bluuebunny/crossref_metadata_2025 huggingface dataset:
Long term results of concomitant strabismus treatment based on operation preliminary modeling using three‐dimensional biomechanical eye model
Authors: Bushuyeva N. , Romanenko D.
Published: September 2016

Purpose

To analyze long term surgical treatment results of concomitant strabismus (CS) patients based on operation preliminary modeling in three‐dimensional biomechanical eye model (TBEM).

Methods

There were analyzed surgical treatment results in 106 patients with CS, which were operated on after the operation was preliminary modeled at TBEM ‘SEE‐KID’.

Results

Orthotropy was obtained in 54/106 patients (50.9%) at the first day postoperatively. 52/106 patients (49.1%) had residual angle of 5–10° – hypocorrection was in 44 patients, and hypercorrection was in 8 patients. 18 patients were lost to follow‐up. At 6–12 months follow‐ups ortothropy has been preserved in 53/88 patients (60.2%), and in 35/88 patients residual angle of 5–10° remained – hypocorrection was in 31 patient, and hypercorrection was in 4 patients.

Conclusions

TBEM use in complex examination and treatment of CS patients allows predicting surgery result in some cases and accelerates diagnostic process, but the method needs further investigation. Particularly, extraocular muscles biomechanics needs to be more precisely estimated (degree of the muscle hyper‐ or hypofunction, movement amplitude).
Reduced vascular response in patients with normal tension glaucoma in response to hypoxia
Authors: Dalgaard L.M. , Vibæk J. , Jensen L.T. , Olsen N.V. , Kolko M.
Published: September 2016

Purpose

Increased evidence exists on an association between normal tension glaucoma (NTG) and endothelial dysfunction. Moreover, it is recognized that glaucomatous damage is linked to episodes with hypoxia. The aim of our study was to investigate the vascular response after hypoxia in patients with NTG compared to controls.

Methods

The vascular response was evaluated after hypoxia by Peripheral Arterial Tonometry (PAT) and recorded as Reactive Hyperemic Index (RHI). All subjects went through two days of investigation. In random order the first visit included either hypoxia or normoxia with successive measurements. Hypoxia/normoxia was induced in 2 h through a tightly fitting face mask. Additionally, the peripheral circulation was measured by a thermographic camera. Blood samples were taken before, during and after hypoxia/normoxia to evaluate stress factors such as cathecolamines. The two days of investigation were at least three weeks apart.

Results

RHI measurements showed a tendency of greater difference between hypoxia and normoxia in the NTG group. Thermographic images showed a tendency of colder temperatures in the fingertips of the NTG patients before hypoxia compared to the controls. A significant difference in temperature between the hypoxia day and the normoxia day was seen in the NTG group after both 2 h of hypoxia/normoxia and half an hour after the mask was removed. Adrenalin levels differed significantly in response to hypoxia in the control group, whereas no significant change was observed in response to hypoxia in patients with NTG.

Conclusions

Over all, the vascular response to hypoxia was less prominent in patients with NTG compared to controls. This confirms a decreased ability to regulate the vascular tonus in response to vascular stress (hypoxia) in patients with NTG.
Ab Interno Collagen Stent implantation as a treatment option for open angle glaucoma
Authors: Crisóstomo S. , Cardigos J. , Costa L.M. , Basílio A.L. , Anjos R. , Cardoso M. , Gomes T.
Published: September 2016

Purpose

To establish the efficacy and safety of an Ab Interno Collagen Stent (AICS) in combination with subconjunctival Mitomycin C (MMC) in patients with open angle glaucoma (OAG), in the reduction of intraocular pressure (IOP), hypotensive treatment (HT) and progression on structural retinal nerve fiber layer (RNFL) exams.

Methods

Prospective, non‐randomized study involving 10 eyes with OAG, not controlled by HT, submitted to AICS implantation (Xen Gel Stent, Aquesys, Calif., USA) following subconjuntival MMC, with 6 month of follow‐up. Patients were reevaluated on the 1st day, 1st week and at 1st, 3rd and 6th months of follow‐up. IOP and bubble dimensions were registered and the need for re‐interventions or HT was analyzed. Structural RNFL evaluation was performed at 6 months (Spectralis OCT, Heidelberg Engineering, Heidelb., Germany), and compared to preoperative values. Correlation analysis was made between IOP reduction, bubble dimensions and age.

Results

Mean IOP values were 21.8 ± 5.87 mmHg, 11.4 ± 4.5 mmHg, 13.2 ± 3.93 mmHg; 18.1 ± 6.9 mmHg, 14.2 ± 3.19 mmHg and 13.7 ± 3.10 mmHg and mean bubble dimensions were 3.1; 2.5; 2.5; 2.5 and 2.6 at 1st day, 1st week and 1st, 3rd and 6th months, respectively. Re‐interventions were necessary in 4 cases. IOP reductions compared to preoperative values were statistically significant at all follow‐up visits (p < 0.05), except for the 1st post‐operative month. There was a statistically significant correlation between bubble dimensions and IOP reduction (p < 0.05; r = −0.788). There was no significant progression of RNFL loss. Hypotensive medication was reduced by 87.5%. No complications were reported.

Conclusions

The insertion of an Ab Interno Collagen Stent with adjunctive MMC significantly reduced IOP over a 6 months follow‐up period without significant complications, notwithstanding a considerable need for re‐interventions.
Inflammatory cell infiltrates in metastatic uveal melanoma
Authors: Krishna Y. , McCarthy C. , Kalirai H. , Coupland S.
Published: September 2016

Purpose

Current treatments for metastatic UM (MUM) are very limited and rarely prolong patient survival. Immunotherapy trials for MUM are few, and to date have only demonstrated marginal success. High densities of tumour associated macrophages (TAMs) and infiltrating T lymphocytes (TILs) in primary UM are associated with a poor prognosis. There is little known about the immunomodulatory/microenvironment of MUM. Our aim was to examine the presence and distribution of TAMs and TILs in MUM within the liver.

Methods

Whole tissue sections of liver MUM (n = 16) were examined by immunohistochemistry. For TAMs, the monoclonal antibodies (mAb) against CD68 and CD163 were used. Macrophage number and morphology were graded following the method described by Mӓkitie et al (IOVS 2001;42(7):1414–21). Number and spatial distribution of TILs were highlighted using Abs against CD3 (pan‐lymphocyte marker), CD4 (T‐helper cells) and CD8 (T‐cytotoxic/suppressor cells).

Results

CD68+ and CD163+ TAMs were noted within the tumour in all 16 specimens; their numbers were ‘few to moderate’ in ≥85% of cases and the majority showed an intermediate phenotype. CD3+ TILs were noted both within MUMs and surrounding the tumour, at the interface with normal liver. Of these CD8+ TILs were ‘few’ in number within MUM but were predominantly seen at the tumour/normal liver interface, whilst CD4+ TILs showed a high perivascular density within MUM. The CD4 mAb also highlighted resident Kupffer‐Stern macrophages.

Conclusions

CD68+ and CD163+ TAMs of intermediate morphology were observed in MUM, suggesting a tendency towards the pro‐tumourigenic M2 phenotype. CD4+ TILs were seen mainly infiltrating MUM, whereas CD8+ TILs tended to be peritumoural. The biological role of inflammatory cells in MUM requires further investigation, to determine if they represent potential targets for future therapies in MUM.
Sequential bilateral optic nerve infiltration as the sole manifestation of relapsed T‐cell lymphoblastic lymphoma: a case report.
Authors: Khayat H. , Alsulami R. , Alsobhi E. , Alqahtani A. , Alkahtani A. , Alzahrani S.
Published: September 2016

Purpose

Central nervous system (CNS) involvement in non‐Hodgkin lymphoma (NHL) is well‐known, occurring in approximately 10% of all cases. Among these, infiltrative lymphomatous optic neuropathy (LON) affects 5% usually in the setting of active CNS disease. However, isolated LON in relapsed NHL remains exceptionally rare. Herein, we present a unique case of sequential bilateral optic nerve infiltration as the sole manifestation of relapsed T‐cell lymphoblastic lymphoma.

Methods

Case report.

Results

A 30‐year‐old male patient diagnosed as a case of mediastinal T‐cell lymphoblastic lymphoma (LBL).Staging CT confirmed no other site was involved. He received chemotherapy as per protocol. Re‐evaluation with chest CT showed complete resolution of the mass. Five weeks later, the patient presented to private hospital complaining of right eye pain with blurred vision and by the fifth day his vision deteriorated to no light perception. He was diagnosed as relapsed LBL with isolated right optic nerve infiltration and treated accordingly. Two months later, he presented to our center for the first time with left eye pain and blurred vision. Full eye examination revealed blind right eye with no perception of light. Retinal examination for right eye was consistent with combined retinal artery and vein occlusion. Left eye fundus examination revealed gross swelling of the optic disc. Brain MRI showed swollen left optic nerve with no mass occupying lesion. He was treated promptly with radiotherapy and planed for re‐induction chemotherapy.

Conclusions

Optic nerve infiltration represents an ocular emergency where timely diagnosis and intervention can prevent the irreversible loss of vision. Ophthalmologists should keep high index of suspicion and consider prompt through eye examinations along with brain imaging in patients with history of lymphoma presenting with visual complaints.
Fundus autofluorescence and SD‐OCT in progressive cone dystrohy
Authors: Hassairi A. , Falfoul Y. , Turki A. , Maamouri R. , El Matri K. , Chebil A. , El Matri L.
Published: September 2016

Purpose

To describe fundus autofluorescence (FAF) and Spectral domain optic coherence tomography (SD‐OCT) findings in progressive cone dystrophy (PCD) and evaluate the benefits of these methods for diagnosis.

Methods

All patients with the diagnosis of PCD based on color sense, visual field and electrophysiological tests were included. They underwent full ophthalmic examination with best‐corrected Snellen visual acuity (BCVA), fundus photography, SD‐OCT and FAF.

Results

Sixteen eyes of 8 patients were included. Mean age was 36.5 years and 19 years at the beginning of signs. Mean BCVA was 0.18 (range 0.05–0.4). On biomicroscopy, we found changes in the retinal pigment epithelium ranging from barely detectable changes (6 eyes) up to the typical bull's eye appearance (8 eyes). We found central macular atrophy in 2 eyes. OCT showed statistically significant reduction in the thickness and structural changes in the macular retina, predominating at the perifoveolar zone in 8 cases. Atrophy was evident especially in the outer nuclear layer and the ellipsoid zone. Visual acuity was mainly dependent on the degree to which the continuity of the ellipsoid was maintained in subfoveolar. FAF was normal in 2 eyes, showed heterogeneous hyper‐FAF in 4 eyes, hypo‐FAF in 2 eyes, small area of mild hypo‐FAF in the perifoveal region surrounded by a ring of hyper‐FAF in 8 eyes. The junction between normal and abnormal outer retina on OCT corresponded to the hyper‐autofluorescent ring.

Conclusions

OCT and FAF specifies the quantitative and qualitative changes in the macula and may contribute significantly to the diagnosis of the progressive cone dystrophy, particularly in the early stages of the disease which is difficult to diagnose.
Choroidal thickness in diabetic patients without diabetic retinopathy
Authors: Pinto Proença R. , Vicente A. , Oliveira Santos B. , Cunha J.P. , Alves M. , Papoila A.L. , Abegão Pinto L. , Tavares Ferreira J.
Published: September 2016

Purpose

Compare choroidal thickness (CT) between diabetic patients without diabetic retinopathy (DR) and a non‐diabetic group. Explore how CT relates to disease duration, mean arterial pressure (MAP), glycaemia, glycosylated haemoglobin (HbA1c), intraocular pressure and ocular pulse amplitude (OPA).

Methods

In this cross‐sectional study, CT was assessed using SD‐OCT (Spectral Domain Optical Coherence Tomography) and enhanced depth mode at 13 different locations (subfoveal and 3 measurements 500 μm apart in all 4 directions – nasal, temporal, superior and inferior). Linear regression models were used to analyse the data.

Results

175 patients were recruited (125 diabetic patients without DR and 50 non‐diabetics patients). In diabetic patients, CT was significantly thicker than in non‐diabetic group in two locations: 1,500 μm nasal (p = 0.036) and 1,500 μm superior to the fovea (p = 0.021). CT was negatively associated with age (p < 0.001) in both groups, but only in the diabetic group was it positively associated to OPA (with a mean increase in thickness between 8.5 and 11.6 μm for each increase of one OPA's unit). CT values seem to stabilize after 150 months of diabetes, with patients presenting higher glycaemia levels (>160 mg/dl) while showing no fluctuation in neither HbA1c nor MAP.

Conclusions

There appears to be a thickening of the choroid in diabetic patients without DR. Moreover, this tissue may be functionally different in diabetic patients, as the pattern of associations seems to differ between groups.
Severe ocular manifestations of rosacea in adult
Authors: Hassairi A. , Limaiem R. , Kortli M. , Maamouri R. , El Matri L.
Published: September 2016

Purpose

Ocular rosacea in adult is a rare condition that may be responsible for palpebral, cunjonctival and corneal complications with severe visual functional prognosis in some cases. The purpose of this study is to determine the nature and prognosis of corneal complications in this disease through our study and literature review

Methods

We report seven patients (14 eyes) with severe ocular rosacea requiring hospitalization.

Results

The mean age of our patients was 59.6 years. Six patients (85.6%) were female. Visual acuity was <1/10 in 10 eyes. The complications were keratitis in 7 eyes, corneal ulcerations in 5 eyes, corneal perforation in 5 eyes, and catarrhal infiltrates in 6 eyes. Limbal neovascularization was noted in 11 eyes. Only one patient has ocular‐cutaneous form. All patients were treated with oral cycline, topical steroids in acute phase, artificial tears and eyelid hygiene. A bandage contact lens was applied to 4 eyes. Three eyes required penetrating keratoplasty. They were successfully treated with improvement of symptoms and cicatrisation of corneal lesions. One case of corneal graft failed secondary to infectious keratitis.

Conclusions

The diagnosis of ocular rosacea is difficult because it often occurs without skin involvement. Ocular rosacea is the only complication of cutaneous rosacea. Diagnosis should be as early as possible because ocular complications are possible, with blinding potential. The best treatment is prevention with regular eyelid hygiene.
Upregulated expression of proteolytic enzymes in the cultured retinal pigment epithelial cells of minipig transgenic for the human mutated huntingtin
Authors: Ardan T. , Kocurova G. , Hrnciarova E. , Motlik J.
Published: September 2016

Purpose

Huntington′s disease (HD) belongs to the hereditary neurodegenerative disorder that is caused by an expansion of a polyglutamine (polyQ) domain in the protein of huntingtin (Htt). Since mutant Htt (mtHtt) and especially their small proteolytic fragments are very toxic to all HD cells (particularly those of neuroectodermal origin such as neurons or retinal pigment epithelial cells), it has been suggested that upregulated proteolysis of mtHtt plays a crucial role in the HD pathogenesis including damage of the retina. Therefore, the purpose of the present study was to investigate the possible participation of the proteolytic enzymes from the group of caspases, matrix metalloproteinases (MMP), calpains in HD pathology of retinal pigment epithelial cells.

Methods

In this study we used wild type (WT) and transgenic minipigs for N‐terminal part of the human mtHtt (TgHD) (548aaHTT‐145Q, F2 generation age 36 and 48 months, respectively). Proteases were examined in cultured retinal pigment epithelial cells immunocytochemically (ICC) or biochemically by western blotting (WB) using the following primary antibodies: anti‐caspase‐3, anti‐caspase‐8, anti‐calpain‐5, anti‐MMP‐9.

Results

Using biochemical and immunocytochemical analysis, we detected increased expressions of caspase‐3, caspase‐8, matrix metalloproteinase‐9, calpain‐5, and probably its multiple proteolytic cleavage products (generated from mtHtt) in cultured RPE cells of TgHD minipigs in comparison to WT animals.

Conclusions

Increased expression of proteolytic enzymes in TgHD RPE cells can contribute to the retinal damage during development of HD.
Novel OCT prognostic indicators in diabetic macular oedema
Authors: Manns R. , Begum S. , Mourtzoukos S.
Published: September 2016

Purpose

Despite advances in optical coherence tomography (OCT), clinicians have few prognostic indicators. We chose anomalous features found in OCTs, and retrospectively analysed OCT images for subsequent progression in visual acuity (VA), OCT results and interventions required over 22–24 months.

Methods

Putative risk factors were grouped into sets based on similar putative aetiology:

sub‐retinal fluid and large cysts,

hyperreflective dots,

partial/total disorganisation of retinal inner layers (DRIL) and photoreceptor disruption,

epiretinal membranes, vitreomacular traction, vitreomacular adhesion.

Eyes were stratified according to how many of these groups of features they displayed (0–4) and were all treated as per protocol and clinical need.

Results

Increasing risk factors correlated with increasing initial OCT central retinal thickness (CRT) (387 vs. 555) and volume (9.99 vs. 11.28), and poorer initial visual acuity (0.41 vs. 0.60) on presentation.

Whilst final CRT results showed no significant differences between the groups (325–248 nm), and no significant differences between numbers of injections performed (6.8 vs. 7.35), more features correlated with poorer VA, both absolute and relative to baseline, irrespective of whether there had been previous treatment.

Conclusions

These features are better prognostic indicators than OCT measurements alone.
The impact of efferent oculomotor signals on size and distance perception
Authors: Krastel H. , Streuer A. , Magerl W. , Kubarko A. , Jonas J.B.
Published: September 2016

Purpose

To demonstrate the influence of efferent oculomotor signals on perceived size and distance of visual objects.

Methods

By fingertip, a pencil target has to be localized. The target is seen at 25 cm of distance on a 45° mirror mounted in front of the subject. With the finger behind the mirror, the subject is deprived from visual feedback. Observation is done either by naked eye or by looking through binocular prisms of 6 pdpt b.i. The fingertip estimate is recorded by an ElGuide® ultrasound position control system (Zebris Medical, Isny, Germany).

Results

In first results, the prisms produced a mean 25% overestimation of target distance as recorded by fingertip position. The target appeared visibly larger. This prompted us to do trials with a minus −3 dpt lens instead of prisms, forcing the subject to overaccommodation. Hereby, the target appeared visibly smaller and more distant, but now, fingertip pointing ends up at reduced distance.

Conclusions

With reduced convergence the object appears larger and nearer. The distance of the object is over‐estimated by fingertip localization. Hyperaccommodation results in a smaller and more distant appearance of the object, but its fingertip distance is underestimated. Sense and purpose of these contradictory effects are not yet well understood. Visitors of the poster are encouraged to self experience.
The venous oxygen saturation predicts the visual prognosis after anti‐VEGF treatment of central retinal vein occlusion
Authors: Jeppesen S.K. , Bek T.
Published: September 2016

Purpose

Central retinal vein occlusion (CRVO) is a frequent cause of visual impairment. The visual prognosis is known to be related to the degree of retinal ischaemia which is presently assessed indirectly by the accompanying visual loss. However, the advent of retinal oximetry has introduced a new method for more directly assessing the metabolic consequences of retinal ischaemia.

Therefore, the purpose of the present study was to determine the predictive value of the oxygen saturation in larger retinal vessels for the visual prognosis after treatment with intra‐vitreal anti‐VEGF medication.

Methods

Retinal oximetry was performed in 73 consecutive patients with CRVO (age 71.5, 28–96 years) (mean, range) in one eye referred to the Department of Ophthalmology, Aarhus University Hospital, and the saturation values were related to the visual acuity before and after three monthly injections with anti‐VEGF medication.

Results

At baseline the oxygen saturation in larger retinal vessels was significantly higher in the affected (101.3 ± 13.0% for arterioles and 37.1 ± 23.1% for venules) than in the unaffected eye (96.5 ± 5.3% for arterioles and 58.0 ± 11.0% for venules), p < 0.001 for both comparisons. The visual acuity showed a significantly negative correlation with the oxygen saturation in retinal arterioles (p = 0.013) and a significantly positive correlation with the oxygen saturation in retinal venules (p = 0.014). In a linear regression model the oxygen saturation in venules at baseline was predictive for the visual acuity after treatment (p = 0.044).

Conclusions

In CRVO the oxygen saturation in retinal vessels correlates with visual acuity before treatment, and the saturation in venules at baseline can predict the visual outcome after treatment with anti‐VEGF medication.
Taking a roller coaster ride with autophagy markers p62 and LC3
Authors: Koskela A. , Reinisalo M. , Kaarniranta K.
Published: September 2016

Purpose

Lysosomal autophagy is crucial for the removal of dysfunctional proteins, aggregated cellular material and organelles. Post‐mitotic cells, such as retinal pigment epithelial cells, are particularly susceptible to age‐related aggregation‐prone proteins. Excessive or defective activity of the autophagy leads to detrimental effects on RPE cell homeostasis. Therefore, autophagy must be controlled not only with positive but also with negative signals to retain homeostasis. In this work, autophagy markers LC3 (microtubule‐associated protein 1A/1B‐light chain 3) and p62 (SQSTM1) were monitored in ARPE‐19 cell line.

Methods

ARPE‐19 cells were treated with autophagy inducers, proteasome inhibitor MG‐132 and Resvega (contains resveratrol and omega‐3 fatty acids), in normal and serum‐starved growth conditions up to 48 h. Protein samples from different time points were collected and the protein levels of LC3‐II, LC3‐I and p62 were analyzed with Western blot.

Results

The levels of LC3‐II, LC3‐I and p62 fluctuated during the monitored time period in both growth conditions. The magnitude of the fluctuation was highest in the serum‐starved samples at early time points and became weaker at the later time points. The expression levels of autophagy markers were constant throughout the experiment in normal growth conditions.

Conclusions

This data showed that autophagy regulation is a dynamic process that coincides with changed and time dependent expression levels of LC3 and p62 in response to MG‐132, Resvega and starvation. This should be noticed when autophagy data is analyzed.
A novel homozygous c.1154+3_1151+6delAAGT mutation in CERKL causes autosomal recessive retinitis pigmentosa with a special phenotype in a consanguineous Tunisian Family
Authors: El Matri L. , Falfoul Y. , Habibi I. , Turki A. , Maamouri R. , El Matri K. , Chebil A.
Published: September 2016

Purpose

The aim of our study was to assess the clinical phenotype and to determine the causative gene in a Tunisian family with an autosomic recessive retinitis pigmentose (arRP).

Methods

All accessible members of a consanguineous Tunisian family were included and underwent full ophthalmic examination with best corrected Snellen visual acuity, fundus photography, optical coherence tomography (SD‐OCT) and full field electroretinography (ERG). Index patient was selected for whole exome sequencing (WES) followed by homozygosity mapping. All detected variations were confirmed by direct Sanger sequencing.

Results

The clinical data of the patients showed typical hallmarks of RP symptoms for which affected individuals initially experienced night blindness with progressive visual loss and hemeralopia since the first decade of life. Visual acuity at baseline ranged from 1/10 to 5/10. Funduscopy revealed essentially mild optic disc and retinal atrophy and virtually no clumped pigmentation. Macula was normal in young patients and showed atrophic alteration in advanced stages. ERG was unrecordable in scotopic conditions and the cone responses were markedly hypovolted. Homozygosity mapping and whole exome sequencing identified a 4‐pb deletion, c.1154+3_1151+6delAAGT, located in the donor splice site of intron 8 of CERKL. The mutation impacts pre‐mRNA splicing of CERKL. This new deletion was present at a homozygous state in the two affected sons and was heterozygous in the parents. It was not present in the unaffected sister.

Conclusions

Mutations in CERKL gene have been reported in patients with retinitis pigmentosa, c.1154+3_1151+6delAAGT is a novel splicing variant associated with arRP. Extending the mutation spectrum of CERKL with additional families is important for genotype‐phenotype correlations.
Pupillary reaction according to a balance autonomic nervous organ of vision in healthy children
Authors: Bushuyeva N. , Dukhayer S. , Slobodianyk S.
Published: September 2016

Purpose

For the diagnosis and prevention of asthenopic complaints need to study pupillary reactions normal in response to light stimulus and the presentation of the object in the vicinity of somatically healthy persons without ophthalmic pathology taking into account the balance of the autonomic innervation. The aim of the work was to study the direct pupillary reaction to light stimulus.

Methods

Pupillografiya was performed in 78 somatically healthy individuals (156 eyes) in the age of 5–9 years. 27 people prevailed balance the sympathetic autonomic nervous system, in 34 parasympathetic, 17 persons observed eutonic. The visual acuity, refraction static on autorefractometry Humphrey, Oftalmometres on Oftalmometres Zhavalya and ultrasound biometry of eyes have been studied. Provision of accommodation (RA) have been determined by the method Dashevskiy. The balance of the autonomic nervous system has been studied with the help of cardio‐vascular index Cerdo.

Results

All the healthy children, whose emmetropic refraction had been observed, had visual acuity for distance 1.0 ± 0.02 in the both eyes. The pupil reaction with the sympathetic innervation before the light stimulus by direct reaction was OD 63.65 ± 2.61 mm2, OS 66.92 ± 2.27 mm2. The eutonic reaction was OD 34.99 ± 1.18 mm2, OS 31.77 ± 1.42 mm2. The reaction with the parasympathetic innervation was OD 28.93 ± 0.94 mm2, OS 25.72 ± 1.08 mm2. After the presentation of the light the reaction with the prevalence of sympathetic innervation was OD 15.77 ± 1.09 mm2, OS 15.87 ± 1.30 mm2. The eutonic pupillary area was OD 10.73 ± 1.13 mm2, OS 8.74 ± 0.60 mm2, while the pupillary area with a predominance of parasympathetic innervation was OD 8.63 ± 0.74 mm2, OS 7.19 ± 0.54 mm2.

Conclusions

The connection between types of autoinnervation interrelationship must be studied for the diagnostic and intreatment of asthenopia.
Loss of 5 hydroxymethylcytosine in conjunctival melanoma
Authors: Moulin A. , Caseiro P. , Schalenbourg A. , Zografos L. , Kaya G.
Published: September 2016

Purpose

Recent studies suggest that conjunctival and cutaneaous melanoma partially share similar molecular features. In cutaneous melanoma, loss of 5 hydroxymethylcytosine (5‐hmc) was identified in tumor progression and associated with a poorer survival. We decided to assess if similar epigenetic events occur in tumor progression of conjunctival melanoma and evaluated 5‐hmc expression in benign and malignant conjunctival melanocytic proliferations.

Methods

5‐hmc expression was evaluated by immunohistochemistry in 32 conjunctival naevi and 36 conjunctival melanomas from respectively 32 and 31 patients. Statistical analysis was performed with JUMP 8.0 software. Immunohistochemistry was assessed by three observers. Discrepant cases were simultaneously reviewed to achieve complete agreement.

Results

5‐hmc was found in all the nevi. There was a significant downregulation of 5‐hmc in conjunctival melanoma compared to benign conjunctival nevi (p > 0.0001), 5‐hmc loss being identified in 52.3% of the melanoma. In the melanomas, 5‐hmc loss was significatively correlated with the depth of invasion (p = 0.0043) and local lymphatic invasion (p = 0.0149). There was no correlation with the proliferation index, local recurrences, metastasis and death.

Conclusions

Our results demonstrate in vivo a significant downregulation of 5‐hmc in malignant conjunctival melanocytic proliferations suggesting that similar epigenetic modifications occur in conjunctival and cutaneous melanoma. Restauration of 5‐hmc loss in conjunctival melanoma might represent a potential therapeutical epigenetic option for this tumor.
Subgroup analysis of two phase III studies of 0.1% cyclosporine A cationic emulsion (CsA CE) in patients with dry eye disease
Authors: Leonardi A. , Garhöfer G. , Amrane M. , Garrigue J.S. , Ismail D. , Sainz de la Maza M. , Labetoulle M.
Published: September 2016

Purpose

Dry eye disease (DED) increases the risk of ocular surface damage, severe keratitis, vision loss and impaired quality of life. In two randomized phase III studies (SANSIKA and SICCANOVE), the cationic emulsion formulation containing 0.1% (1 mg/ml) cyclosporine A (CsA CE) improved ocular damage and inflammation in patients with moderate to [AS1] severe DED. This analysis evaluated the efficacy of CsA CE in improving signs of DED in specific patient subgroups.

Methods

Analysis was performed based on efficacy data from the SANSIKA study (n = 215) and pooled efficacy data from the SANSIKA and SICCANOVE studies (n = 629); change from baseline in corneal fluorescein staining (CFS) at Month 6 was analyzed in subgroups of DED patients defined by age, sex, menopausal status, DED duration (ranging from <4 to ≥12 years) and the presence of Sjögren disease.

Results

Of the patients included in the pooled analysis, 65% were <65 years old, 83% were female (72% in menopause) and 38% had Sjögren disease. The overall change in CFS score from baseline to Month 6 favored CsA CE over vehicle (treatment difference −0.303; 95% confidence interval, −0.464 to −0.142). In the SANSIKA study and in the pooled analysis, the effect of CsA CE on CFS score was comparable in patients regardless of age, sex, menopausal status, DED duration and Sjögren disease status. In the subset of patients with severe keratitis, the effect of CsA CE on CFS was also comparable across all subgroups. CsA CE was well tolerated, with a safety profile consistent with ophthalmic CsA use.

Conclusions

These data suggest that CsA CE is well tolerated and comparably efficacious in improving signs of DED across multiple DED patient subpopulations.
The effect of culture medium and carrier on explant culture of human limbal epithelium: a comparison of ultrastructure, keratin profile and gene expression
Authors: Pathak M. , Olstad O.K. , Drolsum L. , Moe M.C. , Katerina J. , Nicolaissen B. , Noer A.
Published: September 2016

Purpose

To examine the effect of medium and substrate on morphology, on expression of selected keratins and on global gene expression in ex vivo engineered corneo‐limbal grafts.

Methods

Limbal biopsies retrieved from corneo‐scleral rings of cadaveric donors were placed on human amniotic membranes or on plastic inserts and cultured for 3 weeks in parallel in either a complex medium (COM) or in medium containing human serum (HM) as single growth promoting supplement at 37°C and 5% CO2. Culture medium was changed every 2–3 days. Grafts were examined using light microscopy (LM) and transmission electron microscopy (TEM) and immunohistochemistry (IHC) (for 8 keratins), microarray and qRT‐PCR were performed.

Results

LM and TEM examination revealed similar multilayered stratified epithelium with cuboidal basal cells and flattened superficial cells with microplicae, attached to one another by desmosomes. In explants cultured on HAM, hemidesmosome‐like junctions were observed between the expanded cells and the underlying HAM. Using IHC, expression of keratins was found to be similar in grafts engineered in the different conditions. We observed that cells cultured in the same medium (HS or COM) have more similarities in gene expression than cells cultured on same scaffold (PL or HAM).

Conclusions

All explants have similar morphology and keratin expression. The presence of hemidesmosome‐like junctions between the expanded cells and underlying HAM on TEM may indicate better attachment of the expanded cells to the carrier surface as compared to the cells cultured on PL. Gene expression was more similar in cells cultured in the same medium (HS or COM) as compared to cells cultured on the same scaffold (PL or HAM), suggesting that choice of media is of greater significance for explant cell characteristics than choice of carrier.
Human anterior lens epithelium in presenile cataract‐ scanning and transmission electron microscopy study
Authors: Andjelic S. , Drašlar K. , Hvala A. , Hawlina M.
Published: September 2016

Purpose

Presenile cataracts, including juvenile and congenital cataract, are rare. As a presenile cataract is considered a subcapsular senile cataract in a person under 45 years of age. Clinical examination before the cataract surgery showed the subcapsular changes in the opacity on the anterior lens. The purpose was to study the structure of the lens epithelial cells (LECs) of presenile cataract in order to investigate possible structural reasons for its development.

Methods

The anterior lens capsule (aLC: basement membrane and associated lens epithelial cells) were obtained from cataract surgery and prepared for scanning electron microscopy (SEM) and transmission electron microscopy (TEM).

Results

We present the results of the SEM and TEM study of the anterior lens epithelium. The most prominent abnormal features observed by SEM for all studied presenile cataract patients were the changes of the LECs structure with the dents on the apical side centrally toward the nucleus. The individual LECs or smaller regions of lens epithelium are damaged with the several lesions of this type that are present diffusely. TEM also showed the thinning of the lens epithelium with the segmentally concave cells and the compressed and elongated nucleuses.

Conclusions

Abnormal, distinguishable structural features were observed in the anterior lens epithelium LECs in presenile cataract patients. Disturbed structure of LECs may play a role in water accumulation in the presenile cataract lens. We suggest that the presence of LECs with damaged nucleuses may be associated with the genetic/congenital origin of the presenile cataracts.
The zinc‐metallothionein redox system in human retina and RPE
Authors: Alvarez L. , García M. , Rodríguez S.M. , Fernández B. , Pereiro R. , Sanz‐Medel A. , Coca‐Prados M. , González‐Iglesias H.
Published: September 2016

Purpose

The retina contains the highest concentration of zinc in the human eye and it is primarily associated with the photoreceptors and the RPE. Metallothioneins (MTs) are the main cytosolic zinc‐ion‐binding proteins, and their main roles include neuroprotection and maintenance of cellular zinc homeostasis. Zinc is the main regulator of MTs, and there is a tight control in the number of atoms of zinc bound to the MT proteins (stoichiometry), which could be related with their antioxidant and neuroprotective functions. The main purpose of this work is to study the Zn‐MT system in the RPE and retina of the human eye.

Methods

We first determined the total content of Zn by elemental mass spectrometry (i.e., ICP‐MS), in RPE and retina from post mortem human donors, and compared its quantitative distribution by bio‐imaging (i.e, laser ablation‐ICP‐MS), on cryogenic eye sections. Secondly, we carried out the quantitative speciation of zinc in the water‐soluble protein fractions of RPE and neural retina, to study its protein binding profile. Finally we studied the effects of metals (i.e., ZnSO4), inflammatory cytokines (i.e., IL1a) and glucocorticoids (i.e., dexamethasone), by ICP‐MS, in an in vitro cellular model of human RPE cells (HRPEsv).

Results

We found preferential quantitative distribution of zinc in the RPE, followed by the retina in lesser levels. Zinc is mainly associated to high and low molecular mass proteins in both RPE and retina. Exogenous zinc, interleukin and dexamethasone increased MT proteins synthesis and induced a stoichiometric change in MT proteins in HRPEsv cells.

Conclusions

The stoichiometric transition on Zn‐MT proteins in HRPEsv and its potential implication against oxidative stress processes will be discussed.
High‐intensity focused ultrasound cyclocoagulation: a 6‐month study
Authors: Vandewalle E. , Somers A. , Vermorgen K. , Stalmans I.
Published: September 2016

Purpose

To evaluate the safety and efficacy of high‐intensity focused ultrasound (HIFU) cyclocoagulation in reducing intraocular pressure (IOP) in patients with glaucoma by using a novel miniaturized delivery device (EyeOP1) after 6 months of follow up.

Methods

This was an interventional study of 61 eyes of 61 patients with glaucoma. The first series of 39 patients did not receive Pilocarpine before intervention and the second series of 22 patients received Pilocarpine before intervention. All eyes were treated with 6 activated transducers operating at 21 MHz with a duration of 8 sec. A complete ophthalmic examination was performed before the procedure and at day 1, week 3, month 3 and 6 after the procedure. Primary outcome was to evaluate intraocular pressure (IOP) at 3 and 6 months. Secondary outcomes were to assess intra‐ and postoperative tolerance, visual acuity, medication use, complication rates and re‐interventions.

Results

IOP results of months 3 and 6 will be available at November 2016. Due to increased pupil distortion and astigmatism in the first series, a second series with the use of preoperative Pilocarpine was performed. In this series, pupillometry was also performed pre‐ and postoperatively.

Conclusions

The current study investigates the influence of preoperative Pilocarpine on the safety outcomes of this procedure.
Assessment of chorioretinal blood flow and vessel diameter by laser speckle flowgraphy in three animal models
Authors: Wei X. , Barathi A. , Sai B.B. , Balne P.K. , Khandelwal N. , Agrawal R.
Published: September 2016

Purpose

To investigate the differences in optic nerve head (ONH) blood flow and retinal vessel diameter measured by laser speckle flowgraphy (LSFG) in C57 BL/6 (wild type) mouse, Akita (diabetic) mouse, and wild‐type monkey models.

Methods

LSFG measurements of mean blur rate (MBR), relative flow volume (RFV) and vessel diameter were obtained in 20 C57 BL/6 mice, 10 Akita mice and 8 wild‐type monkeys. Comparisons of the three measurements were made between C57 BL/6 and Akita mouse models, and between C57 BL/6 mouse and monkey models using Student's t‐test.

Results

RFV which measures retinal blood flow, was significantly reduced in one of the retinal veins (V4, p = 0.004) as well as globally (p = 0.04) in Akita mice compared to C57 BL/6 mice. There were no significant differences in MBR which is a measure of ONH choioretinal blood flow, or retinal vein diameter between C57 BL/6 and Akita mice. In monkeys, we noted significantly increased MBR (p < 0.001) compared to C57 BL/6 mice. There were also increased RFV and vein diameter in two of the retinal veins (V4 and V6) as well as globally in monkeys.

Conclusions

Diabetic mice had compromised retinal blood flow while maintained similar level of ONH total choroiretinal blood flow compared to wild type mice. This may indicate retinal vessels are more affected by diabetes compared to choroidal vessels. Our data also suggest that ONH total and retinal blood flow and retinal vein diameter were increased in big monkey model compared to small mouse models.
Ocular manifestations in dengue fever
Authors: Remond A.L. , Butel N. , Fardeau C. , Errera M.H. , Le Hoang P. , Bodaghi B.
Published: September 2016

Purpose

Dengue fever, a viral disease epidemic in some parts of the world, caused by a virus, is characterized by fever, headache, muscle and joint pains. Ocular manifestations are uncommon, but of great significance. Main symptoms include blurring of vision, scotomata, metamorphopsia, and floaters. We describe the clinical spectrum of fundus manifestations and angiographic, optical coherence tomographic and electrophysiology features of dengue‐ associated maculopathy in few patient.

Methods

We reviewed clinical records and report 6 serial cases of ophthalmic complications resulting from dengue infection. Serology was positive in 100%. Investigations included Humphrey automated visual field analyzer, optical coherence tomography, fundus fluorescein and indocyanine green angiography, and electrophysiology.

Results

12 eyes of 6 patients, 5 women and 1 man, were studied. The mean age was 26.8 years.The mean log MAR presenting best corrected visual acuity was 0.53 (range of 1 to counting fingers). Multiple retinal yellowish deposits at fovea were an usual finding in 9 eyes. Of these, optical coherence tomography (OCT) showed focal disruption of the outer neurosensory retina in 8 eyes, and indocyanine green angiography corresponding hypofluorescent spots in 3 eyes. Intraretinal hemorrhage was seen in 1 eye, in association with an artery sheathing. In this case, OCT showed a thickening of the inner retina, the result of retinal arteriolar occlusion. Central or paracentral scotomas were observed in 83%. Multifocal electroretinography showed decreased foveal and parafoveal responses. Final visual acuity increased while relativ scotoma remained.

Conclusions

Ocular damage in Dengue fever are extremely varied and all examinations are needed to better characterize the lésion and thus assess the best visual prognosis of often young and active patients.
Analysis of retinal and choroidal thickness in the macular area in patients with Parkinson's disease using swept‐source optical coherence tomography
Authors: Obis J. , Cipres Alastuey M. , Villades E. , Garcia‐Martin E. , Satue M. , Rodrigo M.J.
Published: September 2016

Purpose

To analyze the retinal and choroidal thickness in the macular area in patients with Parkinson's disease (PD) using swept‐source optical coherence tomography (SS‐OCT) as a marker for neurodegenerative injury.

Methods

108 eyes of patients with PD and 90 eyes of healthy controls were included. All subjects underwent ophthalmologic evaluation including retinal and choroidal assessment using SS‐OCT Triton (Topcon), 3DH Wide protocol. Macular ETDRS data were analyzed, including retinal and choroidal thickness evaluation.

Results

Patients with PD revealed significant thinning compared to healthy controls concerning the outer nasal region of macular thickness (276.70 ± 17.64 μm in patients vs. 282.44 ± 9.64 μm in controls; p = 0.043). Regarding choroidal thickness, patients with PD revealed significant thickening compared to healthy controls in the inner nasal region (250.78 ± 99.50 μm in patients vs. 205.28 ± 81.62 μm in controls; p = 0.014), outer nasal region (207.11 ± 97.78 μm vs. 163.39 ± 70.02 μm; p = 0.011), inner inferior region (252.25 ± 96.54 μm vs. 213.65 ± 80.31 μm; p = 0.032) and outer inferior region (233.00 ± 89.10 μm vs. 200.15 ± 75.19 μm; p = 0.049).

Conclusions

PD patients present reduced retinal thickness and increased choroidal thickness in the macular area compared to healthy subjects detectable with new SS‐OCT technology.
Case report of a choroidal ganglioneuroma
Authors: Van Ginderdeuren R. , Missotten G.
Published: September 2016

Purpose

To describe an extremely rare ganglioneuroma of the choroid.

Methods

A 68 year old man was referred for longstanding retinal detachment on his right eye. There was loss of vision to <0.01 without pain or trauma. The left eye was normal. He was in normal good health. A retinal detachment with subretinal mass mid‐peripheral was detected and a metastatic disease was the most probable diagnosis. After general investigations and full body scan, no other suspicious tumors were found. After consultations the patient choose to have his eye enucleated and the eye was sent for histopathology.

Results

Pathology examination revealed a broad and flat choroidal tumor consisting of mature nerves and ganglion cells. A retinal detachment with atrophy of photoreceptor layers, and large zones with hemorrhage were present. There were no signs of atypia, pleiomorphisme or malignancy remarked. The abnormal tissue stained positive with S100, neuron specific enolase, neurofilamnet and synoptophysine. Ki67 was negative.

Conclusions

An unexpected diagnosis of benign ganglioneuroma of the choroid was established. This is an extremely rare tumor an a non‐Neurofibromatosis‐1 adult man.
Transmission electron microscopy study of the collagens of the trabecular meshwork in glaucoma patients
Authors: Ramirez A.I. , García‐Antón M. , Rojas B. , Salazar J.J. , de Hoz R. , Triviño A. , Escribano J. , García‐Feijoo J. , Ramírez J.M.
Published: September 2016

Purpose

To analyze the ultrastructural features and the distribution of the collagens of the different regions of the trabecular meshwork (TM) in patients with primary open‐angle glaucoma (POAG) and primary congenital glaucoma (PCG).

Methods

Iridocorneal angle tissue from healthy donors and surgical specimens from trabeculectomies of glaucomatous patients were fixed with glutaraldehyde and processed for examination by transmission electron microscopy (TEM).

Results

In comparison with normal eyes, both the trabecular beams and the juxtacanalicular tissue of glaucomatous eyes had changes in the size, distribution, and organization of fibrillar collagens (type I, III, V), non‐fibrillar collagens (type IV), and filamentous collagens (type VI).

Conclusions

The ultrastructural changes detected in collagen constituents of the trabecular meshwork impair its biomechanics and increase aqueous humor outflow resistance, thus contributing to the elevation of the intraocular pressure.
Macular thickness and retinal layer measurements in multiple sclerosis patients using new Swetpt‐Source Optical coherence tomography Triton device
Authors: Cipres Alastuey M. , Vilades Palomar E. , Garcia Martín E. , Satué M. , Rodrigo M.J. , Obis Alfaro J.
Published: September 2016

Purpose

To evaluate macular thickness measurements changes in multiple sclerosis (MS) patients using Swept‐source optical coherence tomography (SS‐OCT)

Methods

101 healthy and 97 MS eyes were included in the study. All of them underwent evaluation of retinal measurements using DRI Triton 3DH wide scan SS‐OCT. Nine macular ETDRS areas, average and central thickness, total macular volume and choroidal thickness were analysed. Comparisons between the two groups were performed using Student's T test

Results

All retinal measurements in the ETDRS macular map showed significant reduction in MS patients. Average thickness (280.41 μm in controls vs. 266.96 μm in patients, p = 0.010) and total macular volume (7.92 μm vs. 7.54 μm; p = 0.010). No significant reduction of the choroid layer thickness was found between patients and controls

Conclusions

SS‐OCT Triton is an efective method to detect retinal atrophy in MS patients. Further studies comparing Spectral domain and Swept source OCT are needed to demonstrate superior capability of SS‐OCT technology to detect retinal changes.