bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of SERPING1 and its association with age‐related macular degeneration
Authors: CARTER JG , CHURCHILL AJ
Published: September 2009

Purpose The genetics of age‐related macular degeneration (AMD) pathogenesis is a growing area of interest. In the last year a new potential association locus has been reported; SERPING1, a C1 inhibitor of the compliment pathway. We present our own assessment of the SERPING1 AMD‐risk locus.

Methods Patients with exudative AMD (n=94) and age‐matched controls (n=95) were selected for study. All subjects were genotyped for the SERPING1 polymorphism identified as a new risk locus for AMD; rs2511989, IVS6‐865 g>a. Genotyping was determined by direct sequencing. Statistical analysis was attained using SPSS v15 (SPSS Inc.).

Results Carriage of the G allele was raised in AMD group vs. controls (61.2% vs. 57.6%), but was not statistically significant (p=0.48). No significant associations were seen in genotype carriage between AMD and control groups (e.g. GG genotype, 40.4% vs. 30.4%, p=0.22).

Conclusion No significant associations were seen between SERPING1 and AMD in this study. Only two published analyses have examined this potential association, and these studies produced conflicting results. While it appears SERPING1 mRNA is produced in the eye, the functional effects of the rs2511989 locus have yet to be determined. More work is needed to identify the biological role, if any, SERPING1 plays in the development of AMD.
Toxic effect of vigabatrin on retinal nerve fiber layer
Authors: MIDELFART A , MOSENG L , SAETER M
Published: September 2009

Purpose To investigate whether peripheral and central visual field defects detected among epilepsy patients treated with vigabatrin are associated with reduced peripapillary retinal nerve fiber layer thickness as measured with optic coherence tomography (OCT).

Methods Nine epilepsy patients with vigabatrin‐attributed visual field loss (group 1) and seven patients(age and sex matched) with epilepsy treated with other drugs(control group 2) were regularly examined with automated perimetry up to 60 degrees from fixation point (Humphrey Field Analyser). Peripapillary retinal nerve fiber layer thickness (RNFLT) was quantified by optic coherence tomography (OCT) using Fast RNFLT protocol, Stratus OCT (3.0). Five of the patients in group 1 had peripheral visual field defects, (group 1a), four had a central field defect(group 1b). All patients in control group 2 had normal visual field.

Results Patients with vigabatrin‐attributed visual field loss had attenuated total RNFLT compared to controls (right eye : mean total RNFLT: group 1: 75.6 µm (SD 12.7); group 2: 103.5 µm (SD 9.7), mean difference 27.9 µm (CI 15.9‐39.9;P < 0.001). The nasal and inferior sectors RNFLT were more attenuated in patients with vigabatrin‐attributed visual field loss compared to controls, while no difference was detected in the temporal RNFLT. Both individuals with peripheral and central visual field losses had attenuated mean total RNFLT compared to controls (P = 0.006 and P= 0.002, respectively).

Conclusion Vigabatrin‐attributed visual field defects are associated with reduced RNFLT. Combination of perimetry and OCT can efficiently detect vigabatrin induced retinal nerve fiber damage.
A new technique of anterior TAP enhances the positivity of CMV by PCR in hypertensives anterior uveitis
Authors: KOCH P , LIESNARD C , JUDICE L , MAKHOUL D , WILLERMAIN F , CASPERS L
Published: September 2009

Purpose Anterior uveitis can be severely disabling. Especially, hypertensives anterior uveitis can lead to a decrease in visual acuity, posterior synechiaes, cataract, glaucoma, etc. Diagnosis is frequently complex. Two main aetiologies are retained: non infectious (auto‐immunes) and infectious forms. Amongst the lasts, various aetiologies are possible. Viral anterior uveitis remained difficult to diagnose for a long time. However, since the emergence of the polymerase chain reaction (PCR), the diagnosis is definitely easier. Nevertheless, anterior TAP result is determined by different limitations including the puncture technique, the PCR primers used, and of course the investigated virus.

Methods We hereby propose a new technique of anterior TAP that allowed us to increase our PCR results in CMV anterior uveitis. Two samples were obtained: firstly, a conventional anterior TAP was realised; followed by a rinsing of the anterior chamber with saline solution. A Goldman‐Witmer index for rubeola was performed in the first sample. Both samples were examined for viral PCR (HSV1, 2, VZV, CMV, EBV, Rubeola)

Results We did not found any side effect of the technique used by comparison with normal anterior TAP. Diagnosis was obtained in 20 of the 35 eyes tested. Rubeola diagnosis was obtained in 11/20 eyes, VZV in 1/20, HSV1 in 4/20, and CMV in 4/20. Intriguingly, CMV diagnosis was obtained in three cases only in the second syringe and not in the first

Conclusion We have, to date, detected 4 cases of CMV anterior uveitis in a cohort of 35 patients with anterior uveitis. We did not meet any complication but obtained interesting results concerning CMV diagnosis, using a rinsing of the anterior chamber (second syringe).
Can the corneal endothelium of the pig proliferate in vivo?
Authors: NICHOLLS S , BAILEY M , MITCHARD L , DICK AD
Published: September 2009

Purpose To further validate a recently developed pre‐clinical model of corneal graft rejection in the inbred minipig, we have tested whether the corneal endothelium of the pig has proliferative capacity in situ.

Methods Eyes of pigs were enucleated at slaughter, corneas were removed aseptically and subjected to freezing injury. They were cultured in vitro in OPTI‐MEM with 5% serum, endothelial side up, for up to 8 days. On days 0, 2, 4 or 8, corneas were washed, fixed and subjected to a silver stain to determine endothelial cell migration into the wound, or to Ki67 immuno‐labelling to determine whether endothelial cells had entered the cell cycle. Corneas of transplanted minipigs were monitored post‐rejection to determine whether graft opacity and oedema diminished.

Results By day 8 of in vitro culture there was up to 6‐fold enlargement of endothelial cells on the periphery of the wound, but minimal migration of cells into the wound. Ki67+ endothelial cells were absent at harvest (n=5) and on day 1 of culture (n=3). Scattered isolated and occasional small clumps of Ki67+ cells were evident on day 2 (n=6), with no difference between injured and non‐injured corneas. Such cells were interpreted to be detached epithelial or endothelial cells, because they were not associated with the wound margin, appeared to be above the cells in the endothelial monolayer and had smaller nuclei. Results to date of clinical post‐graft monitoring reveal that corneal opacity and oedema did not improve by 37 days after maximal leukocyte infiltration, i.e. 50 days after onset of clinical rejection.

Conclusion The pig corneal endothelium appears to have minimal capacity to proliferate in vivo. This model would therefore be valuable for testing anti‐rejection therapies.
Results of amniotic membrane transplantation with diathermocoagulation for corneal hydrops secondary to kerotoconus
Authors: MILKA M , WYLEGALA E
Published: September 2009

Purpose To present the outcomes of corneal hydrops diathermocoagulation with amniotic membrane transplantation in eyes with keratoconus.

Methods Studied group consisted of 15 persons, 6 women and 9 men (mean age 31,14± 9,92 years).All patients had extensive and persistent hydrops in the course of keratoconus,present for more than 20 weeks and refractory to traditional therapy.Time of observation ranged from 1.5 to 3.5 years.Central corneal thickness (Visante OCT, Carl Zeiss),corneal protuberance,BSCVA,subjective eye’s discomfort symptoms before and after the surgery,time to hydrops resolution and postoperative complications were assessed.

Results Hydrops was successfully resolved in all eyes.The mean time of hydrops resolution was 15,7±5,78 days.The mean central corneal thickness was 487,24±19,57 µm 4 weeks after surgery and 463,59±17,21 µm 8 weeks after surgery.BSCVA was 0,18±0,28 4 weeks after surgery (before surgery 0,042±0,27).Eye’s discomfort symptoms (pain, tearing) collected 4 weeks after surgery completely receded in 5 patients (33,3%),decreased in 7 patients (46,6%),did not change in 3 patients (20%).Postoperative complications were:loss of contact lenses,suture loosening and corneal vascularization.In 3 patients,penetrating keratoplasty was performed with no episodes of rejection.

Conclusion Diathermocoagulation of hydrops provides faster complete recession of the edema.Amniotic membrane transplantation strongly and sucsesfull reduces inflamation,scarring and vascularization of patient’s cornea.This kind of combined therapy effectively treats persistent hydrops,increases the comfort of patient’s life and stabilize ocular condition before penetrating keratoplasty.
In vivo confocal microscopic evaluation of inflammatory changes in the ocular surface
Authors: LABBE A , BAUDOUIN C
Published: September 2009

Purpose The ocular surface constitutes a complex physiopathological and anatomical entity assuring the barrier between the outside world and the fragile ocular structures. Ophthalmic instruments such as the slit lamp, which magnifies approximately 40 times, cannot provide details of the corneal structures at the cellular level.

Methods In vivo confocal microscopy using the HRT Rostock Cornea module® (HRT / RCM) provides better resolution and therefore outlines distinctively in vivo inflammatory changes occurring in the ocular surface.

Results In vivo confocal microscopy is capable of providing corneal, conjunctival and limbal cellular details in different ocular surface diseases such as dry eye, infectious keratitis, toxic keratitis, corneal intraepithelial neoplasia or vernal keratoconjunctivitis.

Conclusion In correlation with ex vivo impression cytology analysis, in vivo confocal microscopy constitutes an interesting aid in the diagnosis and management of complex ocular surface conditions.
Role of NO in retinal vascular disease
Authors: SCHMETTERER L
Published: September 2009

Purpose Nitric oxide (NO) is a key regulator of vascular tone in all vascular beds including the eye. Hence, inhibition of NO synthase with L‐arginine analogues leads to a reduction of blood flow to all ocular tissues. This enables the investigation of the role of NO in the physiology of blood flow regulation, but also abnormalities of the vascular L‐arginine/NO system in ocular vascular disease.

Methods A variety of studies investigating the role of NO in healthy humans but also in patients with vascular disease is summarized.

Results Inhibition of NO synthase reduces retinal, choroidal and optic nerve head blood. A variety of studies also indicate that NO plays a role in the ocular vasodilator effects of numerous agonists including acetylcholine, bradykinin, carbon dioxide, histamine and insulin. In addition, NO appears to modulate the autoregulatory behavior of ocular vascular beds and is involved in retinal neurovascular coupling. In several ocular diseases such as diabetic retinopathy or open angle glaucoma abnormalities in the NO system can be observed.

Conclusion NO is a major regulator of ocular blood flow in humans. The existence of different NO synthase isoforms makes it, however, difficult to therapeutically intervent via the L‐arginine/NO pathway. Further studies are required to characterize the role of the NO synthase isoforms in the control of ocular blood flow in more detail and to allow for therapeutic interventions in ischemic ocular eye disease via this attractive pathway.
Introduction on the multifaceted roles of nitric oxide in the retina
Authors: OSBORNE NN
Published: September 2009

Multifaceted roles of nitric oxide in the retina. N.N. Osborne. Nuffield Lab of Ophthalmology, University of Oxford, Oxford, United Kingdom Nitric oxide (NO), a free radical gas with a half‐life of a few seconds is implicated in various physiological and pathophysiological roles associated with the retina and its vasculature. Generated by a family of nitric oxide synthetases (NOS), NO has been shown to bind to soluble guanylyl cyclase and to mitochondrial cytochrome c oxidase to activate defined signalling cascades. Different types of NOS exist and can be activated by calcium dependent (NOS1 and NOS3) or independent (NOS2) mechanisms. Generally, NOS1 is located to neurones while NOS2 and NOS3 are in glial and endothelial cells, respectively. NO is involved in communication between different neurones, glial cells and neurones, and in the interactions of endothelial cells with pericytes and neurones. As a consequence, a reduction in the generation of endogenous NO in the healthy retina can result in vasoconstriction; the consequences of such an affect on the retina and alterations in visual processing may alter the photoreceptor transduction mechanism and communication between retinal cells. The binding of NO to mitochondrial cytochrome c oxidase to effectively compete with oxygen has been suggested be involved in a number of processes. NO‐elicited events act as triggers by which mitochondrial signal transduction cascades become involved in the induction of cellular defence mechanisms and adaptive responses. Moreover, the effect of NO on the electron transport chain might lead to mitochondrial dysfunction and pathology. NO clearly has a multifaceted role in the healthy and unhealthy retina.
Nitric oxide and inflammation
Authors: DICK AD
Published: September 2009

Purpose The talk will discuss the dichomatous role of nitric oxide in inflammation as a result of macrophage activation and also its role in controlling T cell responses.

Methods We have used both microglial cell cultures, bone marrow derived macrophages and finally animal models of uveitis to dissect the role of macrophage activation and nitric oxide production in both tissue damage and limiting the extent of the inflammatory response.

Results Macrophages when activated via T cell responses secreting interferon gamma, elicit a TNF‐dependent nitrite response. Inhibiting nitric oxide activity by either suppressing NOS2 or via inhibiting TNF activity results in marked suppression of macrophage activation and reduction in retinal damage observed during experimental autoimmune uveoretinitis (EAU). Macrophages regulate T cell responses, in part via nitric oxide production, but is dependent upon IFN‐gamma and autocrine TNF signalling via TNFReceptor1.

Conclusion TNF and Interferon play essential roles in generating macrophage activation that elaborates in turn nitric oxide production. The nitric oxide, whilst damaging to cell membranes thus contributing to tissue damage during autoimmunity, also assists in regulating T cell responses by down regulating of T cell proliferation within the target tissue.
Relationship between the automated classification of Heidelberg retina tomograph and main indices of short‐wavelength automated perimetry
Authors: CALVO PEREZ P , FERRERAS A , PABLO LE , PAJARIN AB , POLO V
Published: September 2009

Purpose To evaluate the relationship between Glaucoma Probability Score (GPS) provided by the Heidelberg Retina Tomograph (HRT) version 3 and main indices of short‐wavelength automated perimetry (SWAP) in glaucomatous eyes.

Methods A total of 66 glaucoma patients were included in the study. Eyes were classified depending on intraocular pressure and standard automated perimetry (SAP) results. Only one eye per patient was randomly chosen. All participants underwent imaging with the HRT3, and numerical values of GPS were included in the statistical analysis. The Kolmogorov Smirnov test was applied to check data were normally distributed. Pearson’s correlations were calculated between global indices of SWAP (mean deviation [MD] and pattern standard deviation [PSD]) and global GPS values of HRT3.

Results Mean age was 54.75 ± 9.1. MD of SAP was ‐6.2 ± 6.1, and MD of SWAP was ‐7.1 ± 5.8. No significant (p<0.05) correlations were found between GPS values and main indices of SWAP.

Conclusion GPS evaluates glaucomatous damage independently of SWAP results.
Keratinisation of the Meibomian gland as an important factor in Meibomian gland dysfunction (MGD)
Authors: KNOP N , KNOP E
Published: September 2009

Purpose Obstructive Meibomian gland dysfunction (MGD) is a widespread alteration and represents a main reason for evaporative dry eye syndrome. Hyper‐keratinisation of the ductal epithelium in response to various pathological stimuli appears as a typical underlying reason.

Methods Own morphological data together with findings from the literature on Meibomian gland anatomy, physiology and pathology are discussed and used to propose factors and their interactions involved in the pathology of obstructive MGD.

Results A large body of literature indicates that obstruction of the Meibomian gland is an important and widespread contributor to the pathology in MGD. Several findings indicate that keratinisation of the ductal system and orifice is the primary factor in obstruction of the gland. Histological and immunohistological data indicate that the whole ductal epithelium of the normal Meibomian gland shows signs of incipient stages of keratinisation, derived from its embryological ancestry. Hence, the gland preserves a commitment to full keratinisation if a proposed developmental block is removed due to various factors. Keratinisation leads to obstructive stasis of secretum inside the gland and to dilatation of the ductal system as well as to atrophy of the secretory acini. This results not only in decreased availability of Meibomian oil on the lid margin and tear film but also to secondary hypo‐secretion. Increase of commensal bacteria and their products may have a certain role in this process although a real infection does not usually occur.

Conclusion Events in obstructive MGD which share hyper‐keratinisation as a starting point, interact via different pathways that may form vicious circles and eventually lead to evaporative dry eye and gland atrophy.
New insights into Meibomian gland function from gene expression experiments
Authors: SCHIRRA F , SEITZ B
Published: September 2009

Purpose The definitive goal of scientific work is to elucidate connections and understand associated functions. In that respect comprehensive, expression studies using microarrays appear to be supreme instruments. We strived to reveal mechanisms of meibomian gland control by sex steroids.

Methods The gene expression of mouse meibomian gland under the influence of sex steroids is being presented based on own work group data along with results from literature work‐up. GeneSifter Software is used for analysis based on z‐score analysis and visualization of affected genes within known KEGG pathways.

Results Androgens were activating, for instance, pyruvate metabolism, steroid biosynthesis, regulation of autophagy, PPAR signaling pathway, lipid‐related pathways but down‐regulating immune‐related pathways such as B and T cell receptor or Jak‐STAT signaling pathways. Estrogens mainly influenced genes related to lipid metabolism and immune factors.

Conclusion The combination of gene expression microarrays and appropriate analysis software contributed significantly in starting to elucidate information on meibomian gland control.
Reproducibility of optic disc measurements acquired with spectral‐domain optical coherence tomography
Authors: FERRERAS A , CALVO PEREZ P , PAJARIN AB , FOGAGNOLO P , FIGUS M , PABLO LE
Published: September 2009

Purpose To compare the reproducibility of peripapillary retinal nerve fiber layer (RNFL) measurements of 2 optical coherence tomography (OCT) systems.

Methods Fifty‐seven healthy individuals were prospectively selected. Only one eye was randomly chosen. All participants had intraocular pressure less than 21 mmHg and normal standard automated perimetry. Peripapillary RNFL thicknesses were measured with the Cirrus (Carl Zeiss Meditec, Dublin, Ca) and Spectralis (Heidelberg Engineering, Heidelberg, Germany) OCTs. The same operator acquired 3 consecutive series of scans. Left eye data were converted to a right eye format. Intraclass correlation coefficient (ICC), coefficient of variation (COV), and test‐retest variability were calculated for all parameters.

Results Mean age was 58.3±11.3 years. The ICC was higher than 0.92 for all parameters of both OCTs. The COV ranged from 1.8% (average thickness, Spectralis) and 2.5% (average thickness, Cirrus) to 5,8% (nasal inferior segment, Spectralis) and 6.4% (2 o’clock segment, Cirrus). Test‐retest variability was lower than 12.2 µm for Cirrus parameters and lower than 10.9 µm for Spectralis parameters.

Conclusion Both OCT systems had similar reproducibility of peripapillary RNFL measurements.
The role of SERPING1 in age related macular degeneration
Authors: LOTERY AJ , ENNIS S , GIBSON J , CREE A , HARRIS C , MORGAN P
Published: September 2009

Purpose To evaluate the role of SERPING1 by genetic and functional analysis in a cohort of patients with Age related macular degeneration (AMD)

Methods We performed SNP genotyping to assess the role of SERPING1 in AMD. We also analysed other genes known to be associated with AMD and performed a variety of functional analyses. We developed a logistic regression analysis to predict the risk of AMD taking into account genetic and envirnomental risk factors.

Results Our logistic regression analysis accounts for 45 % of the risk of developing AMD. Results implicate the SERPING1 gene as being strongly associated with AMD. There is no convincing evidence for involvement of other genes or intergenic variants in LD with SERPING1 at this locus.

Conclusion In our cohort SERPING1 is a strong genetic risk factor for AMD. Ongoing functional analyses of SERPING1 will be presented at this meeting.
Can diet reduce the genetic risk of AMD?
Authors: KLAVER C
Published: September 2009

Abstract not provided
Impact of medication on ocular blood flow
Authors: SCHMETTERER L
Published: September 2009

Purpose Reduced ocular blood flow appears to play a role in the pathophysiology of glaucoma. Hence, there is considerable interest in drugs that are capable of improving ocular perfusion.

Methods A large numer of clinical trials have been performed investigating the ocular hemodynamic effects of topical and systemic medications. Such trials used a variety of different methods to assess ocular blood flow parameters.

Results When adminsitered systemically most vasodilators decrease systemic blood pressure thereby reducing ocular perfusion pressure (OPP). Only few classes of drugs have been reported to increase ocular blood flow with no or minimal effect on OPP. Among these carbonic anhydrase inhibitors and endothelin receptor anatgonists show the most prononced ocular vasodilator effects. The ocular hemodynamoic effects of topical medications is generally considered small.

Conclusion When drugs are given systemically the effects on OPP have to be considered. In addition, the potentially positive effects on ocular perfusion need to be carefully weighed against the side effects. With topically administered drugs the ocular hemodynamic effects will be generally small, because the drugs reach the posterior pole of the eye in small concentrations only.
Differences in retinal nerve fiber layer meassurements between time domain optical coherence tomograph (OCT) and spectral domain OCT in patients with type 1 diabetes without retinopathy
Authors: IDOIPE M , GARCIA MARTIN E , PINILLA I , GIL‐ARRIBAS L , FUERTES LAZARO M
Published: September 2009

Purpose To compare Retinal Nerve Fiber Layer measurements with Time Domain Optical Coherence Tomograph (OCT) and Spectral Domain OCT and to get a formula to extrapole thickness results from time domain to spectral domain OCT.

Methods Thirty patients with Type 1 diabetes (DM) without retinopathy were prospective and consecutively studied. All underwent imaging of Retinal Nerve Fiber Layer with Stratus OCT (Carl Zeiss Meditec, Inc.)(Fast RNFL thickness scan strategy), Cirrus HD OCT (Carl Zeiss Meditec, Inc.)(optic disc scan stratagy) and Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany)(RNFL scan strategy). RNFL measurements with the 3 devices were compared for the average thickness and for the four quadrants.

Results Mean RNFL average thickness was 100.02 ± 11.28 microns with Stratus OCT, 95.35 ± 8.38 μm with Cirrus OCT and 98.9 ± 8.92 μm using Spectralis OCT. All RNFL measurements show significant differences except nasal quadrant between cirrus and stratus, and temporal quadrant between stratus and spectralis. We found that Stratus average thickness is 4.67 microns larger than Cirrus, and 1.12 microns higher than Spectralis OCT.

Conclusion Retinal Nerve Fiber Layer measurements show differences between Stratus, Cirrus and Spectralis OCT in type 1 DM patients without retinopathy.The 3 device are not directly comparable.
Recent developments of glaucoma in children
Authors: NISCHAL KK
Published: September 2009

Pediatric glaucoma can be a very challenging area of practice. There have been four areas of advances in the last 5‐10 years to help improve the outcomes of treatment. Improved pharmacological agents available have been developed for adult glaucoma some of which have been safely used in children , the exception being brimonidine. A better understanding of the dynamics of aqueous flow and how to harness this have led to a safer filtration methodology with the use of antimetabolites especially Mitomycin C. Tubes or setons have been improved in terms of design with valved tubes eg the Ahmed tube , becoming more popular. Lastly, high frequency ultrasound has led to a better understanding and also better delievery of cyclodiode laser ab externo. Endophotocycloablation has also offered increased efficacy of cyloablation.
Management of neuro‐ophthalmology cases in children
Authors: MILAZZO S
Published: September 2009

Neuro‐ophthalmological conditions in children must be analyzed carefully and some emergencies must be recognized. Clinical and practical cases are illustrated. On that basis the most important aspects of the field of neuro‐ophthalmology are covered succinctly but sufficiently to enable the practitioner to determine an appropriate diagnosis and course of treatment. Rare and unusual diseases are included but those that are especially critical to the patient’s vision or general health and life. Some specific clinical signs and symptoms need to be carefully evaluated as papilledema, papillary abnormalities, ptosis, diplopia or ocular motility abnormalities. Each clinical case deals with a symptom that leads the patient to seek medical attention or a sign that is demonstrated on physical examination. The proper diagnosis is frequently made with the imaging but must be repeated if necessary. Specific techniques in children are described including oculomotor and electrical testing, tomodensitometry and magnetic resonance imaging. Different treatment as medical surgical and neurosurgical are discussed. The physician evaluating neuro‐ophtalmic patients needs to have a broad background of medical information. So the patient’s workup is properly managed and therapeutic orientations can be done.
Recent developments of ocular allergy in children
Authors: CHIAMBARETTA F
Published: September 2009

First we summarize the clinical presentations associated with the classification of ocular allergy, and present the last agreement for treatment. Vernal keratoconjunctivitis is the more severe form affecting children and iatrogenic complications must be avoided. In vernal keratoconjunctivitis, a new grading system is introduced based on clinical signs and symptoms of ocular surface inflammation. Based on this new grading of vernal keratoconjunctivitis, different treatment options are proposed, essentially steroid sparing. Based on new information about the pathogenesis of vernal keratoconjunctivitis, recent and more selective drugs like anti‐chemokine receptor antibodies and leukotriene receptor antagonists and cyclosporine are evaluated.
Concordia pro visu: initiative, purpose and developments
Authors: KIVELÄ T
Published: September 2009

Purpose To present the idea behind the Concordia collaboration, a joint portal for European education in ophthalmology, for those who want to promote European ophthalmology.

Methods Personal remembrances.

Results The field of European ophthalmology has been characterised by proliferation of new societies and congresses ever since its birth, perhaps more than that of is counterparts over the world. In an effort of strengthening Europe as a center for education and research in ophthalmology, the idea was born to bring together major societies that cover all ophthalmologial subspecialties and the whole of Europe, especially in the field of education, so as to increase collaboration and to avoid duplicating efforts and wasting resources. To avoid creating yet another society, a virtual portal, Concordia pro visu, was designed as a common entry site into European education in ophthalmology. This page now replaces the previous home pages of European Board of Ophthalmology (EBO), European Society of Ophthalmology (SOE) and European University Professors in Ophthalmology (EUPO), the Concordia partners, and is closely linked with the EVER home page, its scientific partner. From the virtual portal, the Concordia collaboration has expanded to joint symposia and joint marketing and publicity of European ophthalmology in international and national congresses. The idea behind Concordia ‐ working together for the benefit of vision ‐ has proved viable indeed.

Conclusion Collaboration and convergence are necessary to paragon European ophthalmology in face of natural divergence induced e.g. by increasing subspecialisation.
SOE and its role in Concordia
Authors: SEREGARD S
Published: September 2009

Purpose To review the role of European Society of Ophthalmology (SOE) and its role in the integration of Europan Ophthalmology and the Concordia initiative

Methods Review of records and SOE Congress Programmes combined with interviews of key leaders.

Results The European Society of Ophthalmology currently have 42 member societies (national ophthalmic socities). The SOE is largely confined to geographical Europe but notably also includes three associate member societies of Jordan, Egypt andIisrael. The SOE strongly supports the Concordia initiative. Current work includes the revision of statutes to be able to work more closly with membership societies and subspeciality socities. Also, the biennual Congress has now been transformed to a "platform" for subspeciality, educational and research socities to further integrate European ophthalmology. The SOE strongly believe that for European integration to be lasting it should be designed "bottom‐up" based on common goals.

Conclusion The SOE support the Concordia intiative and further integration of European ophthalmology.
EVER and emphasis of research in teaching
Authors: RIVA CE
Published: September 2009

One of the biggest challenges faced by the current medical professionals is to keep current with clinical information to practice evidence‐based medicine. Conducting research during the clinical training will help future physicians better understand their field and the latest clinical developments. In this context, this presentation will emphasize what can be specifically gained by being exposed to research in a laboratory: a deeper understanding of one's chosen discipline; knowledge of on how research is conducted in one' discipline; be exposed to creative problem solving; learn how to apply concepts to real time situations, present findings at conferences; read more critically the pertinent literature and others.
Current methods of teaching ocular microsurgery
Authors: ZAGORSKI ZF
Published: September 2009

Purpose To present methods of teaching residents ocular surgery and present the future needs.

Methods Reviewing the existing methods from the literature and selected national society programmes, including the own experience.

Results The important features of surgical training programmes are: 1.Selection of trainees, 2.Training methodology, 3.Assessment of results, 4.Disclosure to patients that residents are involved in surgery and informed consent. The training methodology comprises of knowledge of the procedure, supervised training, practical surgical exposure and practice, experience, folow‐up and audit of outcomes. The knowledge comes from reading textbooks, observing videos, 3‐D animation, live surgery and assisting an experienced surgeon. Supervised training should be conducted in skills centers, using practice eyes and/or surgical simulators. Assessment of surgical skills should be a part of continuous assessment of all physicians. Currently no system exists for the routine accurate assessment of surgical skills relating to surgical outcomes in clinical practice. It can be assessed objectively using surgical simulators and by analyzing the database of all surgeries performed by residents and developing an evaluating form of residents surgical skills (OASIS). Patients should be informed that residents may be involved in their surgery in order to avoid possible litigation.

Conclusion 1.Reliable methods of candidate selection and assessment need to be developed and established. 2.Continuous assessment of all surgeons and trainers should be introduced. 3.Skills centers and modern training technologies should be available to all trainees. 4.The above considerations could be included in the development of CME programs concerning the improvement of surgical skills
Anterior segment optical coherence tomography imaging of OculusGenTM implants in trabeculectomy blebs
Authors: BOEY PY , NARAYANASWAMY A , ZHENG CE , TUN TA , HTOON HM , AUNG T
Published: September 2009

Purpose To image blebs of phacotrabeculectomies performed with OculusgenTM implants (ProTop and MediKing Co Ltd, Taiwan) using Anterior Segment Optical Coherence Tomography (ASOCT) and compare these to mitomycin‐C (MMC) augmented phacotrabeculectomies

Methods Thirty three subjects underwent phacotrabeculectomy with OculusGen implant, and 33 controls underwent phacotrabeculectomy with MMC. Blebs were imaged with ASOCT (Carl Zeiss Meditec Inc, Dublin, CA) and assessed for bleb height and area at postoperative month 1, 2 and 3

Results Mean age was similar in both groups (71.1 ±7.2 vs 69.9 ±6.8 years, p=0.67, OculusGen vs MMC). Distribution by gender and diagnosis (primary open vs closed angle glaucoma) was also similar. Mean baseline intraocular pressure (IOP) was comparable(18.4 ±4.7 vs 21.0 ±6.7mmHg, p=0.07, OculusGen vs MMC). There was no difference in mean bleb height at month 1 (1.02 ±0.34 vs 0.87 ±0.34mm, p=0.07, OculusGen vs MMC) or month 2 (0.83 ±0.26 vs 0.86 ±0.24, p=0.34), but mean bleb height at month 3 was lower in the OculusGen group (0.74 ±0.20 vs 1.00 ±0.28, p=0.00). There was no difference in mean bleb area at month 1 (2.91 ±0.54 vs 2.77 ±0.62mm2, p=0.41, OculusGen vs MMC), month 2 (3.19 ±0.54 vs 3.10 ±0.73, p=0.65) or month 3 (2.97 ±0.66 vs 3.23 ±0.59, p=0.16). Mean reduction in IOP at month 3 was greater in the MMC group (2.18 ±4.93 vs 8.00 ±7.60mmHg, p=0.00, OculusGen vs MMC). At month 3, the OculusGen implants were visible in 13/33 (39.4%) subjects.

Conclusion Mean bleb height was lower in the OculusGen compared to MMC group at month 3, but mean bleb area was similar. Mean IOP reduction at month 3 was greater in the MMC group. At 3 months, OculusGen implants had not degraded in a third of eyes.
Is subconjunctival inflammation associated with failure of filtering surgeries?
Authors: VERONESE RODRIGUES ML , FORTES FURTADO JM , GARCIA SOARES E , DEGHAIDE NHS , FELIPE CROSTA D , DONADI EA , SILVA DE PAULA J
Published: September 2009

Purpose To investigate if inflammatory conjunctival reaction associate with antiglaucoma treatment, compromises the results of filtering surgeries.

Methods Histological sections of conjunctival specimes obtaining from 35 eyes, during surgical procedure, were fixed in glass slides, prepared and submitted to immunohistochemical reaction for detection of HLA‐DR marker (presence of brown staining close the cell membrane).

Results The presence of inflammation was detected in specimens from 45.7% of the eyes. The rate of surgical success in these eyes was 87.5% and in the eyes without inflammation was 89.4%. The difference was not significant (p>0.05)

Conclusion Subclinical inflammation, caused by antiglaucoma drugs use, was not associated with failure of filtering surgeries, in the participants of this study.
Low dose verteporfin (1.5mg/m2) in chronic idiopathic central serous chorioretinopathy
Authors: SETROUK E , GARCIA T , DUCASSE A , ARNDT C
Published: September 2009

Purpose In chronic idiopathic central serous chorioretinopathy (ICSC), recent studies indicate that photodynamic therapy (PDT) could be effective in subretinal fluid resorption with reduced dose of verteporfin (3mg/m2) and reduced fluence PDT. However safety and cost issues remain to be addressed. This prospective randomized controlled study has been designed to evaluate the efficacy of a further reduced dose of verteporfin for PDT in chronic ICSC.

Methods Patients with chronic ICSC greater than 3 months of documented duration were included. Visual acuity had to be <20/40. The patients were randomly assigned to 2 treatment groups. They received either 3 mg/m2 or 1,5 mg/m2 verteporfin and reduced fluence PDT. All patients had visual acuity, ocular coherent tomography (OCT), fluorescein and indocyanine green (ICG) angiography on inclusion, follow up was based on ETDRS and OCT at 6 weeks, 3 and 6 months.

Results Ten patients were included, randomized to each treatment group. Mean duration of symptoms prior to PDT was 6 months. After 6 month follow‐up, no significant difference between the 2 groups was observed: the reduction of mean foveal thickness was equivalent in both groups. In all treated eyes, visual acuity remained stable or improved. OCT showed a reduction in serous detachment in 2 eyes of 10 eyes, complete resolution was demonstrated in 8 of 10 eyes. None of the eyes required more than 1 treatment for recurrent serous detachment.

Conclusion Our preliminary data suggest that PDT leads to resolution of serous detachments and visual improvement in patients with chronic ICSC even with a low dose of verteporfin. This will reduce the cost of PDT for each patient. Long term follow‐up should enable to address safety issues.
Intravitreal bevacizumab as primary local treatment for choroidal neovascularization secondary to uveitis
Authors: JULIAN K , FARDEAU C , TERRADA C , FRANCAIS C , LEHOANG P , BODAGHI B
Published: September 2009

Purpose To report short term results of intravitreal (IVT) bevacizumab as primary local treatment for choroidal neovascularization (CNV) secondary to uveitis.

Methods Files of uveitic patients receiving one or more 1.25mg/0,05ml IVT bevacizumab treatment for CNV were reviewed for clinical findings,best‐corrected visual acuity (BCVA), fluorescein angiography (FA) and optical coherence tomography (OCT),concurrent treatments, number and frequency of IVT bevacizumab and treatment related adverse events. Patients previosuly treated with any local therapy were excluded.

Results 15 patients included. Underlying diagnosis:multifocal choroiditis and panuveitis in 7, ampiginous choroiditis in 2, and for 6 remaining, serpiginous choroiditis, sympathetic ophthalmia, Vogt‐Koyanagi‐Harada syndrome, punctuate inner choroidopathy, tuberculous uveitis and idiopathic inflammation respectively. Subfoveal neovascularization in 13 eyes, peripapillary in 2. No active intraocular inflammation by time injections were given. 86,66% had a significant decrease in central foveal thickness by the end of follow‐up (mean pre‐treatment OCT 239,06µm, mean post‐treatment OCT 195,2µm). BCVA improved in 80% of eyes at last follow‐up (mean pre‐treatment BCVA logMar 0,53; mean post‐treatment BCVA logMar 0,29). 12 eyes received more than one IVT bevacizumab, mean number of injections in this group was 4,25(2‐8), with a frequency of 1 injection every 13,68 weeks. No adverse effect related to bevacizumab nor to the injection procedure. Median follow‐up 15,93(2‐25 months).

Conclusion IVT bevacizumab was safe and effective first local treatment for inflammatory CNV, in patients under adequate control of intraocular inflammation.
Effect of nitric oxide synthase inhibition and nerve stimulation frequency on autonomous choroidal vasodilation
Authors: REITSAMER HA , BOGNER B , RUNGE CW , BRANDTNER H , STROHMAIER C , KIEL JW
Published: September 2009

Purpose To investigate the effect of non selective nitric oxide synthase inhibition and the influence of nerve stimulation frequencies on parasympathetic choroidal vasodilation.

Methods Stimulations of parasympathetic nerve fibers of the greater petrosal nerve with 8 and 20 Hz were performed simultaneously with continuous measurements of intraocular pressure (IOP), choroidal blood flow (ChorBF), orbital venous pressure (OVP) and arterial pressure at the eye level (MAP). Stimulations were perfomed at baseline, after non selective inhibition of all nitric oxide synthases with L‐NAME and after systemic administration of atropine in an anesthetized acute rabbit model.

Results Baseline values (mean ± sem, n=6): MAP 66.9 ± 1.8 mmHg, IOP 17.3 ± 0.8 mmHg, ChorBF 467 ± 54 P.U. Facial nerve stimulation with 8 Hz under baseline conditions causes a significant increase of ChorBF 660 ± 80 P.U. and IOP 20.7 ± 1.6 mmHg and a non significant decrease of MAP 61.1 ± 5.0 mmHg. The effects of 20 Hz stimulation did not differ significantly from the 8 Hz results (MAP 68.1 ± 5.0, IOP 22.86 ± 2.0, ChorBF 688 ± 73). Non selective inhibition of the nitric oxide synthases with L‐NAME (20 mg/kg) changed the vasodilatory effects of the two stimulation frequencies. The relative effect of 8 Hz stimulation was significantly smaller than the effect of 20 Hz stimulation. However, baseline blood flow after L‐NAME was lower than under baseline conditions.

Conclusion 8Hz and 20 Hz parasympathetic stimulation had similar effects before but not after non selective NOS inhibition. However, no dose of L‐NAME completely suppressed the effect of parasympathetic stimulation.
Consequences of dietary omega‐3 polyunsaturated fatty acid deficiency on retinal function and intraocular pressure in the rat
Authors: BARDET B , ACAR N , CREUZOT C , BRON AM , BRETILLON L
Published: September 2009

Purpose Omega‐3 polyunsaturated fatty acids (ω3) are key components in nervous structures but their dietary intakes in the overall population are often below nutritional requirements. A chronic deficiency in ω3 is recognized to be associated with functional impairment of the retina. At the opposite, ω3 supplementation is associated with a reduced risk for AMD. The consequences of ω3 deficiency on other eye structures than the retina, such as ciliary bodies, are scarce. The purpose of our study was to compare the response of the retina and ciliary bodies to dietary ω3 deficiency in terms of fatty acid profile and eye functionality.

Methods Two successive generations of Lewis rats (G1 and G2) were obtained under either a standard or ω3‐deficient diet. Intraocular pressure (IOP) was measured by rebound tonometry throughout the experiment. Retinal functionality was assessed by scotopic electroretinography (ERG). Gas chromatography was used to determine the fatty acid profile of the ciliary bodies and retina.

Results A 2‐fold fall in DHA content of the retina was observed in ω3‐deficient G1 animals. This decrease was accentuated in G2 (‐66%) and counterbalanced by an increase in DPAω6 in the retina. The b‐wave amplitude of the ERG was decreased by 50% at 9mcds/m² in ω3‐deficient rats. In ciliary body DHA was reduced by 80% in ω3‐deficient in G1 animals but not in G2. Meanwhile, animals from the ω3‐deficient diet had increased IOP (18 vs 12mmHg, p<0.0001).

Conclusion The crucial role of ω3 in retinal function was confirmed. The most relevant finding from our study is the rise in IOP, the major risk factor for glaucoma, which was observed in animals reared under dietary deficiency in ω3.
Wavefront aberrations variations with accommodation
Authors: GICQUEL JJ
Published: September 2009

Purpose To study the effects of phenylephrine 5% topical administration on accommodative response and wavefront aberrations variation.

Methods The research followed the tenets of the Declaration of Helsinki . 28 eyes from 14 volunteers with spherical equivalent defocus error between –2D and +1D, no eye disease history and between 20 to 25 years of age, underwent wavefront measurements with a Shack–Hartmann wavefront aberrometer which included a movable accommodative target. Wavefront data was acquired while applying 6 different increasing accommodative stimuli, from 0 D to 5 D by steps of 1 D, before and after pupil dilation with Phenylephrine 5%.

Results The dilation using Phenylephrine 5% was found to larger lag errors in the accommodative response of about half of the subjects. The total RMS amount of aberrations above defocus remained stable during accommodation with and without dilation. Spherical aberration was positive in average in the non accommodated eye and changed toward negative values with increasing accommodation (p<0.05). Cylinder axis came closer to 90° as accommodation increased (p<0.05). Although vertical coma did not significantly vary with accommodation, horizontal coma increased significantly with accommodation (p<0.05). These changes in aberrations with increasing accommodation were similar on average in both pupil conditions

Conclusion Phenylephrine 5% modifies the accommodative focus response of a significant proportion of young adult eyes. Wavefront aberrations above defocus undergo similar variations in both natural and dilated pupil conditions. However the total RMS error of aberrations above defocus remains relatively constant when the eye accommodates.
Custom wavefront contact lenses
Authors: LOPEZ‐GIL N
Published: September 2009

Abstract not provided
Is inhibition of VEGF165 sufficient to inhibit scar formation after trabeculectomy?
Authors: VAN BERGEN T , VAN DE VEIRE S , VANDEWALLE E , MOONS L , STALMANS I
Published: September 2009

Purpose We have previously shown that VEGF plays a role in scar formation after glaucoma surgery and that inhibition of all VEGF‐isoforms by bevacizumab is able to reduce scar formation. This study was designed to elucidate the exact role of VEGF165 in scar formation after trabeculectomy. The effect of pegaptanib (Pfizer), which specifically blocks VEGF165, was investigated in vitro and in vivo.

Methods The effect of pegaptanib on Tenon fibroblasts and HUVEC in vitro was determined using a WST‐1 proliferation assay. The effect of the aptamer was also investigated in vivo in a rabbit model for glaucoma surgery by studying angiogenesis, inflammation and collagen deposition.

Results A dose‐dependent reduction of HUVEC proliferation was seen after pegaptanib administration in vitro (P<0.05 with a dose of at least 0,3 mg/ml). A concentration of 2 mg/ml pegaptanib was necessary to inhibit the proliferation of Tenon fibroblasts. The aptamer also significantly reduced blood vessel density 3 days after surgery in a rabbit model of trabeculectomy (P=0.001). There were no significant differences in inflammation and collagen deposition in the treated eyes compared to control.

Conclusion Whereas HUVEC cells were inhibited by pegaptanib in a dose‐dependent way, Tenon fibroblasts were only inhibited at the highest dose. A single administration of pegaptanib at the time of trabeculectomy reduced postoperative angiogenesis, but not inflammation or collagen deposition. Further studies using repeated pegaptanib injections are necessary to investigate whether the lack of effect of pegaptanib on scarring was due to a shorter working time of pegaptanib compared to bevacizumab, or due to the difference in their effect on the various VEGF isoforms.