bluuebunny/crossref_metadata_2025 huggingface dataset:
In vivo laser scanning microscopy of cornea, conjunctiva and ocular adnexa with a handheld dermatological laser‐scanning microscope: new perspectives
Authors: GRIVET D , ESPINASSE M , CINOTTI E , LABEILLE B , CAMBAZARD F , PERROT JL , CAMPOLMI N , PEOC'H M , DUMOLLARD JM , FOREST F , GAIN P , THURET G
Published: August 2012

Purpose In vivo confocal microscopy (IVCM) is routinely used in well‐equipped reference centers for the diagnosis of complicated corneal and conjunctival diseases, mainly infectious and tumoral ones. At present, only two CM are available for ophthalmology. Both are attached on a classical ophthalmology stand optimized for corneal examination. Aim: to expose new perspectives in examination of cornea, conjunctiva and ocular using a handheld dermatological CM

Methods Using the handheld dermatological reflectance laser‐scanning microscope (Vivascope 3000, MAVIG GmbH) equipped with a 830nm laser, we observed cornea, bulbar and tarsal conjunctiva, eyelid margin, lacrimal puncta and palbebral skin of healthy volunteers as well as none pigmented or pigmented lesions of these sites. Correlations with histopathology were established whenever surgery was necessary

Results Thanks to its compact configuration and flexible, handheld positioning, the Vivascope3000 made it possible to easily access ocular and periocular tissue that remained challenging to observe with ophthalmological CM. With a definition of 1pixel/μm and 1000x1000 μm images, the handheld CM allowed non‐invasive optical biopsy of all normal and pathologic ocular surface as well as periocular tissues. Diagnosis of benign or malignant tumors (melanoma or epidermoid carcinoma) could be highly suspected. Confocal images were well correlated with conventional histopathology

Conclusion The compact handheld Vivascope 3000 offers new perspectives for diagnosis, optimization of treatments, and follow‐up of ocular surface and ocular adnexa diseases
Fluorescence multi‐laser scanning microscopy of the cornea and ocular adnexa: a new era for functional confocal microscopy in ophthalmology
Authors: THURET G , ESPINASSE M , GRIVET D , HE Z , CAMPOLMI N , PERROT JL , LABEILLE B , CAMBAZARD F , GAIN P
Published: August 2012

Purpose In vivo confocal microscopy (IVCM) is a routine investigation for the ocular surface in reference centres. It provides high resolution pseudo histology. Nevertheless its unique laser source and imaging principle (reflectance) only provide morphological information. Multi‐laser and fluorescence laser scanning microscope add a supplementary dimension by allowing the use of fluorescent markers liable to provide specific functional data

Methods Ex vivo animal and human corneas, healthy volunteers and patients were successively examined using the multilaser vivascope 1500 (MAVIG GmbH, Germany) equipped with 3 lasers (488, 658, 785nm) and the corresponding emission (Em) filter sets. For each excitation (Ex) wavelength (λ), 3 observation modes were available: reflexion (all λ), pure reflectance (λEx = λEm), fluorescence (3 specific band pass). Ex vivo, all corneal layers were analysed without preparation and after topical application of Fluoresceine (F) and Indocyanine green (ICG) and of numerous other molecules. Topical instillation and of intraveinous injection of F and ICG were analysed in healthy volunteers and in patients

Results Using reflexion and reflectance, the 3 Ex λ gave complementary structural informations with the highest resolution obtained at 488nm. Topical markers helped identify specific cell populations and intracellular structures. Intraveinous ICG was inefficient whereas fluo provide highly contrasted conjunctival images

Conclusion IVCM coupled with fluorescence opens a new era in the clinical imaging of the ocular surface and probably more largely in Ophthalmology. A new semeiology remains to be learned
Spatial arrangement of collagen fibrils in normal and keratoconus human cornea studied by low‐frequency dielectric spectroscopy
Authors: TARNAWSKA D , KOCOT A , JASTRZEBSKA M , WYLEGALA E , RATUSZNA A
Published: August 2012

Purpose Spatial structure of collagen lamellae of the human cornea is thought to be an important determinant of corneal rigidity. Analysis of the low‐frequency (1–107 Hz) dielectric spectra of the normal and keratoconus human cornea in the temperature range of 140‐300 K and for different hydration states were examined.

Methods For the measurements, the 100 – 200 μm specimens containing the middle layers of corneal stroma were used. The 9 specimens of healthy, control corneas from Eye Bank were obtained with second microkeratom section during Ultra Thin‐DSAEK. The 12 specimens of keratoconus corneas were manually prepared from corneas removed during penetrating keratoplasty.

Results Experimental results were interpreted in terms of ionic diffusion and space charge polarization according to the Sawada’s theory. The new presentation of the dielectric spectra, i.e.: (delta eps’/delta ln f)*f, was used. The presented method and the Sawada’s expression were applied to the analysis of the changes in spatial molecular structure of collagen fibril network in human cornea.

Conclusion Fitting procedure of the theoretical function to the experimental data allowed us to determine two diffusive relaxation regions with two structural distance parameters ds, describing spatial arrangement of collagen fibrils in cornea.
Tear film break‐up time evaluation by real‐time wavefront aberrometry in normal subjects
Authors: DJABAROUTI M , ZAKARI W , NOCHEZ Y , PISELLA PJ , GICQUEL JJ
Published: August 2012

Purpose To evaluate tear break‐up time (BUT) with repeated higher order wavefront aberrations (HOA) measurements.

Methods Wavefront aberrations up to the sixth order for a 4‐mm pupil were measured in 10 subjects using the IRX3 (Imagine Eyes, Orsay, France) Hartmann‐Shack (H‐S) aberrometer. The aberrometry was performed once every second for up to 20 seconds. HOA measurements were performed 3 times in a row. HOAvariations were compared with the BUT by the conventional fluorescein method (CFM).

Results In 9 patients out of 10 there was an excellent correlation between the HOA variation and the BUT recorded by the CFM. There was also an excellent reproducibility of the HOA measurements in all patients.

Conclusion H‐S aberrometry can be used in our daily practice for an objective and reproducible assessment of the BUT.
Corneal respiratory function by FAD autofluorescence lifetime
Authors: BATISTA A , LOUREIRO C , DOMINGUES JP , SILVA JS , MORGADO AM
Published: August 2012

Purpose We intend to develop an efficient method to assess in‐vivo the corneal respiratory function in order to diagnose corneal cells dysfunction prior to its pathologic expression.

Methods Metabolic alterations can be assessed by measuring the amount of the metabolic co‐factors flavin adenine dinucleotide (FAD) and nicotinamide adenine dinucleotide (NADH). FAD has advantages over NADH, like being present only in the mitochondria. Furthermore, using fluorescence lifetime imaging microscopy (FLIM) we are able to discriminate between its free or protein‐bound states. We resorted to a PicoQuant MicroTime 100 (PicoQuant GmbH, Berlin, Germany) coupled to an Olympus BX51 Microscope (Olympus Corporation, Tokyo, Japan). This setup uses a pulsed blue diode laser with a trigger frequency of 40 MHz with an excitation filter of 440±10 nm. Intensity decay curves were processed with SymPhoTime v5.3 Software (PicoQuant GmbH). The instrument response function was acquired to improve data analysis precision.

Results We successfully acquired ex‐vivo autofluorescence images of male Wistar rat and Bovine corneas. A bi‐exponential decay was observed in both cases with a fast decay around 1 ns and a longer one around 4 ns, which correspond to protein‐bound and free FAD, respectively. These results are in accordance with other studies, although there is some controversy regarding FAD lifetimes.

Conclusion We showed that it is possible, with our apparatus, to acquire metabolic images of the cornea using FAD autofluorescence. We intend to modify the instrument optical setup in order to acquire reflectance and fluorescence lifetime images simultaneously for corneal layer identification.
Blockade of the chemokine receptor CXCR3 lowers intraocular pressure and prevents retinal degeneration in an animal model of glaucoma
Authors: DENOYER A , FRUGIER J , GODEFROY D , DEGARDIN J , BRIGNOLE‐BAUDOUIN F , HARRISON JK , ROSTENE W , BAUDOUIN C
Published: August 2012

Purpose Blockade of the chemokine receptor CXCR3 lowers intraocular pressure and prevents retinal degeneration in an animal model of glaucoma.

Methods Twenty Long‐Evans male rats underwent episcleral vein cauterization in order to induce stable elevation in intraocular pressure (IOP). CXCR3 antagonist or the vehicle only were subconjunctivaly injected in glaucomatous eyes (n=10 in each), which were assessed for IOP weekly during two months. Aqueous humor outflow and trabecular filtrating function were studied using fluorophotometry and microsphere trabecular trapping respectively. Retinal nerve fiber density was quantified by scanning laser ophthalmoscopy, and optokinetic testing was performed to assess visual function.

Results IOP was significantly decreased during 6 weeks in glaucomatous eyes treated with CXCR3 antagonist as compared to untreated eyes.(P<0.01 at each time point) CXCR3 antagonism increased aqueous humor outflow (P<0.01) by improving the trabecular filtrating function.(P<0.01) Retinal nerve fiber density was higher in treated glaucomatous eyes than in untreated eyes,(P<0.01) and correlated with a better visual function in eyes receiving the CXCR3 antagonist.(P<0.01)

Conclusion In vivo blockade of CXCR3 in a rat model of glaucoma improves the trabecular filtrating function and subsequent aqueous humor outflow, further protecting the retina against IOP‐related degeneration.
Outcome improvement of glaucoma filtration surgery through the effect of local rock‐inhibition on wound healing
Authors: SIJNAVE D , HOLLANDERS K , VAN BERGEN T , VAN DE VELDE S , VANDEWALLE E , MOONS L , STALMANS I
Published: August 2012

Purpose The aim of this study was to investigate the efficacy of a local ROCK‐inhibitor; AMA0076 (Amakem NV) for improving surgical outcome, after glaucoma filtration surgery in a rabbit model.

Methods The in vivo effects of local ROCK‐inhibition were investigated in a rabbit model of glaucoma filtration surgery (n=5 per histological analysis group). Topical treatment with AMA0076 (study eye) and vehicle (control eye) was administered every day 3x/day (9h/13h/17h) from day 1 after surgery. Treatment outcome was studied by clinical investigation (IOP; intraocular pressure, bleb area and bleb survival) as well as immunohistological analyses for inflammation (CD45), angiogenesis (CD31) and collagen deposition (Sirius Red) at day 3, 8 and 14 after surgery.

Results Bleb survival showed no difference between treated and non‐treated eyes however, there a trend (p=0,09) can be distinguished. Topical treatment of AMA0076 reduced inflammation on day 3 (p=0.036) and day 8 (p=0.044) as well as angiogenesis on day 8 (p=0.04). There were no differences in collagen deposition.

Conclusion Targeting ROCK with a local ROCK inhibitor, AMA0076, is efficacious in reducing inflammation and angiogenesis on several time points in a rabbit model of glaucoma surgery. These results render ROCK an interesting target to increase the success rate of filtration surgery and point to potential therapeutic benefits of the local ROCK inhibitor, AMA0076.
Natural history of an early diagnosed retinocytoma: case report and literature review
Authors: DE FRANCESCO S , GALLUZZI P , RENIERI A , BORRI M , MAZZERA L , MENICACCI C , HADJISTILIANOU T
Published: August 2012

Purpose To study the ophtahlmoscopic evolution of a retinocytoma diagnosed in a 8 months old boy.

Methods The patient was referred at the Referral Center for Retinoblastoma of the University of Siena, with the suspect of unilateral retinoblastoma. The boy was diagnosed as having retinocytoma based on ophthalmoscopic appearance. Monthly ophthalmoscopic and ecographic evaluation were recommended. Detailed fundus drawings and fundus photographs and descriptions of the retinocytoma were collected. The little boy underwent also MRI, genetic testing and fluorangiography.

Results Throughout the months, we observed a tumor regression from avascular mass with fish‐flesh appearance and microscopic calcifications to a retinal transparent mass with calcifications, retinal cysts and surrounded by chorioretinal atrophy.

Conclusion Retinocytoma is a rare benign retinal tumor with characteristic clinical features. Usually diagnosed in parents of retinoblastoma children, “silent” retinocytoma diagnosis is more rare in babies. In our case, we observed a natural “regression” of a retinocytoma in a 8 months old boy kept under close RETCAM follow‐up for the risk of malignant transformation.
Bilateral primary iris pigment epithelial cysts
Authors: MAMUNUR R , KIVELÄ T
Published: August 2012

Purpose To report a patient who presented with bilateral primary iris pigment epithelial cysts.

Methods Interventional case report.

Results A 30‐year‐old lady with the diagnosis of bilateral primary cysts of the iris pigment epithelium was referred. Her father had been diagnosed with a uveal melanoma 13 years earlier. Two smaller circumferential midzonal iris pigment epithelial cysts and a larger inferonasal cyst located in the temporal area were observed in her right eye, and a similar but much larger cyst was observed in her left eye temporally between 1 o'clock and 6 o'clock meridians. Otherwise, the anterior and posterior segment as well as the intraocular pressure (16 mmHg) were normal. The visual acuity was 20/20 without correction, right eye, and 20/20 with a +0.75 sphere, left eye, with a shadow in the field. For the decrease of vision in her left eye the cyst was treated with neodymium‐doped yttrium aluminum garnet (Nd:YAG) laser cystotomy without any ocular tissue damage using the Abraham iridectomy lens and a 1.0 mJ single pulse. Cystotomy resulted in immediate collapse of the cyst with no change in intraocular pressure.

Conclusion Laser cystotomy yielded a favorable result. Generally, these cysts which most frequently occur in young females do not need any treatment, but transpupillary laser cystotomy is an alternative to a conservative regimen if iris the cyst is symptomatic.
Combined topical 5‐Fluoruracil and extensive surgery in the management of corneo‐conjunctival squamous cell carcinoma.
Authors: PARROZZANI R , PILOTTO E , DARIO A , MIGLIONICO G , MIDENA E
Published: August 2012

Purpose To evaluate safety and efficacy of combined neo‐adjuvant topical chemotherapy with 1%5‐Fluoruracil (1%5‐FU), followed by extensive surgery and adjuvant (post‐surgical) 1%5‐FU topical chemotherapy in the management of corneo‐congiuntival squamous cell carcinoma (SCC).

Methods Twenty‐nine consecutive patients, with histological evidence of SCC, were included in this prospective study. Each patient was treated by combined neo‐adjuvant topical chemotherapy (1%5FU, four time daily for four week, 1 cycle), followed by extensive surgery (5 mm of free conjunctival surgical margins) with contemporary amniotic membrane reconstruction. Adjuvant topical chemotherapy was started 3 months after surgery (1%5‐FU, four time daily for four week, 1 cycle). Follow‐up was performed every 3 months for the first year and every 6 months thereafter, including clinical confocal microscopy. Follow‐up was longer than 36 months.

Results Mean follow up was 56±11(range, 36‐78 years). Good functional, anatomic and aesthetic results were obtained by surgery. Two patients (5%) needed short‐term surgical amniotic membrane repositioning due to early sutures dehiscence. 1%5FU, used both as an adjuvant or neo‐adjuvant treatment caused low‐to‐mild temporary local irritation. No‐one patient discontinued therapy because of 5‐FU side effects. No other long‐ or short‐term side effects were documented. No local recurrences were documented during follow up.

Conclusion Combined neo‐adjuvant topical chemotherapy with 1%5FU, extensive surgery and adjuvant 1%5FU topical chemotherapy appear a safe and effective combined treatment in the management of conjunctival SCC.
MicroRNA profiling in ocular adnexal extranodal marginal zone lymphoma and diffuse large B‐cell lymphoma
Authors: RASMUSSEN P , HOTHER C , JOSHI T , REKER D , RALFKAER U , WORKMAN C , RALFKAER E , GRONAEK K , HEEGAARD S
Published: August 2012

Purpose To investigate changes in microRNA (miR) expression in ocular adnexal extranodal marginal zone lymphoma (EMZL) and diffuse large B‐cell lymphoma (DLBCL), and to perform a pathway analysis of differentially expressed miRs.

Methods Global miR expression profiling was performed using miRCURYTM LNA miR‐arrays, v. 11.0, (Exiqon) on formalin‐fixed paraffin‐embedded tissue from 18 ocular adnexal EMZLs and 25 DLBCLs. The result of microarray was confirmed using quantitative real time (RT)‐PCR. Predicted and validated targets of the significantly differentially expressed miRs were obtained from MiR‐walk. Transcription factor (TF)‐miR interactions were obtained from the TransmiR database.

Results The microarray results revealed two up‐regulated and 41 down‐regulated miRs in the DLBCLs compared to the EMZLs. Further, the differentially expressed miRs separated EMZLs and DLBCLs into two distinct entities using a supervised clustering analysis. These findings were confirmed by quantitative RT‐PCR. Five of the down‐regulated miRs (let‐7g, miR‐26a, miR‐29a, miR‐29c and miR‐221) were identified to be regulated negatively by MYC. A small set of miRs (let‐7g, miR‐199a‐5, miR‐26a, miR‐27a* and miR‐342‐3p) that regulate NFKB1 were all down‐regulated in the DLBCLs compared to the EMZL samples. Further, the NFKB1 regulated miRs (miR‐29a/b/c and miR‐125b) were down‐regulated significantly in the DLBCLs compared with the EMZLs (log2 fold‐changes: miR‐29a/b/c < ‐1.9 and ‐1.1 for miR‐125b).

Conclusion We demonstrated that fundamental differences in miR expression exist between ocular adnexal EMZLs and DLBCLs, mainly due to differences in MYC and NF‐kB regulatory pathways.
Pink pseudohypopyon as a presenting feature of large B‐cell lymphoma
Authors: MESQUIDA M , SOLE M , LLORENS V , ADAN A
Published: August 2012

Purpose To describe the clinicopathologic features of a patient who developed an anterior chamber (AC) infiltrate mimickina pink pseudohypopyon as a presenting feature of large B‐cell lymphoma.

Methods The clinical and pathologic findings in a patient with AC infiltrates secondary to systemic B‐cell lymphoma are reviewed. Main outcome measurements were clinical observation and cytologic/flow cytometric examination of the infiltrate after AC aspiration.

Results A 51‐year‐old woman was evaluated for decreased vision in her right eye. On examination, her visual acuity was 20/30 in the right eye (RE) and counting fingers in the left eye. Abnormalities were confined to the RE. Slit lamp examination revealed +1 AC cells with a pink pseudohypopyion occupying 40% of the AC. The iris was corrugated and had small new vessels in the stroma. An anterior chamber aspirate was performed, and 0.8 ml of fluid was obtained. The sample was formed by 32% of lymphocytes and 54% of neutrophils. B‐lymphocytes were predominant over T‐lymphocytes (91% and 8%, respectively). Cytologic examination showed scattered atypical mononuclear cells. Immunohistochemical stains were positive for CD19 in the atypical cells. Flow cytometric immunophenotyping revealed a clonal, kappa restricted population of B‐lymphocytes comprising 97% of the viable cells in the sample. These results were consistent with a large B‐cell extranodal lymphoma.

Conclusion Anterior chamber/iris infiltration from systemic lymphoma is exceedingly rare, present in less than 10% of patients. Herein, we describe a patient with systemic lymphoma in whom the first manifestation was a pink pseudohypopyon.
Diagnosis of choroidal lymphoma, difficulties and possibilities
Authors: VAN GINDERDEUREN R , MISSOTTEN G , VAN CALSTER J
Published: August 2012

Purpose To describe a case of choroidal lymphoma

Methods A 66 y old man presented with left vitritis; 3y before presentation a testicular large B‐cel lymphoma was detected and treated by 8x R‐CHOP and 4x intrathecal chemo. General and hematologic examination failed to indicate a recurrence; because of the negative vitreous biopsy, the hematologists decided to give no systemic treatment. The left eye lost slowly vision and had the aspect of diffuse uveal melanocytic proliferation (BDUMP). After 6 methotrexaat vitreal injections, the choroid remain flat with the image of BDUMP, then very fast, a tumour was growing in the choroid and an enucleation was unavoidable

Results The first vitreous biopsy showed multiple cells with a majority of macrophages (CD68+, 75%), small mature T‐Lymphocytes (CD3+, 20%) and very few larger B‐lymfocytes (CD20+, 5%). A second vitreous biopsy after 2 years showed a very cellular sample with a majority of macrophages, and small T‐lymphocytes, there were no B‐lymphocytes. 3 months later a spectacular tumour growth in all parts of the uvea necessitated an enucleation. This confirmed the diagnosis of uveal large B‐cell lymphoma, with a Ki‐67 positivity of nearly 100%

Conclusion Lymphoma in the eye is a difficult diagnostic problem
Schwannoma of the ciliar body (clinical case)
Authors: SAAKYAN S , AMIRYAN AG , ZAHAROVA G , TSYGANKOV A
Published: August 2012

Purpose Schwannoma is a very rare benign intraocular tumor, arising from the uveal tract. Only several cases have been described so far in literature. We describe a case of ciliar body schwannoma.

Methods A 13‐year‐old girl presented with rapid decreasing visual acuity and intraocular pressure increase for 3 months. The patient was examined with standard ophthalmological procedures. Ultrasonography with Doppler techniques and computed tomography revealed a huge tumor mass, totally filling the eye cavity. IOP was measured as 26 mmHg. The fine needle aspiration biopsy revealed no signs of tumor (retinoblastoma or uveal melanoma were expected). To prevent the tumor spread and further IOP increase, we performed the enucleation of the eyeball.

Results Histologically the tumor was determined as Verocai schwannoma (cellular solid component or Antoni A type). Immunohistochemical study revealed a positive reaction for vimentin, protein S‐100 and neuronspecific enolase.

Conclusion Unfortunately, it is not easy to make a differential diagnosis between the nonpigmented melanoma and schwannoma without performing an enucleation in advanced cases. Nevertheless, in our case enucleation was the appropriate method to determine this rare tumor and to administer further treatment.
New straylight issues in treatment of the eye
Authors: VAN DEN BERG TJTP
Published: August 2012

Purpose Straylight exerts its deleterious effect on visual function by reducing the sensitivity of the retina for whatever visual task the retina must perform: face recognition, movement detection, color discrimination etc. It can be expected that patients suffering from a retinal condition will be handicapped by straylight twice as much. To assess retinal condition in a non‐confounded way, flicker sensitivity has been proposed. Such a test was developed on the C‐Quant. Moreover, the test serves to assess whether a paptient has sufficient flicker sensitivity for the normal straylight test itself.

Methods Visual field lay‐out was identical, as well as the subject's 2AFC task, but the peripheral annulus was silent, as well as one of the two half fields in the center. The other half flield flickered at 8 Hz, with modulation depth according an adaptive staircase procedure. Outcome measure is logTCS (temporal contrast sensitivity). An uncertainty parameter (Unc) was included. Population test was performed in science fair settings on 400 subjects. Moreover in the laboratory 2 subjects were extensively tested to check whether optical defects, mimicked with trial lenses and scatter filters, affected the TCS outcome.

Results Repeated measures standard deviation was 0.11 log units for the reference group using as reliability criterion unc<0.15. Normal values for logTCS were around 2 (threshold 1%) with some dependence on age (range 6‐85 years). Test outcome did not change upon a ten‐fold (optical) deterioration in visual acuity or straylight.

Conclusion The test has adequate sensitivity to check a subject's capability to perform straylight assessment. The unc reliability criterion secures sufficient precision, also for assessment of retinal sensitivity loss.

Commercial interest
General planning and thoughts for the operation
Authors: MOURTZOUKOS S
Published: August 2012

For any surgical procedure you must get prepared prior to theatre. Technically you have to use all necessary instruments and or consumables to achieve a good result and practically you must have all the support from the stuff. Thus it is necessary to organise a plan prior to operation. A “battle plan” that allows you to get prepared for any scenarios. In order to follow your plan you will need a very good examination and documentation of all the findings. Any prioritised information prior to the surgery could improve the efficiency. In example the number and the type of breaks, the location, the possible type of sponge you may use as well as an alternative option. The decision in advance to perform or to skip significant parts of the procedure such as drain or not drain may provide as well more safety and /or efficiency.
Cryo treatment and problems
Authors: PAPPAS G
Published: August 2012

Cryo from one point is necessary to create adhesions around the break. But from the other point of view it is possible to facilitate the development of PVR.We will discuss all these details for the cryo.
Complications following conventional surgery for retinal detachment
Authors: KATSIMPRIS J
Published: August 2012

Purpose To describe the possible complications following conventional surgery for retinal detachment Scleral buckling procedure has a primary success rate of 85–90%. Complications, although rare, may occur. Some of them may be severe. In some instances, patients lose sight in the affected eye or lose the entire eye.

Methods Conventional retinal detachment surgery under general anaesthesia.

Results Possible, but infrequent, complications from scleral buckle surgery include failure of the operation, loss of some or all vision, loss of an eye (rare), double vision, retinal hemorrhage, cataract formation, glaucoma, further retinal detachment, proliferative vitreoretinopathy, vitreous hemorrhage, drooping of the upper lid, and infection. Drainage of the subretinal fluid during surgery, is associated with a higher risk of complications such as bleeding, perforation of the retina, incarceration of the retina at the drainage site, infection etc. Even though the incidence of such complications is low, the risks should be explained to patients. As the scleral buckle is left in place permanently and behaves as a foreign body to the eye there is a risk that there may infection and extrusion many years after the surgery. There is also the small risk of the buckle eroding into the eye, necessitating its removal. A change of patient’s refraction is observed usually (increased shortsightedness) after scleral buckling surgery. In some instances, although the retina reattaches, visual acuity is not restored. The risk of surgery also rises with the use of general anesthesia.

Conclusion Scleral buckling, however, is considered a safe, successful procedure. Restored vision depends largely on the location and extent of the detachment, and the length of time before the detachment was repaired.
Determination of the optimal colour space for distinguishing small retinal haemorrhages from dust artefacts
Authors: SUZUKI N , YAMANE K
Published: August 2012

Purpose To determine the optimal colour space from eight types of colour spaces for the purpose of distinguishing small retinal haemorrhages from dust artefacts in cases of early diabetic retinopathy.

Methods We constructed an experimental device, which comprised an illumination optical system and a photographic optical system separated by a mirror having a hole. The device included a canon EOS 50D camera, an EF 50 mm f/1.8‐2 camera lens, a Speedlite 270EX flash, an object lens, four double‐convex lenses, three aperture stops and six artificial eyes. The eye ground was a hemisphere made of polythene terephthalate painted with six matt colour sprays: red, white brown, ochre, yellow, ivory and orange. Five fragments of house dust on the object lens and the two lenses were photographed under each artificial eye. The RGB colour space, measured by Paint Shop Pro from pictures, was changed into seven kinds of colour spaces: XYZ, CMY, HSL, HSV, HSI, L*a*b* and L*u*v*.

Results The evaluation values of the following three colour spaces were favourable: the L*u*v* colour space (L*, 5.7±1.1; u*, 8.5±1.8 and v*, 6.7±1.1), the HSV colour space (hue, 2.0±0.5; saturation, 9.5±3.7 and value, 6.7±0.7) and the HSL colour space (hue, 2.0±0.5; saturation, 7.8±2.5 and lightness, 6.8±0.8). The other colour spaces did not show a good result.

Conclusion The L*u*v* colour space is highly sensitive; therefore, it is most effective in distinguishing small haemorrhages from dust artefacts. The HSV and HSL colour spaces were highly sensitive in terms of saturation, lightness and value. Using Scilab and SIVP software, we are currently researching methodology that applies the use of colour spaces such as L*u*v* and HSV for automatic distinction.
Matched pairs analysis of retinal navigated laser versus conventional laser
Authors: KERNT M , KOZAK I , FREEMAN W , KAMPIK A , ULBIG M , NEUBAUER A
Published: August 2012

Purpose To compare clinical outcome and retreatment rate of a novel computer navigated laser versus conventional slit‐lamp‐microscope laser treatment of diabetic macular edema

Methods Focal laser for diabetic macular edema (DME) in 46 consecutive patients was digitally planned on fundus images and performed utilizing retinal navigation (Navilas® Laser System, OD‐OS GmbH, Teltow / Berlin, Germany). We investigated the number of retreat‐ments and monitored visual acuity (VA) over 6 months and compared to 119 patients treated with a conventional laser via a slit‐lamp‐microscope.To match control group and Navilas pa‐tients propensity score matching was performed with STATA based on the nearest neighbour method.

Results The propensity score algorithm for age, gender, baseline VA and number of laser spots yielded 28 patients for the matched control group. All baseline characteristics were comparable, VA was 0.48 +/‐0.37 Log MAR for Navilas and 0.43 +/‐0.36 Log MAR for conventional laser. Visual outcome at 3 and 6 months follow‐up was better for the Navilas group, but did not reach statistical significance. The Laser retreatment rate using Kaplan‐Meier analysis showed separation of the survival curves after 2 months. For the first 6 months the cumulative retreatment rate was 18% in the Navilas and 31% in the conventional laser group (p=0.02)

Conclusion Lower retreatment rates were observed with navigated laser treatment compared to conventional laser within 6 months after treatment, indicating a more sustained effect and faster stabilization using navigated laser, hence, reducing the treatment burden for the patient.

Commercial interest
A shift in the balance of vascular endothelial growth factor and connective tissue growth factor by bevacizumab causes the angiofibrotic switch in proliferative diabetic retinopathy
Authors: SCHLINGEMANN RO , VAN GEEST RJ , LESNIK OBERSTEIN SY , VAN NOORDEN CJF , KLAASSEN I , GOLDSCHMEDING RG
Published: August 2012

Purpose In proliferative diabetic retinopathy (PDR), vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) may cause blindness by neovascularisation followed by fibrosis of the retina. It has previously been shown that a shift in the balance between levels of CTGF and VEGF in the eye is associated with this angiofibrotic switch. This study investigated whether anti‐VEGF agents induce accelerated fibrosis in patients with PDR, as predicted by this model.

Methods CTGF and VEGF levels were measured by ELISA in 52 vitreous samples of PDR patients, of which 24 patients had received intravitreal bevacizumab 1 week to 3 months before vitrectomy, and were correlated with the degree of vitreoretinal fibrosis as determined clinically and intra‐operatively.

Results CTGF correlated positively, and VEGF correlated negatively with the degree of fibrosis. The CTGF/VEGF ratio was the strongest predictor of fibrosis. Clinically, increased fibrosis was observed after intravitreal bevacizumab.

Conclusion These results confirm that the CTGF/VEGF ratio is a strong predictor of vitreoretinal fibrosis in PDR, and show that intravitreal anti‐VEGF treatment causes increased fibrosis in PDR patients. These findings provide strong support for the model that the balance of CTGF and VEGF determines the angiofibrotic switch, and identify CTGF as a possible therapeutic target in the clinical management of PDR.
Measurement of subfoveal choroidal thickness before and after cataract surgery using enhanced depth imaging optical coherence tomography
Authors: PIERRU A , BAILLIF‐GOSTOLI S , GASTAUD P
Published: August 2012

Purpose To compare subfoveal choroidal thickness (SFCT) before and after cataract surgery using enhanced depth imaging optical coherence tomography (EDI OCT)

Methods Cross‐sectional observational prospective study. Spectral‐domain EDI OCT was performed with a Heidelberg Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) using a standardized protocol. SFCT of 67 patients was measured manually from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction before surgery, 1 day, 7 days, 1 month, 3 month after. Choroidal thicknesses were independantly assessed by two masked graders. Statistical analysis was performed to evaluate variations of choroidal thickness before and after cataract surgery.

Results Eighty four eyes of 67 patients who had cataract surgery were included. Mean SFCT ± SD was 215,9 ± 69,4 μm before surgery, 213,3 ± 67,3 μm at Day 1, 221,9 ± 67,8 μm at Day 7, 226,5 ± 68,9 μm at 1 month and 230 ± 62,2 μm at 3 months. Mean SFCT increased significantly between before and 3 months after surgery (p<0,04). For diabetic patients mean SFCT increased in the same proportion as in general population but later (Day 7 versus Day 30). No significative difference was observed between group with Diabetic Retinopathy (DR) and group without. For the only patient who developed an Irvine Gass Syndrom, SFCT increased.

Conclusion Mean SFCT seems to increase after phacoemulsification. EDI OCT can be used to evaluate choroidal changes after cataract surgery in diabetic patients, and to detect patients who would develop an Irvine Gass syndrome.
Peripheral capillary network enlargement in diabetic maculopathy
Authors: RADOI C , ZAMBROWSKI O , DUCASSE A , ARNDT C
Published: August 2012

Purpose Diabetic macular edema has been associated with increased intravitreal levels of VEGF. Therefore, ischemia is probably part of the physiopathology. The purpose of this study is to evaluate the rarefaction of peripheral capillaries.

Methods A retrospective analysis of large field angiographic images with a scanning laser ophthalmoscope (OPTOS, Edinburgh, Scotland) was performed between Novembre 2011 and March 2012was performed. After excluding patients with previous panretinal laser photocoagulation and those with peripheral non‐analyzable images, the peripheral area on early phase images in 112 patients were evaluated. 38 had a diabetic maculopathy and 78 served as non diabetic controls. The enlargement of the peripheral capillary network was graded from 1 to 3 (1: normal, 2: moderate, 3: severe).

Results A total of 43 patients were excluded because of panretinal photocoagulation in the diabetic group, possible VEGF involvement in the control group and poor image quality in either group.When comparing the remaining patients of the two groups, no significant difference in peripheral capillary network changes was observed.

Conclusion The peripheral capillary rarefaction is difficult to analyze on conventional angiography (peripheral images are usually obtained in the late phase). This angiographic finding is probably not encountered more often in diabetic maculopathy than other retinal diseases. It remains to be demonstrated in which cases peripheral capillary rarefaction should be considered as significant and whether targeted laser treatment as a part of diabetic macular edema therapy should be discussed.
Synthetic eye prosthesis – phase I results of a succesfully developed biomaterial
Authors: STORSBERG J , KOBUCH K , DUNCKER GIW , KNAK M , REHFELDT S , SCHMIDT C , NASS N , SEL S
Published: August 2012

Purpose Development of an biomimetic artificial cornea to provide a long term stable keratoprostesis for ultima ratio patients

Methods A hydrophobic biomaterial was selectively modified by physical and chemical nanotechnological methods. The modified biomaterial was tested in cell culture experiments (primary epithelial cells, porc), implanted into rabbits eyes and finally into eyes of ultima ratio patients.

Results After very successful in vitro evaluation, keratoprostheses were implanted to rabbit eyes (New Zealand white rabbit) and showed excellent in vivo performance in the animal experiment. After a follow‐up of 2.5 years, the implanted keratoprosthesis into human eyes showed no significant sign of complication such as infection or protrusion. There was a substantial increase in vision.

Conclusion We could develop a new keratoprosthesis for ultimo ratio patients which is well tolerated in human eyes.
Biomimetic materials for regenerating the cornea
Authors: GRIFFITH M
Published: August 2012

Abstract not provided
Quantitative and qualitative label free imaging using mass spectrometry in the context of an ophthalmic application
Authors: HAMM G , DESBENOIT N , LEGOUFFE R , BRUNELLE A , BRIGNOLE‐BAUDOUIN F , STAUBER J
Published: August 2012

Purpose We present a new Label free quantitative imaging of small molecules in order to investigate their roles in ophthalmic disorders (toxicity, inflammation)

Methods Quantitative Mass Spectrometry imaging has been developed and applied to ophthalmology to assess the distribution and quantification of Benzalkonium chloride (BAK) compound in specific areas of the eye after instillation. This method has been compared to gold standard technique as liquid chromatography ‐ Mass spectrometry to validate the data.

Results The distribution of two BAK compounds (BAK C12 and BAK C14) were investigated in small specific histological regions of the eye (such as iridocorneal angle or sclera, choroid, retina regions) in order to estimate efficiency of action or adverse effects of the treatment. High spatial resolution images were performed at cells level (30 µm). Molecular distribution was also correlated to tissue histology using H&E staining. Then, our methodology of quantification by MSI was applied.

Conclusion MSI offers new insight in ocular therapeutic/pharmaceutical research, especially for high‐precision distribution and quantification studies
How to get your work published ?
Authors: PLEYER U
Published: August 2012

Junior researchers often face the challenge of get their interesting work published. The goal of this course will be to provide some keys to write a high quality paper that will help to transform innovative ideas into a research article. The panelists will discuss major aspects of the editorial process including basic decisions: where to submit the work, how to organize and prepare a manuscript, how to deal the review process in particular the revision process for eventual resubmission. The panelists will raise the discussion on issues like: How to choose a journal ? How to organize your paper ? What are the characteristics of a good manuscript ? Delayed response: When is it appropriate to ask for the status of your manuscript ? How to interpret the letter from the editor ? How to write a good reply to the reviewers ? What to do when your paper is rejected ? When can it be appropiate to request a reevaluation of a rejected paper ? In addition, the personal view from an authors and editors perspective will be given in a vivid discussion with the participants.
How to get your work published ?
Authors: KIVELÄ T
Published: August 2012

Abstract not provided
How to get your work published?
Authors: STEFANSSON E
Published: August 2012

Purpose The intrinsic quality of a scientific article depends first and foremost on its scientific content. However, the way in which the scientific material is presented and the paper is written may determine whether the scientific content will ever receive the attention it deserves. There may not be any perfect recipe for a perfect paper, but it is possible to point out some general characteristics of good papers, and we will try to do so. The title sometimes decides whether a potential reader will give your article a proper look. A good title is descriptive, and it may also give a statement if the journal style allows. The abstract is the most important part of your article. It is what most people will read, and they will proceed to read the article proper only if they find the abstract to be interesting. If you excuse the parable, a good abstract is like a miniskirt – short enough to be exciting and long enough to cover the essentials.

Methods Describe the material or patients and the methods in brief. It is advisable to specify the study design.

Results Present the most important results in a brief manner. Please give quantitative data with confidence limits whenever applicable. The reader wants to know what your results were, not just whether they were “statistically significant” or not.

Conclusion Put your data into context with the clinical practice, literature or both. How do your results add to the scientific knowledge or preferred practice? What have we learned? A common mistake is to include general conclusions which are not specifically supported by the data presented. Please check that the conclusions are in line with the stated aim of the study.

Commercial interest
Surgery of the inflammatory cornea or sclera
Authors: BOURGES JL
Published: August 2012

Abstract not provided
Glaucoma surgery in uveitis
Authors: LACHKAR Y
Published: August 2012

Glaucoma surgery and uveitis (course) Management of uveitis glaucoma requires careful diagnosis and managment of both uveitis and glaucoma. Before deciding surgery it is essential to identify the mechanisms of IOP elevation and to differentiate secondary open angle glaucoma, secondary angle closure glaucoma with or without pupillary block. In case of secondary glaucoma with pupil block in phakic patients lens extraction might be considered if the uveitis is well controlled. Uveitis can negatively affect the outcome of glaucoma surgery. Filtration surgery with the use of adjunctive mitomycin C is the standard of care because of the risk of fibosis of the filtration bleb. Non penetrating surgery is an attractive option if the angle is open avoiding anterior chamber entry and hypotony. Aqueous shunt implantations is another option and could be proposed as a primary surgical procedure. Cyclophotocoagulation is best avoided in uveitics because the ciliary body is compromised by cyclitis. This procedure should be used cautiously because patients with uveitis already have atrophic ciliary epithelium, and the risk of permanent hypotony is increased with a cyclodestructive procedure
Visual fields for Ever ‐ and more
Authors: MARTIN L
Published: August 2012

Purpose Visual field examinations are essential in eye care, especially in patients with glaucoma or neuro‐ophthalmological disorders. During the last three decades an explosive development has led to automation of examination procedure, new stimulus modalities and a spread of the methods outside eye clinics. Recently, the advent of other physiological tests and imaging methods has presented new ways for analysis of the visual system. The lecture will highlight some of the factors influencing the choice of method, considering the medical situation, patient characteristics and the care setting.

Conclusion Optimum use of available examination techniques requires good understanding of the methods positive and negative predictive value, the disease prevalence and course, and the “real‐world” consequences for the individual patient
Comparison of three different methods of intraocular pressure (IOP) measurements including properties of the cornea
Authors: SMEDOWSKI A , WYLEGALA E , WEGLARZ B , ORSKI M , WOJCIK L
Published: August 2012

Purpose The aim of this study was to show the usefullness of three different methods of Intraocular Pressure (IOP) measurements: Goldmann Applanation Tonometer, Rebound Tonometer and Ultra High‐Speed Scheimpflug Technology.

Methods The examined group consisted of 96 patients, 192 eyes (63 females, 33 males of mean age 59,3±19,9 years old). IOP measurements were carried out using Goldmann Applanation Tonometer (GAT), Rebound Tonometer Icare Pro (RT) and Ultra High‐Speed Scheimpflug Technology (UHS ST) –“Corvis ST” with pachymetry which automatically took into account of central corneal thickness (CCT) correction. Additionally corneal pachymetry with Pentacam, Oculus were made to considered CCT in GAT IOP value. Statistical analysis was based on the software Statistica 10.0 PL, Statsoft, Poland.

Results Mean IOP measured with GAT was 15,6±3,75 mmHg; GAT with CCT correction 15,7±3,7 mmHg; mean IOP measured with RT was 15,6±3,5 mmHg; with UHS ST 16,1±4,0 mmHg. Mean CCT measured with UHS ST was 543,7±52,7 µm; with Pentacam 547,9±54,0 µm. In comparison, there is significant difference between IOP measured with GAT and GAT+CCT, RT versus UHS ST (P<0,001) and no significant between GAT, GAT+CCT versus RT (p>0,5). Central Corneal Thickness was without differences in measurements carried out with UHS ST and Pentacam. All technics showed correlation IOP with CCT (p<0,05; r~0,3).

Conclusion Applanation Tonometer and Rebound Tonometer can be equal methods of IOP measurements in contrast to Ultra High‐Speed Scheimpflug Technology which give significant different values but can be use to take accurate measurements of Central Corneal Thickness
24‐hour intraocular pressure of healthy humans in supine position: rhythm and reproducibility
Authors: MOTTET B , CHIQUET C , APTEL F , NOEL C , ROMANET JP
Published: August 2012

Purpose To evaluate the reproducibility over time of 24H intraocular pressure (IOP) rhythm in healthy humans in supine position.

Methods In a sleep laboratory, six healthy young Caucasian male subjects were included in each six weekly 24H sessions of hourly IOP measurements in a control supine position using the pneumatonometer Digilab Modular One. IOP 24H rhythm was modelled using a nonlinear least squares dual harmonic regression analysis. The intra‐ and inter‐subject variability of acrophase, bathyphase, amplitude and IOP values were evaluated.

Results A significant nyctohemeral IOP rhythm was noted in 30/36 (83%) sessions. Nocturnal IOP was significantly higher than diurnal IOP (20.1 ± 0.2 vs. 18.8 ± 0.1 mmHg). Reproducible distribution over 24H of intra‐subject acrophase and bathyphase was found respectively in 3/6 (50%) and 4/6 (67%) subjects. Intra‐subject means of amplitude were not statistically different between subjects. IOP values at 2:00, 3:00, 4:00, 10:00, 11:00 AM and 2:00 PM and IOP mesor had fair to good agreement between sessions.

Conclusion Most healthy subjects exhibited a nyctohemeral rhythm of IOP with fair reproducible characteristics in supine position. Amplitude is the best reproducible parameter. This result strongly suggests that chronobiological lower IOP therapies could be powerfully studied using paired intra‐subject 24H nyctohemeral rhythm data comparison, during repeated sessions overtime before and after treatment.