bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in visual acuity after intravitreal ranibizumab injections in patients with ischemic and non‐ischemic central retinal vein occlusion
Authors: MOUSTAKA L , AMARIOTAKIS G , PARIKAKIS E , KARAGIANNIS D , STRATOS A , BARLA P , MITROPOULOS P
Published: November 2010

Purpose To evaluate changes in visual acuity after intravitreal injection of ranibizumab (0.5 mg) in patients with ischemic and non‐ischemic central retinal vein occlusion (CRVO).

Methods In a retrospective study, 25 consecutive patients (25 eyes) where included, 15 eyes with ischemic CRVO and 10 eyes with non‐ischemic CRVO. Ophthalmic examination included decimal best corrected visual acuity (BCVA) and OCT at presentation and follow‐up visits. Changes on BCVA after treatment, in a period of follow up from 3 to 24 months, were evaluated. SPSS18 was used for statistical analysis.

Results In ischemic CRVO group, patients’ mean age was 70.53 years. BCVA at presentation was 0.025 +/‐ 0.034 (mean +/‐SD), and BCVA at the last follow up was 0.072 +/‐ 0.13. The number of intravitreal injections performed was 3.07 +/‐ 2.12. In non‐ischemic CRVO group patients΄mean age was 69.60 years. BCVA at presentation was 0.33 +/‐ 0.22, and BCVA at the last follow up was 0.60 +/‐ 0.24. The number of intravitreal injections performed was 2.7+/‐ 1.2. In ischemic CRVO group there was no statistically significant improvement in visual acuity (0.046 +/‐ 0.13, paired t‐test p=0,186), whereas in non‐ischemic CRVO group the BCVA after treatment improved significantly (0.27 +/‐ 0.23 paired t‐test p=0,006).

Conclusion Intravitreal ranibizumab injections in patients with CRVO may result in a significant improvement of BCVA in patients with non‐ischemic CRVO. Future prospective studies and a larger number of patients are needed to verify these results.
Angioid streaks beyond pseudoxanthoma elasticum
Authors: DE ZAEYTIJD J , VANAKKER OM , COUCKE PJ , DE PAEPE A , LEROY BP
Published: November 2010

Purpose Angioid streaks (AS) are funduscopic findings, caused by crack‐like dehiscences in elastic portions of Bruch membrane. AS are a manifestation of underlying systemic conditions, such as pseudoxanthoma elasticum (PXE), Paget disease, sickle cell anemia, other blood dyscrasias and, rarely, Ehlers‐Danlos syndrome. By far the commonest association is PXE. Differences and similarities of AS in β‐thalassemia minor, PXE‐like syndrome and Savanna haemoglobinopathy with AS seen in PXE are discussed. The description of AS in Savanna haemoglobinopathy is a first.

Methods Angioid streaks were detected in one patient with β‐thalassemia minor, one with PXE‐like syndrome and one with Savanna haemoglobinopathy. They underwent a full ophthalmic work‐up. Molecular analysis of the ABCC6 gene to exclude PXE was performed by dHPLC (denaturing high‐performance liquid chromatography) and direct sequencing.

Results A 34 year old lady with β‐thalassemia minor had a fundus appearance which was an exact phenocopy of PXE retinopathy, including angioid streaks, peau d’orange and comets. In contrast, a 51 year old lady with PXE‐like syndrome and a 55 year old man with Savanna haemoglobinopathy had a limited number of short, thick, feathered, white streaks around the optic disc.

Conclusion AS differ in aspect depending on the underlying condition. The exact etiology of AS in these systemic conditions has not yet been elucidated. However, it is tempting to suggest that distinct pathogenetic mechanisms underlying very different blood dyscrasias as well as PXE, meet at a final common pathway, leading to breaks in Bruch membrane.
AMD edemas: diagnosis, follow‐up, therapeutic, prognosis, spectral domain OCT, fluorescein, ICG angiographies interests
Authors: GONZALEZ C
Published: November 2010

Purpose To evaluate OCT, Fluorescein, ICG Angiography signs of various types edemas complicating AMD, so their diagnosis, follow‐up, therapeutic , prognosis value

Methods 236 eyes of 203 patients, with retrofoveolar neovascularisation complicating AMD, were treated with a series of 3 IVT Ranibizumab protocol. First and 2 months’ interval follow‐up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein(FA) and infracyanine (ICG) angiography, and Spectral Domain optical coherence tomography OCT ( Spectralis and Cirrus). Exudative and inflammatory reaction were analyzed cut to cut, cut by cut and time to time at OCT. Thickness, edema type, other lesions are always evaluated and compared.

Results Diffuse edema was present in 90% eyes, focal diffuse in 25%, OMC in 60% cases , SRD in 30% , resorption vacuoles in 25% , inflammatory reaction in 95% cases, epiretinal membrane (ERM) was associated in 20% cases. During therapeutic protocol , diffuse edema was 70% reduced in 80%, OMC 75% in 65% cases, and SRD about 80% in 78% cases. OCT alone allow treatment decision in 74% cases, therapeutic protocol determination in 58% cases, prognosis and scalable potential pathology in 45% cases. FA, above all ICG were needed and necessary to determine neovascular activity.

Conclusion Edemas are main signs of neovascular AMD. OCT is the reference exam for their evaluation. OCT efficiency and reliability depend on results’ analytic and comparative analysis. Confrontation of clinic, AF, ICG, OCT data enable diagnosis error coefficient to be down by 42% and prove anyone exam complement each other, particularly FA and ICG.OCT is of course necessary but not sufficient to well determine and evaluate AMD edemas.
Analysis of reading eye movements with Tobii 1750TM eye tracker in AMD patients pre and post op ranibizumab (LucentisTM) treatment
Authors: KÄLLMARK F
Published: November 2010

Purpose In age‐related macular degeneration (AMD), the main deficit is the loss of reading ability. The neovascular form of age‐related macular degeneration (AMD) is the leading cause of irreversible vision loss in the developed world among people over 50 years of age. With ranibizumab (Lucentis) a new efficient drug treatment has now become available. However, despite good outcome of visual acuity, patients often reports affected reading ability. A new technique to study reading performance and eye‐movements has been developed (Tobii eye tracker)and the aim of this project was to evaluate, by using the Tobii eye tracker, if patients with neovascular AMD, treated with Lucentis, gained a better reading ability.

Methods Fourteen patients, with subfoveal neovascular AMD who after clinical examination was assessed for treatment with intravitrial Lucentis, were recruited. All had, before and after treatment, their reading speed, comprehension, fixations, saccadic eye movements (number of saccades per word and saccade amplitude)measured with the Tobii Eye tracker while reading two texts with an equal readability rating.

Results For all eye movement parameters, except the number of regressions per word, there was no statistically significant difference when comparing the results from before and after treatment.There was a statistically significant increase in the number of regressions per word after treatment as well as increased visual acuity.

Conclusion An increased VA will not necessarily equal an increased reading ability.Reading should therefor be tested in order to fully understand a patient’s complaints. The results also show that the Tobii system is suitable for evaluation of reading performance in a clinical setting.
Evaluation of oxidative stress on patients with age‐related macular degeneration
Authors: QUINTYN JC , GALINIER A , CASPAR‐BAUBIL S , PERIQUET B
Published: November 2010

Purpose To investigate the state of stress oxidation on age macular degeneration patients using a biological test named “KRL”.

Methods This prospective study is on age macular degeneration patients with active form. No one had vitamin supplementation. The KRL testevaluates the resistance generated under standardized conditions to lyses of red blood cells treated by free radicals. We used the KRL test to evaluate the global oxidation stress on 21 patients and on 21 control patients. Results are expressed as the time that is required to reach 50% of maximal haemolysis (half‐haemolysis time, in minutes), the lower the results, the lower antioxidant capacity.

Results The both groups are similar for age, sex, BMI, smoking status. The mean of red cell half time is 83,54 (SD:6.99) min for the control group and 77,81 (sd=6.29); min for the patients group. A significant haemolysis is noticed between the control group and the patients group (p<0.001).

Conclusion AREDS study reported the benefit action of antioxidants against age macular degeneration. The protective mechanisms against oxidative RPE damage decrease dramatically in age macular degeneration patients. We demonstrated age macular degeneration patients have a diminution of overall antioxidant defence too. KRL test is an easy test which might use to determine the predisposed patients. The age macular degeneration patients have an increased oxidative stress. Age macular degeneration may be not only a local disease but a systemic disease too.
Recurrence of posterior polymorphous corneal dystrophy is caused by the overgrowth of the original diseased endothelium
Authors: MERJAVA S , MALINOVA E , LISKOVA P , ZEMANOVA Z , MICHALOVA K , JIRSOVA K
Published: November 2010

Purpose To establish the origin of cells causing the recurrence of posterior polymorphous corneal dystrophy (PPCD).

Methods A corneal explant obtained from a male patient suffering from PPCD, who had undergone repeat penetrating keratoplasty (female donor), was examined. Cytokeratin (CK) 19 was detected using indirect immunofluorescence to confirm the presence of abnormal epithelial‐like cells on the endothelial layer. The origin of these CK19‐positive aberrant cells was then determined using fluorescence in situ hybridization of the X and Y chromosomes.

Results Two out of 559 cells evaluated (0.4%) were XX positive and CK19‐negative throughout the pathological explant. 99.6% of the endothelial cells were positive for CK19 and exhibited XY staining. These results indicate that the abnormal endothelial cells, which overgrew the posterior surface of the explant within 3.5 years, originated from the patient (XY) but not from the donor tissue (XX). Extreme aggressivity of the cells could be clinically correlated with the finding of retrocorneal membrane on the iris, anterior synechiae, corectopia and secondary glaucoma.

Conclusion PPCD recurrence is caused by the abnormal proliferation and migration of the patient’s aberrant endothelium, which remained localized at the periphery of the original cornea, into the donor graft. The presence of retrocorneal membrane prior to the surgery should be considered as an indication of potential aggressive behavior of these cells and it should be taken into consideration prior to the indication of corneal grafting.
Effects of amniotic membrane suspension in corneal epithelialization
Authors: CHOI JA , JOO CK
Published: November 2010

Purpose To define the biochemical role of amniotic membrane (AM) suspensions on corneal epithelial wound healing, particularly with regards to epithelial proliferation

Methods ELISAs were used to measure the concentrations of mitogenic growth factors in AM suspensions compared to human serum. Human corneal epithelial cells (HCECs) were cultured in medium with AM suspension (5%, 30%), negative and positive control. Migration assays and immunocytochemical staining of cell adhesion molecules were conducted. The relative expression of MMP9 and adhesion molecules and the proliferation assay using BrdU incorporation and Western blot analysis for PCNA were determined.

Results ELISAs showed that our AM suspension contained large amount of HGF, EGF, KGF, FGF, especially large amount of HGF, followed by EGF compared to human serum. On migration assay, migration rates enhanced as the concentrations of AM increased, with statistical significant changes seen in AM 30% and positive control compared to negative control (P<0.05). RT‐PCR and Western blot revealed that the expression of MMP9 was upregulated by AM, and the expressions of E‐cadherin and fibronectin were downregulated by AM. Upon immunocytochemistry, large quantities of E‐cadherin were detected near the wound edges in the AM‐treated groups. On the proliferation assay, the BrdU positive cell counts / total cell counts (labeling index) were augmented by AM to a statistically significant degree. On Western blot analysis, the expression of PCNA was increased gradually with increasing AM concentration.

Conclusion The suspension form of AM contains large amount of growth factors and maintains its beneficial effect on corneal epithelial wound healing in vitro, especially in corneal epithelial migration and proliferation.
Toxic keratopathy associated with abuse of topical anesthesic
Authors: EGEA ESTOPINAN C , PRIETO CALVO E , GUERRI MONCLUS N , FERNANDEZ PEREZ S , BRITO SUAREZ C , SANCHEZ PEREZ A , IDOIPE CORTA M
Published: November 2010

Purpose OBJETIVE: To describe the clinical course and treatment of toxic keratopathy associated with abuse of tocical anethetic

Methods CASE REPORT: A 46‐year old male patient with blurred vision and irritated both eyes was referred to the ophthalmology emergency. On initial examination, the right and left best‐corrected visual acuity (BCVA) was 0,05 and 0,1 respectively.Under slit‐lamp microscope, central corneal epithelial defect with underlying infiltrative and opaque stroma was observed in both eyes. Three weeks before, the patient used oxybuprocaine eye drops frequently

Results RESULTS: We prescribed topical antibiotics and therapeutic contact lens but the patient did not used these treatment. And finally we practised a penetrating keratoplasty in both eyes

Conclusion CONCLUSIONS: Toxic keratopathy may result form abuse of topically administered anesthetics. The topical anesthetics must be used very cautiously because these can produced important damages
Meibomian glands diagnostic expressibility: a new diagnostic medical device
Authors: CELLINI M , CELLINI L , VERSURA P , CAMPOS EC
Published: November 2010

Purpose To assess the expressibility of the meibomian gland we proposed a new diagnostic tool. We evaluated the use of the instrument by assessing the time of the meibomian gland expressibility and the intraocular pressure change in two groups of healthy patients.

Methods We selected two groups of patients divided according to age. The first group consisted of 45 subjects aged between 20 and 30 years (mean 28 ±4.5 yrs) and a second group (group B) of 45 subjects aged between 40 and 50 years (mean 46±3.8 yrs). Meibomian gland evaluations were performed using a standardized technique with an evolved new diagnostic instrument patented in Italy. The instrument has a rectangular contact surface area of 40.57 mm2. The head surface is covered with a plastic film that is changed at each examination. The instrument exerts a constant pressure of 1.2 gr/mm2 under piezoelectric control. We evaluated the time to onset of fluid at the orifices of the meibomian glands and changes of intraocular pressure (IOP) after compression of the lower eyelid with applanation tonometry.

Results In the group A and in group B the time to onset the fluid was 3.69±1.22 vs. 6.62±1.39 sec. (p<0.001). The IOP before and after compression of the eyelid was 14±1.13 vs. 23.4±2.0 mm/Hg (p<0.001). The mean number of meibomian gland secretion in each third of the lower eyelid were significantly different (p<0.001). Temporal: 1.29±0.13, central: 2.72±0.11, nasal: 3.51±0.14.

Conclusion Our custom diagnostic meibomian gland expression instrument that is an evolution of other proposed devices has proved effective in evaluating the expressibility of the meibomian gland with a small increase of the intraocular pressure.
Mebomian gland dysfunction and hypercholesterolemia
Authors: PINNA A , ZINELLU A , GIACOBONI M , BLASETTI F , CARTA F
Published: November 2010

Purpose To investigate a possible correlation between Mebomian gland dysfunction (MGD) and hypercholesterolemia (total cholesterol ≥200 mg/dL).

Methods Fasting blood cholesterol was measured in 35 MGD patients (mean age 47±14 years) with no history of hypercholesterolemia and in 35 control subjects (mean age 44±12 years) without MGD and no history of hypercholesterolemia, all accrued in September‐November 2009. Subjects aged <18 years or >65 years were excluded from this study

Results Hypercholesterolemia was found in 19 (54.3%) cases and 4 (11.4%) controls. Mean cholesterol was 211±38 mg/dL in cases and 160±33 mg/dL in controls. Both differences were statistically significant (P<0.001).

Conclusion Results suggest that middle‐aged MGD patients with no history of hypercholesterolemia may have higher blood cholesterol levels than controls of similar age without MGD. If these results are confirmed by larger studies, MGD may become a marker of previously unknown hypercholesterolemia and ophthalmologists may increase their role in the early diagnosis of an important risk factor for coronary heart disease and other atherosclerotic diseases.
Cell proliferation studies of novel biomaterials to be used as synthetic keratoprosthesis skirts
Authors: TAN A , MEHTA J
Published: November 2010

Purpose In vitro studies of human cornea stroma keratocyte proliferation and cytokine secretion on the various kerato‐prosthesis skirt material. In the development of an artificial cornea, an appropriate skirt material which encourages keratocytes proliferation is important to help wound healing and integration. Epidermal growth factor (EGF), insulin growth factor (IGF‐1) and hepatocyte growth factor (HGF) stimulate corneal keratocytes proliferation. IGF‐1 and EGF have an anti‐apoptotic effect of keratocytes. Conclusion:

Methods Three materials were studied: Hydroxyappatite (HA), titanium substate (TiO2) and aluminium oxide substrate (Al2O3). Corneal stromal were seeded on top of these materials for EDU image assay and real time PCR analysing. Conditioned cell culture medium was collected for cytokine array.

Results Cytokine array showed the levels of EGF, IGF‐1 and HGF were no statistical significance among the HA, TiO2 and Al2O3. RT‐PCR, showed that the expression level of EGF, IGF‐1 and HGF were highest with TiO2 substrates and lowest with HA substrates with statistical significance. Edu assay showed a comparable number of proliferating cells on the HA and TiO2 with significantly more cells on the Al2O3 dics.

Conclusion TiO2 is a comparable material to HA at promoting corneal keratocytes proliferation, hence is a possible alternative material to generate synthetic keratoprosthetic skirts.
23‐gauge versus 20‐gauge vitrectomy for diabetic vitreous hemorrhage
Authors: IVASTINOVIC D , VELIKAY‐PAREL M , HAAS A , EL‐SHABRAWI Y , NEUWIRTH R , ARDJOMAND N , WEDRICH A
Published: November 2010

Purpose To compare 23‐gauge and 20‐gauge vitrectomy for diabetic vitreous hemorrhage (VH) regarding postoperative VH (PVH), re‐operation rates, visual acuity (VA) and safety profiles.

Methods This was a retrospective chart review of diabetic patients who underwent 20‐gauge or 23‐gauge vitrectomy for persistent VH at our unit between January 2004 and June 2009. Exclusion criteria were silicone oil or gas tamponade, prior vitrectomies, perioperative injection of anti‐vascular endothelial growth factor and a follow up less than 12 months. PVH was classified as early and late PVH occurring within and >2 months after surgery. Samples were compared with independent t test and Mann‐Whitney‐U test depending on distribution. Categorical data were compared with Fisher exact test.

Results Hundred and six eyes met our inclusion criteria. Sixty one eyes underwent 20‐gauge and forty six 23‐gauge vitrectomy. Early PVH was observed in 27.8% and 20% in the 20‐gauge and 23‐gauge group, respectively (p=0.44). Late PVH was noted in 24.6% and 22.2% using 20‐gauge and 23‐gauge system (0.83). Re‐operation rates due to early and late PVH were similar among the groups. Final VA averaged 0.71 and 0.68 logMAR in the 20‐gauge and 23‐gauge group (p=0.81). Postoperative hypotony was observed in 8.9% of cases in the 23‐gauge group. Rhegmatogeneous retinal detachment occurred in one eye in each group.

Conclusion 23‐gauge vitrectomy is a viable method for diabetic VH providing similar anatomical and functional outcome like after conventional 20‐gauge vitrectomy. The safety profile is acceptable since postoperative hypotony resolved in all cases without intervention.
The MIVI‐007 Trial – phase III evaluation of single intravitreous injection of microplasmin or placebo for treatment of focal vitreomacular adhesion
Authors: VAN CALSTER J , ON BEHALF OF THE MIVI‐007 INVESTIGATORS
Published: November 2010

Purpose Focal vitreomacular adhesion (fVMA) can result in vitreomacular traction syndrome and macular hole, and is associated with more severe disease in other conditions such as diabetic retinopathy and AMD. The MIVI‐007 trial was a Phase III study to evaluate single injection microplasmin (generic name ocriplasmin) for treatment of fVMA.

Methods A Phase III, randomized, placebo controlled, double‐masked clinical trial was designed to investigate intravitreal microplasmin 125 µg in eyes with symptomatic focal VMA. Exclusion criteria included proliferative retinopathy, MH diameter >400um, and prior RD/macular laser/vitrectomy. Subjects were randomized to microplasmin or placebo intravitreous injection (allocation ratio 3:1). Primary endpoint was nonsurgical resolution of fVMA at day 28, determined by Central Reading Centre OCT evaluation. Secondary endpoints included total PVD at day 28, nonsurgical MH closure, nonsurgical VA improvement, and VFQ‐25. Eyes were followed for 6 months.

Results 326 eyes were treated. Mean age at baseline was 72 yo, with 68% Female. In addition to focal VMA, 20% had full‐thickness MH (mean MH diameter 300um). The mean baseline BCVA was 64 letters. Endpoint results and 6 month safety results will be presented.

Conclusion In Phase II clinical trials, microplasmin has been associated with nonsurgical resolution of focal VMA and MH closure. This Phase III program is the largest trial ever conducted to evaluate a pharmacologic intervention for treatment of focal vitreomacular adhesion.
Vitrectomy for epiretinal membrane in eyes with a preoperative visual acuity ≥ 20/40 (0.3 LogMAR)
Authors: BERROD JP , SAYEN A , HUBERT I
Published: November 2010

Purpose To evaluate the functional and anatomical outcomes of vitrectomy for epiretinal membrane (ERM) in eyes with a preoperative (acuity (VA) ≥ 0,3 LogMAR (20/40) .

Methods Sixty‐seven of sixty‐six consecutive patients that undergone surgery for an idiopathic ERM were studied retrospectively. A combined surgery was performed on phakic eyes (n=45). The other eyes were all pseudophakic (n=22). All patients underwent ERM and internal limiting membrane removal by using 20 (n=19) or 23‐gauge (n=48) vitrectomy. The main studied criteria were preoperative and postoperative best corrected visual acuity (BCVA), preoperative and postoperative central macular thickness (CMT) and integrity of junction between inner and outer segments of photoreceptors (IS/OS junction) evaluated with OCT.

Results The mean preoperative VA was 0.28 logMAR (range 0.15 logMAR to 0.3 logMAR). The mean VA improved to 0.19 logMAR at a mean of 27 months following surgery (p<0.0001). 71,6 % patients recovered visual acuity ≥ 0,1 logMAR (20/25). The mean preoperative CMT was 367 μm and the mean postoperative CMT was 304 μm . No correlation between postoperative BCVA and postoperative central macular thickness was noted (p=0.46). The preoperative integrity of the IS/OS line correlated with postoperative BCVA (p=0.004) but not with BCVA improvement (p=0.177).

Conclusion Vitrectomy for epiretinal membrane is a safe and effective procedure that provides VA ≥ 0,1 LogMAR in 71,6% eyes with relatively good preoperative VA ( ≥ 0,3 LogMAR).Besides the baseline VA, the integrity of the IS/OS line can be used to predict excellent functional outcomes after surgery.
New method of lasercoagulation in treatment of retinoschisis
Authors: BAGDASAROVA T
Published: November 2010

Purpose Retinoschisis is a minimum retinal splitting of retina which is seen in ophthalmoscopy.

Methods Laser treatment was conducted on 60 eyes. 30 eyes were with 2nd stage of process, 20 with 3rd stage. Diode laser “Milon Lachta” was used. Radiation parameters were as follows: wave‐length – 0,83 mkm, radiation power 350‐850 mWt, exposition 0.2 s, diameter of spot pointing was 150‐200 mkm. In 5 days we carried out our method of staged advancing laser coagulation beginning from retinal macular zone along all cyst area and along vessels. As intraretinal fluid was diminishing we moved to periphery till full blockage of limited area of retinoschisis or complete intraretinal fluid resorption. As criteria of positive laser action we considered cyst flattening and visible in ophthalmoscopy intraretinal fluid resorption with the appearance of distinct border between retina without fluid and retinoschisis with coagulant pigmentation.

Results Success is connected with technical biologic peculiarities of diode laser action on retinaand choroid and with method of laser coagulation application.

Conclusion Success is connected with technical biologic peculiarities of diode laser action on retinaand choroid and with method of laser coagulation application.
Natural evolution of idiopathic lamellar macular holes
Authors: GARCIA FERNANDEZ M , CASTRO J , SLIESORAITYTE I , GONZALEZ CASTANO C
Published: November 2010

Purpose To analize the natural course of patients with idiopathic lamellar macular hole (LMH), based on their optical coherence tomography (OCT) configuration and visual prognosis.

Methods A retrospective observational case series study was performed, in 19 eyes (17 patients) over a period of 5 years. A number of factors were analized, including: best visual corrected acuity (BVCA), refractive error, lens status, presence of epirretinal membranes (ERM) and other alterations identified by OCT, and the size of the lamellar defects (diameter, residual foveal thickness, perifoveal thickness).

Results Most of them were unilateral defects, and were found in elderly women. More than 50% were found to be myopic patients and 90% of them had cataracts. Fifty‐ per cent of all lamellar defects had an associated ERM. Other alterations like vitreomacular traction syndrome and posterior vitreous detachment were less frequent. No significant differences were found regarding size of the lamellar defects, nor BCVA during the follow‐up period (p>0.05), except those who underwent cataract surgery, who experienced a significant increase of their BCVA (p<0.05), and one patient who developed a full‐thickness macular hole. The presence of ERM was significantly correlated with greater residual foveal thickness (p<0.05).

Conclusion According to our study, most of LMH do not progress, and they do not contribute to a diminished BCVA. Frequently, LMH are associated with cataracts and ERM. Hence, a reduction in BCVA in these patients can be related to the mentioned concomitant eye diseases, and should be taken into account before surgery.
Histology of vitreous floaters, after removal by pars plana vitrectomy
Authors: VAN GINDERDEUREN R , STALMANS P , VAN CALSTER J
Published: November 2010

Purpose To investigate the histopathology of vitreous floaters.

Methods Ten consecutive (10) patients with vitreous floaters creating visual disturbance and affecting their daily life underwent 23G vitrectomy. First, a core vitrectomy was performed. If not already present, a posterior vitreous detachment was created. Next, a shaving of the vitreous base was done. All the aspirated fluid was collected in the vitrectomy cassette and fixed in Cytorich Red. After fixation, the fluid was centrifugated and the pellet was embedded in paraffin and sectioned and stained routinely for microscopy with H&E and PAS. Immunostainings for lymphocytes (CD3, CD20), macrophages (CD68) and retinal (nse) and glial tissue (gfap) were performed.

Results In all cases sufficient material was collected for histology. The vitreous core consisted of fine fibrillar tissue in which floaters were recognised as a small fragment of glial tissue with cells with fibrillar cytoplasm, staining specifically for gfap. In most cases macrophages were randomly and diffuse present.

Conclusion Vitreous floaters seem to originate from glial origin
A numerical model of the eye for simulation of corneal surgery and corneal biomechanical properties
Authors: DEL BUEY MA , LANCHARES E , CRISTOBAL BESCOS JA , CALVO B , ASCASO FJ , PALOMINO C , LAVILLA L , DOBLARE M
Published: November 2010

Purpose To obtain a numerical model of the ocular globe in order to simulate different corneal surgery techniques and to measure changes in geometry and mechanical properties of the cornea.

Methods A biomechanical Finite Element model was created with the geometry of the anterior half of the ocular globe. Each part (cornea, limbus and sclera) has different material properties, and behaviours as hyperelastic anisotropic material. The reference configuration is achieved with initial stresses and then applied the mean physiological intraocular pressure (15 mmHg) during the whole simulation process. In order to validate the model, a serial of arcuate relaxing incisions (o.z. 6 mm) and limbal ones (10 mm) were simulated. One of the principal measurable biomechanical properties of the cornea, which is the Corneal Hysteresis, was also simulated with this model.

Results Regarding the simulation of arcuates and limbal incisions with the model, the obtained results were similar to those stated in different nomograms and surgical in vivo outcomes. The measure of Corneal Hysteresis was reproduced with this model obtaining similar results to measures in vivo performed with the Ocular Response Analyzer (REICHERT). The model can also be useful to simulate other surgical techniques like intracorneal rings, LASIK or keratoplastia. This model is a first approach to a future one which can customize by reproducing a patient specific corneal geometry and material properties.

Conclusion The model was useful to reproduce several surgical techniques and properties measures and offers a lot of possibilities for predicting effects of future surgery techniques.
Oxygen and treatment of ocular ischemic diseases
Authors: STEFANSSON E
Published: November 2010

Purpose In ischemia, reduced blood flow results in hypoxia. Hypoxic cells make hypoxia inducible factor (HIF), which controls many of the adaptive responses of tissue to ischemia. This includes vasodilatation, production of vascular endothelial factor (VEGF) with neovascularization and leakage, and finally apoptosis and tissue atrophy.

Methods If hypoxia is improved this will reduce the production of VEGF and thereby reduce new vessel formation on one hand and vascular leakage and edeam formation on the other. Several methods are available to improve retinal hypoxia, including laser treatment, vitrectomy, vasodilatory drugs such as carbonic anhydrase inhibitors in addition to breathing oxygen. These treatment methods have been studied by many research groups with invasive polarographic electrodes and optical probes as well as noninvasive oxymetry in human patients and animal subjects.

Results We will review experimental and clinical studies, which confirm that oxygen tension of the retina is increased following 1. retinal laser treatment 2. Vitrectomy 3. carbonic anhydrase inhibitors

Conclusion Oxygen is the natural control of VEGF. VEGF levels in the retina and other ocular tissues are affected by oxygen levels and ischeimc diseases are currently treated with methods that affect oxygen and consequently VEGF. The addition of anti VEGF drugs to oxygen directed treatment such as laser and vitrectomy further influences the oxygen‐HIF‐VEGF‐neovascularization/edema axis in ischemic retinopathies.
Regulation of retinal tissue oxygenation
Authors: POURNARAS CJ
Published: November 2010

Purpose To evaluate the changes in the retinal oxygen partial pressure (PO2) following physiological stimuli.

Methods Evaluation of either the preretinal and intraretina partial pressure of oxygen (PO2) distribution, using oxygen sensitive microelectrodes, in various animal models. Measurements were obtained during changes of the perfusion pressure, systemic hyperoxia, hypoxia, hypercapnia, carbogen breathing and following carbonic anydrase inhibitors use.

Results The oxygen tension (PO2) in the inner half of the retina remains largely unaffected by moderate changes in perfusion pressure. The increase of the systemic PaO2 through breathing of 100% O2 (hyperoxia) induces endothelin (ET) mediated marked vasoconstriction of the inner retinal arterioles in both anesthetized animals and normal human subjects. The regulatory vasoconstriction maintains the PO2 in retinal tissue constant. A decrease in PaO2 (hypoxia) induces a vasodilation of the retinal arterioles through endothelium‐derived NO release. As a result, trans‐retinal PO2 profiles made during steps of systemic hypoxia have shown that the values measured in the inner retina up to half of its thickness, remain rather stable. By contrast, the PO2 values, measured close to the choroid and in the outer retina, decrease in a linear manner with the decrease of the PaO2. An increase in the PaCO2 (hypercapnia) of arteriolar blood, produces an increase in retinal blood flow and retinal tissue PO2. Intravenous injection of acetazolamide (carbonic anhydrase inhibitor) produces an increase in preretinal PO2 due to dilation of the retinal vessels

Conclusion Thanks to the autoregulatory capability of the retinal circulation, the oxygen tension (PO2) in the inner half of the retina, remains largely unaffected during physiological stimuli.
Non‐invasive measurement of retinal oxygenation: principles and expectations
Authors: HAMMER M , SCHWEITZER D
Published: November 2010

Purpose To determine oxygen saturation (SO2) of blood inside retinal vessels which is an essential measure for the estimation of oxygen supply to the tissue as well as its oxygen consumption.

Methods Two‐, four‐, and multiple ‐ wavelength approaches to the non‐invasive measurement of SO2 will be discussed. The dual wavelength technique, imaging the fundus at 548 and 610 nm, showed to be most appropriate for clinical routine investigations. The SO2 of the hemoglobin in retinal arterioles and venules is calculated from the ratio of the optical densities of the vessels at both wavelengths.

Results From a healthy control population, mean arterial and venous SO2 were measured to be 98±10.1% and 65±11.7% with reproducibility of 2.52% and 3.25% respectively. In a cohort of 41 patients (mean age: 65±12.3 years) with diabetic retinopathy (DR), we found an increase of the venous SO2 with the severity of DR: Mild non‐proliferative DR 69±7%, moderate non‐proliferative DR 70±5%, severe non‐proliferative DR, 75±5%, and proliferative DR 75±8%. Measurements of SO2 in accordance with vessel diameters revealed a correlation of the venous SO2 with arterial as well as venous diameters in 159 diabetic patients (mean age: 55.8±13.9 years) with no or non – proliferative DR. Increased venous SO2 is an indicator of insufficient oxygen supply to the retinal tissue. The correlation of the vessel diameters with venous SO2 may point to compensatory mechanisms of retinal blood flow regulation.

Conclusion Accurate retinal vessel oximetry is possible by non – invasive optical methods. Combined with measurements characterising the retinal blood flow, it is a powerful tool for the estimation of retinal oxygen supply and consumption.

Commercial interest
Endothelial involvement indicates disease activity in Herpes simplex virus keratitis
Authors: HILLENAAR T , REMEIJER L
Published: November 2010

Purpose Corneal endotheliitis is a potentially sight‐threatening clinical manifestation of herpes simplex virus (HSV) keratitis. Early detection and consequent treatment may prevent development of endothelial decompensation. The goal of this previously published study was to describe the morphological features, frequency, and clinical consequences of endothelial involvement in HSV keratitis as seen by in vivo confocal microscopy (IVCM).

Methods We examined both eyes of 250 patients with HSV keratitis by slit‐lamp and IVCM. All examinations were assessed for endothelial deviations characteristic of endotheliitis. To determine the specificity, we reviewed our IVCM database for morphologically comparable alterations. This database included 200 healthy volunteers and 1400 patients with various corneal pathologies. The endothelial cell density (ECD) change between the first and last visits of patients with HSV keratitis was evaluated.

Results Endotheliitis‐specific deviations were detected in 107 of 250 patients with HSV keratitis (43%). Pseudoguttata, enlarged intercellular gaps, infiltration of inflammatory cells into the endothelial layer, loss of defined cell boundaries, spot‐like holes, and endothelial denudation disappeared within 3 weeks with appropriate antiviral and anti‐inflammatory treatment. Alterations were non‐specific for HSV keratitis. Similar alterations were detected in adenoviral, fungal, bacterial, and acanthamoeba keratitis. The HSV affected eyes with endothelial involvement showed a mean ECD decrease of 10.3% per year.

Conclusion Endothelial involvement indicates inflammatory activity in HSV keratitis and is associated with irreversible endothelial cell loss. IVCM allows early detection and follow up of endotheliitis‐specific alterations.
The presence and suggested role of mesothelial proteins in the human corneal endothelium
Authors: JIRSOVA K , MERJAVA S
Published: November 2010

Purpose To determine whether proteins that are characteristic of the human mesothelial cell phenotype are expressed in human corneal endothelium.

Methods Cadaverous human corneo‐scleral discs and pathological corneal specimens (melted and rejected corneas) were used. The detection of mesothelin, proteinase inhibitor‐9 (PI‐9), calretinin and HBME‐1 protein (a membrane protein of mesothelial cells) was performed on cryosections and corneal endothelial imprints using indirect immunofluorescent or enzymatic immuncytochemistry. The staining intensity was assessed using fluorescent or light microscopy, and the percentage of positive cells was calculated. Semi‐quantitative RT PCR of PI‐9, mesothelin and calretinin was performed using mRNA isolated from endothelial imprints.

Results A strong signal for mesothelin was present in the corneal epithelium, while less intensive staining was visible in the endothelium. These results were confirmed using qRT‐PCR. Immunostaining for PI‐9 was observed in almost all corneal epithelial cells and in approximately 50% of the endothelial cells. An increased number of PI‐9‐positive cells was detected in stromal infiltrates of most melted corneal explants, while almost no positivity was observed in rejected explants. Calretinin was detected in the corneal epithelium and less intensively in the corneal endothelium, where both cytoplasmic and nuclear localisation were demonstrated. HBME‐1 antibody strongly stained the corneal endothelium and stromal keratocytes.

Conclusion The proteins expressed constitutively in mesothelial cells (PI‐9, mesothelin, calretinin and HBME‐1 protein) are present in adult human corneal endothelium, confirming that this layer expresses markers typical of mesothelial cells.
Identification of potential human corneal endothelial stem‐like cell niches
Authors: THURET G , HE Z , PIPPARELLI A , PISELLI S , PEOC'H M , DUMOLLARD JM , ACQUART S , GAIN P
Published: November 2010

Purpose to study the localization of potential stem‐(like) cells in human adult corneal endothelium

Methods Fresh (6‐12h post mortem) and organ cultured (OC) corneas were studied after flat mount. The whole endothelium and posterior limbus (PL) was observed after triple staining with Trypan blue, Alizarin red and Hoechst 33342, in order to determine cells shape, localization and viability. The level of endothelial cell (EC) differenciation was determined after immunostaining (fluorescence) for ZO‐1, Na+/K+ ATPase and COX IV; the cell proliferation status was assessed using Ki67; four markers for stem cells were used: Oct‐4, BCRP, Nestin and Telomerase; ability for cell migration was evaluated from Myosin IIA expression

Results In several corneas, the nuclei of peripheral EC were centripetally aligned suggesting continuous slow central migration. Numerous small cells with a reduced expression of differenciation markers were accumulated near peripheral Hassall Henle bodies. In these potential niches, cells were distributed in 3‐5 layers. A high expression of Myosin II was found in peripheral cells. Ki67+ cells were found in PL and peripheral EC only after OC. None of the 4 stem cell markers was found in EC, and their expression in PL was poorly reliable because of high background noise. Numerous trypan blue positive cells were located at the PL and in the extreme periphery of endothelium

Conclusion several strong arguments suggest the location of corneal endothelial stem‐like cell niches in endothelial periphery or in the PL, and the capacity of EC to migrate from these niches toward the centre. Trypan blue staining pattern suggests that they could rapidly die in ex vivo corneas, and be therefore hard to indentify
Modulation of apoptotic signaling pathways to promote survival of endothelial cells by gene therapy
Authors: FUCHSLUGER T , JURKUNAS U , KAZLAUSKAS A , DANA R
Published: November 2010

Purpose Corneal transplantation is the most common transplantation worldwide. Surgeons and eye banks face major problems: (1) shortage of tissue in aging populations, (2) loss of high‐quality tissue due to cell loss during storage, (3) graft failure. It has been demonstrated that EC loss is mediated by the cells’ intrinsic death machinery resulting in apoptosis. Identification of survival strategies could raise the availability of tissue, with a significant impact on transplantation by lowering graft rejection rate. The purpose of this study different apoptotic pathways and to determine the protective effect of the anti‐apoptotic proteins bcl‐xL and p35.

Methods Intrinsic (mitochondria‐mediated) and extrinsic (ligand‐mediated) apoptotic pathways were selectively activated to provoke apoptosis of murine and human corneal endothelial cells suspensions and corneas. Gene transfer of bcl‐xL or p35 was accomplished, survival of EC was determined by flow cytometry and laser scanning microscopy.

Results Interestingly, we were able to determine distinct differences in cell survival enhancement depending on the type of overexpressed protein. Whereas uninfected controls showed significant EC death, gene‐therapeutically treated EC demonstrated significantly increased cell survival. We will present data on the efficacy of certain anti‐apoptotic proteins in select pathways.

Conclusion Exploring inhibitory strategies of EC death can lead to clinically relevant survival strategies with significant impact on corneal grafting.
Donor and recipient endothelial cell populations in transplanted corneas: new insights from endothelial imaging
Authors: LAGALI N , STENEVI U , CLAESSON M , FAGERHOLM P , HANSON C , WEIJDEGåRD B , STRöMBECK AS
Published: November 2010

Purpose To elucidate the pattern of donor and recipient endothelial cell population in transplanted human corneas and investigate factors impacting this mosaic.

Methods 36 corneal grafts were collected from recipients of opposite sex to the donor, at the time of re‐transplantation. An endothelial sheet was harvested from each graft, and labeled by fluorescent in situ hybridization of the sex chromosomes, to identify cells as donor or recipient‐derived. Images of the graft endothelium were assembled to depict the pattern of cell population of the graft, and the proportion of donor cells present was estimated.

Results Endothelial cells of donor origin were found in 26 of 36 grafts, persisting up to 26 years after transplantation. The proportion of donor endothelial cells in the graft was not significantly correlated with postoperative time (P = 0.19). Endothelial images indicated a highly variable pattern of recipient cell repopulation of the graft. A tendency towards donor cell retention in transparent, successful grafts was noted; however, this feature alone was not a reliable indicator of long‐term graft transparency. Recent in‐vivo optical coherence tomography studies of transplanted corneas indicate a possible mechanism impacting the donor and recipient cell patterns observed on the endothelial surface.

Conclusion Two‐dimensional imaging of the corneal graft endothelium revealed a variable pattern and extent of donor and recipient cell population, indicating the highly dynamic nature of the corneal endothelium after transplantation.
Oxidative stress in corneal limbal rings
Authors: JOHNSEN‐SORIANO S , ARNAL E , ROMERO FJ
Published: November 2010

Purpose The aim of this work was to study oxidative stress markers in corneal limbal rings stored in Optisol at different preservation times.

Methods Total Antioxidant capacity was measured with a commercial kit (Antioxidant Assay Kit, Cayman). Total nitrites were measured with a commercial kit where the amount of total nitrites was monitored spectofotometrically by reading the absorbance at 540 nm. Moreover, HNE (4‐hydroxy‐2‐nonenal) immunohistoquemistry was performed at 3 µm thick paraffin sections.

Results The antioxidant capacity in corneal limbal rings preserved for 7 days were decreased significantly (0.5 ± 0.02 mM/mg prot) when compared to a fresh corneal limbal ring (1.1 ± 0.28 mM/mg prot) * p< 0.05. Moreover, the total nitrites were significantly elevated in corneal limbal rings preserved for 7 days (1.47 ± 0.18 umol/L/mg prot) when compared to fresh corneal limbal rings ( 0.89 ± 0.46 umol/L/mg prot) * p< 0.05. Immunohistoquemistry revealed that there exist an increase in HNE positive cells as conservation time increases.

Conclusion Oxidative stress factors increases with time in corneal limbal rings preserved in Optisol.
Welcome & Aim of the SIS
Authors: GRAW J
Published: November 2010

Abstract not provided
Radiation‐induced lens opacities: towards a new strategy to address the low dose risk research with the European network DoReMi
Authors: GOURMELON P , JOURDAIN JR , JACOB S
Published: November 2010

In 2010, a Network of Excellence called DoReMi was launched by the EURATOM FP7 programme. DoReMi will act during the next six years as an operational tool for the development of a research platform devoted to low dose risk research in Europe. The research activities of DoReMi are implemented within three work packages: WP5, WP6, and WP7, which are respectively concerned with the shape of the dose effect relationship, individual radiation sensitivity and non‐cancer effects. The overarching objective of WP7 is to implement a long‐term, integrated approach involving several disciplines, namely, epidemiology, radiobiology and toxicology, for the purpose of risk evaluation for radiation‐induced non‐cancer effects. One of the operational objectives of the DoReMi WP7 consists of undertaking feasibility studies addressing the issues of vascular effects, lens opacities and cognitive effects. The presentation to be given will provide the assembly with (i) information about the European low dose risk research strategy; (ii) latest knowledge about the epidemiological evidence of radiation‐induced lens opacities; (iii) information about the feasibility study of lens opacities to be launched in a group of interventional cardiologists (iv) most promising mechanistic hypotheses for the development of radiation‐induced lens opacities recognizing that while posterior subcapsular cataracts are characteristic of an exposure to ionizing radiation, several sets of data suggest that the broader category of posterior cortical cataracts may also be regarded as radiation‐associated. Eventually the presentation will discuss the issue of a threshold for the development of radiation‐induced lens opacities and list the scientific questions raised by the radiation protection community to the vision and eye research community.