Effect of different lightning conditions on daily living activities of glaucoma patients
Authors: Zenouda A. , Lombardi M. , Gutman E. , Brasnu E. , Hamard P. , Sahel J.A. , Baudouin C. , Labbe A.
Published: September 2016

Purpose

To determine the impact of different lightning conditions on glaucoma patient's ability to perform activities of daily living.

Methods

Twenty‐three glaucoma patients and 8 age‐matched control subjects were included. All glaucoma patients had a best corrected visual acuity >20/30. Best corrected visual acuity, contrast sensitivity, monocular automated Humphrey 24‐2 visual field test, and binocular visual field test were obtained from all subjects. Two tasks of daily living were evaluated: (i) Mobility performance was assessed in an artificial street (StreetLab®) by the time required to complete an established travel path (TP) and the number of mobility incidents (MI); (ii) Reaching‐and‐Grasping performance was evaluated on a kitchen worktop in the HomeLab®. The movement onset time (MO) and the overall movement time (OM) for reaching‐and‐grasping the object were recorded. Trials were carried out with three lighting conditions: scotopic 2 lux, photopic 250 lux and photopic 1,500 lux.

Results

Glaucoma patients completed the travel path 8.8% more slowly than controls (p = 0.013). Under high luminosity, all participants completed the path 3.7% and 2.7% more quickly than under low and intermediate luminosity respectively (p < 0.01). The influence of light condition was not different between the glaucoma and control group (p = 0.16). The number of MI was not different between both groups (p = 0.65). There was no difference in average MO time between the two groups (p = 0.086) but glaucoma patients had a significantly longer OM time as compared to control subjects (p < 0.01). Low light condition increased the MO time for all subjects without difference between the two groups.

Conclusions

Glaucoma patients had decreased performance in mobility and motor control tasks. The influence of light condition was not different between the glaucoma and control group.
Morphological, phisiological and immunocytochemical evaluation in patients with idiopathic epiretinal membranes
Authors: Miniewicz J. , Romanowska Dixon B. , Petka O. , Elas M. , Sarna M. , Kubicka‐Trzaska A.
Published: September 2016

Purpose

To investigate changes of the vitreoretinal interface in patients with idiopathic epiretinal membranes (ERM).

Methods

Analysis of 23 patients treated by 25G PPV due to visual imparment caused by idiopathic ERM. BCVA and DRI OCT (Atlantis Topcon) imaging was performed before surgery and in one year follow up. Retinal and vitreoretinal interface morphology was evaluated and compared with changes in visual fuction. ERM and internal limiting membranes (ILM) were collected intraoperatively for immunocytochemical analysis. Photographeis of probes were made by scanning confocal microscope LSM 88‐ Zeiss, with seven laser lines, 32‐channel spectral detector GaAsP and two photomultiplier for fluorescence and one for transmission. Scanning module was connected with reverse optic microscope Axio Observer Z1 Zeiss with fluorecsent lamp and adequate filters.

Results

BCVA before surgery was from counting finger from 3 m to 0.5 (mean 0.1) and in one year of postoperative follow up ipmroved to 0.3–0.9 (mean 0.6). In 18 eyes (78%) vitreoretinal traction was visualized by OCT DRI before the surgery. Mean central retinal thickness (CRT) was 487 μm. In patients with CRT more than 500 μm macular oedema in preoprative scans was observed. In these cases the oedema was reduced in one year of postoperative observation. Microscopic and immunocytochemical analysis revealed a high amount of cells in ERM probes and low number of cells in ILM probes (immunoreactivity was positive for glial cells, retinal pigment epithelium, hyalocytes, actin and macrophages).

Conclusions

New techniques of visualisation and analysis improve possibilities of diagnostic and evaluation of treatment results in patients with ERM. These methods should be used as complementary. Evaluation of wider group of patients may improve the knowledge in the field of idiopathic ERM etiopathogenesis.
Mechanisms of ocriplasmin uptake by retinal cells
Authors: Candi A. , Fonteyn L. , Porcu M. , Barbeaux P. , Feyen J.H. , Hu T.T.
Published: September 2016

Purpose

Retinal cells participate in the transport and clearance of therapeutics. In this study, we used in vitro retinal cell models to investigate the uptake and transport of ocriplasmin, a protease used for the treatment of vitreomacular traction.

Methods

Cultures of primary porcine Müller and human ARPE‐19 cells were incubated with Alexa488‐labeled ocriplasmin or its inactive form for up to 3 h. Spatial distribution and colocalization with vesicle transport proteins were assessed at several time points.

Results

Ocriplasmin was rapidly detected in Müller and RPE cells. Uptake was observed as cytoplasmic foci and confirmed by confocal microscopy. In contrast, enzymatically inactive ocriplasmin was taken up at a significantly slower rate. Given its focal cytoplasmic distribution, we investigated whether ocriplasmin was present in cellular transport organelles. In Müller cells, ocriplasmin colocalized partly with Rab5‐positive early endosomes and Rab7‐positive lysosomes but with very few Rab11‐positive recycling endosomes. In RPE cells, ocriplasmin also colocalized in part with early endosomes and lysosomes, but to a larger extent with recycling endosomes.

Conclusions

Taken together, our data indicate that ocriplasmin can be taken up by Müller and RPE cells and that this uptake depends in part on its enzymatic activity. Ocriplasmin was found in transport vesicles, indicating active transport mainly through the degradation pathway in Müller cells whereas in RPE cells, outward transport is preferred. It is described that RPE cells transport anti‐VEGFs which emphasizes their role in retinal drug clearance. Our study suggests that retinal cells might participate in ocriplasmin drug clearance. Further in vivo studies will need to assess the ocriplasmin transport in the retina as well as the impact of uptake on ocriplasmin activity.
Iluvien monotherapy for diabetic macular oedema in vitrectomised and non‐vitrectomised eyes: one year data
Authors: Hawrami A. , Laviers H. , Patra S. , Zambarakji H.
Published: September 2016

Purpose

To assess the effectiveness of the Fluocinolone intravitreal implant (Iluvien) in patients with diabetic macular oedema (DMO) following previous pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). The data from vitrectomised eyes are compared with a consecutive group of non‐vitrectomised eyes with DMO who received the Iluvien implant in our institution.

Methods

Retrospective analysis of a consecutive series of patients who received the Iluvien implant for DMO. Best‐corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and 0–2 months, 3–5 months and 6–12 months following placement of the implant. Analysis of variance was carried out using Stata 14.1 (StatCorp LP) Software.

Results

Seven eyes with recent PPV and 17 eyes without previous PPV received an Iluvien implant for DMO. Mean improvement in BCVA in the PPV group to 6–12 months was 0.33 logMAR (95% CI: −0.2 to 0.8) compared with 0.13 logMAR (95% CI: 0.0–0.2) in the no PPV group (p = 0.355). Mean improvement in CMT in the PPV group to 6–12 months was 59.6 μm (95% CI: 18.0–137.2) compared with 78.4 μm (95% CI: 21.3–126.9) in the no PPV group (p = 0.745). Individual OCT images showed persistent cystoid macular oedema in 7/7 eyes in the PPV group. A persistent pre retinal hyper‐reflective line at the macula suggestive of residual cortical vitreous or pre retinal membrane was identified in 4/7 eyes in the PPV group and 9/17 eyes in the non‐PPV group.

Conclusions

Vitreoretinal interface proliferation may explain the absence of a response to intravitreal Iluvien in some DMO eyes. Prospective randomised studies are needed in order to establish a uniform evidence based approach for classification and treatment in vitrectomised eyes.
Evaluation of Tumor Necrosis Factor inhibitor therapy in Susac syndrome
Authors: Buelens T. , Ossewaarde‐van Norel A. , Nubourgh I. , Glibert G. , Kamgang Semeu P. , Caspers L. , Postelmans L. , Willermain F.
Published: September 2016

Purpose

To analyze the effect of tumor necrosis factor inhibitor therapy on ocular relapses in patients with Susac syndrome.

Methods

Multicenter retrospective case series of patients with ocular Susac syndrome treated with a TNF inhibitor (either infliximab or adalimumab). Diagnosis was based on neurologic, ophthalmic, otologic, biologic and imaging typical findings.

Results

Five patients were included. All were initially treated with a combination of corticosteroids and classical immunosuppressive drugs. In 4 of the 5 patients a TNF‐inhibitor (3 infliximab and 2 adalimumab) was started due to treatment failure. In these patients cortisone could not be decreased below a daily dose of 10 mg without the occurrence of relapses (with an average of 4.25 relapses over a mean follow‐up of 330 days) despite the use of a mean of 2.75 different immunosuppressive drugs. After introduction of an anti‐TNF agent the daily cortisone dose could successfully be tapered below 10 mg in all patients with a complete stop in 3 patients, with a mean number of 1.25 relapses during a mean follow‐up of 1,199 days. In the fifth patient, disease activity was well controlled with only steroid sparing immunosuppressive agents and only 1 relapse during approximately 5 years of follow up until these had to be stopped for a desired pregnancy. No relapse was documented during 60 weeks of follow‐up while on infliximab treatment afterwards.

Conclusions

Anti‐TNF antibodies can be a valuable option for the treatment of ocular Susac syndrome and may especially be considered in those patients unresponsive to conventional immunosuppressive treatment.
Follow‐up of patients treated by prostaglandins eyedrops. Preliminary results from the FREE survey
Authors: Grabska‐Liberek I.
Published: September 2016

Purpose

After lack of efficacy, local intolerance is the second reason to change glaucoma treatment. It was demonstrated that preservatives alter the local tolerability. With the newly available preservative‐free (PF) prostaglandins and the launch of a PF latanoprost (Monoprost®), it is interesting to assess the evolution of ocular signs and symptoms after switch from preserved to PF glaucoma treatment. This was the objective of the FREE survey (Follow‐up of glaucoma patients treated with Prostaglandins EyEdrops).

Methods

FREE is a prospective, European, multicentre, prospective survey implemented in ophthalmological private practices in France, the Netherlands, Norway, Poland and Sweden. The study is still ongoing to recruit a total of 1400 patients. Three study visits (inclusion and two visits after 6 and 12 months) are planned. Hyperemia and patient's satisfaction with regards to tolerance are the main evaluation criteria. Other parameters are recorded: patient feeling assessment on tolerance to the current glaucoma treatment, the ocular surface diseases, the use of tear substitutes, the ocular signs, fluorescein corneal and conjunctival stainings and tear BUT.

Results

The first results from the five countries will be presented here for the first time. From the first analysis of 588 patients (354 in France, 96 in Poland, 79 in Sweden, 35 in the Netherlands and 24 in Norway), clinical signs appeared to be more present with preserved eyedrops than with PF treatment and especially with PF latanoprost at the subsequent visits. The results with PF latanoprost (Monoprost®) on long term (superior to 6 months) will be presented here for the first time.

Conclusions

This preliminary first results of FREE survey confirm the clinical interest of switching from a preserved to a PF prostaglandin for a better treatment tolerability and patient satisfaction.