bluuebunny/crossref_metadata_2025 huggingface dataset:
Cortical cataracts: the case for mechanical stress
Authors: Michael R. , Pinilla Cortés L. , Montenegro G.A. , D'Antin J.C. , Barraquer R.I.
Published: September 2016

In previous publications, we found that human cortical and cuneiform opacities are accompanied by changes in fiber structure and architecture mainly in the equatorial border zone between the lens nucleus and cortex. Because the lens cortex and nucleus have different viscoelastic properties in young and old lenses, we hypothesized that external forces during accommodation cause shear stress predominantly at this nucleus‐cortex interface. The location of the described changes suggested that these mechanical forces may cause fiber disorganization, small cortical opacities, and ultimately, cuneiform cataracts.

Recently, we tested our hypothesis in a stretching device for anterior eye segments from human donor eyes. Lenses with cortical cataracts showed ruptures at the nucleus‐cortex interface adjacent to the cortical cataracts. These ex vivo experiments indicate that the nucleus‐cortex interface is vulnerable and it can be separated when external forces are applied. In vivo forces from the attempt to accommodate are smaller, but a continuous action during years may induce micro ruptures at this interface which may lead to cortical cataract.
Controversies in the use of mydriatics
Authors: Labetoulle M.
Published: September 2016

To obtain a good mydriasis is a key step for a safe and efficient cataract surgery. The most common protocols to dilate the pupil before surgery are based on the instillation of several mydriatic eyedrops, usually a mix of parasympatholytic (mostly tropicamide or cyclopentolate) and sympathomimetic (mostly phenylephrine) preparations. This usual regimen is efficient, but presents several disadvantages, including the side effects due to a systemic passage of the drugs, the topical toxicity on the ocular surface, and the time required by the staff to instillate the drops. One emerging alternative is the intracameral injection of the mydriatic drugs, combined with anaesthetics, just before proceeding to the surgery. We will present the results of a multicenter, randomized and controlled study about the use of a standardised intracameral combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1% before cataract surgery, compared to a standard eyedrops regimen. The intracameral mix was safe and non‐inferior to the comparator in terms of pupil dilation, with several potential advantages, including less discomfort during surgery and fewer time spent by the patient in the operating theater.
Anterior chamber lenses
Authors: Moschos M.M.
Published: September 2016

The anterior chamber intraocular lens (ACIOL) is the ideal intraocular lens (IOL) both for implantation during intracapsular cataract extraction and for secondary implantation. It is also useful during extracapsular cataract surgery, being especially indicated if there is a total absence of capsular support.

ACIOLs are preferred over sulcus‐sutured IOLs because they are technically easier to implant, are reasonably well‐tolerated, and have a low rate of postoperative IOL decentration or tilt. However ACIOLs have also become one of the causes of IOL exchange and explantation.

Implant‐related problems such as discrepancies between anterior chamber biometry and IOL size may cause pseudophakodonesis in the aqueous, resulting in progressive endothelial cell loss. Because of endothelial complications, they must be reserved for elderly patients.

Infrequently, ACIOL‐iris contact may lead to pigment dispersion with subsequent inflammation. Occasionally, secondary angle closure and glaucoma with corneal decompensation due to haptic displacement may develop. Due to these reasons, eyes with shallow anterior chambers or early corneal guttata have been treated as relative contraindications for ACIOLs.
Presentation skills for oral presentations
Authors: Jóhannesson G.
Published: September 2016

An important part of being a scientist is communicating findings and results to fellow colleagues and the public. This is often achieved through oral presentation in front of a group of people. How well the message is conveyed to the crowd depends largely on the presentation skills of the oral presenter. Yet many scientists do not get adequate education or training in presentation skills and techniques. Consequently many presenters are forced to learning by doing. This short talk will highlight a selection of tips and tricks to improve the presentation skills for oral presentations.
OCT‐A and FA in irradiation induced microangiopathy
Authors: Zografos L.
Published: September 2016

Irradiation induced microangiopathy of the macular area is a severe complication of conservative management of uveal melanomas with with proton beam teletherapy or plaque brachytherapy. It occurs in 20–30% of the cases according the position of the posterior margin of the tumor and the selection criteria for the various therapeutic options.

The aim of this study is to present the anatomic damage observed in fluoresceine angiography and OCT‐angiography as well as the modifications observed in B‐mode OCT and OCT en face. Following the evaluation of 80 cases of irradiation induced maculopathy, the most meaningfull anatomic damage, which correlates with visual function are the modifications of the outer perifoveal capillary plexus. According the results of this study, a therapeutic approach with anti‐VEGF's can be considered in all the cases presenting minimal or mild vascular damage.
Challenges in the clinical applications of cornea limbal stem cells
Authors: Ferrari S.
Published: September 2016

According to regulation (EC) 1,394/2007 on Advanced Therapy Medicinal Products (ATMPs), manipulation of corneal limbal stem cells for clinical applications aiming to treat limbal stem cell deficiency (LSCD) has to be carried out in certified Cell Factories according to the Good Manufacturing Practises (GMP). For hospitals and tissue banks wanting to provide ATMPs many challenges lie ahead, including (1) setting up GMP laboratories, (2) validating personnel, procedures and analytical methods continuously and (3) dealing with the costs associated with the maintenance of pharmaceutical grade environments. Results from clinical trials have been reported by different groups worldwide and data are so promising that the European Medicines Agency has recently issued the first marketing authorization for a corneal stem cell‐based ATMP. Despite this, the appropriate selection of the patients and follow‐up analyses remain crucial for successful treatments. In the meantime, R&D studies are looking further ahead with research focusing on cell therapy‐based strategies for the treatment of pathologies affecting the conjunctival epithelium and the corneal endothelium and on gene therapy approaches for rare disorders, such as the EEC syndrome.
Ocular pharmacokinetics assessed by in‐vivo microdialysis
Authors: Garhofer G.
Published: September 2016

A key challenge in drug development is to obtain reliable concentration‐time profiles in potential target tissues. For the eye, data regarding drug concentration in the anterior chamber and the vitreous is crucial for optimizing the dosing for topically applied therapies. Given that in most cases, invasive serial probe sampling in humans is not possible for ethical reasons, data regarding drug penetration in the eye routinely relies on in‐vivo animal models. Classical pharmacokinetic models are based on obtaining single samples of the anterior chamber and the vitreous at consecutive timepoints in different animals. In contrast to that, in‐vivo microdialysis offers a new possibility to determine statistically robust pharmacokinetic profiles without including large numbers of animals. As described previously described for other tissues, microdialysis allows for the continuous in‐vivo sampling of analytes in a tissue by implantation of a probe with a semi‐permeable membrane in the target tissue. The current talk aims to give an overview about the microdialysis technique with special regards to the ocular tissues. In addition, advantages and potential disadvantages as well as the limitations of the technique will be discussed.
Tridimensional studies on the adult rat optic nerve head
Authors: Pazos M. , Yang H. , Gardiner S. , Cepurna W. , Elaine J. , Morrison J. , Burgoyne C.
Published: September 2016

Purpose

To reconstruct rat optic nerve heads (ONHs) with unilateral experimental glaucoma (EG), so as to 3D characterize the normal and early EG ONH anatomy in the rat.

Methods

Hypertonic saline was unilaterally injected into the episcleral veins of 8 Brown rats that were sacrificed 4 weeks later. Orbital optic nerve (ON) sections were graded. ONH's were 3D reconstructed, delineated, and parameterized. Overall and individual EG versus control eye differences were studied by linear mixed effect models adjusted for multiple comparisons.

Results

The rat ONH has 2 scleral openings (superior neurovascular and inferior arterial) separated by a sling. In the superior one, the nerve abuts a prominent extension of Bruch's Membrane (BM) superiorly and is surrounded by a plexus. ON and anterior scleral canal opening (ASCO) expansions were significant overall and in 7 EG eyes. In at least 5 EG eyes, significant expansions in BM Opening (BMO) (3–10%), ASCO and Posterior Scleral Canal Openings (PSCO) (8–21 and 8–41%, respectively) were found. ON expansion was correlated to ON damage.

Conclusions

The 3D complexity of the rat ONH has been undervalued in previous 2D studies. ON, BMO and neurovascular canal expand early in response to IOP elevation.
Cytoprotective alpha crystallins in the regulation of RPE cell proteostasis
Authors: Kannan R.
Published: September 2016

AlphaB‐Crystallin (αBC) is an ubiquitous protein with dual function as a molecular chaperone to preserve proteostasis and as an anti‐apoptotic agent. We studied the regulatory role of αBC in murine models of oxygen‐induced retinopathy (OIR), laser‐induced choroidal neovascularization (CNV) and subretinal fibrosis (SF). αBC KO attenuated retinal NV in OIR as compared to WT. In the laser model, CNV lesion size was significantly reduced in αBC KO vs. WT mice. VEGF increased 8 fold in WT vs. αBC KO on day 3 and 7 post‐laser and VEGF secretion was lower in αBC KO vs. WT. Increased mono (tetra)‐ubiquitination of VEGF was observed in αBC siRNA RPE. Further, αBC regulated SF in mice. Attenuation of SF after regression of laser‐induced CNV of αBC KO and a decrease in mesenchymal RPE cells as compared to WT was found. αBC was prominently expressed in SF lesions. TGF‐β induced EMT was further enhanced by αBC overexpression but was inhibited by suppression of αBC. Silencing of αBC inhibited RPE cell proliferation, migration, and fibronectin production. αBC overexpression enhanced nuclear translocation and accumulation of SMAD4 and SMAD5. Thus, αBC is an attractive therapeutic target for AMD with an advantage in controlling both CNV and SF.
Innovative pathology techniques for small tissue samples or cytology of vitreous biopsies
Authors: Van Ginderdeuren R.
Published: September 2016

Vitreal samples contain only very few cells in comparison with cytology specimens from other medical specialists and oncology samples. The gelatinous structure of fine fibrils in the vitreal gel interferes with normal cytology protocols. The former treatment of steroids induces apoptosis of fragile lymphoma cells. The rarity of these masquerade syndromes give less experience and causes delay in referring and diagnosis. For all these reasons a routine and standardized protocol in an experienced referral center is necessary. Concentration or centrifugation of the cells in solution is mandatory. The Cellient® from Hologic is an automated embedding system from a cytology specimen to a paraffin block. Very small fragments and cells or cell clusters can be automatically handled without loss of material. All routine histochemical and immunologic stainings can be performed on a small representative portion of the sample. Genetic analysis are possible with the used fixatives of PreservCyt® and Cytolyt®. Flow cytometry is an alternative way to discriminate the cells, but without histology.
29G chandelier‐assisted scleral buckling with new instruments
Authors: Lytvynchuk L. , Binder S.
Published: September 2016

Purpose

To modify a scleral buckling technique for retinal detachment (RD) treatment using 29‐gauge twin‐light chandelier, non‐contact viewing system and a new illuminated indenter‐marker.

Methods

Eight consecutive patients (8 eyes) were enrolled to this prospective observational study. During every surgery a new illuminated indenter‐marker was used. Standard ophthalmologic examinations were performed before and after the surgery. The evaluation of the surgery duration was performed in every case.

Results

The mean initial best corrected visual acuity (BCVA) was 20/200, and after the surgery – 20/80. The retina reattached in all cases. The mean time of the surgical procedure was 35.12 min ± 9.05 min. In all cases minimal segmental buckle were used. In two cases an additional suturing of the sclerotomy after endolight withdrawal was necessary.

Conclusion

Endoillumination‐assisted scleral buckling is a novel approach for RD treatment, which can be performed using microscope and non‐contact viewing system. The new illuminated indenter‐marker facilitates easier, and more controlled localisation of the retinal breaks with simultaneous marking of the desired area.
Topical chemotherapy for pigmented and epithelial tumors of the conjunctiva
Authors: Desjardins L.
Published: September 2016

Topical chemotherapy drops are very useful in the treatment of conjunctival malignancies. Mitomycine drops can be used for in situ squamous cells carcinomas. We use the 0.02% as an adjuvant therapy when the carcinoma has been surgically removed and (15 days treatment, stop 15 days and again 15 days of treatment) 0.04% drops if there is incomplete removal of the tumor. In some rare instances, mitomycine drops can be used to reduce the tumor volume for invasive squamous cells carcinoma before surgery. Mitomycine 0.04% is also very useful in the treatment of primary acquired melanosis. (cycles of 8 days or 15 days according to local tolerance) We limit the use of such a treatment to patients who have atypical cells or have already developed a previous malignant melanoma. Toxicity of mitomycin drops on the cornea is higher with the 0.04% drops and careful follow up is warranted. Drops of interferon alpha can also be used. They are less toxic but the treatment needs to be applied several months and the cost is higher.
Diabetic maculopathy: Confrontation of FA and OCT‐A findings
Authors: Coscas G. , Lupidi M. , Fiore T. , Cagini C. , Coscas F.
Published: September 2016

Purpose: To perform a qualitative and quantitative assessment of the foveal microvasculature in diabetic maculopathy using OCT‐A. Methods: Retrospective case series of 50 eyes with DM and 30 eyes of age‐matched controls, evaluated by conventional multimodal imaging and Spectralis OCT‐A Clinical features of DM were qualitatively analyzed and recorded on OCT‐A images. Moreover a fully automated micro‐structural analysis of the FAZ (area, perimeter, major axis, orientation), foveal vessel's density and non‐perfused areas was performed. Quantitative values were then compared with those of healthy subjects. Results: In the superficial capillary plexus, non‐perfused areas were present in all DM eyes. Conversely, in the deep capillary plexus, non‐perfused areas were detected in a lower number of cases. No significant differences were found in number of microaneurysms. Capillary density values were significantly lower in nearly all layers of DM patients. There was high (p < 0.05) inter‐observer agreement. Conclusion: OCT‐A is a useful technology for detecting DM abnormalities .The fully automated quantitative retinal vascular analysis may offer an objective method for monitoring disease progression and response to treatment.
Primary vitreo‐retinal lymphoma, an increasing pseudo‐uveitis to be taken into account
Authors: Neri P. , Cesare M. , Baruffa D. , Pirani V.
Published: September 2016

The clinical assessment of most of vitreo‐retinal (VR) inflammations is often challenging: the clinical picture of such diseases can be overlapping and, despite the advances in medical technologies, the routine diagnostic tools might not provide conclusive data. The term ‘Masquerade Syndrome’ was first used in 1967 to describe a case of conjunctival carcinoma that mimicked a chronic conjunctivitis. Masquerade syndromes are disorders that occur with intraocular inflammation and are often misdiagnosed as a chronic resistant, non‐infectious uveitis. Very often mesquerade syndrome is a synonymous of intraocular lymphoma which can present insidious clinical pictures, which are very often confused. At this point, the possibility to take a vitreous tap via pars plana can help the ocular immunologist to differentiate between different sub‐sets of infectious diseases and masquerade syndrome. The possibility to test the interleukines’ (IL) ratio and to analyze the cytology represents a great scientific advance. Once there is the evidence of a masquarade syndrome, the urgent referral to the hematologist is mandatory, in order to start an appropriate and prompt chemotherapy, both local and systemic.
Retinal vasculature structure and function
Authors: Schmetterer L.
Published: September 2016

The human retina has a complex vascular supply. The inner retina including the retinal ganglion cells is supplied by the retinal circulation, the outer retina including the photoreceptors is supplied by the choroidal circulation. Whereas the retinal circulation is characterized by high vascular resistance, low blood flow rate and high arterio‐venous oxygen difference the choroidal circulation is characterized by low vascular resistance, high blood flow rate and low arterio‐venous oxygen difference. The choroidal vessels are richly innervated and as such blood flow is under neural control. The retinal vessels distal to the central retinal artery are not innervated. The optic nerve head has a particular vascular supply: the anterior vessels receive their input via the central retinal artery, the posterior vessels receive their input via the posterior ciliary arteries. An overview of the anatomy and physiology of the ocular vasculature is provided.
The first cataract surgery
Authors: Grzybowski A.
Published: September 2016

The couching technique was the predominant procedure to surgically remove cataracts until the 18th century, when Jacques Daviel introduced the extracapsular technique of extraction. The exact time of couching introduction is unknown, although Sushruta has been pointed for many years as its pioneer and the one who firstly described it. However, the first clear mention of this procedure comes from non‐ophthalmologist, the Greek stoic Chrysippus in the third century BC. There is no proof that cataract surgery was performed in ancient Egypt, although our present knowledge on ancient Egypt medicine is rather scarce. Sushruta also described the technique of extraocular evacuation of cortical masses with Valsalva maneuver, and later in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis.
Antibiotics in intravitreal injections
Authors: Grzybowski A.
Published: September 2016

Endophthalmitis following intravitreal injection is uncommon. It was shown in several retrospective studies that pre‐injection and post‐injection antibiotic treatment was not supported by sufficient evidence of efficacy, and may in fact increase the rate of endophthalmitis. It is of increasing awareness that antibiotic use causes antibiotic resistance and that globally antibiotics are overused in different fields of medicine, including ophthalmology. This may lead to loss of activity of major antibiotics and inability to use them in future, increase in multidrug resistance, increase in infections caused by antibiotic‐resistant bacteria, and increase in health‐care costs. It was shown in several studies that repeated use of topical antibiotics lead to increase of antibiotic resistance in conjunctival flora and the use of antibiotics might be related with increased risk of endophthalmitis caused by resistant bacteria. Concluding, antiseptics (specifically povidone‐iodine), rather than antibiotics, are preferred for the majority of patients undergoing intravitreal injections.
Controversies in the use of antibiotics
Authors: Grzybowski A.
Published: September 2016

Postoperative endophthalmitis is an uncommon but potentially sight‐threatening complication of cataract surgery. Antibiotics have been used before, during or after surgery and delivered by various routes, including topical, subconjunctival, in the irrigating solution, or by bolus intracameral injection in an attempt to decrease the rates of endophthalmitis. There are also controversies regarding the antibiotic to be used, even when one route of administration is considered. Since there are relatively few randomized clinical trials comparing the timing and administration of prophylactic antibiotics, there are wide variations in prevention practices around the world.
Yag laser glaucoma treatments; iridotomies and beyond
Authors: Crawley L.
Published: September 2016

YAG lasers have a multitude of uses in the glaucoma patient beyond capsulotomy and iridotomy. In this session we will discuss how YAG can optimize Tube flow, its role in managing misdirection and how and when to use it in manipulating iris tissue in compromised drainage angles.
Introduction to ultrahigh‐resolution OCT
Authors: Werkmeister R.
Published: September 2016

Various diseases can have significant effects on morphological and functional aspects of the anterior segment of the eye. These may include alterations in corneal anatomy, i.e. changes in thickness of epithelium and Bowman's layer, structural changes in the anterior chamber and aqueous outflow system or alterations in tear film thickness and tear secretion.

Optical coherence tomography (OCT) is a non‐invasive optical imaging modality enabling cross‐sectional in vivo imaging of internal microstructure in biological tissues. However, commercially available OCT technology sometimes does not provide sufficient resolution for in vivo visualization of the fine anatomy of the anterior eye segment. In this talk, an ultrahigh‐resolution OCT system that is based on a Titanium:Sapphire laser and provides an axial resolution below 2 μm is introduced. It allows in vivo imaging the anatomy of the cornea, limbal and scleral region as well as the structure of the lens with unprecedented richness of detail and resolution. Furthermore, the precorneal tear film can be visualized.

The technology might have considerable potential for both the diagnosis and the investigation of surgical outcome in various ocular diseases.
Cytogenetic or molecular analysis for prognosis?
Authors: Jager M.J.
Published: September 2016

Prognostication in uveal melanoma can have several functions: to advice the patient, to council patients with regard to monitoring, and to stratify patients in trials. Scientifically, determination of the parameters that define the development of metastases is of interest to understand tumour behaviour and develop treatments.

The behaviour of tumor cells is related to changes at the DNA level, which lead to differences in mRNA, lncRNA, miRNA, and protein expression. A variety of tests using different technical platforms identify these differences, and can, after validation, be used for prognostication. Commonly‐used tests use the chromosome status (chrom 3, 8q), or the RNA expression pattern (Class 1 and 2). Expression of BAP1 can also be used. Some patients with low risk uveal melanoma also develop metastases, and these have been associated with the presence of extra copies of chromosome 8q, and with a specific marker, PRAME.

The biological pathways that lead to metastases are still under investigation, although it is clear that a combination of loss of one chromosome 3 and loss of expression of BAP1 on the other chromosome 3 plays an important role in this pathway.
You Tube: Different tubes for different glaucomas: XEN
Authors: Arciniegas‐Perasso C.A.
Published: September 2016

Based on current evidence and clinical experience, this part of the SIS aims to introduce the participant into XEN tube glaucoma surgery.

Indications and contraindications, as well as the recommended preparation (anesthesia, mitomycin C use, instruments) will be reviewed.

The surgical technique will be considered from a step‐by‐step approach. Important surgical and clinical tips to make it easier to start with this device will be presented as a troubleshooting guide.
Causes of night blindness
Authors: Leroy B.
Published: September 2016

Purpose

To describe the causes of both genetically determined and acquired night blindness.

Methods

A case presentation format will be used to illustrate different genetically determined and acquired conditions leading to night blindness. Both clinical and electrophysiological phenotypes as well as genotypes will be discussed.

Results

Phenotypes and genotypes of genetically determined diseases leading to night blindness are very different. An important distinction to be made is the one between stationary and progressive diseases. Indeed, other than night blindness the visual outcome differs considerably between different conditions.

Conclusions

The causes of night blindness are diverse. Taking a thorough history in combination with an extensive clinical examination and psychophysical and electrophysiological tests most often allows a to make a specific diagnosis. Acquired conditions are generally treatable, and should be differentiated from those that are inherited. For genetic disease, it is important to distinguish between progressive and stationary conditions.
Controversies between retinal dystrophies and uveitis – the point of view of the retina specialist: does electrophysiology help?
Authors: Leroy B. , Holder G.
Published: September 2016

Purpose

To describe cases in which both genetically determined and acquired inflammatory retinal disease can be suspected.

Methods

A case presentation format will be used to illustrate different genetically determined and acquired conditions leading to similar phenotypes of retinal dysfunction.

Results

Phenotypes of genetically determined diseases can mimic and overlap those of acquired conditions of the inflammatory and paraneoplastic type. Using a combination of detailed patient history taking, specialized imaging, psychophysics and electrophysiology, disease in most patients can be classified as either probably genetic or acquired.

Conclusions

Taking a thorough history in combination with an extensive clinical examination and psychophysical and electrophysiological tests most often allows to make a specific diagnosis, although an exact diagnosis in some cases remains elusive. The presentation will examine various aspects of inflammatory and inherited disease using a case based approach. The similarities and differences between the electrophysiology of retinal dystrophies and inflammatory disorders will be discussed. The particular role of electrophysiology in the management of birdshot retinochoroidopathy, a disorder with an unpredictable course that is highly variable from patient to patient, will be addressed; ERG data are used to monitor the efficacy of treatment and facilitate management decisions in relation to treatment dose and nature. True unilateral retinitis pigmentosa is rare but exists; the topic of unilateral pigmentary retinopathy, which can often be post‐inflammatory, will also be examined.
How to succeed with grant applications?
Authors: Danielson P.
Published: September 2016

To accomplish scientific breakthroughs, all researchers are dependent on funding to support their studies. Without funding, not even the best idea or the most thrilling hypothesis will ever be tested. In a climate of increasing competition for grants, the art of forcefully conveying the message of one's research in a proposal, and making the funders understand its importance, is becoming more and more crucial for any researcher. Not least clinician‐scientists, having to confront competition for grants from full‐time researchers that are not torn from their projects by ‘distractions’ like clinical work, face an ever increasing challenge in getting their research funded. This brief tutorial talk will share some insight in the art of writing grant proposals and highlight some tricks and tips for the first‐time applicant as well as more experienced writers of grants.
Magnetized nanoparticles for transfection of the corneal endothelium
Authors: Fuchsluger T. , Mykhailyk O. , Christian P. , Singer B. , Czugala M.
Published: September 2016

This talk will present principles of transfection of corneal cells with magnetized nanoparticles. Transfecton efficiencies, particles preparations, apoptosis induction and functional approaches will be discussed. In addition, translational aspects will be highlighted.
Classification of uveitis
Authors: Androudi S.
Published: September 2016

Classification and standardization of uveitis is important, as it enhances the precision and comparability of clinical research from different centers and assists in the development of a complete picture of the course of the disorders and their response to treatment. Uveitis may be classified in a number of ways, according to several systems and multiple descriptors. The uveitis classification includes anterior uveitis (iritis, iridocyclitis, and anterior cyclitis), intermediate uveitis (pars planitis, posterior cyclitis, and hyalitis), posterior uveitis (focal, multifocal, or diffuse choroiditis, chorioretinitis, retinitis, and neuroretinitis) or panuveitis (anterior chamber, vitreous, retina, and choroid).Today's uveitis nomenclature has been revised regarding the anatomical location and the grade of inflammation, and supplemented by the inclusion of definitions for onset, duration and course. While helpful for clinical practice and clinical trials, further work still needs to be carried out concentrating on validated clinical assessment tools for activity and damage for common, specific uveitic entities.
Prevention of retinal detachment
Authors: Stangos A.
Published: September 2016

Rhegmatogenous retinal detachment (RRD) is usually caused by peripheral retinal breaks related to anomalous posterior vitreous detachment (PVD). A smaller percentage is caused by atrophic retinal holes or traumatic dialysis of the ora serrata in the absence of a PVD. Although RRD affects only a small percentage of the general population, it can cause significant vision loss. A 5–10% of retinal reattachment attempts may fail whereas only half of the eyes with reattached retinas will maintain ≥ 20/50 vision. Furthermore, RRD repair harbours complications such as endophthalmitis, cataracts and diplopia. Prevention of RRD is therefore important. In this course we will explore the risk factors predisposing to RRD and will discuss preventive measures.
The E3 consortium – European eye epidemiology
Authors: Delcourt C.
Published: September 2016

The European Eye Epidemiology (E3) consortium is a recently formed consortium of 32 groups from 13 European countries. It already comprises more than 40 studies (population‐based, case‐control, cases only, randomized trials), providing ophthalmological data on more than 170,000 European participants. The aim of the consortium is to promote and sustain collaboration and sharing of data and knowledge in the field of ophthalmic epidemiology in Europe, with particular focus on the harmonization of methods for future research, estimation and projection of frequency and impact of visual outcomes in European populations (including temporal trends and European subregions), identification of risk factors and pathways for eye diseases and development and validation of prediction models for eye diseases. Coordinating these existing data will allow a detailed study of the risk factors and consequences of visual impairment and eye diseases, including study of international geographical variation which is not possible in individual studies. Most studies also include biobanks of various biological samples, which will enable identification of biomarkers to detect and predict occurrence and progression of eye diseases.
Indications and interpretation of various imaging techniques
Authors: Zografos L.
Published: September 2016

A large variety of imaging techniques are used in ocular oncology in order to document intraocular tumors.

The imaging of choroidal and retinal tumors is obtained either by digital or by scanning laser fundus cameras. Panoramic fundus pictures are obtained both with transpupillary or transscleral illumination.

Standard fluoresceine angiography and ICG as well as panoramic angiography (102°–150°) are used according to the location of the tumors and the extend of the serous retinal detachment, in order to document the integrity of the outer and inner blood retinal barrier as well as the presence of retinal ischemia.

Retinal thickness, and serous retinal detachment in the macular area are studied with b‐mode OCT and OCT ‘en face’.

More recently, OCT‐A provide useful informations on irradiation induced damage of the macula and optic disc.

The more appropriate technique has to be always used in order to obtain the best quality of imaging and avoid diagnostic errors.
Controversies between retinal dystrophies and uveitis – the point of view of the uveitis specialist: does retinal antibody detection help?
Authors: Willermain F. , Draganova D. , Leroy B.P. , Caspers L. , Postelmans L. , Corazza F.
Published: September 2016

Many diseases, presumed to be mediated by autoimmune mechanisms, may have clinical picture suggestive of retinal dystrophies. The paradigm of such cases is illustrated by cancer associated retinopathies. However the spectrum of antibody mediated retinopathy is expanding and non neoplastic forms are grouped under the name autoimmune retinopathy (AIR). However, the difficulties to demonstrate the presence of retinal antibodies, as well as their presence in control and retinal dystrophy patients render the diagnosis very challenging. In this talk, we will, through case reports, illustrate the potential usefulness and pitfalls of antiretinal antibody search in the management of such cases.
Imaging of corneal lesions and wound healing
Authors: Schmidl D.
Published: September 2016

New techniques, such as ultrahigh‐resolution optical coherence tomography allow for the noninvasive, objective assessment of the anterior segment of the eye. It also provides the possibility for longitudinal follow‐up of changes in the corneal structure, allowing for monitoring of affected patients. In the present talk, examples for the application of this technique in corneal lesions, such as abrasions or infiltrates, will be given and possible applications in clinical practice will be discussed.
OCT angiography in mitochondrial optic neuropathies
Authors: Barboni P. , Balducci N.
Published: September 2016

We evaluated peripapillar and optic disc vessel density (VD) in mitochondrial optic neuropathies (MON) and we correlated them with functional and anatomical parameters. Patients affected by Dominant optic atrophy (DOA), Leber's hereditary optic neuropathy at the acute stage (LHONa), at the chronic stage (LHONch) and carriers (LHONc) were analyzed. Different changes in VD were detected in patients affected by MON and were correlated with different stages of the disease and with functional and structural parameters. VD could be a useful parameter for the monitoring of the disease and of the future therapeutic approaches.
Update on the 8th Edition TNM staging system for conjunctival tumours
Authors: Coupland S.
Published: September 2016

This presentation will provide an update on the 8th Edition of the Tumor Node and Metastasis (TNM) system for malignant tumours of the conjunctiva, which can be broadly grouped into conjunctival carcinomas and melanomas. The 8th Edition of the TNM staging of these tumours is presently being finalised by members of the Ophthalmic Oncology Tumour Force, a mixed and experienced international group of ophthalmologists, oncologists and pathologists who have extensively reviewed evidence in the literature to improve upon the 7th TNM Edition. Following sign‐off by the American Joint Committee on Cancer (AJCC), the 8th Edition for all tumours, including those pertaining to the eye, the ocular adnexa and the orbit, will be available in the Autumn of this year, around the time of the EVER meeting.
Fundamental principals and applied biophysics
Authors: Marques‐Neves C.
Published: September 2016

Pascal tonometry is a pressure sensor, made by a piezoresistive mycrocristal mounted on a concave tonometer, thus allowing a minimal contact with the anterior surface of the cornea. This design is meant to minimize the impact of the corneal components in the measurement of the transmural pressure. Carrying a weight of approximately 1 g, the tonometer itself has 7 mm in diameter with the crystal occupying the central 1.2 mm. Its 100 Hz reading rate allows a continuous pressure measurement which can be influenced by a number of variables ranging from axial length, to corneal elasticity.
Pharmacological restoration of transparency in cataract
Authors: Makley L. , Andley U. , Gestwicki J.
Published: September 2016

Cataracts are the leading cause of blindness in the world, currently treatable only with surgery. The molecular chaperone α‐crystallin helps to maintain the transparency of the crystallin lens. The soluble fraction of this protein decreases with aging, a phenomenon that is associated with presbyopia and age‐related cataract. Moreover, destabilizing mutations in α‐crystallin are associated with early onset, hereditary cataract. We hypothesized that a ligand that binds and stabilizes α‐crystallin may prevent its aggregation, representing a strategy for preventing or even treating cataract. We developed computational and experimental high‐throughput screening techniques to identify small molecule ligands for α‐crystallin. These molecules prevented and reversed protein aggregation and improved lens transparency when dosed to mice with cataracts. The presentation will include a discussion of the potential of the molecular chaperone α‐crystallin as a target for therapeutic intervention in cataracts. The safety, efficacy, bioavailability, and mechanism of the active compounds will be discussed, along with considerations of how a potential pharmacological intervention might complement the existing surgical treatment paradigm.
Endoscopic laser‐ a direct view on the direct view
Authors: Bloom P.
Published: September 2016

With the current direction of travel towards Minimally Invasive Glaucoma Surgery (MIGS), Endoscopic laser Cycle‐Photocoagulation (ECP) is enjoying a resurgence in popularity. Is this justified given examination of issues of safety and efficacy? Is there still a place for trans‐scleral CP? This presentation will answer these questions and more, in a practical yet evidence‐based manner.
The review process – reviewer friend or foe?
Authors: Pleyer U.
Published: September 2016

All – authors, reviewers, editors and publishers and reader – play their role in scientific publishing. Since the peer review system still is the dominant component of scientific publishing, editor and reviewer are key players in the manuscript processing system. The role of the reviewer is well defined and critical for the selection process. She/he is committed to support the editor's decision and selection which manuscript is suitable for publication – and which is not….. Since the number of manuscript submissions continues to grow, the quality of the peer‐review process are the key to support the journal's reputation and its standing in the field.This presentation will not only focus on the role of the reviewer, but also raise the question how to become an active member of the peer‐review process.
Proteomics of tear fluid
Authors: Beuerman R.
Published: September 2016

The tear film overlying the delicate ocular surface epithelial cells are a complex extra‐cellular fluid with components from the orbital and accessory lacrimal glands, ocular surface epithelial cells, goblet cells, Meibomium glands and as an ultrafiltrate of the blood. Molecular information regarding the health of the ocular surface is reflected in both the quantity and quality of the tear constituents. Moreover, this information can be acquired quantitatively and used for the diagnosis, prognosis and treatment of ocular surface disease and can be used as biomarkers for precision medicine. Recent studies have shown that the tear proteome contains over 1,500 identifiable proteins. Highly abundant proteins include lysozyme, lactoferrin, lipocalin, lacritin, and the proline rich proteins. The tear proteome is clearly shown not to be a simple reflection of the blood. As an extracellular fluid, inflammation is revealed in the tear fluid by upregulation of the pro‐inflammatory proteins S100A8 and S100A9.
Quantifying Inflammation as a common component of eye disease
Authors: Beuerman R.
Published: September 2016

Inflammation accompanies most pathologies regardless of their origin. Inflammation can become part of the pathology as well in the form of heightened fibrosis or some other adverse outcome. As part of innate immunity it is often desirable to monitor the level of inflammation as part of the response, using the tears as source of proinflammatory mediators coupled with mass spectrometry it is feasible to identify and measure levels of critical tear proteins such as S100A8, S100A9 and alpha‐1‐acid glycoprotein in patients with diseases such as dry eye. These S100 proteins are particularly interesting as they are likely from tear PMNs, they act in both monomeric and dimeric form, and are particularly involved in calcium regulation. These have been noted to be upregulated in most ocular pathologies. As these can be readily quantified they provide a background to determine the relative levels in different ocular diseases.
Intravitreal mobility of nanoparticles: how to make a move toward successful ocular gene delivery?
Authors: Remaut K. , Devoldere J. , Peynshaert K. , Martens T. , Engbersen J. , Braeckmans K. , De Smedt S.
Published: September 2016

Intravitreal injection is an interesting delivery route for the administration of nanoparticles for treatment of a variety of retinopathies. To reach the retina, nanoparticles need to diffuse through the vitreous and travel across the vitreoretinal interface. We have recently optimized an ex vivo assay that allows to measure the mobility of fluorescent nanoparticles in intact vitreous humour on a single‐particle level. With this model, we optimize surface coating strategies of nanoparticles to assure good vitreal mobility, while maintaining the normal transfection efficiency. Also, we developed a novel ex vivo retinal model that is bovine‐derived and, in contrast to existing models, keeps the vitreous and the vitreoretinal interface intact. This model is used to identify the potential of nanoparticles to reach retinal cell types after intravitreal injection. As Müller cells are the only cell type connecting the vitreal and retinal side of this interface, we specially focus on the role of Müller cells as our gateway to shuttle intravitreally injected particles across the vitreoretinal interface. As nanoparticles, we focus on polymer‐ or lipid based nanoparticles carrying messenger RNA or plasmid DNA as therapeutic molecules.
Looking for a sensitive biomarker for genetically determined neurodegenerative diseases through the window of the eye
Authors: Martinuzzi A. , Vavla M. , Capello G. , Papayannis A. , Petacchi E. , Paparella G. , Privato F. , Prosdocimo G.
Published: September 2016

Biomarkers are valuable tools offering quantifiable objective measures for biological processes. In neurodegenerative diseases mitochondria are frequently either primarily or secondarily involved, but the difficulty in directly assessing the target tissue and the frequently slow progression makes the search for reliable, convenient, sensible, specific and objective biomarkers a particularly relevant issue. The visual system is the primary target where mitochondria dysfunction frequently manifests itself. The definition of a typical, objective, quantifiable pattern of neuro‐ophtamological alteration that shows correlation with clinical measures and is sensible to progression may be very important. We had previously identified by advanced neuroimaging and OCT specific changes discriminating patients from controls in f hereditary spastic paraplegia (HSP) and Friedreich's ataxia (FRDA) patients. We now tested these approaches for their ability to provide timely information on disease progression by evaluating longitudinally 21 HSP and 12 FRDA patients.
Current gene therapy trials for inherited retinal disorders
Authors: Leroy B.P. , Maguire A.M. , Russell S.R. , Wellman J. , Yu Z.F. , Chung D.C. , High K.A. , Bennett J.
Published: September 2016

Purpose

To discuss the current status of gene therapy for inherited retinal disease.

Methods

Data from the literature on gene therapy trials for several inherited retinopathies will be combined with those of the Phase 1, Phase 1 follow‐on and Phase 3 trials for RPE65‐related inherited retinal disease at The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Results

Gene therapy is capable of improving or stabilizing visual function. According to some recent reports, there is progression of disease in RPE65‐related IRD trial participants despite successful subretinal delivery of RPE65 using an AAV2 vector. Other data suggest that there may at least be a decrease in the speed of retinal degeneration, if not stabilization.

Conclusions

Gene therapy for inherited retinal disease using viral vectors has demonstrated safety and improvement or stabilization of visual function in some diseases. Whereas disease progression is noted in some RPE65‐related IRD trial participants, despite successful application of subretinal gene therapy, others may even have either a stable or slower disease course after treatment.
OCT imaging in glaucoma and PEX
Authors: Sapeta S.
Published: September 2016

Glaucoma, as one of the leading causes of blindness worldwide, can be characterized by abnormalities in the aqueous outflow system (AOS) structures, including Schlemm's canal, that regulate the IOP in a healthy eye. Furthermore, the accumulation of pseudoexfoliation (PEX) deposits in the anterior chamber can increase the risk of the disease. The imaging of the anterior eye segment and here in particular the limbal area and anterior lens capsule could have a special clinical significance, since there is an evidence that symptomatic PEX is preceded by subclinical ultrastructural changes in the anterior segment including the lens surface.

In this course, ultrahigh‐resolution optical coherence tomography for imaging of the anterior eye segment in glaucoma and PEX patients will be introduced. The advantage of the superior resolution as compared to commercially available OCT technology for visualization of AOS structures and PEX deposits on the lens capsule as well as its potential for evaluation of Schlemm's canal diameter will be shown and possible applications of the technology in clinical practice will be discussed.