bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual phenotyping at the Institut Clinique de la Souris
Authors: ROUX M , RIET F , MITTELHAEUSER C , MONTIAL M , LECOCQ M , MEZIANE H
Published: September 2009

Visual diseases come in many flavors, with a large variety of affected tissues (eye anterior segment, retina, optic nerve, cortex …), ages of onset, rates of progression and causal factors. In Western countries, if the majority of these diseases are now curable, millions of people are still affected by blindness or low vision, as many retinal diseases (age‐related macular degeneration, retinitis pigmentosa, diabetic retinopathy, glaucoma…) still lack efficient treatments. In a facility devoted to mouse phenotyping, it is thus of major importance to propose an efficient visual phenotyping platform, to pick up visual defects in screened mutants, to assess the beneficial effects of potential treatments or the eventual adverse effects of drugs targeting the CNS – vision screen being mandatory in CNS drug development. While the tests performed in human clinics are transposable to rodents, the small eye size of the mouse hinders a fine assessment of the retinal fundus, especially in the periphery. To maximize our chances to detect even early phenotypes, we are moving toward a recently developed fundus imaging system (Paques et al., IOVS 2007), which allows to acquire high quality digital images of the fundus, up to the ciliary margin, and fluorescein angiography, allowing for a later diagnostic confirmation by ophthalmologists. Together with slit lamp examination and electroretinography, this constitutes a solid first line of visual phenotyping.
Precise monitoring of intraocular inflammation by LFP: the gold standard
Authors: TUGAL‐TUTKUN I
Published: September 2009

Purpose Laser flare photometry is an objective quantitative method that enables accurate measurement of anterior chamber flare with a very high reproducibility.

Methods Review of literature

Results Clinical studies of uveitis patients have shown that flare measurements by laser flare photometry allowed precise monitoring of well defined uveitic entities and prediction of disease relapse. It is useful both in acute and chronic forms of intraocular inflammation. Sensitivity of laser flare photometry has been shown in posterior uveitic entities as well. Relationships of laser flare photometry values with complications of uveitis and visual loss have been reported.

Conclusion Flare measurement by laser flare photometry should be included in the routine follow‐up of patients with uveitis.
Progress in monitoring inflammation in JIA
Authors: BODAGHI B
Published: September 2009

Purpose To analyze the most appropriate strategy to monitor ocular inflammation in children with juvenile idiopathic arthritis ‐ associated uveitis.

Methods Slit lamp biomicroscopy is widely used to evaluate the importance of anterior segment flare and cells in children with anterior uveitis. However, different studies have clearly shown that other tools such as laser flare photometry and OCT may improve the monitoring during the follow‐up. Therefore, both tests are performed in all children referred to our Department for the management of JIA‐associated uveitis.

Results Laser flare photometry showed for the first time that active ocular inflammation may be associated with a significant level of flare even in the absence of detectable cells. This is a major finding to start a therapeutic approach or change it for a more aggressive strategy and monitor the decrease of flare. Moreover, the level of flare decrease under therapy may predict further serious complications such as secondary glaucoma or cataract. OCT features are important to identify macular alterations in nearly 85% of children with anterior uveitis associated with JIA.

Conclusion Both laser flare photometry and OCT are non invasive and quantitative methods that may significantly improve the visual outcome of JIA‐associated uveitis.
Gain in accuracy for diagnosis and follow‐up of uveitis through indocyanine green angiography
Authors: HERBORT CP
Published: September 2009

Purpose The proportion of diseases involving principally the choroid is as frequent if not more frequent than those involving the superficial structures of the fundus and are therefore not accessible or poorly accessible to fluorescein angiography (FA) nor OCT.

Methods Illustrative cases where the preponderant lesions are in the choroid are presented showing that the detection and follow‐up of choroiditis is only meaningful using indocyanine green angiography (ICGA).

Results Diseases that do not involve the choroid are the minority. Except for intermediate uveitis, mainly of the pars planitis type, and Behçet’s uveitis, choroidal involvement cannot be excluded. Therefore in most other uveitis cases with suspected posterior involvement, if angiographic investigation is felt necessary, the initial angiography should always be a dual FA/ICGA angiography even if the predominant fundus sign is retinal vasculitis. Only if the initial angiography does not show choroidal involvement can the follow‐up be preformed by FA alone.

Conclusion In order to perform adequate diagnosis, adequate assessement of lesions and adequate follow‐up in uveitis cases with choroidal involvement ICGA is mandatory.
Global angiographic scoring system for inflammatory diseases
Authors: KHAIRALLAH M , TUGAL‐TUTKUN I , HERBORT CP
Published: September 2009

Purpose Fundus fluorescein and indocyanine green angiography are essential imaging techniques in the appraisal of posterior segment inflammation. A combined fluorescein and indocyanine green angiographic scoring system has been developed in order to provide semi‐quantitative data for follow‐up of disease progression, monitoring response to treatment, and comparison between clinical studies. We tested interobserver variations in the semi‐quantitative scoring of dual fluorescein/indocyanine green angiograms.

Methods Four observers scored 32 dual fluorescein and indocyanine green angiograms. Spearman rank correlation was used to analyze correlation between scores assigned to each angiographic sign. We used the Kappa statistics to test agreement between pairs of observers in comparative total fluorescein and indocyanine green angiographic scores.

Results We found a significant correlation between pairs of observers in scores assigned to each fluorescein angiographic sign and the total score of fluorescein angiograms. A significant correlation was found only between 2 separate pairs of observers in scores assigned to early stromal vessel hyperfluoresence on indocyanine green angiography. However, a significant correlation was found in other indocyanine green angiographic signs and the total score of indocyanine green angiograms. There was a good agreement between observers in comparative fluorescein – indocyanine green angiographic total scores.

Conclusion Further experience with the scoring system, especially with the indocyanine green angiographic scoring, may improve its reproducibility.
Clinical presentation, pathological features and natural course of metastatic uveal melanoma (MUM) as an orphan and commonly fatal disease
Authors: VAN GINDERDEUREN R , CERBONE L , FIEUWS S , VAN EENO L , SPILEERS W , SCHOFFSKI P
Published: September 2009

Purpose Uveal melanoma (UM) is a rare disease characterized by an unpredictable course and variable outcome ranging from cure by local treatment to the occurrence of untreatable metastasis. The current project is focused on the characteristics of the metastatic phenotype of the disease

Methods We performed data collection from 76 pts with MUM treated in Leuven between 1957‐2008. Statistical analysis involved nonparametric technics, Kaplan Meyer and log rank test

Results The median age at diagnosis of UM was 58 yrs (range 30‐94). Common initial treatments were surgery (71%), brachytherapy (20%) and external beam RT (7%). Synchronous metastasis was found in only 9% of cases, all others had metachronous disease after a median interval of 40 mo (range, 7‐420). Metastasis in >1 organ, was seen in 47% of cases. The most frequent metastatic site was the liver (96%), followed by lung, subcutaneous, bone and brain lesions. The median OS from diagnosis of UM was 46 months (range, 2‐182), and only 4,5 months in pts with MUM (range, 1‐128). 65% of MUM pts qualified for further treatment, The most common drugs given were DTIC, cisplatin, tamoxifen or phase I agents. Patient benefit (PR+SD) was seen in 16/45 pts (36%), including 2 PR

Conclusion In this orphan disease with female predominance metastasis occurs late, is mainly found to the liver, and is associated with high morbidity, as >1/3 of pts do not qualify for further therapy. Advances in MUM can only be achieved by networking of sites interested in this tumour type with systematic collection of data and tissue to improve our understanding of the molecular biology of the disease
Does delayed treatment shorten the life of patients with fatal choroidal melanoma?
Authors: DAMATO B , COUPLAND SE
Published: September 2009

Purpose Metastatic death from uveal melanoma occurs in about 50% of patients many of whom experience a delay in treatment, either intentionally or accidentally. The aim of this study was to determine whether treatment delay shortens survival in patients with choroidal melanoma whose disease apparently proved fatal.

Methods Patients with choroidal melanoma were included in the study if resident in mainland Britain and if deceased. Survival was analysed according to basal tumour diameter by Kaplan‐Meier and Log rank analysis.

Results A total of 696 patients with choroidal melanoma died. The patients had a median age of 65 years and a median basal tumour diameter of 15.0 mm. The basal tumour diameter was <10mm in 41 patients; 10‐11mm in 88; 12‐13mm in 108; 14‐15mm in 165; 16‐17mm in 123; and >17mm in 171 patients. Log‐rank analysis showed no correlation between survival and basal tumour diameter in these patients (Log rank analysis, p = 0.5537). There was perhaps a trend towards longer survival in patients with a basal tumour diameter less than 10mm.

Conclusion In patients with fatal uveal melanoma, there is no significant correlation between basal tumour diameter and survival time. Delay in treatment does not seem to worsen prognosis for survival significantly, except perhaps in patients with small tumours. This finding adds further support to the concept that the main objective of ocular treatment is to conserve the eye with as much useful vision as possible. Since ocular treatment can itself cause significant visual loss, the benefit of treating asymptomatic uveal melanomas is uncertain. There is scope for randomized, prospective studies of treatment versus non‐treatment of patients with asymptomatic choroidal melanoma.
An audit of eccentrically‐positioned ruthenium plaque radiotherapy of choroidal melanoma in Liverpool
Authors: RUSSO A , DAMATO B
Published: September 2009

Purpose Brachytherapy is usually administered with the plaque overlapping the entire tumour margin by at least 1‐2mm. With posterior tumours, our practice is to position the plaque with its posterior edge aligned with the posterior tumour margin. We audited ocular outcomes after eccentrically‐placed ruthenium plaque radiotherapy of choroidal melanoma.

Methods Patients were included if receiving primary ruthenium brachytherapy for choroidal melanoma during the three years up to the 31st July 2007. A perforated template was used to facilitate plaque positioning. For posterior tumors, the template was positioned so that trans‐illumination produced a glow at the posterior tumour margin (‘sunset sign’). Minimum doses of 300‐350 Gy and 80‐90 Gy were prescribed to the sclera and apex, respectively.

Results The cohort comprised 162 patients (93 female and 69 male). The time to the last known visual acuity had a median of 23 months. The initial visual acuity was 20/40 or better in 94.6%, 20/60 to 20/200 in 13.0% and worse than 20/200 in 1.9% of patients. The tumours had a mean basal diameter of 11.7mm. Ten tumours exceeded 5.4 mm in height. Tumour extension to within 5mm of optic disc, fovea or both occurred in 18 (11.1%), 28 (17.3%) and 27 (16.7%) cases respectively. Risk factors for visual loss were proximity to optic disc or fovea, initial visual acuity worse than 20/40 and tumour height exceeding 5.4 mm. In 66 patients with none of these risk factors, 92% retained 20/40 or better and 5 had vision of 20/60 – 20/200. In 72 with one risk factor, 74.3% retained 20/16 – 20/40 and 95.7% had vision of 20/200 or better. In 12 patients with 2 risk factors, these percentages were 25.0% and 91.7%. Only 3 patients had 3 risk factors and one retained vision of 20/200 or better. Tumours distanced < 5 mm to fovea were divided in 3 groups, and visual acuity analysed. Three patients had local tumour recurrence and were treated respectively by proton beam radiotherapy, plaque radiotherapy and enucleation (the only eye lost in this series).

Conclusion Eccentric plaque radiotherapy of choroidal melanoma achieves good rates of local tumour control, ocular retention and preservation of vision.
Ocular hypertension and uveitis: about 103 cases of uveitis
Authors: POGORZALEK N , DE MONCHY I , GENDRON G , KASWIN G , LABBE A , OFFRET H , LABETOULLE M
Published: September 2009

Purpose To determine the prevalence of intraocular hypertension (IOH) in 103 patients referred for uveitis in a tertiary care centre.

Methods 103 consecutive patients referred to our department for uveitis were included. Files were retrospectively analyzed for age at time of presentation, gender, type of uveitis (as definedy by International Uveitis Study Group) and etiology, time of IOH (primary or secondary to treatment) and filtering surgical procedure associated. IOP was measured using Goldmann aplanation tonometry and IOH was defined as intraocular pressure ≥ 21mmHg.

Results Among all patients, 36% of uveitis were related to a concomitant infectious disease (herpetic disease in 20% of cases and herpes‐zoster in 4%). No significant difference on age, gender was found between all 103 cases of uveitis. At least on episode of IOH was found during the acute phase of the disease in 27 patients (26.2%): anterior uveitis represented 74% of patients. Most of hypertensive cases were associated to herpetic disease (37%), than undetermined etiology in 6 patients (22%), toxoplasmosis uveitis in 2 patients (7,4%). Topical steroids and IOH were associated in 2 patients (7,4%). The IOH was controlled by topical hypotensive treatment in 74,1% of patients, and a filtering surgical procedure was found necessary in 7 patients (25,9%).

Conclusion This retrospective study confirms that IOH is a major complication of uveitis, especially in those involving the anterior chamber of the eye and/or related to viruses. Most of cases responded rapidly to combined topical steroids / antiglaucomatous therapy.
Wet AMD treatment with ranibizumab ‐ structural and functional changes during treatment
Authors: RADECKA L , LAGANOVSKA G
Published: September 2009

Purpose To analyse the changes of central retinal thickness and visual acuity in patients with subfoveolar neovascular membrane due to wet age‐related macular degeneration who have been treated with intravitreal ranibizumab 0,5mg injections.

Methods Ten patients with wet AMD received monthly treatment with ranibizumab (Lucentis). All patients have recieved three or more injections up till now. Measurement of central retinal thickness was done by using optical coherence tomography (OCT). All injections were done in P.Stradins University Clinical Hospital, Riga during October 2008 ‐ May 2009.

Results Eight female and two male patients with active subfoveolar neovascular membrane were observed. Age of patients was from 62 up to 84 years (mean age 75 years). Mean central reinal thickness before treatment was 395 ±166μm and visual acuity 0.3 ±0,17. A month after the first injection mean central retinal thickness was 283±56μm (mean improvement by 111,5μm) and visual acuity 0,34±0,2. Mean central retinal thickness after the third injection of ranibizuamab was 222,4±62μm (reduction by 172,7μm compared with baseline findings) and visual acuity was 0,37±0,28 (mean improvement by 0,05 ( in one case even by 0,3)).

Conclusion Our results of intravitreal injection of ranibizumab show improvement or stabilisation of visual acuity and reduction of central retinal thickness in all cases. The major improvement in most cases we observe after the first injection and stabilisation after following injections.
Retinal hemodynamic changes in diabetic macular edema
Authors: HUDSON C , GUAN K , LAM WC , MANDELCORN M , DEVENYI RG , FLANAGAN JG
Published: September 2009

Purpose To report the 1 year prospective hemodynamic results in a cohort of patients with varying levels of risk for the development of diabetic macular edema (DME) and to correlate these parameters to systemic changes in blood pressure and diabetes control.

Methods The sample comprised 4 groups. Group 1: 37 non‐diabetic controls; Group 2: 42 patients with no diabetic retinopathy (DR); Group 3: 38 patients with DR but no DME; Group 4: 27 patients with DME. Retinal arteriolar diameter, velocity, maximum‐to‐minimum (max:min) velocity ratio and flow were measured using the Canon Laser Blood Flowmeter. Blood pressure, blood and urine tests were taken and correlated to changes in retinal hemodynamics. A sub‐group of patients with progressive DR was analyzed separately.

Results There was a trend for elevation of the max:min velocity ratio (p=0.060) with increasing risk of DME at baseline which was significant on follow‐up (p=0.020). Diameter decreased for all groups (p<0.056) except for patients with DME. Changes in retinal blood velocity, max:min velocity ratio and flow were correlated to blood pressure mostly in patients with DR and DME. Blood albumin level was negatively correlated to retinal blood velocity and flow in the DME group. Patients with progressive DME had elevated blood velocity and flow.

Conclusion Patients with DME have a higher max:min velocity ratio. Changes in retinal hemodynamics were correlated to changes in blood pressure and were negatively correlated to changes in blood albumin. The results indicate a loss of vascular compliance with diabetes, particularly in patients with DME, and elevated retinal perfusion in patients with progressive DME.
The relationship between retinal hemodynamics and systemic markers of endothelial function and inflammation in type 2 diabetes
Authors: HUDSON C , KHUU LA , PALKA E , FLANAGAN JG , WONG T , LAM WC , MARKOWITZ SN , BRENT M , MANDELCORN M , DEVENYI RG
Published: September 2009

Purpose The aim of the study was to investigate the associations, if any, between retinal hemodynamics and systemic markers of endothelial function and inflammation in patients with type 2 diabetes and non‐proliferative diabetic retinopathy (NPDR).

Methods Retinal blood flow measurements and blood serum samples were obtained from 9 healthy controls (Group 1, mean age 53.8 yrs, SD 11.7), 23 patients with mild‐to‐moderate NPDR (Group 2, mean age 61.4 yrs, SD 8.5; duration 9.9 yrs, SD 8.8) and 14 patients with moderate‐to‐severe NPDR (Group 3, mean age 60.3 yrs, SD 9.9; duration 17.0 yrs, SD 9.4). Retinal blood flow was measured in the supero‐temporal arteriole using the Canon Laser Blood Flowmeter. Blood samples were collected to derive levels of intercellular adhesion molecule (ICAM‐1), vascular adhesion molecule (VCAM‐1), E‐selectin and von Willebrand factor (vWF).

Results Diameter, velocity, maximum‐to‐minimum velocity ratio and flow were the same across the groups and did not change over a 6 month follow‐up. A1c and ICAM‐1 were significantly elevated across the groups (p=0.001 and p=0.030, resp., ANOVA). VCAM‐1 (r =0.325, p=0.046) and vWF (r =0.334, p=0.050) showed relatively weak associations with baseline max:min velocity ratio. vWF showed moderate associations with change in velocity (r = 0.571, p=0.007) and change blood flow (r = 0.455, p=0.038).

Conclusion The relationship between endothelial dysfunction and inflammation markers and retinal hemodynamics in type 2 diabetes is complex since not all markers show an association. This work is on‐going.
The Boston keratoprosthesis in autoimmune disease
Authors: CHODOSH J
Published: September 2009

Purpose Patients with corneal blindness due to mucous membrane pemphigoid and Stevens Johnson syndrome who undergo corneal transplantation carry a poor prognosis for visual recovery. The Boston keratoprosthesis has been demonstrated to provide excellent retention rates and postoperative visual acuity in patients with corneal graft failure, however, poor visual outcomes still occur in patients with underlying autoimmune disease.

Methods We reviewed the current literature to determine the results of keratoprosthesis in patients with blinding autoimmune diseases.

Results Much of the published literature on keratoprosthesis fails to clearly differentiate outcomes on the basis of the underlying disorder. Based on available evidence, inflammation, retinal detachment, and glaucoma appear to be the most significant complications after keratoprosthesis in autoimmune patients, and a diagnosis of mucous membrane pemphigoid or Stevens Johnson Syndrome appears to be associated with a significantly higher complication rate than other preoperative conditions.

Conclusion Patients with autoimmune diseases carry the worst prognosis for success with keratoprosthesis. Improvement in clinical outcomes might be achieved with changes in keratoprosthesis design and material, perioperative therapy, and/or surgical technique. Possible approaches to complications after Boston keratoprosthesis in patients with underlying autoimmune diseases will be discussed.
Boston keratoprosthesis in pediatric patients
Authors: AQUAVELLA J
Published: September 2009

Abstract not provided
Long‐term functional and anatomical results of OOKP and tibial OKP: Barcelona experience
Authors: DE LA PAZ MF , BARRAQUER J
Published: September 2009

Purpose To report the long‐term functional and anatomical results of OOKP and Tibial OKP performed at the Barraquer Eye Center from 1974‐2006. Different factors like surgical technique, clinical diagnosis, age and post‐operative complications are also analyzed and reported.

Methods A retrospective study on 330 eyes of 227 patients who underwent OOKP or tibia OKP was performed. Kaplan Meier survival curves and multivariate analysis using Cox regression model of the different variables mentioned are presented.

Results OOKP and Tibia OKP have comparable functional and anatomical results in the long‐term. Best long‐term functional and anatomical results are for patients with chemical burns, cicatricial trachoma and Stevens‐Johnsons/Lyell syndrome. Thermal burns have a higher anatomical retention than other diagnostic categories. Younger patients have better visual prognosis and anatomical retention than older patients. Patients must be warned of the possibility of sight‐threatening complications like extrusion of the prosthesis, retinal detachment and glaucoma.

Conclusion Our more than 35 years experience with biological keratoprosthesis using the OOKP and the tibia OKP shows that the two techniques are comparable. Certain variables like clinical diagnosis, age and post‐operative complications affect the anatomical and functional results in the long‐term.
Tibial KPro
Authors: TEMPRANO J
Published: September 2009

The clinical results, from the anatomical point of view, are very good, although in the cases of mucosynechial syndromes, which also affect the buccal mucosa, pemphigoids or necrolysing epidermosis (Lyell), the mucosa may retract or necrolyse. In these cases we use the transtarsal method. In elderly patients with osteoporosis the bone may be resorbed and it would be necessary to repeat the procedure using bone from a more favorable area of the tibia, which should be determined with local densitometry. As far as the functional results are concerned, these depend on the conditions of the retina and the optic nerve. If both are in good conditions and the ocular pressure is normal, 20/20 vision may be achieved, although the visual field will never be more then 30º maximum. Indications: We perform this type of keratoprosthesis in patients without suitable teeth, affected with: Physical caustications (metal burns, bomb explosions, fire burns, etc.) Chemical caustications, no matter whether the origin be alkali (worse prognosis because of the glaucoma which usually develops in these cases) or acids (lime, sulphuric acid, sodium hydroxide, etc). Important trauma where the eye had to be covered with skin because of extensive lid destruction. Advanced trachoma with total leucoma and extensive vascularization. Pemphigus and all mucosynechial syndromes which lead to total xerosis Lyell’s syndrome, epidermizing necrolysis Cases of repeated failure of corneal transplantations Anterior segment alterations due to complicated aphakia, bullous keratopathy affecting the entire cornea after previous failure of keratoplasty. Generally, total leucoma with important alterations of the limbus which would not permit survival of a corneal homotransplant.
MOOKP clinical results and Indications
Authors: FALCINELLI G
Published: September 2009

Purpose To demonstrate which are the reasons that permit by the modified osteo‐odonto‐keratoprosthesis (Mookp) technique to obtain in 275 blind eyes,with a basic pathology where 42% of eyes were dry,and 32% had severe physical/chemical burns,excellent anatomical and functional results.

Methods Tables are shown which put into evidence the best visual acuity obtained in the 275 eyes affected by corneal blindness,operated by the Mookp technique from 1973 to 2008, with a 36 years causistry,with a very long follow‐up.

Results 275 blind eyes. Best Visual Acuity recovered, between 10/10 and 5/10 in 80.25% of operated eyes, excellent for any working activity,( best visual acuity recovered), between 10/10 and 2/10 in 91,20%, useful for any activity. Final V.A., between 10/10 and 5/10 in 67,68%, and between 10/10 and 2/10 in 78,11%‐

Conclusion The reasons for these excellent results are due to the biological properties of this Kpro invented by Strampelli and to the modifications made by Falcinelli. The indications for this technique are all those types of corneal blindness not treatable by penetrating keratoplasty.
Intravitreal bevacizumab for neovascular age‐related macular degeneration: twelve months of follow up
Authors: EL MATRI L , BAKLOUTI K , BOURAOUI R , KORT F , LIMAIEM R , BEN YOUSSEF N , LANDOULSI H
Published: September 2009

Purpose To evaluate the efficacy and safety of intravitreal bevacizumab for managing choroidal neovascularization (CNV) due to age‐related macular degeneration (AMD) at one‐year of follow‐up.

Methods A retrospective review of all patients treated with intravitreal bevacizumab (1.25mg in 0.05ml) for subfoveal or juxtafoveal CNV from AMD between June 2006 and December 2008. The files were reviewed for background data, visual acuity, fluorescein angiography, central retinal thickness and complications. Patients received injections every 4 to 6 weeks until resolution of CNV activity.

Results A total of 72 eyes of 67 patients were treated. Mean follow‐up was 14.1 months (range 11 to 16 months). Twenty seven percent of patients had undergone previous PDT treatment for CNV. The mean number of injections was 2.9. The mean best corrected visual acuity was 1.06 logMAR (range 2 – 0.1 logMAR) at baseline and improved to 0.9 logMAR (range 2‐ 0.2 logMAR) at the last visit. The mean central retinal thickness was 404µm (range 191 – 1070 microns) at baseline and decreased to 279.9µm (range 140‐ 620µm) at 14‐months follow‐up. Statistically significant differences were found in visual acuity (p=0.044) and central retinal thickness (p=0.01) before and after intravitreal injections. No significant ocular or systemic side effects were observed.

Conclusion Our results suggest that intravitreal bevacizumab is well tolerated and is associated with improvement in visual acuity and decrease in retinal thickness at 12 months of follow‐up. Further controlled, prospective and long term evaluation of this treatment is warranted.
Can preoperative bevacizumab improve trabeculectomy outcome? Avastin‐Trab study
Authors: VANDEWALLE E
Published: September 2009

Purpose The aim of this project is to study whether peroperative intracameral bevacizumab (Avastin®) might improve the outcome of filtration surgery.

Methods This study will be carried out in a prospective, placebo‐controlled, double‐blinded experimental setup. The effect of peroperative administration of bevacizumab on intraocular pressure, bleb characteristics and post‐operative medication and surgical intervention will be investigated. The risk of systemic side‐effects will minimalized by using local anti‐Vascular Endothelial Growth Factor treatment. The study patients will be divided into two major groups: A) Patients with primary open angele glaucoma and B) Patients with normotensive glaucoma, in which very low IOPs are targeted. Both groups of patients will undergo a trabeculectomy. Patients in group A will not be given the antimetabolite Mitomycin C (MMC), while patients in group B will receive MMC to obtain sufficiently low IOPs. This strategy adheres to standard operating procedures for filtration surgery.

Results will follow

Conclusion Our study will potentially shed new light on a plausible and simple method to improve the prognosis of glaucoma filtration surgery. Since this study will provide direct data on the effectiveness of a one‐time treatment that might reduce the risk of bleb failure after filtration surgery, avoiding or reducing the need for long‐term medication use or secondary surgical intervention, the potential clinical implications of this study are clear. Thus, our project opens exciting new perspectives for the treatment and prognosis of the blinding condition of glaucoma
Is neuroglobin (Ngb) a perspective for glaucoma?
Authors: YOU Y
Published: September 2009

Purpose To further explore the mechanisms of Ngb function in the retina, and investigate the possible neuroprotective potency of this O2‐binding protein in glaucoma. Our project will potentially open exciting perspectives for the treatment and prognosis of the blinding condition of glaucoma.

Methods 1) In vitro: We will set up cultures for primary RGCs. The cultured RGCs will be subjected to hypoxia by incubation in a controlled‐atmosphere incubator. Cell survival and apoptosis will be assessed using MTT method and TUNEL staining. Ngb expression in normoxic and hypoxic cells will be compared. Additionally, the RGCs will be transfected with plasmids expressing Ngb mRNA to evaluate the neuroprotective effect of Ngb. 2) In vivo: The ischemia/reperfusion model and the staurosporine intravitreal injection model cause acute RGC loss. We will also use a laser model to induce chronic elevated IOP by obstructing the aqueous outflow pathway. We will first analyze upregulated Ngb expression in these models. The localization of both Ngb mRNA and protein will be assessed. Ngb‐Tg mice will be subjected to the glaucoma models. We will measure cell density or retinal thickness and perform electroretinography to evaluate the physiological function of retina. We will also analyse the possible contribution of oxidative stress via immunostainings for ROS and determine possible effects on NO scavenging by evaluating the expression of NOS. Furthermore, we will transfect RGCs in vivo using intravitreal injections of a Ngb expressing adeno‐associated virus (AAV) to test the therapeutic potential of Ngb.

Conclusion Our project will not only provide us with an improved understanding of neuroglobin, but also open a new perspective for the treatment of retinal ganglion cell apoptosis and glaucomatous neuropathy.
Micro‐incision (MICS), perfecting wound incision
Authors: COCHENER B
Published: September 2009

It is nowadays well admitted that a perfect incision in microincision (means size inferior to 2 mm) is crucial: for easy manipulation in the eye, anterior chamber stability during surgery, self sealing without suture and no induced astigmatism. This presentation will focus on incision architecture including location, size, shape and self sealing. We will provide some practical tips and tricks for performing a corneal incision as perfect as possible, which is the key for a successful MICS, whatever a bimanual (B‐MICS) or coaxial approach (C‐MICS).
MICS, mastering the critical steps
Authors: BELLUCCI R
Published: September 2009

Although every manoeuvre has to be modified for MICS, there are some more critical steps. Capsulorhexis through 1.8 mm incision requires a dedicated forceps, usually coaxial, that should be appropriately managed. However it is easier than capsulorhexis through larger incision, because of the improved visibility and chamber stability. The fluidics control of MICS is also different from that of standard phacoemulsification, and includes low hysteresis of the system, reduced fluid volumen, dual control of vacuum and ultrasound, and the removal of lens particles from the aspiration line. With this “microfluidics” of phacoemulsification there is no need to increase the bottle height above 90 cm.
18 years experience of the use of proton beam in ophthalmic tumours
Authors: DESJARDINS L , LUMBROSO‐LE ROUIC L , LEVY C , PLANCHER C , ASSELAIN B , DELACROIX S , DENDALE R
Published: September 2009

Purpose Since 1991, more than 3000 patients were treated at Curie Institute by proton beam for uveal melanoma. All datas concerning tumor characteristics, treatment planning and follow up are registered in the data base

Methods We have performed a retrospective review of patients treated before 2005. Patients were sent to Curie by their local ophtalmologist. Clip positioning and proton beam therapy with a dose of 60 grays in 4 fractions was scheduled; All patients were seen once a year in our clinic after treatment with liver ultrasounds twice a year.

Results 2214 patients were treated, median age 61 years, median diameter 13,6 mm, median Thickness 4,7 mm. 20% of patients develloped metastasis,25% of patients died, 4% had local recurrences, 6,7% had secondary enucleations; With multivariate analysis Significant risk factors for metastasis were age (>60 ), tumor location, tumor diameter and tumor thickness( p<0,0001); Significant risk factor for local recurrence was tumor diameter (p<0,001) significant risk factor for secondary enucleation were tumor diameter (p<0,0001) and tumor thickness (p= 0,003) Neovascular glaucoma was 10% at 2years , 30% at 5 years and 34% at 10 years. Maculopathy was 40% at 2 years, 62% at 5 years and 66% at 10 years Optic neuropathy was 14% at 2 years, 29% at 5 years and 38% at 10 years At last follow up 36,2% of patients have more than 20/40 vision

Conclusion Tumor control obtained by proton beam is excellent with a long follow up For big tumors news additional techniques like endoresections, additional TTT or antiVEGF could enhance globe preservation
The use of ruthenium plaque brachytherapy in retinoblastoma
Authors: ABOUZEID H , MOECKLI R , GAILLARD MC , BECK‐POPOVIC M , PICCA A , ZOGRAFOS L , BALMER A , PAMPALLONA S , MUNIER F
Published: September 2009

Purpose To evaluate the efficacy of 106Ru plaque brachytherapy for the treatment of retinoblastoma.

Methods We reviewed a retrospective, noncomparative case series of 39 children with retinoblastoma treated with 106Ru plaques at the Jules‐Gonin Eye Hospital between October 1992 and July 2006, with 12 months of follow‐up.

Results A total of 63 tumors were treated with 106Ru brachytherapy in 41 eyes. The median patient age was 27 months. 106Ru brachytherapy was the first‐line treatment for 3 tumors (4.8%), second‐line treatment for 13 (20.6%), and salvage treatment for 47 tumors (74.6%) resistant to other treatment modalities. Overall tumor control was achieved in 73% at 1 year. Tumor recurrence at 12 months was observed in 2 (12.5%) of 16 tumors for which 106Ru brachytherapy was used as the first‐ or second‐line treatment and in 15 (31.9%) of 47 tumors for which 106Ru brachytherapy was used as salvage treatment. Eye retention was achieved in 76% of cases (31 of 41 eyes). Univariate and multivariate analyses revealed no statistically significant risk factors for tumor recurrence. Radiation complications included retinal detachment in 7 (17.1%), proliferative retinopathy in 1 (2.4%), and subcapsular cataract in 4 (9.7%) of 41 eyes.

Conclusion 106Ru brachytherapy is an effective treatment for retinoblastoma, with few secondary complications.Local vitreous seeding can be successfully treated with 106Ru brachytherapy.
Comparison of corneal thickness, anterior segment depth and pupil diameter between patients with neovascular age‐related macular degeneration and controls
Authors: PAHOR D , KNEZ N , SISKO K
Published: September 2009

Purpose The goal of this study was firstly to compare corneal thickness at four different locations, anterior depth and pupil diameter between patients with neovascular age‐related macular degeneration and healthy individuals and secondly, to find out any possible anterior segment related risk factor for AMD development.

Methods In this prospective study 69 patients (119 eyes) with neovascular age‐related macular degeneration with no history of any ocular disease or surgery were included. The 31 controls (56 eyes) were also enrolled. Informed consent was obtained from all recruited individuals. Each subject underwent complete ophthalmic examination. Galilei Dual Scheimpflug Analyzer (version 3.0, Ziemer Ophthalmic Systems AG, Switzerland), a non‐invasive diagnostic system designed for analysis of anterior chamber of the eye, was used for anterior segment evaluation.

Results Comparison of corneal thickness at central, paracentral, peripheral zone and at the thinnest point revealed no statistically important difference between patients with age‐related macular degeneration and controls (P<0,5). There was a statistically significant difference in the mean anterior chamber depth between both groups (P=0,002). We did not observe statistically important difference in pupil diameter between both group (P>0,5).

Conclusion The results of our study confirmed that the corneal thickness and pupil diameter are not associated with age‐related macular degeneration. Further investigations are necessary to confirm our results and to find out a possible role of anterior chamber depth as an additional risk factor for AMD development.
Repeatability in the measurement of macular pigment optical density using the Metropsis Test.
Authors: PEREZ CARRASCO MJ , BARRIO AR , PALOMO C , PUELL MC
Published: September 2009

Purpose This study was designed to report the reproducibility of macular pigment optical density (MPOD) assessed with the Metropsis Test.

Methods In two separate sessions, we measured macular pigment (MP) optical density at the fovea in 22 healthy young subjects (21.4 ± 2.26 mean age) with the Metropsis Test (Cambridge Research Systems) that is based in the apparent motion photometry method and employs a CRT monitor for stimulus presentation. The reliability was estimated by the Bland‐Altman statistical method and Student’s t‐test for paired data. The factors determined were mean difference and the coefficient of repeatability (COR = 1.96 x SD).

Results The mean MPOD in right eyes at the first visit was 0.347 ± 0.20 and 0.348 ± 0.25 at the second. The mean difference between sessions was ‐0.0009 ± 0.183 without statistical significance (p < 0.382); and with a normal distribution. The coefficient of repeatability was ± 0.358.

Conclusion The mean difference of MPOD values was practically zero, but if we keep in mind the ends of the interval we must conclude that Metropsis Test presents a moderate repeatability in the measurement of macular pigment optical density.
Spectral domain OCT of exudative AMD
Authors: LEVEZIEL N , VOIGT M , COSCAS G , SOUBRANE G
Published: September 2009

Age‐related Macular Degeneration (AMD) is the main cause of vision loss in developed countries. Spectral domain OCT (SD‐OCT) is a non invasive technique providing in vivo imaging of the retina, with a higher resolution than time domain OCT. This SIS will describe the clinical features of exudative AMD with SD‐OCT, including occult choroidal neovascularization (CNV), classic CNV, idiopathic polypoïdal vasculopathy, and chorioretinal anastomosis. The improvement of the resolution of retinal imaging will provide a better classification and explanation of the pathological processes observed during AMD.
Chorioretinal anastomosis in adaptive optic and high definition spectral domain optical coherence tomography
Authors: MAILLON C , VOIGT M , COSCAS G , SOUBRANE G
Published: September 2009

Purpose To assess morphologic variations in the outer and inner retinal layers in eyes with chorioretinal anatomosis using high definition Spectral Domain Optical Coherence Tomography (Spectralis HRA OCT, Heidelberg Engineering, Heidelberg, Germany) and to compare these scans with images acquired by Adaptive Optics (AO).

Methods This was a prospective observational case series including 50 patients. SD‐OCT scans were obtained with combined confocal scanning laser ophthalmoscope (cSLO) and SD‐OCT for simultaneous tomographic and topographic in vivo imaging. Patients underwent fluorescein and ICG‐ angiography and Adaptive Optics assessment with Imagine Eyes™ System. The neurosensory retina and the photoreceptor layer were analyzed using both HR‐OCT and AO imaging.

Results Combining of the adaptive optics with SD‐OCT may give us further information of the early stage development of chorioretinal anastomosis.
Perspective for adaptive optics
Authors: CHATEAU N , LAMORY B
Published: September 2009

Abstract not provided
Runnig a clinical service for KPros
Authors: BARATZ K
Published: September 2009

Abstract not provided
How do we get started with offering MOOKP clinical service?
Authors: FUKUDA M , HAMADA S , LIU C
Published: September 2009

Modified osteo‐odonto keratoprosthesis (MOOKP) is complicated two step surgery. Firstly, we must understand why it is effective for visual recovery of end‐stage ocular surface diseases like Stevens‐ Johnson syndrome. MOOKP have a lot of advantages compared to other K‐pros, for example the using auto tissue of canine tooth root and buccal mucous membrane, the tight adhesions between optical cylinder and canine tooth root, the adhesion between MOOKP lamina and sclera or cornea, the strong ocular surface by auto buccal mucous membrane, no inflammation on the back of optical cylinder and so on. However, the precise surgical techniques and proper instructions are necessary to succeed the very first case in newly set surgical center. In Japan, we successfully set up the MOOKP center and did perform 4 cases of MOOKP since 2003. We share our experience about it and point out our modification adjustable for Japanese patients.
Why we never use a KPro and MOOKP
Authors: KINOSHITA SS
Published: September 2009

Abstract not provided
Inflammatory responses to KPro: can we control them?
Authors: PEREZ VS
Published: September 2009

Abstract not provided
Retinal detachment in Falcinelli's modified osteoodontokeratoprosthesis
Authors: COLLIARDO P , FALCINELLI G
Published: September 2009

Purpose Aim is to evaluate the incidence, surgical treatment and outcomes of retinal detachment in eyes that had undergone Falcinelli's modified osteoodontokeratoprosthesis (MOOKP).

Methods Technological and surgical advancements allow to treat successfully a severe pathology as retinal detachment, even in eyes with keratoprosthesis (KPro). The autors accurately describe the surgical technique which usually uses an Eckardt or Landers temporary KPro, a pars plana vitrectomy and a gas or silicone oil tamponade, even if in selected cases it is possible to perform just a scleral buckling.

Results By the means of the described techniques good anatomical success and improvement in visual acuity have been obtained. Nine retinal detachments were successfully operated, one retinal detachment was unsuccessfully operated, four retinal detachments were judged to be inoperable for severe proliferative vitreoretinopathy because of late turning‐up to clinical examination and lack of technology in the 70's.

Conclusion The autors point out that an accurate MOOKP procedure it is necessary for preventing the retinal detachment. An early diagnosis by echography performed at every clinical examination during the follow‐up in patients with MOOKP and an appropriate surgical planning for each case are fundamental for a better anatomo‐functional outcome.
Effects of photodynamic therapy on retinal vessels in the mouse model of laser‐induced choroidal neovascularization
Authors: EVERS C , RANJBAR M , GROSS NJ , MARTIN G , AGOSTINI HT
Published: September 2009

Purpose Primary treatment of mouse eyes with argon laser and subsequently photodynamic therapy (PDT) with verteporfin 10 days after results in a destruction of retinal structures. Our study analyses the preconditions of this effect and examines its potential benefit to a model for retinal angiogenesis.

Methods Eyes of adult mice were treated with argon laser in three areas of the eye background to induce CNV formation. Two of these areas additionally got PDT 10 days after. The mice obtained a perfusion with fluorescein isothiocyanate (FITC) dextran after another 4 days. Retinal flat‐mounts were stained with lectin.

Results Areas without laser‐treatment before PDT showed no lesions in retinal vessels, whereas in areas that underwent a combination of laser‐treatment and PDT destructions of retinal capillary vessels cropped up. Conditions for this effect were optimized.

Conclusion Laser‐treatment seems to be prerequisite for a destructive effect on retinal capillary vessels by means of a following PDT.
In vitro antimicrobial effect of vitreous endotamponading substances
Authors: MONTERO MORENO JA , SANCHIS MERINO ME , RUIZ‐MORENO JM
Published: September 2009

Purpose To demonstrate the in vitro bactericidal, bacteriostatic or inert role of endotamponading substances.

Methods Clinical isolates of Staphylococcus epidermidis, Staphylococcus aureus and Clostridium sp were cultured on blood agar plates in sulphur hexafluoride (SF6)and perfluoropropane (C3F8)atmospheres and under silicone oil (SO) and liquid perfluorocarbon (LPFC). The same germs were cultured under aerobic and anaerobic atmospheres as controls.

Results SO, SF6 and C3F8 did not significantly inhibit the growth of anaerobic bacteria but markedly reduced the growth of aerobic germs, as compared with aerobic conditions. The growth of the bacteria under SO and SF6 and C3F8 was very similar to that observed under anaerobic conditions. LPFC did not affect the growth of aerobic or anaerobic bacteria.

Conclusion Endotamponading gases and liquids seem to improve the visual and anatomical outcome of infected eyes and may limit the proliferation of aerobic germs in vitro. It is not known to what extent the antimicrobial effect of these substances would appear in vivo since oxygen diffusion from the blood could allow the growth of aerobic germs.
Pigmented eyelid lesion ‐ unexpected findings
Authors: LOEFFLER KU
Published: September 2009

Purpose To present the clinical and histologic findings of an unusual eyelid lesion.

Methods A 63‐year‐old patient was referred to our Department with a small painless nodular tumour of his left lower eyelid. The lesion had been present for about six months and had increased in size during the last weeks. Slit lamp microscopy revealed a lesion with a smooth surface near the lid margin. On eversion of the eyelid there was some associated pigmentation on the tarsal conjunctiva which had caused the referring Ophthalmologist to suspect a melanocytic process. The lesion was removed by wedge resection and examined by light microscopy and immunohistochemistry.

Results Findings will be demonstrated at the meeting.

Conclusion The lesion presented here is a rare entity but should be considered in the differential of some fairly common eyelid tumours.
Orbital mantle cell lymphoma
Authors: BRISCOE D
Published: September 2009

Abstract not provided