bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing gene therapies for corneal endothelial disorders
Authors: LARKIN F
Published: September 2009

Techniques of gene transfer to corneal cells have been in development for at least 15 years. Studies on feasibility of gene transfer and kinetics of transgene expression have been undertaken ex vivo and in vivo using physical, viral vector and non‐viral vector techniques of gene transfer. Functional gene transfer research has been developed for applications such as anti‐angiogenesis, modulation of stromal wound healing or endothelial cell cycle control and prevention of allotransplant rejection. The absence of such application in inherited disorders of corneal endothelium points to absence of in vivo models for study and the availability of surgical treatment which, in many patients, is effective. Opportunities in the field of gene‐based approaches to disorders of corneal endothelium lie in newer designs of low‐immunogenicity vectors, longer duration of transgene expression and application in eye banking. Experimental approaches which in essence use cDNA as an alternative to protein or drug treatment will be discussed. Supported by NIHR Biomedical Research Centre in Ophthalmology, Moorfields Eye Hospital & UCL Institute of Ophthalmology, London, United Kingdom
Oxidative stress from in vivo dual waveband exposure to ultraviolet radiation
Authors: SÖDERBERG PG , LI Y , GALICHANIN K , KRONSCHLäGER M
Published: September 2009

Purpose The purpose of the current project was to elucidate if the effect of exposures to two wavebands is directly proportional to the sum of the biologically efficient dose for each of the two wavebands.

Methods Altogether 40 albino Sprague‐Dawley rats, 6 weeks old (150 g), were exposed unilaterally in vivo to UVR. Half the group was exposed to 8 kJ/m2 biologically efficient dose (= absolute dose) of UVR centered at 300 nm. The other 20 rats were exposed, first to 4 kJ/m2 biologically efficient dose (= absolute dose) of UVR centered at 300 nm, and then to 4 kJ/m2 biologically efficient dose (= 42 kJ/m2 absolute dose) centered at 310 nm. All animals were sacrificed at 1 week after exposure and intensity of forward light scattering was measured in both lenses.

Results The UVR 300+310 nm group expressed slightly more light scattering than the UVR 300 nm only group as indicated by a 95 confidence interval for the difference approximating the degrees of freedom due to different variances (CI:D(0.95)= ‐8.69 +/‐6.92 x10‐2 tEDC, d.f = 32.7).

Conclusion Although, the outcome indicated that there is a difference between the two groups, the difference is very small in relation to spectral sensitivity. It is therefore concluded that it is a valid approximation to assume spectral additivity of biologically efficient doses when estimating effects of broadband exposures.
The role of mitochondrial glutaredoxin‐2 in protecting cells against oxidative stress
Authors: LOU M , WU HL
Published: September 2009

Purpose Glutaredoxin 2 (Grx2) is an isozyme of glutaredoxin (Grx1) present in the mitochondria. Similar to Grx1, it has dethiolase activity but the general function is largely unknown. In this study, we investigate the potential anti‐apoptotic function of Grx2 through its ability to protect complex I enzyme in the mitochondrial electron transport system.

Methods Grx2 plasmid or Grx2 siRNA was tramsfected in human lens epithelial B3 cells (HLE‐B3) to generate Grx2 overexpressed (OE) or Grx2 knockdown (KD) cell line. Cells with empty vector were used as the control. All three cell lines were incubated with and without H2O2 (0.2 mM) for 24 hrs before examining for cell viability (WST8 colorimetric method). Apoptosis was measured by flow cytometry, and the protein levels of Bax, Bcl‐2, cytochrome C and caspase 3 activation by Western blot analysis using specific antibodies. In some experiments, rotenone (0.5 mM), a specific inhibitor of complex I, was used together with H2O2 to evaluate complex I activity protected by Grx2.

Results Grx2 OE protected HLE‐B3 cells from H2O2‐induced cell viability loss and apoptosis. These cells also exhibited high level of Bcl‐2 and inhibited cytochrome C release and caspase 3 activation induced by H2O2. In addition, Grx2 OE also protected mitochondria from H2O2‐induced loss in complex I activity. In contrast, Grx2 KD enhanced H2O2‐induced cellular damage and complex I inactivation.

Conclusion Grx2 can protect HLEB3 cells against H2O2 induced apoptosis. The mechanism of this protection is likely associated with its ability to protect complex 1 in the electron transport chain and preserve the mitochondrial membrane integrity.
The ubiquitin proteasome pathway ‐ Repair or degradation of damaged proteins
Authors: FERNANDES R , BENTO C , SEIÇA R , PEREIRA P
Published: September 2009

Purpose Accumulation of methylglyoxal (MGO), a highly reactive side‐product of glycolysis can modify proteins. Increased levels of MGO in cells have been implicated in diabetic vascular complications. In physiological conditions, proteolytic systems and chaperones together ensure maintenance of protein quality control. We hypothesize that MGO impairs the function of UPS and on molecular chaperones.

Methods Rats with moderate type 2 diabetes (GK) and retinal epithelium pigment cell line were used. Protein oxidation was assessed by formation of carbonyl groups. Production of intracellular ROS was assessed in frozen sections of diabetic retinas by DHE incorporation. 20S proteasome activities were assessed by fluorogenic peptides. Ubiquitin (Ub) conjugation activity was determined by the ability of retinal extracts to conjugate 125I‐Ub to endogenous substrates. Ub conjugates, Hsp90, Hsc70, Hsp40 and CHIP levels were assessed by WB. Cell viability was determined by MTT while proliferation was assessed by BrdU‐incorporation.

Results Data show that accumulation of endogenous Ub conjugates in the presence of MGO is associated with an increased ability of retinal extracts to conjugate 125I‐Ub to endogenous substrates. Moreover, MGO significantly decreases the 20S ptoteasome activity. Data further show that MGO decreases the levels of the molecular chaperones Hsp90 and Hsc70 and promotes aggregation of Hsp40 and CHIP. Moreover, these aggregates revealed immunoreactivity against Ub. Consistently, these effects are associated with increased cell protein oxidation, decreased cell proliferation and viability.

Conclusion In diabetes, accumulation of MGO may impair the UPP and the protein quality control, leading to accumulation of obsolete proteins and cell injury.
Cataract, loss of visual acuity, infection after trabeculectomy
Authors: BRON AM
Published: September 2009

Purpose Trabeculectomy is the most popular surgery for glaucoma, however some complications may impair the success of the procedure. Moreover without impacting the overall efficacy of trabeculectomy, the quality of life of the patients could be affected in a certain number of cases.

Methods In this session we will give some tips to prevent and to treat these complications.

Results Cataract is frequent after trabeculectomy and is mainly related to postoperative hypotony. In most recent clinical studies cataract has been shown to occur in half of the eyes 3 years after trabeculectomy. This has led H Jampel to write a provocative editorial; Trabeculectomy: more effective at causing cataract surgery than lowering intraocular pressure (Ophthalmology 2009;116:173‐174). In advanced cases, severe sight‐threatening complications such as the wipe‐out syndrome, even uncommon may definitely lead the patient to blindness. The two more frequent presentations of infection after trabeculectomy are blebitis and endophthalmitis. Both can occur several years after trabeculectomy and Streptococci which are frequently found are devastating strains. Antimetabolites greatly increase the prevalence of endophthalmitis after trabeculectomy. Other less severe complications such as bleb dysesthesia may alter the quality of life of the patients.

Conclusion The information of the patients and the quality of the follow‐up are of paramount importance when a trabeculectomy is considered.
Regulation of transgene expression
Authors: KOCH P
Published: September 2009

Purpose Regulation of the transgene expression in the targeted cells is of course of major importance when using gene therapy. Actually, we have a huge range of possibilities to regulate gene expression.

Methods There are two main classes of promoters: constitutive and inducible promoters. Amongst constitutive promoters, we have two sub‐forms: non‐tissue and tissue specific promoters. The lasts allows us to better target the tissue or cells in which we want to express our gene of interest. On the other hand, inducible promoters have been widely developed recently and allow us to obtain a regulated expression, depending on different factors. Very recently, disease specific inducible promoters emerged for a more precise regulation.

Results We will together examine more precisely the different possibilities offered by gene regulation in Gene Therapy. Thereafter, we will more specifically describe usable promoters in ocular inflammation. Finally we will examine the effects of some inflammatory, disease specific, promoters.

Conclusion Regulation of transgene expression is one of the fundaments of efficient gene transfer. Recent developments actually allow us to play within the targeted cell(s) to obtain an expression in specific conditions.
Gene therapy for posterior uveitis
Authors: DICK AD
Published: September 2009

Purpose To investigate the role of gene therapy incorporating release of immunomodulatory cytokines in animal models of intraocular inflammation

Methods By inoculating with either AAV or lente viruses incorporating genes for IL‐1RA or IL‐10 into either the anterior chamber or subretinally we onserved the ability to suppress either endotoxin induced uveitis (EIU) or experimental autoimmiune uveoretinitis (EAU).

Results Anterior chamber inoculation with lente‐IL‐10 or IL‐1RA successfully suppresses inflammation and protein exudation into the eye during the course of EIU. Subretinal injection of AAV‐IL‐10 suppresses EAU. The extent of local macrophage activation is also suppressed as there is marked reduction in nitrotyrosine expression within the retina.

Conclusion Gene therapy with immunomodulatory cytokines offers a potential to suppress active inflammatory processes within the retina. Mechanisms will be discussed in the talk in relation to macrophage activation and restoring myeloid cell (microgolial) homeostasis within the retina.
Uveal metastasis as initial manifestation of cancer
Authors: NOVAK ANDREJCIC K , KRAUT A , TEKAVCIC POMPE M , JANCAR B
Published: September 2009

Purpose To report clinical features of patients with uveal metastases and no known history of primary cancer at the time of ocular diagnosis.

Methods A retrospective chart review of all patients with uveal metastases and with no history of primary cancer, evaluated at University Eye Hospital in Ljubljana over a 10‐year period was performed.

Results A total of 9 patients, 4 women and 5 men with uveal metastases were included. Referral diagnosis was iris tumour in 2 patients, suspected uveal melanoma in 3 , choroiditis in 1 and undetermined choroidal tumour in 3 patients. None of the patients had a history of previous cancer. The diagnosis of uveal metastasis was established on the basis of medical history, clinical picture, standardised echography, fluorescein angiography and systemic evaluation. Iris and ciliary body were involved in one patient, iris in one, ciliary body and choroid in one, while choroid was the only site of metastatic involvement in 6 patients. In all patients only one eye was affected. A primary lung carcinoma was detected in 8 patients, whereas in 1 patient a primary carcinoma of the gastrointestinal tract was found.

Conclusion Lung carcinoma was the most common site of primary cancer in our patients. Patients may have no known history of primary cancer at the time of ocular diagnosis, hence a thorough subsequent systemic evaluation is mandatory.
IgG4‐related sclerosing disease: Is there an association with orbital inflammatory pseudotumours?
Authors: HERWIG MC , FISCHER HP , HOLZ FG , LOEFFLER KU
Published: September 2009

Purpose IgG4‐related sclerosing disease is a systemic disease characterized histopathologically by extensive infiltration of various organs by IgG4‐positive plasma cells (and T lymphocytes). Frequently associated with elevation of serum IgG4 levels, major clinical manifestations are apparent in organs in which tissues fibrosis is induced, e.g. in the pancreas. Some variants of inflammatory pseudotumour of the orbit reveal histopathologically a close relationship to multifocal fibrosclerosis. We therefore evaluated the presence of IgG4‐positive plasma cells in this disease to possibly find an association with systemic IgG4‐related sclerosis.

Methods We investigated 10 specimens of orbital pseudotumours that had been diagnosed by the Dep. of Pathology using HE&PAS staining. Immunohistochemical labeling was performed using antibodies against κ‐ and λ‐chains, IgA, IgD, IgM, IgG, and IgG4 and the staining intensity was independently evaluated by MCH and HPF.

Results 3 specimens showed an increased immunoreactivity with anti‐IgG4 (2/3 intensive staining, 1/3 moderate staining). In addition, in these specimens there was only a slight expression of IgA, IgD and IgM. With regard to all specimens, plasma cells secretion of λ‐chains was insignificantly stronger than that of κ‐chains.

Conclusion This being the first investigation of IgG4‐immunostaining in ocular pseudotumours, our results indicate a possible relationship between this disease entity and IgG4‐related sclerosing disease. Further investigations including IgG4 serum levels and a more detailed history regarding associated systemic disease is warranted.
Serous retinal detachment caused by a choroidal metastasis treated with subtenon triamcinolone injection
Authors: EGEA ESTOPINAN MC , PRIETO CALVO E , GUERRI MONCLUS N , RUIZ MORENO O
Published: September 2009

Purpose Ocular metastases are becoming less and less rare. Choroidal metastases are recognized as the most common intraocular malignancy. Most ocular tumors metastasize from systemic origins in breast carcinoma in females, and bronchial carcinoma in males

Methods CASE REPORT A 44 years‐old woman with an history of breast adenocarcinoma three years ago, who complained of visual disturbance of the left eye. On initial examination, the left best‐corrected visual acuity (BCVA) was 0,3. Left fundoscopy revealed several elevated yellowish masses with peripapillary serous retinal detachment. The fluorescein retinal angiography showed a choroidal lesion highly suggestive of choroidal metastasis

Results The patient was treated with subtenon triamcinolone intection. Five moths later the left BCVA was improved to 0.8. Funduscopy and optical coherence tomography confirmed reduction of edema

Conclusion CONCLUSIONS Subtenon triamcinolone inyection reduced subretinal edema. Optical coherence tomography (OCT) is useful in the follow‐up of choroidal metastasis after treatment. However, some limitations result from the choroidal location of the metastasis.
How does normal crowding affect visual acuity?
Authors: RAUSCHER F , HARLOW A , BARBUR J
Published: September 2009

Purpose Clinical tests of visual acuity (VA) that employ multiple, neighbouring optotypes assume that visual 'crowding' at the fovea is negligible. Findings from recent studies suggest that crowding effects can affect high contrast acuity thresholds at the fovea. The absence of data to describe the distribution of crowding effects within 'normal' vision makes it difficult to establish when a measured reduction in VA (with crowding) can no longer be considered to be within the normal range and is therefore indicative of abnormal development or pathology. The aim of this study was to quantify the effects of crowding on VA in the normal population.

Methods We measured acuity thresholds, with and without crowding, in central vision (i.e. at the fovea and at +/‐1 degree, +/‐1.5 degrees, and +/‐2 degrees) in 80 normal subjects with the age range of 29.3 +/‐10.7 years. The stimulus optotype was a Landolt ring of 100% luminance contrast presented either in isolation or together with four surrounding rings at a distance equal to 1.5 times the diameter of the stimulus, these parameters were selected on the basis of preliminary studies varying the spacing and the number of distracters.

Results The threshold stimulus size for correct discrimination of gap orientation increased almost linearly with eccentricity, the presence of distracter rings caused a significant reduction in VA.

Conclusion The statistical distribution of the differences between the two measures of VA provides the data needed to define the effects of crowding in “normal” vision. The template extracted from these data is clinically useful to identify those subjects that show abnormal sensitivity to crowding, i.e. amblyopia or early degenerative conditions/ disease.
Anterior segment biometrics – investigation of hyperopic eyes with Orbscan
Authors: JONUSCHEIT S , DOUGHTY MJ
Published: September 2009

Purpose Assessment of the anterior segment by Orbscan in hyperopic eyes.

Methods 30 normal right eyes (10 younger hyperopes, 10 older hyperopes, 10 younger emmetropes) were assessed with Orbscan II. Anterior chamber depth (ACD), horizontal corneal diameter (HCD), anterior (AK) and posterior corneal radius (PK), central (CCT) and peripheral corneal thickness (PCT, 4mm from centre) were analysed in the younger (≤ 45 years of age) and older hyperopic subjects (> 45 years). The data from the younger hyperopic group were also compared with the age‐matched emmetropic subjects.

Results All data were normally distributed (p ≥ 0.403). For the 20 hyperopic subjects, the mean refractive error was +2.33 D (SD+/‐ 1.85 D), the mean ACD was 2.59 +/‐ 0.35 mm, with a mean HCD of 11.76 +/‐ 0.33 mm. The mean ACD was less in young hyperopes than in emmetropes (2.72 mm vs 2.91 mm). ACD was a further 10 % shallower in older hyperopes when compared to younger hyperopes, with the peripheral cornea also being slightly thinner (by about 4 %). No substantial differences between the younger and the older hyperopes were noted in HCD, PK, and CCT (p ≥ 0.094, independent samples t‐test), but younger hyperopes had on average a larger AK than older subjects, the difference being only just significant (p = 0.02).

Conclusion These pilot studies indicate that most anterior segment biometrics are not substantially different between younger and older subjects with hyperopia. However, younger subjects had a slightly flatter anterior corneal radius and a thicker peripheral cornea, along with the expected (on average) lower ACD in hyperopic eyes and older subjects. Further studies are needed for refractive surgery procedures in older hyperopic patients.
Electroretinogram alterations in a monozygotic twin sisters discordant retinitis pigmentosa
Authors: HALFELD FURTADO DE MENDONCA R , OLIVEIRA MAIA JúNIOR O , HENRIQUE NOVER G , YUKIHIKO TAKAHASHI W
Published: September 2009

Purpose We describe the electroretinographic alteration in an interesting and unusual case of a twin sisters discordant Retinitis Pigmentosa (RP).

Methods A 30‐year‐old woman complained of night blindness. She and her twin sister, underwent complete ophthalmological exams including fundoscopy, retinography and electroretinogram at the Clinical Hospital of the University of São Paulo.

Results The scotopic full‐field electroretinogram was non detectable and not significantly different from noise. The fotopic and flicker responses were present, but abnormal. The multifocal electroretinogram (mfERG) showed a residual central cone response. The scotopic and fotopic full‐field electroretinogram and mf‐ERG of the sister were normal.

Conclusion The discordant RP is very rare and the electrophysiological tests are important to confirm diagnosis. We believe that RP can manifest in incomplete penetrance or in different phenotypes.
The damaging effect of various intensities of light on retinal function in pigmented rats.
Authors: BARYLUK A , THALER S , REJDAK R , BOLZ S , ZRENNER E , ZARNOWSKI T
Published: September 2009

Purpose To investigate the functional retinal damage following the short term (6h) light exposure in pigmented rats.

Methods One group of dark adapted Brown‐Norway rats was exposed for 6 h to 10 klux without mydriasis. Five groups of rats were exposed to different intensities of light (10, 5, 3.4, 2.7 and 1.7 klux) for 6 h with pupil dilatation. Electroretinography (ERG) was recorded prior to, and at 1st and 7th day after light damage (LD). ERG protocol enabled quantification of scotopic sensitivity parameters (Vmax‐saturated b‐wave amplitude and k‐ luminance to reach Vmax/2),photopic cone response and oscillatory potentials(OPs).

Results The exposure to 10 klux without mydriasis did not result in significant retinal injury. In groups subjected to mydriasis, the light of 1.7 klux resulted in nonsignificant (ns) decrease of ERG response. However, the severe loss of retinal function was reported after exposure to higher intensities. The value of Vmax at 1st day after LD was reduced respectively to 90±25%(ns), 19±5%, 7±4%, 4±1% and 3±0.3% of baseline value (p<0.05).No significant improvement was recorded during the following 7 days. The parallel decrease was observed in scotopic mixed (rod+cone) a‐ and b‐wave amplitude,in photopic response and in OPs. The scotopic threshold luminance increased gradually together with the damaging light intensity, while the value of parameter k was only narrowly altered (p>0.05) after LD in all animal groups.

Conclusion Our results show, that a few hours' illumination with the light of even moderate intensity may result in severe functional retinal impairment in pigmented rats. Presented model may be useful to study the cell degenerations in pigmented retinas.
Analysis of multifocal electroretinography implicit times in the prediction of macular hole formation
Authors: VARSANYI B , TUZSON R , NAGY BV , FERENCZ M , FARKAS A
Published: September 2009

Purpose Our aim was to investigate the predictive role of multifocal electroretinography (mfERG) by analyzing the implicit time changes in the fellow eye of patients with unilateral macular hole.

Methods 80 eyes of 40 patients with unilateral macular hole were examined by mfERG (RetiScan, Roland Consult, Germany). Ring ratios of the multifocal electroretinograms were calculated by correlating the central rings’ implicit time with that of the peripheral ones (T1/T2, T1/T3, T1/T4 and T1/T5). After vitreoretinal surgery, during the follow‐up period of 24 months, in 13 of 40 cases macular hole formation was detected in the previously intact fellow eye by optical coherence tomography. Patients were divided into two groups according to this. The implicit time ring ratios of the two groups were compared.

Results Surprisingly, although the implicit times showed no significant difference in the two groups, the ratios T1/T2, T1/T3, T1/T4 and T1/T5 were significantly lower in the eyes that later developed macular hole (1.08, 1.12, 1.14, 1.16) than those which remained intact (1.01, 1.03, 1.05, 1.07, respectively; p<0,05).

Conclusion By analyzing the mfERG implicit time, using ring ratios seems to be a more sensitive method in predicting macular hole formation in the fellow eye, than analyzing the implicit times alone. Lower values might forecast propensity for subsequent macular holes. These patients may require stricter follow‐up.
Development of a software for the exchange of electrophysiological data of vision with PACS systems based on DICOM
Authors: STRASSER T , AVCU S , KONEV V , KORKMAZ F , MANAV E , SCHRECK T , TAUKOVIC M , WILKE R , ZRENNER E
Published: September 2009

Purpose Digital imaging and communications in medicine (DICOM) is widely acknowledged as standard in medical informatics. It provides a communication protocol for interchange of diagnostic and therapeutic information, images, and any associated data. Medical devices with DICOM interfaces can be connected to share data. DICOM evolves continuously in supporting new modalities and services and now allows also the interchange of waveforms. In electrophysiology of vision however, storage and exchange of data is mostly based on proprietary protocols of device vendors. We developed a software for vendor neutral storage of electrophysiological data based on DICOM.

Methods DICOM follows the object‐oriented paradigm and defines information object definitions (IODs), describing the type of data dealt with (e. g. CT image) as well as service classes (SC) specifying valid operations for specific IODs (e. g. store). SCs and IOPs form so called service object pairs (SOP). In this work, the IOD for waveform data was extended using private attributes as designated by the DICOM standard. A service class user (SCU) for the connection to a picture archiving and communication system (PACS) was developed. The software is based on the PixelMed Java DICOM Toolkit. Testing was done using dcm4chee as PACS.

Results The software is integrated in Tuebingen ERG Explorer, allowing for submission of electrophysiological recordings to a PACS. It is used as a prototype at the University Eye Hospital Tuebingen.

Conclusion We have introduced a IOD for storage of electrophysiological data of vision as a first step of integration into a distributed eHealth network, leveraging existing DICOM infrastructure like PACS.
From intravitreal cell‐encoated drug therapy to low‐(brain‐)pressure‐glaucoma
Authors: JONAS JB
Published: September 2009

Purpose To present potentially new developments in the intraocular drug delivery for therapy of retinal diseases as well as new development for the discussion of the pathogenesis of glaucomatous optic neuropathy.

Methods The advantages and limitations of the current intraocular drug therapy will partially be discussed. Additionally, morphologic findings of the optic nerve head assessment inglaucoma and of measurements of the lumbar cerebrospinal fluid pressure (CSF‐P) will be presented.

Results Analysis of morphologic differenecs between glaucomatous versus non‐glaucomatous optic nerve damage suggests that high‐pressure glaucoma and normal‐pressure glaucoma may share some aspects in their pathogenesis. Correspondingly, the CSF‐P data suggest that normal‐pressure glaucoma may be associated with a low brain pressure. Experimental studies omn the intraocular cell‐based drug delivery suggests that these cells survive for several weeks int he viotreous cavity and continously produce substances, e.g. glucagon‐like peptide 1 and endostatin.

Conclusion The prelimanry data suggest that intraocular cell‐based therapy is potentially useful for the treatment of intraocular diseases. Addtiionally, the CSF‐P meausrements suggest that a low brain pressure may potentially be connected with glaucomatous optic neuropathy.

Commercial interest
A new treatment for Meibomian gland dysfunction
Authors: PURSLOW C
Published: September 2009

Abstract not provided
Macular edema and RVO. Role of inflammation
Authors: POURNARAS CJ
Published: September 2009

Abstract not provided
Use of steroids in Macular Edema, are all the steroids the same?
Authors: DE SMET M
Published: September 2009

Abstract not provided
Implantation of intraocular lens in children with uveitis : long term visual outcome and prognosis
Authors: HAY A , TERRADA C , AKNIN C , CASSOUX N , LE HOANG P , BODAGHI B
Published: September 2009

Purpose To evaluate long term visual acuity, intra ocular inflammation and late complications for children with chronic uveitis who underwent cataract surgery with posterior chamber intra ocular lens (IOL) implantation.

Methods Retrospective, monocentric study of children under 16 with chronic uveitis and who underwent cataract surgery between january 1996 and december 2001. Surgical protocol included : phacoaspiration with posterior capsulorhexis, anterior vitrectomy and IOL implantation. Visual acuity, intra ocular pressure, slight lamp examination, laser flare photometry and anti inflammatory treatment were analyzed at different time points.

Results 17 eyes of 12 children (8 boys, 4 girls) were included. Uveitis was bilateral in 6 cases. The mean age at surgery was 10.5 years (ranged from 4 to 15) and the mean follow up time was 8.9 years (from 7 to 13). Diagnosis of uveitis was idiopathic juvenile arthritis in 8 cases (64.7%), sarcoidosis in 1 case and finally no etiology was identified in 3 cases (29.4%). Seven years after surgery, the mean visual acuity was 0.33 logMAR and 82% of children had still an immuno modulatory treatment. Late complications were : glaucoma (11.7%) , Elschnig perls (11.7%) , giant cells on IOL (35%) and CME (6%) of cases.

Conclusion IOL implantation in children with chronic uveitis prevents amblyopia and allows rapid visual recovery. Complete surgical procedure in this group of children has interesting results on visual acuity and rehabilitation. Strict and long‐term control of intraocular inflammation is mandatory in order to prevent major complications and blindness. Implantation should not be proposed in young children with JIA‐associated uveitis.
Aqueous humor keratinocyte growth factor levels in patients with acute anterior uveitis.
Authors: FRANCES‐MUNOZ E , GALLEGO‐PINAZO R , DIAZ‐LLOPIS M , GARCIA‐DELPECH S , SALOM D , UDAONDO‐MIRETE P , MARIN‐LAMBIES C
Published: September 2009

Purpose Keratinocyte growth factor (KGF) is produced by cells of mesenchymal origin and has an important role in repairing tissues and possesses anti‐inflammatory properties. The aim of this study was to evaluate the levels of KGF in the aqueous humor in eyes with acute anterior uveitis (AAU).

Methods A prospective, comparative control study. Aqueous humor was collected from 16 eyes of 16 patients with AAU. The level of KGF was determined with a commercially available enzyme‐linked immunoabsorbent assay kit. The control group comprised 16 aqueous samples from 16 patients about to undergo cataract surgery and without any other ocular or systemic diseases.

Results The concentration of KGF in aqueous humor was markedly higher in patients with UUA than in control subjects (Mann‐Withney U test, P< 0.001). The level of KGF was 38.06 ± 37.46 (mean ± SD) pg/ml in eyes with UUA and 3.50 ± 1.3 pg/ml in the eyes of the control group.

Conclusion The aqueous humor KGF level is increased in eyes with AAU. These results imply that KGF is associated with the regulation of inflammation in patients with AAU.
Inhibition of viral replication in vitro by antiviral‐treated amniotic membrane
Authors: MENCUCCI R , PALADINI I , MENCHINI U , DEI R
Published: September 2009

Purpose To investigate if amniotic membrane soaked with antivirals could inhibit viral growth in vitro

Methods Amniotic membrane fragments were incubated with antiviral solutions of acyclovir and trifluridine . After having inoculated vero cells with a viral suspension of HSV1 and added with the AM fragments we tested them for the antiviral activity by recording the cytophatic effect and DNA assessment by Quantitative‐PCR.

Results AM soaked in ACV 50 mg/ml was capable to inhibit the development of HSV viral growth in cell cultures. Non‐treated AM did not significantly affect viral replication.

Conclusion Our preliminary in vitro data show that amniotic membrane can absorb the antivirals
Non surgical approach in diabetic macular edema : the future ?
Authors: CHIQUET C
Published: September 2009

Purpose To present the different non surgical therapeutical options of diabetic macular edema

Methods The pathogenesis of diabetic macular edema is multifactorial. Hyperglycemia and poor systemic factor balance are major risk factors. Laser treatemnts and antiagiogenic treatments represent the main non surgical options to treat macular edema.

Results Focal macular edema remains the best indication of laser treatment. Laser remains also the standard of care of diffuse macular edema but some edemas remain resistant. Several therapeutic options have been proposed : Steroid intravitreal injection and antiVEGF therapy (either PKC inhibitors, VEGF aptamers or VEGF antibodies) represent the future alternative treatments as well as their potential combination.

Conclusion Laser remains the main treatment of diabetic macular edema. However, steroids and antiangiogenic agents either isolated or combined represent the main alternative treatment for non responding diffuse macular edema.
Macular edema in epiretinal membrane and vitreomacular traction
Authors: CREUZOT C
Published: September 2009

Purpose Macular edema occuring during macular diseases is a frequent situation. The purpose of this course is to highlight the clinical signs and the different treatments which can be used to treat macular edema occuring during epiretinal membrane and vitreomacular traction syndrome.

Methods Macular edema is frequently associated with epiretinal membranes and vitreomacular traction. Up to now, no specific preoperative macular edema phenotype can predict the postoperative recovery. Different methods were proposed to improve functional results: ILM peeling, intravitreal steroid injection, intravitreal antiangiogenic injections…

Results The widespread use of transconjunctival vitrectomy, the combination of cataract and macular surgeries will probably change the indication of macular surgery leading to sooner surgical indications for better recovery. By contrast, vitreomacular traction often leads to a rapidly progressive visual loss. The analysis should distinguish diffuse diabetic macular edema which remains the only validated surgical indication of macular edema in diabetes and the vitreomacular traction without diabetes. This latter needs a rapid surgical management as macular edema is often severe.

Conclusion Macular edema is a frequent situation associated to macular disease. It can compromise the outcomes after macular surgeriy. Attempts to define the best moment to consider surgery should improve the functional results.
History of and necessity for KPros
Authors: LIU C , GOMAA A
Published: September 2009

The history of keratoprostheses goes back over 200 years. There was a resurgence in interest in the second half of the twentieth century as it was recognised that keratoplasty could not solve all types of corneal blindness. Many devices have been described but few have survived. Corneal transplantation is complicated by graft rejection and astigmatism. There is also a problem with adequate supply, and there is a risk of transmission of infection. There is a desire for an artificial cornea which surpasses cadaveric transplantation. There is much ongoing work, but the majority of clinical work on keratoprostheses are for corneal blindness not amenable to cadaveric grafts. These can be separated into two main groups. The wet blinking eye which have had multiple graft failures, and the dry eye with a keratinised ocular surface which may also have a deficiency in lid cover. The approaches to these are quite different.
Boston keratoprosthesis
Authors: DOHLMAN CH
Published: September 2009

Purpose To outline the present designs, recent outcomes and acceptance of the Boston devices. In addition, several areas of new developments will be briefly discussed.

Methods The Boston KPros implanted in Boston from 1990 to present provide the clinical basis for recent studies on materials, optics, drug delivery, intraocular pressure transducers, complications such as infections and retinal detachment, cost‐effectiveness, outcome in the developing world, etc. The details are presented in accompanying posters.

Results More than 3000 Boston Keratoprostheses have so far been implanted worldwide. Recent outcome studies that have been published from centers outside Boston are particularly suitable for meta‐analysis. For outcome of recent research in Boston, see posters.

Conclusion The Boston Keratoprostheses have shown clinical value but there is still a substantial gap to fill before having arrived at a simple, safe and inexpensive keratoprosthesis procedure for all corneal blindness, in all parts of the world.
Boston type I in pediatric patients
Authors: AQUAVELLA J , CHAK G
Published: September 2009

Purpose To present a retrospective review of keratoprosthetic implantation and retention in patients with congenital corneal opacities.

Methods Pediatric patients younger than seven years old, the average age of permanent visual loss from understimulation of the visual cortex, were selected from a single center Boston Type I keratoprosthesis database and categorized by 1) primary diagnosis, 2) short‐term visual outcome, and 3) post‐operative complications.

Results Seventeen patients, with an age range of 41 days up to 6 years, were selected from a database of over one hundred and forty patients. Six had a primary diagnosis of sclerocornea and eleven had Peter’s anomaly. Visual outcome after one year improved in fourteen of the patients, with patients who previously could not detect light to subsequently being able to fixate and follow or even read allen cards. The remaining three patients showed no improvement in visual acuity but also no worsening from their baseline condition. In terms of post‐operative complications of the optic, two had retroprosthetic membrane formation, and another patient required replacement of the keratoprosthesis due to phthisis and optic melting. From a retinal standpoint, four patients had retinal detachments. There were no cases of choroidal hemorrhaging or hypotony in these patients.

Conclusion Based on visual outcome, the Boston Type I keratoprosthesis is a safe and effective procedure for patients with congenital corneal opacities. With great retention, the artificial cornea is a viable option for prevention of amblyopia. Due to comorbidities such as congenital cataracts, congenital glaucoma, and retinal detachments, it is crucial to have glaucoma and vitreo‐retinal surgeons on hand when managing and implanting keratoprosthesis in a pediatric population.
Design, surgical technique and complications MOOKP
Authors: FALCINELLI GC , COLLIARDO P
Published: September 2009

Purpose To describe design, surgical technique of the modified osteo‐odonto‐keratoprosthesis (MOOKP),originated from Strampelli's OOKP, with the modifications and the innovations made by Falcinelli, between these thoseones of the last years to the first stage of the procedure, never published.

Methods First stage:abstraction of the mono‐rooted tooth with surrounding root and bone. Preparation of the lamina to which, in the dentine central part,the PMMA optic cylinder is glued.Burying of the lamina for 3 months (subcutaneoos pocket). New modification:opening of the A.C., complete removal of the iris, lens cryo‐extraction,anterior vitrectomy.Intermediate stage: after 1 month covering of the eye surface by buccal mucosa. Final stage: after3 months implant of the lamina on the eye with insertion in A.C. of the cylinder after corneal trephining,covering with buccal mucosa previously detached.

Results MOOKP COMPLICATIONS‐ 1‐ Intraoperative, easy to be cured. 2‐ After the 1st stage and intermediate stage: all easily treatable. 3‐ After the prosthesis implant, more severe: a) Prosthesis complications which affect mainly the mucosa, easy to be cured, or the lamina and the cylinder, more rare, difficult to be cured. b) Eye complications: retinal detachment, not frequent and easily cured. Retroprosthetic membranes, very rare. Endophthalmites, very difficult to treat, fortunately rare.

Conclusion Biological properties Strampelli's osteo‐odonto lamina (OOL)with Falcinelli's surgical modifications make of MOOKP a KPro with best results, teorically without duration limits in the less and in the very severe cases of corneal and anterior oculare surfice alterations like the last stage of dray eye.
AlphaCor, Pintucci, Supradescemetic
Authors: STOIBER J , HILLE K
Published: September 2009

Abstract not provided
Gene transfer of disease regulated promoters during experimental autoimmune uveitis
Authors: ELMALEH V
Published: September 2009

Purpose Adeno‐associated virus (AAV) vectors have been successfully used to transfer immunosuppressive genes into the retina to prevent experimental uveitis development. Transgene expression is classically regulated by constitutive or tetracycline inducible promoters. It might be more advantageous that the control of transgene expression depends on the pathological process itself. Inflammation activates transcription factors acting on promoters containing short responsive sequences, responding, for example to nuclear factor kappa B (NFκB‐RE). These responsive elements can be used to generate disease regulated promoters.

Methods An AAV vector with the GFP gene under the control of a NF‐kB‐RE containing promoter will be injected subretinally in C57Bl6 mice. Autoimmune uveitis will be induced by adoptive transfer of IRBP specific lymphocytes. Animals will be sacrificed at different time points. GFP expression will be analysed by immunofluorescence. VCAM1, MHC II and CD45 will be analysed by immunofluorescence and used to monitor the level of retinal inflammation.

Results One week after disease induction, GFP expression was found in eyes injected with this new vector. Milder GFP expression was also found in mice who did not received adoptive transfer. This background was increased a J14.

Conclusion Our preliminary results suggest that disease driven GFP expression can be obtained by the use of AAV vectors containing disease regulated promoters. We still need some more times to improve our model. In the future, we plan to replace the GFP gene by an immunosuppressive gene and test if the system can be use to treat experimental uveitis.
Investigating the influence of wavelength, light intensity and macular pigmentation on retinal straylight
Authors: ROZEMA J
Published: September 2009

Purpose To investigate the influence of wavelength, light intensity and macular pigmentation on retinal straylight. This will be tested in both phakic and pseudophakic eyes by means of color filters, as well as by comparing postoperative straylight results of eyes implanted with either clear or blue‐blocking IOLs. It has also been suggested in the literature that the yellow macular pigment reduces the effects of the short wavelength components of retinal straylight.

Methods In this prospective study the straylight is measured on two groups of pseudophakic subjects: one group of 25 subjects implanted with a clear IOL (Alcon AcrySof SA60AT) and another group of 25 subjects implanted with a yellow IOL (AcrySof Natural SN60AT) using white light as well as with blue, green and red filters. These measurements are repeated on a group of age matched 25 phakic subjects. All retinal straylight measurements will be performed using the Oculus C‐Quant straylight meter. In the normal and clear IOL subjects the macular pigment is measured as well using the Tinsley M|Pod device.

Results The first, preliminary results demonstrate that in healthy eyes the retinal straylight measured by the Oculus C‐Quant depends on the wavelength of the stimulus light. Measurements performed with blue light were lower than those performed in green or red light.

Conclusion Stimulus light wavelength appears to have an influence on straylight measurements. Further study on a larger population is required to confirm this trend and to study how IOL color may influence this result in pseudophakic eyes. The possible influence of macular pigment on retinal straylight will be studied simultaneously.
The effect of microplamin on wound healing after glaucoma filtration surgery
Authors: VAN BERGEN T
Published: September 2009

Purpose The outcome of trabeculectomy can be diminished due to a decreased bleb function secondary to blood/ fibrin clot in the aqueous outflow pathway. The aim of this study is to investigate whether the administration of Microplasmin (ThromboGenics), a recombinant protein that dissolves clot and fibrin, could lead to a better maintenance of the constructed channel, and thus improve surgical outcome after trabeculectomy.

Methods The effect of Microplasmin will be investigated in vivo in a mouse model for conjunctival fibrosis and in a rabbit model for glaucoma surgery. Postoperative follow up of the animals will take place daily during the first week and two‐daily until they are scarified. On specific time points animals will be sacrificed and both eyes will be enucleated. Seven‐µm thin slides will be (immuno‐)stained for CD45 to evaluate inflammation and for Sirius red and Trichrome to evaluate fibrosis.

Results Preliminary results showed that Microplasmin significantly improved glaucoma surgery outcome in the rabbit model of aggressive scarring compared to control.

Conclusion Our proposed research project will elucidate the potential role of Microplasmin in the improvement of filtration surgery outcome, and will highlight any anti‐clotting, anti‐inflammatory, and/or anti‐fibrotic effects of this molecule. Microplasmin as an adjuvant therapy in glaucoma surgery might open new perspectives for more efficient surgery.
Study of the immune response in patients with uveitis and latent tuberculosis
Authors: MAKHOUL D
Published: September 2009

Purpose Mycobacterium tuberculosis infects up to 30 % of the population worldwide. In the majority of the cases a lifelong immune response, based on the production of IFNγ by CD4+ lymphocytes, restricts the infection into lung granulomas. A dysregulation of T regulatory cell function has also been implicated. It has been postulated that this constant immune response might contribute to certain forms of tuberculosis associated uveitis (hypersensitivity uveitis). The aim of this work is to analyse the lymphocyte production of IFNγ and the percentage of regulatory T cells in sight threatening uveitis patients with or without latent tuberculosis.

Methods Patients with sight threatening uveitis suspected to be related to tuberculosis or to autoimmune disease will be recruited at the CHU St‐Pierre. Patients will be included if the work‐up is compatible with the diagnosis of tuberculosis related uveitis or autoimmune uveitis used as a control. Signed informed consent will be obtained and blood samples will be taken.

Results IFNγ production in response to different mycobacterial peptides will be measured by QuantiFERON™‐TB Gold in‐tube and by ELISA. IL‐17 will be quantified by ELISA and the percentage of T regulatory cells analysed by flow cytometry (CD3+CD4+ CD25high, CD127low, FOXP3+).

Conclusion The diagnosis of tuberculosis uveitis is a clinical challenge. The disease is probably mediated through infectious and immune mechanisms. By studying the CD4 + and regulatory T lymphocytes function in patients with uveitis and latent tuberculosis, we hope that we will better understand this pathology. In addition, this study will evaluate the usefulness of QuantiFERON™‐TB Gold in‐tube in the evaluation of patient with uveitis.