bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistochemistry and Western blot methodologies to evaluate neuroprotective agents in models of retinopathies
Authors: THERMOS K , GIANNOGONAS P , KOULAKIS E , KOKONA D , MASTRODIMOU N , KIAGIADAKI F , CHARALAMPOPOULOS I , GRAVANIS A
Published: November 2010

Purpose Many retinopathies that lead to visual loss and blindness are characterized by neovascularization and neural retinal defects, such as a marked loss in retinal neurons and an increase in apoptosis. There are no therapeutic agents for the treatment of the neurodegenerative component of retinal disease. Immunohistochemistry and western blot methodologies were employed to determine retinal viability and to elucidate the putative neuroprotective properties of new therapeutic targets, in animal models of retinopathy (chemical ischemia, excitotoxicity, STZ).

Methods To assay retinal viability, the following antibodies for retinal markers were employed in immunohistochemical assays: PKC (rod bipolar cells), ChAT, bNOS, TH (cholinergic‐, nitric oxide synthetase‐, and dopamine‐ containing amacrine cells, respectively), calbindin‐containing horizontal, amacrine and cone bipolar cells, NFL and MAP1 (ganglion axons and cells, respectively). Antibodies against various pro‐survival or pro‐death molecules (western blots), as well as the TUNEL‐assay, were employed to examine retinal apoptosis and neuroprotection.

Results Loss of retinal marker immunoreactivity was differentially observed according to the animal model employed. The neuroprotection of specific retinal neurons by the new therapeutic targets examined (somatostatin and neurosteroids) reflect the existence of protein substrates involved in the mechanism of action of these molecules.

Conclusion Immunohistochemical and western blot analysis techniques provide important information on the retinal damage induced by ischemic insults and the neuroprotection afforded by new targets of retinal therapeutics.
Biochemical methods and X‐ray based imaging strategies to evaluate retinal glucose metabolism
Authors: POITRY‐YAMATE C
Published: November 2010

Purpose Evaluating the coordinated energy metabolism between neurons and glia in situ as a means to evaluate retinal glucose metabolism and function.

Methods The imaging of metals conjugated to sugar substrates or metals linked to compounds that affect glycolysis were detected using synchrotron‐based low and high energy x‐ray fluorescence imaging. X‐ray fluorescence maps with <1 micron resolution were placed in a morphological context using simultaneously acquired transmission images of the preparation. Spectrophotometric enzymatic microassays with high selectivity and sensitivity were performed to confirm the intracellular incorporation and metabolism of the delivered substances.

Results In the dark‐adapted rat retina, glucose transport and phosphorylation were specifically localized to the Müller glia in situ and an activated glycolysis was not measurable in neurons. Glial glucose metabolism was moreover coordinated with excitatory synaptic transmission in the mid to outer retina.

Conclusion Given that oxygen metabolism predominates in neurons and that oxidative metabolism is fuelled by glucose metabolism, fuel transport obligatorily occurs from glia to neurons in intact healthy retina. Combining x‐ray techniques with micron to submicron resolution and biochemical microassays with nM sensitivity offers: (1) a unique experimental strategy to evaluate retinal and cerebral energy metabolism and compartmentation at the cellular level in situ; and (2) is important to the interpretation of images using in vivo functional imaging techniques in the clinic.
The fundamentals of visual acuity measurement
Authors: CHISHOLM CM
Published: November 2010

Purpose To provide the background to the symposium on visual acuity and its measurement

Methods The parameters employed to quantify visual performance will be defined. Commonly used measurement techniques ranging from traditional letter charts to psychophysical computer‐based programmes, will be described and compared, with reference to the peer‐reviewed literature in this area. The issues of accuracy and repeatability will be considered in the context of the clinical setting and scientific studies.

Results Letter charts are most commonly employed to assess visual performance because of their ease of use for both the patient and assessor, but they suffer from design limitations. Psychophysical procedures are more flexible and can improve repeatability, but are time consuming and fatigue can start to play a part. Such techniques are generally more suited to the research environment. High contrast visual acuity measurement can give a misleading impression regarding the quality of vision. This is particularly the case for subjects with impaired optical quality relating to an increase in intraocular light scatter and/or increased higher order aberrations. Assessment in the contrast domain is essential to build up a fuller picture.

Conclusion The assessment of visual quality requires an understanding of test design and limitations. The method used should be chosen to suit the aims of the work and partly depends on whether it is taking place in a clinical practice setting or as part of a research study.
Snellen or logMAR in clinical ophthalmology
Authors: SPILEERS W
Published: November 2010

Purpose The question remains if visual acuity measurements in clinical ophthalmology should use the well known Snellen notation or instead should switch to the slightly less intuitive logMAR notation

Methods The differences in Snellen and logMAR notation will be explained in order to understand the (dis)advantages of each notation

Results When measuring visual acuity, we should always take into account the purpose of the measurement: refraction and prescription of correction, reporting (low) visual acuity in clinical trials, ...

Conclusion LogMAR notation of visual acuity has several advantages but the Snellen notation is widespread and can be maintained in specific conditions.
To crowd or not to crowd? The influence of surrounding contours on measures of visual acuity
Authors: BARRETT BT
Published: November 2010

Purpose Crowding refers to the finding that visual acuity (VA) for isolated letters is better than the VA measured when the letters to be identified are flanked by other letters. Although crowding was first described over 50 years ago, it remains the subject of much research interest. Here, I summarise the reasons why crowding is so important and the current thinking about it.

Methods Crowding is important for at least three reasons: (1) Children and amblyopes suffer more from the effects of crowding. Accurate VA measures are a key component of attempts to detect and diagnose visual disorders that first emerge in early life but whose effects can last a lifetime. (2) Following on from (1), crowding has had, and continues to have, a major influence on VA test‐chart design. This is because crowded VA scores can’t easily be predicted from unflanked VA scores. (3) Until recently, crowding was studied only from the perspective of its influence on VA measures. However, it is now recognised that crowding influences not just the ability to identify letters but all kinds of object recognition. For example, eye care professionals need to be aware that crowding limits reading speed, and hence that changes to letter/word spacing can improve reading proficiency.

Results Recent research findings greatly simplify the story about crowding, but they also highlight how the significance of crowding for eye care professionals extends well beyond VA measurement.

Conclusion Crowding has important implications for patients both in the clinic and for their everyday activities, most notably in relation to reading. With greater understanding of crowding, we are in a better position to help and advise our patients.
Recurrent inflammatory optic neuropathy (RION)
Authors: ARNDT C , GARCIA T , TOURBAH A , LABAUGE P , JEAN JEAN L , VERMERSCH P , DEFOORT S , SPEEG C , DE SEZE J
Published: November 2010

Purpose Optic neuritis is a demyelinating inflammation of the optic nerve. Many cases of optic neuritis are associated with multiple sclerosis or neuromyelitis optica. In some cases, a recurrence of isolated optic neuritis is observed. However this existence of entity remains controversial. Yhe present retrospective study was designed to estimate the prevalence of this condition.

Methods In five university hospitals (Lille, Montpellier, Nimes, Reims and Strasbourg), between October 2005 and October 2009, the charts of patients with recurrent isolated optic neuropathy (RION) and normal cerebral magnetic resonance imaging included prospectively were reviewed. The following parameters were analyzed: date of the first relapse, age at onset, duration at the time of inclusion, recurrence after steroid withdrawal, unilateral or bilateral involvement, number of relapses, visual acuity, retinal nerve fiber layer thickness, diagnostic workup, and longterm treatment with immunosuppressive or immunomodulatory drugs.

Results During the predefined period, 18 patients (15 women, 3 men; age 17–54 years at onset) matched the inclusion criteria. Between two and six relapses of optic neuropathy were observed. The median duration was 6 years. In untreated patients (n=9), a significant inverse correlation was observed between visual acuity and duration of the disease; this correlation was not found in the group of patients (n=9) with long‐term treatment

Conclusion The progressive loss of vision over time in this retrospective study of recurrent isolated optic neuropathy could be related to axonal loss. A prospective cohort study is necessary to confirm this hypothesis and to evaluate the benefit of long‐term treatment on this progression.
Wavefront aberration variations with aspheric toric intraocular lenses
Authors: PISELLA PJ
Published: November 2010

Abstract not provided
Updates on the vision simulator
Authors: CHATEAU N
Published: November 2010

Abstract not provided
Wavefront guided and custom wavefront refractive surgery
Authors: COCHENER B
Published: November 2010

Abstract not provided
Evolution of visual field defects and alterations of the retinal nerve fiber layer in the pituitary macroadenoma
Authors: GUERRI MONCLUS N , EGEA ESTOPINAN MC , PRIETO E , IDOIPE M , GIL ARRIBAS L , FERNANDEZ PEREZ S , CALVO P , GARCIA MARTIN E
Published: November 2010

Purpose To evaluate the evolution of the visual field defects and the alterations of the retinal nerve fiber layer (RNFL), which are produced in intracranial neoplasms that affect the visual pathway.

Methods Description of a clinical case. 44 years old male with a prolactin‐producing pituitary macroadenoma. The patient presented progressive defects in the visual field (bitemporal hemianopsia), observed by standard automated perimetry (SAP) (Humphrey, SITA Standard 30.2), and RNFL atrophy evaluated by means of monochromatic fiber photography, optical coherence tomography (OCT) and laser polarimetry (GDx VCC).

Results An uncompleted removal of the tumor was performed by transsphenoidal approach. It was observed a mild and progressive recuperation of the visual field defects. The RNFL alterations did not show any change.

Conclusion The visual field defects caused by intracranial space‐occupying tumors, may improved after resection of the tumor. Structural alterations in the RNFL remain stable.
Validation of PCR for the detection of pseudomonas aeruginosa from cornea specimens
Authors: KOWALSKI R , HILLENBRAND M , THOMPSON P
Published: November 2010

Purpose The definitive detection of Pseudomonas aeruginosa from the cornea is essential for effective therapy especially in cases complicated by anti‐infective pre‐treatment.

Methods The present study investigated the validation of PCR for detecting Pseudomonas aeruginosa from corneal specimens using a real‐time method with the SmartCycler (Cepheid, Sunnyvale, CA, USA). Primer and probes directed toward the ecfx (63 bp) and the 16s rRNA genes were validated against 20 true‐positive specimens (corneal specimens positive for Pseudomonas aeruginosa) and 20 true‐negative samples (spiked samples of HSV, VZV, Candida, Aspergillus, and Fusarium).

Results The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of PCR to the ecfx and 16s rDNA genes were, respectively: [80%, 95%, 95%, 80%, 87%], and [77%, 100%, 100%, 77%, 87%]. The amplification efficacy and limit of detection were respectively: [0.97, 33.6 µg/ml], and [1.03, 8.12 µg/ml].

Conclusion PCR was validated for detecting Pseudomonas aeruginosa from corneal specimens. The impact of detection of Pseudomonas aeruginosa from cases of non‐specified keratitis will need to be determined.
Retinal AAV2‐mediated SOCS1 overexpression in the chronic model of experimental autoimmune uveoretinitis
Authors: KOCH P , MAKHOUL M , ELMALEH V , LAU‐KILBY A , DE MAERTELAER V , DE GRAEF C , CASPERS L , BRUYNS C , TENENBAUM L , WILLERMAIN F
Published: November 2010

Purpose Activation of retinal cells by IFNγ is required for inflammatory cell recruitment during experimental autoimmune uveitis (EAU) development. IFNγ activates pro‐inflammatory genes transcription but also induces suppressor of cytokine signaling (SOCS) proteins, which negatively regulate IFNγ signaling.

Methods To study the effects of retinal SOCS1 overexpression on EAU, adeno‐associated vectors AAV2‐SOCS1 or AAV2‐GFP were injected intravitreally in the right eye of C57Bl6 mice. Four weeks later, EAU was induced by s.c. immunisation with IRBP peptide 1‐20.

Results A high inter‐animal variability of disease induction was observed, possibly masking the effect of SOCS1. In order to normalize for disease severity, the means of ratios of the clinical and histological scores of the AAV injected eyes over the contralateral non‐injected eyes (I/NI) were calculated and found to be significantly lower in the SOCS1 group, especially in the infected layers. Unexpectedly, the mean I/NI was significantly higher than 1 in the GFP group, suggesting that injection of AAV2‐GFP itself was pro‐inflammatory. MHCII was strongly expressed during EAU. None of the MHCII+ cells was GFP+, suggesting that SOCS1 effects were not mediated through a downregulation of MHCII in transduced cells. Nevertheless, the profile of MHC class II expression in the ciliary bodies was different in AAV2‐SOCS1 injected and contralateral eyes.

Conclusion In conclusion, although AAV2‐mediated SOCS1 retinal expression did not globally protect against EAU development, it significantly reduced inflammation locally at the site of infection.
Efficacy of IL‐17A mAbs on Toxoplasma gondii proliferation and intraocular inflammation in a murine model of ocular toxoplasmosis
Authors: SAUER A , SCHOLLER M , SPEEG C , GARWEG J , PFAFF A , CANDOLFI E , BOURCIER T
Published: November 2010

Purpose The aims of our study are to determine the possible efficacy of IL‐17A mAbs on Toxoplasma gondii proliferation and the benefit on intraocular inflammation in a murine model of ocular toxoplasmosis.

Methods Mice infection is done by intravitreal injection of Toxoplasma gondii, PRU type II strain, and leads to severe ocular inflammation. At the same time of infection, IL‐17A mAbs is administered by intravitreal route. Intraocular inflammatory grading and histological datas are determined. Parasites counting and mRNA levels of Tbet, Foxp3, IL‐27 and ROR‐gammaT are quantified using RT‐PCR. Cytokines levels and profiles are established on murine aqueous humor using multiplex assay.

Results Intraocular inflammation is significantly decreased after IL‐17A mAbs intravitreal injection in infected mice. Parasite counting shows a significant decrease after IL‐17A mAbs. mRNA levels of T‐bet, Foxp3 and IL‐27 are increased with IL‐17 abs. mRNA‐ROR‐gammaT levels are unchanged. In aqueous humor, cytokines pattern shows a Th1/Treg profile after IL‐17 mAbs intraocular injection.

Conclusion IL‐17A mAbs may mitigate chorioretinitis by antagonizing the Th17 phenotype through induction of Th1 and Treg cells in the eye. T regulatory (Treg) cells secreting could play an important protective and homeostatic role in modulating hypersensitivity responses induced by Toxoplasma infection. Antagonism of Th17 by Treg cells could be a way to limit ocular lesion. These data open new in vivo therapeutic approaches by repressing the Th17 pathway using IL‐17A mAbs.
The influence of inhibitors of α‐adrenergic receptors on uveitis induced by endotoxins
Authors: POZNANSKI Z , MISIUK‐HOJLO M
Published: November 2010

Purpose Investigation of anti‐inflammatory activity of Prazosin and Carvedilol in the experimentally induced anterior uveitis in rats. Activity of the Prazosin was compared to the activity of prostaglandin’s cyclooxygenase inhibitor – ibuprofen.

Methods Prazosin suspended in PBS (phosphate buffered saline) was injected intra‐peritonealy (i.p.) in the dose of 2 to 30 mg/kg of body mass(b.m.) 24 and/or 3 hours prior to and/or 3hours after the induction of EIU – endotoxin induced uveitis – achieved by subcutaneous injection of 50 μg of the lipopolysaccharide (LPS) from Hafnia alvei 981. Carvedilol suspended in PBS was given i.p. in the dose of 30mg/kg b.m. 3hours before and after induction of EIU. Ibuprofen suspended in PBS was given i.p. in the dose of 100mg/kg b.m. 3hours before and after the EIU induction. Animals in the control group received PBS i.p. only. 24 hours following the EIU induction clinical assessment was performed with evaluation of the inflammatory cells in the anterior chamber fluid.

Results Investigation of Prazosin’s influence on EIU induction showed, that when given 24hours prior to LPS injection it had no influence on inflammatory cells density or symptoms intensity. However, when given 3 hours before the induction, resulted in significant reduction of both parameters. Even stronger anti‐inflammatory reaction was observed, when given 3 hours post EIU induction. Doses reduced to 2 and 6 mg/kg b.m. proved to be active, when given in the same pattern. Administration of Prazosin 24 and 3 hours pre‐ and 3 hours post induction all together, blocked EIU induction.

Conclusion Carvedilol proved to be far less active than Prazosin. It was also noticed that the Ibuprofen does not stop inflammation process.
Intravitreal fluocinolone acetonide implant (RetisertTM) in the management of severe non‐infectious posterior uveitis.
Authors: CHAKRABARTI M , UPENDRAN MR , FRAZER D , SILVESTRI G
Published: November 2010

Purpose To report our experience with the intravitreal fluocinolone acetonide implant (Retisert TM) in treating patients with severe chronic non‐infectious posterior uveitis.

Methods Retrospective review of case notes of patients with severe posterior uveitis who had Retisert TM implants over a 6‐year period. 12 eyes of 9 patients were identified. Indications for implantation included need for repeated sub‐tenon triamcinolone injections, non‐responsiveness, poor tolerance to systemic medication or unilateral disease.

Results The follow‐up time ranged from 9 to 76 months (mean ‐ 35.4). 3 patients received implants in both eyes. In 3 patients who were followed up for longer than 36 months, a second implant was inserted. Snellen visual acuity improved in all eyes, average gain being 3.5 lines (range 1‐6). There was improved control of the intraocular inflammation in all patients. All patients have been able to either stop or reduce systemic immunosuppressant therapy within 6‐ 12 months of the procedure. Six (40%) eyes developed raised IOP with 4 requiring trabeculectomy. Five patients required cataract surgery. One patient developed a peripheral retinal tear with localised detachment, which was treated successfully with vision returning to 6/6.

Conclusion RetisertTM is very effective in severe non‐infectious posterior uveitis and may be the ideal option in those intolerant or unresponsive to topical and systemic immunosuppression. It can also be used in bilateral disease. The significant complications are acceleration of cataract and raised IOP. However, these need to be considered against the benefits of better control of inflammation and reduced systemic immunosuppression.
Evaluation of new quality of life questionnaire in children with strabismus and amblyopia before and after re‐education
Authors: BREMOND‐GIGNAC D , BERTRAND‐MASLIEU H , BERESNIAK A , MILAZZO S
Published: November 2010

Purpose To evaluate a new quality of life questionnaire in children presenting a strabismus with abnormal retinal correspondence and amblyopia before and after reeducation.

Methods Twenty children of a mean age of 4,2 yo (range 2‐7yo) were included with a strabismus with 3 type deviations. They presented amblyopia of at least 2 lines VA. They underwent a complete ocular and orthoptic examination with binocular quantification. At the consultation, parents and child completed a self‐administered questionnaire of quality of life. The questionnaire has three major items including a total of 10 criterions. Criterions were quoted by 4 colors corresponding to a score (from 0 to 30) reflecting the daily activity. Children were treated with optical correction, eye‐patching and orthoptic reeducation as needed. Six months after, examination and questionnaire was completed again to appreciate the progression of the children capacities.

Results Of the twenty children, 16 presented an esotropia, 4 an exotropia and 10 an isolated or associated vertical hypertropia. The mean rate of the questionnaire at baseline was 18. The twenty patients who presented an amblyopia had an improvement of VA after treatment. After 6 months, rate of all questionnaires was improved with a mean score of 25.

Conclusion Very few QOL questionnaires had been developed and even more in ophthalmology. This questionnaire appears simple to complete for parents and children, it can also be a basis to evaluate the progress of amblyopia reeducation.
What difference can one day of ophthalmology teaching make?
Authors: LAM FC , LIM LT , DUTTON G
Published: November 2010

Purpose Massive advances in medical knowledge, therapeutic opportunities and increasing specialisation have led to an increasingly packed curriculum. Many medical schools have moved towards a more streamlined integrated curriculum. In view of the time constraints faced by many educators, we look at the effectiveness of 1‐day of intensive structured specialty teaching in improving medical students abilities in performing ophthalmic examinations and assessing eyes in order to evaluate out how much can be achieved in just one day of ophthalmology teaching.

Methods Fourth year medical students were invited to attend an optional day of structured ophthalmology teaching with lectures and OSCE‐style bedside teaching. Participants were asked to fill in pre‐validated questionnaires before and after teaching on their confidence and perceived competence in ophthalmic assessments, management of simple eye conditions, and the identification of ophthalmic emergencies.

Results 175 sets of questionnaires(81%) were returned. 92% felt that their prior teaching was inadequate. Our participants confidence in taking an ophthalmic history, performing various ophthalmic assessments, dealing with simple eye problems and recognising an ophthalmic emergency improved significantly after teaching(p<0.01). However, a significant proportion were still not confident in examining(52%) or managing red eyes(71%), or identifying an ophthalmic emergency(51%).

Conclusion An intensive and structured teaching day is an effective way of delivering and standardising specialist teaching.
Is the eye a window to the mind? Retinal vascular reactivity as a marker for endothelial function in Alzheimer’s disease
Authors: MROCZKOWSKA S , BENAVENTE‐PEREZ A , PATEL S , QIN L , BENTHAM P , GHERGHEL D
Published: November 2010

Purpose To assess the retinal and systemic vascular function in patients diagnosed with mild Alzheimer’s disease in comparison to healthy age matched controls

Methods Nine newly diagnosed mild AD patients (MMSE score 18‐ 24) and 23 healthy age‐matched controls without any cognitive dysfunction (ACE‐R score ≥ 88) were recruited for the study. Retinal vessel reactivity was assessed using the retinal vessel analyser (RVA, IMEDOS, Germany). From these recordings the time taken to reach maximum dilation (RT), was determined for each individual flicker cycle. Systemic vascular function was assessed using flow mediated dilation (FMD) technique at the brachial artery level (Siemens; Acuson Sequoia, UK). Intraocular pressure (IOP) and systemic blood pressure (BP) were also recorded for each participant and OPP was then calculated

Results There were no significant differences in age, mean BP, IOP or OPP between the two study groups (p>0.05). The retinal arterial RT to flicker light stimulation was found to be significantly longer in AD patients as compared to healthy control for both the first (p= 0.01) and the third (p=0.049) flicker cycles. In addition, the RT measured at the chosen vein level was significantly longer in AD patients compared to controls for the first (p=0.046) and second (p=0.043) flicker cycles. No significant differences were found in the brachial arterial diameter between the two groups (p>0.05).

Conclusion In patients suffering from AD, the prolonged retinal vessel RT to flicker provocation could represent an early sign of vascular dysfunction evident at the microvascular level
Long‐term outcome and morphology/function correlates in cases of shaken baby syndrome
Authors: PINELLO L , MAZZAROLO M , ROSA RIZZOTTO M , DE BELVIS V , BUA M , FACCHIN P
Published: November 2010

Purpose Shaken Baby Syndrome(SBS) presents with acute encephalopathy,subdural and retinal haemorrhages,with inconsistent history,in < 2 years old.Long‐term sequelae are still under study.Aim is to present the long‐term outcome in a case series of SBS followed‐up by a multidisciplinary team.

Methods Case series of 14 children(9 M,5 F)with confirmed SBS has been examined and followed‐up.Patients underwent fundus evaluation (indirect ophtalmoscopy) and wide‐field digital ophthalmic camera (RetCam II) until bleeding reabsorption.Assessment was repeated at follow‐up combined with ocular motility evaluation, visual field(BEFIE test),visual acuity(Teller acuity cards),refractometry, cognitive‐behavioral evaluations (Griffiths scales,Child Behaviour Check List), and family stress measurement(Parenting Stress Index),segmentation analysis of MRI.

Results Mean age at acute episode of SBS: 6.5 months (range 2‐20), 9/14 in the first 6 months of life. Mean age at last follow‐up evaluation: 32 months (range 8‐65). 4 cases were lost to follow‐up. At last follow‐up evaluation: 4 out of 10 had a decreased visual acuity (cortical visual impairment), 4 out of 10 had visual field deficits, 3 out of 10 had strabismus. None of the cases showed significant refractive errors. Cognitive/behavioural assessment demostrated global delay and impairments in neuromotor ability, speech/language development and attention problems. MRI analysis showed atrophic alterations in several brain areas.

Conclusion Multidisciplinary assessment including ophthalmologic examination and neuro behavioural evaluation provides crucial prognostic information in cases of suspected SBS.Functional outcome is largely dependent on brain injury and atrophy.
Intravitreal triamcinolone acetonide injection in the acuite phase nonarteritic anterior ischemic optic neuropathy
Authors: ARNDT C , RADOI C , BONNAY G , GARCIA T , DUCASSE A
Published: November 2010

Purpose In nonarteritic anterior ischaemic optic neuropathy (NA‐AION), no treatment has shown to be effective in recovering visual loss in a randomized controlled clinical trial. Oral steroids have been evaluated and small series of IVTA have been reported. The purpose of this study was to analyse the visual outcome in response to a single intravitreal triamcinolone acetonide injection (IVTA) as a treatment for patients with acute NA‐AION.

Methods Consecutive patients with either significant visual loss (visual acuity < 0.4) in the first eye or optic nerve head swelling in the second eye due to acute NAION were treated with 4 mg/0.1 mL IVTA. Patient's best‐corrected visual acuity, optical coherence tomography of the retinal nerve fiber layer (RNFL) and visual field were performed before injection, visual acuity was assessed at 1 week, and 2‐12 months after.

Results Visual acuity was between 0.08 and 1.0 on inclusion, it improved in 2 eyes (more than 1 line) and remained stable (+/‐ 1 line) in 4 eyes after injection. In the group of eyes reaching (n=2) or maintaining (n=1) a final visual acuity of 1.0, the delay between onset and injection was 7 days or less. In the second group of patients, final visual acuity was between 0.08 and 0.4, the delay between onset was between 2 and 3 weeks.

Conclusion The clinical course of these patients suggests that an IVTA may be effective in increasing or maintaining visual acuity following an acute NAION if the treatment is applied within one week. A large randomized controlled study is required to confirm these preliminary data.
The optic nerve, mitochondria, age, energy, apoptosis and vision
Authors: TAYLOR D
Published: November 2010

Optic Neuropathy‐ any disorder leading to dysfunction or death of retinal ganglion cells and their axons. This presentation will focus on acute and chronic post‐natal optic neuropathies due to dysfunction of cellular organelles, mitochondria in particular. A. Mitochondrial structure & function Citric Acid Cycle Oxidative phosphorylation Fusion & fission Aging DNA Mitochondrial. Why do Mitochondria need their own DNA? Nuclear Heteroplasmy B. Acute Optic Neuropathies LHON History Clinical Phases Pre‐symptomatic Acute Chronic Visual Recovery Why does the vision improve? Systemic Associations LHON‐OPA1 interaction LHON at all ages? Precipitating factors and summation Management & Treatment Present Rx Possible‐ Ooplasmic Transfer Nuclear DNA swap C. Chronic Optic Neuropathies ADOA Clinical Symptoms & signs OPA1 Functions & distribution Non‐ocular manifestations OPA1: can the vision improve? OPA 2‐OPA7 OPA3‐ ADOAplus Other chronic disorders with Optic Atrophy & organelle disease DIDMOAD Wolframin (Endo Retic) CDGSH AROA TMEM126A Leigh’s disease. ATPase subunit 6 Charcot Marie Tooth Friedreich’s ataxia Mohr Tranebjaerg Normal tension glaucoma
Trehalose, anhydrobiosis for the eye
Authors: CHEN W , LI JY , ZHANG XB
Published: November 2010

Purpose To determine whether topically applied trehalose could heal ocular surface epithelial disorders caused by ocular surface desiccation.

Methods This study used a novel murine model of dry eye induced by continuous controlled low‐humidity air velocity in an intelligently controlled environmental system. the efficacy of 87.6 mM trehalose eyedrops was compared with that of 20% serum, 0.05% CsA and Optive ®. The resultant changes in corneal barrier function, inflammation and histopathologic examination of cornea and conjunctiva were analyzed and the level of apoptosis and MMP‐9 on the ocular surface was assessed.

Results After 14 days of treatment, the corneal fluorescein staining area, the ruffling and desquamating cells on the apical corneal epithelium, as well as the apoptotic cells on ocular surface epithelium had significantly reduced in eyes treated with trehalose compared with those treated with serum. Trehalose produces some of the same responses as CsA upon topical application and can maintain corneal health, even though it is more effective on reducing epithelial apoptosis on ocular surface.The CD4‐positive T cells on ocular surface were significantly increased in both trehalose and PBS treated mice compared to baseline and the CsA group.Dryness significantly increased production of MMP‐9 by the corneal epithelium which reduced significantly in eyes treated with trehalose compared with Optive ®.

Conclusion Trehalose could improve the altered corneal barrier function caused by desiccation through suppression of apoptosis and Matrix Metalloproteinase‐9. Trehalose produces some of the same responses as serum, 0.05% CsA and Optive ® upon topical application and can maintain corneal health.
Examining the effects of Blephasteam® ‐ clinical safety study results
Authors: PURSLOW C , MURPHY PJ , GILL FR
Published: November 2010

Purpose Heat therapy is the standard treatment regime for obstructive meibomian gland dysfunction (MGD). Research has shown the melting point of the meibum is raised to 35C in MGD compared to 32C in normal subjects, and sustained heat delivery is essential in effective treatments. This study was designed to evaluate the changes in ocular surface signs and temperature efficacy of a novel device which delivers latent moist heat to the eye lids and surrounding area for 10 minutes.

Methods A prospective, controlled, single intervention trial recruited 25 normal subjects (M8, F17; age 29.2±5.7yrs). Ocular temperature, tear film stability, ocular hyperaemia and surface staining were measured, using non‐invasive ocular thermography and Efron grading respectively,, before and after device application. Results were checked for normality and compared using paired t‐testing.

Results Temperature significantly increased to effective levels in both the upper (37.7±0.58C; p<0.0001) and lower (37.7±0.57C; p<0.0001) eyelids after treatment. Bulbar conjunctival hyperaemia significantly decreased after treatment (p<0.005), but limbal and palpebral hyperaemia were not significantly affected (p=0.33 and p=0.11 respectively). No significant change in corneal or conjunctival staining was observed (p=0.74 and p=0.97, respectively). Non‐invasive tear break‐up time (NIBUT) was not significantly changed in this normal cohort(p=0.12).

Conclusion The Blephasteam® device provides safe and effective warmth to the ocular area without any adverse effects on the ocular surface in this study. Interestingly, even normal subjects had significantly less ocular redness after treatment.

Commercial interest
Profile of preservative‐free TafluprostTM
Authors: UUSITALO H
Published: November 2010

Prostaglandin analogues are the most commonly used treatment choice in various forms of glaucoma. They have gained their popularity mostly by their efficacy, once a day dosing and their high systemic tolerability. However, the topical tolerability of the glaucoma drugs are in general is an issue; not only on the basis of quality of life of the patients but also as a factor of adherence and overall success of the glaucoma therapy. Tafluprost is a novel prostaglandin analogue. It has a high affinity and potent agonistic activity for prostaglandin F receptor. In non‐clinical and clinical phase !/II/III studies, tafluprost has shown an excellent IOP‐lowering effect. As a difluorinated prostaglandin analogue Tafluprost has also unique stability which makes it suitable for preservative free formulation. In this formulation it is proven to be efficacious and safe. In patients having ocular surface problems with a preserved prostaglandin analogue, a switch to preservative free tafluprost has shown to significantly reduce both symptoms and signs of ocular surface disease. Preservative‐free formulations of glaucoma drugs, now available also as a prostaglandin analogue, are tools in our armamentarium to target our medical management of glaucoma to balanced long term efficacy and safety.
TafluprostTM in clinical practice
Authors: HOMMER A
Published: November 2010

Lowering intraocular pressure is currently the only proven approach to preserve visual function in glaucoma. Hereby medical therapy is the initial treatment option. According to the guidelines of the European Glaucoma Society monotherapy is the first step in medical therapy. Prostaglandin analogues (PG) are approved for first line therapy for several years and they are the most frequently used IOP lowering agents now, because of their strong IOP lowering effect and once daily application. All PG that have been on the market are containing Benzalkonium chloride (BAK) as preservatives. These preservatives may cause tolerability problems and inflammation. Dry eyes and ocular surface disorders (OSD) have been limiting the use of PG with BAK. The introduction of Tafluprost without BAK is a significant addition in our medical options for glaucoma treatment. In clinical use we can consider Tafluprost sine as a useful option in patients with dry eye, ocular surface disorder, allergy to BAK or intolerability. The IOP lowering effect is comparable to the most frequently used PG Latanoprost. The application is once daily as well. Because of the high rate of dry eye patients and OSD patients Tafluprost sine is a very useful option. If these patients need more than one medication the combination of Cosopt sine and Tafluprost sine is an option of three IOP lowering molecules with three drops a day in total but unpreserved.
From repair to regeneration – from laboratory discovery to clinic advance
Authors: KHAW PT
Published: November 2010

Biological processes involved in tissue repair play a part in every major blinding disease. We investigated the mechanisms involved in ocular tissue repair following surgery and disease, and have used in vitro cell culture and in vivo models of conjunctival scarring based on our clinical experience. In our laboratory work, we take into account evolving surgical aspects of our treatments, using the model of fistulising surgery for glaucoma, the most common cause of irreversible blindness. We then translate our laboratory findings into new clinical treatments. Using this approach, we investigated the role of several aspects of scarring ‐ cellular proliferation, growth factors, inflammation and matrix remodelling. We then used our in vivo model to evolve further treatments. Some have been taken through to pilot and large scale international clinical trials, and have shown reduction in scarring and improvement in the survival of surgery. The treatments include single applications of inexpensive anticancer agents, combinations of these with growth factor antagonists (including the first successful treatment for retinal scarring), nanomolecule dendrimers and matrix metalloproteinase inhibitors for clinical use. Our glaucoma trials showed that, in patients in whom scarring is well controlled, none progressed over nearly a decade. This enabled us to improve our surgical techniques and considerably reduce the incidence of sight threatening post‐surgery complications. Our lab experiments suggest that if scarring can be controlled, tissues may be permissive to regenerative processes including stem cell transplantation. Ultimately, we hope most scarring processes can be controlled, to allow the human body to regenerate after disease and injury.
A novel association of Cowden syndrome and combined hamartoma of retina and retinal pigment epithelium
Authors: DE ZAEYTIJD J , BANO G , HODGSON S , WILSON P , PAL B , EGAN C
Published: November 2010

Purpose To describe a patient with Cowden syndrome(CS), the multiple hamartoma and neoplasia syndrome, who was diagnosed with a unilateral combined hamartoma of retina and retinal pigment epithelium(CHR‐RPE).

Methods A 27‐year old lady presented with a history of headaches. She also had thyroid enlargement. She underwent MRI brain, full ophthalmic and genetic work‐up.

Results MRI brain showed a cerebellar lesion and examinations of the eyes revealed an anomalous right optic disc on top of bilateral papilloedema. Histology of the cerebellar lesion was suggestive of Lhermitte‐Duclos disease. This together with the thyroid enlargement raised the suspicion of Cowden's disease. DNA analysis of PTEN gene confirmed the clinical diagnosis. BCVA was 6/24 in the right eye and 6/6 in the left. Funduscopy revealed an anomalous right optic disc covered with elevated grayish glial tissue, distorted and dilated vasculature, retinal folds and exudation around the disc. FFA revealed typical CHR‐RPE characteristics: multiple, irregular, dilated blood vessels, dilation of the retinal capillary network and diffuse leakage during late phase. OCT demonstrated an elevated mass with hyperreflectivity in the retina and hyporeflective shadowing of the underlying tissue, total retinal disorganization, and an epiretinal membrane.

Conclusion Some ocular anomalies have been described in Cowden syndrome, however not CHR‐RPE. Therefore CHR‐RPE should alert the clinician to the possibility of CS in a suspected scenario. The recognition of this rare finding as a possible presenting feature can lead to earlier diagnosis, which is vital to appropriate surveillance and possibly life saving surgical intervention of the highly frequent neoplasias in CS.
MFGE8 expression in uveal melanoma
Authors: MOULIN AP , CARRASCOSA C , PAULILLO SARA , ZOGRAFOS L , MARIOTTI A
Published: November 2010

Purpose MFGE8 (lactadherin) is a pro‐angiogenic glycoprotein of milk fat‐globule that has been involved in tumor progression in an angiogenesis dependent mouse model of carcinogenesis. In a study evaluating protein expression in membrane rafts of cutaneous melanoma at different stages of progression, MFGE8 expression was found to be enriched in membrane rafts of metastatic cutaneous melanoma cell lines. The purpose of this pilot study was to assess the expression of lactadherin in primary and metastatic uveal melanoma.

Methods Expression of MFGE8 was assessed by immunohistochemistry in 10 primary and 10 metastatic non irradiated uveal melanoma. Western blot analysis was also performed in 3 uveal melanoma cells lines. Statistical analysis was performed using JMP software.

Results MFGE8 expression was identified in only 2 primary uveal melanoma and in 7 metastatic uveal melanoma (p=0,0349). In the primary uveal melanoma, MFGE8 expression was cytoplasmic and membranous in one case and only cytoplasmic in one case. In the metastases, expression was cytoplasmic and membranous in 5 cases and only cytoplasmic in 2 cases. There were no correlation between MFGE8 expression and cell type. Confirmation of MGFE8 expression was identified by Western blot analysis in OCM3, OCM8 and 92,1 uveal melanoma cell lines.

Conclusion This pilot study demonstrate for the first time the expression of MFGE8 in uveal melanoma and uveal melanoma cell lines. MFGE8 expression appears to be significantly higher in metastatic tumour and might play a role in tumour progression. Functional studies should be performed to better delineate the role of MFGE8 in uveal melanoma tumor progression.
Pilot study of adjuvant immuno‐chemotherapy for high risk uveal melanoma
Authors: MAZZINI C
Published: November 2010

Purpose Despite successful in local control of uveal melanoma,30‐50%of high risk patients with medium and high tumor size will develop metastatic disease of the liver which is highly resistant to systemic therapy

Methods Mar01‐Dec07, 31high risk patients with uveal melanoma(10medium;21high tumor size)were enrolled into a pilot trial of adjuvant immuno‐chemotherapy.We measured tyrosinase mRNA levels by real time quantitativeRT‐PCR in blood of all patients during a period of 5years.Results were correlated with clinical data and with the number of CTC evaluated by ISET.The therapeutic regimen consisted of fotemustine100mg/m2 e.v. on days1‐8 of the first month and every 4weeks for 6months.Interleukin‐2 s.c. at the dose of 4,5millionIU daily for 5days a week for 2weeks every month for 6months as immunotherapy

Results 30patients,treated and evaluated for the trial,received a median of 5,6cycles and were evaluable for toxicity and response.After a follow‐up period of 5years,25of30 treated patients(83%)were still alive without recurrences,4died for liver metastases(17%).The toxicity was low and the treatment could be administered on an outpatients basis.A significant correlation was found between mRNA tyrosinase levels and tumor size(p<0.01),disease free and overall survival(p<0.05).5patients who developed liver metastases and died,all of them showed an increase in tyrosinase mRNA levels and was correlated to the number of circulating tumor cells

Conclusion Our data indicate that the fotemustine and interleukine‐2 as adjuvant treatment of high risk uveal melanoma patients is well tolerate and is associated with a very low rate of metastatic recurrences.Although our data suggest a survival benefit further studies are recommended in a large,coordinate,prospective randomized trial
Achromic choroidal melanoma in a 9 year‐old boy
Authors: DE FRANCESCO S , GALLUZZI P , TOTI P , HADJISTILIANOU T
Published: November 2010

Purpose to report a case of achromic choroidal melanoma in a 9 year‐old boy.

Methods case report.

Results We report on the case of a 9 year‐old boy with no predisposing factors who was referred to the Siena Retinoblastoma Center with suspect of an atypical, late, unilateral retinoblastoma. The affected eye was enucleated. Pathologic examination showed an achromic choroidal melanoma. No further therapies were necessary. The child has been regularly examined by paediatric and ocular oncologists. After six months, there is no evidence of local and/or systemic recurrence of disease.

Conclusion Choroidal melanoma should be included in the differential diagnosis of leukocoria in children, even if it is very unusual at that age. MRI findings could suggest correctt diagnosis.
A systemic view on retinal ciliopathies: inherited retinal degeneration revisited
Authors: ROEPMAN R
Published: November 2010

Although over 200 different genes causing inherited retinal degeneration (IRD) have been mapped to date, a number that is steadily increasing, the molecular pathogenesis in most cases remains largely unknown. An increasing group of IRD genes encode proteins that localize to the connecting cilium of the photoreceptor cells, the structure that connects the inner to the outer segment. Interestingly, mutations in these genes are often not only causing retinal dystrophy, but can lead to a wide spectrum of phenotypes including renal failure, deafness, obesity, hypertension, and cognitive disabilities. The common denominator in these diseases is a dysfunctional cilium, a microtubule‐based protrusion from the cell membrane with a wide variety of functions, such as propulsion, intracellular transport, mechano‐ and chemosensation. Therefore, this group of disorders in now commonly referred to as “ciliopathies”. By structurally dissecting the protein‐protein interaction networks of retinal proteins involved in ciliopathies, we are gaining a detailed view on the complex disease mechanisms underlying this newly defined group of disorders, and are starting to understand the tremendous importance of the cilium in cell function.
Eye protection for ultraviolet B phototherapy and psoralen ultraviolet A patients
Authors: ANSARI E , OTMAN S , EL‐DARS LD , EDWARDS C , ANSTEY ALEX
Published: November 2010

Purpose We tested eye protection used for phototherapy patients. The study also established current practice concerning eye protection in a sample of UK phototherapy units.

Methods The ultraviolet (UV) transmission spectra of 30 'UV protective' contact lenses were measured at 5 nm intervals between 290 and 400 nm. Sunglasses, small UV goggles and UV visors were tested between 270 and 420 nm. We surveyed the use of eye protection during phototherapy in 78 UK phototherapy units.

Results All samples of sunglasses, eye protection goggles, visors and sunglasses comfortably passed previously published arbitrary limits of acceptability. Most contact lenses showed some protection in the UVB, but most had little or no UVA protection. Of 78 UK phototherapy units 21 (33%) use tinted goggles during UV exposures, two (3%) use a visor only, 28 (43%) use both and nine (14%) use clear plastic (probably polycarbonate) goggles.

Conclusion UV transmission for sunglasses and contact lenses is lower compared with samples tested 10 years ago. All samples of glasses, goggles and visors tested provided adequate protection in the UV range according to published arbitrary limits of acceptability. Most contact lenses did not provide significant UV protection in the UVA range.