bluuebunny/crossref_metadata_2025 huggingface dataset:
Human pluripotent stem cell derived retinal pigment epithelium fulfills requirements of the in vitro functionality
Authors: SKOTTMAN H , VAAJASAARI H , NYMARK S , JUUTI‐UUSITALO K , HYTTINEN J , UUSITALO H , ILMARINEN T
Published: August 2012

Purpose Human pluripotent stem cell (hPSC) therapy is a potential approach for the replacement of degenerated retinal pigment epithelium (RPE) cells. For therapeutic use, safety and functionality of the RPE cells needs to be guaranteed. In addition to the basic cell and molecular biological characterizations it is vitally important to assess the differentiation status of acquired cells with functional tests.

Methods We have previously shown that hPSC differentiate into RPE in xeno‐free and defined conditions. Recent advances as a culture of hPSC‐derived RPE cells sheets on clinically accepted material have led us to investigate the functionality of the RPE epithelium. The tightness of the epithelium was evaluated by measuring transepithelial electrical resistance and cell permeability. The phagocytic properties of hPSC‐RPE cells were studied using rat retinal explants.

Results Human PSC‐derived putative RPE cells exhibits typical pigmented cobblestone‐like morphology and express RPE specific markers at both mRNA and protein level. In addition, cultured cells form a polarized epithelium with high integrity. In addition, co‐culturing hPSC‐RPE monolayers with rat retinal explants demonstrated that rhodopsin is internalized by cells in vitro.

Conclusion We have demonstrated that hPSC‐RPE monolayers acquired RPE‐like properties, including characteristic RPE phenotype, expression of RPE markers and barrier functions. In addition, cells were capable of binding and internalizing rat rhodopsin when co‐cultured with rat retinal explants. Currently we investigate the correlations of the functions in the Royal College of Surgeons (RCS) rats.
The influence of retinal oxygenation on the clinical outcomes in eyes with epiretinal membrane after successful vitrectomy
Authors: WEIGERT G , SACU S , GEORGOPOULOS M , PALKOVITS S , BLUM R , REZAR S , EIBENBERGER K , SCHMIDT‐ERFURTH U , SCHMETTERER L
Published: August 2012

Purpose In the present study patients with epiretinal membrane underwent 23G vitrectomy and ICG membrane peeling. Little information is available about the effects of this treatment on retinal oxygenation. Hence, we set out to investigate the effects of vitrectomy on retinal oxygenation in patients with epiretinal membrane.

Methods In this unmasked, prospective study, patients with macular edema as a result of epiretinal membrane scheduled to undergo vitrectomy without endotamponade, were included. The main outcome measure was oxygenation of the retinal vessels. The measurement of oxygenation in retinal vessels and retinal vessel diameters was performed with the Retinal Vessel Analyzer at baseline, at day 1, day 7, week 4, and week 12 after surgery. At each follow‐up visit, a high‐definition OCT examination and ETDRS visual acuity were also performed.

Results Retinal venous diameter increased significantly at the first follow‐up examination. There was no significant change in oxygen saturation in retinal arteries. Retinal oxygen saturation in retinal veins showed a tendency to decrease at the 3 months follow‐up visit. Visual acuity did not change significantly after 3 months. Central retinal thickness was decreased after 3 months as expected but not to a significant level.

Conclusion Vitrectomy for epiretinal membrane may show beneficial short‐term effects on retinal oxygenation. In eyes with macular edema due to other pathologies with retinal ischemia, vitrectomy may be performed as an additional treatment modality. Further studies evaluating whether these effects are associated with changes in long‐term visual acuity are warranted.
Pars plana vitrectomy for valsalva retinopathy: a case series
Authors: GARCIA FERNANDEZ M , CASTRO NAVARRO J , GONZALEZ CASTANO C
Published: August 2012

Purpose To investigate the utility of pars plana vitrectomy in a series of patients with Valsalva retinopathy.

Methods A retrospective, case series study that includes five patients with sudden visual acuity loss owing to Valsalva retinopathy with too dense premacular hemorrhages, treated in our hospital in the last three years. The etiology of the premacular hemorrhage was: vomiting (cases 1, 2 and 3), trauma (case 4) and vigorous dancing (case 5). Mean age was 33±19 years. After a period of observation ranging between three and four weeks, all patients underwent 23‐gauge pars plana vitrectomy. The internal limiting membrane (ILM) was released and the hemorrhage was cleaned.The sub‐ILM localization was confirmed in all cases during vitrectomy. One patient suffered an accidental break during peribulbar anaesthesia which was resolved successfully with laser photocoagulation. Full clinical examination including best‐corrected visual acuity (BCVA) (Snellen chart), intraocular pressure, fundus examination, and Optical Coherence Tomography (OCT) was performed at baseline and at last examination in all patients. The mean follow‐up was 16.1 (3‐32) months.

Results BCVA was 10/10 in all patients one month after surgery and it remained unchanged during the follow‐up period. Funduscopy appearance was excellent in all eyes. No postoperative complications were found.

Conclusion Valsalva retinopathy is a very rare condition that causes sudden visual acuity loss. In those cases with too dense hemorrhages it is necessary to perform vitrectomy, with excellent visual outcomes, as these hemorrhages are highly unlikely to resolve spontaneously.
Boston Keratoprosthesis in 2012: preventing complications and optimizing outcomes
Authors: COLBY K
Published: August 2012

Purpose To provide an update on Boston KPro indications, post‐operative care and prevention and management of the complications based upon experience at the MEEI and results presented at the Eighth KPro Study Group Meeting in May 2012.

Methods Clinical records were reviewed to determine outcomes of primary KPro surgery and surgery done using backplates of different materials and design. The origin of retroprosthetic membranes (RPM) from 4 explanted KPro’s was determined using immunohistochemistry and light and transmission electron microscopy. Wound anatomy in 6 KPro patients with larger 9.5 mm backplates was evaluated by anterior segment OCT and compared to wound anatomy in patients with standard 8.5 mm backplates.

Results Titanium backplates reduce RPM formation. Histopathologic evaluation showed that RPM are fibrous membranes that originate from activated host stromal cells that migrate through gaps in the graft‐host junction, suggesting that better wound apposition may reduce RPM formation. OCT demonstrated that larger backplates clamp the graft‐host junction more effectively than standard backplates, resulting in a thinner graft‐host junction and better wound apposition. Primary Boston KPro surgery provides good outcomes and device retention in situation such as limbal stem cell deficiency where traditional keratoplasty does poorly.

Conclusion Indications for the Boston KPro continue to expand as complications are reduced. Primary Boston KPro may be considered in certain circumstances. Strategies for prevention of RPM include titanium backplates and complete apposition of the graft‐host junction using larger KPro backplates.
Advances in imaging of the OOKP lamina
Authors: LIU C , NORRIS J , FRANCIS I , AVADHANAM V , THORP S , HEROLD J
Published: August 2012

Purpose The anatomical integrity of an eye bearing an OOKP depends on the integrity and dimensions of the OOKP lamina itself. The lamina is anchored onto the corneo‐scleral envelope initially through suturing. Later on, the overlying buccal mucous membrane graft adheres onto the soft tissues invested into the bone of the lamina, retaining it and providing a seal to guard against entry of microbes into the eye. The integrity and dimensions of the lamina is ascertained clinically at each hospital visit, and this is aided by periodic radiological imaging.

Methods We studied the relative merits of volumetric analysis, multislice CT vs Aquilion, and texture analysis. We also studied the feasibility of inserting radioopaque markers into the optical cylinder to aid inter examination orientation thus allowing subtraction radiology.

Results Volumetric analysis has proven useful but cannot detect fractures in the lamina. The Aquilion provides slightly superior images but its major advantages are speed of acquisition and a much lower radiation dosage, allowing more frequent examination in cases where there is a suspicion of rapid dissolution of the lamina. Asymmetric markers placed with an optical cylinder can be imaged successfully.

Conclusion Much work remains to be done to improve imaging of the OOKP lamina. Consideratons include image resolution, speed of acquisition, radiation dosage, costs, and repeatibility.
A study of the real life performance of OOKP optical cylinders
Authors: LEE R , ONG G , LAM F , WHITE J , HEROLD J , LIU C , HULL C
Published: August 2012

Purpose To evaluate the optical and visual functional characteristics of the Osteo‐Odonto‐Keratoprosthesis (OOKP)

Methods Nine patients with implanted OOKP devices were examined. Glare effect (Low, Medium and High intensity) was measured with a brightness acuity test (BAT) and contrast sensitivity was assessed using Metropsis Visual Stimulus Generation software (Cambridge Research System) at 0.3; 0.7; 2.20; 3.50; 10.4 and 14.5 cpd. Kinetic Goldmann perimetry and wavefront aberrometry (Nidek OPD‐scan) were performed in each patient. All patients completed a Quality‐of‐Life questionnaire (NEI VFQ‐25)

Results A reduction in mean visual acuity (logMAR) with increasing glare settings was observed from 0.12 without BAT to 0.27 with BAT at High. Mean visual acuities (logMAR) measured with BAT at Medium (Mann Whitney U‐test p<0.05) and High (U‐Test p<0.01) intensity settings were found to be significantly reduced statistically when compared to VA without BAT. Contrast Sensitivity was significantly reduced when compared to age‐matched control at medium and high spatial frequencies. Several vision‐related VFQ‐25 sub‐scales correlated significantly with visual acuity at various BAT levels such as General Vision, Near Activities and Distance Activities (correlation coefficients: ‐0.71 to ‐0.86; 0.05>p>0.001). Correlation with these subscales was also observed with contrast sensitivity at medium spatial frequencies (‐0.67 to ‐0.83; 0.05>p>0.001)

Conclusion The optics of the OOKP can provide patients with excellent visual acuity that correlates well with visual function. Visual acuity is significantly reduced by glare and patients experienced a lower contrast sensitivity compared to age‐matched controls. Glare reduction and cylinder alignment could further improve function
The effect of Benzalkonium chloride on the intraocular pressure lowering efficacy of a local ROCK‐inhibitor (AMA0076)
Authors: HOLLANDERS K , SIJNAVE D , VAN BERGEN T , VAN DE VELDE S , MOONS L , STALMANS I
Published: August 2012

Purpose To elucidate the effect of Benzalkonium chloride (BAK) on the intraocular pressure (IOP) lowering efficacy of a local ROCK‐inhibitor AMA0076 (Amakem NV) in the rabbit eye.

Methods Topical administration of AMA0076 (0.1%, 0.3% and 0.5%) was tested in a normotensive New Zealand White rabbit model (5 rabbits/group). The IOP lowering efficacy of the compound was determined with or without the addition of 0.01% BAK. The contralateral eye was used as a control and was treated with vehicle (H2O PEG) in all groups. IOP was measured at baseline and at 1, 2, 3, 4, 5, 6, 7 and 8h post administration. Data at individual time points were analyzed using mixed model analysis for repeated measures. P < 0.05 was considered to be statistically significant.

Results Single topical administration of AMA0076 significantly lowered IOP in a concentration dependent manner compared to the control eye (p<0.05). Placebo/vehicle administration did not induce significant changes in IOP. The maximal IOP lowering effect of AMA0076 0.1%, 0.3% and 0.5% containing 0.01% BAK was 38%, 45% and 53%, which was significantly stronger compared to their BAK‐free equivalents: 21%, 28% and 37% (p=0.005, p=<0.001; p=0.008 respectively).

Conclusion The local ROCK inhibitor, AMA0076 was significantly more effective in lowering IOP in the presence of 0.01% BAK.
Inhibition of placental growth factor improves surgical outcome of glaucoma surgery
Authors: VAN BERGEN T , JONCKX B , HOLLANDERS K , SIJNAVE D , VAN DE VELDE S , VANDEWALLE E , MOONS L , STASSEN JM , STALMANS I
Published: August 2012

Purpose We checked the hypothesis that placental growth factor (PlGF) plays a role in scar formation after glaucoma filtration surgery (GFS), and that it may be a target for improvement of the outcome of this surgery.

Methods The effect of the anti‐murine PlGF‐antibody (5D11D4) was investigated in a mouse model of GFS in C75Bl/6 mice. Immediately after surgery 5D11D4 (1µl; 5.2mg/ml) or 1C8, an irrelevant mouse IgG antibody (1µl; 4.8 mg/ml), was injected in the anterior chamber (n=10 eyes for both groups). An anti‐murine VEGF‐R2 antibody (DC101) was used as a positive control (1µl; 6.2 mg/ml; n=10). Mice were killed on post‐operative day 8. Treatment outcome was studied by clinical investigation of bleb area and bleb survival every other day. All antibodies were kindly provided by ThromboGenics NV.

Results In the mouse model of GFS, treatment using the anti‐PlGF antibody (5D11D4) significantly improved surgical outcome by increasing bleb survival (p=0.04) and bleb area (p=0.01) with 29% compared to negative control (1C8). A single administration of anti‐VEGF‐R2 (DC101) also significantly improved bleb area with 7% as compared to 1C8 (p=0.05), but had no effect on bleb survival (p=0.23). A trend towards an increased bleb area after 5D11D4 administration was observed compared to DC101 delivery (p=0.07).

Conclusion Targeting PlGF with an inhibitory monoclonal antibody is efficacious in improving GFS outcome, possibly even more effectively than inhibition of VEGF‐R2. These results render PlGF an appealing target for ocular wound healing and point to the potential therapeutic benefits of PlGF‐inhibition.
Retinal MMP expression is upregulated in an excitotoxic mouse model of glaucoma
Authors: DE GROEF L , GAUBLOMME D , JANSSENS E , DEKEYSTER E , MOONS L
Published: August 2012

Purpose Multiple studies in glaucoma patients and animal models, have reported differential expression and activity of matrix metalloproteinases (MMPs). These data have led to the hypothesis that MMPs are involved in glaucoma disease onset and/or progression. However, their in vivo functions remain poorly understood and contradictorily results prevent a clear definition of their role. Here, we describe the expression of MMP‐2, ‐3, ‐9 and ‐14 in the retina of mice subjected to an acute excitotoxic glaucoma model.

Methods Excitotoxic RGC death was induced via intravitreal injection of 20 mM NMDA. Expression of MMP‐2, ‐3, ‐9 and ‐14 was examined via immunohistochemistry, Western blot and quantitative RT‐PCR.

Results MMP‐2 and ‐3 are expressed by glia, presumably Müller glia, in the healthy retina and are strongly upregulated at 24h after NMDA injection. MMP‐9 expression, which is not detectable in naive retinas, is observed in RGCs at 24h post NMDA injection, which confirms its suggested role in RGC apoptosis. In the naive retina, MMP‐14 is expressed by bundles of RGC axons in the nerve fiber layer, from where its expression is extending through the optic nerve to the primary visual areas in the brain. Within the first 48h after NMDA injection, MMP‐14 expression increases and is also seen in the inner nuclear layer and both plexiform layers.

Conclusion Our results reveal a strong upregulation of MMP‐2, ‐3, ‐9 and ‐14 in the mouse retina after NMDA injection, suggesting that these proteinases might be involved in excitotoxic neurodegeneration and/or glial reactivity. Further analysis of their involvement, including studies in MMP knockout mice, is currently ongoing.
Acute lymphoblastic leukemia in the eye region
Authors: LARSEN A , STENMAN L , RASMUSSEN P , PRAUSE JU , RALFKJAER E , HEEGAARD S
Published: August 2012

Purpose Manifestations of acute lymphoblastic leukemia (ALL) in the eye area are rare and mainly occur in children. The purpose of this study was to investigate clinical, histopathological and genetic characteristics of Danish cases with ocular manifestations of ALL.

Methods Patients with orbital and adnexal leukemia were identified by searching the Danish Registry of Pathology between 1980 and 2009. Clinical files from the patients were collected. Specimens were re‐evaluated using a panel of monoclonal antibodies.

Results We report two cases with extra‐ocular manifestations of ALL as first presenting symptom, and one case with late manifestations of ALL in the eye. Case 1 was a 5‐year‐old boy with a tumour mass in the left orbit extending along the orbital roof. Case 2 was a 9‐year‐old girl with a tumour in the upper left eyelid that laterally encircled the lacrimal gland. Case 3 was a 32‐year‐old man relapsing with leukemic infiltration of the iris. Histologic and immunophenotypic examination revealed that all cases were pre‐B‐cell ALL. Cytogenetic analysis of case 1 revealed a pseudodiploid karyotype with a t(2;3) translocation and case 2 showed a hyperdiploid karyotype with a t(12;21) translocation and trisomy 21. Cases 1 and 2 were successfully treated according to the NOPHO ALL 1992 and 2000 protocols and were in complete remission nine and five years after respectively. Case 3 did respond to therapy, and was alive with disease 29 years after primary diagnosis.

Conclusion Ocular and extra‐ocular manifestations of leukemia are rare with only three cases observed during 30 years in Denmark. All cases were pre‐B‐cell ALL. Our patients responded well to therapy.
A statistical eye model that incorporates straylight
Authors: ROZEMA J
Published: August 2012

Purpose To illustrate how a recently developed statistical eye model can be expanded to include light scattering.

Methods This work uses previously measured biometric data from a large group of normal eyes. After confirmation of the Gaussian shape of their distributions, these parameters were then used to calculate their mean and covariance matrices. From these matrices a multivariate Gaussian distribution was calculated, which was then used to generate an amount of random, but plausible, biometric data. After a refractive filtering procedure, this data had a realistic refraction distribution and could be combined with the recent literature on the relations between straylight and ocular biometry, as well as on straylight and types of cataract

Results The straylight distributions of the simulations closely resemble those measured in the population.

Conclusion Using these methods a fair straylight simulation can be made for the general population.
Straylight values in pseudophakes ‐ standard IOL versus bag‐in‐the‐lens IOL
Authors: TASSIGNON MJ , ROZEMA J , NONE NONE , NONE NONE
Published: August 2012

Purpose To evaluate straylight and contrast sensitivity (CS) in eyes with various cataract morphologies, to determine which type of cataract presents a higher impairment of visual function with respect to proposed norms for driver safety and to compare retinal straylight and CS before and after implantation of a Morcher 89A IOL.

Methods BCVA, CS and straylight were measured in 97 cataractous eyes using respectively a Snellen chart, a Pelli‐Robson chart and the C‐Quant. Cataracts were graded using the LOCS III scale and divided into four groups: nuclear, cortical, nuclear‐cortical and posterior subcapsular cataract. A separate group of 71 eyes had their straylight measured before and after cataract surgery.

Results CS was reduced and straylight increased in all cataract patients, most notably in posterior subcapsular and nuclear‐cortical cataract. CS and BCVA were correlated (r = 0.44), whereas straylight and BCVA were not. Applying cut‐off values as proposed by European drivers studies of l.25 log CS and 1.4 log straylight as safe margins for driving, 31% would be considered unfit to drive on the basis of CS and 78% on the basis of straylight although their visual acuity was still above the current European visual acuity requirement for driving. Retinal straylight reduced significantly from 1.56 ± 0.26 to 1.25 ± 0.22 log units (P < 0.001) after IOL implantation and the group eligible to drive increased from 26% to 76%.

Conclusion Straylight and, to a lesser extent, CS are complementary to BCVA and should be taken into account when considering driving eligibility. After IOL implantation straylight reduces significantly, resulting in a significant increase in driving eligibility

Commercial interest
Local v 360 degree plomb
Authors: TSERVAKIS I
Published: August 2012

There are some strict lows concerning the placement of the buckle on the scleral wall mainly in accordance to the retinal pathology which created the RD. The question is whether buckling should be limited to the area of the break or extended over the retinal periphery.
To drain or not and how to drain
Authors: ANASTASAKIS A
Published: August 2012

There is a basic question. Is it necessary to drain?? Because if it is not necessary then is better to avoid drainage because complications are always possible to happen.
Where are the limits of corneal transplantation ‐ why is there a need for biomaterials?
Authors: FUCHSLUGER T
Published: August 2012

Purpose This presentation will give insight into clinical limitations of corneal allografting and ocular surface reconstruction. this provides the rationale for the development of novel biomaterials for ophthalmosurgery.

Methods Novel developments of tissue engineering covering the three major layers of the cornea (epithelium, stroma, endothelium) will be presented.

Results Different success rates (in animals and human trials) and limitations will be presented and will provide a platform for discussion.

Conclusion Biomaterials will be a part of ophthalmosurgery in the decades ahead.
The changing roles of perimetry and perimeters in glaucoma management
Authors: HEIJL A
Published: August 2012

Abstract not provided
Prostaglandin drug partitioning into contact lens material
Authors: FLEITMAN J , KENLEY R
Published: August 2012

Purpose Patients who take topical ocular hypotensive medications are often instructed to remove their contact lenses prior to instilling the drug. These instructions have been based upon the known affinity that polymeric material has for the most commonly used ophthalmic preservatives. Newer, preservative‐free agents, such as Saflutan® (tafluprost 0.015mg/ml), offer no direction to patients concerning contact lens wear. This study was conducted to determine if the possibility arises that tafluprost could partition between the solution phase (drug product formulation) and the contact lens polymeric material, thereby potentially impacting pharmokinetics and efficacy.

Methods Tafluprost 0.015mg/mL and bimatoprost 0.3mg/mL preservative‐free solutions were added to single contact lens and incubated up to 2 hours at either 25 or 37 C. After the incubation interval, a 0.20 mL aliquot of product was withdrawn and diluted 10X in mobile phase for determination of drug concentration by reverse‐phase ultrahigh performance liquid chromatography (RP‐UPLC).

Results Tafluprost and bimatoprost partition from product solution into contact lens material rapidly (within 15 min). At 37 C, for all solution volumes tested, Fsoln for bimatoprost was approximately 2X higher than Fsoln for tafluprost.

Conclusion Both tafluprost and bimatoprost partition rapidly from product formulation into soft contact lens material. Tafluprost (logP = 4.2) is more hydrophobic than bimatoprost (logP = 3.2) and partitions more strongly than bimatoprost into contact lens material. This study demonstrates that contract lens wearers should remove lenses prior to instilling the product formulations. Lenses may be reinserted after drop instillation.

Commercial interest
Valuation of surgery in combination chamber angle lens
Authors: RAMIRO P , CABEZON L , IBANEZ J , PINILLA I , PEREZ D , CRISTOBAL JA , DEL BUEY MA
Published: August 2012

Purpose To assess the variation of the chamber angle in glaucoma patients postphacotrabeculectomy primary open angle.

Methods Was measured by optical coherence tomography Fourier domain (Spectralis, Heidelberg Germany) the chamber angle in 30 patients diagnosed with primary open‐angle glaucoma with cataract surgery combined before and postoperatively, performed with the same protocol and evaluated the difference of the angle pre‐and postoperatively.

Results We observed a statistically significant increase in the chamber angle in patients undergoing phacotrabeculectomy

Conclusion The phacotrabeculectomy is a safe and effective procedure with minimal complications and good results of intraocular pressure and visual acuity postoperatively.
Megalocornea, iris desinsertion and crystalline luxation in congenital glaucoma
Authors: ARA GABARRE M , EGEA ESTOPINAN MC , FERNANDEZ‐PEREZ S , HERRERO LATORRE R , GARCIA‐MARTIN E , DE LA MATA PEREZ G , SATUE PALACIAN M , BAMBO M
Published: August 2012

Purpose To present a case report of a patient with congenital glaucoma and megalocornea, who suffer iris desinsertion and crystalline luxation during adulthood.

Methods We present a 46‐year‐old male with bilateral congenital glaucoma treated with bilateral goniotomy in pediatric age and right eye (RE) blind after a traumatism. He refered visual acuity (VA) loss in his left eye (LE). The visual acuity was light perception in RE and count fingers at 50 cm in LE. Ophthalmological exams evidenced asymmetric bilateral buphthalmos. The LE shows 21 mm of diameter corneal, transparent cornea, severe iridodonesis, 360º iris desinsertion, afaquia, and 22 mmHg of intraocular pressure by applanation tonometry. This eye was treated with dorzolamide and timolol maleate. Posterior luxation of the crystalline was found in the ophthalmic ultrasound.

Results A +14 diopters lens provided the best corrected visual performance achievable of 0.05 with LE. Non‐invasive treatment was selected in order to avoid surgery complications.

Conclusion Ophthalmologists should to monitor intraocular pressure and corneal diameter in patients with congenital glaucoma because increase in corneal diameter is a biomarker of progression of glaucoma. In these patients, interdisciplinary valuation of systemic and ophthalmological findings should be performed.
Eye refraction: a comparative study between autorefractometer, aberrometer and subjective test
Authors: SEGURA CALVO F , SANCHEZ‐CANO A , LOPEZ DE LA FUENTE C , FUENTES BROTO L , PINILLA I
Published: August 2012

Purpose To compare the ocular refractions given by three different techniques and to determine which provides better visual comfort.

Methods All subjects underwent a completed optometric examination including clinical history, biomicroscopy of the anterior segment, subjective best corrected visual acuity, autoref/keratometer WAM‐5500 and aberrometer iTrace. Monocular measurements were made under natural accommodation and pupil size. The conditions of the tests were vertex distance 12mm, resolution of the refraction 0.12D, distance 7m and 3 measures each time. Subjects were classified as myopic group (20 eyes) if they presented subjective refraction ≥|‐0.50|D and low‐hyperopic/emmetropic group (22 eyes) if their subjective refraction was <|‐0.50|D. The equipments were calibrated with an artificial eye before the tests were done.

Results Subjects chose as the best refractive option the subjective refraction (over 50% in all cases). In hyperopic/emmetropic eyes, subjective refraction showed smaller spheric values (0.22 and 0.18 D comparing to the autorefractor and the aberrometer respectively) and cylinder (0.17 D and 0.21 D, respectively), whereas in the myopic group, the autorefractor gave higher spheric values (0.21 and 0.26D comapring to the aberrometer and the subjective method respectively).

Conclusion Most subjects involved in the present study achieved a better visual comfort with subjective refraction. Significant differences among the three techniques were found, although objective methods represent a good approximation to the refraction.
Visual capacity in albino mice. Are albino mice good for every neuroscience’s experiment?
Authors: VICENTE TEJEDOR J , RAMIREZ L , TORETS C , CARRALERO S , DE LA VILLA P , SANCHEZ‐RAMOS C
Published: August 2012

Purpose To show the visual capacity in two different albino mice (NMRI and CD1).

Methods 66 albino mice from two mice’s strains were analyzed: CD1 and NMRI, obtained about from two different organizations. Full field Electroretinogram was used in the functional analysis. The recommendation of the International Society for the Clinical Electrophysiology of Vision (ISCEV) was followed. Furthermore, we recorded ERG responses at chromatic sensitivity. We have compared immunohistoquimical photoreceptor’s stain with arrestin, rodopsin, S‐opsin and M‐opsin. We have used antibodies anti‐achromatopsia gens, like GNTA2 and CNGB3.

Results CD1 and NMRI electroretinogram results showed two different visual patrons: a normal responses and coneless vision. An important per cent of CD1 mice (≅ 30%) and NMRI mice (≅ 20%) have visual defects in the photopic responses. The affected mice show a very significant reduction on the cone responses (p<0,01). Because we used chromatic stimulus we can say that the photopic defect occur in every cone, we can appreciate colorblindness. The structural study allows us to say how the photoreceptors are affected when the electroretinogam photopic response is not adequate. The functional and cellular results seem to indicate that these mice suffer an achromatopsia.

Conclusion Our experiments show the significant number of coneless mice in a normal order of the experimental animals. Ignorance of visual problems in experimental animals might compromise the results of conductual experiment or other kinds of studies. Electroretinogram tests are recommended before conductual studies with albino mice or different works, to know if the mice have a correct vision.
Adhesion molecules in experimental autoimmune uveitis
Authors: DEWISPELAERE R , LIPSKI D , MAKHOUL M , JUDICE L , CASPERS L , BRUYNS C , WILLERMAIN F
Published: August 2012

Purpose Non infectious uveitis are characterized by the penetration of immune cells into the eye which depends on adhesion molecules expression on the blood retinal barrier (BRB). In this work, we have studied the expression of the adhesion molecules VCAM‐1 and ICAM‐1 in experimental autoimmune uveitis (EAU) by adoptive transfer and the expression of their ligands, VLA‐4 and LFA‐1, on autoreactive T‐lymphocyte (TL)

Methods Autoreactive TL, obtained from the lymph node of C57BL6 mice immunized with IRBP 1‐20, were purified using CD4+ magnetic cell sorting. Those cells were studied by flow cytometry for their expression of VLA‐4 and LFA‐1. ELISAs and intracytoplasmic flow cytometry were performed to study the cytokine expression profile. Then, EAU were induced by adoptive transfer of those cells into naive mice. VCAM‐1 and ICAM‐1 histological and cellular expression was studied by immunofluorescence on eye cryosections

Results Autoreactive TL were found to be from the Th1 and Th17 phenotypes. LFA‐1 was expressed on all T and non T cells and VLA‐4 mostly on non T cells. Only a minority of TL showed VLA‐4 expression. In the eye of naïve mice VCAM‐1 was absent and ICAM‐1 present only at very low level. VCAM‐1 and ICAM‐1 expression is correlated to the severity of the disease. Interestingly, VCAM‐1 was more expressed on the internal BRB and ICAM‐1 on the external BRB

Conclusion This work shows that the adhesion molecules VCAM‐1 and ICAM 1 were expressed differently on the internal and external BRB and that their respective ligands VLA‐4 and LFA‐1 were also expressed differently on lymphocytes. This works complete the understanding of the major role of the adhesion molecules VCAM‐1 and ICAM‐1 in the induction uveitis in the adoptive transfer model
Polyphenolic compounds reduce inflammation in ARPE‐19 cells
Authors: HäNLER M , SUURONEN T , SALMINEN A , KAARNIRANTA K , KAUPPINEN A
Published: August 2012

Purpose Age‐related macular degeneration (AMD) is a major cause of blindness among the elderly in western countries. Currently, the majority of AMD patients are out of any treatment modalities. In the aging eye, a variety of intrinsic and extrinsic factors contribute to the development of inflammation which plays a major role in the pathogenesis of AMD. Several fruits, berries, and vegetables contain polyphenolic compounds which have shown to possess anti‐oxidative and anti‐inflammatory properties. In the present study, we have examined the influence of quercetin, fisetin, and luteolin on the inflammatory response in ARPE‐19 cells.

Methods In order to induce inflammatory response, the cells were exposed to the lipid peroxidation end product 4‐hydroxynonenal (HNE). Polyphenols were added concurrently with HNE, or one hour before or one hour after the exposure of the cells to HNE.

Results Our results show that the addition of polyphenols significantly decreased the production of pro‐inflammatory cytokines interleukin (IL)‐6 and IL‐8. Moreover, the compounds decreased the release of lactate dehydrogenase (LDH) enzyme to the culture medium. This implies that the polyphenols are able to help the cell to maintain the integrity of its cellular membrane under stressful conditions.

Conclusion Our present results indicate that plant‐derived polyphenols are effective in reducing the inflammatory response in ARPE‐19 cells, and could be useful in the therapy of AMD.
Baseline predictive factors of visual prognosis in acute bacterial postcataract endophthalmitis
Authors: CHIQUET C , CREUZOT‐GARCHER C , COMBEY A , CORNUT PL , CAMPOLMI N , ROMANET JP , BRON A , GAIN P , MAURIN M
Published: August 2012

Purpose To identify baseline clinical factors of visual prognosis in patients with acute endophthalmitis following cataract surgery.

Methods 99 patients of four academic hospitals (FRIENDS group). Factors were analyzed based on the final visual outcome, defined as poor (<20/100) or good (≥20/40) using univariate and multivariate analysis

Results Multiple logistic regression analysis showed that high bacterial virulence was the only independent factor (odds ratio [OR]= 14, 95% confidence interval [CI]: 2.7–71, p=0.001) for poor visual outcome. On the other hand, low bacterial virulence (OR=0.1 95%CI: 0.03–0.6, p=0.01) and the absence of complications (OR=0.07, 95%CI: 0.01–0.4, p=0.003) during cataract surgery were independent factors for good VA.

Conclusion Visual outcome factors in acute postcataract endophthalmitis identified in this prospective study (2004–2007) were similar to those reported by the EVS 10 years ago. The bacterial virulence level was the main predictive factor of final visual prognosis. This emphasizes the need for rapid bacterial identification and characterization using new biomolecular tools.
Effect of tocilizumab for uveitis accompanied with Castleman disease
Authors: TOBE A , OSHITARI T , YAMAMOTO S
Published: August 2012

Purpose Although multicentric Castleman disease is a rare but life‐threatening disease, eye complications are extremely uncommon. We present a case of refractory uveitis accompanied with Castleman disease successfully treated with tocilizmab.

Methods A 58‐year‐old man with Castleman disease was introduced for refractory uveitis to Chiba University Hospital. Large cells were detected in the anterior chamber and increased vascular permeability of retinal vessels has been found in both eyes. Although the patient was treated with oral and eye drop steroid treatment, the uveitis symptoms had not decreased. The serum levels of CRP and IL‐6 were increased. The level of IL‐6 concentration in the anterior chamber was the same as the serum level of IL‐6. The humanized anti‐IL‐6 receptor‐antibody (tocilizumab: 8 mg/kg per two weeks) was administrated for the patient because of poor general condition. The effect of tocilizumab was evaluated with routine ophthalmological examinations, fluorescein angiography (FA), Glodmann perimetry, and OCT.

Results After tocilizmab treatment, large cells in the anterior chamber were undetectable and vascular permeability was improved in FA. The serum levels of CRP and IL‐6 decreased and the general condition improved. The side effect of tocilizumab was not observed during the treatment.

Conclusion Tocilizumab treatment was significantly effective for uveitis accompanied with Castleman disease. Although it is extremely rare, uveitis accompanied with Castleman disease may reflect poor general condition in patients with Castleman disease, and it may be one of the hallmarks to consider tocilizumab treatment.
Augmentation of the ocular penetration of dexamethasone with β‐blocker and α‐agonist co‐administration
Authors: ELENA P , SENSEBY F , BERMON F , CHARFEDDINE R , REKIK R
Published: August 2012

Purpose This study evaluated the ocular penetration of the radiolabelled corticosteroid 3H‐dexamethasone after topical administrations of the β‐blocker Ophtim®(0.5% timolol) and the α‐agonist Iopidine®(1% apraclonidine) alone or in combination in pigmented rabbits.

Methods Animals were randomized in 4 treatment groups : Ophtim® or Iopidine®, or both of them, or NaCl 0.9%, first in 3 3‐min apart topical administrations of 30 µL, followed by a single 30 µL instillation of 3H‐dexamethasone (5 µCi), in both eyes and then in a single instillation every 2 hours, each also followed by a single instillation of 3H‐dexamethasone. At 1, 2 and 8 hours after the first instillation, animals were euthanized and the aqueous humor, vitreous, retina and choroid were taken to determine 3H‐dexamethasone concentrations with a liquid scintillation counter.

Results 3H‐dexamethasone was detected in all tested ocular matrices, regardless of the pre‐treatment. The 3H‐dexamethasone concentrations tended to moderately increase in ocular tissues from animals pre‐treated with either Ophtim® or Iopidine®. However, the preliminary topical administration of Ophtim® associated to Iopidine® resulted in a significant increase in the 3H‐dexamethasone concentrations in sampled ocular tissues, including a nearly 3‐fold increase in aqueous humor, compared with NaCl 0.9%.

Conclusion In conclusion, the association of the β‐blocker Ophtim® with the α‐agonist Iopidine® in multiples instillations prior to 3H‐dexamethasone instillation increased the ocular penetration of the radiolabelled corticosteroid.

Commercial interest
Retinal vessel reactivity after cigarette smoking
Authors: CUBBIDGE R , SUMMERS RJ , HEITMAR R
Published: August 2012

Purpose To evaluate the acute impact of cigarette smoking on retinal vessel reactivity during flicker light provocation.

Methods 12 otherwise healthy smokers (mean age 28 (SD 5) years) underwent non‐contact tonometry (Keeler Pulsair, UK), manual shygomanometry and continuous retinal vessel diameter measurements using flicker light provocation (RVA, ImedosSystems, Germany) at baseline and after smoking one cigarette. Smokers had regularly smoked for at least 6 months. For retinal vessel diameter measurements we used a standard protocol with 50 sec baseline diameter recording followed by 3 cycles of 20 sec flicker and 80 sec recovery.

Results Immediately after smoking systolic, diastolic blood pressure and heart rate increased significantly (SBP: 112 (13)mmHg to 124 (11)mmHg, p=0.0001; DBP: 69 (10)mmHg to 78 (8)mmHg, p<0.0001; HR: 73 (11)bpm to 83 (10)bpm, p=0.009). However, intra ocular pressure as well as arteriolar and venular diameter were unchanged (IOP: 15 (3)mmHg to 15 (3)mmHg, p=0.633, arteriolar diameter: 126 (15)au to 125 (15)au, p=0.416; venular diameter: 163 (16)au to 167 (15)au, p=0.329). Area under the curve results revealed no effect of acute smoking (arterial: AUC(FL) at baseline 61 (57) and post‐smoking 60 (34), p=0.923; AUC(Cess) at baseline ‐22 (38) and post‐smoking ‐11 (49), p=0,309; venous: AUC(FL) at baseline 54 (56) and post‐smoking 65 (29), p=0.322; AUC(Cess) at baseline 51 (36) and post‐smoking 50 (26), p=0.976).

Conclusion The acute effect of a single cigarette did not have an effect on dynamic retinal vessel dilation to flicker light stimulation in cigarette smokers arterioles and veins
Aqueous erythropoietin level in retinal vein occlusion
Authors: SHIN HJ , LEE SH
Published: August 2012

Purpose To investigate the aqueous level of erythropoietin (EPO) and associated factors in patients with retinal vein occlusion (RVO).

Methods The aqueous EPO level was measured prospectively with chemiluminescent immunoassay in consecutive patients with macular edema (ME) secondary to branched retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Aqueous fluid of cataract patients served as control. Patients taking anti‐hypertensive medication with angiotensin converting enzyme inhibitor or angiotensin II receptor blocker, prior intraocular surgery or injection of steroid or antiangiogenic factors, or longstanding (3> months) BRVO or CRVO were excluded. We also evaluated whether aqueous EPO was associated with factors such as serum EPO concentration, non‐perfusion area, and arterio‐venous (AV) transit time, and central macular thickness (CMT).

Results Aqueous level of EPO was higher in RVO (27 eyes; BRVO 16 eyes/CRVO 11 eyes) than in control subjects (RVO, 68.1 [19.8‐190] mU/ml vs. control, 12.9 [5.4‐24.4] mU/ml, P<0.001). More specifically, aqueous EPO was higher in CRVO than in BRVO (CRVO, 118.9 [31.8‐190] mU/ml vs. 33.3 [19.8‐62.5] mU/ml, P<0.001). However, no differences were found in serum levels of EPO among controls, BRVO, and CRVO groups (CRVO, 11.1mU/ml[5.4‐16.4] vs. BRVO, 10.0mU/ml[6.7‐16] vs. control, 9.2mU/ml[5.7‐11.2], P=0.091). CMT in RVO patients had positive correlation with the aqueous level of EPO in RVO (P=0.003). Also, in terms of non‐perfusion area, there was a significant difference in the aqueous level of EPO between ischemic and non‐ischemic subtypes of CRVO (ischemic, 172 [156‐190] mU/ml vs. non‐ischemic, 83.6 [56.3‐142.5] mU/ml, P=0.0027).

Conclusion In RVO, aqueous levels of EPO are elevated and could be associated with retinal ischemia and ME
Structural changes of the cornea in a patient with mucopolysaccharidosis (Hurler‐ Scheie) in confocal microscopy images
Authors: WYLEGALA E , SMEDOWSKI A , TARNAWSKA D , WOJCIK L , JANISZEWSKA D , PUZOLLO D
Published: August 2012

Purpose To determine the characteristic structural corneal changes in a 22 years old patient with Hurler Scheie syndrome using confocal microscopy in vivo.

Methods The study was conducted in 22 year old man with Hurler syndrome. The patient presents typical phenotype of this syndrome. Additionally the symptoms reduced by enzymatic treatment confirms the diagnosis of disease. Slit lamp examination, corneal scans using the Scheimpflug camera (Pentacam, OCULUS) and corneal confocal microscopy in vivo (Rostock Cornea Module, Heidelberg Engineering Retina Tomograph III) were performed.

Results In all performed examinations the edema and loss of transparency of the cornea have been documented, but the characteristic structural changes were only demonstrated in in vivo confocal microscopy images. Abnormalities in microscopic images were described in all layers of the cornea. The tear film was found containing numerous non‐characteristic inclusions, as well as in the epithelial layer. The most common change was found in front part of corneal stroma ‐ a system of highly hyperreflected, stimulated, vacuolisated keratocytes of "honeycomb‐like" structure and a very sparse amount of stromal matrix. Posterior stroma appeared non‐characteristic hazes, presence of scarring and corrugations up to Descemet’s membrane. Due to the thickness of the cornea more than 1000 microns, it was impossible to image the endothelium.

Conclusion Corneal confocal microscopy in vivo, is a useful tool in the diagnosis of corneal opacities in the course of MPS Hurler. By characteristic structural features, it can be used for confirming the diagnosis.
The mitotic index in secondary enucleated eyes of previously treated uveal melanoma patients
Authors: BAKALIAN S , CASSOUX N , LEVY C , LUMBROSO‐LE ROUIC L , DESJARDINS L
Published: August 2012

Purpose The aim of this study is to evaluate the difference of mitotic activity in secondary enucleated uveal melanoma cases in two different groups of patients who have been treated previously with conservative therapy.

Methods We evaluated two groups of patients. The first group consisted from treated uveal melanoma patients who developed a blind painful eye due to end stage of vascular glaucoma, while the second group consisted from uveal melanoma patients who developed a recurrence of uveal melanoma in the same eye after several years. Moreover, we assessed the relationship of the mitotic activity with the other clinicopathological features of the enucleated eyes of the two groups of uveal melanoma patients. We also, recorded and analysed the data including the age of the patients, the size of the tumor, the location, the cell type, and the treatment modality and correlated with the survival rate.

Results Our results showed that there was a significant difference in the mitotic activity between the two groups of patients. The mitotic index was higher in the enucleated eyes of uveal melanoma patients who developed a recurrence at the same eye as opposed to the enucleated eyes of uveal melanoma patients due to other reasons such as vascular glaucoma and blind painful eye. The mitotic activity was almost absent in the majority of enucleated uveal melanoma cases due to vascular glaucoma.

Conclusion To the best of our knowledge this is the first report that evaluates the mitotic index in secondary enucleated eyes of uveal melanoma patients.
Peripapillary changes detected by SD OCT in eyes with high myopia
Authors: CHEBIL A , BEN ACHOUR B , BOULADI M , KORT F , MGHAIETH F , EL MATRI L
Published: August 2012

Purpose To investigate the morphologic alterations around the optic disc by SD‐OCT with high myopia

Methods One hundred eyes (54 patients) with high myopia (>‐6.00 diopters) were included. The participants had ophthalmologic examinations including stereoscopic fundus observations, OCT examinations. For OCT, multiple horizontal and vertical and cercle scans were obtained around the optic disc and fovea in each patient.

Results Patients were mean age 43.2+/‐9.4 years, with a spherical‐equivalent refractive error of ‐11.26+/‐4.85 D and mean axial length of 27.65+/‐1.82 mm. A peripapillary detachment was detected by OCT in 8 eyes (8%) as a hyporeflective space intrachoroidally and subretinally. It was also observed within the tissue posterior to the conus in eyes without the typical ophthalmoscopic yellow‐orange lesions. Microfolds in the retinal vessels were detected at the conus edge in 40 of the highly myopic eyes (40%), and 10 of these eyes had paravascular cysts (10%). A retinoschisis was present at the site of the retinal vessels in 10 eyes (10%).

Conclusion The SD OCT examinations demonstrated different types of peripapillary changes in highly myopic eyes. It is important to detect these peripapillary changes especially peripapillary detachment by OCT to be able to predict the later development of visually disabling conditions.