bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in optical coherence tomography findings in early intervention vs late intervention surgically treated submacular hemorrhages
Authors: CANASTRO M , FARIA M , MARQUES‐NEVES C , MONTEIRO‐GRILLO M , NETO E , PERPETUA C , PROENCA H
Published: August 2014

Purpose The purpose of this retrospective observational study is to compare Spectral‐Domain OCT findings in early‐intervention vs late‐intervention submacular hemorrages treated surgically with vitrectomy, recombinant tissue Plasminogen Activator (rtPA) subretinal injection and gas injection.

Methods Retrospective analysis of pre and post operative OCT findings of 4 patients with submacular hemorrhages treated with 23G vitrectomy, rtPA subretinal injection and gas (SF6, C3F8) injection. 2 patients were treated after 6 and 10 days of diagnosis establishment and the other 2 were treated after 21 and 28 days of diagnosis establishment. Subfoveal thickness was measured in both pre and post operative exams. Analysis of the retinal structure and submacular hemorrhage characteristics were performed.

Results The early intervention group presented with higher pre‐operative subfoveal thickness (716 and 973 microns compared with 405 and 554 microns). Post operative OCT showed an important decrease in subfoveal thickness in the early intervention group (716 to 260 microns and 973 to 433 microns), not seen in the late intervention group (405 to 593 and 554 to 548 microns). Images analysis shows recent submacular hemorrhages as low density, thick, homogeneous, subretinal tumefactions that do not severely distort retina internal anatomy. Older submacular hemorrhages appear as more dense, thinner, heterogeneous masses, with retinal distortion, cysts formation and separation of the inner and outer layers of the retina.

Conclusion OCT is an important exam in the evaluation of submacular hemorrhage, which may differentiate recent and late hemorrhages. Early intervention is crucial for good post operative anatomical result.
Compressive chiasmal lesions: optical coherence tomography, ganglion cell and inner plexiform layers and visual field tests
Authors: VICENTE A , ANJOS R , COSTA L , VIEIRA L , SANTOS A , FERREIRA J , AMADO D , CUNHA JP
Published: August 2014

Purpose The authors present an analysis of the automated macular ganglion cell complex measurements in patients with compressive chasmal lesions.

Methods Observational study of 20 eyes of 20 patients with compressive chiasmal lesions followed at the neurophthalmology outpatient clinic. Optical Coherence Tomography (OCT SPECTRALIS® ‐ Heidelberg Engineering GmbH) was performed and high‐resolution macular scans were obtained. Ganglion cell layer and inner plexiform layer (GCL+IPL) average thickness and retinal nerve fiber layer (RNFL) thickness were also determined. A functional evaluation was performed with Static Computerized Perimetry (Octopus Perimetry®, Haag‐Streit). Statistical analysis was done with SPSS Statistics. A p value < 0.05 was considered statistically significant.

Results There was a significant decrease in the RNFL and GCL+IPL thickness when compared with average values from normal population (p<0,05). Average RNFL and GCL+IPL thickness reduction evaluated by OCT were positively correlated. We identified a positive structural and functional correlation between the tomographic and perimetric evaluations. Nevertheless, 4 of the 20 patients had normal visual fields.

Conclusion Although the changes determined by OCT and perimetry are different, both methods are useful in studying the relationship between structure and function in patients with chiasmal compressive lesions. Structural damage documented by OCT was associated in the majority of the patients with functional damage. This study also emphasizes the importance of the GCL+IPL thickness measurement with OCT. Evaluation of RNFL and GCL+IPL with OCT appears to be accurate in predicting functional damage.
Macular and retinal degeneration in Alzheimer's disease
Authors: CUNHA JP , SANTOS A , FERREIRA J , AMADO D , LOURO C , CASTANHEIRA‐DINIS A , VICENTE A
Published: August 2014

Purpose To evaluate the differences between the thickness of the separate quadrants at the peripapillary RNFL, thickness and volume of the macula and choroidal thickness in Alzheimer disease ( AD) patients compared with a control group.

Methods Transversal case control study in 50 eyes of AD patients and 150 eyes of heathy subjects, measuring the thickness of the separate quadrants at the peripapillary RNFL, thickness and volume of macula with SD OCT (spectral domain optical coherence tomography) and choroidal thickness (CT) with enhanced depth imaging OCT in Alzheimer disease patients compared with a control group.

Results The average thickness of temporal superior quadrants of RNFL in AD patients was 30,5 ± 8,5 μm thinner than control group (p<0,05 t student test). Macular thickness and volume had no statistical differences between AD patients and heathy subjects. Mean subfoveal choroidal thickness was higher in AD than in control group ( 246,31 ±68,23 versus 214,31±72,85 μm( p< 0,05 t student test).

Conclusion This findings suggest that the macular and retinal degeneration may be multifactorial such as retrograde degeneration in retinal changes and ischemic factor in choroidal changes.
Retinal oximetry in diabetic retinopathy
Authors: BEK T
Published: August 2014

Background: Diabetic retinopathy is accompanied by disturbances in retinal blood flow, but the consequent changes in oxygenation of the retinal tissue have not been studied in detail. The advent of retinal oximetry for assessing the oxygen saturation in retinal vessels has enabled the study of changes in retinal oxygen saturation during the progression and after treatment of the disease. Methods: 71 patients with proliferative diabetic retinopathy and 149 with diabetic maculopathy were subjected to retinal oximetry of the larger retinal arterioles and venules before, immediately after and three months after retinal photocoagulation. Results: Before treatment the oxygen saturation was significantly increased, both in patients with proliferative diabetic retinopathy and diabetic maculopathy. The oxygen saturation was unchanged immediately after treatment, but had further increased three months after treatment. Conclusion: Disturbances in retinal oxygen saturation in diabetic patients are complex and may be due to changes in blood flow, oxygen extraction and regional variations in blood flow. Retinal photocoagulation in diabetic retinopathy does not exert its effect by normalizing retinal oxygenation.
The effect of image quality on retinal oximetry
Authors: HARDARSON S
Published: August 2014

Dual wavelength retinal oximetry has proven to be a useful tool for detecting abnormal retinal vessel oxygen saturation in various diseases. Oximetry images are acquired in a similar fashion as regular fundus images. Oximetry calculations use light intensity measured from oximetry images. A ratio is taken of light intensity at and beside the retinal vessels. This means that the overall illumination of the image has less effect on the result. Despite the ratiometric approach, it is clear from experience and studies on cataract patients that image quality does influence oxygen saturation calculations. The challenge is to estimate or quantify image quality in a reliable manner and to control for image quality in all comparisons between healthy groups and patient groups.

Commercial interest
Current and future use of contact lenses
Authors: GRUENERT A
Published: August 2014

This talk gives an overview of different types of contact lenses and their present applications and future perspectives. The advantages and disadvantages of contact lenses will be discussed. Furthermore, we will present our own data regarding correction of infant aphakia and irregular astigmatism following PKP with rigid gaspermeable contact lenses and the use of soft silicone contact lenses as a drug delivery tool.
Ensuring advanced therapy treatments for ocular surface patients
Authors: PONZIN D
Published: August 2014

Ensuring Advanced Therapy treatments for ocular surface patients. Diego Ponzin Recent advances in the fields of eye banking, ophthalmology and regenerative medicine are challenging the traditional activities of eye banks. Autologous serum eye‐drops and amniotic membrane transplantation are being offered as complementary or alternative remedies for ocular surface disorders. While penetrating keratoplasty remains the most common procedure for cornea transplantation, advances in corneal surgery have led to the development of lamellar keratoplasty (LK) as a way to replace only the anterior stroma or the posterior stromal/endothelial layers. Progress in femtosecond lasers and microkeratome‐based techniques in creating precut endothelial donor tissues are at the basis of the success of lamellar procedures, most of which are performed with tissues pre‐cut, pre‐stripped or pre‐bubbled in the eye banks. Autologous cultured limbal stem cells have been used to restore damaged corneal surfaces in hundreds of patients with limbal stem cell deficiency. Strategies aimed at the regeneration of conjunctival epithelium and corneal endothelium through cell therapy and genetic engineering of c
Treatment of neovascular glaucoma by Anti VEGF injections and laser
Authors: MASCHI C
Published: August 2014

Since the 90s, most of the choroidal melanomas have been treated by radiotherapy either with brachytherapy or external beam.Unfortunately, post radiation complications may occur and neovascular glaucoma (GNV) is one the most feared. GNV happens in almost 23% of the cases at 5 years after irradiation, mostly for large melanomas but also for small ones. It complicates radiation retinopathy and toxic tumoral syndrome. As for diabetic retinopathy, laser photocoagulation can prevent the iris neovascularisation and glaucoma. If high pressure and secondary corneal edema are present, several authors have shown that intra‐vitreal or intra cameral injections of anti‐VEGF make iris neovessels regress and help the control of intra ocular pressure. In case of toxic tumoral syndrome, laser is ineffective and enucleation has often been necessary for intolerable pain. There is no recognized treatment for toxic tumoral syndrome: anti VEGF agents have shown good results for some patients but recent publications suggest that corticoid injections and surgical treatments may more efficient. GNV is a frequent and feared complication of ocular irradiation and its management requires several tools including laser and anti VEGF agents.
New insights into uveal melanoma
Authors: KALIRAI H
Published: August 2014

Abstract not provided
Revisiting infectious triggers of chronic intraocular immunity
Authors: BODAGHI B
Published: August 2014

The pathogenesis of intraocular inflammation has been extensively revisited on the basis of different sophisticated experimental models but also new molecular tools applied to ocular fluids or tissues. Experimental ocular inflammation may not be induced in germ‐free animal facilities. Moreover, an infectious agent has been identified in patients presenting with different uveitis entities, previously considered as autoimmune and therefore treated with corticosteroids and aggressive immunosuppressive agents. Molecular mimicry or expression of foreign antigens may trigger an inflammatory reaction, masquerading as an autoimmune uveitis. Fuchs cyclitis, Posner‐Schlossman syndrome, serpiginous choroiditis, nonnecrotizing herpetic retinopathies have been recently characterized, expanding the spectrum of infectious uveitis. Microbiological identification remains the first step prior to initiation of a specific therapy, reducing the risk of relapse and achieving a better visual outcome in challenging situations.
Photodynamic therapy outcomes in myopic CNV
Authors: XIROU T
Published: August 2014

Choroidal Neovascularization (CNV) is a vision threatening complication of pathological myopia. Treatment modalities include thermal laser photocoagulation, surgical management, photodynamic therapy with verteporfin (vPDT) and Vascular endothelial growth factor (VEGF) inhibitors. The Verteporfin in Photodynamic Therapy (VIP) Study Group recommended verteporfin therapy for subfoveal CNV resulting from pathologic myopia based on 2‐year results of this randomized clinical trial, although the primary outcome was not statistically significantly in favor of verteporfin therapy at 2 years follow‐up. Since anti –VEGFs became available they have been used successfully in the treatment of CNV and promising results on their short‐term efficacy have been reported. Furthermore clinical trials comparing anti‐VEGFs with verteporfin therapy demonstrated superior efficacy of anti‐VEGFs. The reason to concern an anti‐VEGFs treatment is arising over their long‐term safety and efficacy. Recent reports on long‐Term inhibitory effects of PDT on myopic CNV arising at the edge of chorioretinal atrophy, in eyes with juxtafoveal neovascular membranes show that PDT remains to play a role in the management of myopic CNV.
Anti VEGF treatment in myopic CNV
Authors: SOUBRANE G
Published: August 2014

Abstract not provided
Russian KPro – UV crosslinked cornea complex implanation: Techniques and clinical results
Authors: MOROZ Z , KOVSHUN E , GOLOVIN A
Published: August 2014

Penetrating keratoprosthetics of thin irregular corneal leukomas requires several preliminary surgical procedures. To reduce the period of visual rehabilitation and number of operations for this group of patients a new type of surgical treatment, combining keratoplasty and keratoprosthetics, was developed in 1996. This technique was named “K‐Pro – cornea” complex transplantation. Methods: At first collagen‐crosslinking procedure was performed for allogeneic preserved donor cornea according to the Zurich protocol with the use of UV‐X‐1000 (IROC Innocross, Switzerland) and 1% riboflavin solution (Dextralink). Further Fedorov‐Zuev keratoprothesis was implanted into the modified cornea. Resulting complex was cut out of the corneal‐scleral rim with 9,0 mm trephination blade. Recipients corneal disk of the same diameter was removed and all procedures, necessary for the lens and anterior chamber, were performed before placing “K‐Pro – cornea” complex into the bed and fixing it with interrupted sutures. All in all 64 patients with vascularized leukomas were treated with the use of this technique. Observation period was up to 10 years. Results: Best spectacle‐corrected visual acuity (BSCVA) rose from pr. l. certae before surgery to 0,01‐1,0 after. Following complications were met in the postoperative period: retroprothesis membrane (99,9%), aseptic necrosis (39,6%), K‐Pro protrusion (11%). Conclusions: Developed technique of transplantation of “K‐Pro – cornea” complex enabled to reduce the number of main and preliminary surgical procedures and the period of patients visual rehabilitation. Key words: K‐Pro, keratoplasty, collagen‐crosslinking.
BAP1 germline mutations in Finnish uveal melanoma patients
Authors: TURUNEN J , MARKKINEN S , WILSKA R , MUONA M , RAIVIO V , TÄLL M , LINDH S , LEHESJOKI AE , KIVELÄ T
Published: August 2014

Purpose To estimate the frequency of germline mutations in the BRCA‐1 associated protein‐1 (BAP1) gene that predisposes to a range of cancer types, including uveal melanoma.

Methods In Finland, all uveal melanoma patients are referred to the Ocular Oncology Service, Helsinki University Central Hospital. We collected clinical data and genomic DNA from 146 patients treated between 2011 and 2013. In addition, we identified 12 families each with two uveal melanoma patients. We were able to collect genomic DNA from 14 members of uveal melanoma families. All 17 exons of the BAP1 gene were sequenced in a total of 160 patients.

Results We found two possible dominant mutations: a sporadic mutation in a highly conserved donor splice site after exon 2 and a frameshift insertion mutation in exon 14 in three patients. The latter mutation was found in a mother and son both diagnosed with uveal melanoma. The third patient, who shared the same mutation, is potentially a distant relative of this family. These mutations were not present in 3,325 Finnish controls from the Sisu project (www.sisuproject.fi).

Conclusion BAP1 germline mutations in Finland contribute to uveal melanoma in only 1.4% of patients (2 mutations, 147 patients; 95% CI 0.2 ‐ 4.8) based on our non‐selected sample, excluding second cases in families. The BAP1 syndrome exists but does not seem to be particularly prevalent in Finland in spite that Northern Europe is a high risk region for this cancer.
NRAS, BRAF and KIT expression/mutational status, miRNA related profile and clinico‐pathologic parameters in pigmented lesions of the conjunctiva
Authors: PARROZZANI R , FRIZZIERO L , PERRINI P , ALESSANDRINI L , BLANDAMURA S , MIDENA E
Published: August 2014

Purpose To investigate NRAS and BRAF mutations and BRAF immunohistochemical expression in a group of melanocytic conjunctival tumors previously tested for KIT status, and to verify the correlation between KIT/BRAF mutational statuses with miRNAs involved in the RAS‐RAF‐MAPK pathway.

Methods 85 non‐consecutive cases of conjunctival melanocytic proliferation whit no remarkable KIT gene mutations were included. BRAF was analyzed for the V600E mutation, whereas NRAS molecular analysis was conduced for exons 1 and 2. Expression profiling of mature miRNAs was performed with the NCode miRNA qRT‐PCR method.

Results The nucleic acids amount was suitable for the analyses in 25 cases (29%). Of these, two melanomas (15%) presented a NRAS point mutation (Q61K) and other two melanomas (15%) and one nevus (10%) resulted V600E BRAF‐mutated. The sensitivity and specificity of VE1 antibody in detecting BRAF V600E mutation were, respectively, 100% and 82%. Expression levels of miR‐15b and miR‐16 detected in BRAF mutated cases were higher than in wild type cases (p=0.05). MiR‐222 was associated with tumor thickness (p=0.01) and tumor stage (p=0.02) whereas miR‐15b was related to tumor stage (p=0.04). Let‐7a, miR‐15a/b and miR‐16 were significantly down‐regulated in melanomas and PAMs compared with nevi.

Conclusion VE1 immunohistochemical staining is an accurate, rapid, and cost‐effective method in selecting cases that should undergo molecular testing. Specific miRNAs have been identified as a potential diagnostic tool to differentiate between benign and malignant melanocytic lesions of the conjunctiva, and as prognostic markers among malignant ones.
Refractive error changes in cortical, nuclear, and posterior subcapsular cataracts
Authors: ELLIOTT D
Published: August 2014

In addition to the well known myopic shift in nuclear cataracts, astigmatic shifts have been reported in cortical cataracts, although posterior subcapsular cataracts typically show no significant refractive error change. These refractive shifts are thought to be due to changes in refractive index that are either diffuse (nuclear) or in isolated sections (cortical). Correction of these refractive changes can be troublesome for the patient as updated spectacles provide magnification changes as well as improved vision and older patients can find it difficult to adapt. Both spherical and astigmatic spectacle magnification changes can have significant effects on the vestibulo‐ocular reflex gain and can lead to potentially unsafe adaptive gait on steps and stairs in older patients. Indeed, fully correcting large refractive changes in older, frail patients has been shown to increase the likelihood of falls and a conservative approach to correcting these refractive changes is recommended.
Is it possible to see through a cataractous lens?
Authors: ARTAL P
Published: August 2014

Cataract increases light scatter in the lens and reduces the contrast in the retinal images severely degrading vision. The current solution is to perform surgery to remove the natural lens that is substituted by an intraocular lens. This is a successful procedure restoring good quality of vision in most patients. However, in many situations it would be incredible advantageous to actually “see” through a cataractous eye. I would address several options based in the use of spatial and temporal photonics techniques for imaging through the turbid media of the cataractous eye. There are two possible applications: a fundus camera to register images of the retina in patients affected by cataracts and opto‐electronics spectacles to restore some vision in cataract patients.
Assessment and novel classification of vitreoretinal interface disorders
Authors: GUALINO V
Published: August 2014

Optical coherence tomography has nowdays become essential investigation device in patient evaluation. It has changed our understanding of vitreomacular interface disorders. Principal pathologies include epiretinal membrane, vitreomacular traction syndrome, macular holes, and less commonly myopic foveoschisis. They characteristics will be detailled. Recently, new international classification of vitreomacular adhesion, traction, and macular hole has been proposed considering anatomical oct considerations. According to panel consensus definitions, this classification may help clinician in predicting therapeutical outcomes.
What's new for the surgical management of vitreoretinal interface disorders?
Authors: POURNARAS JA
Published: August 2014

The main vitreomacular interface disorders include epiretinal membranes, macular holes, vitreomacular traction syndrome, and less commonly myopic foveoschisis. They are characterized by abnormal mechanical and biochemical interactions between the posterior hyaloid and retinal surface. Based on patient visual impairment and on OCT findings, surgical approach may be considered. Depending on pathophyisiological process, ILM peeling may be discussed. Latest developments of surgical technology for the management of vitreomacular interface disorders will be detailled based on most recent data.
Anti‐glaucoma drugs and their additives, testing the influence of excipients on the corneal healing process in the EX‐Vivo Eye Irritation Test (EVEIT) system
Authors: DUTESCU M , PINHEIRO R , PANFIL C , SCHRAGE N
Published: August 2014

Purpose This study examined the impact of anti‐glaucoma medications and their additives on the corneal healing process and corneal toxicity.

Methods BAK‐free PG analogues (Lumigan UD, Monoprost, Taflotan Sine), soft preserved Travatan BAK free, as well as polyquaternium‐1 (0.001%) and Macrogolglycerolhydroxystearate 40 (5%) were tested regarding corneal irritability and effect on corneal healing against HYLO COMOD (1 mg/mL sodium hyaluronate) as positive and 0.02% benzalkonium chloride (BAK) as negative control. Formulas were applied over three days, six times daily on rabbit corneas cultured on an artificial anterior chamber the Ex Vivo Eye Irritation Test (EVEIT) system. Initially, four corneal abrasions (2.5–4.5 mm2) were induced. All defects were monitored by fluorescein stains and photographs.

Results For BAK, the corneal erosion size increased from 14.16 mm² to 88.89 mm². A delay of corneal healing is evident for Monoprost (14.84 mm² to 9.45 mm²) and Macrogolglycerolhydroxystearate 40 (11.58 mm² to 1.56 mm²) in comparison to a complete healing for HYLO COMOD, Lumigan, Taflotan Sine, Travatan and polyquaternium‐1®. For both Monoprost and macrogolglycerolhydroxystearate 40, a bright opaque halo around the remaining erosion area could be noticed. Histology revealed severe alterations of the superficia stroma. Cornea tested without erosions show no corneal toxicity of macrogol 4000.

Conclusion Macrogolglycerolhydroxystearate 40, an additive found in Monoprost® shows corneal toxicity solely in case of corneal erosions. This excipient is a known skin irritant. Therefore, the use of Monoprost® in patients with epithelial defects should be questioned.

Commercial interest
Singapore results for OOKP and superfunctional OOKP implants
Authors: MEHTA J , TAN X , TAN D
Published: August 2014

Purpose: To describe the outcome of OOKP in Singapore and improvements in outcomes Method: Retrospective Case Review and comparison to the literature Results: We have performed 40 cases over the last decade. The median visual acuity postop was 6/18. The most common complications postop were glaucoma, mucosal ulceration and bone resorption. Titanium is a possible replacement for the tooth in OOKP. Functionalisation of the surface with antimicrobial peptide has been shown to reduce infective rates both in vitro and in vivo Conclusion: Our OOKP program has promising results, however, development of an artificial haptic instead of a tooth that can be functionalized may improve outcome even further.
Challenges to globalizing keratoprothesis surgery
Authors: CHODOSH J
Published: August 2014

This presentation will address the current status of keratoprosthesis globalization, world‐wide, with special attention to use in less economically developed countries. The author will review the existing literature, and discuss obstacles and opportunities encountered in implementation of keratoprosthesis surgery in blind, indigent patients, world‐wide. Implantation of keratoprostheses, including the modified osteo‐odonto keratoprosthesis and the Boston keratoprosthesis, is increasing internationally, and in particular, in less economically developed nations with large proportions of indigent, corneal blind patients. Based on the published literature, specific complications, such as device extrusion and infectious endophthalmitis, may be more common in these settings. Increased implantation of keratoprosthesis use in less economically developed countries will bring new challenges. We can expect increased reports of severe complications after keratoprosthesis implantation, particularly in the poorest patients. New designs and approaches are needed before keratoprosthesis implantation can be fully globalized.
Tumour regression pattern according to tumour shape after brachyther‐apy for 330 uveal melanomas
Authors: MAMUNUR R , KIVELÄ T
Published: August 2014

Purpose To describe regression patterns and their relationship with tumour shape of uveal melanoma by thickness and cross‐sectional area.

Methods A retrospective study of 330 consecutive ciliochoroidal melanomas treated with I or Ru plaques in 2000‐2008 and imaged with Innovative Imaging I3‐ultrasound. Tumours were measured with Olympus DP‐Soft from original digital images. The COMS shape groups were partially collapsed: group 1: flat and crescent; group 2: oval and dome; group 3: mushroom; group 4: lobulated; and group 5: other or undetermined. Regression patterns were adapted from Abramson et al. (1990) into 4 main types: D (net decrease), S (stable), I (net increase), and M (for miscellaneous). We further subdivided M into 5 subtypes: DI (D>I), DS (D>S), ID (I>D), SD (S>D), and Z (zigzag; no trend).

Results The regression pattern D was always the most common (31‐63% of tumors by thickness and 33‐72% by cross‐sectional area, for shape groups 1‐4); and the DS pattern was the second most common one (22‐24% and 16‐26%, respectively), except for group 2. Of the DI and Z patterns with later tumor increase, the former was fairly evenly spread across groups (5‐6% and 8‐10%, respectively) whereas the latter was observed mainly in shape groups 1 and 2 (15% and 17‐22%, respectively). The SD and ID patterns later tumor decrease were most common in shape groups 1 and 2, respectively, and most tumors representing the S pattern were shape group 1.

Conclusion Heterogeneity in regression patterns and tumour shapes must be taken into account when using regression as a statistical variable in outcome analysis. Until now, all tumours have been pooled together despite significant differences in regression patterns, except in the study by Abramson et al. (1990).
Reasons for secondary enucleation after eye preventing treatment of uveal melanoma
Authors: SAAKYAN S , AMIRYAN A , MIRONOVA I
Published: August 2014

Purpose To determine the reasons for secondary enucleation after eye preventing treatment of uveal melanoma (UM).

Methods A retrospective analysis of cases of enucleation after previously treated UM. During 2007 65 patients underwent secondary enucleation ‐ 39 (60%) women and 26 (40%) men, mean age before enucleation was 54 years (range, 25‐75). The period of time between UM local treatment and enucleation planning composed 32 ± 26,7 months (range, 2‐108).

Results Tumor thickness prior the enucleation was 4,36±3,5 mm and base diameter ‐ 9,8 ± 5,6 mm, before local therapy‐5,2±2,7 mm and 11,7 ± 4,3 mm, respectively. UM was localized in the choroid (43 patients, 66.1%), ciliochoroidal localization was observed in 12 (18.5%), in the iris ‐ 1 (1.5%), iridociliary ‐ 5 (7,8%), iridociliochoroidal ‐ 4 (6.1%) patients. In most cases, the patients had previously been undergone brachytherapy (45 patients, 69.2%), much less ‐ other methods: combined treatment ‐ 6 (9.2%), laser treatment ‐ 4 (6.2%), local excision ‐ 8 (12.3%), proton irradiation ‐2 (3.1%) patients. The reasons for enucleation were: continued growth ‐ 41 patients (63.1%), secondary incurable hypertension ‐ 23 (35.4%), vitreos body hemorrhage ‐ 13 (20%), extraocular extension ‐ 19 (29.2%), sclera necrosis ‐ 8 (12.3%), the residual tumor ‐ 23 (35.4%). Histologically, spindle cell tumor type was confirmed in 17 patients (26.1%), epitelioid cell UM ‐ 15 (23.1%), mixed cell UM ‐ 19 (29.2%) patients and total tumor necrosis‐ 14 (21.6%).

Conclusion The most frequent causes of enucleation after previously local treatment were tumor continued growth and the presence of incompletely tumor tissue resorption. UM any location and with different cell types can be the cause of secondary enucleation.
Aneurysmal bone cyst: an exceptional entity in the orbit
Authors: LEMAITRE S , ZMUDA M , JACOMET PV , BERGES O , GALATOIRE O
Published: August 2014

Purpose Aneurysmal bone cyst is a rare benign bone neoplasm. The most common affected anatomical sites are vertebral column and long bones. We report two uncommon cases of orbital aneurysmal bone cyst.

Methods Two patients presented with a sudden left proptosis and ocular motility restriction. Case 1 is a 74‐year‐old female whose visual acuity is perception of light in the left eye due to severe papilledema. Imaging studies of the orbit reveal a large cystic frontal bone tumor associated with a subperiosteal hematoma causing eyeball and optic nerve compression. A preoperative arteriography shows a moderate vascular blush. Drainage of the haematoma is performed. A local recurrence with hematoma formation occurred two years after the first surgery. Case 2 is a 45‐year‐old female. Imaging studies reveal a smaller cystic frontal bone tumour associated with a subperiosteal hematoma. The patient achieved full visual recovery after the drainage of the hematoma with no recurrence after treatment.

Results In both cases the aneurysmal bone cyst was revealed by an acute orbital compartment syndrome due to a subperiosteal hemorrhage. A biopsy of the tumor within the frontal bone was performed during surgery and submitted to pathology for examination. Aneurysmal bone cyst secondary to another primary bone lesion was therefore excluded.

Conclusion Aneurysmal bone cysts are tumors of unknown cause which occur more often in the first 2 decades of life. Complete surgical resection is not always possible and the local recurrence rate is 20%.
Effects of punctal occlusion on clinical signs, symptoms, and tear cytokines in patients with dry eye
Authors: BEUERMAN R , TONG LMG , SIMONYI S , HOLLANDER DA , STERN ME
Published: August 2014

Purpose To investigate changes in signs and symptoms, and tear cytokines following punctal plug occlusion.

Methods In this prospective longitudinal study, parasol silicon plugs were inserted bilaterally in the lower punctum. Fluorescein corneal staining, tear film break up time (TBUT), Schirmer’s test, dry eye symptoms, tear cytokine levels, and safety were assessed in the more severe eye over 3 weeks.

Results 23 females (mean age, 51.5 y) and 6 males (mean age, 44.7 y) with moderate dry eye were evaluated. Females had significantly worse global symptoms score (P=0.03) and TBUT (P=0.04) at baseline. At 3 weeks after occlusion, global irritability was significantly reduced (P<0.001). Fluorescein staining decreased in all (P<0.01) but the inferior zone; inferior staining was significantly reduced in patients with staining grade >1 at baseline (P<0.001). Patients with more severe dry eye had significantly greater improvements in TBUT (P=0.045) and Schirmer’s score (P=0.01). At baseline, there was no significant correlation between 16 key cytokines and either TBUT or global irritation symptoms; levels of several cytokines were higher in patients with low Schirmer’s scores (≤8 mm vs >8 mm), notably TNF‐α (P<0.001), IL‐2 (P<0.03) and MIP‐1α (P<0.002). After occlusion, no significant changes in raw tear cytokine levels were observed.

Conclusion Punctal occlusion improved global irritation score and reduced fluorescein staining in all zones except inferior zone overall, but did not generally affect tear cytokine levels in dry eye patients.

Commercial interest
Anti‐evaporative mechanism of wax esters: implications for the function of tear fluid
Authors: PAANANEN RO , RANTAMÄKI AH , HOLOPAINEN J
Published: August 2014

Purpose Our aim was to explain the molecular level basis of the ability of wax ester (WE) films to retard evaporation close to their bulk melting temperature. We studied the surface behavior of behenyl palmitoleate (BP), a WE representing the most abundant meibum WEs.

Methods Isotherm and isochor measurements coupled with imaging by Brewster angle microscopy (BAM) were used to study BP films at the air‐water interface. In addition, evaporation rates through BP films were measured.

Results Close to room temperature, BP formed solid, non‐spreading islands when applied to the air‐water interface. Between 35 and 38 °C, a fluid, effectively spreading monolayer phase coexisted with solid domains of BP. At higher temperatures, BP formed completely fluid films. Mean molecular areas of the fluid and solid films were determined to be approximately 50 Å2 and 18 Å2, respectively. The thickness of a solid BP monolayer was determined to be 42 ± 6 Å by BAM measurements. A fluid BP monolayer only had minimal evaporation resistance, while a solid monolayer retarded evaporation by > 50%.

Conclusion Below 35 °C, BP assumes an extended conformation at the air‐water interface, similar to the bulk crystal structure of WEs. The extended conformation allows tight packing of hydrocarbon chains, which hinders the permeation of water molecules and leads to the evaporation retarding effect. Although the solid islands effectively retard evaporation, they do not spread at low temperatures and water evaporation proceeds through the uncovered areas of the surface. Coexistence of fluid and solid monolayer phases between 35 and 38 °C allows the film to spread, leading to a complete coverage of the interface by the solid phase and effective evaporation retardation.
Morphogenesis of eyelid meibomian gland
Authors: GUEDIRA TARIGHT G , TARIGHT N , SEVESTRE H , COPIN H , BREMOND‐GIGNAC D
Published: August 2014

Purpose Dysfunction of Meibomian gland is the primary cause of dry eye. The purpose of our study is to understand embryogenesis for a better understanding of the pathophysiology of these diseases.

Methods Eyelids were obtained from 22 fetuses formalin fixated of 10‐34 weeks gestational age (GA) with approval of Ethics Committee. These 88 eyelids were processed with sections 5µm thick and analyzed by light microscopy after staining with hematoxylin‐phloxine‐saffron and PAS reaction. For each sample, different morphological criteria were investigated: evaluation of glandular bud, sebaceous gland differentiation, arborization of the gland, opening of excretory duct.

Results Histological analysis revealed that up to 13 weeks of GA, the fetal lid consists of fine vascular structures in a loose mesenchyme, under a very thin epithelium. At 14 weeks of GA, a first process of the excretory duct is individualized as a cell invagination extending from the eyelid margin. Sebaceous cell differentiation is identified at 15 weeks of GA. The excretory canal keeps its maturation to appear as a small cellular cord, unique and full around 16 weeks of GA, glands begin its buds arborization at 19 weeks of GA. This channel gradually widens and expands, appearing always blocked by a plug of squamous cells and keratin cuticle at 22 weeks of GA. The plugging lasts until 34 weeks of GA.

Conclusion Glandular structures involved in tear secretion appear in fetus around fourteen weeks of gestation. The Meibomian glands extend its maturation after birth. Further studies will allow a better understanding of the physiopathology of dry eye.
Impact of Baseline (BL) Visual Acuity (VA) in the VIVID‐DME and VISTA‐DME trials
Authors: MASSIN P , KOROBELNIK J , METZIG C
Published: August 2014

Purpose To evaluate the impact of BL VA on changes in best‐corrected VA (BCVA) and central retinal thickness (CRT) in patients (pts) with diabetic macular edema (DME) in the VIVID‐DME and VISTA‐DME trials.

Methods Pts received intravitreal aflibercept (IVT‐AFL) 2 mg plus sham laser every 4 wks (2q4) or every 8 wks (2q8) (after 5 monthly doses), or laser photocoagulation plus sham IVT treatment. Subgroup analyses assessed the impact of BL BCVA on changes in BCVA and CRT at Week 52 (W52). BL BCVA subgroups were <40, ≥40‐<55, ≥55‐<65, and ≥65 ETDRS letters.

Results VIVID‐DME: Mean BCVA changes from BL to W52 for laser, 2q4, and 2q8, respectively were 2.8, 15.3, and 20.6 (<40); –0.1, 12.0, and 10.2 (≥40‐<55); 2.4, 11.6, and 11.5 (≥55‐<65) and 0.5, 8.6, and 8.1 (≥65). Mean CRT changes (µm) for laser, 2q4, and 2q8 were –29.8, –423.3, and –355.3 (<40); –80.2, –256.2, and –204.9 (≥40‐<55); –111.2, –209.1, and – 215.1 (≥55‐<65); and –34.7, –135.7, and –132.6 (≥65). VISTA‐DME: Mean BCVA changes from BL to W52 for laser, 2q4, and 2q8, respectively were –4.7, 19.9, and 14.5 (<40); 5.2, 14.1, and 9.4 (≥40‐<55); 1.6, 12.8, and 11.7 (≥55‐<65); and –1.8, 9.8, and 9.4 (≥65). Mean CRT changes (µm) for laser, 2q4, and 2q8 were –124.9, –358.7, and –401.9 (<40); –145.9, –209.2, and –209.4 (≥40‐<55); –72.6, –194.6, and –179.5 (≥55‐<65); and –33.7, –131.2, and –128.4 (≥65). IVT‐AFL was generally well tolerated. Incidence of AEs and serious AEs was similar across all groups, with no significant differences in the incidence of APTC events.

Conclusion Outcomes based on BL VA were consistent with those in the overall study population, with greater improvements seen in the IVT‐AFL groups vs laser. There was a trend towards greater improvements in pts with worse vs better BL VA.

Commercial interest
Multicenter OZurdex long term assessment for diabetic macular edema: MOZART 2 study
Authors: MATONTI F , HAJJAR C , PARRAT E , MERITE PY , POMMIER S , MEYER F , PROST‐MAGNIN O , GUIGOU S
Published: August 2014

Purpose To evaluate the long‐term efficacy and safety of intravitreal implant of 0,7mg dexamathasone (ozurdex®) in diabetic macular edema(DME)

Methods This was a retrospective, multicenter, study. 19 patients, with mean age of 67years, followed for at least 8 months (mean 10,7 months) were included in 5 French eye clinics (P1,5 network). The mean systolic blood pressure was 138 mmHg and the mean HbA1c was 7,2%. We monitored 2 systemic parameters: blood pressure and glycemic balance. Best‐corrected visual acuity (BCVA), central retinal thickness by spectralis OCT, intraocular pressure and cataract progression are studied at baseline and then at 1, 6 and 12 Months.

Results Visual acuity significantly increased compared to baseline: at M1, M6 and M12, mean value of 8,7, 9,1 and 5,8 ETDRSletters, respectively. The improvement was ≥ 10 ETDRS letters in 46,7%, 57,9% and 58,3% of patients at M1, M6 and M12, respectively. The average CRT decrease was: 332μm at M1, 259μm at M6 and 296μm at M12. The average interval between two injections was of 5.6months. Ocular hypertension greater than 25 mmHg, managed by topical treatment, was observed in 13,4% of patients. None glaucoma surgery was necessary

Conclusion Ozurdex® has an anatomical and functional effectiveness in the treatment of DME. Outcomes for naive patients and lower CRT suggest that the duration of diabetes mellitus and previous treatments are negative factors for recovery. Side effects are rare and manageable. Ozurdex® seems to be an effective treatment for visual impairment due to DME with a favorable safety profile. Patient follow‐up must be adapted to half‐life of the product with a control before M1 (intraocular pressure) and before M5 (DME recurrence)

Commercial interest
Spectral domain ocular coherence tomography finding post vitrectomy and membrane delamination for proliferative diabetic retinopathy
Authors: DOOLEY I , LAVIERS H , PAPAVASILEIOU E , MCKECHNIE C , ZAMBARAKJI H
Published: August 2014

Purpose To describe the intra‐retinal microstructure using serial spectral domain‐optical coherence tomography (SD‐OCT) following pars plana vitrectomy (PPV) and delamination of fibrovascular membranes for severe proliferative diabetic retinopathy (PDR).

Methods This retrospective, interventional case series included 26 eyes. Outcome measures included LogMAR best‐corrected visual acuity (BCVA) and SD‐OCT findings, including automated central 1‐mm subfield retinal thickness, integrity of photoreceptor inner and outer segments junction (IS/OS) and integrity of external limiting membrane (ELM). Two vitreoretinal‐trained observers graded SD‐OCT images.

Results The eyes were into 3 groups based on post‐op IS/OS integrity (group 1: IS/OS intact; group 2: IS/OS irregular but not completely disrupted; group 3: IS/OS completely disrupted. Mean BCVA improved significantly in group 1 (n = 9) from 1.64 ± 0.71 preoperatively to 0.33 ± 0.21 (student’s t‐test: p = 0.01), in group 2 (n = 8) the BCVA improved from 1.30 ± 0.75 to 0.63 ± 0.30 (student’s t‐test: p = 0.44) and in group 3 (n = 9) the BCVA improved from 1.65 ± 0.53 to 1.53 ± 0.75 (student’s t‐test: p = 0.47). IS/OS integrity and ELM integrity were positively correlated with final BCVA (Pearson’s coefficient: r = 0.61, p < 0.001 and r = 0.68, p < 0.001, respectively).

Conclusion The postoperative intra‐retinal structure at the level of the IS/OS and ELM based on SD‐OCT imaging are positively correlated with final postoperative visual acuity. The IS/OS boundary and ELM continuity appear to be indicators of macular function. These findings may provide prognostic factors for patients with this challenging and blinding disease.
Electrospun nanofibrous scaffolds and corneal tissue engineering
Authors: SALEHI S , BAHNERS T , GUTMANN J , FUCHSLUGER T
Published: August 2014

Generation of a tissue‐engineered cornea composed of biomaterials and cells will reduce dependency on the short supply of donor corneal tissue. In the last decade, the supply of viable donor tissue for corneal transplants is relatively less than the demand for donor corneal tissue. A tissue‐ engineered cornea that incorporates cells with a biocompatible and aligned nanofibrous scaffolds that replicates the stromal extracellular matrix will be an optimal alternative to synthetic replacements and donor tissue. Biodegradable aligned electrospun substitutes of a tissue‐ engineered cornea would also serve as an in‐ vivo and ex‐vivo platform for investigating the mechanisms of corneal diseases, regeneration of corneal cell layers and human cellular responses to new ophthalmic drugs.
Functional properties of nerves regenerating within bioengineered corneas
Authors: GALLAR J
Published: August 2014

Bioengineered substitutes for corneal extracellular matrix based on crosslinked collagen promote nerve regeneration. Electrophysiological recording of corneal nerves at different time points after implant showed no electrical activity inside the implant 1 day‐2 months after surgery. Active mechano‐ and polymodal nerve terminals showing increased spontaneous activity in absence of intended stimulation were recorded inside the implants at 3 months. At 8 months after the implant, active mechano‐ and polymodal nociceptors, and cold thermoreceptors with normal response to natural stimulation were recorded at the implant area. Spontaneous firing of nociceptive units was higher and spontaneous activity of cold thermoreceptive units was slightly lower than in intact eyes. Corneal nerves regenerate into collagen‐based materials, starting to be functional at 3 months post surgery. This is on the basis of the recovery of corneal sensitivity with time in transplanted corneas. The altered activity observed in regenerating corneal nerves is probably due to an increased expression of ion channels induced after nerve lesion, and may explain the presence of abnormal sensations experienced by patients after keratoplasty. (SAF2011‐22500 MINECO)
Hydrogel based keratoprosthesis
Authors: STORSBERG J
Published: August 2014

Keratoprosthesis (KPs) are made from biomaterials which can differ significantly in their physical, chemical and biological properties. There are hydrophobic matteials as well as hydrophilic materials, each material has a limited spectra of use. An complex implantant, such as a KPs needs different surfaces to be integrated stable and for a long term without causing side reactions such as inflammation or rejection. This, there a different pre requirements to be fullfilled in order to create a long tetm stable KP. Articial hydrogels differ in many kinds from the natural hydrogel, the collagen, of the cornea.In this presentation, the fundamental mechanisms of understanding hydrogels and there limits of use as well the modification of artifical hydrogels to adopt the requirements to be be used for long‐term stable KP are discussed. Furthermore it will be shown, how the perfomrkance of a KP can be predicted in vivo and the results can be used to use this expermental results and translate them into clinical application. Different kinds of KPs based an hydgrogel materials, native based and artifical materials, their limits, use andtheir performanance will be presented in order to contribute to the medical advances in corneal science.
Next generation corneal implants as alternative to high risk donor transplantation
Authors: GRIFFITH M , ISLAM M , IAKYMENKO S , PASYECHNIKOVA N , BUZNYK O
Published: August 2014

We have previously shown that recombinant human collagen (RHC)‐based hydrogels fabricated into cell‐free corneal implants are able to induce regeneration of the corneas of 10 patients in a Phase 1 clinical study. At four years post‐operative, all implants were stably integrated without the use of sustained immunosuppression. Corneal tissue and nerves were regenerated. For use in high risk corneal transplantation such as burns and cases of persistent, non‐infectious ulcers, we had reinforced the collagen implants with a second network of synthetic phosphorylcholine to form a hydogel comprising of interpenetratig networks of collagen‐phosphorylcholine (RHC‐MPC). In a pilot study within a hospital setting, in accordance to the Declaration of Helsinki, with ethical permission and informed consent, four patients were grafted with cell‐free RHC‐MPC implants after manual excision of the ulcerated areas. After six to 12 months post‐grafting, all implanted corneas had a stable epithelium and visual acuity improved 1‐2 lines compared to pre‐operative levels. Our pilot study shows RHC‐MPC implants are safe in patients and appeared to withstand the adverse microenvironment within the corneas with severe pathology and high risk of rejection.