bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioengineering of endothelial grafts using femtosecond Laser cut corneal lamellae or collagen lenticules, endothelialized with immortalized or hIPSC‐derived endothelial cells
Authors: FOREST F , HE Z , MOULARD A , SUFFEE N , FOREST F , DUMOLLARD JM , PEOC'H M , GAIN P , THURET G
Published: August 2014

Purpose The bioengineering of endothelial grafts appears as a realistic solution to reduce the global scarcity for corneal donation worldwide. We focused our strategies of endothelial bioengineering on the endothelialization of human corneal stromal lamellae with hiPSC‐derived endothelial cells.

Methods Human corneas unsuitable for graft but with a normal stroma, were cut into 4 to 7 lamellae of <100 μm thickness with a femtosecond laser (FsL), decellularized from their keratocytes using an optimized protocol (Ethanol/DNAse/SDS) and stored at +4°C. They were compared with collagen I compressed thin discs (RAFT) already described as carrier. Endothelialization was performed with immortalized endothelial cells (ECs) (BAG12) and hIPSC‐derived ECs (also presented during this congress). Efficiency was assessed by determining endothelial cell density (ECD), morphology after alizarin red staining and SEM and immunolabeling for Na/K‐ATPase expression. Transparency was measured using our customized transparometer

Results both carriers were evenly endothelialized by B4G12 with similar alizarin red staining and Na/K ATPase expression patterns but higher ECD for stromal lamellae. Transparency was better for stromal lamellae. hIPSC‐derived ECs gave similar characteristics

Conclusion Decellularized Fsl cut stromal lamellae seem better than collagen I compressed lenticules for the endothelial bioengineering using hISPC‐derived ECs. Unsuitable human cornea could be therefore “recycled” to increase the pool of available grafts. Grants: ABM2013, AIRE2013
3D reconstruction and segmentation methods for endothelial cell count of stored corneas
Authors: BERNARD A , HOR G , TIFFET T , RANNOU K , GAVET Y , PINOLI JC , ACQUART S , GAIN P , THURET G
Published: August 2014

Purpose Measurement of the endothelial cell density (ECD) is the main criterion to validate the quality of corneal grafts in eye banks. Because of corneal curvature and of deep storage‐induced endothelial folds, parallax errors may result in ECD overestimation. We designed a software with 3D reconstruction and optimized segmentation methods to improve cell count reliability

Methods After acquisition of endothelial Z stacks by conventional motorized bright field microscopy, a depth map was obtained by researching maximized measurements of the focus in images (shape‐from‐focus method). Texture of the surface was built by summing image parts presenting the right focus leadind to an all‐in‐focus image. By calculating first derivative in all directions of depth map, precise estimation of cells in folds surfaces could be found. In order to improve and facilitate the cell count, a segmentation method based on watershed technique was applied on the texture image. Taking account of the new 3D area, a precise corrected ECD (cECD) could be calculated. We validated the cECD by comparison with ECD obtained manually by an expert. Two types of images were used: the Keratotest (cells boundaries engraved on a quartz wafer) and real endothelial images. Two parameters were compared: quality of cells borders recognition (correct shapes) and ECD.

Results Comparison results showed the relevance of these algorithms for both criteria. Automation of processing allowed gain of time compared to manual estimation

Conclusion 3D endothelial count can be useful to improve corneas selection in eye banks. Grant: ANR2012 CORIMMO3D
Comparison of ultrathin manual and automated stripping of the endothelium in Fuchs endothelial dystrophy
Authors: DUNCOMBE A , MATHIEU B , ROSSI P , TOUBEAU D , GUEUDRY J , MURAINE M
Published: August 2014

Purpose This study compares two techniques of preparation of the endothelial graft: the DSAEK (Descemet Stripping Automated Endothelial Keratoplasty) and an ultrathin endothelial graft manually prepared.

Methods A randomised prospective study is being conducted at the Hospital of Rouen, France. Patients presenting a Fuchs dystrophy are included in two groups. Patients from Group A receive an ultrathin manually prepared endothelial graft and patients from Group B receive a DSAEK. In order to improve the power of our study, one patient from each group is grafted on the same day, with a corneal endothelium coming from the same donor. Improvement of visual acuity is the main outcome measure. Vitality of the graft, refractive modifications induced by surgery and complications are also studied.

Results Currently, 22 patients with a follow up of 6 months have been included. At inclusion, patients from Group A and B were not statistically different. Six months after surgery, mean best corrected visual acuity has significantly improved in both groups but is statistically better in Group A (0,18 logMar in Group A versus 0,31 logMar in Group B (p<0,05)). Mean endothelial cell density is 1686 cells in Group A statistically more than in Group B (1260 cells) p<0,05. There were no refractive modifications in either group. There was no episode of graft rejection.

Conclusion Ultrathin endothelial graft seems to give better results than DSAEK in Fuchs dystrophy in terms of visual acuity and endothelial cell density. It could be a good alternative to DMEK (Descemet membrane endothelial keratoplasty) because it is easier to prepare and inject than DMEK and should then be favoured when DMEK is not possible.
Surgeon graft less viable endothelial cells than the eye bank cell count suggests
Authors: NEFZAOUI C , TRONE MC , HE Z , BERNARD A , PISELLI S , ACQUART S , THURET G , GAIN P
Published: August 2014

Purpose it is universally admitted that a very early important postoperative decrease in ECD occurs after all types of corneal graft, generally attributed to surgical traumatism. This presumed cell loss is calculated between eye bank ECD (ebECD) and post op cell count done in recipients by specular microscopy (SM). Aim: to redefine the very early postop cell loss.

Methods 1/Prospective series of consecutive penetrating keratoplasty for all‐comer indications with post‐op follow‐up by SM (SP3000‐P) performed as soon as possible and at least at D15, M1 and M3. This series provided reasonable quantification of the gap between ebECD and very early postop ECD in patients. 2/Ten pairs of corneas with comparable left/right ebECD were randomized: one cornea was grafted, the other was stored similarly and its viable ECD was measured after triple labelling with Hoechst/Ethidium/calcein‐AM (IOVS2011 Pipparelli) and quantification with CorneaJ (Cornea2014 Bernard). Graft and vECD measurement were done simultaneously. Relationship between vECD and early postop ECD were studied.

Results For series 1, a gap of 623 (98‐1479) cells/mm2 (median (range)) between ebECD and early postop was measured. For series 2, vECD and early postop ECD of paired corneas were well correlated (r=0.7, P<0.05), with a difference of only 143 (5‐359) cells between them.

Conclusion These 2 complementary series demonstrated that ebECD provided to surgeons overestimate the number of viable CEC grafted to patients. Taking account only the vECD at the end of storage (just before graft) and the postop ECD measured as early as possible, we show that the presumed initial very important cell loss is fictive and that the model of postop ECD decrease should be revisited.
The role of inflammation in chronic DME
Authors: SOUBRANE G
Published: August 2014

Abstract not provided
Functional presence of Na+‐K+‐2Cl‐ cotransporter in rabbit lacrimal gland ductal epithelial cells
Authors: TÓTH‐MOLNÁR E , KATONA M , VIZVARI E , FACSKO A , VENGLOVECZ V , RAKONCZAY Z , HEGYI P
Published: August 2014

Purpose Capability of fluid secretion of rabbit lacrimal gland duct epithelial cells was recently demonstrated by the authors using isolated duct segment model developed earlier. Inhibition of basolateral Na+‐K+‐2Cl‐ cotransporter (NKCC1) with bumetanide resulted in a complete stoppage of fluid secretion. Aim of the present work was to determine the activity and the regulation of NKCC1.

Methods Experiments were performed on isolated rabbit lacrimal gland interlobular duct segments. Intracellular fluorophotometry with ammonium pulse technique was used to measure cotransporter activity. The rate of bumetanide sensitive cytosolic acidification after addition of NH4‐ can be used to quantify the activity of the cotransporter. Role of various potentially stimulatory effects were investigated.

Results Unstimulated activity of NKCC1 was determined. Elevated intracellular cAMP level evoked by forskolin stimulation resulted in marked increase in NKCC1 activity. Beside increased intracellular cAMP levels, low cytosolic Cl‐ concentration and cell shrinkage evoked by hyperosmotic environment were significant determinants of increased cotransporter activity.

Conclusion Our earlier results suggested the dominant role of Cl‐ dependent mechanisms in lacrimal gland ductal fluid secretion. The presented experimental work proves the substantial role of NKCC1 in basolateral Cl‐ uptake. Intracellular regulation of Cl‐ handling and luminal Cl‐ secretion needs further investigation.
Pharmacological matrix metalloproteinase (MMP) inhibition blocks axonal regeneration in the damaged retinotectal system of the adult zebrafish
Authors: LEMMENS K , BOLLAERTS I , BHUMIKA S , VAN HOUCKE J , VAN HOVE I , MOONS L
Published: August 2014

Purpose Complete restoration of the injured mammalian central nervous system (CNS) remains a challenge, making the search for regenerative molecules essential. Matrix metalloproteinases (MMPs), (non)‐matrix protein cleaving endopeptidases, are upregulated during CNS repair, reduce glial scar formation and potentially promote axonal regrowth. As such MMPs or their underlying molecules likely form potent regenerative molecules. One study already reported upregulated mRNA levels of specific MMPs in spontaneously regenerating eyes of adult zebrafish subjected to an optic nerve crush (ONC). Here, we intend to elucidate the role of these MMPs in zebrafish retinotectal regeneration.

Methods Immunohistochemistry and Western blotting were used to determine the protein expression pattern of MMP‐2,‐9,‐13a and ‐14 after ONC in the regenerating zebrafish retina. To investigate the role of MMPs in retinal ganglion cell (RGC) axonal regeneration, a broad‐spectrum (GM6001) inhibitor was intravitreally injected at specific time points after ONC. Biocytin labeling was used to study tectal reinnervation.

Results Our expression data show a spatiotemporal expression of these MMPs in the regenerating zebrafish retina and suggest an individual role in RGC survival, axonal regrowth and dendritic/synaptic remodeling. Moreover, broad‐spectrum MMP inhibition during the first week after ONC significantly reduces retinotectal regeneration without influencing RGC survival.

Conclusion Our study reveals that MMPs are associated with zebrafish retinotectal regeneration and that these enzymes or their downstream targets might be of therapeutic value for the injured mammalian CNS.
Rabbit cornea epithelization after the antlerogenic stem cells of Cervus elaphus homogenate
Authors: SZUMNY D , CEGIELSKI M , GROSMAN‐DZIEWISZEK P , SZELAG A , BOCHNIA M , DZIEWISZEK W
Published: August 2014

Purpose There are many possibly cause of disturbances of the injured cornea epithelization, like for example corneal limbal stem‐cell deficiency, diabetes. Growing antlers constitute a model organ for examining regeneration processes of tissues because they are the only mammalian appendages capable of regeneration.

Methods New Zealand White rabbits were used, one eye of each animal was treated, and the fellow eye was the control. Erosion of the corneal epithelium was performed: after local anesthesia a 3 mm diameter disc soaked in n‐heptanol was placed on the cornea for 30 seconds. Then the eye was washed with a saline. Formulation was made of antlerogenic stem cells of Cervus elaphus cultured under standard conditions. After homogenization of 500000 cells we received 1ml of drops or gel. Rabbits received the homogenate ‐ drops or gel ‐ 3 times a day. The eyes were examined using slit lamp, fluorescein staining and photography of the cornea ‐ test and 10 hours after injury. The surface of the damaged cornea was measured in pixels, analyzing the extent of damage using Adobe Photoshop CS4 Extende

Results The results were averaged ‐ assessing the reduction in the surface of the wound over time. The experiment was terminated to obtain 100% of the closing of each corneal wound ‐ test and control groups. Corneal healing treated by the investigated preparations followed on the second day and on the 3rd day in the control group. There was observed no magnification the lesion of the injury in case of gel application in the first 10 hours.

Conclusion Further experimental and clinical studies of Cervus elaphus stem cells are recommended. They are necessary for evaluation of usefulness to treat corneal injures.
Ocular toxicity of voriconazole: a case report and review of litterature
Authors: MOUNIER A , DOUMA I , EL CHEHAB H , VIE A , AGARD E , RUSSO A , DOT C
Published: August 2014

Purpose Voriconazole is an antifungal therapy widely used for invasive fungal diseases, particularly in aspergillosis.

Methods We report a 77 year‐old man treated by voriconazole (100mg twice a day) for a pulmonary aspergillosis. Three days after voriconazole initiation, he complained of visual disorders such as dyschromatopsia and visual hallucinations. Visual acuity was measured at 10/10 in both eyes. Goldman visual field found a bilateral enlarged blind spot. Color vision was assessed using the Lanthony desaturate panel D 15 test, and demonstrates disorders along the tritan confusion axe for the left eye. The multifocal electroretinogram (mfERG) found a global decrease of the foveal peak on both eyes. Visual Evoked Potentiel (VEP) showed asymetric data and lower amplitudes of the P(100) wave on the left eye.

Results In a first time, according to the dose dependant toxicity, it was decided to reduce the voriconazole dose to 50 mg twice a day. In spite of this, visual acuity decreased at 8/10 in the left eye and visual field worsed. Voriconazole was then switched with itraconazole (SPORANOX). The outcome was improved one month after, visual field and mfERG were better, visual hallucinations disappeared.

Conclusion Voriconazole ocular toxicity is not well known and few publications exist on this topic. Visual hallucinations, dose dependant macular toxicity, reversible disorders were described. On our knowledge we report the first case of combined macular and optical nerve dysfonction. This case suggests that voriconazole can induce reversible macular and optical nerve dysfunctions if the treatment is early stopped. Visual symptoms must be checked and patients reffered to ophthalmology.
Characterisation of RPGRIP1 and its interacting partners in Zebrafish
Authors: KOTAPATI RAGHUPATHY R , MCCULLOCH D , CRAFT J , SHU X
Published: August 2014

Purpose Mutations in the gene RPGRIP1 causes LCA, most severe form of retinal dystrophy. Several studies using animal models demonstrate RPGRIP1 show species specific expression and different isoforms of the gene have subcellular specific localisation. RPGRIP1 is mainly localised in the connecting cilium and interacts with RPGR, RPGRIP1L, but the exact function of the RPGRIP1 is still unclear.

Methods We have carried out gene expression pattern analysis at various stages of development and different adult tissues of zebrafish using PCR and SYBR green based QPCR. We have also carried promoter analysis of human and zebrafish RPGRIP1 to understand mechanism regulating the transcription of these genes in retina using dual luciferase reporter assay.

Results The expression pattern analysis of ZRPGR demonstrates ZRPGR2ORF15 and ZRPGR2Ex1‐17 have different expression pattern in the tissues and the developmental stages. ZRPGR2ORF15 is highly expressed in the eye and brain compared to the expression of ZRPGR2Ex1‐17. Both ZRPGRIP1 and ZRPGRIP1L show higher expression in the eye and ZRPGRIP1Like is highly expressed during the early stages of the development. The binding sites of key transcription binding factors such as CRX, NRL, PAX6 were identified in the 3Kb region upstream of the human RPGRIP1start‐coding site, and a 288bp fragment upstream of transcription start site directed higher luciferase activity in the RPE‐1 cells.

Conclusion In this study we found that ZRPGRIP1 is highly expressed in the eye and in the early stages of development than that of its interacting partners ZRPGR and ZRPGRIP1L. 288bp promoter region upstream of human RPGRIP1 transcription start site showed high luciferase activity and supposed to be the core promoter of RPGRIP1.
The embryonic stem cell derived retinal pigment epithelial cell trial for Stargardt macular dystrophy: preliminary phase 1 results in Asian
Authors: KWON HJ , SONG W , CHOI J , CHUNG SY , KIM HJ , LEE JH
Published: August 2014

Purpose To report interim results of Stargardt macular dystrophy(SMD) patients who underwent human embryonic stem cell derived retinal pigment epithelial cells(hES‐RPE) transplantation.

Methods hESC‐RPE cells were manufactured in a fully validated good‐manufacturing‐practice facility. Total pars plana vitrectomy with induction of posterior vitreous detachment was performed in the eyes with the worst vision. A volume of 150µL of RPE reconstituted in BSS Plus with the target dose of 50000 RPE cells was injected into the subretinal space. Immunosuppression was started at lower dosages of tacrolimus and mycophenolate mofetil. Ophthalmologic examinations; ETDRS visual acuity(VA), visual field examination(VF), fluorescein angiography, spectral‐domain OCT, and electroretinography were performed.

Results A 45‐year‐old male SMD patient with initial VA of 1 letter(Counting fingers) had improved to 13 letters(20/640) and smaller central scotoma observed on goldman VF at 52 weeks. A 40‐year‐old male SMD patient with initial VA of 13 letters(20/640) improved to 30 letters(20/200) at 26 weeks. Subretinal pigmentations with multiple increased autofluorescence spots were noted. A 40‐year‐old male SMD patient with initial VA of 41 letters(20/160) has stable VA of 41 letters(20/160) at 4 weeks. Subretinal pigmentations around injection site were noted at 4 weeks.

Conclusion Two of three SMD patients who received the target dose and relevant immunosuppression showed gradual improvements of visual acuity only in the study eye. No serious systemic or ocular adverse events occurred. Longer follow up and further randomized studies with a control group are needed to determine the safety, tolerability, efficacy.
Ocular manifestations in a patient with osteopetrosis
Authors: KABANAROU S , MOSCHONAS K , PAPAPANOS P , KOUROUPAKI A , TSAKIRIS K , XIROU T
Published: August 2014

Purpose To report a case of osteopetrosis, a rare genetic disorder, with ocular manifestations.

Methods A 45 year old male was presented with a history of progressive visual loss. There was a past medical history of osteopetrosis. He underwent a full ophthalmic examination and best corrected visual acuity (BCVA) was recorded. Subsequently, visual field test, OCT and international‐standard electrophysiological (ISCEV) evaluation including pattern and full‐field electroretinography (PERG and FFERG), visual evoked potentials (PVEP), were performed. Genetic evaluation and counselling were scheduled.

Results BCVA was 0.8 in the right and hand movements in the left eye. Anterior segment examination was normal. Fundoscopy revealed disc pallor in the right eye and optic disc atrophy in the left eye. There was a visual field defect in both eyes, mainly in the left one. OCT‐RNFL thickness was found borderline in the right and reduced in the left eye. The P100 component of PVEP demonstrated latency delay in the right eye and reduced amplitude in the left eye, indicative of optic nerve dysfunction. The N95 component of PERG was also affected. Full field ERG for both scotopic and photopic responses was borderline in the right eye and subnormal in the left eye, indicating mild retinal dysfunction. Genetic testing showed mutations in the CLCN7 gene.

Conclusion In osteopetrosis there is a dysfunction in or lack of osteoclasts resulting in an increase in bone mass. Visual loss occurs because of optic nerve compression, and more rarely retinal dysfunction.
Bilateral macular coloboma of sorsby: contribution of the oct
Authors: BELAHDA A , MATONTI F , RENDU I , DENIS D
Published: August 2014

Purpose To assess the contribution of the Optical Coherence Tomography (OCT) for the diagnosis of macular coloboma.

Methods We report the case of a 33‐year‐old patient affected by a bilateral macular coloboma of Sorsby. The medical check‐up was negative. Eye fundus imaging, OCT and fluorescein angiography were performed.

Results Eye fundus imaging found a deep macular defect putting the sclera to naked, pigmented, well bounded, with size about one papilla diameter in both eyes The fluorescein retinal angiography revealed a hypofluorescent macular lesion with a bigger size than the one visible at the eye fundus. The lesion was fulfilled with fluorescein in a heterogenous way during the angiographic sequence because of atrophic damage of the pigmentary epithelium and the infringement of the surrounding choroid layer area. The OCT showed in the crater shape a depression regarding the lesion with atrophy of the retinas neurosensory, the major damage of the pigmentary epithelium, the choroïd and scleral infringement regarding the lesion. We observed more marked deficits in the scleral and the choroïdal layers than in the neurosensory retina. However, changes within the retina were also visible in the form of microcysts and of disintegration of the retinal stratification.

Conclusion In front of a crater macular pigmented lesion, the first diagnosis to think about is toxoplasmosis chorioretinitis, however you should not neglect a large number of other pathologies whithin the Sorsby coloboma because the scleral defect found in OCT is strongly suggestive. The OCT’s aspect of the macular lesion allows us to diagnose with more precision a macular infringement and to confirm the diagnostic of macular coloboma.
Comparison of efficacy between focal laser photocoagulation and photodynamic therapy in CSCR
Authors: STRUPAITE R , KUOLIENE K , STRELKAUSKAITE E , ASOKLIS R
Published: August 2014

Purpose To evaluate and compare clinical outcomes for patients with acute central serous chorioretinopathy (CSCR) undergoing either focal laser photocoagulation (LPK), photodynamic therapy (PDT) or just observation.

Methods In a retrospective, comparative case series study 73 patients (73 eyes) with acute central serous chorioretinopathy of at least 3 months’ duration were recruited. Out of 73 patients 51 were treated with LPK, 10 with half dose PDT and 12 patients have been in the observation group. Patients follow‐ups were conducted every one to two months until complete subretinal fluid resorbtion on OCT was achieved. The main outcome measures were change in BCVA by Snellen and subretinal fluid (SRF) assessed by OCT (Zeiss Stratus OCT).

Results The mean age of the patients was 47.76±8.43 years (range 24‐65). 55 of 73 patients were male, 16 were female. The mean BCVA (by Snellen) at baseline was 0.81±0.23 in LPK group, 0.69±0.24 in PDT group and 0.88±0.15 in the non‐treated group. At the last visit, comparing BCVA between LPK and PDT, LPK and non‐treated group and PDT and non‐treated group – there was no statistically significant differences between these groups, p<0.289, p<0.089 and p<0.894 respectively. Comparing the central retinal thickness outcomes by OCT, there was also no statistically significant difference between these groups: LPK and PDT (p<0.387), LPK and non‐treated group (p<0.371), and PDT and non‐treated group (p<0.246).

Conclusion Our study did not comfirm that any of the used therapy options is superior to another. At the final visit after treatment no statistically significant difference in anatomical and functional recovery was noted between the two modalities of treatment and observation.
Retinal nerve fibre layer thickness measurements in myopia by optical coherence tomography
Authors: MORREALE BUBELLA R , MORREALE BUBELLA D
Published: August 2014

Purpose Our study aimed to evaluate through OCT, in a homogeneous group of subjects with various degrees of myopia, the macular thickness and that of the RNFL with the purpose of highlighting the possible presence of a correlation between their impairment and the degree of myopia.

Methods 83 students of the Faculty of Medicine and Surgery of the University of Palermo were considered, distinguished into 4 groups, 3 of them according to the degree of myopia and the last group (control group) was made of emmetropic subjects. Each subject was submitted to a determination of visual acuity and refractive defect and evaluation of the thickness of the macular fibres and of the retinal nerve fibre layer (RNFL) through OCT (Stratus Oct 3000 ‐ Carl Zeiss Meditec inc.).

Results With a growth in axial length there was a reduction in the average macular thickness in all quadrants of the parafovea with the exception of the superior one. By contrast, in the foveola and fovea there was an increase in thickness with a rise in the refractive defect. The lowest thickness was found in the emmetropic subject.

Conclusion The data found therefore allow us to conclude, in agreement with others, that the progressive increase in axial length in myopic subjects involves reshaping of the arrangement of the nerve fibres which needs to be taken into account, especially in subjects with glaucoma that are also very myopic.
The relation between peripapillary and macular thickness with refractive errors
Authors: OSTADIMOGHADDAM H , AHMADI HOSSEINI M , YEKTA AA , SEDAGHAT M , AZIMI A , MOHAMMADIAN M , NAKHJANPOUR N , FAZILATI F
Published: August 2014

Purpose To determine the correlation of the peripapillary retinal nerve fiber layer thickness (RNFLT) and macular thickness (MT) with type and degree of refractive errors.

Methods Seventy‐four (37 myopic and 37 hyperopic) subjects with the mean age of 26.47 ± 0.75 years were participated in this study. Visual acuity (VA), Refractive errors (RE), axial length (AL), Intra ocular pressure (IOP) and corneal power (CP) were determined. RNFLT were measured by cirrus OCT using circular scan with diameter 3.4mm around optic disc, and MT was captured using radial scan in a 200 × 200mm area, Independent student T‐test was performed to compare the CP, RNFLT, MT and AL between groups. The correlation of the AL with RNFLT and MT were assessed using the Pearson correlation.

Results There was a significant difference in AL between myopic and hyperopic eyes (p<0.05). In myopic eyes, the AL significantly correlated with RNFLT (p<0.001) and MT (p<0.05). Notwithstanding, axial length had no significant correlations with RNFLT and MT in hyperopic eyes. Also there is statistically significant relationship between MT and RNFLT with degree of the refractive errors in myopic eyes (p<0.05).

Conclusion The results of this investigation indicated that myopes have thinner RNFLT and MT than hyperopes. These results could help clinicians in diagnosis and management of the patients with glaucoma.
The comparison of OCT findings and retinal artery diameter in good and poor prognosis RAO patients
Authors: PARK J , JO S , LEE S
Published: August 2014

Purpose To determine the different clinical findings between good and poor prognosis group which is diagnosed with branch retinal artery obstruction(BRAO) and treated with conservative care. We evaluate the average macular thickness, foveal thickness, outer nuclear layer(ONL) on optical coherence tomography(OCT) and retinal artery diameter in both groups.

Methods 9 eyes(9 patients) in patients with non‐complicated BRAO with good prognosis and a poor prognosis control group with non‐complicated BRAO of 11 eyes(11 patients) were used in this study. The average macular thickness, foveal thickness and ONL thickness at the center of fovea on OCT were measured. And branch retinal artery widths were measured by a semi‐automated retinal vessel width measurement system retrospectively.

Results The average age of the patients was 67.3 ± 11.5 years. The average ONL thickness at the central fovea of the good prognosis group was significantly thicker than that of the control group (p = 0.016). There were no statistically significant result at average macular thickness and foveal thickness. In good prognosis group, Ischemic retinal artery diameter and Central retinal artery equivalent(CRAE) were wider than those of poor prognosis group and they were statistically significant (p = 0.028, p = 0.01).

Conclusion In the patients diagnosed with BRAO and treated with conservative care, foveal thickness, ischemic retinal artery diameter and CRAE were statistically significant between good and poor prognosis groups. In the patients diagnosed with BRAO, foveal thickness and retinal artery diameter could be prognostic factors that predict visual prognosis.
Can Ozurdex® make the difference in a retinal vein occlusion population with longstanding macular edema and multiple prior treatments?
Authors: VAN CALSTER J
Published: August 2014

Purpose To evaluate the efficacy and safety of Ozurdex® in the treatment of macular edema (ME) due to retinal vein occlusion (RVO) in a difficult‐to‐treat population with multiple prior treatments and long‐standing ME

Methods In this multicentric, anonymised, retrospective data collection, 77 patients were included during the early access program in Belgium. 46 patients had CRVO (59.7%) and 31 had BRVO (40.3%).

Results The mean time between the diagnosis of RVO and the first Ozurdex® injection was 1.91±2.13 years, with a median time of 1.26 (0.03 – 10.57) years. In 55.8%, this interval was more than one year. Concerning prior treatments before the first Ozurdex® injection, 55 patients (71%) did receive one or more anti‐VEGF injections, 24 patients (31%) did receive one or more Triamcinolone injections and 33 patients (43%) underwent laser treatment (panretinal/focal). A total of 40 (52%) patients showed 2 line improvement and 29 (38%) showed 3 line improvement in BCVA (ETDRS letters). Nine (11.6%) patients underwent cataract surgery. Post‐injection, 14 (18%) patients had an IOP >25 mmHg. There was no need for glaucoma surgery.

Conclusion In this difficult‐to‐treat population with multiple prior treatments and long‐standing ME, Ozurdex® has shown to be efficacious. The safety profile is in line with previously reported trials. Larger prospective observational studies are currently underway to clarify the usage patterns of Ozurdex® in clinical practice.
Inhibition of NO and COX products modifies the hypoxia‐induced dilatation of retinal vessels in vivo
Authors: KAYA M , PEDERSEN L , BEK T
Published: August 2014

Purpose Retinal hypoxia with consequent changes in blood perfusion is a central feature in common vision threatening diseases. The aim of this study was to examine the effects of inhibiting COX and NO‐synthesis on hypoxia‐induced relaxation of retinal vessels in humans

Methods Twenty healthy persons aged 20‐55 years were examined on two days separated by 4‐7 days. The resting diameter and the diameter response to isometric exercise and flicker stimulation of retinal vessels were studied using the Dynamic Vessel Analyzer before and during breathing a hypoxic gas mixture and before and during intravenous infusion with the NOS inhibitor L‐NMMA and were repeated on a second day after topical administration of the COX‐inhibitor diclofenac

Results The resting diameter of arterioles increased significantly during hypoxia and decreased significantly during L‐NMMA infusion (p<0.0001) whereas no change in diameter was observed with the two applied together. When hypoxia and L‐NMMA were applied simultaneously, the gain factor was significantly lower than 1 (p=0.002) indicating that when diameter changes were corrected for changes in arterial blood pressure the blood flow increased, whereas this was not the case for either of the two interventions alone. Diclofenac significantly reduced contraction of retinal arterioles induced by isometric exercise (p=0.04) but not by the other interventions. Flicker‐induced dilatation of retinal arterioles was increased during L‐NMMA infusion (p<0.0001) but not during the other interventions

Conclusion Diameter changes of retinal vessels during hypoxia are influenced by NO and COX products. This may point to new treatment strategies for diseases characterized by retinal hypoxia and disturbances in retinal perfusion
Diabetic retinopathy: A descriptive study of a method of investigation: BOA’s project
Authors: BAZIN L
Published: August 2014

Purpose The purpose of this study is to report the results of 208 patients observation comparing two different interfaces of delayed reading retinophotographies and thus two different logistics managements of diabetic patients at the University Hospital of Brest

Methods Prospective study of 208 diabetic patients followed. Retinophotographies were automatically and randomly assigned to one of two consoles for delayed reading by an ophthalmologist.The « examination time » and « writing report time » were identified. The settings « diagnosis », « image quality » and «follow‐up » were graduated

Results 208 patients were included.The examination time did not differ between the two consoles (Student t test: t = 0.623, p = 0.534). « Writing report time » differ a statistically significant manner (p << 10‐4).There is a positive correlation between « examination time » and « writing report time » (r = 0.382, p <10‐4) for both consoles. There are no statistically significant differences in the « image quality » setting between the two systems (p = 0.623). There was no statistically significant difference between the two consoles on the variables « follow‐up » (p = 0.067)

Conclusion There is a positive correlation between « examination time » and « writing report time » (r = 0.382, p <10‐4) for both consoles. There are no statistically significant differences in the « image quality » setting between the two systems (p = 0.623). There was no statistically significant difference between the two consoles on the variables « follow‐up » (p = 0.067)
Effects of combination of antioxidants and omega 3 fatty acids in diabetic retinopathy
Authors: SANTANDER‐TRENTINI F , VIVAR‐LLOPIS B , CHAQUES‐ALEPUZ V , ALONSO L , ZANON‐MORENO V , GALLEGO‐PINAZO R , DOLZ‐MARCO R , SHOAIE‐NIA K , PINAZO‐DURAN MD
Published: August 2014

Purpose Oxidative stress is a relevant pathogenic factor in the development of diabetic retinopathy (DR). We evaluated whether the combination of antioxidants and omega 3 fatty acids (A‐O3FA) would reduce the biochemical parameters of risk for diabetic complications in patients with type 1 (T1) and 2 (T2) diabetes mellitus (DM) who were vulnerable to vitreoretinal disorders.

Methods A prospective case‐control study was carried out in 400 initial participants of both sexes aged 15 to 80 years that were distributed into three groups: 1) T1DMG (n=80), 2) T2DMG (n=220), and 3) healthy controls (CG; n=100). We randomly assigned half participants of each group to be orally supplemented (+OS) with 1 pill/day of open‐label formulation containing A‐O3FA, during one year of follow‐up. Demographics, nutrition, life style, ocular and blood biochemical data were recorded and statistically processed by the SPSS 15.0 program.

Results Best‐corrected visual acuity did not vary during the follow‐up, irrespective of supplementation. Diabetics showed severer glycosilated haemoglobin, lipid profile, homocysteine and C‐reactive protein levels than the CG. Plasmatic malondialdehyde (MDA) (p< 0,01), total antioxidant activity (TAA) (p< 0,001) and glutathione (GSH) (p< 0,01) levels were significantly higher in T1DMG/T2DMG than in the CG. All these parameters noticeably changed in the supplemented groups. No significant variations were detected in the ocular coherence tomography examinations regarding three macula parameters, and no correlation with the biochemical data was found.

Conclusion The biochemical background in DM creates the optimal conditions for the increased oxidative stress that can be minimized by the appropriate combination of A‐O3FA. Plasmatic homocysteine, C‐reactive protein, MDA, TAA and GSH can be presumptive biomarkers for DR.
Results from the treatment of refractory diabetic macular oedema with Bevacizumab in a clinical setting
Authors: PAPANDREOU I , TING M , MENSAH E
Published: August 2014

Purpose To evaluate the outcome of the treatment of patients with refractory diabetic macular oedema with intravitreal bevacizumab (Avastin).

Methods Prospective data was entered into an in house database of all patients being treated for refractory diabetic macular oedema at the Ophthalmology Department, Central Middlesex Hospital, London, UK. All patients received bevacizumab on a pro re nata basis after an initial loading phase of three injections. Best corrected visual acuity (BCVA) on the logMAR chart and the central retinal thickness (CRT) on the optical coherence tomography (OCT) scan were recorded at each visit. OCT was performed with the Spectralis OCT device (Heidelberg Engineering, Heidelberg, Germany) using the standard protocol of the clinic. Statistical analysis involved the Wilcoxon signed rank test and Spearman correlation test.

Results 64 eyes of 48 patients were included in this study. The mean age was 68 years (range 45 ‐ 87). Patients received a mean of 3 bevacizumab (range 1‐10) injections. The follow‐up time was up to 15 months. The mean logMAR BCVA at baseline for Avastin was 0.74. At 2, 3, 7, and 11 months the mean BCVA was 0.77, 0.75, 0.67, and 0.69 respectively (p=0.01, 0.006, 0.02 and 0.05). There was no significant difference between baseline and any period thereafter during follow‐up to 15 months. Mean CRT at baseline was 527μm. The mean CRT at months 1‐4 were 456, 491, 490 and 480μm respectively and were significantly different for baseline, (p=0.001, 0.01, 0.03 and 0.04). CRT for months 5 to 15 were not significantly different from baseline.

Conclusion The treatment of refractory diabetic macular oedema with intravitreal bevacizumab made little difference to improving the BCVA and CRT of the patients.
Antiangiogenic effect of ALS‐L1023 on experimental choroidal neovascularization in mice
Authors: KANG S , RHO YJ
Published: August 2014

Purpose This study was conducted to evaluate the effect of ALS‐L1023 on experimental choroidal neovascularization (CNV) in mice.

Methods C57BL/6 mice were administered either vehicle or ALS‐L1023 daily by oral gavage for three weeks (day 0‐21). CNV was induced in each mouse by rupturing Bruch’s membrane using laser photocoagulation (day 7). Two weeks after laser injury (day 21), the CNV lesions were evaluated by choroidal flat mounts using fluorescein‐labeled dextran, immunofluorescence staining with isolectin IB4, and fluorescence angiography. The effects of ALS‐L1023 on endothelial cell tube formation and on the expression of phosphorylated extracellular signal‐regulated kinase (p‐ERK1/2) were evaluated using human umbilical vein endothelial cells (HUVECs).

Results ALS‐L1023 reduced the extent of CNV. The groups treated with 100 and 200 mg/kg/day showed 43.3 and 68.1 % reduction of CNV lesions, respectively, compared to the vehicle group (P < 0.001). The size of isolectin IB4 labeled area was also significantly decreased in the ALS‐L1023‐treated group (P < 0.001). On fluorescein angiography, ALS‐L1023‐treated mice had significantly less fluorescence leakage than vehicle‐treated mice. ALS‐L1023 decreased VEGF‐stimulated tube formation of HUVECs in a dose‐dependent manner. The expression of p‐ERK was suppressed by ALS‐L1023.

Conclusion ALS‐L1023 can inhibit laser‐induced CNV in mice and may have therapeutic potential for treatment of choroidal neovascularization diseases.
Evaluation of two methods for measurements of macular pigment optical density (MPOD)
Authors: BIRKELDH U , WAHLBERG RAMSAY M , NILSSON M , BRAUTASET R
Published: August 2014

Purpose To evaluate the outcomes of two methods for measurements of macular pigment optical density (MPOD).

Methods In 33 subjects (mean age 51.85 years ±17.79; 4 men and 29 women), without any signs of ocular pathologies, MPOD was measured in the right eye using single‐wavelength reflectometry (Visucam 500) and heterochromatic flicker photometry (MacuLux®). In 13 subjects with discrete signs of age‐related macuolopathy (ARM), i.e., soft drusen and/or hyper‐/hypopigmentation of the retinal pigment epithelium (RPE), MPOD was measured after 6 and 12 methods of supplementation with MacuShield® (lutein 10 mg and zeaxanthin 2 mg and the non‐dietary carotenoid meso‐zeaxanthin 10 mg).

Results There was a statistical significant difference (p<0.001) between the average maximum MPOD in the healthy subjects measured with the Visucam (0.384 ±0.049) and with the Maculux® (0.559 ±0.133). No correlation (r2= 0.089, p=0.09) was found between the two techniques. In the 13 subjects, treated with Macushield, the Visucam measurements showed a statistically significant MPOD reduction (p<0.0005) while a significant increase (p<0.0045) in MPOD was found with the MacuLux®.

Conclusion The results from this study indicate that measurements of MPOD with different techniques do not correlate and that the Visucam seems unable to detect the increase in macular pigment after intake of supplementation.
Method for comparative evaluation of therapeutic efficacy in dry AMD patients using 3D‐CTAG
Authors: MILYUTKINA S , FINK W , KOVALEVSKAYA M
Published: August 2014

Purpose Evaluation of therapeutic efficacy in dry AMD patients using 3DComputer‐automated Threshold Amsler Grid testing (3D‐CTAG; Fink &Sadun, 2004).

Methods Dry AMD patients (n=87, 174 eyes). Group#1 (n=29): 200 mg Docosahexaenoic Acid (DHA) and 300 mg Eicosapentaenoic Acid (EPA). Group #2 (n=29): Lutein (12 mg) and Zeaxanthin (0,5 mg). Controls (n=29). 3D‐CTAG testing after 3 months of treatment.Indices: number of VF defects per eye (ND),lowest perceivablecontrast level (CL), absolute volume lost (AVL), VF volume lost relative to hill‐of‐vision (VLRH).

Results Group#1: ND=0,31±0,54 (before) down to 0,16±0,37(after treatment); CL=12,31±8,03% down to 10,9±7,21%; VLRH=1,2±1,14% down to 0,26±0,52%.Group#2: ND=0,29±0,5 down to 0,21±0,41; CL=11,72±12,79% down to 9,66±10,2%; VLRH=1,01±0,88% down to 0,68±1,14%. Controls: ND=0,29±0,5 up to 0,34±0,51; CL=13,79±8,65% up to 14,38±10,38%; VLRH=0,93±0,9% up to 1,22±1,21%.

Conclusion We demonstrated with 3D‐CTAG a decrease of VLRH of 0,94% (p=0,01) in group#1 after 3 months DHA/EPA treatment compared to 0,33% (p=0,05) in group#2, and an increase of VLRH of 0,29% (p=0,01) in the controls. This seems to indicate that DHA/EPA treatment of dry AMD may be more effective than Lutein‐Zeaxanthin therapy.

Commercial interest
Relation between subfoveal choroidal thickness and visual acuity in patients with wet and dry age‐related macular degeneration
Authors: ZABADANI K , HERRERA L , ASCASO FJ , CARAMELLO C , ALMENARA C , PEREZ NAVARRO I , MARTINEZ M , ESTEBAN O , PADGETT E , CABEZON L , CRUZ N , CRISTOBAL J
Published: August 2014

Purpose To evaluate the relationship between best‐corrected visual acuity (BCVA) and subfoveal choroidal thickness (SCT) in patients with wet and dry age‐related macular degeneration (AMD).

Methods We investigated 63 eyes of 58 patients who were diagnosed with wet AMD, and 69 eyes of 56 patients who were diagnosed with dry AMD. All patients were evaluated in the Department of Ophthalmology at the “Lozano Blesa” University Clinic Hospital, Zaragoza, Spain, between January and October 2013. SCT was measured by using enhanced depth imaging (EDI) in spectral domain optical coherence tomography (SD‐OCT).

Results The mean age of patients was 80.2 ± 5.9 year and 81.1 ± 5.2 years in patients with wet and dry AMD respectively (p>0.05, t student test). BCVA was 20/100 and 20/40, in patients with wet AMD and dry AMD, respectively (p<0.001, t student test). Mean SCT was 151.1 ± 73.5 µm and 155.6 ± 55.1 µm, in wet AMD and dry AMD patients, respectively (No statistically significant differences, p>0.05). Wet AMD patients showed a positive and statistically significant correlation between SCT and BCVA (r=0.298, p=0.018). Nevertheless, patients diagnosed with dry AMD showed no relationship between SCT and BCVA (r=0.085, p=0.488).

Conclusion BCVA is positively correlated with SCT in patients diagnosed with wet AMD. No correlation was observed between both parameters in patients with dry AMD.
AMD Drusenoid deposits “Lipid Type” characteristics and evolution. Multimodal imaging evaluation
Authors: GONZALEZ C
Published: August 2014

Purpose To study AMD drusenoid deposits “Lipid Type” evolution with multimodal imaging. To individualize their evolution and complication and to consider various etiopathogenic AMD options

Methods 98 eyes of 49 patients, 18 men, 31 women, with AMD. AMD drusenoid deposits, “Lipid type”: soft Drusen, Drusenoid PED (lipid type), were evaluated by Autofluorescence, IR imaging, ETDRS visual acuity (VA), ocular Fundus examination, Ocular Confocal Tomography exam (OCT), OCT en Face software (Spectralis HRA‐OCT). Size, characteristics, number, topography of the lesions, growth were evaluated, as well as their environment above and below. With OCT, each element was studied, compared cut to cut, layer to layer and time to time to itself and to each other data. Follow‐up was done every 4 months during 2 years

Results Soft drusen were larger, roughly homogenous, dark‐grey, translucent, dome‐shaped mounds of deposit under the RPE; Drusenoid PED, lipid type, were homogeneous, as convergence of soft drusen, dark‐grey. Multimodal imaging, especially OCT, OCT en Face features let individualize “lipid type” drusenoid deposits: morphologic types appearing homogeneous, dark, optically empty, fatty. Evolution change, depend on those characteristics, rather to IS/OS impairment, photoreceptor disappearance, RPE involution, and so atrophy. They seem result from a specific metabolic defect outcome, peculiar etiopathogenic pathways: lipid metabolic pathway disorder with particular metabolic dysfunctions inrolled. Furthermore, lipid type drusenoid deposits’ prognostic, predictive value allow to designate them for biomarker feature

Conclusion AMD Drusenoid deposits “lipid type” knowledge, evolution allow better AMD metabolism dysfunction understanding and etiopathogenic concept
Management of choroidal neovascularisation in late onset retinal degeneration
Authors: WIRYASAPUTRA S , YONG SO
Published: August 2014

Purpose Late onset retinal degeneration is a hereditary condition characterized by progressive difficulty in dark adaptation and risk of choroidal neovascularisation. This in turn leads to a marked decline in visual acuity. We describe our experience treating a patient with a positive family history of late onset retinal degeneration who developed subfoveal choroidal neovascularisation.

Methods Case report. A 57 year old Caucasian lady with a positive family history of late onset retinal degeneration and progressive decline in dark adaptation presented to us with a 1‐week history of blurring of vision. Fundus fluorescein and indocyanine green angiography revealed a subfoveal classic neovascular membrane.

Results Our patient was initially treated with intra‐vitreal Ranibizumab and clinical activity of neovascularisation was monitored with serial spectral domain optical coherence tomography and visual acuity. Serial scans revealed recurrence of activity within a month of intra‐vitreal Ranibizumab. With the advent of intra‐vitreal Aflibercept, we offered our patient a change in treatment regime. Treatment with Aflibercept has thus far demonstrated a stabilization of disease activity on spectral domain optical coherence tomography and visual acuity for at least 8 weeks.

Conclusion Whilst Ranibizumab and Aflibercept remain off‐label for the treatment of late onset retinal degeneration, this suggests that Aflibercept is possibly more efficacious in the management of choroidal neovascular membranes in late onset retinal degeneration.