bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced visualization of retinal vasculature using image processing
Authors: Jung Do‐Hyun , Taek Kim Yun 
Published: December 2019

AbstractObjectiveTo develop a digital filter that enhances visualization of retinal blood vessels.MethodsFour‐hundred 24‐bit color fundus images were analyzed and properties of red, green, and blue channels were extracted. Then, using hemoglobin absorption coefficients, the relevant weights for gray‐scale conversion that emphasizes retinal vessels were calculated. To evaluate images, edges were detected via convolution‐al 2D Laplacian kernel from the processed images, and the number of edges, number of effective edges, and sum of intensities of edges were evaluated. To validate the clinical usefulness, two independent observers graded 100 fundus photographs from subjects with diabetes mellitus before and after image process described above. Agreement between observers and the diagnosis from fluorescein angiography was calculated using Cohen’s kappa coefficient (κ).ResultsThe values of weights for red, green, and blue channels were calculated to be −0.0572, 0.7335, and 2.2079, respectively. When comparing the images that were processed using the new digital filter based on these values with the original image, gray‐scale, green, red, blue, and green and blue digital filter images, the number of edges, effective edges, and sum of intensities of edges were all found to be significantly higher in the images processed with the new filter (p < 10−16). Cohen’s kappa coefficients (κ) of grading diabetic retinopathy from two independent observers comparing to the diagnosis from fluorescein angiography were 0.36, 0.29 respectively from fundus photographs and 0.61, 0.65 respectively from processed images. And Cohen’s kappa coefficients (κ) on the presence of any grade of diabetic retinopathy from two independent observers comparing to the diagnosis from fluorescein angiography were 0.69, 0.69 respectively from fundus photographs and 0.86, 0.84 respectively from processed images.ConclusionsThe RGB filter developed here was based on actual fundus images. The hemo‐globin absorbance reinforced the edges of retinal blood vessels, verifying that the new RGB filter can en‐hance the visualization of retinal vasculature. Significance: This digital filter was developed targeting hemoglobin for enhancement of retinal vasculature. Because this digital filter is simple to build, it can be applied for fundus camera.
Clinical & pathologic features of lacrimal ductal cyst
Authors: Choi Hye Sun , Jang Jae Woo , Kim Sung Joo , Baek Ji Sun 
Published: December 2019

AbstractPurposeTo evaluate the clinicopathological features of lacrimal ductal cyst.MethodsA retrospective study was performed on patients who underwent the surgery to remove the lacrimal ductal cyst at Kim’s Eye Hospital from January 2013 to December 2017. We analyzed the clinical data obtained from the medical records, including slit lamp examination and pathologic findings.Results57 patients was enrolled in this study. There was a male predominance and the average age was 42.9 years (range 15–73). 55 patients showed unilateral disease and two patients showed bilateral disease. Palpable mass lesion was most common symptom, but other symptoms, such as discharge, injection, cystic lesion, itching, epiphora, pain, swelling, foreign body sensation were also seen. Conjunctival injection was most common findings in the slit lamp examination. Pathologically, acute and chronic inflammation was most common findings. Cilia was founded on the cyst in 45.6% and concretion was founded on the cyst in 42.1% in pathologic examination.ConclusionsLacrimal ductal cyst is rare and few case series were reported. Large population study of lacrimal ductal cyst was first. This report would be helpful to distinguish the lacrimal ductal cyst from other disease in lateral canthal area.
Primary Open Angle Glaucoma and Vascular Risk Factors: a review of population based studies from 1990 to 2017
Authors: Grzybowski Andrzej , Och Mariusz , Kanclerz Piotr , Leffler Christopher 
Published: December 2019

AbstractPurposeGlaucoma is one of the leading causes of blindness worldwide, and as the proportion of those over age 40 increases, so will the prevalence of glaucoma. The pathogenesis of primary open angle glaucoma (POAG) is unclear and multiple ocular risk factors have been proposed, including intraocular pressure, ocular perfusion pressure, ocular blood flow, myopia, central corneal thickness, and disc hemorrhages. The purpose of this review was to analyse the correlation between systemic vascular risk factors and POAG pathogenesis based on major epidemiological studies.MethodologyWe used the PubMed database to identify studies including the term glaucoma in association with the following keywords: vascular risk factors, systemic risk factors, blood pressure, systemic hypertension, systemic hypotension, diabetes, dipping, vasospasm, age and migraine.ResultsThe search identified 270 unique articles. After including only relevant English‐language articles only 66 studies were reported in the analysis. Reports presenting the association between POAG and systemic vascular risk factors included a total of over 50,000 patients. Several epidemiological studies confirmed the importance of vascular risk factors in the pathogenesis and progression of glaucomatous optic neuropathy, including hypertension, blood pressure dipping. The pooled analysis confirmed hypertension as the most significant risk factor for primary open angle glaucoma.ConclusionsVascular risk factors play a significant role in the pathogenesis and progression of glaucoma. The association between POAG and diabetes mellitus type 2 or migraine still needs to be evaluated in future studies.
The effect of antiamoebic agents and Ce6‐PDT on acanthamoeba castellani trophozoites and cysts, in vitro
Authors: Shi Lei , Stachon Tanja , Latta Lorenz , Ibrahem Elhawy Mohamed , Gunaratnam Gubesh , Orosz Erika , Kiderlen Albrecht F. , Seitz Berthold , Bischoff Markus , Szentmáry Nóra 
Published: December 2019

AbstractPurposeTo analyze the concentration dependent effect of diamidines (hexamidine‐diisethionat (HD), propamidin‐isethionate (PD), dibromopropamidine‐diisethionat (DD)); biguanides (polyhexamethylen biguanid (PHMB), chlorhexidine (CH)); natamycin (NM); miltefosine (MF); povidone iodine (PVPI) and chlorin e6 photodynamic therapy (PDT) on Acanthamoeba castellani trophozoites and cysts, in vitro.MethodsAcanthamoeba castellani strain was cultured in 712 peptone‐yeast extract‐glucose (PYG) medium. Thereafter, trophozoites or cysts were cultured in 0.25–0.1% HD, PD or DD, or 0.005–0.02% PHMB, CH or NM or 0.001625–0.0065 MF or 0.25–1% PVPI containing PYG medium for 2 h or underwent Chlorin e6‐PDT. Then, the percentage of dead trophozoites was determined by CytoTox 96® Non‐Radioactive Cytotoxicity assay and trypan blue staining and those of cysts using trypan blue staining. Treated trophozoites and cysts were also inoculated to non‐nutrient agar Eshericia coli plates and were observed for 5 weeks.ResultsAll concentrations of different antiamoebic agents had a significant cytotoxic effect on AK trophozoites and cysts (p < 0.05), except 0.02% PHMB and CH, using trypan blue assay for trophozoites, and Ce6‐PDT for cysts. Observing the agar plates, HD, PD, PHMB, CH, NM and PVPI led to morphological changes of acanthamoeba trophozoites, which could not form cysts within 5 weeks. DD and MF treated cysts could excyst and later encyst again.ConclusionsConservative treatment using different antiamoebic agents or Ce6‐PDT can not eradicate all Acanthamoeba castellani trophozoites and cysts. In vitro analyzis of treatment efficacy of different antiamoebic agents may alow a more specific treatment in acanthamoeba keratitis.
Required stage dependent therapy in coats disease
Authors: Brockmann Claudia , Müller Bert , Schönfeld Shideh , Winterhalter Sibylle , Zeitz Oliver , Joussen Antonia M. 
Published: December 2019

AbstractPurposesCoats disease is a rare retinal vascular disorder characterized by telangiectasia and exudation affecting predominantly young male. Due to its rareness, analyses of large cohorts over long periods are of particular importance to give a prognosis for the usually very young patients and their parents, especially with regard to required therapy.MethodsWe retrospectively analyzed patients diagnosed with Coats disease and treated between May 1992 und March 2019. The minimum follow‐up was 12 months. We evaluated the interventional procedures with regard to the initial stage.ResultsSeventy‐seven eyes of 75 patients were included in the analyses. Eighty‐one percent were male; mean age was 17.8 ± 18.2 years (range 1–71; median 10.0). Mean follow‐up time was 7.3 ± 5.6 years (range 1.1–21.4; median 6.5). In eyes with stage 1 (n = 2) only lasercoagulation (LC) was necessary. In stage 2A 65% (11/17) of eyes required LC, 30% (5/17) cryotherapie (CT), 25% (4/17) vitrectomy (VT) and 18% (3/17) ruthenium brachytherapy (RT) due to secondary vasoproliferative retinal tumor. In stage 2B 88% (29/33) were treated with LC, 30% (10/33) with CT, 21% (7/33) needed VT and 6% (2/33) RT. In 89% (8/9) of eyes staged 3A1 LC was necessary, in 100% (9/9) CT and in 44% (4/9) VT. Three eyes were staged 3A2 and all of them required VT, two additional LC and one additional CT. Similar results were seen in stage 3B (five eyes): in all eyes VT was performed, in 80% (4/5) LC and CT was done in addition. Four of six (66%) stage 4 eyes were enucleated, the 2 remaining received CT and VT or RT. We had 2 stage 5 eyes, thereof one required enucleation.ConclusionTherapy in patients with Coats’ disease strongly depends on the initial stage with less intense procedures in early stages. While most invasive treatment was necessary in stage 3, the rate of enucleation was, as expected, highest in stage 4. Therefore early diagnosis and immediate treatment is of highest priority to preserve the eye.
Efficacy and safety of Resvega in diabetic macular edema: preliminary results of a pilot study
Authors: Chatziralli Irini , Dimitriou Eleni , Chatzirallis Alexandros , Aissopou Evaggelia , Theodossiadis Panagiotis 
Published: December 2019

AbstractPurposeThe protective effects of resveratrol within the eye are extensive. It has been demonstrated to have anti‐oxidant, anti‐apoptotic, anti‐tumourogenic, anti‐inflammatory, anti‐angiogenic and vasorelaxant properties. Of note, resveratrol inhibits vascular endothelial growth factor (VEGF) expression in human adult retinal pigment epithelium cells. The purpose of this study was to examine the efficacy and safety of vitamin supplements with resveratrol (Resvega, Thea Laboratories) in patients with diabetic macular edema (DME).MethodsParticipants in this prospective, pilot study were 23 patients with DME, who were previously treated with anti‐VEGF injections. All patients presented mild DME, with good visual acuity (>7/10) and central retinal thickness (CRT) 280–330 μm, where anti‐VEGF injection was not needed at the current time at the discretion of the physician. All participants received Resvega (2 tablets once/day) for 4 months. Visual acuity and CRT were assessed every month, while potential adverse events were recorded.ResultsThe visual acuity remained stable at the 4‐month follow‐up. The mean CRT increased slightly at month 4 post initiation of treatment compared to baseline, but the difference was not statistically significant. Four out of 23 patients (17.4%) needed additional anti‐VEGF injection at the end of the follow‐up due to worsening of macular edema. No adverse events were reported.ConclusionsResvega was found to be safe and effective in patients with DME, since it stabilized visual acuity and CRT in the short‐term follow‐up of 4 months. Long‐term studies are needed to confirm our results.
Outcome simultaneous replacement of stromal donor lenticul in cornea with ectasia during Smile surgery
Authors: Doroodar Farideh 
Published: December 2019

AbstractPurposeLenticule implantation can be used to correct vision problems. The aim of the present study was to investigate the feasibility and effects of Simultaneous replacement of stromal donor lenticul in cornea with ectasia during Smile surgeryMethodsSix patients with decreased visual acuity due to corneal ectasia were included in this prospective pilot study. These lenticules were extracted during SMILE procedures using the VisuMax femtosecond laser (Carl Zeiss Meditec) on 6 donors with myopia and Simultaneous replacement of stromal donor lenticul in cornea with ectasia. Pre‐ and postoperative (1 or 3 days, 1 month, and 6 months) slit lamp microscopy, corneal topography, anterior segment optical coherence tomography, and in vivo confocal microscopy were performed.ResultsThe surgeries and postoperative follow‐up examinations were uneventful and no complications were noted over 6 months of follow‐up. At the last measurement, the corrected distance visual acu‐ity of all recipient eyes gained at least two lines. Two eyes (33.3%) gained at least two lines of uncorrected distance visual acuity compared to their preoperative levels.Mean keratometric power increased by 5.97 ± 3.73 diopters and central corneal thickness increased by 55.25 ± 36.38 μm. Anterior segment optical coherence tomography observation showed the lenticule was transparent with a visible demarcation line during the follow‐up examination.ConclusionsThis technique seems to be feasible and safe for increasing corneal stromal thickness and changing corneal refractive power, which may provide a useful method for treatment of keratoectasia, presbyopia, and hyperopia.
NRF‐2 and PGC‐1α signaling regulate epithelial‐mesenchymal transition in mouse model
Authors: Felszeghy Szabolcs , Ruuth Johanna , Viiri Johanna , Hyttinen Juha , Koskela Ali , Kaarniranta Kai 
Published: December 2019

AbstractPurposeEpithelial‐mesenchymal transition (EMT) is estimated to play critical role in the development of advanced age‐related macular degeneration (AMD). Key players associated with EMT were studied in NRF‐2 and PGC‐1α knock‐out mice model resembling dry AMD phenotype.MethodsRetina paraffin sections from NRF‐2 and PGC‐1α knock‐out mice and wild‐type (WT) animals were analyzed for EMT biomarkers by semiquantitative confocal, highly specific and sensitive immunofluorescence method. Retinal pigment epithelium (RPE) cell morphology was analyzed by optical coherent tomography and ultrathin transmission electron microscopy.ResultsSemiquantitative image analysis revealed that collagen 1 is downregulated in knock‐out samples compared to WT animals. Upregulation of key EMT markers such as, vimentin, e/n‐cadherins, snail, fibronectin and slug were detected in the knock‐out mice rather than in WT samples. RPE cells showed morphological transition in the knock‐out animals.ConclusionsDisturbed anti‐oxidant production through nrf‐2 and mitochondrial biogenesis through pgc‐1α seem to regulate emt in the dry amd resembling mouse model.
Fluocinolone acetonide for the treatment of chronic diabetic macular edema: an Italian real‐world experience
Authors: Zollet Piero , Capone Luigi , Lattanzio Rosangela , Bandello Francesco 
Published: December 2019

AbstractPurposeThis is a retrospective real‐world study on the use of Fluocinolone acetonide (FAc) intravitreal implant (Iluvien®) for the treatment of chronic diabetic macular edema (DME) insufficiently responsive to available therapies. Its aim is to give a further contribution in assessment of efficacy and safety of this drug delivery system.MethodsPatients included were collected from July 2017 to May 2019. 53 pseudophakic chronic DME patients (69 eyes) were enrolled to evaluate anatomo‐functional outcomes; namely, best corrected visual acuity (BCVA), central macular thickness (CMT) and complications (i.e. rise in intraocular pressure (IOP) and need for IOP lowering medications, hemovitreous, endophtalmitis) of Iluvien® implants. The study partecipants were all previously unsuccessfully treated with first‐line therapies (anti‐VEGF and laser) and intravitreal dexamethasone (Ozurdex®). Patients were considered eligible only in presence of response to the latter drug without significant intra‐ocular pressure increase. Information about further need for DME additional therapies post‐FAc were also recorded. The data of 18 eyes with at least 12 months follow‐up are reported.ResultsAt baseline the mean overall BCVA was 58.3±17.5 ETDRS scale letters. Post‐FAc implant, mean BCVA rised to 63.9 ± 15.2, 60.8 ± 18.3, 61.3 ± 16.9 and 64.5 ± 13.9 ETDRS letters at 2, 4, 6 and 12 months respectively. The percentage of eyes achieving 15 or more ETDRS letters improvement within 12 months was 33.3%. CMT values, from a baseline mean of 517.4 ± 204.0 µm, decreased to 364.9 ± 138.4 µm, 410.8 ± 192.4 µm, 339.0 ± 126.8 µm and 339.9 ± 82.0 at 2, 4, 6 and 12 months, respectively. In this period of observation a dry macula (<300 µm) was obtained in 33.3% of eyes. Recorded complications included increase in IOP with need for IOP lowering medications in 18.9% of study population. Only 8.7% patients needed to perform additional DME therapies for poor response to FAc.ConclusionsThe preliminary results of our study support the use of FAc for the treatment of chronic DME. Efficacy and safety profiles seem to be comparable with the ones of the FAME pivotal study but with less IOP concerns. Selecting patients previously treated with intravitreal steroids and without increase in IOP can further minimize risks. Mean increase of IOP over time can be safely managed with topical therapy in the large majority of cases.
Observational study of magnitude of ocular manifestations of rheumatoid arthritis in a tertiary care hospital in East India
Authors: Dutta Udbuddha 
Published: December 2019

AbstractPurposeTo evaluate the magnitude of ocular manifestations in patients suffering from rheumatoid arthritis. To establish a statistical significance of age of patients to frequency of ocular manifestations. To establish a statistical significance of duration of disease to frequency of ocular manifestations.MethodsStudy Design: Cross sectional observational study. Sample Size: 144. Duration of Study: 18 months. Case control was not required in this study. Investigations: Slit lamp biomicroscopy with 90 D Volk lens was done for anterior and posterior segment examination. Gonioscopy, Applanation Tonometry, Automated Perimetry and Indirect Ophthalmoscopy were done . Dry eye evaluation was done. Statistical Analysis: SPSS version 20 was used with a p value of less than 0.05 taken as significant.ResultsOut of 144 patients, females (118) dominated .Ocular manifestations were seen in 53(36.8%) patients, bilateral in 35 (66%) patients and multiple in 32 (60.4%) patients. Dry eye was the most common ocular manifestation (30.5%). The duration of disease was statistically significant(p=0.001)with respect to ocular manifestations and also age groups (p = 0.000).ConclusionDry eye was the most common ocular manifestation. The duration of disease was statistically significant with respect to ocular manifestations. The duration of disease was statistically significant when co related with age groups.
Clinical stability in the fellow non‐operated eye from asymmetric keratoconus patients
Authors: Lopes Diogo , Baptista Pedro , Sena Nelson , Barros Sandra , Machado Inês , Ambrósio Renato 
Published: December 2019

AbstractPurposeTo assess the clinical status of corneal ectasia, including clinical outcomes and tomographic/biomechanical assessments of asymmetric keratoconus patients who had surgical treatment only in the most advanced eye.MethodsThis retrospective study included 100 eyes of 50 asymmetric keratoconus patients who had surgery in one eye. The eyes were divided in two groups, the operated group (OG) which underwent surgery and the fellow non‐operated eyes (NOG). Both groups received medical treatment for ocular allergic disease and ocular surface optimization, along with the general advice to avoid eye rubbing.ResultsMean follow‐up time was 41 ± 33.26 months (range 6.4–182.4) and mean age at the first visit was 25 ± 9.8 years (range 6–60), including 43 patients with less than 34 years. Regarding to the NOG, the baseline average UDVA was 0.40 (20/50) ± 0.46 logMAR and CDVA was 0.10 (20/25) ± 0.17 logMAR. In the last visit, despite of no surgical treatment, average UDVA and CDVA showed improvement to 0.34 (20/44) ± 0.43 (p > 0.05) and 0.06 (20/23) ± 0.15 logMAR (p = 0.02), respectively. Analysis of biomechanical parameters of the NOG showed a statistically significant difference (p < 0.05) of deflection amplitude ratio. The comparison of ABC parameters of Belin’s tomographic grading system between first and last visit showed non statistically significant difference (p > 0.05) in the NOG.ConclusionClinical anti‐allergic and ocular surface optimization treatment, along with patient education for avoiding eye rubbing (as in the Violet June Keratoconus Awarenes Campaign) is indicated to all keratoconus/ectasia patients best first line of treatment. The stability of the ABCD parameters of Belin grading system in the NOG and even the improvement of CDVA supports that, regardless age, in many cases with mild ectasia, medical management is sufficient without the need for surgical procedure, even in young patients.
The effect of Tetrahydrocannabinol on optic nerve head blood flow in healthy subjects
Authors: Hommer Nikolaus , Kallab Martin , Szegedi Stephan , Puchner Stefan , Bauer Martin , Werkmeister René , Schmetterer Leopold , Abensperg‐Traun Marihan , Garhöfer Gerhard , Schmidl Doreen 
Published: December 2019

AbstractPurposeThere is ample evidence that optic nerve head blood flow (ONHBF) is impaired in patients with glaucoma. Tetrahydrocannabinol (THC) is used in the treatment for glaucoma in some countries for several years due to its intraocular pressure (IOP) lowering effect. Beside its IOP lowering potential, THC features neuroprotective effects and may improve ocular hemodynamics. The aim of the present study was to investigate whether oral administration of THC alters ONHBF in healthy subjects.MethodsThe present study was carried out in a double‐masked, randomized, placebo‐controlled, two‐way crossover design in 24 healthy subjects. For each study participant, two study days were scheduled, on which they either received capsules containing 5 mg Dronabinol (a synthetic THC) or placebo capsules identical in appearance. ONHBF was assessed using laser Doppler flowmetry at baseline and 1 hr after drug administration. Ocular perfusion pressure (OPP) was calculated as 2/3*mean arterial pressure (MAP) ‐ IOP.ResultsTwenty‐four healthy subjects (12 female and 12 male) aged between 20 and 35 years participated in the present study. The study medication was well tolerated and no cannabinoid‐related psychoactive effect was observed. Neither administration of THC nor placebo had an effect on IOP, MAP or OPP. In contrast, THC significantly increased ONHBF by 9.5 ± 8.1% whereas placebo did not show a change in ONHBF (0.3 ± 7.4 % vs. baseline, p < 0.001 between groups).ConclusionsThe present data indicate that orally administered, low dose THC increases ONHBF in healthy subjects without affecting IOP, OPP or inducing psychoactive side effects. Further studies are needed to investigate whether this effect can also be observed in patients with glaucoma.