bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of acute in vivo exposure of rabbit cornea and conjunctiva to artificial sunlight
Authors: ALMALIOTIS D , VARSAMIDOU E , GOULAS A , MARKOPOULOU S , KARAYANNOPOULOU G , VARSAMIDIS K , KARAMPATAKIS V
Published: November 2013

Purpose Acute exposure of ocular and periocular tissues to natural or artificial light can induce inflammatory responses, attributed mainly to the UVB range of the spectrum. In this study, we have used a model of acute exposure of rabbit eyes to artificial sunlight, to study possible alterations in the architecture of corneal and conjunctival tissue as well as in the expression of tumor necrosis factor (TNF) and platelet activating factor (PAFR) in these tissues.

Methods New Zealand albino rabbits were immobilized opposite a 300W light bulb and exposed for 30 min to an equivalent of 7,500 Jm‐1 of UVB irradiation, in the range of the reported threshold for corneal damage. Corneal and conjunctival tissue samples were removed from exposed eyes at 2, 6 and 24 hours following the end of the exposure to the bulb light, and were subsequently processed for histochemical staining or RNA extraction. The gene expression of TNF and PAFR was monitored with RT‐PCR.

Results Histopathological examination revealed minor changes in the corneal architecture. A distinctive eosinophilic infiltration was observed, as early as 2 hrs post‐exposure, in the conjunctiva of the third eyelid, both in the epithelial layer and the basal lamina, which had apparently subsided by t = 24 hrs. The gene expression of TNF and PAFR was monitored with RT‐PCR.

Conclusion Acute exposure to artificial sunlight caused a marked accumulation of eosinophils in rabbit conjunctival epithelium but only minor changes in the corneal epithelium. Neither TNF nor PAFR gene expression was affected appreciably
Prevalence of allergic conjuctivitis in allergic population in northern greece
Authors: ALMALIOTIS D , MICHAILOPOULOS P , GIOULEKAS D , GIOULEKA P , PAPAKOSTA D , SIEMPIS T , KARAMPATAKIS V
Published: November 2013

Purpose A retrospective study on the prevalence of conjunctivitis and the commonest allergens in Northern Greece.

Methods From the archives of an outpatient unit in Thessaloniki‐Greece, the patients with conjunctivitis were evaluated. The patients underwent skin prick tests (SPTs) according to current guidelines. The patients were divided into 4 groups: Group A : Patients with conjunctivitis alone, Group B: patients with asthma and conjunctivitis, Group C: patients with rhinitis and conjunctivitis, Group D: patients with all three co‐morbidities.

Results 49 out of 1239 allergic patients had only conjunctivitis, 102 conjunctivitis and asthma, 117 conjunctivitis and rhinitis and 229 all three co‐morbidities.

Conclusion In the Northern Greek population allergic conjunctivitis is common. There was no significant statistical difference between men and women in the aforementioned groups.
Management of HSV‐1 necrotizing keratitis with amniotic membrane transplantation combined with antiviral and steroid therapy
Authors: GUEUDRY J , DUNCOMBE A , MARINGE E , MURAINE M
Published: November 2013

Purpose To report promoted healing of necrotizing herpetic keratitis after amniotic membrane transplantation (AMT) in conjunction with antiviral and corticosteroid therapy.

Methods Herpes necrotizing stromal keratitis was defined as a corneal ulcer with a dense, whitish inflammatory infiltration and corneal scrapping positive for HSV‐1 by polymerase chain reaction (PCR). Corneal smears and cultures were made to rule out bacterial and fungal infections. All patients received systemic antiviral treatment and topical antibiotics. When corneal ulcers were refractory to medical treatment, multilayered AMT was considered. During the post operative period, systemic antiviral treatment was continued and local corticosteroids were started. Main outcome measures were visual acuity and wound healing of corneal ulcers.

Results Thirteen patients (13 eyes) with herpes necrotizing stromal keratitis were retrospectively reviewed. The mean follow up was 13.1 months (range 2‐30 months). Amniotic membrane transplantation was performed in 9 cases (twice in one patient), within a mean of 17 days (range 2‐43 days) after medical treatment initiation. Epithelial defects healed within a mean of 40 days (range 9‐97 days) after AMT. At the last visit, mean visual acuity improved from 2.2 logMAR to 1.3 LogMAR (p=0.016). No serious side effects occurred during the follow up.

Conclusion Multilayer AMT combined with antiviral and corticosteroid therapy seems to be effective in treating herpes necrotizing stromal keratitis. It provides restoration of ocular surface integrity and improvement of vision.
Risk factors for contact lens‐related microbial keratitis: A case‐control multicenter study
Authors: SAUER A , MEYER N , BOURCIER T , THE FRENCH STUDY GROUP FOR CONTACT LENS‐RELATED MICROBIAL KE
Published: November 2013

Purpose The most feared complication of contact lens (CL) wear is microbial keratitis (MK), even though its incidence remains low. While CL materials and replacement schedules have developed greatly in recent years, the risk of MK, however, has not been reduced in users of daily disposable and silicone hydrogel CL. This study aimed to identify the risk factors of CL‐related MK while putting into perspective individual patients’ risks and societal burdens.

Methods A multicenter case‐control study was designed. The CL‐related MK subpopulation (Case) was compared to healthy CL wearers (Control) using a complete a 52‐item anonymous questionnaire designed to determine subject demographics and lens wear history. Univariate and multivariate logistic regression analyses were performed in order to compare both groups.

Results The study enrolled 508 cases and 499 controls, and revealed a higher risk for MK patients wearing soft CL, with cosmetic CL, with overnight wear, exceeding the CL‐ or the cleaning solution replacement delay, using a multipurpose cleaning solution. On the contrary, hyperopia, fitting and follow‐up by an ophthalmologist, and respect of basic hygiene rules were protective against CL‐related MK.

Conclusion The infectious determinants were linked to the patient, type of lenses, hygiene routine, CL handling, cleaning solution, and storage case. This study aimed to highlight the increasingly documented CL‐associated complications, which likely occur due to insufficient health professional supervision and lack of patient information regarding basic rules of hygiene, as well as CL care and handling.
Differences in corneal epithelium in patients with diagnosed macular and granular corneal dystrophy
Authors: SMEDOWSKI A , WYLEGALA E , WOJCIK L
Published: November 2013

Purpose To describe severity and forms of epithelial changes in patients suffering from macular and granular corneal dystrophy.

Methods In examined group 9 patients were included, 4 with diagnosis of macular and 5 of granular corneal dystrophy. Patients underwent basic slit lamp examination and in next order in vivo corneal confocal microscopy. Full thickness corneal scans were made and compared with corresponding images from healthy objects. Additional imaging of epithelial layer with higher magnification was made to compare detailed changes within single cells.

Results On a slit lamp examination we described: in case of granular dystrophy macroscopic, polymorphic deposits of crystal structure, located in full thickness of corneal stroma and in epithelium. In macular dystrophy cornea stromal and epithelial changes took more diffused form. The corneal confocal microscopy images showed different intensity of typical stromal changes (crystalic or diffused depends on dystrophy type). In epithelium, in cases of macular dystrophy, we found different stages of intracellular changes, which secondary involved intercellular space. In granular dystrophy changes localized mostly in intercellular space with preserved cellular architectonic.

Conclusion However both described dystrophies are classified as stromal, in different way involve cells in epithelial layer. Corneal confocal microscopy can be useful for detailed examination of corneal dystrophic changes.
Biomechanical consequences of keratoconus treatments
Authors: HUGNY LARROQUE C , COCHENER B
Published: November 2013

Purpose to evaluate, biomecanical consequences of Crosslinking (CXL) in keratocônus, with intracorneal ring (ICR) or not, with a new instrument : Corvis © (Oculus).

Methods Our prospective study included ten patients with evolutive keratoconus (i.e. keratometric modification more than 0.5 D and/or refraction modification in 6 months), with pachymetry superior to 400 microns. For patients had both CXL and ICR (operated 3 months after CXL), six CXL only. The procedure was flash CXL (4 minutes of riboflavine, 15 minutes of UltraViolets). Patients were seen at 1, 3 and 6 months, with visual acuity, topography, corvis (deformation amplitude, aplanation length, corneal velocity), vidéotopography.

Results The evaluation of corneal biomechanical properties of the cornea with corvis shows, after CXL, an increase of the aplanation lentgh of the second palanation pic : 0,8 pre‐CXL, 1,02 post‐CXL. Now, A2’s length is usually decreased in keratoconus compared to normal cornea. Therefore, the A2 lenght change after CXL could be a parameter for the follow‐up after CXL to show it’s efficacy.

Conclusion Corvis can be another tool in keratoconus’ follow‐up, based on the impacts of treatments (ICR and CXL) on biomechanical properties of the cornea.
Microbial keratitis after penetrating keratoplasty
Authors: EL MATRI L , LIMAIEM R , CHEBIL A , KORT F , MGHAIETH F
Published: November 2013

Purpose To investigate the prevalence of microbial keratitis, predisposing risk factors, the spectrum of pathogens and the prognosis for graft survival and visual outcome in patients who developed microbial keratitis following penetrating keratoplasty (PK).

Methods We reviewed 14 cases (14 patients) of microbial keratitis after PK from January 1 2007, to December 31 2011. In all cases, corneal scrapings were obtained and microbiologically analyzed. Efficacy of treatment was evaluated by anatomical clarity of graft.

Results There were 100 PKs performed and 14 (1,4%) cases of culture‐positive keratitis during the study period. Principal indications for PK were corneal perforation (6 cases) and pseudophakic bullous keratopathy (3 cases). Fifty per cent of infections occurred within 1 year of PK. Principal predisposing risk factors were suture‐related problems (64,8%), epithelial defect (50%) and microbial keratitis in the previous graft (50%). Fifty of the scrapings were positive according to the microbiological evaluation with gram‐positive cocci (42,85%), fungi (7,14%). We found 1 case of polymicrobial infection in renal graft. After medical and surgical treatments, 3 patients (21,42%) had a clear graft.

Conclusion : The development of bacterial keratitis after PK is a serious complication that is associated with a high incidence of graft failure and poor visual outcome. Postoperative control of risk factors and early recognition of infectious complications may decrease the incidence of severe microbial keratitis after PK.
Cytomegalovirus retinitis (CMVR)‐related retinal detachment (RD) surgery in AIDS patients in an Asian population
Authors: WONG J , WONG E , TEOH S
Published: November 2013

Purpose This study reports the outcomes of retinal re‐attachment surgery in patients with Cytomegalovirus retinitis (CMVR)‐related retinal detachment (RD) in an Asian population.

Methods Review of CMVR characteristics, surgical outcomes and complications in 19 patients with CMVR‐related RD who underwent surgery from January 2000 to June 2011.

Results CMVR was inactive in 73.7% of the patients at the time of surgery. Fourteen (73.7%) of RDs were macula‐off and 4 (21.1%) patients had proliferative vitreo‐retinopathy (PVR). Anatomical success was achieved in 14 patients (73.6%). Eight patients (42.1.%) had improvement of 1 or more lines in BCVA, 7 patients (36.8%) maintained BCVA and 4 patients (21.1%) had poorer BCVA at 6 months after surgery. Of the 13 patients who presented with worse than 6/120 vision, 30.8% regained ambulatory vision or better. Five patients had re‐detachments (26.3%). Six phakic patients (54.5%) developed cataracts post‐surgery at a median interval of 6 months. Seven patients had immune recovery uveitis (IRU) prior to RD. Median durations from CMVR and IRU diagnoses to RD were 2.0 and 1.0 months respectively.

Conclusion Surgery for CMVR‐related RD is associated with good anatomical outcomes with most patients maintaining or improving vision. Factors related to better outcomes include smaller CMVR lesion size and the absence of PVR. CD4 counts were not related outcomes. Patients diagnosed with CMVR and IRU require close monitoring for development of RD.
The regulatory effects of 1, α, 25‐dihydroxyvitamin D3 on the expression of inflammatory cytokines in diabetic retinopathy
Authors: TOHARI A , CRAFT J , SHU X
Published: November 2013

Purpose Diabetic retinopathy (DR) is typically characterized by abnormal changes in the microstructure of retina as a result of prolonged uncontrolled diabetes mellitus. Several mechanisms on how high glucose concentration alters retina microvasculature have been proposed. One of these mechanisms is the activation of alternative glucose pathways leading to accumulation of several metabolic end‐products which induce oxidative stress in retina causing cellular changes of the expression of pro and inflammatory mediators. Thus, the aim of this study is to investigate the protective function of vitamin D in diabetic retinopathy

Methods 1‐Treatment of ARPE‐19 cell line with the active form of vitamin D 2‐Diabetic animal models are induced for type 1 diabetes mellitus and treated with calcitriol

Results 1‐Vitamin D down‐regulates the expression of pro and inflammatory cytokines involved in DR 2‐It up‐regulates the expression of antioxidative stress scavengers 3‐Vitamin D improves cell survival during inflammatory process

Conclusion Changes in the expression patterns of immunomodulatory and antioxidative proteins after vitamin D treatment propose a protective function of vitamin D in DR
Persistent macular edema with secondary neovascular membrane following a panuveitis in woman with Behçet’s disease resolved by a switching to aflibercept injections
Authors: TORO M , REIBALDI M , STELLA S , AMATO R , LONGO A , GAGLIANO C
Published: November 2013

Purpose To report the effective treatment of a neovascular membrane following recurrent panuveitis associated to Behçet’s Disease, in a woman no responders to cyclosporine and biological response modifiers, refractory to ranibizumab, who was switched to aflibercept injections.

Methods An interventional case report with optical coherence tomography (OCT) scans.

Results A 56‐year‐old Caucasian woman was suffering from recurrent panuveitis on both eyes for Behçet’s Disease with a neovascular membrane on left eye. She had undergone one entire cycle of therapy with cyclosporine (5mg/Kg/die) and two infusion of infliximab which resolved panuveitis, without functional or anatomical improvement of the eye clinic on the left eye. Six months after the second infusion of infliximab, she received two consecutive intravitreal injections of ranibizumab with the persistent of the neovascular activity and without any improvement of visual acuity (VA). Four weeks following the second injection, the treatment was switched to two aflibercept injections. Two weeks later, her best‐corrected visual acuity improved from 0.4 to 0.7. Macular edema resolved with a reduction of central retinal thickness from 398 μm before Aflibercept injections to 274 μm after Aflibercept injections, as measured by OCT scan.

Conclusion Aflibercept could be a new therapeutic,effective,safe,local treatment option in patients with complicated noninfectious uveitis as Behçet’s Disease, no responders to immunosuppressive agents or immunobiological response modifiers and previous anti‐VEGF treatments.
Cataract and uveitis: Comparison of two different anti inflammatory protocols for the prevention of post‐operative complications
Authors: BUTEL N , FARDEAU C , LE HOANG P , BODAGHI B
Published: November 2013

Purpose In the context of cataract surgery in patients followed for chronic uveitis, evaluate the effectiveness of a standart protocol corticosteroids versus a simplified protocol , by comparing the visual acuity and inflammation pre‐and postoperatively in each two groups.

Methods Prospective non‐randomized single‐center study was conducted in 2012, including 35 eyes(30 patients), mean age was 54.9 years. Patients were followed for chronic uveitis, whatever the cause, and were elligibles for a cataract surgery. 20 eyes received the standart protocol of corticosteroids, wich was oral corticosteroids combined pre‐and postoperatively, as well as bolus injection of solumedrol and subconjunctival injection of dexamethasone in peroperative time. On the other side, 15 eyes received a lightweight protocol comprising only intraoperative corticosteroids (bolus and subconjunctival injection) without oral corticosteroids.

Results With a median follow up of 6 months, after surgery, gain of visual acuity was significant in all patient. We lamented 4 earlier acute inflammatory relapses , 2 postoperative macular edema ,1 epimacular membrane and 1 retinal detachment. These complications did not link siginficatif with the choice of protocol, completeness or light. They were put in relation with the severity of previous inflammation, and particularly his etiology , preoperative inflammatory state, and if it was an antecedent of macular edema or not.

Conclusion Simplified protocol can be proposed for cataract surgery in patient with chronic uveitis, especially for patients who did not relapse over a year and with no history of macular edema, as well as patients who were not found obvious systemic cause
In vivo analysis of protein quality control in response to aging using transgenic mice
Authors: MARQUES C , MATAFOME P , SANTOS A , LOBO C , SHANG F , PEREIRA P , GIRAO H
Published: November 2013

Purpose It has been suggested that aging affects the cells ability to protect protein integrity, which is essential for cellular homeostasis. On cell aging there is impaired protein homeostasis, which can lead to protein insolubilization that is toxic to cells. The carboxyl terminus of Hsp70‐interacting protein (CHIP) is an important ubiquitin ligase for protein quality control, and particularly in selective degradation of aggregation prone proteins. The objective of this study was to characterize the transgenic mice that overexpress CHIP/Ubc5 in lens epithelial cells and investigate the role of these proteins in the process that maintains proteins in solution and therefore participates in a number of age‐related diseases, including cataract.

Methods To overexpress CHIP, the α‐crystallin promoter was used to drive the expression of CHIP‐Ubc5 in lens epithelial cells of transgenic mice. The CHIP levels of transgenic mice (Tg) were determined with western blotting analysis. Cataract was induced by single subcutaneous injection of sodium selenite and the lens transparency was assessed by slit lamp examination. The soluble and insoluble protein content in all groups was evaluated.

Results The data show that the transgenic mice only overexpress the transgene in lens epithelial cells.The slit lamp analysis showed that transgenic mice appears developed less cataract compared with wild type, with concomitantly increase in ratio of the soluble and insoluble proteins.

Conclusion Together the data suggest that overexpression of CHIP/Ubc5 in lens epithelial cells could prevent cataract formation by promoting reduction of protein insolubilization.
Comparison of different techniques to evaluate the biomechanics of the accommodative apparatus in human eyes
Authors: PINILLA L , BURD HJ , MONTENEGRO GA , MIKIELEWICZ M , BARRAQUER RI , MICHAEL R
Published: November 2013

Purpose For the study of the biomechanical properties of lens and zonules in a stretching device, we wanted to investigate the effect of keeping the ciliary body intact or cutting it radially.

Methods We studied the anterior eye segment of 3 pairs of presbyopic human donor eyes (ages 51‐85). These segments, comprising of lens, zonules, ciliary body and sclera, were radially stretched in our device which allows force and tissue elongation measurements to be made. First, each pair (OD and OS) was stretched with the ciliary body intact and the lens in place, afterwards, in OD, the ciliary body was cut radially and the lens was kept, and in OS, the ciliary body was kept intact and the lens removed, then we stretched again. Forces are given at 500 µm stretch, measured from lens centre to ciliary body edge.

Results The mean force with the ciliary body intact and the lens in place was 74 mN. When the ciliary body was cut (with lens in place) the required force was 35 mN. When the ciliary body was keep intact and the lens removed we measured a force of 47 mN, which represents the contribution of the circumferential stretch of the ciliary body.

Conclusion Stretching anterior eye segments showed that the required forces were considerably higher when the ciliary body was kept intact as compared when it was cut radially. These forces were increased due to the circumferential resistance by the ciliary body.
Quality of vision with traditional monovision versus modified monovision
Authors: VANDERMEER G , LEGRAS R , GICQUEL JJ , PISELLA PJ
Published: November 2013

Purpose To compare binocular subjective quality of vision with modified monovision (MMV) (ie different combinations of spherical (SA4) and secondary spherical (SA6) aberration on each eye) versus traditional monovision (TMV) with different level of anisometropia

Methods A numerical eye model was used to generate images (ie three 0.4 logMAR high contrast letters) viewed through a 4.7mm pupil, degraded by various condition of SA and for proximities from ‐5D to 5D (Naked eye, SA4‐0.4μm, SA4+0.4μm, SA4‐0.4 and SA6+0.2μm, SA4+0.4 and SA6‐0.2μm). Binocular vision was simulated using a 3D‐NVIDIA video device projecting different image on each eye. Binocular through‐focus (TF) quality of vision was evaluated using a grading scale (ITU‐R 500 recommendation) by four subjects with TMV for different level of anisometropia (ie 0.5 to 3D at 0.5D step) and with various combination of MMV

Results Area under TF curve (ie a way to evaluate quality of vision) measured for a fair or higher image quality was increased with TMV and MMV compared to naked eye because of the summation of the two best monocular curves. With TMV, a 2.5D anisometropia was the more effective to increase area under TF curve with however a lack of intermediate vision. With MMV the greatest increase of quality of vision was obtained with reverse profile of SA4 and SA6 on each eye (ie SA4‐0.4 and SA6+0.2μm on one eye and SA4+0.4 and SA6‐0.2μm on the other eye). Compared to TMV, reverse profiles of MMV showed a significant benefit in improving area under TF curve thanks to a better quality of intermediate vision

Conclusion MMV especially with reverse profiles of SA improved overall quality of vision without the lack of intermediate quality of vision intermediate quality of vision induced by TMV
Synchronous malignant transformation of bilateral symmetrical retinocytoma
Authors: DE FRANCESCO S , DE LUCA M , GALIMBERTI D , CAINI M , HADJISTILIANOU T
Published: November 2013

Purpose To report the outcome of a 4‐year‐old girl who was found to have bilateral malignant transformed retinocytoma.

Methods The patient was treated with systemic chemotherapy and photocoagulation followed by intraarterial chemotherapy.

Results Complete remission was achieved.

Conclusion Chemotherapy destroyed malignant retinoblastoma and the “retinoma” component remained unchanged.
Müller cell response during degenerative retinopathy in mice
Authors: MENDES‐JORGE L , VALENÇA A , PIRES VMR , CATITA J , RAMOS D , LOPEZ‐LUPPO M , NACHER V , NAVARRO M , CARRETERO A , RODRIGUEZ‐BAEZA A , RUBERTE J
Published: November 2013

Purpose Structural retinal alterations were evaluated in a murine model of retinopathy with photoreceptor degeneration, in order to establish response patterns for each stage of the inflammatory process.

Methods In this work, a murine model of retinopathy with photoreceptor degeneration was studied. Groups of 4 animals were intraperitoneally injected with 100 mg/Kg of sodium iodate, and euthanized 24, 48 and 72 hours after injection. A non‐injected animal was used as a control in each group. The retinas were analyzed by means of histological techniques, immunohistochemistry, Western Blotting and q‐RT‐PCR.

Results In the retina, aggressive stimuli are known to induce reactive gliose. In our murine model of retinopathy, Müller cell activation was accompanied by cell proliferation and glial fibrillar acidic protein (GFAP) over‐expression with maximum values 48h after injection.

Conclusion The differences in GFAP expression allowed us to establish expression patterns of this protein which may be used to identify the phase of the inflammatory response in progress.
Secondary glaucoma in familial amyloid polyneuropathy
Authors: ROUSSEAU A , BARREAU E , KASWIN G , CAUQUIL C , THEAUDIN M , ADAMS D , LABETOULLE M
Published: November 2013

Purpose To describe the clinical features of secondary glaucoma associated with transthyretin (TTR)‐related Familial Amyloid Polyneuropathy (FAP).

Methods In this retrospective monocentric study, 5 patients with FAP associated secondary glaucoma were seen at the ophtalmologic consultation of the french national center for FAP between 2011 and 2012. The mutation of the amyloidogenic TTR variants was analysed for all patients. All patients had a complete ophthalmic examination including BCVA, IOP, slit lamp and optic disc photographs, gonioscopy, pachymetry, automated perimetry, and OCT‐RNFL. Glaucomatous optic neuropathy was diagnosed based on the presence of visual field abnormalities, neuroretinal rim thining, excavation or RNFL defects. Medical and surgical treatments were analysed for all patients.

Results All cases had bilateral involvement except 2 monophtalmic patients. All patients were of portuguese origin and carriers of the Val30Met mutation. There were 4 women and 1 man with a mean age of 58.8±7.7 years. Mean BCVA was 0,83±0.9 LogMAR. Three eyes had a BCVA below 20/400. Mean IOP was 26.6±6.6 mmHg. Mean deviation was ‐17.6±11.2dB. Fringed pupil and anterior chamber amyloid deposition were noted in all affected eyes. Three patients had concomitent vitreous involvement. Patients were treated with 1.2±1.5 ocular hypotensive drugs. Four eyes had been treated with at least 1 filtrating surgery.

Conclusion FAP‐associated secondary glaucoma is a very severe disease, associated with amyloid deposits in the anterior chamber and characteristic pupil deformation. Systematic and comprehensive eye examination should be performed in all patients affected with FAP in order to improve early detection of glaucoma.
Effectiveness of the glaucoma screening in employees of the University Hospital St. Luc, UCL, in Brussels
Authors: STINGLHAMBER A , POURJAVAN S
Published: November 2013

Purpose To assess the effectiveness of free glaucoma screening for the employees of University Hospital St. Luc, UCL, Brussels, during the World Glaucoma Week 2013.

Methods During 1 week, the employees in the university hospital St.Luc, were invited to Glaucoma outpatients' free screening consultation. 320 responded positively. The participants filled before the examination a questionnaire: age, sex, personal ocular trauma or surgery, and familial history was asked. The subjects were examined by an ophthalmologist in training and supervised by an experienced glaucoma consultant if needed (SP). The examination of anterior segment (Van Herick’s, depth, Krukenberg’s spindle, iris transillumination and pseudoexfolliation), the optic disc (size, rim and peripapillary hemorrhages) and the IOP by GAT were performed. Depending of clinical examination, a visual field test was performed. Finally, according to the results, the examiner classified the subjects in ‘Normal’, ‘suspect’ and ‘Glaucoma’ group. A second appointment was scheduled for the patients in the ‘Suspect’ or ‘Glaucoma’ classification.

Results From the 640 eyes, there were in total 15% in ‘suspect group’ classified. The aspect of their optic disc and a suspect visual field was the main reason for this classification.5% of the total eyes undergone a preventive iridotomy, none of these patients had experienced any ocular symptoms. 3% of all eyes showed glaucoma with structural and functional glaucomatouse damage.

Conclusion Glaucoma is still not widely known. Even for the employees of a large university hospital white easy access to the care, is screening important. The preventive iridotomy was the best result of this WGW screening.
Comparing the use of steroid vs artifitial tears following selective laser trabeculoplasty
Authors: ALI ALJASIM L
Published: November 2013

Purpose To compare between using potent steroid, mild steroid or just artificial tears following selective laser trabeculoplasty (SLT) , and its effect on outcome

Methods Retrospective file review of all patients underwent SLT in our institute for a year, the data divided into 3 groups: group 1 received Prednisolone acetate 1% ophthalmic suspension ± their glaucoma medications, in the immediate post laser period, group 2 had Fluorometholone eye drops, and group 3 had artificial tears. The rate of complication & outcome was compared between the groups.

Results 215 eyes of 129 patients underwent SLT, from October 2012‐October 2013. During the post‐laser period, Prednisolone acetate 1% was used in 134 eyes, for 8.79±3.6days (3‐14 days), Fluorometholone for 41 eyes for 6.85±2.1 (3‐14 days) & 40 patients had neither. Most of the eyes had 360* treatment, half of the patients had DM & 40% had hypertension Pre‐SLT intraocular pressure(IOP) in group 1 was 19±6mmHg on 2.4 glaucoma medications, in group 2 19.4±5.4mmHg on 2.4 medications & in group 3 was 21±6.2mmHg on 2.5 medications. The first group treated with 78.6±13.2 shots of 0.56mj per shot, group 2 with 81.1±16.6 shots of 0.59mj, and group 3 with 75.9±15.2 of 0.59mj. The resulted decrease of IOP in the first group was 2.4±5.3mmHg (12.7%), in group 2 was 3.4±4.8mmHg (17.7%) & in the last group was 5.5±6.1mmHg (26.1%). One patient had persistent anterior chamber reaction for more than 2 week, in both eyes, in the first group( that was treated with prednisolone). In the other groups, no eye showed any degree or AC reaction.

Conclusion The use of steroid had an adverse effect on the result of SLT, while the use of artificial tears post‐SLT did not result in increased rate of complication.
Ganglion cell complex measurement and glaucoma diagnosis using two SD‐OCT
Authors: FRANCOZ M , EL CHEHAB H , FENOLLAND JR , DELBARRE M , MARéCHAL M , OUANEZAR S , GIRAUD JM , MAY F , RENARD JP
Published: November 2013

Purpose Macular retinal ganglion cell analysis from Cirrus HD‐OCT (Carl Zeiss Meditec, Dublin, CA) and RTVue‐OCT (Optovue Inc., Fremont, USA) were evaluated in their glaucoma diagnostic ability.

Methods A total of 169 eyes were enrolled in 3 groups: (1) 70 early primary open angle glaucoma patients (POAG), (2) 44 moderate‐to‐advanced POAG, (3) 55 normal subjects. All patients underwent a complete examination and a macular analysis using GCA algorithm from Cirrus HD and GCC algorithm from RTVue. Macular average, minimum and 6 sectoral GCL‐IPL thicknesses obtained with Cirrus and average, inferior and superior GCC thicknesses and FLV and GLV obtained with RTVue were analyzed. Each eye underwent cpRNFL analysis using Cirrus and RTVue. Glaucoma discrimination ability was assessed using area under the receiver operator characteristic curve (AUC) for all parameters.

Results Average GCL‐IPL thickness with Cirrus was 65.6 ± 7.4 μm, 57.8 ± 13.1 μm and 80.3 ± 9.9 μm and average GCC with RTVue was 75.7 ± 10.7 μm, 72.6 ± 9.7 μm et 93.9 ± 7.7 μm, for group 1, 2 and 3 respectively (p<0.05 between each group). AUCs ranged from 0.836 to 0.925 for Cirrus macular parameters and from 0.878 to 0.949 for RTVue macular parameters. These values were compared to the discrimination ability of cpRNFL parameters from each OCT.

Conclusion The two OCT macular ganglion cell analysis showed similar glaucoma diagnostic ability and were comparable with that of cpRNFL. Specific macular parameters: GCL‐IPL minimum, GCL‐IPL inferotemporal, FLV and GLV have a high diagnosis performance.
Analyse of segmented macular inner layers by spectral domain optical coherence tomography in glaucoma
Authors: DELBARRE M , EL CHEHAB H , FRANCOZ M , ZERROUK R , MARECHAL M , OUANEZAR S , GIRAUD JM , MAY F , RENARD JP
Published: November 2013

Purpose To evaluate the glaucoma discriminating ability of macular inner layers measured by SD‐OCT (Cirrus HD‐OCT, Carl Zeiss Meditec (CZM) Dublin, CA, USA).

Methods Our study concerns 252 primary open angle glaucoma (POAG) eyes (early, moderate and advanced glaucoma) and 337 normal eyes which underwent a visual field testing (Humphrey Field Analyser, SITA‐Standard 24‐2, CZM), and Cirrus HD‐OCT imaging (macular and optic disc cube 200x200). OCT macular scans were segmented into macular nerve fibre layer (mNFL), ganglion cell layer with inner plexiform layer (GCIPL) and ganglion cell complex (GCC=GCIPL+mNFL). Area under the receiver operator characteristic curve (AUC) for macular parameters and mean circumpapillary retinal nerve fibre layer (cpRNFL) were used.

Results There is a statistically significant difference between glaucomatous and control eyes for all parameters (p <0.05). For early POAG group the best AUCs were respectively minimum GCIPL (0.747), average GCIPL (0.716), GCC (0.71), cpRNFL (0.704), minimum mNFL (0.673) and average mNFL (0.655). For moderate POAG group the best AUCs were respectively minimum GCIPL (0.864), GCC (0.858), cpRNFL (0.853), average GCIPL (0.838), average mNFL (0.82) and minimum mNFL (0.815). For advanced POAG group the best AUCs were respectively minimum GCIPL (0.938), GCC (0.928), minimum mNFL (0.92), average GCIPL (0.908), cpRNFL (0.854) and average mNFL (0.854).

Conclusion Minimum GCIPL would have the highest sensitivity to diagnosis glaucoma. It may represent an interesting complementary parameter to cpRNFL thickness.
Correlation between retinal ganglion cell count and morpho‐functional parameters in glaucoma
Authors: MILANO G , LOMBARDO S , DISTANTE P , TINELLI C , LANTERI S , VERTICCHIO VERCELLIN AC , CUTOLO CA , RAIMONDI M , ROLANDO M , ROSSI GCM
Published: November 2013

Purpose To evaluate the correlation between retinal ganglion cell (RGC) count and morpho‐functional parameters provided by spectral‐domain optical coherence tomography (SD‐OCT) and standard automated perimetry (SAP)

Methods 52 eyes evaluated for open angle glaucoma underwent a complete ophthalmologic examination including SAP and SD‐OCT evaluation of retinal nerve fiber layer (RNFL) thickness and macular ganglion cell complex (GCC). RGC counts were obtained using a previously derived algorithm proposed by Medeiros et al. Patients were divided into 3 groups according to glaucoma severity staged by Glaucoma Staging System 2: suspects (stage 0‐border), early (stage 1‐2) and manifest glaucoma (stage 3‐4‐5)

Results Average RGC count estimate was 933803±132506 in suspects, 685583±158345 in early and 385316±185374 in manifest glaucoma (p<0.001). The same trend was noticed for the considered parameters, even if the major loss was found between early and manifest glaucoma in functional data (MD and PSD) and between suspects and initial glaucoma in structural data (RNFL and GCC). RGC count showed very poor correlation with PSD in all groups (r<‐0.3), a progressively increased correlation with MD according to glaucoma severity (r>0.3 in suspects, r>0.9 in manifest glaucoma), a moderate correlation with RNFL (r>0.6) and GCC (r>0.5) in all groups

Conclusion A substantial loss of RGCs is detectable in all groups and proportional to glaucoma stages. Structural evaluation of optic nerve (RNFL) and inner macular retina (GCC) can provide a useful diagnostic tool in all stages while SAP is well correlated only to substantial loss of RGC. Macular RGC are involved in early glaucoma loss
Ocular Pulse Amplitude is associated with ocular blood flow velocities in healthy subjects and patients with primary open angle glaucoma, but not normal tension glaucoma
Authors: PINTO LA , VANDEWALLE E , STALMANS I
Published: November 2013

Purpose Purpose: to determine the correlation between ocular blood flow changes throughout the cardiac cycle on ocular pulse amplitude (OPA) in glaucoma patients and healthy subjects.

Methods Method: A prospective, case‐control study was designed with dynamic contour tonometry and color Doppler Imaging performed in healthy controls and glaucoma patients. An offline waveform analysis of the Doppler signal was performed by a masked observer for each of the retrobulbar arteries. Linear regression models using intraocular pressure (IOP), age and Doppler waveform variables [(resistance index (RI) and systolic/diastolic velocity ratio (Sm/Dm)] were designed to identify independent variables associated with OPA.

Results Results: 192 patients were included [healthy controls: 55; normal tension glaucoma (NTG): 63, primary open‐angle glaucoma (POAG): 74]. OPA showed a significant associated with the constructed model in healthy individuals and in POAG patients (r=0.54, p<0.001; r=0.43, p<0.001, respectively). Short ciliary arteries flow variables were the only vascular‐related parameters independently associated with OPA in these groups (p<0.05). IOP was independently associated with OPA in the POAG group (p<0.001), but not the healthy group (p=0.48). OPA in the NTG group did not correlate with the constructed model (r=0.24, p=0.21).

Conclusion Conclusions: OPA seems to reflect blood flow changes in the short ciliary arteries in healthy individuals and POAG patients, but not in NTG patients. In the latter, the ocular pulse may relate to other variables than blood flow velocities.
Distribution of ocular biometric parameters during the eye growth
Authors: YEKTA A , HASHEMI H , OSTADIMOGHADDAM H , JAFARZADEHPOUR E , KHABAZKHOOB M , REZVAN F
Published: November 2013

Purpose To determine the distribution of ocular biometric parameters and their correlation with age and gender during the eye growth.

Methods In a cross‐sectional study, a multi‐stage stratified cluster sampling was used to sample the study population from Dezful schools, a city in the southwest of Iran. Participants were selected from the all school grades and both genders. Examinations were performed after obtaining consent from the subjects's parent. LENSTAR/BioGraph (WaveLight AG, Erlangen, Germany) was used for ocular biometry.

Results Of 864 selected subjects, 683 participated in the study (response rate:79.1%); 377 participants (55.2%) were males. Mean age of the subjects was 12±3.4 years (range: 6.0‐18 years). Mean and 95% confidence interval(CI) of axial length (AL),anterior chamber depth (ACD), lens thickness (LT),central corneal thickness (CCT),corneal diameter (CD), and pupilary diameter(PD) were 23.13 mm (22.93‐23.33), 3.01 mm (2.96‐3.06), 3.58 mm (3.55‐3.61), 549.33 mic (546.59‐552.07), 12.34 mm (12.31‐12.38), and 4.97 (4.91‐5.03), respectively. Ocular biometric parameters were normally distributed. Distribution of LT and CD were leptokurtic and the distribution of the PD was platykurtic. The mean of AL, ACD, CD and CR were significantly higher in boys and the mean of LT was significantly higher in girls. Axial length and ACD increased and the LT decreased significantly with age. Axial length and CR had the highest correlation (r=0.669) and ACD had the strongest correlation with the

Conclusion The results of this study indicated that AL and ACD were intermediate and shorter respectively. Corneal diameter was bigger in comparison with the other studies. The majority of the changes were observed in AL and LT.
Interleukin‐8 promoter polymorphism is associated with the initial repose to bevacizumab in AMD treatment
Authors: IMMONEN I , HAUTAMÄKI A , KIVIOJA J , VAVULI S , KAKKO S , SAVOLAINEN ER , SAVOLAINEN M , LIINAMAA J , SEITSONEN S , ONKAMO P , JÄRVELÄ I
Published: November 2013

Purpose To study the association of potential key single‐nucleotide polymorphisms with the short‐term anatomic response to bevacizumab treatment in exudative age‐related macular degeneration (AMD).

Methods Clinical data of 96 bevacizumab‐treated exudative age‐related macular degeneration patients were analyzed retrospectively. Blood DNA was collected. Based on the disappearance of intra‐ or subretinal fluid in optical coherence tomography, patients were graded as responders, partial responders, or nonresponders after 3 initial treatment visits and a median time of 3.5 months. Representative single‐nucleotide polymorphisms of interleukin 8, vascular endothelial growth factor, erythropoietin, complement factor H, complement component C3, and LOC387715 genes were analysed.

Results Interleukin 8 promoter polymorphism −251A/T,conferring a more acitve interleuking‐8 system, was significantly associated with persisting fluid in optical coherence tomography. The A allele was more frequent in nonresponders than in responders (P = 0.033). In multivariate modeling, the AA genotype of −251A/T (P = 0.043) and occult (P = 0.042) or predominantly classic (P = 0.040) lesions predicted a poorer outcome.

Conclusion The interleukin ‐8 pathway may modulate the early anatomic response to anti‐VEGF treatment in AMD. A possible activation of interleukin ‐8 production in patients may represent a compensatory mechanism to chronic blockade of VEGF signalling in AMD lesions
Angiopoietin‐like protein 2 contributes to pathogenesis of diabetic retinopathy
Authors: ITO Y , OIKE Y , TANIHARA H
Published: November 2013

Purpose Recent studies show that angiopoietin‐like protein 2 (Angptl2) contributes to chronic inflammation in diabetes, tumor, rheumatoid arthritis and dermatomyositis, Angptl2 is expressed in endothelial cells, and increased by hypoxia and endoplasmic reticulum stress in HUVEC, and serum level of Angptl2 is increased in diabetes. However, the function of Angptl2 in diabetic retinopathy is still unknown. In this study, we investigate the Angptl2 concentration in vitreous fluid and expression in fibrovascular membrane of PDR patients to evaluate the role of Angptl2 in pathogenesis of diabetic retinopathy.

Methods We collected vitreous samples at the time of vitreous surgery from 33 PDR and 29 nondiabetic patients. The concentration of Angptl2 in vitreous samples was measured by using the human Angptl2 enzyme‐linked immunosorbent assay, and we examined Angptl2 protein expression in fibrovascular membrane from PDR patients by immunohistochemistry using both anti‐Angptl2 and anti‐CD31 or anti‐Mac2 antibody. Next, we examined Angptl2 expression under the hypoxic condition, and ICAM‐1 expression induced by Angptl2 in human retinal endothelial cells (HRECs).

Results The vitreous concentration of Angptl2 significantly increased in patients with PDR compared with controls (P< .001). Double immunofluorescent staining showed that Aangptl2 was expressed in endothelial cells and macrophages in fibrovascular membrane. In vitro study, we found that Angptl2 expression was increased under 2% hypoxic condition in HRECs, and Angptl2 promoted ICAM‐1 expression in HREC through the activation of NFkB signaling.

Conclusion Aangptl2 may play an important role in the pathology of diabetic retinopathy by causing the chronic inflammation in retinal endothelial cells.
Association of serine racemase gene variants with type 2 diabetes in the Chinese Han population
Authors: Zhang Simin , Xiao Jianzhong , Ren Qian , Han Xueyao , Tang Yong , Yang Wenying , Zhou Xianghai , Ji Linong
Published: November 2013

A genome‐wide association study in the Chinese Han population has identified several novel genetic variants of the serine racemase (SRR) gene in type 2 diabetes. Our purpose was to systematically evaluate the contribution of SRR variants in the Chinese Han population. rs391300 and rs4523957 in SRR were genotyped respectively in the two independent populations. A meta‐analysis was used to estimate the effects of SRR in 21,305 Chinese Han individuals. Associations between single‐nucleotide polymorphisms and diabetes‐related phenotypes were analyzed among 2,615 newly diagnosed type 2 diabetes patients and 5,029 controls. Neither rs391300 nor rs4523957 were associated with type 2 diabetes in populations. Furthermore, meta‐analysis did not confirm an association between type 2 diabetes and SRR. In the controls, rs391300‐A and rs4523957‐G were associated with higher 30‐min plasma glucose in an oral glucose tolerance test. The present study did not confirm that SRR was associated with type 2 diabetes.
Golgi protein 73, not Glypican‐3, may be a tumor marker complementary to α‐Fetoprotein for hepatocellular carcinoma diagnosis
Authors: Wang Yichen , Yang Huayu , Xu Haifeng , Lu Xin , Sang Xinting , Zhong Shouxian , Huang Jiefu , Mao Yilei
Published: November 2013

Background and Aim

This study aimed to evaluate the effectiveness of serum Golgi protein 73 (GP73) and Glypican‐3 (GPC‐3) as tumor markers for diagnosis of hepatocellular carcinoma (HCC).

Methods

A total of 257 subjects were enrolled and consisted of 61 healthy controls, 32 hepatitis B virus carriers, 80 cirrhosis patients, and 84 HCC patients. Diagnosis was performed based on established clinical procedure. Serum GP73, GPC‐3, and α‐fetoprotein were measured. Receiving operating characteristic (ROC) curves were plotted to determine the sensitivity and specificity of each serum marker and their combinations.

Result

Serum GP73 levels were significantly increased in HCC patients. No significant differences were observed between GP73 and α‐fetoprotein (AFP) as markers for HCC diagnosis. However, GP73 was more sensitive than AFP in the diagnosis of small HCC. A combination of GP73 and AFP tests increased the sensitivity and specificity for HCC diagnosis. The area under the ROC curve (AUC) of combined test was 0.93 compared with 0.88 for GP73 and 0.90 for AFP alone. GPC‐3 tests were negative in all 84 HCC patients. The AUC for GPC‐3 is 0.43, indicating that serum GPC‐3 was not an effective tumor marker for HCC diagnosis.

Conclusion

Serum GP73 is a potential tumor marker for HCC diagnosis, especially for differential diagnosis of small HCC and cirrhosis. The combination of GP73 and AFP is more sensitive than AFP alone. Serum GPC‐3 does not appear to be an effective tumor marker for HCC diagnosis.