bluuebunny/crossref_metadata_2025 huggingface dataset:
OCT and vitreomacular interface
Authors: Pournaras J.A.
Published: September 2017

Nowdays, OCT examination is currently available and offers many insights for the management of vitreomacular interface disorders. We will review carefully the natural history of these disorders nicely described by OCT images. Furthermore, mainly after surgery, this examination play an important role in the followup of those patients and will be presented. At the first visit, correct recognition of the alterations of vitreomacular disorders helps clinicians to predict the visual prognosis of the patients.
Novel concepts in corneal reconstruction
Authors: Fuchsluger T. , Stafiej P. , Florian K. , Schubert D.
Published: September 2017

This presentation will present new approaches regarding biomaterials for ocular surface reconstruction.
Acquired retinal disease
Authors: Holder G.
Published: September 2017

This lecture will address the role of electrophysiological testing in the diagnosis and management of acquired retinal disease. Topics will include toxic, vascular, inflammatory and autoimmune disorders. The functional data provided by electrophysiology will be combined with the structural data from various imaging modalities to show that the optimal management of the patient requires knowledge both of structure and function.
Paediatric applications
Authors: Thompson D.
Published: September 2017

The International Society for Clinical Visual Electrophysiology of Vision, [ISCEV], publishes standards for performing five clinical visual electrophysiology tests; ffERG, mfERG, PERG, VEP and EOG, (www.ISCEV.org/standards). Older and co‐operative children tolerate these adult standard protocols well. Less compliant, younger infants, children with systemic as well as ocular disease or those with learning difficulties can benefit from adaptations that account of visual system maturation, make the test time shorter and the test experience less stressful. This talk will describe the key maturational changes and their impact on ERGs and VEP waveforms. Ways of combining and modifying tests for alert infants will be described that account for visual pathway development and limited tolerance. These will include the effects of anaesthesia, choice of electrodes and stimulation techniques. Case examples will be presented to show how visual electrophysiology maybe used to diagnose retinal dysfunction and to monitor visual pathway dysfunction in children.
Novel pathophysiological mechanisms in dominant optic atrophy beyond the mitochondrial dynamics equilibrium
Authors: Lenaers G. , Charif M. , Amati‐Bonneau P. , de la Barca J. Chao , Procaccio V. , Chevrollier A. , Leruez S. , Bonneau D. , Reynier P.
Published: September 2017

Inherited Optic Neuropathies are blinding diseases related to mitochondrial dysfunctions in retinal ganglion cell (RGC). There are two main forms: the Leber Hereditary Optic Neuropathy (LHON) related to mutations in the mitochondrial genome, and the Kjer dominant optic atrophy (DOA) related to mutations in nuclear genes. Since the initial discovery of the OPA1 gene in 2000 as the major gene causing DOA, the use of WES and re‐sequencing chips disclosed many novel genes responsible for DOA. Beyond genes recently identified involved in mitochondrial dynamics, we identified novel candidate genes crucial for RGC physiology. Using patient fibroblasts, we analyzed the consequences of their mutation on mitochondrial physiology and metabolism. Altogether, these data are shedding novel lights on DOA pathophysiology, beyond mitochondrial dynamics, as novel culprit mechanisms responsible for RGC degeneration, which should condition the design of future therapeutic approaches.
β‐catenin activation in conjunctival melanocytic proliferations
Authors: Larivé E. , Nicolas M. , Schalenbourg A. , Zografos L. , Moulin A.
Published: September 2017

Purpose

Conjunctival and cutaneaous melanoma partially share similar genetic alterations. β‐catenin is a dual‐function protein that acts not only as a structural component of adherens junctions but also as an effector molecule involved in the Wnt pathway. In skin melanoma, in vitro activation of the Wnt pathway led to nuclear localization of β‐catenin and increased invasiveness. We investigated the expression and activation of β‐catenin in benign and malignant conjunctival melanocytic proliferations.

Methods

β‐catenin expression was assessed by immunohistochemistry in 43 conjunctival naevi, 48 PAM (including 23 PAM with atypia) and 44 conjunctival melanomas as well as in 4 conjunctival melanoma cell lines at various stages of confluence. Statistical analysis was performed with JUMP 8.0 software.

Results

In the naevi, membranous expression of β‐Catenin was found in all the cases and nuclear expression in 14% of the cases. In the PAM, membranous expression of β‐catenin was identified in all the cases without nuclear expression. Membranous expression of β‐catenin in melanoma was found in 94% of the cases and nuclear expression in 15.9% of the cases. There were no significant differences in the nuclear expression of β‐catenin between conjunctival nevi and melanoma. In the melanoma group, there was a significant correlation between nuclear expression of β‐catenin and depth of invasion. In the 4 conjunctival melanoma cells lines, no significant nuclear expression of β‐catenin was identified at various stages of confluence.

Conclusions

β‐catenin activation and nuclear localization does not appear to be a major mechanism occurring in conjunctival melanoma. It is however possible that β‐catenin activation might occur at a late stage in tumor development.
Primary human choroidal melanocytes express functional Toll‐Like Receptors (TLRs)
Authors: Cioanca V.A. , McCluskey P.J. , Madigan M.C.
Published: September 2017

Purpose

Human choroidal melanocytes (HCMs) are an abundant heterogeneous, melanin‐containing population of cells within the vascular uveal tract. Toll‐like receptors (TLRs) are pattern recognition receptors involved in the innate immune response against phylogenetically conserved microbial components. Immune cells are established to express TLRs and more recent studies showed TLR expression on non‐immune cells including corneal and conjunctival epithelia, retinal microglia and RPE, iris pigment epithelium, and skin melanocytes. The expression of TLRs on uveal melanocytes however remains to be investigated.

Methods

HCMs were isolated and cultured from donor human eyes. TLR1‐10 and MYD88 (a critical adaptor protein in the TLR signalling pathway) expression was investigated using RT‐PCR and confirmed by immunocytochemistry. The production of IL‐8 and CCL2 in response to TLR agonists was measured by ELISA.

Results

HCMs constitutively expressed TLR1‐6, TLR9, and MYD88. Stimulation of HCMs with bacterial‐derived TLR agonists [Pam3CSK4 (TLR1/2), HKLM (TLR2), LPS (TLR4), Flagellin (TLR5) and, FSL‐1 (TLR6/2)] and virus‐mimicking TLR agonists [Poly I:C (TLR3), Imiquimod (TLR7), ssRNA40 (TLR8) and ODN2006 (TLR9)] induced variable secretion of IL‐8 and CCL2 (MCP‐1). Control levels of IL8 (140 pg/ml) increased in response to Pam3CSK4 (2360 pg/ml), Poly I:C (3620 pg/ml), LPS (4100 pg/ml), Flagellin (1550 pg/ml) and FSL‐1 (2160 pg/ml). Virus‐mimicking agonists imiquimod, ssRNA40 and ODN2006, and intriguingly bacteria‐derived HKML, did not significantly affect secreted IL8. Secreted CCL2 showed a similar pattern of response following stimulation with TLR agonists. HCMs were immunoreactive for TLR2, TLR3 and TLR4 protein.

Conclusions

The findings suggest that HCMs are potentially involved in innate immune responses against bacterial and viral pathogens within the human choroid.
Tear sample collection in ocular allergy
Authors: Munk S.A.J. , Heegaard S.
Published: September 2017

Purpose

To evaluate four different methods of tear collection in healthy participants.

Methods

Four methods used for tear collection were evaluated in both eyes of 20 healthy participants. Methods tested: capillary tubes (CT), capillary tubes with instillation of saline (CT saline), Schirmer's Tear Test Strips (STTS) and Polyvinyl Alcohol sponges (PVA). Volume, duration of collection, participant‐reported discomfort, concentration and mass of histamine were evaluated.

Results

With CT saline the largest volume was collected in the shortest time. A significantly higher concentration of histamine was found in samples collected with STTS compared to CT saline (p = 0.04) and PVA (p = 0.02). CT and CT saline were associated with no or mild discomfort in 95% and 90%, STTS and PVA with moderate or severe discomfort in 70% and 85%.

Conclusion

For collection of tear fluid for the measurement of histamine the CT saline method was found to be a technically easy and quick method of obtaining sufficient volumes of tear fluid, with low discomfort for participants.
Vitreo‐retinal pathology and multifocal IOLs
Authors: ASCASO F.J.
Published: September 2017

Cataract surgery is the most common and successful surgical procedure performed today. Multifocal intraocular lenses (m‐IOLs) offer good uncorrected distance and near visual acuity. However, the reduction in contrast sensitivity attributed to m‐IOLs might manifest as compromised visual acuity, especially in eyes with macular disease. Because of this, not every currently available IOL is suitable for every patient. Furthermore, retinal visulization problems when performing vitrectomy with these lenses in place can be challenging. We will discuss the visual disturbances that m‐IOLs produce in a patient with vitreoretinal pathology; the need for an accurate preoperative evaluation to assess macular function, including the role of OCT for identifying occult macular disease preoperatively in patients with dense cataracts; the convenience or not of m‐IOLs in the presence of macular disease, which depends on the stability or the expected progression of the condition over time, and the availability of treatment. Finally, retinal surgeons need to be aware of the challenges of the impaired fundus visualization during vitrectomy following m‐IOL implantation and the recommended strategies to minimize intraoperative complications.
Ocular motility, do we know what is the dominant eye?
Authors: Shah S.
Published: September 2017

Ocular motility, do we know which is the dominant eye?

Ocular dominance, is the tendency to prefer visual input from one eye to the other. It is somewhat analogous to the laterality of right‐ or left‐handedness; however, the side of the dominant eye and the dominant hand do not always match.

Approximately two‐thirds of the population are right‐eye dominant and one‐third left‐eye dominant; however in a small portion of the population neither eye is dominant. Eye dominance has been categorized as “weak” or “strong” and highly profound cases are sometimes caused by amblyopia or strabismus.

This talk will discuss

what is ocular dominance

different techniques for measuring dominance

what we have learnt from contact lens practice and monovision

whether it can change and what influences that change

surgical interventions relevant to ocular dominance

The relevance to multifocal intraocular lenses with comorbidity will be detailed.
Exploring molecular mechanisms underlying Fuchs endothelial corneal dystrophy and their relevance to therapeutic interventions
Authors: Davidson A.
Published: September 2017

Fuchs endothelial corneal dystrophy (FECD) is an age‐related degenerative condition characterised by bilateral progressive loss of corneal endothelial cell (CEC) function leading to severely impaired vision. An unstable intronic tri‐nucleotide CTG repeat expansion within the transcription factor‐encoding gene, TCF4, has recently been discovered to account for more than 70% of cases. An overview of our current understanding of the genetics of FECD, as well as the underlying molecular mechanisms responsible for the disease pathology will be provided. Furthermore, future potential avenues for targeted therapeutic interventions will be discussed in context of what has already been learnt from the broader field of non‐coding repeat expansion disease, well‐established causes of both neuromuscular and neurodegenerative disorders.
Novel tissue‐targeted localized corneal gene therapy
Authors: Mohan R.
Published: September 2017

This presentation will provide an overview of corneal gene therapy and stipulate novel bench‐to‐bedside translational strategies for human application. The talk will include information about identified potent adenoassociated virus (AAV) and nanoparticle vectors, simple and minimally invasive vector delivery techniques for delivering genes into desired corneal cells, and defined gene therapy approaches for introducing therapeutic genes selectively into corneal keratocytes or endothelium in vivo through single application of vector employing customized delivery techniques. Further, talk will discuss cornea‐specific mechanisms driving pathologic process, novel molecular targets for interrupting TGFb1 signaling pathways, and therapeutic genes identified from basic‐science corneal wound healing investigations performed in my lab laboratory using established small and large animal and donor human corneas. Finally, it will show potential of single‐ and two‐gene combination therapy given locally in the cornea via optimized methods in inhibiting and eliminating corneal scarring and neovascularization in vivo in preclinical rabbit studies. The optimized gene therapy approaches could be easily applied in a clinical setting, if safety and toxicity are proven.
Life as a junior postdoc in ophthalmology and neurobiology research: challenges and opportunities
Authors: De Groef L.
Published: September 2017

While equally represented in scientific courses at the age of 16–19 years, only 28% of researchers are women – according to the UNESCO report on science in 2030 (2015) – and only 3% of the Nobel Prizes for Science (6% for Medicine) have been awarded to women. Despite the progress that has been made, glass ceilings still appear to hinder the career of woman in science, female top scientists still miss out recognition for their work, and the scientific community – especially leadership positions – remains male‐dominated. What struggles are women in science (woman in EVER) being faced with, and how can we use creativity and innovation to overcome these issues?
Surgical treatment of traumatic macular hole
Authors: Ruban A.
Published: September 2017

Purpose

To present the results of the treatment of traumatic macular holes.

Methods

This study is a retrospective consecutive case series of 7 patients who underwent a 25G PPV with the displacement of macular retina after subretinal balanced salt solution injection to treat traumatic full thickness macular holes (TFMH). The efficiency was evaluated by the anatomical macular hole closure rate and best‐corrected visual acuity (BCVA) during follow‐up visits. The degree of retinal displacement was accessed by comparing the preoperative and postoperative fundus photographies.

Results

Complete closure of macular hole was achieved in 85,7% and 14,3% had partial closure. Average macular hole diameter was (825 μm). Visual acuity after surgery in the total group was significantly increased. All patients revealed a negative correlation between postoperative visual acuity and the time elapsed from the moment of the trauma, and a strong positive correlation between the macular hole size and elapsed time from the injury. There were no intraoperative or postoperative complications.

Conclusion

Vitrectomy with the «retinal displacement» technique may be an effective addition to surgical options for treating traumatic macular holes.
Intraoperative OCT for inverted ILM flap technique
Authors: Lytvynchuk L.
Published: September 2017

Purpose

To evaluate the use of intraoperative spectral‐domain optical coherence tomography (iSD‐OCT) for large macular hole (MH) surgery using inverted internal limiting membrane (ILM) flap technique.

Methods

We analyzed 7 consecutive cases of iSD‐OCT assisted pars plana vitrectomy (PPV) with inverted ILM flap technique for large and chronic MHs. iSD‐OCT was performed using Rescan 700 (Zeiss, Oberkochen, Germany). iSD‐OCT data were post‐processed and analyzed postoperatively (study of tissue behavior).

Results

In all cases iSD‐OCT imaging allowed the surgeon to carry on the procedure without significant time consumption. The iSD‐OCT imaging assisted: 1) to find the safe place on the retina while starting ILM peeling; 2) to control the formation of the inverted ILM flap; 3) to conduct the inversion of the ILM flap over MH. iSD‐OCT allowed to keep safe positioning of the vitreoretinal instruments.

Conclusions

iSD‐OCT is a strong supporting tool during PPV, that gives prompt information about tissue behavior and surgical maneuvers. Inverted ILM flap technique for large MH can be performed in more controlled and save way without interruption of the surgical workflow.
siRNA and regeneration
Authors: Logan A.
Published: September 2017

Crushing the optic nerve induces death of retinal ganglion cells (RGC) by apoptosis, but suppression of CASP2, using a stably modified short interfering RNA CASP2, inhibits RGC apoptosis. Combined delivery of short interfering CASP2 and inhibition of CASP6 using a dominant negative CASP6 mutant activates astrocytes and Müller cells, increases CNTF levels in the retina and leads to enhanced RGC axon regeneration. In mixed rat retinal cultures, dominant negative CASP6 mutant + short interfering CASP2 treatment also significantly increases GFAP+ glial activation, increases the expression of CNTF, and increases the number and length of RGC neurites. These effects are abrogated by the addition of MAB228 (blocks the CNTF receptor) and AG490 (inhibitor of CNTF signalling). Similarly, in the optic nerve crush injury model, MAB228 and AG490 neutralizes dominant negative CASP6 mutant + short interfering CASP2‐mediated RGC axon regeneration, Müller cell activation and CNTF production in the retina without affecting RGC survival. We propose that axon regeneration promoted by suppression of CASP2 and CASP6 is CNTF‐dependent and mediated through the JAK/STAT signalling pathway.
Primary stromal choroiditis
Authors: Herbort C.P.
Published: September 2017

Optimal outcome measures are necessary to monitor adequately the diverse uveitis entities and follow‐up modalities should be tailored according to the disease process. Stromal choroiditis entities are diseases predominantly involving the choroidal stroma, such as Vogt‐Koyanagi‐Harada disease (VKH) and birdshot retinochoroiditis (BRC), both considered as primary stromal choroiditis because the disease process starts within the stroma of the choroid. Sarcoidosis and tuberculous chorioretinitis are considered as secondary choroiditis, as the choroid is the innocent bystander structure where a systemic disease causes lesions Consequently a follow‐up modality capable of optimally evaluating this structure should be privileged in the assessement at presentation and for monitoring disease evolution. Among imaging modalities, the ones best accounting for choroidal stromal involvement are indocyanine green angiography (ICGA) and measurement of choroidal thickness by enhanced depth imaging optical coherence tomography (EDI‐OCT). ICGA is more suited for acute and subacute stages of disease, while EDI‐OCT useful to follow medium and long‐term evolution. The precision obtained with these modalities will be demonsrated.
Systematic laser suturolysis in post‐operative management in trabeculectomy – early results from pilot study
Authors: Mano S. , Nuno P.F. , Marques R.E. , Abegão Pinto L.
Published: September 2017

Purpose

The early stages of a filtering surgery are usually associated with a number of procedures aimed at sustaining an optimal aqueous humour drainage. One option is to decrease the resistance to outflow by laser suturolysis of the scleral flap. We aim to explore the early effects of systematic suturolysis in efficacy and safety in post‐operative trabeculectomies.

Methods

Prospective interventional study enrolling patients undergoing primary trabeculectomies with mytomicinc C (0.4 mg/mL) for open angle glaucoma. A protocol in which suturolysis were done routinely if intraocular pressure greater than 10 mmHg starting at day 8 post‐operative. Only one suturolysis was done at each visit. Intraocular pressure (IOP) ‐ lowering efficiency of each suturolysis was assessed. Safety parameters were also analyzes.

Results

Thirty‐one eyes of 27 patients (13 males) were enrolled with a mean age of 68 years. Pre‐operative pressure was 25 mmHg. Twenty‐nine patients underwent a suturolysis on day 8, with an IOP‐lowering efficacy of 36%. A second suturolysis, when performed (n = 17), had an additional IOP lowering of 27%. At 1 month, 3.2%, 96.8% and 51.6% of patients had 0, 1 or 2 suturolysis, respectively. Mean IOP at this period was 12.93 mmHg. During this period, there were 2 patients with choroidal detachments, and 9 patients needed an additional bleb needling with 5‐fluorouracil (5‐FU).
Iatrogenic intraocular pressure elevation after repeated intravitreal injection, a prospective cohort study
Authors: Lereuil T. , Agard E. , Elchehab H. , Dot C.
Published: September 2017

Purpose

To report the rate of intraocular pressure (IOP) elevation after repeated intravitreal injections (IVIs) of anti–vascular endothelial growth factor (anti‐VEGF) agents and to assess its evolution over time.

Methods

Our study was a prospective cohort including 221 patients (253 eyes) with exudative age‐related macular degeneration (AMD) or diabetic macular edema, undergoing ranibizumab (n =207) or aflibercept (n=44) or bevacizumab (n = 21) IVIs. Patients who received intravitreal or periocular corticosteroid injection were excluded. The incidence of ocular hypertension (OHT) after these injections was investigated with respect to the number of injections, pre‐existing open‐angle glaucoma, diabetes, YAG capsulotomy, age, and sex.

Results

1721 IVIs was performed. After a mean of 7.3‐4.1 IVIs (range 3‐62), 10 (4.6%) had IOP elevation more than 25 mmHg and required medical treatment, 1.4% of them spiked above 30 mmHg. 12 patients received medical treatment (10 monotherapies and 2 dual therapies), no surgical or laser treatment was required.Patients with pre‐existing glaucoma experienced higher prevalence of OHT (11.9%) and greater rates than the control group (19.3‐6.2 mmHg vs 15.6‐5.2 mmHg, p<0.001). No significant difference was found in the diabetes subgroup (81(??%, p=0.55) or in the YAG capsulotomy subgroup (32(??%, p= 0.44) compared with the control group. The IOP peak was significantly correlated with the total number of IVIs (p=0.0002). Results are consistent with previous work on the oldest cohort.

Conclusions

Serial IVIs may lead to persistent IOP elevation that requires medical IOP‐lowering therapy. The risk is correlated with the number of injections and increases in the glaucoma population, therefore should be checked during follow‐up.
Macular features assessed by optical coherence tomography‐angiography after proton beam therapy for choroidal melanoma
Authors: Lumbroso L. , Sellam A. , Coscas F. , Dendale R. , Levy C. , Coscas G. , Desjardins L. , Cassoux N.
Published: September 2017

Purpose

To characterize the macular features of patients treated with proton beam therapy for choroidal melanoma (CM), using the optical coherence tomography‐angiography (OCTA).

Methods

Observational, retrospective, study included patients treated with proton beam therapy for a small CM. All the patients had undergone a full exam including: visual acuity, optical coherence tomography (OCT B‐scan) and OCTA (Spectralis Heidelberg, Germany) focused on the 10 central degrees. Only patients that had received 100% of the dose to the macula were included. Vascular features of both plexuses, of the choriocapillaris and the choroid were analyzed in OCTA.

Results

37 patients had undergone an OCTA following proton beam therapy for a small CM. Only 17 patients (9 men and 8 women) that had 100% of the dose to the macula were included in this study. The mean age of the patients was 56.6 years (28‐86). The mean follow‐up duration was 35.8 months (11‐72 months). The mean tumor thickness was 3.39 mm (1.3‐7 mm). 13 patients (76.5%) had a clinical radiation maculopathy, 8 patients (47.1%) had macular cysts on OCT B‐scan. All the patients (100%) had abnormalities on OCTA. Cysts were found in 9 patients (52.9%) mostly in the deep capillary plexus.The loss of the choriocapillaris was observed in 15 patients (88.2%). Choroid vessels were diminished (by size and density) in the macular area in 13 patients (76.5%).

Conclusions

OCTA permits earlier detection of micro vascular alterations on both plexuses that the post radiation origin is highly probable du to the important doses receivedPatients treated with proton beam therapy for CM with 100% of the dose to the macula, present some alterations at both plexuses but also a vascular rarefaction of the choriocapillaris and of the choroidal vessel.
Neurological involvement in mitochondrial eye diseases
Authors: La Morgia C. , Caporali L. , Di Vito L. , Carbonelli M. , Valentino M.L. , Liguori R. , Barboni P. , Carelli V.
Published: September 2017

The most frequent mitochondrial eye diseases are Leber's Hereditary Optic Neuropathy (LHON) and Dominant Optic Atrophy (DOA). They are both characterized by optic atrophy due to retinal ganglion cell loss. Extra‐ocular features have been described in both diseases. In particular, neurological involvement has been reported even though, for some of the neurological features in LHON, the possibility of a chance association is still debated.

In LHON the main neurological features are: 1) Multiple Sclerosis “like” phenotype 2) Movement disorders including dystonia, parkinsonism and myoclonus 3) Peripheral neuropathy 5) Migraine 6) Hearing loss 6) “LHON‐MELAS‐Leigh” overlap.

In DOA, the “plus” subtype is a well‐recognized entity characterized by the occurrence, over the decades, of optic atrophy and sensorineural deafness, polyneuropathy and myopathy with chronic external ophthalmoplegia, and in some families Parkinsonism and dementia. DOA “plus” is typically associated with missense mutations affecting the OPA1 GTPase domain, and skeletal muscle is remarkable for COX deficient fibers and mtDNA multiple deletions. More recently, a Multiple Sclerosis “like” phenotype has been described also in DOA.
Anatomy and physiology of the anterior eye segment
Authors: Werkmeister R.
Published: September 2017

Non‐invasive, non‐contact imaging methods are essential for diagnostics and therapeutic interventions at the anterior eye segment. Given by the properties of the ocular tissues, optical modalities like optical coherence tomography and confocal microscopy are ideally suited for visualizing the morphology of the anterior segment of healthy and diseased eyes with resolutions in the micrometer range. Furthermore, advances in light source technology allow for high resolution imaging of functional parameters as for example the precorneal tear film thickness and, based on the sample reflectivity, also the evaluation of the tear film lipid layer. The presented cases show the potential of the techniques to help in clinical decision‐making and follow‐up after treatment and surgical intervention, respectively. The results indicate that the technological progress in the OCT field and new imaging developments can help to gain a novel insight in the physiology and pathophysiology of the human anterior eye segment.
The earliest eyes on Earth
Authors: Ascaso F.J.
Published: September 2017

Vision had to start somewhere. During the Precambrian Era, life existed in a quiet gloom where most creatures were blind. There was no need to be camouflaged, warn off predators or seduce a partner with bright patterns. Then, at the beginning of the “Cambrian Explosion”, 540 million years ago, life opened its eyes. Given the tremendous adaptive advantage conferred by sharp vision for avoiding predators and locating food, there must have been tremendous evolutionary pressure to elaborate and refine visual organs. Through well‐preserved Cambrian fossils (Trilobites, Anomalocaris and Fuxianhuia protensa) we will see the evolution of vision through the world's oldest eyes. With very well‐developed compound eyes, these earliest animals had a complex visual system. With up to 16,000 lenses in each eye, some of these animals saw their world with exceptional clarity whilst hunting in well‐lit waters. Only a few arthropods, such as modern predatory dragonflies, have similar resolution. We will show extraordinary fossils to reveal exquisite details about the earliest eyes on Earth.
The evolution of oculoplastic operations
Authors: Papadakis M.
Published: September 2017

Although oculoplastic surgery has only recently been recognized as a subspecialty, the early origins of the interrelationship between plastic surgery and ophthalmology, trace back to the 22th century B.C. Minor eyelid operations performed by Babylonian and Assyrian physicians as well as eyebrow stitching descriptions, contained in the Egyptian Papyrus, serve as the earliest surgical attempts at oculoplastic surgery. Other ancient civilizations also provided accurate descriptions of a number of eyelid diseases, including their surgical treatment. During the Greco‐Roman period, several local flaps, e.g. the double‐pedicled and the V‐Y advancement flap, were first described. Byzantine physicians compiled, standardized and enriched the medical knowledge of their Greco‐Roman predecessors, contributing with the surgical treatment of trichiasis, lagophthalmos, ectropion, hydatids, epicanthus, pterygia, lacrimal fistulae and eyelid adhesions. The following centuries, a variety of surgical techniques were developed. Thus, modern oculoplastic surgeons, have incorporated numerous reconstructive procedures into their practice, ranging from simple local flaps to complicated mucosal or composite flaps and selective microvascular procedures.
Topo‐ and tomographical keratoconus indices in case of progression
Authors: Langenbucher A. , Szentmary N. , Eppig T.
Published: September 2017

Especially in an early stage topography and tomography are perfect tools for diagnosis of keratoconus. Corneal crosslinking requires a documented progression of keratoconus. In this talk we would like to address the Instrument‐based documentation of keratoconus progression for qualifying a Patient for corneal crosslinking in case of keratoconus. Special focus is given to the TMS‐5, the CASIA2 and the Pentacam.
Crosslinking in infectious keratitis‐experimental and clinical data
Authors: Szentmary N.
Published: September 2017

The effect of crosslinking (CXL) on human corneal cells, microorganisms and on viral, bacterial, mycotic and acanthamoeba keratitis is summarized. Keratocyte and human endothelial cell viability decreases significantly at 0.1% riboflavin concentration (P < 0.01) while the percentage of CD34 (P < 0.01) and alpha‐SMA positive keratocytes (P < 0.05) increases. CXL may be effective against Staphylococcus aureus, Staphylococcus epidermidis and pseudomonas aeruginosa in vitro, even if they are metichillin, oxacillin or penicillin resistant. In clinical practice, CXL may be used as an alternative treatment option in bacterial, mycotic and acanthamoeba keratitis, if they are therapy resistant.
Outcome of retinoblastoma patients treated according to the University Hospital of Siena guidelines
Authors: Coriolani G. , Galimberti D. , Guglielmucci D.F. , Caini M. , De Francesco S. , Esposti G. , Bracco S. , Galluzzi P. , Toti P. , Pinto A.M. , Favre C. , Grosso S. , Hadjistilianou T.
Published: September 2017

Purpose

To analyze the results of Retinoblastoma (Rb) treatment according to the University Hospital of Siena guidelines in terms of complete ophthalmoscopic remission (COR) of disease.

Methods

A total of 109 eyes of 87 patients were enrolled from September 2013 to November 2016. The mean patient age at diagnosis was 22.8 months (± sd 20.5 months). Sixtysix/109 eyes (60.55% of cases) were unilateral, 42 (38.53%) bilateral. Thirtyfive/109 (32.11%) were classified as low stage (A‐C of ICRB classification), 36 (33.03%) as D stage and 31 (28.44%) as E stage. Interventions: Conservative treatment with intravenous (IV) chemotherapy (CHT) and/or intrarterial (IA) CHT, both as first or second line therapies; primary or secondary enucleation.

Results

Fourtysix/109 eyes (42.20%) received primary IV CHT, 40 (36.70%) primary IA CHT and 22 (20.1%) were enucleated at diagnosis. Twentyfive eyes (22.9%) were treated with secondary IA CHT (for failure of IV CHT, the majority being bilateral cases), 4 (3.6%) with second line IV CHT (mainly thermo‐CHT after IA CHT). Twentythree/109 eyes (21.1%) were secondary enucleated. Globe salvage with COR of disease has been obtained by 53/109 eyes (49% of all cases, 60.9% of the treated ones), in particular: by the 32.5% of the eyes treated with primary IV CHT, by the 52.5% of those treated with primary IA CHT and by the 60% of the eyes treated with secondary IA CHT. Mean follow‐up is of 21.9 months (± sd 16.9 months).

Conclusions

These results confirm the efficacy of our guidelines for Rb treatment. Particularly we obtained a better ocular salvage rate (p > χ2 = 0.0007, Mantel Cox Comparisons) for the cases treated with secondary IA CHT than with primary IA CHT. This observation demonstrates the efficacy of IA CHT even in recurrences of Rb after primary IV CHT, if early detected with a close follow‐up.
A case of misdiagnosed diffuse infiltrating retinoblastoma
Authors: Esposti G. , Borri M. , De Francesco S. , Coriolani G. , Hadjistilianou T.
Published: September 2017

Purpose

The aim of this case report is to describe a case of a 19 months old female with diffuse infiltrating retinoblastoma in her right eye misdiagnosed as corneal dystrophy in another center. Diffuse infiltrating retinoblastoma can lead to anterior segment seeding with pseudohypopion, pseudoialitis and parsplanitis, intraocular hemorrhage confusing it with uveitis, unexplained vitreous hemorrhage, hyphema or endophalmitis.

Methods

In October 2016 the girl was observed at our Ocular Oncology Unit at the University of Siena. At ophthalmoscopic examination in her right eye she presented hyperemia, corneal edema, endothelium alterations, flocculi in the angle, iris neovascularization, and hematic clots (3–10 h). At fundus examination there were not retinal masses, but cloudy vitreous and vitreous deposits inferiorly. The left eye was normal. B scan echography documented thickened retina and vitreous deposits. RMI excluded extraocular disease.

Results

The eye was enucleated and the diagnosis of diffuse infiltrating retinoblastoma was confirmed.

Conclusions

Diffuse infiltrating is the least common growth pattern of retinoblastoma and often the most difficult to recognize clinically. It grows diffusely within the retina .Any child with signs of uveitis, hyphema, hypopion, vitreous hemorrhage and ialitis should be evaluated for retinoblastoma.
Transpupillary laser versus intravitreal Anti‐VEGF for the management of acute ROP: where do we stand?
Authors: Lorenz B.
Published: September 2017

According to ETROP, treatment‐requiring ROP is any stage in zone I with plus, stage 3 in zone I without plus, and stage 2 +  or 3 +  in Zone II. Zone I disease and aggressive posterior ROP, APROP, still have reduced prognosis as to anatomical and functional outcome. The BEAT‐ROP study compared Anti‐VEGF therapy with Bevacizumab and traditional transpupillary laser therapy to treat zone I and posterior zone II disease in a randomized fashion. Since then many other reports were published, mostly non‐randomized, and often not limited to zone I or posterior zone II disease. An important risk after anti‐VEGF therapy are late recurrences due to persistent immature retinal vascularization. Optimal dosage is not yet known. Also, eventual long‐term negative effects on neurodevelopmental features have been reported. On the other hand less myopia with anti‐VEGF than with laser is claimed as a possible advantage, and also the ease of application not needing anesthesia. From all data it would appear that APROP still remains a major challenge irrespective of the mode of treatment. This paper will discuss the pros and cons for the various treatment options.
Surgery in ROP, when is not too late?
Authors: Flores‐Aguilar M.
Published: September 2017

Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in the premature newborn, when there is retinal detachment (RD) in children with ROP, even in limited detachments, the severity and extent of the RD as well as the expedited treatment are key factors to limit the resulting visual disability. The surgical treatment in children with RD due to ROP is aim to limit its extension, preserve anatomy as far as possible and facilitate visual rehabilitation. Advanced stages of ROP are poorly understood, this results in the lack of early detection of RD. Stages 4A and 4B have better prognosis if treated early, in stage 5 often the doubt exists if the anesthetic risk or the time and work necessary for the surgery are worth it since in most cases the anatomical and visual result is bad. We will analyze the types of traction leading to RD, the planning of surgery, the use of pharmacological agents, the recommended time to perform the procedure, autor's recommendations to decide the type of procedure to be performed and the follow‐up. The surgical management of the advanced stages of ROP in an early form may allow in some cases to preserve vision in eyes with retinal detachments in which the macula is still redeemable.
Bioactive sphingolipid mediators promote corneal epithelial homeostasis and wound healing
Authors: Trzeciecka A.M. , Piqueras M.C. , Bhattacharya S.K.
Published: September 2017

Purpose

To investigate sphingolipid expression profile in alkali‐burned cornea and subsequently evaluate effects of the selected species on corneal epithelial wound healing.

Methods

All experiments were performed using porcine cornea organ culture or porcine corneal epithelial cells (PCEC). For sphingolipid profiling samples were spiked with internal standards, extracted by Bligh&Dyer method and analyzed using liquid chromatography‐mass spectrometry. PCEC viability/proliferation and migration were assessed using MTT and Boyden chamber assays, respectively. Epithelial wound healing in cornea organ culture was followed by fluorescein staining. Molecular mechanisms underlying the action of selected sphingolipids were studied using iTRAQ‐based quantitative proteomics.

Results

Sphingolipid profiling of alkali‐burned corneas revealed early decrease in sphingosine 1‐phosphate and lysosphingomyelin with concomitant increase of ceramide 1‐phosphate. We tested 7 lipids from aforesaid subclasses for their ability to affect proliferation/viability and migration of PCEC. 2 lipids: A, B improved viability/proliferation of alkali‐injured PCEC, induced PCEC chemotaxis as well as promoted re‐epithelialization after alkali burn in cornea organ culture. Another lipid: C potently improved viability/proliferation of healthy PCEC in a wide range of concentrations. In response to A/B/C treatments PCEC displayed differential expression of 114/375/47 proteins, majority with binding and catalytic activity functions. Proteins ↑ upon A/B were involved mainly in proliferation, adhesion and glycolysis, while upon C ‐ in maintenance of corneal epithelial homeostasis.

Conclusions

We identified 2 sphingolipids that facilitate cornea re‐epithelialization by promoting proliferation and migration of corneal epithelial cells and another that promotes healthy corneal epithelial cell phenotype.
The effect of caffeine on retinal vessel diameters in the Inter99 eye study
Authors: Veiby N.C.B.B. , Drobnjak D.N. , Munch I.C. , Toft U. , Glümer C. , Færch K. , Kessel L. , Larsen M.
Published: September 2017

Purpose

To examine the effect of caffeine on retinal vessel diameters in the Inter99 Study.

Methods

The Inter99 Study comprised a population‐based age‐and sex‐stratified sample of 13,016 residents of a suburban section of Greater Copenhagen, Denmark. From 6784 participants aged 30‐60 years who volunteered to participate in the main study, a subgroup of 970 participated in the eye study. Vessel diameters were measured using a semi‐automatic computer program. Exclusion of participants without images of acceptable quality (n󰀽71) left 899 participants for analysis. Coffee and tea intake assessed using a food frequency questionnaire (FFQ) ranged from 0 to 35 cups. One cup of tea or coffee was assumed to contain 100 mg of caffeine.

Results

Of 899 eligible participants, 861 were daily coffee or tea drinkers, a mean of 5 cups per day. Thirty eight did not drink tea or coffee. The central retinal artery diameter was 214 μm in participants who did not drink tea or coffee and 209 μm in participants who drank tea or coffee (B = ‐5.7 CI 95%: ‐10.5 to ‐1.0, p = 0.019, adjusted for age, gender, systolic blood pressure, HDL cholesterol, BMI, diabetes mellitus status and smoking status). The central retinal vein diameter was 261 μm in participants who did not drink tea or coffee and 252 μm in participants who drank tea or coffee (B = ‐8.6 CI 95%: ‐15.2 to ‐2.0, p = 0.011, adjusted for age, gender, systolic blood pressure, HDL cholesterol, BMI, diabetes mellitus status and smoking status).

Conclusions

This cross‐sectional study found that participants who drank tea or coffee on a daily basis had narrower central retinal arteries and veins than participants who did not drink tea or coffee. This is consistent with previous observations that caffeine induces cerebral vasoconstriction by antagonizing adenosine receptors.
Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency and age‐related macular degeneration in a Sardinian male population, Italy
Authors: Pinna A. , Porcu T. , D'Amico‐Ricci G. , Boscia F. , Carru C.
Published: September 2017

Purpose

The reported prevalence of G6PD deficiency in Sardina, Italy, ranges from 8% to 15%. Hemizygous males have totally deficient erythrocytes. Evidence indicates that patients with G6PD deficiency are protected against ischemic heart and cerebrovascular disease, retinal vein occlusion, and nonarteritic anterior ischemic optic neuropathy. The purpose of this study was to assess the prevalence of G6PD deficiency in Sardinian men with age‐related macular degeneration (AMD) and ascertain whether G6PD deficiency may have a protective effect against AMD.

Methods

G6PD blood levels were measured in 81 men with AMD. 119 men without AMD undergoing cataract surgery served as controls. The Z test was used to assess differences in G6PD deficiency prevalence rates between groups. The odds ratio (OR) was used to evaluate the association between G6PD deficiency and AMD.

Results

G6PD deficiency was found in 7 (8.6%) out of 81 patients with AMD and in 10 (8.3%) out of 121 controls. Differences between AMD patients and controls were not statistically significant (Z = 0.095, P = 0.9). G6PD deficiency showed no association with AMD (OR: 1.05; 95% Confidence Interval: 0.38‐2.88).

Conclusions

Results suggest that G6PD deficiency has no protective effect against AMD and is not a risk factor for this degenerative macular condition.
CTG18.1 trinucleotide repeat expansion in Polish patients with Fuchs endothelial corneal dystrophy
Authors: Udziela M. , Oziębło D. , Sarosiak A. , Ołdak M. , Szaflik J.P.
Published: September 2017

Purpose

To genotype the CTG18.1 repeat expansion in TCF4 gene and determine an association between genetic variant and Fuchs endothelial corneal dystrophy (FECD) development in Polish patients.

To analyze possible reationship between the different CTG18.1 genotypes and clinical picture of the patients.

Methods

Clinical evaluation was based on slit‐lamp examination, in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS‐OCT). Genomic DNA was isolated from peripheral blood samples of unrelated FECD patients (n = 236) and control subjects (n = 58). We genotype the CTG18.1 repeat expansion to determine an association between the genetic variant and FECD development and to analyse possible relationships between the different CTG18.1 genotypes and clinical picture of the patients. For this purpose a combination of methods, i.e. analysis of short tandem repeats (STR), triplet repeat primed PCR (TP‐PCR) and statistical analysis were performed.

Results

The results showed that the repeat expansion CTG18.1 is currently the strongest predisposing factor for the development of FECD in a group of Polish patients (OR=43,72; CI:13,20‐144,83; χ2 = 80,77; p < 0,0001). There were no significant associations between the CTG18.1 genotype and the best corrected visual acuity (BCVA), central corneal thickness (CCT) or the density of the corneal endothelium.

Conclusions

Our study confirms association of CTG18.1 repeat expansion with FECD by testing a novel previously not analysed population. This genetic determinant has an important predictive value and may be beneficial in clinical practice.
Changes in axial length before and after recovery in patients with idiopathic central serous chorioretinopathy with serous retinal detachment
Authors: Shin Y.I. , Shin K.S. , Jo Y.J. , Kim J.Y.
Published: September 2017

Purpose

To evaluate the changes of axial length (AXL) in eyes with unilateral idiopathic central serous chorioretinopathy (CSC) after subretinal fluid absorption.

Methods

We studied 31 consecutive patients with unilateral resolved central serous chorioretinopathy. The keratometric value and AXL were measured by partial coherence interferometry (IOL Master®). Presence of subretinal fluid and central macular thickness (CMT) were measured by spectral domain optical coherence tomography (Cirrus HD OCT®).

Results

The mean age of 31 CSC patients was 42.7 years, and 19 males were included. The AXL was statistically significant difference from 23.41 to 23.58 mm after subretinal fluid absorption (p < 0.001). The differences in AXL correlated with CMT differences (r = −0.616, p < 0.001). Best corrected visual acuity and CMT were statistically significant difference after subretinal fluid absorption (p < 0.001).

Conclusions

In unilateral idiopathic CSC, the AXL was increased after subretinal fluid absorption. Therefore, the impact of serous retinal detachment should be considered in AXL measurement.
Enzymatic vitreolysis with ocriplasmin for symptomatic vitreomacular traction syndrome
Authors: Gkizis I. , Garnavou‐Xirou C. , Velissaris S. , Kabanarou S. , Chatziralli I. , Kontou E. , Xirou T.
Published: September 2017

Purpose

To evaluate the anatomical and functional outcomes of patients treated with ocriplasmin for vitreomacular traction syndrome (VMT) or macular holes (MH) combined with VMT in a tertiary retina center.

Methods

Eleven eyes of ten patients (8 females, 2 males) with VMT (8 with VMT alone and 3 with MH combined with VMT) were included in the study. The patients were treated with a single ocriplasmin injection and examined at day 1, 7 and 28 post‐injection. Age, gender, phakic lens status, vitreomacular adhesion diameter, presence of epiretinal membrane, macular hole size, cystoid macular oedema and the status of the ellipsoid zone were recorded. Best‐corrected visual acuity (BCVA) and spectral‐domain‐optical coherence tomography (SD‐OCT) were performed at baseline and at each examination during the follow up period. Adverse effects were also recorded.

Results

Six eyes (54,5%) presented VMT resolution, while one out of three patients presented MH closure. All patients experienced VMT release by 7 days. Patients with VMT resolution had an increase in BCVA of +0.5 logMAR. .

Conclusions

Ocriplasmin may be considered as an effective treatment option for VMT and macular holes with VMT.