bluuebunny/crossref_metadata_2025 huggingface dataset:
Choroidal thickness changes determined by SS OCT following intravitreal bevacizumab
Authors: RUIZ MORENO JM , MONTERO JA , RUIZ‐MEDRANO J , FLORES‐MORENO I , LUGO F
Published: November 2013

Purpose To report choroidal thickness (CT) changes using a SS OCT prototype following intravitreal bevacizumab injections.

Methods Seventeen patients were treated by one single intravitreal 1.25 mg injection of bevacizumab (IVB). The macular area was examined using an SS‐OCT prototype system based on swept‐source OCT and was used to image the full‐thickness choroid and sclera. A CT profile of the macula was created by manually measuring CT (from the posterior edge of retinal pigment epithelium to the choroid/sclera junction) subfoveally, and three further determinations were performed every 750 μm temporal and nasal to the fovea.  CT was determined immediately before and 24 hours after performing 1.25 mg IVB.

Results Seventeen eyes from 17 patients (11 eyes with exudative age related macular degeneration, 4 eyes with retinal vein occlusion, 1 eye with myopic choroidal neovascularization, and 1 eye with diabetic macular edema) were examined. Nine patients were male and 8 were female. Mean age was 73 ± 11years range 53 to 88. Pearson correlation coefficient among observers averaged 0.90 (range 0.54 to 0.99). Changes in choroidal thickness were not significant for any of the determinations (Student t test for paired data). Changes in central foveal thickness were almost statistically significant (Student t test for paired data).

Conclusion Our findings suggest that one single IVB does not seem to induce acute choroidal thinning.
HMGB1 is a potent inducer of choroidal angiogenesis through a MyD88‐dependent manner
Authors: KIM Y , KERUR N , LI S , AMBATI J
Published: November 2013

High‐mobility group box 1 (HMGB1) is an endogenous alarm sensor against extracellular damage signals and initiates TLR (toll‐like receptor) responses closely linked to angiogenesis through MyD88, its specific adaptor protein. Interest in regulation of HMGB1‐TLR as a potential therapeutic approach is increasing but this regulatory effect in pathologic angiogenesis still remains unclear. Through a mouse model of laser coagulation‐induced choroidal neovascularization (CNV) we confirmed that disturbing HMGB1 by its specific antibody and recombinant HMGB1 protein significantly reduces and induces CNV, respectively. To examine whether HMGB1 influences CNV through TLR signal, we then used MyD88 KO mice and the effects of HMGB1 antibody and recombinant protein on CNV completely blocked. Taken together, these data suggest that HMGB1 is a potential endogenous or exogenous regulator of pathophysiologic angiogenesis and MyD88 is an essential mediator for HMGB1‐induced angiogenesis.
Choroidal thickness measurement in children using optical coherence tomography
Authors: BIDAUT GARNIER M , SCHWARTZ C , PUYRAVEAU M , MONTARD M , DELBOSC B , SALEH M
Published: November 2013

Purpose To measure choroidal thickness in children of various ages by using spectral optical coherence Tomography with enhanced depth imaging (EDI). The primary outcome was to measure choroidal thickness in children. The secondary outcomes were to investigate the association between subfoveal choroidal thickness and ocular axial length, age, gender, weight, and height in children.

Methods Hospital‐based cross‐sectional study. Healthy children visiting at the University Hospital of Besançon were prospectively included between May and August 2012. Optical coherence tomography with the EDI system (Spectralis®, Heidelberg, Germany) was used for choroidal imaging at nine defined points of the macula of both eyes. Axial length was measured by using IOL Master® (Carl Zeiss. Meditec. USA). Height, weight and refraction were recorded.

Results Three hundred forty height eyes from 174 children were imaged. The mean age of the children studied was 8.70±2.89 years (mean±SD); range 3.5‐14.9 years. The mean subfoveal choroidal thickness in right eyes was 341.96±74.7 µm. Mean axial length was 22.30±1.05mm. Choroidal thickness increased with age (r=0.24, p=0.017), height and weight but not with sex (p>0.05). It was also inversely correlated to axial length (r=0.24, p=0.001). There was a moderate correlation between the two eyes in terms of choroidal thickness (r=0.6). The nasal choroid appeared thinner than in the temporal area (ANOVA, p<0.0001)

Conclusion In children, choroidal thickness increases with age and is inversely correlated to the axial length. There is a significant variation of the choroidal thickness between children of the same age.
Evaluation of optical features of the macula in multiple sclerosis
Authors: VARGA BE , TATRAI E , LAURIK L , OLVEDY V , SIMO M , NEMETH J , SOMFAI GM , DEBUC D
Published: November 2013

Purpose Differences in optical and irregularity measures of abnormal retinal tissue may provide additional information of impairment of the retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer complex (GCL+IPL) in multiple sclerosis (MS). The purpose of our study was to estimate these retinal changes in MS.

Methods Twenty‐seven patients with MS were examined using Stratus OCT. The raw macular OCT data was exported and processed using OCTRIMA software and the fractal dimension (FD) and layer index (LI) values of seven intraretinal layers were obtained. The enrolled eyes were divided into two groups, based on ON in the history (ON+ group, n=13 and ON‐ group, n=14). Data of 73 healthy subjects (N) were used as controls. ANOVA with Newman‐Keuls post‐hoc analysis was used for the comparison of FD and LI values. The level of significance was set at p<0.001.

Results A significant decrease was observed in LI in the entire macula and the perifoveal region in RNFL (12.4±1.4, 10.8±0.8, 9.3 ±1.4 and 14.0±1.7, 12.0±0.9, 10.0±1.7 for the N, ON‐ and ON+ groups, respectively). The RNFL in the ON‐ group was significantly different from both the N and ON+ groups (p<0.001 for all comparisons). No significant changes were found in the other layers. A significant increase was observed between the ON‐ and ON+ groups in FD in the entire macula and the perifoveal region in the RNFL layer (1.8±0.04, 1.8±0.07 p<0.001 and 1.6±0.06, 1.6±0.1 p<0.001, respectively) but no significant changes were found in the other layers.

Conclusion In MS, the optical features of the ganglion cells and the RNFL also change besides the pathological remodeling of macular tissue. This result may help to improve the diagnostic efficacy of OCT in MS.

Commercial interest
Visual evoked potentials, short wave‐length automated perimetry, standard automated perimetry, contrast sensitivity and stereoacuity testing in visually asymptomatic eyes of patients with multiple sclerosis
Authors: HERAVIAN J , NAJJARAN M , FOROUGHIPUR M , AZIMI A , SABER MOGHADDAM A , OSTADIMOGHADDAM H , YEKTA A , KHOSHSIMA J
Published: November 2013

Purpose To evaluate the efficacy of PVEP, standard automated perimetry, short‐wavelength automated perimetry, CS, stereoacuity in detecting subclinical visual impairment in patients with multiple sclerosis (MS) and no history of optic neuritis.

Methods Twenty‐seven MS patients (average age 33.81±9.33 years) underwent PVEP with 60 and 15‐minute arc check sizes, SAP (Humphrey 750‐II, SITA standard strategy), SWAP (program central 30‐2), CS, Stereoacuity by RSA test. They were age and sex matched with twenty seven normal subjects.

Results Stereoacuity was significantly reduced in MS group compared with controls. (p=0.007). P100 latency time for both check sizes was significantly prolonged in MS group compared with controls (p=0.005). P100 amplitude significantly reduced in MS group compared with controls (p<0.001). When comparing MS patients with the control group significant differences were found for SAP MD, SWAP MD, SAP PSD, SWAP PSD (p<0.001). By considering predefined criteria, asymptomatic MS patients have shown abnormal stereoacuity in 22.2%, abnormal VEP in 40.7%, abnormal CS in 37%, abnormal SAP in 44% and abnormal SWAP in 37% of patients.

Conclusion Our results concluded the probable presence of subclinical visual impairment among MS patients without optic neuritis history and no visual symptoms. The Pattern VEP and perimetry test together are useful choices in the regular assessment of these patients.
Relevance of contrast sensitivity for the diagnosis and monitoring of early stages of Alzheimer's disease
Authors: GARCIA MARTIN ES , ROJAS B , DE HOZ R , GIL P , YUBERO R , RAMIREZ JM
Published: November 2013

Purpose Several visual tests can be used to determine the behavior of neurons, including the contrast‐sensitivity test (CST), which analyzes the actions of retinal ganglion cells and their cortical processes. Brain atrophy, one of the characteristic signs of Alzheimer’s Disease (AD), is caused by severe loss of neurons in the brain, including several areas known to be involved in visual processing. Our aim was to analyze CST changes in early AD in order to ascertain whether or not CST could be used for AD diagnosis and progression control of the disease.

Methods Twenty GDS 4 AD patients, and 25 controls were examined at the Hospital Clínico San Carlos in Madrid (Spain) and underwent a complete ophthalmologic exam (visual acuity, refraction, CST, color test, biomicroscopy, IOP, and fundoscopy). The CST used was CSV‐1000 E chart test, providing for four rows of sine‐wave gratings, which test the spatial frequencies of 3, 6, 12, and 18 cycles/degree. The chart was presented at 2.5 m.

Results In AD patients, the CST proved lower in all spatial frequencies, the greatest decrease affecting the highest frequency.

Conclusion In early AD, the CST registered a decline in the function of both magnocellular and parvocellular retinal ganglion cells. The CST could be a useful tool for early diagnosis and follow‐up of AD patients.
Retinal layer segmentation: Non‐invasive technique demonstrating hyperplasia of nerve fibers and ganglion cells in the Ataxia of Charlevoix‐Saguenay
Authors: GARCIA MARTIN E , BAMBO MP , SATUE S , HERRERO R , OTIN S , GAZULLA J , ALFARO J , VELA A , LARROSA JM , POLO V , PABLO LE , ASCASO J
Published: November 2013

Purpose To present a new retinal layer segmentation technique, in order to evaluate the existence of nerve fiber hyperplasia in patients with the autosomal recessive spastic ataxia of Charlevoix‐Saguenay (ARSACS).

Methods This observational cross‐sectional study included five patients with a molecular diagnosis of ARSACS and 5 sex and age‐matched healthy controls underwent a full ophthalmologic examination, which included a new technique to segment the retinal layers using Optical Coherence Tomography. Images and data were correlated with diffusion tensor colour encoded MRI maps, diffusion tensor tractographies, and retinal anatomopathological analysis.

Results Every patient showed increased thickness in the internal layers of the retina (inner limiting membrane, nerve fiber layer and ganglion cell layer) in OCT evaluation. These findings suggest the presence of neurofilamentous hyperplasia in the retina of patients with ARSACS and correlated with anatomopathological findings.

Conclusion We found evidence of ganglion cell and nerve fiber hyperplasia in the retina of ARSACS patients. Thus, a revision of the aetiopathogenic mechanisms is necessary in this disease.
Eye and optic tract function in patients with cavernous sinus meningioma undergoing CyberKnife robotic radiosurgery
Authors: ORSKI M , TARNAWSKA D , WYLEGALA E
Published: November 2013

Purpose To assess 6–month radiation–related ocular side effects in patients udergoing CyberKnife Robotic Radiosurgery which enables delivery of beams of high dose radiation with extreme accuracy. Ocular side effects after radiation therapy have been reported and include: dry eye syndrome, eyelash loss, cataract formation, retinopathy, corneal changes, neovascular glaucoma, optic neuropthy.

Methods We examined 9 patients undergoing CyberKnife Robotic Surgery for meningiomas located close to optic chiasm in order to assess effects of radiation on ocular tract function. Patients received 18 Gy in 3 fractions. Doses delivered to optic tract were on average 15 Gy in 3 fractions. Ocular structures involve extremely radiosensitive tissues such as natural lens as well as relatively resistant tissues:cornea, sclera and optic nerve. Slit lamp biomicroscopy with dialated fundus exam, Best Corrected Visual Acuity (BCVA), Intraocular Pressure (IOP), Endothelial Cell Count (ECD), cataract formation, Retinal Nerve Fiber Layer (RNFL) and Central Macular Thickness were obtained at a baseline and six months after radiotherapy

Results No pathological changes in slit lamp examination with dialated fundus exam were revealed. No significant cataract formation or progession was observed. No statistically significant changes in measured parameters regarding eye, optic nerve and optical tract were observed (p>0,05 Wilcoxon paired test).

Conclusion Our study did not show any significant inluence of radiation to eye and optic tract in patients treated with CyberKnife Robotic Radiosurgery for brain lesions in six month follow up period. Further observation of potential radiation–related ocular complications is required.
Effects of cyclosporine in an experimental rat model of dry eye
Authors: CIMBOLINI N , ANTONELLI S , FERAILLE L , MARGARON P , ELENA PP
Published: November 2013

Purpose Dry eye syndrome is a relatively common disease with multifactorial causes. It has been shown that rodent models of dry eye experimentally induced by scopolamine, a tropane alkaloid drug with muscarinic antagonist effects, could be helpful to test and select therapeutic candidates in the disease. Here we propose to show the action of cyclosporine A, an inhibitor of T‐cell activation and inflammatory cytokine production, after oral and topical administrations.

Methods Experimental dry eye was induced in female albino rats by a systemic and continuous delivery of scopolamine (20 mg/day) over 21 days via osmotic pumps implanted subcutaneously on day 1. Animals were divided in three groups of five animals: The first two groups were instilled either saline or cyclosporine 0.05% eye drops and the third group received 20mg/kg/day cyclosporine by oral administration. Tear production was measured with the phenol red thread test, tear break‐up time was studied under slit‐lamp, and corneal defects were examined by slit‐lamp observation using blue light after 0.5% fluorescein eye drop instillation and in vivo confocal microscopy. These examinations were performed in both eyes at baseline and on days 7, 14 and 21.

Results Cyclosporine orally or topically administered significantly reduced clinical signs of dry eye by increasing lacrimation and decreasing corneal defect.

Conclusion Cyclosporine appears to show efficacy in this model, regardless of the mode of administration.

Commercial interest
Full‐field optical coherence tomography of human donor and diseased corneas
Authors: GHOUALI W , GRIEVE K , BELLEFQIH S , LAROCHE L , PAQUES M , BORDERIE V
Published: November 2013

Purpose To evaluate the performance of a full‐field optical coherence tomography (FF‐OCT) system in the study of human donor and diseased corneas and assess its suitability for use in eye banks

Methods Our study was carried out using a full‐field OCT system from LLTech ®, developed for non‐invasive imaging of tissue structures in depth. Images were acquired on human donor corneas (in normal and oedematous conditions) and surgical specimens of diseased corneas (Fuchs dystrophy, keratoconus, stromal scar after keratitis)

Results The Full‐field OCT device from LLTech® enabled three dimensional images to be obtained with ultrahigh resolution (1 micron in all directions) comparable to traditional histological sections. This allowed a precise visualisation of the cells and the different structures (epithelium, Bowman’s membrane, stroma, Descemet’s membrane and endothelium) in normal corneas , but also in diseased corneas (even in the presence of an oedema), with specific lesions in each condition.

Conclusion Optical and specular microscopy, with a detailed view of the corneal endothelium and a cell density determination, remain the « gold standard » in the study of human cornea grafts. However, full‐field OCT, thanks to a more complete anatomical stydy of the cornea, could be helpful in the evaluation and the selection of human cornea grafts which quality plays a major role in the outlook of the corneal transplant
Expression of Huntingtons disease markers in the cornea of minipig transgenic for the human mutated huntingtin
Authors: ARDAN T , JUHAS S , MOTLIK J
Published: November 2013

Purpose Huntingtons disease (HD) is a neurodegenerative disorder that is caused by an expansion of a polyglutamine (polyQ) domain in the protein of huntingtin (htt). PolyQ expansion above 35–40 results in disease associated with htt aggregation into inclusion bodies. The recent studies have shown that the illness arises not only in neurons, but also in non‐neuronal cells. Purpose of this study was to investigate the expression of selected HD markers (on htt and their aggregates, ferritin and ubiquitin) in corneas of minipig transgenic for the human mutated huntingtin and compare them with corneas of wild type (WT) minipig.

Methods In this study we used WT minipigs and minipigs transgenic for N‐terminal part of the human mutated huntingtin (both F2 generation, age 24 months). HD markers were examined on cryostat sections immunohistochemically by using the following primary antibodies: anti‐polyglutamines, anti‐polyglutamine‐expansion diseases marker, MW8 marker, anti‐ferritin and anti‐ubiguitin.

Results Immunohistochemical examination on huntingtin demonstrated the increased expression of this protein in corneal epithelium and keratocytes of transgenic minipig in comparison with wild type cornea. The expression of ferritin detected in epithelial cells was very low in both studied corneas without significant difference between them. No nuclear inclusions or ubiquitous proteins were found in the cornea of transgenic minipig.

Conclusion This study showed that preclinical (silent) stages of HD are characterized by an elevated level of mutagenic huntingtin without formation of nuclear inclusions and ubiquitination of proteins. Supported by CHDI Foundation (A‐5378 and A‐5379), TA01011466, CZ.1.05./2.1.00/03.0124 and RVO: 67985904.
Ultrastructure features of dhub lizard (Uromastyx aegyptia) cornea
Authors: AKHTAR S , ALKHALAF M , KHAN A , ALMUBRAD T
Published: November 2013

Purpose The Dhub lizard (Uromastyx egyptia) belongs to the family Agamidae and sub‐family Uromasticinae, which is native of very dry and harsh desert climates. We report ultrastructural features of the dhub lizard cornea.

Methods Four corneas of dhub lizards were fixed in 2.5% glutaraldehyde containing cuprolinic blue in sodium acetate and magnesium chloride buffer. The tissue was washed in the buffer and dehydrated in a graded series of ethanol. The tissue was embedded in spur resin. The ultrathin sections were observed under a JEOL 1400 transmission electron microscope.

Results The cornea of the dhub lizard is very thin (approximately 28µm) and consists of 4 layers: epithelium, stroma, Descemet’s membrane and endothelium. The sub‐epithelial lamellae of the anterior stroma consisted of three or four collagen fibrils interlaced with each other. The lamellae in the anterior, middle and posterior were also thin and running parallel to each other. The epithelium constitutes approximately 14% of the cornea, whereas the stroma constitutes 80% of the cornea. The mean diameter of CF and PGs mean area in the anterior stroma were larger compared to the mean diameter and mean PGs area of the middle and posterior stroma.

Conclusion The relatively thick epithelium of the cornea protects the stroma from drying out in the desert environment. The presence of large PGs suggests that they keep the hydration of the stroma at optimum level in the dry weather.
Galilei Dual Scheimpflug Analyzer: Corneal thickness and anterior chamber characteristics in healthy human eyes
Authors: SEGURA CALVO F , SANCHEZ‐CANO A , LOPEZ DE LA FUENTE C , FUENTES‐BROTO L , ORDUNA HOSPITAL E , PINILLA I
Published: November 2013

Purpose To evaluate the repeatability of Corneal Thickness (CT) measurements and the normal values of Anterior Chamber Volume (ACV), iridocorneal angles and Anterior Chamber Depth (ACD) in healthy human eyes.

Methods Pachymetry and Anterior Chamber (AC) parameters were recorded prospectively in a consecutive case series of 52 normal eyes. All the studied subjects had no ocular abnormalities rather than mild refractive error less than D EE. Measurements were performed using the Galilei Dual Scheimpflug Analyzer.

Results There was a high intra‐observer agreement, finding the best value in the thinnest central CT with an intra‐class correlation coefficient (ICC) of 0.999 and the worst, in the peripheral CT, with an ICC of 0.807. ICC of 0.997 and 0.994 were found in central and paracentral CT respectively. The mean values ± SD for the AC parameters were: ACD 3.29mm ± 0.27mm; ACV 123 mm3 ± 49.05mm3; Temporal Angle ACD 37.58º± 2.83º; Superior Angle ACD 36.71º± 4.05º; Nasal Angle ACD 37.17º± 3.19º and Inferior Angle ACD 38.55º± 3.71º.

Conclusion Galilei device allows a noninvasive measurement of different AC parameters. These data provides benchmark information that can be used to monitor and assess clinical practice; besides pachymetry is found to be a highly repeatable parameter.
Pragmatic approach in a case of unknown bilateral corneal opacity and staphyloma in a child in Timor Leste
Authors: GRAEFF E , MEYER P
Published: November 2013

Purpose To demonstrate limited diagnostic and therapeutic options in ophthalmology in Timor Leste on the basis of a clinical picture of unknown corneal opacity.

Methods Clinical‐pathological case report.

Results A six year old girl was referred into the clinic because of a progressive corneal opacity in both eyes ‐ left more than right ‐ known since 18 life months. Clinically a light perception of the right eye could be observed. The left eye was amaurotic. A complete grayish‐ white opacification of both cornea which impeded any clinical examination of anterior and posterior segment were found.The surface of the left cornea was obviously bulged out, accordingly a proper lid closure was impossible. Further diagnostic testings like ultrasound, CT‐scanner, MRI or blood examination were not possible due to the limited resources. Assuming for a severe pathology and particulary a possible untraeted superinfection later on a evisceration was performed in general anaesthesia on the left eye. Histology done in Switzerland showed congenital corneal staphyloma with marked thickening of the cornea due to abnormal stromal connective tissue. Additionally, absence of Bowman and Descemet membranes as well as large anterior and focal posterior synechias of the iris were found.

Conclusion The present pathologic findings were compatible with a very rare manifestation of Peters anomaly combined with abnormally thick intracorneal fibrosis and congenital corneal staphyloma. In the absence of any clinical supplementary examinations, a malignant intraocular tumour could be excluded histologically.
Evaluation of transplanted oral epithelium by confocal microscopy corelates with success rate in aniridia patients
Authors: WOWRA B , DOBROWOLSKI D , WROBLEWSKA‐CZAJKA E , GROLIK M , WYLEGALA E
Published: November 2013

Purpose To evaluate success of transplanted oral epithelium in corneal surface reconstruction in aniridia patients

Methods 25 patients suffered from congenital aniridia accompanied by aniridial keratopathy underwent COMET procedure. Confocal microscopy examination was performed 7, 14 and 28 days after transplantation. Number of cell layers, cell density and stability of epithelium was evaluated

Results The survival of transplanted oral epithelium is corelated with early postoperative evaluation of epithelial graft

Conclusion Confocal microscopy examination could be useful to predict survival time of oral epithelial graft
Diagnosis of infectious keratitis by mass spectrometry
Authors: HOFFART L , DRANCOURT M , DORNADIN A
Published: November 2013

Purpose Microbial keratitis is an infection of the cornea that can be severe since it leads, in some cases, to blindness. One of the most important prognostic factors is the microbiological diagnosis which determines the rapid use of the appropriate treatment. Therefore we sought a faster and more efficient diagnosis method by using mass spectrometry.

Methods This study is the analysis of corneal samples with MALDI‐TOF MS as a new approach, undeveloped in the literature, without preparation nor culture of infected epithelia. All together 18 human corneal epithelia were studied to characterize the healthy human corneal spectra. An animal experimentation was also conducted on 45 Balb/c mice for comparison of their left healthy corneas and their right infected corneas by two difficult diagnosis seeds: Mycobacterium chelonae or Acanthamoeba polyphaga.

Results Corneal protein spectra can be obtained quickly, in less than ten minutes, and easily by simple deposit on a mass‐spectrometry target. The study of healthy corneas gives reproducible and specific spectra compared to other human tissues available in our database. In animal model, the MALDI‐TOF MS detects an inflammatory response secondary to wound healing corneal and an infectious response to Mycobacterium chelonae.

Conclusion This original work consists in using MALDI‐TOF MS for a microbial keratitis analyze directly on infected epithelium. This technique permits, to differentiate easily and quickly, a healthy cornea from an ulcerated or infected one in mice. After the development of microbiologic recognition algorithms, mass‐spectrometry could be used, in the future, for a “minute” diagnosis of infectious keratitis.Diagnosis of infectious keratitis by mass spectrometry.
The use of tear osmolarity as a diagnostic tool for detection of dry eye prior to cataract surgery
Authors: BAUMANN A , COCHENER B
Published: November 2013

Purpose To determine if the diagnosis of preoperative dry eye can help to improve outcomes following cataract surgery.

Methods This was a prospective that enrolled cataract patients scheduled to undergo standard phacoemulsification surgery followed by placement of an intraocular lens. Patients were assessed for the presence of dry eye before surgery, and then at one week and one month after surgery. Tests used were tear break‐up time (TBUT), Schirmer’s, and tear osmolarity (TearLab Corp, San Diego, CA). All patients were placed on a standard postoperative treatment regime of topical steroids, non‐steroidal anti‐inflammatory drugs (NSAIDs) and antibiotics for one month following surgery.

Results Twenty‐five patients were enrolled in the study. The mean preoperative tear osmolarity was 304.6 mOsm/L Twelve patients had preoperative dry eye, defined as a tear osmolarity level greater than 308 mOsm/L. Mean osmolarity remained stable at the 1st postoperative visit.. At the one‐month postoperative visit, the mean osmolarity was 297.4 mOsm/L.

Conclusion The results suggest that conventional means of dry eye testing may miss patients with preoperative dry eye, compared to osmolarity testing, which provides an objective measurement. The lower postoperative osmolarity levels seen in this study were no doubt related to the postoperative medication regimen and it would be reasonable to expect that the osmolarity measurement would return to baseline after treatment stopped .
Visual acuity outcomes after Descmet’s stripping automated endothelial keratoplasty compared to penetrating keratoplasty
Authors: MOUNA ALI , PREMY S , AGAPIE A , JEAN‐COLAS A , AMELOOT F , MANEA G , PERONE J
Published: November 2013

Purpose To evaluate the difference in visual recovery between Descmet’s Stripping Automated Endothelial Keratoplasty (DSAEK) and Penetrating Keratoplasty (PK).

Methods Retrospective cohort study of 42 eyes. 21 eyes underwent PK compared to 21 eyes underwent DSAEK for a Fuchs’ dystrophy or pseudophakic bullous keratopathy. Preoperative and postoperative best spectacle‐corrected visual acuity (BSCVA) was recorded at 1, 3, 6 and 12 month. The PK and DSAEK procedures were performed by the same experienced surgeon with the same donor and similar recipient criteria. All patients underwent a standardized examination that included tonometry, visual acuity (distance and near) and biomicroscopic examination at 1 month, 3 month, 6 month and 12 month. Improvement in BSCVA between each point time was evaluated using paired‐samples t tests.

Results The donor and recepient demographics were comparable in the PK and DSAEK groups. In the PK group, the visual recovery was significant after 12 month (1,71 logMAR +/‐ 0,33 to 1,25 logMAR +/‐ 0,58; P=0,023). The mean distance gain was 4,53 lines and the mean near gain was 3,89 lines. In the DSAEK group, the visual recovery was significant after 3 month (1,05 logMAR +/‐ 0,50 to 0,68 logMAR +/‐ 0,38; P=0,025). The mean distance gain was 4,25 lines and the mean near gain was 5,7 lines. The mean distance gain was equivalent between the two groups (P=0,91), and the mean near gain was statistically superior in the DSAEK group (P=0,47).

Conclusion There is a faster visual recovery and a more significant near gain after DSAEK surgery for Fuchs’ endothelial dystrophy or pseudophakic bullous keratopathy.
Reproducibility of the thickness of Lasik corneal flaps made by IntraLase FS 60 laser femtosecond (IntraLase, AMO USA) measured by OCT spectral domain (Heidelberg, Germany)
Authors: ABRIEU LACAILLE M , RAMBAUD C , CREPY P , FROUSSART MAILLE F , RIGAL‐SASTOURNE JC
Published: November 2013

Purpose The objective of this study was to appreciate the reproducibility of the thickness of Lasik corneal flaps made by the IntraLase FS60 laser femtosecond (IntraLase, AMO USA).

Methods It was a retrospective, randomized, double‐blind study.Twenty eight eyes were included in the study. Every flap was program to measure 120 µm. The flaps were measured by Spectral Domain OCT (Heidelberg), one month after surgery in five points on a horizontal line through the center of the pupil (center, 1mm and 2 mm from the center pupil in nasal and temporal) The scheduled and the obtained thicknesses were compared in each point.

Results Double reading by two different doctors showed no significant difference in the thickness flap measurements (p<0.3). Average obtained thickness was 6, 84 µm greater than desired thickness (standard deviation of 7, 27 µm), (p<0, 01). The average thickness flap was significantly greater: nasal 2mm: 128µm +/‐7µm, nasal 1mm: 124.4µm+/‐6µm, central: 127.7µm+/‐8µm, temporal 1mm: 125.9µm +/‐7µm, temporal 2mm: 128.2µm +/‐8 µm (p<0.01).

Conclusion We have shown in this study that the cutting of a corneal stromal flap during a LASIK procedure is significant thicker with the IntraLase FS60, but the standard deviation is low.
Age‐related changes in central corneal thickness and corneal endothelial characteristics
Authors: GALGAUSKAS S , NORVYDAITė D , STECH S , ASOKLIS R
Published: November 2013

Purpose To compare how corneal endothelial cell density, their average size and percentage of regular hexagonal cells depends on age; to estimate the average of endothelial cell density and central corneal thickness in diferent age groups.

Methods The data of 211 person (358 eyes), who were examined using a non‐contact specular microscope at the Vilnius University Hospital Santariskiu Clinic Center of Eye Diseases, was analyzed. Parameters examined included corneal endothelial cell density, average size of cells, percentage of regular hexagonal cells, central corneal thickness. Patients age and sex were also noted. All subjects, whose age was from 20 to 89 years, were devided into 7 age groups, each involving 10 years.

Results A total of 114 (54,03%) subjects were women and 97 (45,97%) were men.A strong inverse correlation was observed between subject age and corneal endothelial cell density (r= −0.650, p < 0.01), weak inverse correlation between age and central corneal thickness (r= ‐0,156, p< 0,01) and weak direct correlation between cell density and central corneal thickness (r= 0,232, p< 0,01). Average size of cells was directly correlated with age (r= 0,586, p< 0,01). No correlation between age and percentage of regular hexagonal cells was found (p> 0,05).

Conclusion Young individuals have higher endothelial cell density, which decreases with age. Corneal thickness also decreases, but its dependence on age is weaker. The lower cell density, the lower corneal thickness. Average size of cells is bigger in young subjects. Percentage of regular hexagonal cells does not depend on age.
Analysis of fungal contamination in contact lens storage cases between 2000 and 2012
Authors: BOUHERAOUA N , TEMSTET C , GOLDSCHMIDT P , VAUDRAN P , LAROCHE L , BORDERIE V , CHAUMEIL C
Published: November 2013

Purpose The objective of this study was to identify fungi species isolated in contact lenses boxes from January 2000 to November 2012 and to compare with fungi species found in corneal samples over the same period.

Methods Retrospective study from January 2000 to November 2012. Over the same period, were analyzed isolates from 68 patients with clinical signs of keratomycosis confirmed by corneal samples culture. The temporal analysis (over the last 12 years) of the isolates was performed using the chi2 test pattern.

Results 456/2433 contact lenses boxes fungi (18.7%). Non‐filamentous fungi (yeasts) were isolated in 280 boxes (61.3%), including 85% of Candida (46% Candida parapsilosis) and 15% of other non‐filamentous fungi. Filamentous fungi were isolated in 200 boxes (43.8%): Fusarium sp. (46.5%), Penicillium (23%), Aspergillus (12%)other filamentous fungi (18.5%). Fusarium sp. were isolated in 51.4% of patients with clinical signs of keratomycosis. A significant increase in filamentous fungi (chi2 = 6.4 p <0.05) could be highlighted in contact lens boxes. Increase in Fusarium sp. in contact lens boxes is significant(chi2 = 17.5 p <0.05) as the number of Fusarium sp. keratomycosis (chi2 = 6.2 p <.05). Contact lens wear remains the main risk factor for keratomycosis (54% of patients).

Conclusion Increasing cases of Fusarium sp. kératomycosis must be considered in the development of diagnostic and therapeutic strategies.
Worldwide Eye Banking (WEB) project: International survey of demand and supply
Authors: JULIENNE R , CAMPOLMI N , ALDOSSARY M , THURET G , GAIN P
Published: November 2013

Purpose The whole eye banking (EB) process, from corneal retrieval to surgery, is improving. Paradoxically, corneal blindness worldwide is still increasing. The corneal supply is lagging far behind global demand. Few and partial works exist in this field. This has motivated our international survey: the Worldwide Eye Banking (WEB) project. Our final goal is to identify suitable solutions for countries willing to improve their corneal supply

Methods Design: A descriptive epidemiological worldwide transversal study. A questionnaire consisting of 23 items on keratoplasty and EB was designed. The data was collected from EB staff and corneal specialists via e‐mailing, phone calls or direct interviews during international ophthalmology, eye research or EB congresses

Results Data was collected from more than 100 countries; covering a world population of 6.5 billions. Approximately 125 000 keratoplasties are performed each year from the 175 000 corneas collected. US EBs, first corneal exporter, use short‐term storage while Europeans use long term organoculture. Lamellar keratoplasty is a new trend. Surgical indications have 2 profiles: infections for undeveloped countries; keratoconus and bullous keratopathy in industrial countries

Conclusion This demand/supply disparity is huge in many developing countries. Decreasing demand requires: 1) Trachoma fight in endemic zones 2) Iatrogenic edema prevention. Increasing supply requires: 1) Corneal donation politic dynamism 2) Local eye banking implantation in each country 3) Optimizing storage technique for better efficiency (retrieved/delivered graft ratio) 4) Bioengineering of endothelial graft. No financial interest for all authors
Viable endothelial cell density by triple HEC staining of a failed Descemet stripping automated endothelial keratoplasty
Authors: CAMPOLMI N , GAUTHIER AS , ACQUART S , THEILLIERE C , PEIRERA S , GARRAUD O , HE Z , PISELLI S , THURET G , DELBOSC B , GAIN P
Published: November 2013

Purpose The rate of DSAEK failure decreases during learning curve. It has been previously reported that one of the main cause of rapid DSAEK failure was endothelial cell (EC) loss (Zhang, Arch Ophthalmol 2010). Aim: to report a DSAEK immediate failure and its innovative assessment with determination of the viability of residual EC

Methods In the eye bank, a cornea (donor: 44 years old, organ‐culture: 23 days, ECD the day before cut: 2963 cells/mm2, deswelling 21h) was precut with a single pass of a 350μm head (Moria microkeratome). Lamella thickness was 199μm (ultrasound). The recipient had a Fuchs dystrophy. In the operating room, trephination with a Baron punch was eccentric but insertion was uneventful. The graft failed despite 2 rebubbling. A penetrating keratoplasty was performed 2 months later. During surgery the explanted lamella was immediately incubated with Hoechst 33342‐Ethidium‐Calcein‐AM (HEC triple staining, Pipparelli, IOVS 2011) to determine the viability of residual EC. The thickness map of the lamella was then performed with an OCT (Casia, Tomey). The posterior surface of the recipient corneal button was observed with a macroscope

Results The eccentric trephination caused a important step on 90° of circumference. Unplanned retention of Descemet membrane with guttae was found on the posterior face of the recipient cornea. The viable ECD of the explanted lamella was 585 cells/mm2. Keratocytes of both the lamella and the recipient cornea were viable

Conclusion Allogenic EC and keratocytes survive on a detached lamella at least during 2 months in the anterior chamber of the recipient. Grant: AOL 2012
Intrastromal corneal rings and corneal collagen crosslinking for progressive keratoconus: Comparison of 2 sequences
Authors: SAIB N , BONNEL S , ABRIEU M , RIGAL‐SASTOURNE J
Published: November 2013

Purpose To compare 2 sequences of combined intrastromal corneal ring segment (ICRS) implantation and corneal collagen crosslinking (CXL) in progressive keratoconus.

Methods In this retrospective study, CXL was followed by ICRS implantation (group A) or ICRS implantation was followed by CXL (group B). Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), manifest cylinder and mean keratometry (K) were compared preoperatively and postoperatively.

Results 17 eyes of 10 patients with progressive keratoconus were included in this study, 11 eyes in group A and 6 in group B. The mean interval between treatments was 4.3+/‐2.9 months in group A and 5+/‐4.4 months in group B. The mean age is 27.6 years in group A and 28.4 years in group B. The 2 groups are equivalent preoperatively. The mean UDVA and CDVA improved in both groups (UDVA:0.50+/‐0.22 to 0.60+/‐0.20, group A, and 0.28+/‐0.19 to 0.62+/‐0.22(p<0.05), group B; CDVA:0.60+/‐0.15 to 0.70+/‐0.14 and 0.70+/‐0.14 to 0.88+/‐0.17 respectively). The cylinder and mean k values decreased in both groups (cylinder ‐3.63D+/‐1.27 to ‐0.95D+/‐1.54 (p<0.05), group A and ‐3.60D+/‐1.85 to ‐2.80D+/‐2.19 group B; mean K:44.8+/‐1.45 to 42.8D+/‐1.7 (p<0.05) and 43.98+/‐1.74 to 43.8D+/‐1.8, respectively). SE: values decreased in group A (‐3.4D+/‐1.5 to ‐1.3D+/‐1.4 (p<0.05)) instead increased in group B (‐1.1D+/‐0.8 to ‐1.7D+/‐1.0). Overall, the 2 sequences observed show an improvement in UDVA, CDVA, cylinder and mean K.

Conclusion In our study, there is no statistical difference between the 2 sequences: ICRS implantation followed by CXL or CXL followed by ICRS implantation.
Kyrieleis plaques in herpes zoster virus associated acute retinal necrosis
Authors: KONIDARIS V , BRENT A , VARDARINOS A , DEANE J , EMPESLIDIS T
Published: November 2013

Purpose To present a case of unilateral acute retinal necrosis syndrome (ARNS) with associated Kyrieleis plaques.

Methods A 56 year old male with recently diagnosed ARNS with necrotic lesions, extensive retinitis 360˚ around the arcades and multifocal lesions presented with decreased vision and floaters in his left eye. Anterior uveitis of 3+ cells, with mutton fat keratic precipitates and vitritis 2+ with severe haze settled down following anti‐viral and steroid treatment. Polymerase chain reaction from anterior chamber tap revealed presence of Herpes Zoster Virus.

Results Kyrieleis plaques and segmented periarteritis appeared at presentation and spreaded in the first 2‐3 weeks whilst inflammation was settling down. They affected the majority of retinal arteries near the optic disc; however there was no evidence of sheathing of leakage of the arteries wall on fluorescein angiography.

Conclusion Increased doses of steroids appear to control the inflammation. There was no association found between Kyreileis plaques and severity of inflammation.
High doses of fatty acids for reducing cystoid macular oedema secondary to inflammation or branch retinal vein occlusion
Authors: GEORGIOU T , PHOTIOU DMF , NICOLAOU D , NEOKLEOUS A , MICHAEL S , IKONOMOU C
Published: November 2013

Purpose To evaluate the effect of high doses EPA/DHA for patients with cystoid macular oedema.

Methods 14 eyes with cystoid macular oedema (8 secondary to chronic inflammation and 6 secondary to branch retinal vein occlusion) were treated with 5g/day of EPA/DHA. Visual acuity and macular oedema results from OCT scans were noted.

Results The mean macular oedema was reduced from 564um to 243um in 12 months. The mean visual acuity gain at 12 months was 2.85 lines. No anti‐VEGF injections were given during treatment with high doses EPA/DHA.

Conclusion Innovative therapy of using high doses of fatty acids to reduce macular oedema and improve vision in patients with cystoid macular oedema secondary to inflammation or branch retinal vein occlusion.
Detection of antibodies against homologous Mycobacterium avium subspecies paratuberculosis and beta‐cell antigen zinc transporter 8 epitopes in Sardinian type 1 diabetic patients with proliferative diabetic retinopathy
Authors: PINNA A , MASALA S , BLASETTI F , MAIORE I , BRUNDU E , COSSU D , PACCAGNINI D , SECHI LA
Published: November 2013

Purpose Diabetic retinopathy (DR) is the leading cause of new cases of blindness in developed countries. ZnT8, a beta‐cell membrane protein involved in Zn++ transportation, may act as a major autoantigen in Type 1 Diabetes (T1D). Dysregulation in Zn++ homeostasis has been implicated in the pathogenesis of ischemia in DR. Mycobacterium avium subspecies paratuberculosis (MAP) causes an asymptomatic human infection transmitted from dairy herds through food contamination. MAP3865c, a MAP cell membrane protein, has been shown to display a relevant sequence homology with ZnT8. Moreover, antibodies recognizing MAP3865c epitopes have been found to cross‐react with ZnT8 in T1D patients. The purpose of this study was to detect serum antibodies against 6 highly immunogenic MAP3865c epitopes in T1D patients with proliferative diabetic retinopathy (PDR) and in healthy controls (HCs).

Methods Blood samples were obtained from 23 T1D patients with PDR and 39 HCs. Antibodies against 2 trans‐membrane (MAP3865c125–133 MAP3865c133–141) and 4 C terminal (MAP3865c246–252, MAP3865c256–262, MAP3865c261–267 and MAP3865c281–287) peptides were detected by indirect ELISA. Fisher’s exact test and ROC curves were used to assess results.

Results Antibodies against MAP3865c peptides were found in 6 out of 23 (26%) T1D patients with PDR and 2 out of 39 (5%) HCs, a statistically significant difference (p=0.04).

Conclusion Results suggest that serum antibodies against MAP3865c peptides may play a role in the pathogenesis of PDR in T1D patients.Further larger studies are necessary to confirm these preliminary data.
Risk factors for intraoperative floppy iris syndrome: One year prospective study
Authors: CHATZIRALLI I , PARIKAKIS E , PEPONIS V , MANIATEA A , MITROPOULOS P
Published: November 2013

Purpose Intraoperative Floppy Iris Syndrome (IFIS) was associated with a‐blockers use. Our purpose was to evaluate risk factors for IFIS in patients undergoing phacoemulsification.

Methods Participants in our study were 1024 patients, who underwent routine phacoemulsification cataract surgery. The following data were recorded and evaluated as possible risk factors for IFIS: ophthalmological conditions (glaucoma, pseudoexfoliation, age‐related macular degeneration), sociodemographic features, axial length, hypertension, diabetes mellitus and medications being taken at the time of surgery. Cases were characterized intraoperatively as IFIS and non‐IFIS. Univariate and multivariate logistic regression was performed with SPSS 19.0.

Results IFIS was observed in 61/1024 eyes (5.9%, 95%CI: 4.3%‐7.2%). Current use of tamsulosin, alfuzosin, terazosin, benzodiazepines, quetiapine and finasteride were all independently associated with IFIS. Borderline associations were noted for rivastigmine. Hypertension and short axial length were also significantly associated with IFIS. It is worthy to note that IFIS was not associated with the duration of a‐blockers intake.

Conclusion Apart from the well‐established associations with alpha1‐adrenergic receptor antagonists, this prospective study points to benzodiazepines, quetiapine, hypertension and short axial length as potential risk factors for IFIS.
Transporters of glycine, cystine, glutamate and glutamine in canine lens epithelial cells
Authors: OCHIAI H
Published: November 2013

Purpose The aim of this study is to evaluate GSH synthesis‐related amino acid (glycine, cystine, glutamate and glutamine) transport activity in a canine lens epithelial cell line (cdLEC) and define the transporter.

Methods The primary lens epithelial cells of mature cataract dog were transfected with the expression plasmid DNA of large T antigen from replication origin‐defective simian virus 40 (SV40), then cloned using glass a cylinder. The transport activities of four amino acids in lens epithelial cells were determined. The cDNA sequences of transporter contributing GSH synthesis were also determined.

Results Na‐dependent glycine and glutamate transport activity was 2.70 + 0.26 and 4.40 + 1.10 nmol/mg protein min, respectively. The cystine transport was Na‐independent and the transport activity was 0.626 + 0.17 nmol/mg protein min. The cDNA sequence of the glycine transporter 1(GlyT1), cystine/glutamate exchanger (xCT,), Na‐dependent neutral amino acid transporter 2(ASCT2), and glutamate transporter (EAAT) were determined. Western blot analysis confirmed their expression in membrane protein sample of cdLEC.

Conclusion Lens epithelial cells possess GlyT1, xCT, ASCT2 and EAAT1‐5.