bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioactive lipids and early inflammatory response in diabetic retinopathy
Authors: Al‐Shabrawey M. , Ibrahim A. , Beasley S. , Wang F. , Tawfik A.
Published: September 2015

Diabetic retinopathy (DR) is a leading cause of blindness primarily due to hyperpermeability and subsequent macular edema. Recent studies showed association between dyslipidemia and DR. Diabetic dyslipidemia is characterized by increased arachidonic acid which is converted to inflammatory bioactive lipids via lipoxygenases (LOX), cycloxygenase, and cytochrome P450 enzymatic pathways. Our studies focus on the role of 12/15‐LOX in DR. We have demonstrated upregulation of retinal 12/15‐LOX and its products, 12‐ and 15‐hydroxyeicosatetraenoic acids (HETEs), in retina of diabetic human and animals. Interestingly, 12‐ and 15‐HETEs were the main bioactive lipids generated in cultured human retinal endothelial cells (HREC) under hyperglycemia. Intravitreal injection of 12‐HETE induced DR phenotype in normal mice. Contrary, pharmacological inhibition or genetic deletion of 12/15‐LOX attenuated retinal hyperpermeability and inflammation in diabetic mice. 12‐ and 15‐ HETEs also disrupted HREC barrier function, increased leukocyte adhesion, migration and tube formation. This was associated with increased oxidative stress, nitric oxide generation and inflammatory cytokines. Thus, targeting 12/15‐LOX is a novel therapeutic strategy to treat DR.
Whole exome sequencing in patients with congenital cataracts
Authors: Liskova P.
Published: September 2015

Next‐generation sequencing (NGS) represents one of the most significant technological advances in the biological sciences of the past decade. NGS is now being introduced by many laboratories for routine diagnostic use. For genetically heterogeneous disorders approaches include custom‐designed target enrichment permitting analysis of disease‐associated gene panels and whole exome sequencing (WES). The sensitivity, speed and cost per sample makes WES a valuable tool and it is increasingly being used to identify the molecular genetic causes of inherited cataracts. The detection rate of disease‐causing mutations is high and the results enhance clinical diagnosis and genetic counselling of the affected families.
Vitreoretinal traction syndrome
Authors: Le Mer Y.
Published: September 2015

Individualized from the other vitreoretinal interface diseases in the 80’, the vitreoretinal traction syndrome has really been thoroughly described with the advances in OCT imaging.

We'll present the proposed new international classification. By evaluating physiologic and pathological features, it allows to choose between different therapeutic options: watchful waiting, vitreolysis and vitrectomy.

The new treatment using vitreolysis may in some cases avoid surgery in selected cases highlighted by this classification. We'll show some real life cases illustrating what we may really achieve with this non surgical therapy.
Work up of the patient with suspected pseudotumor cerebri syndrome
Authors: Szatmary G.
Published: September 2015

While various etiologies of secondary pseudotumor cerebri syndrome (PTCS) have been recognized (e.g. venogenic,endocrine) the pathogenesis of primary PTCS remains unknown. The diagnostic criteria of PTCS has been revised (Modified Dandy criteria) in 2013 mainly owing to the increasingly recognized imaging features of the disease. This lecture will present the different etiologies of increased intracranial pressure. We will discuss the diagnostic workup of typical vs. atypical patients suspected of having PTCS. We will highlight red flags that should alert the clinician to pseudotumor cerebri mimics that carry serious neuro‐ophthalmological consequences and require high index of clinical suspicion. Finally, the take home massages and some of the difficult diagnostic dilemmas will be demonstrated through illustrative case presentations.
Defocus Incorporated Soft Contact (DISC) lens
Authors: Lam C.S. , Tang W.C. , To C.H.
Published: September 2015

Purpose

DISC lens is a concentric bifocal contact lens, combining myopia correction and constant myopic defocus. We investigate the effects of wearing time, eye dominance and pupil size on myopia control with DISC lens.

Methods

128 children completed a 2‐year double masked randomized clinical trial of myopic control (65 in DISC lens and 63 in single vision contact lenses). Refraction and axial length were measured with cylcoplegic autorefraction and IOL Master. Ocular dominance was determined with the Miles and Porta tests. Pupil images were captured by EAS‐1000 (Nidek) for children wearing the DISC lens, the area ratio of the two optical zones was then calculated.

Results

Those who have worn the DISC lens for 8 hours daily reached a 60% reduction in myopia progression. There were no significant differences in eye dominance with refractive changes (t‐test), association between myopic progression (chi‐square test) and correlation between the zones ratio at pupil and myopic progression (multiple linear regression analysis).

Conclusions

We identified a dosage effect on the DISC lens in slowing myopia progression. Ocular dominance and pupil size do not have any effect on myopia control using the DISC lens.
The obsession of the eyes in Luis Buñuel's work (Spain, 1900‐ Mexico, 1983)
Authors: Ascaso F.
Published: September 2015

Luis Buñuel was a highly regarded Spanish film director particularly famous for his silent surrealist short movie he made with the famous Spanish painter Salvador Dalí: “An Andalusian Dog”. Released in 1929, it is considered as the first film produced purely from within the Surrealist movement, and a landmark in the history of cinema. Based on an exchange of dreams between Dalí and acclaimed director Luis Buñuel, this tale of unfulfilled desire opens innocently with the words “Once upon a time.” What follows is one of the most shocking and celebrated sequences in movie history: a razor slashing a woman's eye in extreme close up, along with the prolapsing vitreous. Buñuel's violent aggressions against sight actually force us back to his particular way of seeing. His world is seen first as a grey, hazy, distant jumble of undetermined things; no other director shoots a scene from quite that neutral, passive distance. Then the eye of the camera suddenly picks out an object that has been there all the time, or a revealing gesture, zooms into them, makes them come violently alive before again retiring to the indifferent point of view. This particular way of seeing also appears in: “This Strange Passion”, “Belle de jour” and “Viridiana”.
Corneal Imaging Modalities – from Basic Science to Clinical Application
Authors: Stachs O.
Published: September 2015

There are many modalities that acquire data about the cornea: shape, power, morphology, biomechanics, and so forth. This talk will review the technologies on corneal assessment techniques and devices available in experimental and clinical practice. Specifically, it will be discussed slit lamp biomicroscopy, ultrasound, magnet resonance tomography, confocal microscopy, ultrasound biomicroscopy, optical coherence tomography, keratometry, Scheimpflug imaging, and dynamic applanation procedures. In addition, I discuss the necessity of developing new technologies for assessing both the morphology and the physiology of the cornea.
Lessons talk by imaging about atrophy in retinal disease: Fundus autofluorescence
Authors: Lois N.
Published: September 2015

Fundus autofluorescence (AF) and near‐infrared autofluorescence (NIA) have been used for many years to assess clinically, in a non‐invasive manner, the status of the retinal pigment epithelium (RPE). Their value in the evaluation of patients with posterior segment disorders has expanded; both are currently used in ophthalmic clinics throughout the world for the assessment of patients with degenerative, inflammatory and neoplastic disorders, among others. This talk will provide an overview on how AF and NIA have contributed to the characterisation of atrophy in retinal diseases, from lessons learnt using these imaging technologies on the understanding of mechanisms underlying this pathology, to identification of people at risk of visual loss as well as providing enhanced disease phenotyping and assessment of potential, unwanted, treatment effects. Recent advances, such as wide angle autofluorescence imaging, will likely contribute furthering the understanding of atrophy in retinal disease.
History of IOLs – did it start in Poland?
Authors: Grzybowski A.
Published: September 2015

It was reported that 1. the idea of IOL implantation originated from Italian itinerant oculist Tadini, 2. the first attempt of IOL implantation was conducted by Italian ophthalmologist Joannis Virgilius Casaamata (1741–1807) in 1795 in Dresden. The majority of these facts, however, is based on secondary sources and need verification. The study is based on analysis of original materials related to Tadini, Casanova and Casaamata and some contemporary descriptions related to this issue, including original doctoral dissertations. The study enabled to collect some information about life and work of Tadini and Casaamata. The original description of Tadini's concept of intraocular lens implantation was delivered in Casanova's Memoirs. It is clear that Tadini has never attempted this procedure. The interesting description of the first, although unsuccessful, attempt by Casaamata comes from the dissertation of Swiss surgeon Rudolph Schiferli (1775–1837) in 1797 entitled “On Cataract” (Theoretisch‐praktische Abhandlung über den grauen Starr). In conclusion, the first concept of intraocular lens implantation was created by Tadini, and the first attempt of this procedure by Casaamata.
High myopia
Authors: Stangos A.
Published: September 2015

Urbanisation and increasing of education of modern societies is influencing normal homeostasis of eye growth, which in turn is causing an important myopic shift. Myopia is associated with increased vitreous liquefaction and premature synchisis and syneresis of the vitreous body. Syneresis can be anomalous in high myopes owing to stronger vitreoretinal adhesions. Foveoschisis, macular hole with or without retinal detachment, premacular membranes and paravascular retinal microholes are the most frequent myopic‐related vitreomacular intrface disorders.

In this course we will explore the pathogenesis of those vitreomacular disorders and will discuss the therapeutic approaches.
Leber's Hereditary Optic Neuropathy (LHON) mtDNA mutations cause cell death by overproduction of reactive oxygen species
Authors: Sadun A. , Carelli V. , La Morgia C. , Karanjia R.
Published: September 2015

LHON cases are due to point mutations of mtDNA affecting Complex I. Complex I is the first in a series of redox reactions along the mitochondrial inner membrane in which electrons are transferred. In LHON, ATP may be reduced and reactive oxygen species (ROS) overproduced. The actual pathophysiology of Complex I is just starting to be understood. In the Wallace mouse model, the mtDNA ND6 mutation in Complex I produces defects in oxidative phosphorylation and RGC loss. However the mouse synaptosomes demonstrated increased ROS without diminution of ATP production. Hence, ROS production at Complex I is important. We propose that alterations of the Complex I proteins disrupt the distance of electron transfer at the iron‐sulfate clusters. Mathematical analysis shows that if electrons only cross < 14 angstroms, then quantum electron tunneling (QET) is possible. The criticality of this distance may depend upon proteins that surround the cluster. Mutations that increase this critical distance may convert a QET electron transfer to a traditional chemical one. Thermodynamically, this will not only decrease the efficiency of electron transfer but also produce free electrons which lead to ROS overproduction and RGC death.
Corneal ultra‐high relocation OCT
Authors: Schmetterer L.
Published: September 2015

Optical coherence tomography (OCT) has revolutionized ophthalmology. Since its introduction more than 20 years ago there was an enormous improvement in resolution, speed and sensitivity. We present a method for imaging the human cornea with a resolution of approximately 1.3 micrometers. This allows for the visualization of corneal tissues with unprecedented precision enabling visualization of structures that could not be seen before. Most importantly the pre‐corneal tear film can be visualized and quantified. Data in patients with dry eye syndrome are presented as well as data on the effect of lubricants on tear film thickness. Furthermore the present talk will focus on the imaging of corneal pathologies using this novel device.
Systemic dysfunction in glaucoma
Authors: Schmetterer L.
Published: September 2015

The most important risk factors for the development of glaucoma is increased intraocular pressure. There is, however, evidence that systemic facts pay a role as well. As such it has been shown that patients with primary open angle glaucoma show signs of endothelial dysfunction as well as signs of systemic autonomic dysfunction. The latter is supported by data showing abnormal heart rate variability in glaucoma, particularly in normal tension glaucoma. In addition, studies have shown that glaucoma patients exhibit an abnormal systemic and ocular vascular response to warm‐cold stimulation. The consequences of systemic autonomic dysfunction in glaucoma may be wide including abnormal diurnal fluctuations of intraocular pressure, blood pressure and ocular blood flow.
Ocular lubrication
Authors: Schmetterer L.
Published: September 2015

Lubricants are the mainstay of dry eye treatment. Whereas they do not target the disease itself they relief from the symptoms associated with both tear‐deficient and hyper‐evaporative dry eye. The duration of action of lubricants critically depends on the residence time at the ocular surface. This is influenced by the viscosity of the eyedrops, their charge, but also by their ability to bind to mucins. Residence time of drugs at the ocular surface has traditionally been investigated using radio‐active labelling of the drugs. This does, however, have several drawbacks. Labelling changes the molecule thereby potentially changing the residence time. In addition, experiments are costly and require significant experimental effort. We have developed a technique that is capable of measuring tear film thickness using a custom‐built OCT. With this device it is possible to get insight into the residence time of topically administered lubricants. Data for hyaluronic acid, osmoprotective substances and chitosan thiomer are presented.
Retinal vasculature structure and function
Authors: Schmetterer L.
Published: September 2015

The inner retina is supplied from the retinal vasculature, which gets it input from the central retinal artery (CRA). At the optic disc that CRA bifurcates into several branches that provide the blood supply of the entire inner retina. The venous part of the retinal circulation is arranged in a similar way. The central retinal vein leaves the eye through the optic disc and drains blood into the cavernous sinus. The diameter of the CRA before it enters the eye as well as the diameters of the branch arteries is typically below 200 mm. Hence, these vessels are functionally arterioles, and the venous vessels are functionally venules. The larger retinal arteries are surrounded by an avascular zone, because the surrounding tissue receives its oxygen from diffusion through the vessel wall. The capillary network of the retina is organized in two layers. The inner layer lies within the nerve fiber and RGC layer and is called inner plexus, whereas the outer layer lies within the inner nuclear and outer plexiform layers and is called outer plexus. Locally restricted to the region around the optic nerve head is a third capillary layer that is located in the nerve fiber layer consisting of radial peripapillary capillaries.
Are we over prescribing in Glaucoma?
Authors: Tuulonen A.
Published: September 2015

The current cultural and legal environments exert tremendous pressure to do more. To choose to do nothing seems to be more open to criticism, rather than to take action, despite the risk that action might later prove to be harmful. It is well‐known for decades that high resource allocation does not necessarily lead to measurable benefits to the patients.

Prescribing diagnostic tests and treatments are indicated when they provide benefits and outcomes that are important to patients, i.e. when interventions improve patients’ well‐being in every‐day life. More frequent testing leads to more diagnoses with newly detected cases being in general milder and non‐optimal specificities of diagnostic tests falsely classifying non‐glaucoma cases having glaucoma. Thus, outcomes will seem to improve, which stimulates to do even more.

When we have evidence of treatment effectiveness, does it automatically imply that treatment should be administered to every patient? When e.g. the total costs of glaucoma medications increase five‐fold in 5 years, and one country treats 30% more patients with glaucoma compared to its neighbor, which patients are under‐ or over‐treated? Very different conclusions may result from the same evidence.
OCT in animal models
Authors: Normando E.M.
Published: September 2015

Due to their accessibility, animal models are playing a major role in understanding some of the underlying causes of glaucoma. Optical Coherence Tomography (OCT) has been used extensively in these animal models giving us the advantage of longitudinal in‐vivo assessments of the natural history of this disease. Outer retina involvement has recently been demonstrated in‐vivo in experimental glaucoma. OCT segmentation software are now available as an aid for understanding the involvement of retinal layers other than the RNFL. Retinal blood flow is also currently under investigation in experimental glaucoma using ultra high resolution OCT. Furthermore, investigations of the irido‐corneal angle configuration and its structural modifications in response to anti glaucoma drugs have also been conducted in experimental models using anterior segment OCT. The talk will discuss the utility of OCT in animal models in Glaucoma.
Bioinformatics in tear proteome
Authors: Nykter M.
Published: September 2015

Tear is a complex fluid containing rich mixture of biomolecules. Current mass spectrometry based proteomic techniques are able to capture the expression of thousands of proteins from small tear volumes, opening possibility for data driven identification of predictive biomarkers. We have developed a bioinformatic approach for biomarker discovery that effectively finds associations between time course proteomic data and clinical phenotypic data. We first construct a feature matrix that contains the data and clinical information as well as various computationally derived features, for example pathway enrichments scores across thousands of pathways and various biologically motivated activity scores for master regulators. These feature matrices that can contain categorical, discrete or continuous data are then computationally analyzed to identify the strongest statistical associations with the phenotypes of interest. Cross validation strategy is utilized to make sure the identified associations are robust. Our approach has been applied to data from clinical patient samples to identify new candidate biomarkers.
The history of the description of retinopathy in onchocerciasis
Authors: Kestelyn P.
Published: September 2015

Up until 1930 the scientific community considered African onchocerciasis to be a pure skin disease and not the blinding disease encountered in America. Jean Hissette, a belgian general practitioner with a special interest in eye pathology, was the first to document onchocerciasis in Africa as a blinding disease. Between 1931 and 1938, he published a series of articles on the subject, based on the experience he gained from several expeditions in the endemic Babindi country (Belgian Congo). His discussions with J Bryant in 1932 stimulated the latter to publish an article in 1935 on the posible relationship between Onchocerca volvulus and endemic choroiditis in Sudan. As the result of his collaboration with R Strong, an expert from Harvard on the Central American form of the disease, Hissette wrote a paper that appeared in 1938 as a supplement to the American Journal of Tropical Medicine. In this landmark paper he describes with great precision the chorioretinitis of the posterior pole typical of onchocerciasis, later to be known as the Hissette‐Ridley fundus. Although the names of the two men are linked, Hissette's work preceded Harold Ridley's publication in the BJO on ocular onchocerciasis in Ghana by more than a decade.
Peptide versus gene therapy: Cathelicidin LL‐37 and HSV‐1 corneal infection
Authors: Griffith M. , Lee C.J. , Buznyk O.
Published: September 2015

We compared the performance of biosynthetic corneal implants based on collagen‐phosphorylcholine (Coll‐MPC) with anti–Herpes Simplex Virus (HSV)‐1 activity achieved by sustained release of the cathelicidin LL‐37 from incorporated nanoparticles, to cell‐based delivery of the peptide from human corneal epithelial cells (HCECs) transfected to produce endogenous LL‐37. LL‐37 released from the implants blocked HSV‐1 infection of HCECs by interfering with viral binding. However, in pre‐infected HCECs, LL‐37 delayed but could not prevent viral spreading nor clear viruses from the infected cells. HCECs transfected with the LL‐37 to confer viral resistance expressed and secreted the peptide. Secreted LL‐37 inhibited viral binding in vitro but was insufficient to protect cells completely from HSV‐1 infection. Nevertheless, secreted LL‐37 reduced both the incidence of plaque formation and plaque size. LL‐37 released from composite nanoparticle‐hydrogel corneal implants and HCEC‐produced peptide, both showed anti–HSV‐1 activity by blocking binding. While both slowed down virus spread, neither was able on its own to completely inhibit the viruses.
The evolving role of nurses and allied health professionals in the management of age‐related macula degeneration
Authors: Hamilton R. , Mapani A. , DaCosta J. , Pavesio C. , Flanagan D.
Published: September 2015

One of the major developments within the medical retinal (MR) over the last five years has been the introduction of an intravitreal injection of anti‐vascular endothelial growth factor medications (Anti‐VEGFs) for patients with AMD and other macular disease. As a consequence of this development, outpatient attendances within the MR Service have increased significantly.

The Royal College of Ophthalmologists acknowledges challenges related to staffing levels. A document produced by the Royal College of Ophthalmologists in 2009 stated that training nurses or technicians to perform intravitreal injections may offer a potential solution to increased pressure in the retinal therapies clinics despite the label recommending that intravitreal injections be given by trained ophthalmologists.

Nursing staff at Moorfields Eye Hospital have given over 15,000 injections now and are currently giving over 60% of all injections. Enabling nurses to be trained to perform intravitreal injections has improved the efficient delivery and capacity of the injection service and enabled national guidelines and service delivery targets to be met, whilst maintaining high standards of care with an excellent safety record.
Managing a 100 patient glaucoma clinic
Authors: Ahmed F.
Published: September 2015

Due to an aging population the number of patients seen in glaucoma clinics is dramatically increasing year on year, causing great strains on glaucoma services. New methods in efficiently managing increased numbers of patients with the same number of clinicians and time will be discussed. We also look into the future and see how patients maybe managed from their homes.
Cystoid macular oedema in endstage glaucoma
Authors: Bifrare D.
Published: September 2015

Microcystic macular changes associated with optic neuropathy.

Microcystic macular edema has been first described in association with multiple sclerosis in 2012. Since then many papers have emerged, describing microcystic macular changes mainly in connection with inflammatory or non‐inflammatory optical neuropathy, suggesting the neuropathy to be the origin of these microcystic macular changes.

The different neuropathies and the pathomechanism possibilities will be discussed according to recent litterature.
Doppler Optical Coherence Tomography ‐ A New Method For The Assessment Of Neurovascular Coupling In The Retina
Authors: Werkmeister R. , Aschinger G. , Schmetterer L.
Published: September 2015

In recent years, we have shown that a dual‐beam bidirectional Doppler OCT system allows to measure total blood flow in the ocular fundus and can also be used to detect changes in this flow values due to various stimuli.

Neurovascular coupling (NC) refers to a phenomenon where local blood flow is elevated with increased neuronal activity. NC may be essential to deliver increased amounts of oxygen, glucose and other nutrients to neurons when they are active. As such a breakdown in NC may contribute to cell death in neurodegenerative diseases.

OCT ‐ due to its high resolution ‐ is superior to other methods used to measure physiological parameters in the human body. In a recent study, we measured total retinal blood flow in the human eye and assessed flow changes due to a stimulus with diffuse luminance flicker. We measured an increase of about 40%, which is assumed to occur as a consequence of an increased firing rate of retinal ganglion cells.

Our results show that dual‐beam bidirectional DOCT may serve as a powerful tool to study changes in ocular blood flow due to changes in neuronal activity and, thus may contribute to the investigation of neurodegenerative diseases and the development of neuroprotective strategies.
Environmental factors in ocular surface disease
Authors: Calonge M. , Gonzalez‐Garcia M.J. , Enriquez de Salamanca A. , Fernandez I. , Pinto‐Fraga J. , Teson M. , Martin‐Montanez V. , Stern M.E. , Lopez‐Miguel A.
Published: September 2015

It is well known the unquestionable influence of the environment in the prevalence/severity of certain ocular surface diseases such as vernal keratoconjunctivitis, pterigium, allergic conjunctivitis or certain infectious diseases. Our research has been focused however on the effects of indoor artificial environments on the ocular surface. These indoor facilities in which we spend a large percentage of our lives (i.e. work places, homes, shopping centers, recreational facilities, air plane cabins) have in common a low relative humidity and an air flow. These conditions are being shown to greatly influence one of the most prevalent diseases worldwide, Dry Eye Disease (DED). We have recreating these artificial environments in an environmental chamber in a Controlled Environmental Laboratory (IOBA‐CERLab) located in our Institute. Our research group has demonstrated how not only DED patients’ but even contact lens wearers’ or healthy subjects’ lacrimal functional unit worsens when exposed to adverse conditions simulating desiccating stress. The main damage was increase in corneal staining, but also some tear molecules had significant altered levels, showing potential as biomarkers of disease activity. More recently, we have demonstrated how topical steroids can ameliorate that damage provoked by desiccating stress, opening an interesting possibility of studying drug efficacy by using these artificially recreated environments.
Relationship of ocular disease activities before and after starting infliximab using Behçet's disease ocular attack score 24
Authors: Kaburaki T. , Okinaga K.T.R. , Takamoto M. , Ohtomo K. , Yoshida A. , Kawashima H. , Komae K. , Fujino Y.
Published: September 2015

Purpose

To investigate the relationship of ocular disease activities before and after starting infliximab using Behçet's disease ocular attack score 24 (BOS24).

Patients and Methods

We studied 69 eyes of 35 patients with ocular Behçet's disease (BD) who had started infliximab therapy. Total BOS24 scores during 1‐year period (BOS24‐1Y) before and after starting infliximab therapy were calculated and its correlation was examined. Patients were divided into three group according to the BOS24‐1Y before starting infliximab; H group (BOS24‐1Y of 40 points or more, n = 14), M group (20 to 39 points, n = 12) and L group (19 points or less, n = 9). Ocular disease activities after starting infliximab were compared among three groups.

Results

Significant correlation was observed between BOS24‐1Y scores before and after starting infliximab (P < 0.0001). BOS24‐1Y after starting infliximab in H, M and L group were 20.9 ± 28.3, 7.3 ± 15.2, 0.6±1.9 points, respectively (P < 0.05). After starting infliximab, ocular attacks were disappeared in 8 cases (89%) in L group, whereas severe ocular attacks still occurred in 7 cases (50%) in H group.

Conclusions

BOS24‐1Y before starting infliximab could be a predictor for disease activity after starting infliximab.
Subretinal implantation of human stem cell‐derived RPE on ultrathin carriers in rabbits
Authors: Stanzel B.V.
Published: September 2015

Transplantation of retinal pigment epithelium (RPE) is being developed as a cell replacement therapy for age‐related macular degeneration (AMD). Human embryonic and adult human RPE stem cells (hESC and hRPESC, resp.) are known potential sources that are currently being pursued towards the clinic. Polarized monolayers of SC‐derived RPE were shown to grow on biostable polyester (PET) membranes. They were found to be similar to fetal hRPE monolayers and to have near‐native characteristics. Stamped pieces of RPE monolayers on the carrier were loaded into a custom‐designed surgical instrument and transplanted subretinally in the rabbit, a large‐eyed animal model. Compared to fetal and hRPESC derived RPE, hESC‐RPE xenografts showed better preservation of the neural retina overlying the implant. Histology obtained 4 weeks after implantation confirmed a continuous polarized human RPE monolayer on PET. We demonstrate that the xeno‐RPE monolayer implant survived well and retained its polarization. Moreover, our initial data suggest a distinctly advantageous tolerance of hESC derived RPE xenografts in rabbit subretinal space.
Antibiotic resistance and new types of antimicrobials
Authors: Beuerman R.
Published: September 2015

The World Health Organization has pointed out that all current antibiotics exhibit some level of resistance. Moreover, designing new antibiotics to avert resistance is difficult due to the ability of bacteria to mutate targets of current antibiotics. Conceptually, it was realized that to overcome resistance it was necessary to kill bacteria quickly and to avoid mutable targets. New molecules were designed using the fundamentals chemical interactions that would disrupt membrane organization. These small molecules were for both Gram positive and Gram negative bacteria, as well as mouse models of corneal infection. Specific chemical groups were attached to a series of small molecules that resulted in rapid kill time (<60 mins), had no effect on healing of an epithelial wound in rabbits, and in a mouse model of MRSA infection of the cornea were effective at 3 mg/ml compared to vancomycin at 50 mg/ml. Simulation of resistance showed that these new classes of antibiotics did not develop resistance although in the same protocol, MICs for gatifloxicin, gentamycin and norfloxicin increased by 10–140 times. Conclusion: New drug designs based on more predictive behavior could bring a series of new drugs to the clinic to lessen the impact of resistance on healthcare.
To the clinic and back
Authors: Gandolfi S.
Published: September 2015

For a clinician, neuroprotection in glaucoma means “decreasing vision loss without affecting intra ocular pressure”. In recent years, translational research on neuroprotection has offered several molecules for clinical testing. Unfortunately, after evaluation via randomized clinical trials, their efficacy is still a matter of debate. We are presently left with excessive patients’ attrition, poorly defined outcomes, borderline significances, clinically unrelevant results etc. A re‐thinking of the general approach to the issue of neuroprotection in glaucoma is then necessary. The molecules, before being chosen for evaluation in humans, should offer a more striking and unquestionable pre‐clinical efficacy profile. New outcomes, on top of the traditional standard automatic perimetry, are needed in order to shorten the duration of the trials and to reduce the “noise” of the system. New study designs, properly tailored on neurodegenrations, together with new strategies for data analysis are needed: futility trials, Bayesian approach and adaptive study designs will extensively be discussed as potential tools to return from the bench to the bedsite.
Choroidal thickness in acute and convalescent VKH disease
Authors: Takase H.
Published: September 2015

Vogt‐Koyanagi‐Harada (VKH) disease is a systemic autoimmune disorder against melanocytes, and is one of the leading causes of uveitis in many countries including Japan. The distribution of the melanocytes in the systemic organ such as eyes, internal ears, meninges, or skin, leads to the various symptoms or signs of VKH disease. Because melanocytes are abundantly present in the choroid, the primary site of the intraocular inflammation of VKH disease is the choroid. Therefore, to monitor the disease activity of VKH disease, indocyanine green angiography (ICGA) had long been the most useful tool. Recently, advances in optical coherence tomography (OCT) made it possible to visualize the cross section of the choroid in addition to the retina, and the findings in choroidal OCT are found to complement those in ICGA. In this presentation, the features of the choroidal changes by ICGA and OCT in VKH disease are discussed.
Vascular supply in mitochondrial optic neuropathy and glaucoma
Authors: Barboni P.
Published: September 2015

To quantitatively evaluate the vascular supply in patients at different stages of Leber's hereditary optic neuropathy (LHON). Twenty‐six LHON patients were recruited for the study. LHON patients were sub‐grouped in: acute (aLHON), chronic phase (chLHON) and asymptomatic carriers (LHON carriers). All subjects had an extensive ophthalmological examination, including Enhanced depth imaging‐optical coherence tomography (EDI‐OCT). Macular choroid thickness was significantly increased in aLHON patients and this was most evident nasally and superiorly. On the contrary, choroidal thickness was significantly reduced in chLHON patients in all measurement but the 1500 nasal. In comparison, LHON carrier subjects showed a significant increase of choroidal thickness in the 1500 inferior measurement. In the present study we show that choroidal thickness follows a pattern similar to that observed in RNFL, increasing in the pre‐symptomatic and acute stages and decreasing in the chronic stage. This feature might be explained by different hypotheses including: (1) a peripapillar microangiopathy, typical of the acute stage, involving the choroidal vessels; (2) increased blood flow through a thickened choroid in response to inefficient metabolism of the retina requiring more oxygenation or a greater heat state.
The role of Anti‐VEGFs in the management of DME in vitrectomized eyes
Authors: Kourentis C.
Published: September 2015

The role of Anti‐VEGFs in the management of diabetic macula edema (DME) is well established in large, randomized, controlled studies in eyes with naïve vitreous. The effect of Anti‐VEGFs may be altered in vitrectomized eyes and the question arises whether there is a difference in the efficacy of Anti‐VEGFs after vitrectomy. The replacement of the vitreous gel facilitates oxygen transport to the retina, as well as clearance of VEGF, thus VEGF and Anti‐VEGF pharmacokinetics can be altered. Pharmacokinetic data are largely based on experimental animal models but there is also a clinical impression that vitrectomized eyes have augmented pharmacokinetics with a faster clearance of Anti‐VEGFs and therefore their treatment could be less effective and requiring shorter treatment intervals, compared to non‐vitrectomized eyes. According to a study presented January 2015, vitrectomized eyes fared as well as non.vitrectomized eyes after treatment with ranibizumab for diabetic macular edema.
The impact of genetics on the clinical management of patients with monogenic corneal diseases
Authors: Tuft S.J. , Evans C. , Davidson A. , Hardcastle A.
Published: September 2015

Over the last decade there has been a major reassessment of the classification of inherited corneal disease. In this presentation I discuss our program to genotype all patients attending our tertiary referral center who have suspected monogenic corneal disease. This has enabled us to distinguish the phenotypes of several closely related dystrophies as well as identify a small number of patients who have previously been misclassified. Some patients with important systemic associations have been identified and referred for further investigation and management. Finally, patients without changes in the genes commonly associated with corneal dystrophy have been selected for further evaluation. The impact of this for clinical care will be discussed.
Beta II tubulin as molecular marker of intraocular pressure in endothelial cells
Authors: Prokosch‐Willing V.
Published: September 2015

The human CNS ‐ like the adult mammalian CNS in general‐ lacks the capability to regenerate axons and restore neuronal tissue. After injury or in degenerative diseases like e.g. in glaucoma, neurons fail to regrow and reconnect with their target cells, frequently underlay apoptosis and are abnormally replaced. This regenerative failure in CNS remains an enormous scientific and clinical challenge. However under certain conditions neurons may regain the ability to regenerate in vivo and in vitro. One interesting group which shows enormous regenerative potential on retinal ganglion cells are the crystallins. We present our data on the regenerative potential of crystallins in experimental models.
It is a masquerade! A potpourri of rapid cases
Authors: Kivelä T.
Published: September 2015

In this slot, all the speakers will – time permitting – show a quick cavalcade of misleading clinical presentations from ophthalmic neoplasms, different from the most common ones highlighted in preceding talks.
Suspicious choroidal naevi: when to observe when to treat
Authors: Kivelä T.
Published: September 2015

Recognition and characterization of choroidal naevi is based on fundus examination with the slit lamp and indirect ophthalmoscope, which ideally is supplemented with optical coherence tomography (presence of subretinal fluid, thickness and internal structure of lesions less than 1 mm in thickness), fundus autofluorescence (presence if recent or prior subretinal fluid, orange pigment) and ultrasonography (thickness and acoustic profile of lesions thicker than 1 mm). In spite of the advent of imaging, the challenge lies in telling small melanomas from naevi. The mnemonic ‘To Find Small Ocular Melanomas’ reminds us to look for tumour Thickness more than 2 mm, subretinal Fluid, visual Symptoms, Orange pigment and tumour Margin touching the optic disc. Each of these indicators approximately doubles the likelihood of growth and malignancy, although none of them alone is specific – up to ten percent of non‐growing naevi have orange pigment and subretinal fluid, for example, whereas some small melanomas initially show none of the five features. Surveillance for growth, a biopsy, or both, may thus be needed to make the treatment decision. This talk will introduce these principles using clinical examples.
Heterogeneity of retina Müller glia and their possible role neuroprotecting retinal ganglion cells
Authors: Vecino E.
Published: September 2015

The retinal Müller glia, provide structural and trophic support to retinal ganglion cells (RGCs) in the healthy retina and may also have a function in promoting cell survival after injury. Defining and understanding glial heterogeneity is an important goal since it would enable to better understand the fundamental role of these cells during retinal pathologies and could even open novel therapeutic avenues, such as targeted manipulations of sub‐populations in order to quench pro‐inflammatory destructive processes and/or stimulate regeneration of neurons in retinal degenerative diseases. Muller glia primary cell cultures in combination with RGCs have been studied. The heterogeneity of the glial cultures was characterized and their effect on RGC survival and neurite elongation. We found that cultured adult RGCs in close contact with adult Müller cells exhibit improved cell viability and significant neurite elongation. Not all Müller cells express their molecular markers with the same intensity. These results suggest that Müller glia support RGC regeneration not only by direct interaction, but also releasing soluble trophic factors. Further understanding of the relationship between retinal glia and RGCs is important in order to identify potential therapeutic targets to encourage retinal neuroregeneration.
Frequency of refractive errors and binocular vision anomalies in children with learning disability
Authors: Yekta A.A. , Khabazkhoob M. , Hashemi H. , Shadalouee Z. , Ostadimoghaddam H. , Rezvan F. , Azimi A. , Heravian J. , Yekta R. , Davari Ashteyani R.
Published: September 2015

Purpose

To determine the frequency of refractive errors and binocular vision anomalies in children with learning disability.

Methods

In a cross‐sectional study, 406 children with learning disability were selected by systematic sampling from the clinic of psychiatry, Emam Hosein hospital, Tehran, Iran. The mean age of the children was 8.56 ± 2.40 years (range: 5.00–14.00 years). After excluding the subjects with history of eye surgery and including criterias, examinations were carried out by experienced optometrist. Ophthalmic tests included: cycloplegic autorefraction, visual acuity, cover test, amplitude of accommodation, near point of convergence and stereopsis. Myopia and hyperopia were defined as spherical equivalent less than −0.50 Diopter (D) and more than +1.00 D. respectively. Astigmatism was defined as cylinder power worse than 0.75 D.

Results

The frequency of myopia, hyperopia and astigmatism were 14.50%, 6.90% and 18.50% in children with learning diability respectively. Esophoria and exophoria were found in 1.00% and 6.40% of the children respectively. The optimal visual acuity was found in 98.50 % of the subjects.The frequency of exotropia, esotropia and cyclotropia were found in 1.50%, 1.00% and 0.20 % respectively. Suppression was found in 2.20% of the children. The means amplitude of accommodation and near point of accommodation were 15.53 diopter and 10.12 cm in these subjects, respectively.

Conclusions

The results of this study indicated that the frequency of refractive errors and binocular vision anomalies in children with learning disabilities are similar to normal children and are not the main causes of learning disability.
Comparison of long‐term surgical outcomes of 2‐muscle surgery in intermittent exotropia: Bilateral vs Unilateral
Authors: CHO S.Y. , Lee S.Y. , Bang S.P. , Lee Y.C.
Published: September 2015

Purpose

To compare long‐term surgical outcomes after bilateral lateral rectus recession (BLR) and unilateral lateral rectus recession‐medial rectus resection (RR) for the treatment of intermittent exotropia.

Methods

Consecutive patients who underwent BLR or RR for treatment of intermittent exotropia between 1999 and 2010 and had ≥ 5 years’ follow‐up were recruited. Surgical outcomes were grouped according to postoperative angle of deviation as overcorrection (esophoria/tropia>5△), success (esophoria/tropia ≤5△ to exophoria/tropia≤10△), or undercorrection/recurrence (exophoria/tropia>10△), and were compared between the BLR group and the RR group at postoperative 1 week, 1 month, 6 months, 1 year, 2 years, 3 years, 4 years, 5 years, and at the final examination.

Results

Of 99 patients, 37 underwent BLR and 62 underwent RR. The mean follow‐up period was 99.6 months in the BLR group and 96.2 months in the RR group. At 1 week, 6 months, 1 year, 2 years, 3 years, 4 years, 5 years and at the final examination the surgical outcomes in each group were not different (p > 0.05). The surgical success rate was 44.6% in the BLR group and 45.0% in the RR group (p = 0.27). The re‐operation rate was 29.7% in the BLR group and 40.3% in the RR group (p = 0.67).

Conclusions

Surgical outcomes by 5 years after surgery for intermittent exotropia were comparable between the BLR and RR groups. The surgical success rate and the re‐operation rate were not different between the BLR and RR groups.
Blepharitis, chalazion, stye ‐ or rather not?
Authors: Loeffler K.
Published: September 2015

Chronic blepharitis and asociated inflammatory alterations of the eyelids are frequent and usually innocuous. However, inflammation can mimic a variety of malignant lesions. By presenting several clinical cases and the corresponding histology, criteria shall be compiled to allow for a more reliable and possibly earlier clinical diagnostic classification.
Comparative Study of Tacrolimus and Bevacizumab on Corneal Neovascularization in Rabbits
Authors: Kim S.E. , Park J.H. , Chung S.K.
Published: September 2015

Purpose

To compare the anti‐angiogenic effects of tacrolimus and bevacizumab on corneal neovascularization in rabbits.

Methods

Neovascularization was induced in 32 eyes of 16 rabbits by placing suture in the corneal stroma. Seven days after suture placement, all rabbits were divided into four groups and were treated subconjunctivally with bevacizumab 0.05 mL (5 mg/0.05 mL; AVA_sub), Tacrolimus 0.05 mL (0.25 mg/0.05 mL; TAC_sub), balanced salt solution (0.05mL was subconjunctivally injected in one eye of each rabbit and applied by eye drops in the other eye, control group), and Tacrolimus eye drops (5 mg/5 mL applied four times daily; TAC_drop). Digital photographs were obtained and the surface area of corneal neovascularization was measured 7 days after subconjunctival injections. Corneal specimens were analyzed histopathologically and were used to measure the concentration of VEGF, TNF‐α, IFN‐γ, IL‐1β, and MCP‐1 mRNA by RT‐PCR.

Results

In digital photographs, the neovascularized area was decreased in all treatment groups (AVA_sub 0.58, TAC_sub 0.60, TAC_drop 0.68) compared with the control group (BSS 0.81). The histological examination showed markedly regressed new vessels in treatment groups, and the immunohistochemical staining revealed weakly stained with anti‐VEGF and anti‐F4/80 antibodies in the treatment groups. In semi‐quantitative RT‐PCR, the concentration of VEGF (AVA _sub 0.24, TAC_drop 0.18), TNF‐α (AVA_sub 0.19, TAC_sub 0.24, TAC_drop 0.15), and IL‐1ß (AVA_sub 0.19, TAC_sub 0.33, TAC_drop 0.18) mRNA were significantly lower in the treatment groups than in the control group (VEGF 0.47, TNF‐α 0.44, IL‐1β 0.87) (P < 0.05).

Conclusions

Topical and subconjunctival tacrolimus application may be useful in reducing corneal neovascularization and have comparable effects to subconjunctival bevacizumab injection.