bluuebunny/crossref_metadata_2025 huggingface dataset:
Optical coherence topographic features in idiopathic retinitis, vasculitis, aneurysms and neuroretinitis (IRVAN)
Authors: NAITHANI P , VASHISHT N , SANKARAN P , MANDAL S
Published: November 2010

Purpose To evaluate Optical Coherence Tomography (OCT) findings in Idiopathic retinitis, vasculitis,aneurysms and neuroretinitis (IRVAN).

Methods In this case‐series, 3 patients with IRVAN were evaluated. The patients underwent complete ophthalmological examination including fundus photography, fluorescein angiography, and OCT. Main outcome measures: central macular thickness(CMT) & associated morphological changes in different retinal layers on OCT.

Results OCT scans of all patients demonstrated diffuse retinal thickening with loss of normal foveal contour. The increased thickness in 2 patients was associated with focal areas of hyper‐reflectivity with high backscattering of inner layers in macular area suggestive of macular exudation. In third patient, OCT images demonstrated vitreomacular traction(VMT) along with exudative maculopathy. Epiretinal membrane(ERM) was noted in 2 patients.

Conclusion OCT is a valuable tool in evaluating macular changes in IRVAN. It is helpful in detecting early subclinical findings like VMT and ERM & provides further insight into causes of visual loss in IRVAN.
Xanthophylls from blood to retina
Authors: BRETILLON L
Published: November 2010

Xanthophylls are dietary lipophilic compounds. Among them, lutein and zeaxanthin are the major carotenoids found in the human lens and retina, and referred as macular pigment within the retina. Lutein and zeaxanthin cannot be synthesized endogenously. They may therefore be considered as essential and must be provided by adequate dietary intakes. Lutein and zeaxanthin are present in various food items, mainly in plants and fruits such as green vegetables or yellow‐orange fruits, as well as in a few animal sources, such as egg yolk. Epidemiological studies consistently suggest that dietary lutein and zeaxanthin are protective factors against the development of Age‐Related Maculopathies and Age‐related Macular Degeneration. Intervention trials consisting in supplementing the diet with lutein and zeaxanthin demonstrate the bioavailability of those carotenoids in plasma and, in some of them, their efficacy in increasing the density of the macular pigment. An overview will be presented on the mechanisms of xanthophyll bioavailability in blood and retina.
Protective role of xanthophylls
Authors: ACAR N
Published: November 2010

Xanthophylls, also known as carotenoids are a group of natural fat‐soluble pigments that are especially abundant in green and yellow‐orange fruits and vegetables. Based on epidemiologic data, it is now evident that carotenoids provide health benefits and particularly in eye diseases. Molecular characterization of retinal carotenoids has shown that there were actually two xanthophylls that are concentrated in macular region, namely lutein and zeaxanthin. Thanks to a strategic position within inner retinal layers, lutein and zeaxanthin are suspected to act as antioxidants in the retina in order to limit oxidative stress that results from metabolism of light. In addition, they are also supposed to absorb blue light that enters the eye prior to its reaching the delicate functional structures including the photoreceptors and the retinal pigment epithelial cells. The aim of this paper is to summarize the knowledge about the biological mechanisms of the protective role of macular xanthophylls.
How to improve macular pigment in retina?
Authors: LECERF JM
Published: November 2010

Abstract not provided
Lutein and macular degeneration
Authors: DELCOURT C
Published: November 2010

Abstract not provided
Potential retinal causes: when and how to investigate
Authors: LEROY BP
Published: November 2010

Purpose To describe the retinal conditions that need to be excluded when non‐organic visual loss is suspected, and the investigations required to either confirm or exclude them.

Methods A case presentation format will be used to illustrate those conditions which can be discovered using psychophysical and electrophysiological tests as well as special imaging including autofluorescence, infrared and red free imaging and spectral‐domain optical coherence tomography, in patients in whom a non‐organic origin for visual loss is suspected.

Results Inherited retinal diseases such as Stargardt macular dystrophy, X‐linked retinoschisis and cone dystrophy as well as Batten disease in their early stages all need to be excluded when visual loss is thought to be non‐organic. In addition, several acquired retinal conditions such as acute acular neuroretinopathy need to be taken into account. visual field testing, ISCEV‐standard full‐field flash electroretinography, pattern electroretinography and visual evoked potentials and specialised imaging techniques contribute significantly to making the correct diagnosis.

Conclusion Visual loss in a list of organic conditions may mimic non‐organic visual loss. Functional testing as well as specialised imaging techniques are essential in differentiating true organic from non‐organic visual loss.
Neuro‐ophthalmic considerations and investigations
Authors: BORRUAT FX
Published: November 2010

Functional non‐organic patients can be a challenge to the clinical practitioner. Most likely they will complain of decreased visual acuity and/or of altered visual field. However some patients can complain of oculomotility disturbances (diplopia, oscillopsia, ophthalmoplegia), can present with relative eyelid ptosis, or will exhibit anisocoria. This presentation will highlight certain typical findings of such patients as well as which specific tests can be used in order to detect the non‐organic nature of their complaints.
Boston Type 1 KPro ‐ Multicenter study outcomes
Authors: CIOLINO J , RUDNISKY C , ZERBE B , BELIN M
Published: November 2010

Purpose To report indications and outcomes from a multicenter study on the Boston Type 1 keratoprosthesis (Kpro).

Methods Kpro data was collected and analyzed at a central collection site. Kpro survival and visual acuity are the main outcomes measured.

Results 324 Boston Type 1 Kpro implants (310 patients) from 19 surgeons were included. The average age was 63.2±18.7 years, 47.6% female, 53.0% right eyes. The average number of penetrating keratoplasties (PKP) prior to kPro insertion was 1.9±1.5 (range 1‐8). Pre‐operative diagnosis was divided into 3 different categories: “chemical” (32 eyes), “autoimmune” (39 eyes with either Stevens Johnson Syndrome [SJS] or Ocular Cicatricial Pemphigoid [OCP]), “other” (n=188), and “unknown etiology” (n=65). The mean preoperative logMAR visual acuity was 1.77±0.62 (48.1%; n=156 eyes); 32.4% hand motion and 14.2% of light perception. Average follow‐up time was 16.3±14.6 months (range 0.7 – 59.4). The overall retention rate was 92.0% (n=298). Median survival time (months) was 60.9 (autoimmune), 99.1 (chemical), & 139.3 (other). The median survival time for patients with autoimmune disease was significantly lower than for other diagnoses (p<0.0001). Among eyes with at least 1 year of follow‐up (135 eyes), overall Kpro retention was 90.4%. Mean visual acuity (n=151 eyes) was significantly improved to 0.78±0.58 logMAR units after one year of follow‐up (p<0.0001). The retention rate observed in autoimmune patients (71.8%, p<0.0001) followed by chemical (93.8%), “other” (93.1%) & “unknown” (100%).

Conclusion The Boston Type 1 KPro appears to be a viable option for eyes that are not candidates for PKP however caution should be used in eyes with a history of SJS or OCP.
Outcomes of the Boston Keratoprosthesis Type II
Authors: CHODOSH J , PUJARI S , SIDDIQUE S , DOHLMAN C
Published: November 2010

Purpose To report the long term outcomes of Boston keratoprosthesis type II implantation in the management of severe ocular surface disease and corneal blindness.

Methods A retrospective review of medical records of patients after Boston keratoprosthesis type II implantation at the Massachusetts Eye and Ear Infirmary from January, 1, 2000 through December 31, 2009. Main outcome measures included visual acuity, device retention, and postoperative complications.

Results A total of 29 eyes of 26 patients received a Boston keratoprosthesis type II during the study period. Operated patients had corneal blindness due to mucous membrane pemphigoid (51.7%), Stevens Johnson syndrome/toxic epidermal necrolysis (41.4%), or other ocular surface disease (6.9%). Visual acuity after surgery improved to at least 20/200 in 23 eyes (79.3%), and to 20/30 or better in 10 eyes (34.5%). In patients with at least 1 year of follow‐up (n=21), visual acuity of 20/200 or better was maintained in 14 eyes (66.7%). Of these 14 eyes, 6 eyes (42.9%) retained visual acuity of 20/200 or better for more than 5 years. Overall, visual acuity of 20/200 or better was maintained for at least 5 years in 6 of 23 eyes (26.0%). Eyes that failed to improve to 20/200 or lost vision during follow‐up were found to have end stage glaucoma, previous retinal detachment, or age related macular degeneration. Of the total of 29 eyes, 17 devices (58.6%) were retained without extrusion or replacement during a total follow‐up time of 107.9 person‐years.

Conclusion The Boston keratoprosthesis type II is a viable option for corneal blindness from severe autoimmune ocular surface diseases. Complications require prompt recognition and management to promote retention of the device and preservation of vision.
Glaucoma considerations in OOKP
Authors: AL RAQQAD N , LEE R , HEROLD J , LIU CSC
Published: November 2010

Purpose To study the incidence and prognosis of glaucoma in OOKP eyes and to evaluate methods for detection and treatment of glaucoma following osteo‐odonto‐keratoprosthesis surgery.

Methods Retrospective analysis of 49 consecutive patients treated at the national OOKP referral centre in Brighton, UK between November 1996 and September 2009. Data were collected over a 3 month period from December 2009 giving a minimum of 6 months follow up (range: 6 months to 13 years). Data collected include: age at surgery, primary diagnosis, previous surgical procedures (corneal grafts), family history of glaucoma, serial post‐operative cup‐disc ratios and visual fields, glaucoma procedures at any stage, and any OOKP complications.

Results A total of 49 patients were included in the study with age ranging from 19 to 88 years (mean 53.5). 14 (28.5%) patients had pre‐existing glaucoma, 25(51%) patients had glaucoma by the end of the study. 12(24.5%) patients developed de novo increase in intraocular pressure. Of the 49 patients, 5 underwent cyclodialysis ,4 had cyclodiode laser treatment, 4 underwent ECP, 5 had a glaucoma tube inserted and 4 had detachment and reattachment of their recti muscles (VRDR ± MRDR). All patients were treated with oral acetozolamide 250mg once daily (except one who is allergic). Sublingual timolol was used in three patients, one of experienced severe side effects and the treatment had to be stopped. Systemic betablockers were used in 3 patients.

Conclusion Glaucoma is one of the major complications of osteo‐odonto‐keratoprosthesis. It is difficult to monitor and treat in the OOKP eye. Various treatment modalities have been used. Many patients require long term oral medications and many are not adequately controlled and should have surgical treatment the results of which are not satisfactory. VRDR might represent a safer surgical method to control glaucoma in OOKP eyes.
Biosynthetic corneas ‐ 2 year post human implantation
Authors: FAGERHOLM P , LAGALI N , GRIFFITH M
Published: November 2010

Purpose To evaluate biosynthetic corneas as substitutes for donor corneas in humans followed for 2 years.

Methods Recombinant human collagen type III was cross‐linked to fabricate corneal substitutes. Following proper study approval, a Phase I study was initiated. 10 patients , scheduled for corneal grafting, were enrolled. Nine had keratoconus and one a deep scar following Pseudomonas keratitis. Lamellar surgery was performed. Six overlying sutures were used to anchor the graft. Topical dexametasone and chloramphenicol was given postoperatively. The sutures were removed after 6 weeks. The patients were followed clinically and evaluated for UCVA, BSCVA and BCLVA. Sensitivity (Cochet‐Bonnet) and Shirmer were tested. Photography, OCT (Visante), topography and IVCM was documented.

Results After 3 months all patients had epithelialized and implants were anchored by keratocyte ingrowth. The nerve regeneration after 24 months was lower than normal controls but better than after PKP. The mean BSCVA at 24 months was less than after PKP but BCLCVA came up to par with PKP BSCVA.The corneal thickness was stable between 3 and 24 months at about 400 µm. The Shirmer values were 20 ± 10 mm in operated eyes and 17 ± 8 mm in fellow eyes. At 18 months the sensitivity was 37 mm in operated eyes and 60 mm in fellow eyes.

Conclusion Bioengineered corneal substitutes are compatible and promote regeneration of corneal cells. They show stability after 2‐3 months. The results after 2 years will be presented.
Optical characterization of PCO
Authors: VAN DEN BERG TJTP , VAN BREE MCJ
Published: November 2010

Purpose Opacification of the posterior capsule (PCO) is known to degrade visual function on both counts: small angle resolution (visual acuity and contrast sensitivity) as well as large angle light scatter (straylight). No studies have been performed to delineate the optical characteristics of PCO as a basis for explanation of these visual function defects.

Methods Preparations of IOL‐capsule combinations were harvested from donor eyes after removal of the cornea. They were mounted submersed in saline in an optical set‐up, used earlier to characterize the optics of the crystalline lens (van den Berg et al. VR 1999). Illuminated by monochromatic beams of light, the light spreading originating from different areas of the preparation was measured as function of wavelength for different angles. Based on physical optics theory, the optical characteristics of PCO was derived. The data will be presented translated into the straylight parameter, directly comparable to the figures obtained in vivo using the clinical straylight meter (C‐Quant from Oculus).

Results Twenty successful preparations were harvested with at least some PCO areas. PCO grades varied from severe to slight. Two physically different types of light spreading could be discriminated. One type corresponding to pearl‐like appearance, characterized by little wavelenght dependence and smal angle dominance. The other type corresponding to diffuse scatter, characterized by strong wavelength dependence and large angle dominance. The scatter values measured corresponded to clinical measures of straylight in PCO patients using the C‐Quant.

Conclusion The light scattering characteristics of PCO show two types of optical disturbance: a refractile type, probably dominated by pearl‐like structures, and a diffuse type of scattering of yet unclear origin.
Capsular peeling in premium IOLs to improve visual outcome
Authors: TASSIGNON MJ , ROZEMA J
Published: November 2010

Purpose To demonstrate that capsular peeling may improve quality of vision of patients who experienced reduced vision in the short postoperative period after premium IOL implantation due to decentration of the IOL secondary to PCO.

Methods Patients who were refered to our centre because of unsatisfactory quality of vision after premium IOL implantation (more specifically after multifocal IOLs) were scheduled for surgery aiming at peeling the capsular bag. The conditions which the patient needed to meet were: increased higher order aberrations, evidence of tilt or decentration of the IOL, important fibrotic proliferation in the capsular bag, no YAG laser capsulotomy performed.

Results After capsular peeling, it was possible to demonstrate that the quality of vision of the patient improved, the higher order aberrations reduced and it was often unnecessary to explant the premium IOL. Although there was an obvious improvement of the quality of vision, this improvement still did not reached the high standard of vision as measured after monofcal IOLs.

Conclusion This paper shows how important the role is of PCO on quality of vision. Because contrast sensitivity is already reduced after premium IOL implantation, patients will be very sensitive to an additional reduction as it appears after PCO.
General principles of autoinflammation and autoimmunity
Authors: WILLERMAIN F
Published: November 2010

Purpose In this talk, the definition and the molecular mechanisms of autoinflammation and autoimmunity will be introduced.

Methods Defense against invading microorganisms is one of the main challenges of life. Very early in the evolution, a series of germline‐encoded protein capable to detect pathogen associated molecular patterns (PAMP) have evolved. PAMPs include toll‐like receptors, NOD like receptors and C‐type lectin. Their activation converges to the rapid stimulation of proinflammatory pathways.

Results PAMPs are at the basis of the innate immune response which represent the first line of defense and will shape the nature of the adaptive immune system. The latter is mediated by clonal selection and expansion of antigen specific T and B lymphocytes. It is now well described that dysregulations of those two arms of the immune system are associated with distinct clinical diseases.

Conclusion Various anomalies of the innate immune system have been found in a series of disease grouped under the name autoinflammatory syndromes. This term highlight the distinction between those diseases and classical autoimmune diseases, characterized by an abnormal adaptive immune response with the presence of autoantibodies and/or autoreactive T cells.
An introduction to autoinflammatory syndromes
Authors: BODAGHI B
Published: November 2010

To define the spectrum and pathophysiology of autoinflammatory syndromes. This term has been proposed to describe a new group of diseases characterized by attacks of seemingly unprovoked inflammation in the absence of pathogens, without significant levels of autoantibodies and autoreactive T cells. Hereditary periodic fever syndrome, Crohn's disease, Blau syndrome, Chronic infantile neurologic cutaneous and articular syndrome and Muckle‐Wells syndrome are examples of autoinflammatory conditions characterized by recurrent attacks of inflammation without any association with auto‐antigens. The study of autoinflammatory diseases has progressed from genetics to definition of the functional defects. Although a direct association between defective innate immune responses to bacterial components and these diseases has not been established yet, this hypothesis remains highly plausible. Mutations in genes encoding the tumour necrosis factor (TNF) receptor and pyrin superfamilies of molecules may induce persistence of leukocytes that would ordinarily undergo apoptosis with further amplification of inflammatory stimuli. The use of biologics may control some of these conditions.
Role of autoinflammation in the development of non‐infectious uveitis
Authors: ROSENBAUM JT
Published: November 2010

Abstract not provided
Infectious and non infectious triggers in non‐infectious uveitis
Authors: WILDNER G
Published: November 2010

Purpose The induction of autoimmune uveitis is difficult to explain with respect to the immune privileged status of the eye. The intact BRB can only be passed by already activated leukocytes, which should normally be ignorant to the sequestered intraocular antigens. Antigenic mimicry of retinal autoantigens by environmental proteins could explain extraocular activation of effector T cells.

Methods We have previously demonstrated antigenic mimicry of a peptide from retinal S‐Antigen and peptides from rotavirus (Rota) and bovine milk casein (Cas). Both, Rota and Cas, induce T cell lines cross‐reactive with retinal S‐Ag peptide as well as experimental autoimmune uveitis in rats. Patients with uveitis have increased antibody and T cell responses to the mimicry peptides as well as to the S‐Ag peptide compared to healthy donors. Accordingly, Infection with rotavirus or any gastrointestinal pathogen with concomitant ingestion of bovine milk products could induce an immune response in the gastrointestinal tract that is cross‐reactive with ocular autoantigens and lead to induction of autoimmunity in the eye.

Results Uveitis as a well known adverse effect after BCG (Bacille Calmette Guerin) treatment might also be the result of antigenic mimicry. We have shown T cell responses to PPD from M. tuberculosis and the retinal autoantigens S‐Ag, IRBP and CRALBP from a patient who had developed granulomatous uveitis after BCG application for bladder carcinoma. Data base searches revealed a number of amino acid sequence homologies between proteins from mycobacteria and retinal autoantigens, suggesting antigenic mimicry. These findings might as well be an explanation for the occurrence of uveitis in connection with M. tuberculosis infection, even when no mycobacteria are detectable in the eye.
Integrating the interplay between innate and adaptive immunity in the development of non infectious uveitis
Authors: DICK AD , NICHOLSON LB
Published: November 2010

Purpose Whilst uveitis is a CD4 T cell mediated disease, there remains both the interplay with innate immunity at both the affector (initiation) of disease and moreso the phenotype and severity of the effector stages of disease.

Methods The talk will describe the experimental evidence to describe the interplay of T cells and myeloid cells within the retina during intraocular inflammation.

Results TNF, whilst a pleitropic cytokine, has significant influence of the disease phenotype and disease course we observe experimentally. TNF is requred for activation of myeloid cells (macrophages)when in presence of Th1 CD4 T cells, which results in contribution to tissue damage but also controlling T cell proliferation in situ via generation of myeloid suppressor cells. Moreover, the role of resident myeloid cells (microglia) is to down‐regulate the immune response. The role of myeloid cells in the healing response and angiogenesis will also be discussed with respect to T cell responses.

Conclusion Myeloid cells are actively conditioned by their envirnoment (cognate and soluble factors) to respond accordingly. As such the regulation of immune response and healing that follows is dictated by the innate system in response to changes in local and systemic conditions.
Determinants of informed consent in cataract surgery trial: why do patients enter a clinical trial?
Authors: CONSTANTINOU M , JHANJI V , LAMOUREUX E , CHIANG P , REES G , VAJPAYEE RB
Published: November 2010

Purpose To elicit the reasons underpinning willingness to accept or decline enrolment (into a cataract surgery clinical trial and to identify the determinants of patients’ decision making.

Methods Patients interviewed by questionnaire were assigned to two different groups depending on whether they gave consent or refused to participate in the trial. Patient data collected included attitudes on informed consent (attitude to trial and trial clinician; health and illness perceptions), evaluation of information provision (the way information was given, evaluation of written/verbal information, difficulty of understanding written information disclosure) and sociodemographic variables.

Results Of the 40 patients, 20 (50%) consented to enter the trial and 20 (50%) declined. All patients in the consenting group expected positive implications compared to 6 (30%) in the non‐consenting group who expected negative implications (p<0.05). The majority of patients (90%) in the non‐consenting group felt that the degree of risk by undergoing trial treatment was moderate to high. The perceived burden imposed on daily life by participating in the non‐consented group was moderately higher in 11 (55%) compared to 3 (15%) in the consented group (p<0.05).

Conclusion Major reasons for participation in a cataract surgery trial were expected positive implications from involvement, and, satisfaction with the attitudes of medical experiments. Patients who refused to enter the trial felt that the degree of risk as well as burden imposed on daily life by participating was high. Demographic variables did not have any overall significant impact on a patient’s decision to accept or decline entry into the trial.
FNA biopsies for genomic analysis and adjuvant therapy for uveal melanoma
Authors: DESJARDINS L , LUMBROSO‐LE ROUIC L , LEVY‐GABRIEL C , CASSOUX N , COUTURIER J , ASSELAIN B , PIPERNO‐NEUMANN S , SASTRE X
Published: November 2010

Purpose Recent changes in the management of uveal melanoma include the use of biopsies for genomic analysis and the identification of patients with a high risk of metastasis. We wish to describe our first experience with fine needle aspiration (FNA), genome profiling and adjuvant therapy protocol for high risk patients

Methods we have started a multicentric adjuvant phase III trial of intravenous fotemustine (FOTEADJ) for high risk uveal melanoma patients. Patients with tumor of 15 mm or more in diameter with retinal detachment or extrascleral extension, patients with tumors of 18 mm or more in diameter and patients with loss of chromosome 3 and gain of entire 8q were considered high risk and eligible. Tumour genome profiling was achieved by array‐CGH on a NimbleGen 72K microarray, after whole genome amplification (WGA) in cases of FNAs Local treatment consisted in enucleation or proton beam radiotherapy. FNA was offered to patients treated by radiotherapy for a tumor of 5 mm of thickness or more.

Results Between May 2009 and May 2010, 74 patients were offered to participate. Only 16 patients were included because of various reasons: technical problems with the biopsy (13 samples evaluable out of 26 FNA), refusal of the biopsy or the protocol or non inclusion criteria. There has been some improvement in our results since the introduction of WGA for FNA specimens

Conclusion Proposing fine needle aspiration biopsy and obtaining sufficient material is not always easy. Including patients in randomized protocols is always a challenge. During the first year for FOTEADJ, only 22% of the eligible patients were enrolled but this percentage is greatly improving with time and experience .
MLPA of choroidal melanoma
Authors: DAMATO BE , DOPIERALA J , COUPLAND SE
Published: November 2010

Purpose To determine the genotypic profiles of choroidal melanomas using multiplex ligation‐dependent probe amplification (MLPA) and to correlate findings with clinical and pathological features and metastatic death.

Methods DNA samples from 452 choroidal melanomas were analyzed with MLPA evaluating 31 loci on chromosomes 1, 3, 6 and 8. The MLPA results were correlated with survival predictors and wiht metastatic death.

Results The patients (194 female; 258 male) had a median age of 59.4 years and a median follow‐up of 1.89 years. Metastatic death occurred in 47 patients, correlating most strongly with concurrent chromosomes 3 losses and chromosome 8q gains (Logrank analysis, p<0.001). Many small choroidal melanomas with a basal diameter of less than 10mm showed only chromosome 3 loss or chromosome 8q gain or none of these, suggesting that their tumour was 'pre‐lethal' at the time of ocular treatment.

Conclusion MLPA analysis of choroidal melanoma is predictive of metastatic death and, therefore, clinically useful. The findings of this study are most consistent with evolutionary clonal abnormality, suggesting that timely treatment prevents the metastatic genotype and metastatic spread in a proportion of patients.
Observation in choroidal melanomas
Authors: GARCIA‐ALVAREZ C , SAORNIL MA , ALMARAZ GOMEZ A , LOPEZ LARA F , FRUTOS BARAJA J , DIEZHANDINO P
Published: November 2010

Purpose The management of suspected small choroidal melanomas is controversial. The purpose of the present study is to assess tumor growth, visual acuity changes, activity factors and survival on choroidal melanoma patients under observation in our Intraocular Tumors Unit.

Methods Prospective, consecutive and non‐interventional case series. Patients diagnosed with choroidal melanoma from 1990 to 2010 and with observation as therapeutic option were included. Criteria for observation were small size without risk factors for growing; medium and large size: no risk factors for growing (but size), advanced age, bad general health, only eye or treatment rejection. Demographic, tumoral and follow‐up data were collected in a data base and analyzed.

Results 118 out of 397 patients (29.7%) diagnosed with uveal melanoma were enrolled, with mean age of 66.4 years (SD 14.3). The mean follow‐up time was 51.1 months (SD 4.5). Regarding the size, 91 (77.1%) tumors were small and 85 (72.%) were diagnosed in a routine examination. Main reason for observation was tumor small/inactive (80,5%) followed by treatment rejection (17.7%). Mean height was 2.8mm (SD 1.9) and mean base 7.6 (SD 2.8). Along the follow‐up, 17 tumors grew; 11 were treated with brachytherapy, 5 with enucleation and one with brachytherapy and enucleation. Only 16 patients died during the follow‐up, 2 by melanoma metastasis.

Conclusion In our series with more than 4 years of follow up, observation seems to be a safe therapeutic option for selected small choroidal melanomas, allowing the patients to preserve visual function.
Diagnosis and management of iris melanomas: a clinical follow‐up study of 12 years
Authors: RAZZAQ L , KEUNEN J , LUYTEN GPM , DE KEIZER RJW
Published: November 2010

Purpose Diagnosis of iris melanoma is challenging as no clear cut differentiating points exists for differentiation between iris naevi and melanoma. On the basis of our and others experience of iris tumors, an “iris melanoma module” was developed at LUMC in 1997 which included important clinical and UBM features of iris melanoma to diagnose and differentiate between iris naevi and ‐melanoma.This study is to identify important clinical and UBM variables predictive of diagnosing iris melanoma.

Methods Between January 1997 and December 2007, total 117 patients were seen with suspected iris melanocytic tumors and the iris melanoma module is filled in all these patients. On the basis of the module score for each patient, decision was made whether to treat or observe the patient. We analyzed all these patients on the basis of follow‐up and current status that whether the management strategy of these patients’ iris tumors on the basis of module was right.

Results 37 Patients were treated with plaque radiation (32%), 15 patients had excision or enucleation (13%), whereas in 65 patients lesions were observed with periodic follow‐up (55%). The follow‐up period is 2‐12 years. Of the 65 lesions observed for growth only 6(9%) showed growth. Most of the lesions which were excised proved to be the iris melanoma. All the variables of iris melanoma module were also analysed using the univariate and multivariate analysis.

Conclusion Clinical and UBM features of the iris tumors included in iris melanoma module appear to enable clinicians to differentiate reasonably well between probable malignant melanoma, for which prompt treatment is appropriate, and benign naevi, for which observation with periodic follow‐up is the good management option.
Role of blood markers in diagnostics of an age cataract
Authors: KUDRYAVTSEVA YV , CHUPROV AD , TSIBEL VB , BOJKO ER
Published: November 2010

Purpose To reveal in a blood some markers of changes in a lens during development of a senile cataract.

Methods Objects of research were 134 patients at the age from 43 till 84 years, operated concerning a cataract. We determined degree of a cataract maturity and estimated degree of a brown shade of a lens nucleus. The molecular products of peroxidation (primary, secondary, end‐products of a lipidic and proteic genesis), enzymes of antioxidants (glutationperoxidasa, glutationreductasa, superoxide scavenger), natural antioxidants (Retinolum, tocopherol, selenium in a blood were defined.

Results During the development of an age cataract the level of peroxidatoin products ‐ dienic conjugates, crotonic aldehyde and the bases of Shiffa are decreasing. Decrease of content of vitamins В2, A and Е if the intensifying of a brown shade of a lens nucleus was revealed. The content of dienic conjugates decreases, the level of crotonic aldehyde increases and the concentration of the bases of Shiffa also change. The content of selenium in a blood decreases in patients with a brown cataract but it doesn't change in patients with mature cataract.

Conclusion There are markers in a blood in patients with a cataract which change at advance of opacifications and intensifying of brown colour of a lens nucleus. However its changes is non‐specific and means about the general activation of processes of peroxidation and antioxidatic system
Straylight value depending on the location of lens opacity and utility of straylight measurement in deciding cataract surgery
Authors: LEE SY , KIM SJ , OH JH
Published: November 2010

Purpose To evaluate the difference of straylight value depending on the location of lens opacity and to study whether the straylight measurement is useful in deciding the surgery of early cataract.

Methods 139 cataractous eyes were classified into posterior subcapsular opacity type, anterior subcapsular opacity type and diffuse nucleosclerosis type. Straylight values of each groups were measured. Straylight values of 28 patients(28 eyes) who complained visual disturbance despite good visual acuity were measured and compared with 28 control eyes. Postoperative straylight values and best corrected visual acuities of 28 patients were measured and compared with the preoperative values.

Results Posterior subcapsular opacity group showed significantly high straylight values(p=0.000). Mean straylight values of 28 eyes(28 patients) and 28 control eyes were 2.04±0.91 and 1.56±0.29 respectively(p=0.002). This was well matched to the difference of self‐reported visual quality scores of each group(45.1 points and 29.8 points). Postoperative straylight values decreased significantly than preoperative straylight values(p=0.000) in 28 patients. Self‐reported visual quality was well related to the decrease of straylight values(from 45.1 points to 28.2 points).

Conclusion Straylight value was significantly high in posterior subcapsular lens opacity. Straylight is found to have added value for visual quality assessment and it can be useful to determine the time of cataract surgery in early cataractous eyes.
Effects of 17beta‐estradiol in human lens epithelial cells
Authors: CELOJEVIC D , PETERSEN A , KARLSSON JO , ZETTERBERG M
Published: November 2010

Purpose Studies have shown that postmenopausal women have an increased incidence of cataract and it has been suggested that estrogen such as hormone replacement therapy may have protective effects against cataract. The purpose of this study was to investigate the effects of 17beta‐estradiol in cultured human lens epithelial cells (HLEC).

Methods HLEC were exposed to 17beta‐estradiol for 24h and cell number, apoptosis, peroxides, superoxides, glutathione (GSH) and membrane potential were measured using MTT and fluorescent probes for detection of reactive oxidative species (ROS) and caspase‐3 activity. Cells were also simultaneously incubated with 17beta‐estradiol and 25µM H202 for 24h after which the levels of ROS, GSH and the change in mitochondrial potential was measured.

Results Higher concentrations of 17beta‐estradiol (10 µM) showed increased levels of peroxides, superoxides, caspase‐3, MTT, propidium iodide and decreased levels of GSH. Lower concentrations of 17beta‐estradiol (0.1‐10nM) increased the membrane potential and decreased the level of propidium iodide. Low concentrations of 17beta‐estradiol also showed protective effects against oxidative stress induced by H202, which was shown by the reduced production of both peroxides and superoxides.

Conclusion Low concentrations of estrogen may have an antioxidative effect against H202 in cultured HLEC, whereas high concentrations of estrogen alone may induce oxidative damage.
First day post‐operative review after uneventful phacoemulsification cataract surgery: is it necessary?
Authors: CHATZIRALLI I , KANONIDOU E , CHATZIRALLIS A , PAPAZISIS L , SERGENTANIS T
Published: November 2010

Purpose To examine the value of the review on the first post‐operative day after uneventful phacoemulsification cataract surgery.

Methods 291 consecutive patients, who underwent uneventful phacoemulsification cataract surgery in our department, were randomized in two groups: i) Next day review (NDR group, n= 146) and ii) Non‐next day review (NNDR group , n=145). Complications within the first two weeks were assessed and the findings were analysed.

Results Of the 146 patients randomized to NDR group, 8 (5.48%) presented a post‐operative complication vs 9 (6.21%) of 145 patients in the NNDR group. The difference was not statistically significant (p=0.791, χ2 test). Specifically, 3 (2.05%) of NDR group presented allergy to post‐operative treatment vs 1 (0.69%) in NNDR (p=0.622, Fisher exact test). Iris prolapse was remarked only to one patient in NNDR group (p=0.498, Fisher exact test). Two patients of each group presented corneal abrasion (p>0.999, Fisher exact test). Two patients (1.37%) in NDR group suffered from elevated intraocular pressure vs four (2.76%) in NNDR group (p=0.447, Fisher exact test). Two patients in NDR group presented punctuate epitheliopathy vs one in NNDR group (p>0.999, Fisher exact test). Finally, one patient in NNDR group had post‐operative hyphaema (p=0.498, Fisher exact test).

Conclusion First post‐operative day review can be safely omitted in cases of uneventful cataract surgery.
Ranibizumab for macular telangiectasia type 2: a pilot study
Authors: BARBAZETTO IRENE , CONNEY M , KANCNIK J , YANNUZZI L
Published: November 2010

Purpose To investigate safety and maculat telangiectasia type 2.

Methods 5 patients were followed monthly and received 3 initial doses of ranibizumab with monthly PRN treatment thereafter. All patients were evaluated by clinical examination, visual acuity, leakage on fluorescein angiography and OCT.

Results Results: An average of 8 injections (3‐12) over 12 months were given. Mean VA was 0.49 (LogMar) at BSL, 0.41 at wk 1, 0.42 at M1 and 0.45 at M12. Central macular thickness (CMT) measured 390, 265, 350 and 408 µm respectively. Adverse events were limited to surface irritations.

Conclusion Conclusion: Short‐term improvements in visual acuity and CMT, as seen after wk 1, were not sustained over 12 months.
Influence of maternal smoking during pregnancy on the development of retinopathy of prematurity
Authors: FERNANDEZ PEREZ S , PUEYO ROYO V , GONZALEZ VIEJO I , FERRER NOVELLA C , GIL ARRIBAS L , CALVO PEREZ P , DE LA MATA PEREZ G
Published: November 2010

Purpose To determinate the relation between maternal smoking during pregnancy and the development and severity of retinopathy of prematurity (ROP).

Methods We performed a retrospective cohort study including all preterm children borned between September 2008 and February 2010 at Hospital Miguel Servet, Zaragoza (Spain). They were divided in two groups depending on the exposure to tobacco during the pregnancy. The incidence of ROP and its severity were analyzed, as well as other perinatal variables that could act as confounding factors for the above mentioned relationship.

Results Two hundred and eighteen preterm children were included in the study. The smokers’ rate during the pregnancy was 23.2%. We did not find differences between both groups as for the gestational age, birth weight, sex and prenatal and early postnatal diseases. We did not find statistically significant differences in ROP incidence between both groups (p=0.629). As far as the characteristics of the ROP, smokers increased the severity of the retinopathy, the need of treatment with laser and the rate of Posterior Aggressive ROP, though these were not significant.

Conclusion The maternal smoking during pregnancy does not influence the incidence of the ROP, but it seems to increase its aggressiveness and the rate of Posterior Aggressive ROP.
Foveal thickness measured with Heidelberg Retina TomographTM and optical coherence tomography
Authors: ROSÉN R , NILSSON M , MARTIN L
Published: November 2010

Purpose To evaluate the test‐retest variability of foveal thickness measurements using the Heidelberg Retina Tomograph 3 (HRT) and optical coherence tomography (OCT)

Methods 28 subjects were recruited among staff and students at St. Erik Eye Hospital. They all had decimal visual acuity ≥ 1.0, refractive error ≤ 12 D and no ophthalmic disease. Retinal thickness was measured using the HRT3 Retinal Module version 2.0 and OCT Stratus model 3000. The measured area (3.45 mm Ø) is divided in a 9‐zone grid which is used when analyzing the results. The grid consists of 3 circles; in the current study only data from the central circle is (1 mm in diameter) was used for the analysis. All subjects were examined by two experienced examiners at two different occasions. Four different images were obtained and compared according to the following schedule: I. Intraobserver/intravisit II. Interobserver/intravisit III. Intraobserver/intervisit IV. Interobserver/intervisit

Results Mean foveal thickness for all subjects was 258.28 µm ± 24,16 SD measured with the HRT and 201.86 µm ± 4.76 SD with the OCT. There were no significant differences in foveal thickness between any of the five examinations. The coefficient of variation was significantly larger in the HRT measurements compared with the OCT (p= 0.029)

Conclusion The repeatability between examinations was high for both the HRT and the OCT. However, the coefficient of variation was significantly smaller for the OCT, which may indicate that it is easier to detect and/or follow small changes in foveal thickness using this method.
Treatment of focal and/or diffuse central serous chorioretinopathy by series of 3 ranibizumab IVT
Authors: GONZALEZ C
Published: November 2010

Purpose To evaluate the functional, anatomical, vascular flow, effects of intravitreal injections(IVT) for focal and/or diffuse central serous chorioretinopathy (CSC),by a series of 3 Ranibizumab IVT protocol,and the recurrences frequency at 1 year evolution

Methods 9 eyes with focal and /or diffuse CSC. Patients received intravitreous Ranibizumab, 3 times, every 4 weeks in an inductive treatment. The next injections depended on the follow‐up results and were done by series of 3. First and 2 months’ interval follow‐up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein (FA) and infracyanine (ICG) angiography, and optical coherence tomography (OCT).VA and OCT were done before each IVT. We want to evaluate the incidence of this protocol on the exudation and spot leakage, and on frequency of recurrence and so on the number of IVT needed.

Results VA improved in 7 eyes, stabilized in 2. Angiographic leakage reduced about 80% in 8 cases, with resolution of leakage spot in all cases. Choroidal Vessel’s leakage, thickness, dilatation and diameter, reduced significantly at ICG. At OCT, serous retinal detachment disappeared in 7 cases, 80% reduced in 2 cases, pigment epithelial detachment was flattened and less dense in all cases. Most of patients had good functional, anatomical results, with few IVT needed, no scars in the retina. 1serie was enough in 6 cases. This protocol was compared, discussed .

Conclusion The results with improved visual acuity,vessel’s leakage and structure normalized at FA and ICG, reduction of exudation at OCT suggest this protocol, with series of 3 Ranibizumab IVT seems effective. It’s possibly a new treatment option for CSC, and it points out the role of choroidal vessel in CSC etiopathogeny
Treatment of Type 1 idiopathic macular telangiectasia by series of 3 ranibizumab injections after 1 year follow‐up
Authors: GONZALEZ C
Published: November 2010

Purpose To evaluate the functional, anatomical, vascular flow, effects of intravitreal injections(IVT) for Type 1 idiopathic Macular Telangiectasia, by a series of 3 Ranibizumab IVT protocol , and the recurrences frequency at 1 year evolution

Methods 12 eyes of 12 patients, 10 men, 2 women, with Type 1 idiopathic Macular Telangiectasia. Patients received intravitreous Ranibizumab, 3 times, every 4 weeks in an inductive treatment. The next injections (IVT) depended on the follow‐up results and were done by series of 3. First and 2 months’ interval follow‐up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein (FA) angiography, and optical coherence tomography (OCT).VA and OCT were done before each IVT. We want to evaluate the incidence of this protocol on the exudation and frequency of recurrence of exudation and so on the number of IVT needed.

Results VA improved in 85% cases, stabilized in 15%. Angiographic leakage reduced 90% in 80% cases, cystic macular edema disappeared, telangiectasia’s size diminished. Diffuse edema was 80% reduced in 85% ,total thickness was 45% less in the average follow‐up, cysts 100% disappeared in 75% cases, in 30% were diminished in size , volume and number, by OCT. Most of patients had good functional, anatomical results, with few IVT needed, no scars in the retina. Inductive treatment was sufficient in 8 cases, needed added IVT in 4 cases, failed in no cases. This protocol was compared ,discussed .

Conclusion The results, with improved visual function, lack of fluorescein leakage, reduction of exudation on OCT, few recurrences, suggest this protocol, with series of 3 Ranibizumab IVT seems effective, more retinal protective. This protocol seems attractive, speci
Choroidal thickness measurement in highly myopic eyes using SD ‐ OCT
Authors: EL MATRI L , BOULADI M , CHEBIL A , KORT F , TRIKI M , LIMAIEM R , MGHAIETH F
Published: November 2010

Purpose to measure macular choroidal thickness (CT) using spectral domain optical coherence tomography (OCT) and to investigate the correlation between CT and age, degree of myopia, and a history of macular choroidal neovascularization (CNV).

Methods a cross sectional study was performed in 191 eyes of 106 patients with spherical equivalent (SE) refractive error of 6 diopters (D) or more, between early January 2010 and early June 2010. The choroid was imaged using the spectral domain OCT (OCT TOPCON 2000) by changing the reference position from the vitreous to the choroid without inverting the image. CT was measured from the outer border of the hyperreflective line corresponding to the retinal pigment epithelium (RPE) to the inner scleral border.

Results the mean age of the 106 patients was 47,9 years ( ± 14,89 years; range, 18 to 81 years), 32 were men and 74 were women, the mean SE refractive error was 13,73 D (±5,74 D), and the mean subfoveal CT was 100,42 µm (±60,15µm; range, 23‐278). CT was correlated negatively with age (p= 0,01), and refractive error (p=0,01). Fourty eyes had a history of CNV, the mean CT was 52,02 ± 17,65 µm, and this was significantly thinner than the subgroup without CNV (p<0,10‐6 ).

Conclusion in highly myopic eyes, the choroid is thin and undergoes further attenuation with increasing age and increasing myopia. In addition, these findings suggest that the choroid may play a role in the pathogenesis of choroidal neovascularization.