bluuebunny/crossref_metadata_2025 huggingface dataset:
Coats' reaction and angiomas of the retina from mutations affecting telomere maintenance
Authors: KIVELÄ T , LINDAHL P , POLVI A , MAJANDER A , MÄKITIE O , LEHESJOKI AE , LINNANKIVI T
Published: August 2012

Purpose To describe retinal abnormalities other than Coats’ reaction in 4 of 6 Finnish patients with CRMCC, also known as Coats’ plus.

Methods An observational series of genotyped children imaged with RetCam. The children (5 girls, 1 boy) were born prematurely on gestational week 30‐39 and were small for date with birth weights from 770 to 2170 g. Four are alive at age 4‐22 y and two have died at age 6 and 18 y.

Results Of the 6 children, 2 presented with bilateral, asymmetric Coats’ reaction at age 7 and 11 months. The more advanced eye had an exudative retinal detachment (RD). Three children had retinal angiomas without exudation, accompanied with preretinal and vitreous bleedings, and abnormally running circular vascular loops at age 2‐11 months. In two of the latter, traction RD developed. Regardless of the phenotype, the retina peripheral to the vascular anomalies was avascular but without ROP changes. One patient did not have clinically visible retinal vascular anomalies. All patients with retinal changes had the common c.1994T>G [p.Val665Gly] mutation, three with c.2831delC [p.Pro944Leufs*7] and one each with c.3583C>T [p.Arg1195*] and c.3425_3426delTCinsAT [p.Leu1142His] mutations. The genotype did not predict the phenotype. The patient without retinal changes had c.680C>T [p.Ala227Val] mutation with c.2831delC [p.Pro944Leufs*7]. Other Finnish patients with the latter ccombination have had retinal changes since early childhood.

Conclusion It is important to appreciate that CRMCC can present with retinal phenotypes other than Coats’ reaction, and a minority may not have any visible retinal changes. Also angiomas call for neuroimaging to identify brain cysts and calcifications which characterize CRMCC
Von Hippel‐Lindau’s disease : general and ocular management
Authors: GAUDRIC A
Published: August 2012

Abstract not provided
Debate : Epi‐ and peripapillary capillary hemangiomas and hemangioblastomas : in search of an optimal therapeutic approach
Authors: GAUDRIC A , DAMATO B , DESJARDINS L , ZOGRAFOS L
Published: August 2012

Abstract not provided
The contribution of the rod/melanopsin driven ganglion cells to the dynamic pupil light reflex response
Authors: BI W , TSUJIMURA S , PLANT G , BARBUR JL
Published: August 2012

Purpose Intrinsically photosensitive retinal ganglion cells have been shown to contribute to the control of the steady‐state pupil response. The extent to which melanopsin contributes to rapid pupil responses elicited with brief stimuli remains less clear. The principal objective of this study was to examine how the dynamic pupil light reflex response changes with the level of light adaptation for stimuli that isolate luminance, colour or combined rod and melanopsin. The range of light levels that yield useful rod signals was also investigated.

Methods The study involved ten normal subjects, one patient with rod deficiency, one patient with retinitis pigmentosa (RP) and one rod monochromat. The pupil responses were measured to stimuli that isolate photopic luminance, colour or combined rod and melanopsin at three light levels (456, 74.4 and 4.8cd/m2). Visual acuity, contrast sensitivity and chromatic sensitivity were also measured in all subjects.

Results The patients with rod deficiency and RP exhibit pupil responses to luminance and colour modulation, but much reduced or absent response to rod/melanopsin modulation. Conversely, the rod monochromat shows complete absence of pupil colour and luminance responses, but exhibits large pupil rod/melanopsin responses at all light levels.

Conclusion The findings from this study suggest that pupil responses to briefly presented stimuli are mediated largely by rod and cone signals with no contribution from melanopsin. The results also suggest that rod signals remain unsaturated and can contribute to dynamic pupil responses at much higher light levels.
Colour vision as a screening tool for sub‐clinical retinal disease
Authors: KONSTANTAKOPOULOU E , BARBUR JL
Published: August 2012

Purpose Age‐related retinal diseases start developing at a subclinical level, as gradual photoreceptor dysfunction, ganglion cell apoptosis etc. Subtle retinal changes disturb the fine intraretinal signal transmission and despite the lack of clinically detectable signs can cause an impairment of chromatic sensitivity that precedes the loss of performance in processing other stimulus attributes. Colour vision can be used as a sensitive screening tool for retinal diseases when the tests are carried out at lower light levels.

Methods The health of the retina (HR) index was introduced to detect early changes caused by disease by capturing the worsening of chromatic sensitivity as the light level changes from photopic to mesopic (J Opt Soc Am A Opt Image Sci Vis 29,2:A27‐A35,2012). This approach makes it possible to separate changes caused by normal aging from the effects of sub‐clinical retinal disease. Chromatic sensitivity was measured in 60 subjects (mean age 47.6 years, range 16‐79 years) at four light levels using the Colour Assessment and Diagnosis (CAD) test; measurement of pre‐receptoral absorption by the crystalline lens and the macular pigment and the size of the pupil allowed an estimation of retinal illuminance.

Results The HR index proved largely independent of age (r2~0.2), but ~11% of clinically normal older subjects showed impaired chromatic sensitivity that could reflect the development of retinal pathology. Some of these subjects developed AMD and Glaucoma 2.5 years after the assessment. Patients with identified retinal disease also show abnormal HR indices.

Conclusion The HR index is a single number that captures information about the health of the retina irrespective of age and can be used to screen for sub‐clinical signs of retinal diseases.
Age‐corrected monocular limits of normal trichromacy
Authors: RODRIGUEZ ‐ CARMONA M , KONSTANTAKOPOULOU E , KEUKEN A , BARBUR JL
Published: August 2012

Purpose Chromatic sensitivity worsens gradually with increasing age, but the inherent variability in normal colour vision makes this difficult to detect and to separate from very early changes caused by either retinal or systemic diseases. In this study we developed new approaches to identify and screen for changes that cannot be attributed to normal aging. This approach made it possible to produce reliable, age‐corrected limits for normal colour vision.

Methods Red‐green (RG) and yellow‐blue (YB) thresholds were measured monocularly in each eye (using the Colour Assessment and Diagnosis (CAD) test) in 394 subjects (age range: 16 to 90 years). Only clinically normal subjects according to medical history and eye / fundus examination were included. All subjects with congenital colour deficiency were excluded. A new filter based on right / left eye asymmetry for RG and YB thresholds was also employed to exclude subjects with significant differences in monocular thresholds. After filtering, the analysis of the effects of normal aging was based on 178 subjects (age range: 16‐79 years).

Results The effects of age (in the range 20 to 80 yrs) can be accounted for well by a linear trend with just over two‐fold increase in both RG and YB mean colour thresholds. Statistical limits of variability (±2σ) were computed from the normal subject data in order to provide limits of age‐corrected RG and YB colour vision.

Conclusion The age‐corrected CAD thresholds limits established in this study provide a more accurate way of detecting monocular changes in colour vision caused by either retinal diseases or systemic conditions that affect the eye.
Evolution of cataract surgery: Barraquer experience
Authors: DE LA PAZ M , BARRAQUER J , ALVAREZ DE TOLEDO JP
Published: August 2012

Purpose To describe the evolution of cataract surgery at the Barraquer Eye Center

Methods Several videos are presented showing the different techniques of cataract surgery over the last century

Results Intracapsular cataract extraction using the eysiphake was first developed by Prof. Ignacio Barraquer and the surgery was done with topical anesthesia, sutureless technique. This technique was later on enhanced with zonulolysis using alpha‐chymotrypsis as discovered by Prof. Joaquin Barraquer. Anterior chamber intraocular lens implantation using the Strampelli lens thru a small corneal incision is also shown. Finally we show the present day technique femtosecond laser assisted phacoemulsification thru a 2 mm incision with implantation of foldable intraocular posterior chamber lens.

Conclusion Several changes have taken place thru the last century in cataract surgery. Techniques have been developed for less intra operative and postoperative complications, faster visual rehabilitation and excellent refractive results.
Intracameral cefuroxime injection at the end of cataract surgery reduces the incidence of endophthalmitis, a French study
Authors: BARREAU G , MOUNIER M , MARIN B , ADENIS JP , ROBERT PY
Published: August 2012

Purpose To show the interest of intra‐camerular injection of cefuroxime at the end of cataract surgery to decrease the incidence of post‐operative endophthalmitis.

Methods 5115 patients operated from cataract between april 2003 and june 2008 were prospectively and exhaustively included in a survey for operative site infection. Intracameral Cefuroxime injection started in june 2006, so 2289 patient received Cefuroxime, and 2826 did not. Pre‐operative data (betalactamin allergy, history of endophthalmitis, age, sex) and intraoperative data (use of trypan blue, capsular ring or iris retractors, surgical time, senior or junior surgeon, corticosteroids injection, iris retractors), and postoperative infections at 8 days and 1 month were prospectively collected.

Results Respectively, the incidence of endophthalmitis without and with cefuroxime intracamerular injection was 35 of 2826 patients (1,238 %) and 1 of 2289 patients (0,044 %) (p < 0,0001). None of intraoperative factors we considered has been significantly associated to postoperative infection. No allergic reaction has been reported.

Conclusion Intracamerular Cefuroxime injection at the end of cataract surgery is a safe procedure to significatively decrease the incidence of endophthalmitis.
Morphology of age‐related cuneiform cortical cataracts: the case for mechanical stress.
Authors: MICHAEL R , VRENSEN G , BARRAQUER RI
Published: August 2012

Purpose To study the morphology of age‐related cuneiform cortical cataracts.

Methods We evaluated the gross morphology, location, and fiber cell architecture of equatorial cortical opacities in the aging human lens. Using dark‐field stereomicroscopy, we photographed donor lenses in toto and as thick slices. In addition, we investigated the details of the fiber cell architecture using fluorescent staining for membranes and by scanning electron microscopy. We then combined our data with data from recent studies on lens viscoelasticity.

Results We found that small cortical and cuneiform opacities are accompanied by changes in fiber structure and architecture mainly in the equatorial border zone between the lens nucleus and cortex.

Conclusion Because the lens cortex and nucleus have different viscoelastic properties in young and old lenses, we hypothesize that external forces during accommodation cause shear stress predominantly in this border zone. The location of the described changes suggests that these mechanical forces may cause fiber disorganization, small cortical opacities, and ultimately, cuneiform cataracts.
Contribution of 3D anterior segment reconstruction by rotative UBM to the sizing of phakic IOL
Authors: MAINDRON C , LE LOIR M , KOHANDANI TAFRESHI M , LAMARD M , COCHENER B
Published: August 2012

Purpose Posterior phakic implantation is the recommended procedure for high ametropia correction but it is harmed by a difficult sizing inducing errors. We designed a 3D rotative UBM prototype in order to take into account the volume of the posterior chamber to improve the sizing.

Methods 7 myopic eyes (mean MRSE: ‐10.8) of 4 patients underwent a phakic implantation by one surgeon with a “white to white”‐based sizing method. During the 3rd postoperative month, we evaluated several mesures that we assessed by anterior segment OCT (2D) and by our UBM prototype (3D), designed by the LaTIM ‐Inserm U1101 in association with Quantel Medical®. It contains a linear scanning probe of 50 MHz with a rotative motor (acquisition of 30 coaxial slides).

Results 3D reconstruction gives us a representation of one eye on 360°. For each eye, we have compared data pre and postoperative implantation and our results reflect the conventional impact of implant.

Conclusion Our rotative probe has allowed the first 3D reconstruction of the ocular anterior segment. This initial approach reports high anatomical variations and non uniformity of intraocular clearances, explaining potentially some unexpected IOL positioning. Our goal is to have an accurate visualization of relationship between phakic IOLs and intraocular surrounding structures. Perspectives could be the evaluation of the impact of accommodation on intraocular volumes in addition to preoperative simulations in 3 dimensions.

Commercial interest
Influence of multifocal intraocular lenses on standard automated perimetry test results
Authors: AYCHOUA N , JUNOY MONTOLIO F , JANSONIUS NM
Published: August 2012

Purpose To evaluate the influence of multifocal intraocular lenses (MFIOLs) on standard automated perimetry (SAP) and size V perimetry test results.

Methods Sixteen eyes of 16 patients with a diffractive MFIOL (median age 64 years) and 45 phakic eyes of 45 healthy subjects (median age 49 years) were included in this cross‐sectional case‐control study. All eyes underwent (1) SAP with the Humphrey Field Analyzer using a 30‐2 grid and the Swedish Interactive Threshold Algorithm standard strategy and (2) a full threshold test with stimulus size V (instead of the default size III). Our Main Outcome Measures were the mean deviation (MD; for SAP) and mean sensitivity (MS; for both SAP and size V perimetry).

Results The MD of the SAP test results was on average 2.18 dB lower in MFIOL patients than in controls (P<0.001). For all 16 cases and an age‐matched subgroup of 18 controls, this difference was 2.05 dB (P=0.001). The age‐adjusted difference in MS between cases and controls was ‐2.34 dB (P<0.001). For size V perimetry, this was ‐1.67 dB (P<0.001). For a subset of test locations within 10 degree eccentricity, the age‐adjusted difference in MS between cases and controls was ‐2.35 dB for size III (P<0.001) and ‐1.96 dB for size V perimetry (P<0.001).

Conclusion Patients with a diffractive MFIOL have a clinically relevant reduction of the visual sensitivity as assessed with SAP and size V perimetry.
Inflammation in retina disease
Authors: TADAYONI R
Published: August 2012

Abstract not provided
Early markers of inflammation
Authors: BEHAR‐COHEN F
Published: August 2012

Abstract not provided
Inflammation in uveitis
Authors: DE SMET M
Published: August 2012

Abstract not provided
Clinical and OCT outcomes for full‐thickness and lamellar macular hole surgery
Authors: STAPPLER T
Published: August 2012

Purpose Macular hole surgery has been long‐established practice in vitreoretinal surgery and yet there is still controversy over its management especially around the value of postoperative face‐down posturing on its outcome. Surgical indications for lamellar macular holes (LMH) are far more controversial. OCT has become the standard assessment tool for success evaluation and may even yield prognostic value.

Methods Review of current published literature regarding posturing vs. non‐posturing for full‐thickness macular holes (FTMH), surgery vs. observation in lamellar macular holes (LMH).

Results 21 studies investigating the effect of face‐down posturing on the outcome of macular hole surgery were identified. 11 studies included a comparison group and were deemed suitable for inclusion in the meta‐analysis. Of three RCTs, two suggested a benefit in larger holes but none demonstrated evidence of benefit in smaller holes. The lamellar macular hole group is much more heterogenous with some authors distinguishing between lamellar macular holes (LMH) and macular pseudoholes (MPH). Some morphological OCT changes, such as oedema, cystic spaces and lamellar holes were commonly seen in patients with epiretinal membrane (ERM). The presence or absence of an intact IS/OS layer may correlate with visual outcome.

Conclusion The field surgery is constantly changing even for what is considered standard surgery in macular holes. The trend towards postoperative posturing seems to recur, especially for macular holes larger than 400μm. CONSORT‐adherent RCTs would be required to provide future guidance. Lamellar macular holes are still a poorly defined group with proponents and detractors in balance. The presence of concurrent ERM on OCT may tip the balance towards surgery.
Vitrectomy with subretinal t‐PA, gas tamponade and intravitreal ranibizumab for the treatment of submacular hemorrhage due to AMD
Authors: MENDRINOS E
Published: August 2012

Purpose This lecture aims to summarize what is known about the effect of vitrectomy with subretinal t‐PA, gas tamponade and intravitreal anti‐VEGF in the management of submacular hemorrhage in neovascular age‐related macular degeneration.

Methods Submacular hemorrhage associated with neovascular age‐related macular degeneration is a complication known to have potentially devastating effects on visual acuity. The exact incidence of submacular hemorrhage in patients with neovascular age‐related macular degeneration is unknown, and risk factors for its occurrence ill defined. It is known, however, to be a relatively common problem and important because the visual prognosis of these patients is poor.

Results Multiple treatment modalities have been suggested including intravitreal anti‐vascular endothelial growth factor injections, photodynamic therapy, pneumatic displacement with or without adjuvant intravitreal tissue plasminogen activator, and pars plana vitrectomy with or without adjuvant subretinal tissue plasminogen activator. However, there remains no consensus on optimal treatment, as clinical trials for neovascular age‐related macular degeneration have excluded patients with submacular hemorrhage.

Conclusion Although the final visual outcome is often limited by progression of age‐related macular degeneration, significant and stable visual recovery is possible in selected eyes. Prospective clinical trials are needed to clarify the role for vitrectomy/tPA/gas/anti‐VEGF and to provide definitive outcome comparisons with other management approaches.
Gene therapy approaches in corneal pathologies
Authors: FUCHSLUGER T
Published: August 2012

Purpose This lecture will provide an overview over past and current gene therapy approached to treat corneal pathologies.

Methods The presentation will include both viral and non‐viral gene transfer strategies and will present data from the authors and other research groups.

Results Depending on the carrier transduction rates of corneal cells vary. However, outcome has ben promising, also during corneal storage and after corneal transplantation.

Conclusion Gene therapy to the cornea is a relatively new but promising field.
Nanoparticles for drug delivery
Authors: STEFANSSON E , GUDMUNDSDOTTIR B , ASGRIMSDOTTIR G , LOFTSSON T
Published: August 2012

Purpose To test dorzolamide cyclodextrin microparticle eye drops applied once a day (QD)for intraocular pressure control,compared with Trusopt® 3 times a day (TID).

Methods Self aggregating cyclodextrin microparticle eye drops (DorzNP) containing 3% dorzolamide were formulated. The effect of the DorzNP eye drops QD was compared to Trusopt® TID in a prospective randomized single masked crossover trial over 24 hours. Seventeen healthy volunteers with intraocular pressure (IOP) over 18 mmHg were recruited. IOP was measured with an Icare tonometer pro and each patient underwent full eye examination.

Results DorzNP eye drops QD and Trusopt® TID lower IOP in a similar manner. At no time point was there a significant difference in IOP between the two groups. The peak effect in both groups was at 4 hours: In the DorzNP group IOP decreased from 21.7 ± 2.4 mmHg at baseline to 17.9 ± 3.9 mmHg, which is 3.8 ± 2.6 mmHg and 18% IOP decrease. In the Trusopt® group IOP decreased from 20.9 ± 2.2 mmHg at baseline to 17.9 ± 3.3, at 4 hours which is 3.1 ± 3.7 mmHg ,14%, (p = 0.97 between groups) IOP drop. At trough at 24 hours the IOP drop was 1.4 ± 2.8 (6%) in DorzNP eyes and 1.5 ± 2.0 (7%) in Trusopt eyes (p = 0.23). Burning in DorzNP eyes on the scale 1‐100 was 12±15 and in Trusopt® eyes 37±30 (p=0.0038). Vision aquity and redness did not differ between the two groups

Conclusion The results suggest that once a day dorzolamide nanoparticle eye drops have a similiar effect on intraocular pressure as Trusopt® applied 3 times a day. The dorzolamide microparticle eye drops are well tolerated, less burning than Trusopt®and significantly reduce intraocular pressure.

Commercial interest
SEGRAs a new therapeutic option on the horizon?
Authors: PLEYER U
Published: August 2012

Fifty years after their initial clinical use glucocorticoids (GC) are still the most important and most frequent used anti‐inflammatory agents in the treatment of acute and chronic inflammatory diseases. Unfortunately the anti‐inflammatory and immunosuppressive effects of GC are frequently accompanied by undesired side effects. Beside unknown individual factors, recent investigations have idientified molecular mechanisms of GC action that may reveal new antiinflammatory agents with a better effect/side effect profile. The effect of GC on target cells is mediated by the regulation of transcription of steroid‐responsive genes. After binding to cytosolic glucocorticoid receptors (GR) the complex translocates into the nucleus and modulates gene transcription either by a positive (transactivation) or negative (transrepression) mode of regulation. There is growing evidence that beneficial effects as well as undesired effects are related to the dissociation of these two major mechanisms, e.g. steroid diabetes and steroid induced glaucoma seems to be mainly related to transactivation mechanisms. The dissociation of these mechanisms has recently led to the development of new agents that may predominantly induce transrepression over transactivation and subsequently lead to potent anti‐inflammatory effects while displaying less dominant side effects. Indeed, transgenic mice carrying a defective GR could demonstrate the anti‐inflammatory potential of transrepression. The purpose of this presentation is to provide an up‐date on recent developments in this field.
Synthetic eye prosthesis
Authors: STORSBERG J , SCHMIDT C , REHFELDT S , KOBUCH K , MESSNER A , RÖTHGEN H , DUNCKER GIW , KNAK M , CORDES A , SCHRAGE N , NASS N , SEL S
Published: August 2012

Purpose Development of synthetic eye prosthesis to provide a long term stable keratoprostesis

Methods Synthetic hydrophobic and hydrophilic biomaterials were selectively modified by physical and chemical nanotechnological methods. The modified biomaterials were tested in cell culture experiments (fibroblasts L929 and primary epithelial cells, porcine) and implanted into rabbits eyes. The hydrophobic material was implanted finally into eyes of ultima ratio patients.

Results After very successful in vitro evaluation, keratoprostheses were implanted to rabbit eyes (New Zealand white rabbit) and showed excellent in vivo performance in the animal experiment.As for the hydrophibic material, no adverse reaction was observed after follow up of 2.5 years in human eyes.

Conclusion We could develop a new keratoprosthesis which is well tolerated in human eye.
Translating ocular immunology from the laboratory to the clinic ‐ keratoplasty ‐
Authors: PLEYER U
Published: August 2012

Keratoplasty has definitely its paradoxes. It has been the first successful transplantation in man and is with approx.100.000 grafts/year easily the most frequent allograft in human medicine. At the same time it is still the least understood form of transplantation in respect to its biology. It is both, the most successful as well as probably the most underestimated procedure regarding its risks in clinical transplantation. Indeed, the common assumtion, that corneal transplantation is a safe procedure with good prognosis may have hindered more intensive effort of research in this field. There are still limitations to corneal transplantation, and allograft rejection still poses the greatest challenge. In the last two decades, graft survival has been greatly improved by the introduction of efficient immunosuppressive drugs. This lecture aims to highlight the most novel and successful strategies to achieve a better outcome of pkp and e.g. tolerance via induction of Tregs. In addition, the use of lamellar grafts (e.g. DMEC) has significantly changed our perception and will be discussed.
Exploiting the immune response to halt progression of ocular melanoma
Authors: MCKENNA KC
Published: August 2012

Purpose The purpose of this study was to characterize the requirements for spontaneous rejection of tumors transplanted in the anterior chamber (a.c.) of splenectomized mice as a first step toward identifying how to harness the immune reponses to eliminate intaocular tumors.

Methods Luciferase expressing E.G7‐OVA (Luc E.G7) tumors were injected in the a.c. of the eye of wildtype, CD8 depleted, perforin deficient, IFNγ deficient, IFNγ receptor 1 deficient (IFNγR1), or inducible nitric oxide synthase (NOS2) deficient mice that were splenectomized or left untreated prior to tumor challenge. In some experiments intraocular macrophages were depleted by subconjunctival administration of clodronate liposomes. Luc E.G7 tumor growth was measured by bioluminescent imaging using an IVIS imager. Tumor‐specific OT‐I CD8+ T cells were monitored in vivo by flow cytometry.

Results Luc‐E.G7 tumors grew progressively in the a.c. of nonsplenectomized mice but were spontaneously rejected in splenectomized mice. Rejection of ocular tumors in splenectomized mice required CD8+ T cells, macrophages, IFNγ and IFNγR1 expression by host cells. Infiltration of ocular tumors by CD8+ T cells and their expression of IFNγ were equivalent in splenectomized and nonsplenectomized mice. Perforin expression and nitric oxide production were not required for rejection of intraocular tumors.

Conclusion These data suggest a model of ocular tumor regression in splenectomized mice in which CD8+ T cells express IFNγ to induce nitric oxide‐independent tumoricidal activity within intratumoral macrophages. Therefore, restoring tumoricidal activity in intratumoral macrophages is critical for CD8+ T cell mediated elimination of ocular tumors
Regulatory T cell therapy for uveitis
Authors: BODAGHI B
Published: August 2012

New therapeutic strategies, including novel generation of immunosuppressors and biologic agents are currently available for the management of noninfectious uveitis. However, adverse events remain an important issue to consider and other options need to be evaluated. We have previously controlled experimental autoimmune uveoretinitis by administrating activated polyclonal regulatory T cells (T‐regs) intravitreally. Based on these preliminaru results, a clinical study has been initiated to evaluate the safety and efficacy of this approach in patients with uveitis and low vision. Tolerance and efficacy will be monitored with clinical examination, laser flare photometry and imaging. Intraocular levels of pro and anti‐inflammatory cytokines will be determined in each patient at baseline and after T‐reg administration. Cell therapy may become an interesting strategy, expanding the anti‐inflammatory armamentarium.
Spontaneous venous pulsation revisited ‐ relevance to glaucoma?
Authors: PINTO LA
Published: August 2012

Purpose Purpose: Address the clinical significance of spontaneous venous pulsation (SVP) assessment in glaucoma patients.

Methods Methods: Review of the existing literature on the subject, including own published data. Emphasis on studies that have analyzed this phenomenon using OBF studying technologies.

Results Results: Threshold conditions for SVP detection are different in healthy and in glaucoma patients. The variables involved in SVP generation may have a different threshold in normal tension glaucoma (NTG) than the one seen in primary open‐angle glaucoma (POAG) patients. Hemodynamic patterns in POAG reveal a selective venous disturbance in patients lacking SVP, while NTG patients have both arterial and venous changes in their central retinal vessels. Clinically, patients with NTG without a visible SVP have a higher functional damage than their SVP‐positive counterparts.

Conclusion Conclusions: The lack of SVP in NTG patients may not only represent a more advanced condition, but also both an arterial and venous dysregulation. More studies are needed to validate these findings.
From retinal venous pressure to intra‐cranial pressure in glaucoma
Authors: JONAS JB
Published: August 2012

The blood pressure in the central retinal vein is supposed to be at last as high as the orbital cererbospinal fluid pressure (CSF‐P) plus a hypothetical trans lamina cribrosa outflow resistance‐related pressure. The central retinal vein pressure can non‐invasively be estimated by modified ophthalmodynamometry. The talk will present results of clinical studies in which ophthalmodynamometry was used to estimate the orbital (and intracranial) CSF‐P and to estimate the orbital tissue poressure. The findings could be helpful for the discussion whether an abnormally low CSF‐P is associated with glaucomatous optic neuropathy
Aflibercept in clinical practice: Evaluation of the first 50 patients treated with antiVEGF trap for age‐related macular degeneration
Authors: BARBAZETTO I , SORENSON J , ENGELBERT M
Published: August 2012

Purpose To evaluate the short‐term outcomes after intravitreal aflibercept (Eylea; Regeneron Pharmaceuticals, Inc.) injection in a general clinic population treated for neovascular age‐related macular degeneration (AMD).

Methods This is aretrospective chart review of consecutive patients who received intravitreal aflibercept injection for AMD. The main outcome measures were mean visual acuity (VA), central macular thickness, presence of subretinal fluid, cystic changes and pigment epithelial detachment on optical coherence tomography (OCT).

Results Sixty‐three eyes of 52 patients (mean age 81.2, range 59‐98years) were evaluated. Mean baseline visual acuity was 0.79 LogMar (STDEV 0.43)at baseline and 0.66 at follow‐up(STDEV 0.48) (P = 0.43). Mean follow‐up was 1 to 4 month (average 1.7). Mean baseline central macular thickness was 352 microns and improved to 257 microns at 3 months (P < 0.001) in patients who had at least 3 months of follow up. 39 patients (75%) were treated with monthly injections, the remaining patients were treated based on a “treat and extend” protocol. Treatment was well tolerated with no adverse events reported.

Conclusion Short‐term results of aflibercept therapy showed encouraging results with improvement in OCT parameters. Patients who underwent antiVEGF treatment with other medications prior the use of aflibercept may stabilize but not further improve after short‐term treatment with aflibercept. Further studies are needed to assess the effect of aflibercept in patients who are not treatment naïve.
Retrospective analysis of the real‐world utilization of ranibizumab in wAMD
Authors: TADAYONI R , HOLZ F , HEAH TGH , HELDNER S , THE AURA STEERING COMMITTEE FOR
Published: August 2012

Purpose With monthly ranibizumab treatment for wet AMD (wAMD), optimal functional outcomes are achieved. To reduce management burdens, as‐needed dosing regimens have been explored. AURA study examines real‐world utilization of ranibizumab.

Methods Retrospective, international (Canada, France, Germany, Ireland, Italy, Netherlands, UK, Venezuela), non‐interventional, observational study. Target enrollment is 444 patients per country and will be completed by September 2012. Consecutive AMD patients prescribed ranibizumab by their physicians will be included, with a follow‐up period of up to 2.5 years. Primary outcomes are (1) change in visual acuity and (2) resource utilization (number of treatment and monitoring visits, treatment use). Descriptive statistics will be used.

Results Results for Germany are already available: 916 patients from 28 sites were screened. Of these, 462 (50.4%) were not enrolled. The reasons (not mutually exclusive) included no written informed consent (n=349), consent obtained after target patient number reached (n=68), use of non‐conventional interventions (n=21), ranibizumab use did not start between January‐August 2009 (n=23), and no wAMD diagnosis (n=6). Of the 454 enrolled, 437 (96.3%) received ≥1 ranibizumab dose. Of the 437, most were women (n=260, 59.5%), Caucasian (n=368, 84.2%), and initiated treatment at ≥75 years of age (n=304, 69.6%). Mean age was 79.2±8.1 years.

Conclusion These data will provide valuable insight into resource utilization patterns and their effects on visual outcome in various ranibizumab‐treated wAMD patient populations.

Commercial interest
Diagnosis and treatment of vernal conjunctivitis
Authors: BREMOND‐GIGNAC D
Published: August 2012

Purpose vernal keratoconjunctivitis is a rare disease disease

Methods tstyjyjtjkydtktukdtu

Results duykdkfyulyqzreaqtrz

Conclusion qesrytrurursjr

Commercial interest
Cutaneous and ocular signs of childhood rosacea
Authors: MORTEMOUSQUE B
Published: August 2012

Purpose To describe the clinical features of cutaneous and ocular manifestations of childhood rosacea, to propose diagnostic criteria, and to emphasize the possible severity of ocular complications in this age group.

Methods Children aged 1 to 15 years who had received a diagnosis of cutaneous and/or ocular rosacea and were seen between January 1, 1996, and December 31, 2011.

Results Of 20 patients, 11 had ocular and cutaneous rosacea, 6 had isolated cutaneous involvement, and 3 had isolated ocular involvement. Dermatologic examination results were sufficient to diagnose rosacea in 12 of the patients (60%). The most common presentation was a papulopustular eruption on a telangiectatic background. In 11 patients (55%), ocular involvement preceded the skin eruption. Among the ophthalmologic manifestations, chalazions and blepharoconjunctivitis were the main presenting symptoms; keratitis was observed in 4 patients and corneal ulcers in 2. Ten patients were treated with oral metronidazole. Intermittent treatment for at least 3 months was used to avoid neurologic toxic effects and to achieve complete remission.

Conclusion Although rare, childhood rosacea should be recognized because of the possible severity of ocular involvement.
The indications of cyclosporine A in children’s ocular surface diseases
Authors: DOAN S
Published: August 2012

Abstract not provided
Congenital orbital teratoma
Authors: ROSNER M , FABIAN ID , PRIEL A , FRIDMAN E , GREENBERG G , ROSEN N
Published: August 2012

Purpose Congenital orbital teratoma is a rare tumor, composed of all three germ cell layers. The purpose is to present a case with congenital orbital teratoma, and discuss the clinical and histological characteristics of the tumor.

Methods Case report of a newborn girl that had a protrusion of the right globe. Imaging disclosed a big intraorbital lesion and capillary hemangioma was suspected, but treatment with propranolol had no effect during 4 months. At the age of 5 months acute progression of the proptosis developed with enlargement of the orbital mass as seen on MRI, pressing on the optic nerve. She underwent surgery and the lesion was removed completely using a cryo‐probe.

Results The pathologic diagnosis was orbital teratoma including cysts filled with keratin, hair follicles, glands, bone, cartilage, epithelium and neuronal‐brain tissue. On follow‐up examination there was no proptosis but some limitation of ocular movements was seen one month after surgery.

Conclusion In order to diagnose clinically orbital teratoma, a high index of suspicion is needed. Surgical excision is the treatment of choice. Early detection and treatment is important in order to prevent mechanical destruction of adjacent tissues.
Role of laser
Authors: CONRATH J
Published: August 2012

Abstract not provided
Incidence of tears and retinal detachments after macular surgery according to the depression of the vitrectomy cutter
Authors: BERROD JP , SELTON J , CONART JB , HUBERT I
Published: August 2012

Purpose To study the incidence of tears and rhegmatogenous retinal detachments (RD) after macular surgery, according to the vacuum settings during vitrectomy.

Methods Comparative retrospective study of rhegmatogenous complications occurring during and after vitrectomy between 2 groups of consecutive patients. Group G400, included 1432 eyes vitrectomized with a maximum flow set at 4 ml / min and a maximum vacuum at 400 mm Hg. Group G230 included 434 eyes operated with the same flow rate with vacuum limited at 230 mm Hg. All patients were operated between November 2000 and June 2010, by two experienced surgeons.

Results The incidence of tears observed during surgery was 5.1 % for G400, versus 3 % for G230 (p = 0.01). The incidence of postoperative RD was 3.2 % for G400, versus 1.2 % for G230 (p = 0.02). The mean duration before the occurrence of RD was 73.3 + 98.5 days in G400, versus 21.6 + 16.3 days in G230 (p = 0.004).

Conclusion The incidence of tears observed during surgery was 5.1 % for G400, versus 3 % for G230 (p = 0.01). The incidence of postoperative RD was 3.2 % for G400, versus 1.2 % for G230 (p = 0.02). The mean duration before the occurrence of RD was 73.3 + 98.5 days in G400, versus 21.6 + 16.3 days in G230 (p = 0.004).
Macular sensitivity and structure in epiretinal membranes 6 months after surgical treatment
Authors: CREUZOT C , ISAICO R , NICOT F , BRON A
Published: August 2012

Purpose To evaluate the evolution of macular sensitivity (MS) and its correlation with visual acuity (VA) and Spectral‐Domain Optical Coherence Tomography (SD‐OCT) in patients with idiopathic epiretinal membrane (ERM) at 3 and 6 months after surgical treatment.

Methods In this prospective, monocenter, interventional case series, we included 49 patients (49 eyes) with an idiopathic ERM scheduled for a surgical treatment. Among these patients, 34 were evaluated at 3 months (M3) and 32 at 6 months (M6) after ERM and internal limiting membrane removal. At each visit a measurement of ETDRS best‐corrected visual acuity, microperimetry and SD‐OCT were performed for all patients.

Results The MS was improved significantly from 11.7±2.1 dB preoperatively to 12.9±1.8 dB (p=0.001) and 13.3±1.9 dB (p=0.001) at M3 and M6 postop respectively. In the same time we observed an improvement of VA from 70.0±10.2 letters ETDRS at inclusion to 80.1±6.9 letters at M3 (p<0.0001) and 80.8±6.5 letters at M6 (p<0.0001). Macular thickness decreased significantly from 412.6±53.1 µm to 340.5±29.6 µm and 332.9±26.9 µm at M3 and M6 respectively. We found a significant correlation between pre and post operative MS at M3 (r=0.565; p=0.0002) and M6 (r=0.584; p=0.0001). A significant correlation between pre and post operative VA was also found at M6 (r=0.558; p=0.0003) but not at M3 (r=0.229; p=0.097). We did not find any significant correlation between the increase in MS and VA (r=0.286; p=0.112) and between MS improvement and macular thickness decrease (r=‐0.196; p=0.283).

Conclusion Complementary aspects of macular function were given by VA and MS measurements after ERM surgery.
Implication of functional and anatomical preoperative characteristics in the outcomes of epiretinal membrane (ERM) surgery
Authors: CASTRO NAVARRO J , GARCÍA FERNÁNDEZ M
Published: August 2012

Purpose To study the implication and meaning of preoperative functional and anatomical characteristics (based on the parameters Best Corrected Visual Acuity, BCVA, and foveal central thickness, measured by Optical Coherence Tomography, OCT) in the evolution after ERM surgery.

Methods In this longitudinal, prospective study we reviewed 88 eyes (of 86 patients), on whom we had performed vitrectomy or faco‐vitrectomy due to ERM, with a follow‐up period of three years. We analyzed: ERM etiology, BCVA, metamorphopsia, lens status, and central foveal thickness measured by OCT. We collected the following data during the follow‐up: type of surgery (isolated vitrectomy or combined surgery), local complications, changes in BCVA, and changes in foveal central thickness.

Results We observed an improvement in BCVA, and also a decreasement in foveal thickness, being both statistically significant (p<0.01). However, most of the patients showed different grades of oedema and/or macular thickening in the postoperative period. We found significant correlation between preoperative and postoperative BCVA (p=0,001), and also between preoperative and postoperative central foveal thickness (p=0,004), but not between BCVA and foveal thickness.

Conclusion A functional recuperation occurs (based on BCVA) in more of 80% of the patients, after ERM surgery. Most of the eyes show persistent macular thickening, but this does not seem to have influence on the final BCVA. The best determinant of postoperative functional recuperation is, in our experience, the preoperative BCVA, and not the macular thickness.
Content‐based MPEG‐4 video stream retrieval for video‐guided eye surgery
Authors: DROUECHE Z , LAMARD M , QUELLEC G , CAZUGUEL G , ROUX C , COCHENER B
Published: August 2012

Purpose This work introduces ongoing research on computer‐aided retinal surgery. A content‐based video retrieval system is presented: given a video stream captured by a digital camera monitoring the current surgery, the system retrieves similar videos in video archives. These informations could guide the surgery steps or generate surgical alerts if the current surgery shares complications with archived videos.

Methods We propose to use data compression to extract video features. 1: motion vectors are derived from MPEG‐4 stream. 2: image sequence segmentation is performed by a k‐means clustering. 3: we used Kalman filter to track region displacements between consecutive frames and therefore characterize region trajectories. Finally, we combined this motion information with residual consisting of the difference between original input images and predicted images. To compare videos, we adopted an extension of fast dynamic time warping.

Results The system was applied to a small dataset of 24 video‐recorded retinal surgeries (621s +‐ 299s). Images have a definition of 720x576 pixels. An ophthalmic surgeon has divided each video into three new videos, each corresponding to one step of the membrane peeling procedure: Injection, Coat, Vitrectomy. The effectiveness of the proposed method, measured by ROC curve, is interesting (Az ≅ 0.73).

Conclusion A novel CBVR system, allowing retrieval of medical video, has been presented. Experiments on the dataset of retinal surgery steps validate the semantic relevance of retrieved results in ophthalmic applications.
Ocular surfaces in the treatment of glaucoma
Authors: UUSITALO H
Published: August 2012

The ultimate goal of glaucoma therapy is to prevent ganglion cell death and progression of glaucoma. So far glaucoma has been treated by lowering the intraocular pressure. Although this strategy has been successful in many cases there is a great need to understand the overall benefits, risk factors and adverse reactions of the various existing and new treatment modalities to further improve the success of medical and surgical glaucoma therapies. Ocular surfaces are the most important pathway for the topical glaucoma drugs and thus most vulnerable to the topical adverse reactions. In the aging population the risk for the topical adverse reactions is high and they may jeopardize the success of glaucoma therapy by decreasing the adherence to the treatment or by affecting the outcome of the glaucoma surgery. The cause of these problems might lie in the individual vulnerability, in the active or adjunctive compounds of the medical drugs, in the surgical techniques or biomaterial used in the glaucoma surgery. Therefore the identification of the existing risk factors for these reactions are of great importance for the successful glaucoma therapy.
Changes in retinal ganglion cell morphology after optic nerve crush and experimental glaucoma
Authors: KALESNYKAS G
Published: August 2012

Purpose To study sequential changes in retinal ganglion cell (RGC) morphology in mice after induction of experimental glaucoma.

Methods Experimental glaucoma was induced in mice that selectively express yellow fluorescent protein (YFP) in RGCs. Mice were sacrificed 1, 3 and 6 weeks after induction of glaucoma by bead injection. All YFP‐RGCs were identified in retinal whole‐mounts. Confocal images of randomly selected RGCs were quantified for somal fluorescence brightness, soma size, neurite outgrowth, and dendritic complexity (Sholl analysis).

Results After 6 weeks of glaucoma, 31% of axons died, but there was no loss of YFP‐RGC bodies. In combined data from all timepoints, the RGC soma area was larger than control (P = 0.04, generalized estimating equation model). At 3 weeks, glaucoma RGCs had significantly larger values for dendritic structure and complexity than controls (P = 0.044), but no statistical difference was found at 6 weeks.

Conclusion Despite the moderate loss of axons, significant changes in YFP‐RGC morphology were not observed after 6 weeks of follow‐up.
Progressive serpiginous choroidopathy – what to do?
Authors: PAVESIO C
Published: August 2012

A 52 year‐old Caucasian female, diagnosed at the age of 11 with tuberculosis presented years later with a picture of serpiginous choroidopathy initially affecting one eye, but later both. She lost vision in her right eye as a consequence of a CNV. She received three courses of anti‐TBc treatment but the disease continue to progress. Conventional immunosuppressive therapy was also added with minimal impact on recurrences. Currently in the process of receiving anti‐TNF therapy. Infection versus immune response, or a bit of both?
How a benign granulomatous uveitis can become a killer case
Authors: BOUCHENAKI N , HERBORT CP
Published: August 2012

Purpose To show how failure to diagnose correctly uveitis with micro‐granulomatous keratic precipitates and vitritis can have potentially severe and even deadly consequences.

Methods Case presentations.

Results Illustrative cases will show how important it is to diagnose an ubiquitously occurring granulomatous uveitis and crucial elements will be given to avoid to miss the diagnosis.

Conclusion A meticulous clinical examination is the key to a successful uveitis practice.
TB or not TB...or what else?!
Authors: NERI P , ARAPI I , PIRANI V , CAPUANO V
Published: August 2012

Purpose To present the clinical pattern of a complex case with atypical clinical features and controversial laboratory results.

Methods Case report

Results Infectious diseases represent always a challenge both for the clinical presentation and the management. The advent of new laboratory tests has lead to diagnosis of certain diseases which were undetectable in the recent past. These techniques have changed the way of treating several diseases, even though the gold standard still represents a chimera. Infact, it is not uncommon to face diseases which present themselves atypically and with laboratory tests which can be controversial. We want to present an anecdotal case that was defined a "killer case" in our tertiary referral centre.

Conclusion The clinical presentation and the laboratory results of certain diseases can often be a tricky challenge even for highly specialized centres. The scientific "methodic doubt" is mandatory in cases which do not present typical clinical features.