bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced pattern electroretinogram signal in affected patients with Leber Hereditary Optic Neuropathy
Authors: Lalonde Melanie , Kantungane Ange‐Lynca , Sadun Alfredo , Coupland Stuart , Karanjia Rustum 
Published: December 2019

AbstractPurposeThe pattern electroretinogram (PERG) signal has been reported to be a sensitive tool for the detection of retinal ganglion cell (RGC) dysfunction in both animal models and patients suffering from optic neuropathies. This study investigated whether functional PERG can detect different levels of RGC dysfunction in both carriers and affected patients with Leber Hereditary Optic Neuropathy (LHON).MethodsPERG signals were recorded using both checkerboard (0.8° check size, 2 reversals/sec) and bars (0.5 cycles/deg) stimuli with mean luminance of 300 cd/m2 and 100% contrast. PERG signals were measured against functional full field Photopic Negative Response (PhNR) recordings (red flashes at 5 cd s/m2 stimulus intensity on blue rod saturating background) and subjective measures of retinal sensitivity (mean deviation [MD] via 30‐2 automated visual fields) and structural metrics (both ganglion cell complex [GCC] and retinal nerve fiber layer [RNFL] thickness from optical coherence tomography [OCT] scans).ResultsPERG P50 amplitudes were similar across controls, carriers, and LHON affected patients. P50 implicit times were significantly reduced in LHON affected patients (CHECKS: 45.8 ± 1.1 ms; BARS: 43.5 ± 0.8 ms; n = 32) compared to controls (CHECKS: 49.3 ± 0.5 ms; BARS: 48.1 ± 0.4 ms; n = 72). N95 amplitudes elicited by the checkerboard stimulus were significantly reduced and implicit times significantly increased in LHON affected patients (−3.4 ± 0.4 µV; 93.6 ± 2.2 ms; n = 32) compared to controls (−5.9 ± 0.5 µV; 85.3 ± 0.8 ms; n = 72). No differences were seen in PERG signals between control or LHON affected patients and carriers. Although PERG parameters were significantly different in LHON affected patients, the measurements were not correlated with PhNR signals, MD and RNFL thickness in all four quadrants around the optic disc. On the other hand, PhNR amplitudes, which were significantly reduced in LHON affected (−16.3 ± 3.4 µV; n = 32) and in carriers (−21.8 ± 3.0 µV; n = 30) compared to controls (−34.2 ± 2.5 µV; n = 28), were correlated with MD (r = −0.611, p < 0.0005; n = 28), average GCC (r = −0.618, p < 0.0001; n = 32) and average RNFL thickness (r = −0.553, p < 0.001; n = 31) in affected patients.ConclusionsSignificant differences in PERG recordings were measured between control and LHON affected patients. However, no significant differences were seen in carriers and PERG metrics were not correlated with functional PhNR parameters and other subjective and objective measurements tested. Our results suggest that PERG may not be as sensitive as PhNR to discriminate different levels of RGC dysfunction between LHON affected patients and carriers.
Extraction of hyaluronic acid and chondroitin sulfate from marine biomass for their application in the treatment of the dry eye disease
Authors: Abdallah Maha 
Published: December 2019

AbstractPurposeTear film instability, hyperosmolarity and neurosensory abnormality are the key etiological contributors to the pathophysiological process of the Dry Eye Disease (DED).1 Hyaluronic acid (HA) and Chondroitin sulfate (CS) have shown improvements in the corneal epithelial barrier in patients with DED.2 Moreover they are used in pharmaceutical applications due to their biocompatibility, viscoelasticity, lubricity and immunostimulatory effects. In this study, they are extracted from marine wastes and will be evaluated as possible DED treatment using natural, green and novel Deep Eutectic Solvents (DES) to replace time‐consuming and expensive conventional methods and maintaining the quality and purity of the isolated HA and CS. Natural compounds such as menthol and trehalose, are used in DES preparation and have shown to be effective in DED treatment.3,4MethodsHA and CS are isolated from marine wastes using conventional methods and DES as low‐cost alternative technique. DES are prepared by heating and mixing the components at certain ratios. They are mixed with the marine sources at specific extraction conditions. The extracts are then enzymatically hydrolyzed and analyzed by HPLC and capillary electrophoresis to quantify HA and CS.ResultsHA and CS are extracted from mussels, codfish bones and furtherly tuna eyeballs and shark fins using DES. Several DES were tested such as menthol:borneol, menthol:camphor, trehalose:glycerol, and significant amounts of HA and CS were extracted with high specificity. For example, 37.92 µg/gdry codfish bones CS disaccharide (ΔHexAβ1‐3GalNAc4S) were extracted using menthol:borneol.ConclusionDES are effective compounds for the extraction of valuable biopolymers HA and CS. The isolated HA and CS, as well as their therapeutic mixture with DES will be studied in vitro on conjunctival and corneal epithelial human cell lines to assess their toxicity, biocompatibility, muco‐adhesion and anti‐oxidant effects for the treatment of the DED.References

Craig, Jennifer P., et al. “TFOS DEWS II report executive summary.” The Ocular Surface 15.4 (2017): 802‐812.

Limberg, Michael B., et al. “Topical application of hyaluronic acid and chondroitin sulfate in the treatment of dry eyes.” American journal of ophthalmology 103.2 (1987): 194‐197.

Arita, Reiko, et al. “Effects of a warm compress containing menthol on the tear film in healthy subjects and dry eye patients.” Scientific reports 7 (2017): 45848.

Fondi, Klemens, et al. “Effect of Hyaluronic Acid/Trehalose in Two Different Formulations on Signs and Symptoms in Patients with Moderate to Severe Dry Eye Disease.” Journal of ophthalmology 2018 (2018).
Automatic classification and triage of diabetic retinopathy from retinal images based on a convolutional neural networks (CNN) method
Authors: Galdran Adrian , Chakor Hadi , Alrushood Abdulaziz A. , Kobbi Ryad , Christodoulidis Argyrios , Chelbi Jihed , Racine Marc‐André , Benayed Ismail 
Published: December 2019

AbstractPurposeDiabetic retinopathy (DR) is one of the leading causes of adult vision loss in the developed countries. Epidemiological and demographic factors, including the rising rates of diabetes related to obesity and an aging population, are driving the incidence of diabetic eye complication inexorably higher.MethodDeep learning emerges as a powerful tool for analyzing and classifying retinal images in an automatic way, but the classification results depend greatly on the availability of large datasets. As the number of categories and the imbalance ratio increase, the performance of deep learning models diminishes. In the context of DR grading, minority classes (mild and severe DR) are critical to diagnose. Experiments were performed on a real dataset developed at local hospital and at different hospitals around the world. Overall, 42 179 retinal images were obtained from Diagnos database. All images were graded by 3 retinal experts using the early treatment diabetic retinopathy study severity scale (ETDRS). The dataset was built by expanding on 4 categories: R0 or normal, R1 or mild DR, R2 or moderate DR, and R3&R4 or severe and proliferative DR. The data was split 90/10 for training and testing respectively, and an ensemble of Convolutional Neural Networks was trained to perform DR grading.ResultsThe proposed method achieves high accuracy in predicting DR grades, with the R1 class showing lower performance, in line with recently proposed methods. An area under the ROC curve of 0.96 (0.95–0.96) for R0, 0.70 (0.65–0.75) for R1, 0.95 (0.94–0.95) for R2 and 0.92 (0.89–0.96) for R34.ConclusionComparable to the score of human experts, the deep learning techniques in this study were effective to be applied in clinical use as primary care setting and could be a valuable tool to help primary care triage. Improvement in detection of R1 subjects is needed for further progressing in this area.References1. He K, Zhang X, Ren S & Sun J (2016): Deep Residual Learning for Image Recognition. In 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR) 770–778.2. Krause J et al. (2018): Grader variability and the importance of reference standards for evaluating machine learning models for diabetic retinopathy. Ophthalmology 125: 1264–1272.
Giant squamous cell carcinoma of the conjunctiva: a clinical case report
Authors: Lopes Diogo , Loureiro Tomás , Carreira Rita , Barros Sandra , Machado Inês , Campos Paul , Campos Nuno 
Published: December 2019

AbstractPurposeConjunctival Squamous cell carcinoma (SCC) represents a malignant disease that, if untreated, can cause irreversible loss of vision or even death. It is a rare disease, which is why the diagnostic and therapeutic approaches are not always linear. To report a case of a giant conjunctival SCC, including its diagnostic and therapeutic approach.MethodsA 82 years old man, with history of basal cell carcinoma in situ of the upper eyelid, was referred to the emergency department by a conjunctival lesion of the right eye with 3 months of evolution and rapid growth. Examination revealed a whitish, conical‐shaped temporal conjunctival lesion (16 x 18 x 6.5mm) in the right eye with no mobility relative to the scleral plane and staining with 1% toluidine blue. Orbital magnetic resonance imaging identified the temporal conjunctival lesion in the right eye, without unequivocal signs of scleral and other intraocular structures invasion.ResultsThis lesion was excised with a 4 mm margin, using 1% toluidine blue dye, through a no‐touch technique. As adjuvant therapy, we performed cryotherapy of the conjunctival margins and scleral bed, which was covered with amniotic membrane. Histological examination confirmed the presence of a well differentiated conjunctival SCC. One month after surgery, he started treatment with mitomycin‐c 0.04 mg/mL. Three months later, there were no signs of relapse.ConclusionClinical observation allows, in some cases, a high clinical suspicion. The vital staining with topical toluidine blue is an excellent aid in diagnosis, staining most lesions with high sensitivity, and in treatment, allowing to delineate surgical margins. Surgical treatment alone is associated with recurrence rates of up to about 70%, which is why adjuvant therapy, in particular cryotherapy and topical mitomycin‐c, is advocated. Although less common in the daily practice of an ophthalmologist, conjunctival SCC is potentially fatal and, therefore, deserves particular attention.
Visual acuity and structure‐function relationships in acute and chronic LHON patients treated with idebenone
Authors: Pemp Berthold , Kircher Karl , Reitner Andreas 
Published: December 2019

AbstractPurposeLeber's hereditary optic neuropathy (LHON) is a mitochondrial disease characterised by a subacute and progressive impairment and subsequent degeneration of macular retinal ganglion cells and their nerve fibres causing permanently reduced visual acuity (VA) in most cases. Idebenone is currently the only approved treatment for LHON. This study aims to evaluate the course of VA and its correlations with inner retinal layer morphology in LHON patients treated with idebenone.Methods42 eyes of 21 genetically confirmed LHON patients treated with idebenone were examined in regular intervals. VA was measured using logMAR charts. Macular ganglion cell layer volume (GCLV) and peripapillary retinal nerve fibre layer thickness (pRNFLT) were measured by spectral domain OCT. Patients were divided into three groups according to their time from LHON onset until treatment start including acute patients (<1 year, 12 eyes), chronic group 1 (1 to 5 years, 14 eyes) and chronic group 2 (>5 years, 16 eyes).ResultsA significant increase of VA compared to minimum VA was observed in all groups (acute: ‐0.25 logMAR, chronic 1: −0.29 logMAR, chronic 2: −0.31 logMAR; p < 0.001 all groups). VA at baseline was similar between groups, but 6 eyes of 4 acute patients showed a marked decline during the first year reaching a minimum after 9 months. Minimum VA of all patients was significantly correlated with final pRNFLT (r = 0.48, p = 0.002) and GCLV (r = 0.40, p = 0.008), but OCT and maximum VA during continued treatment showed stronger correlations (pRNFLT: r = 0.50, p = 0.001; GCLV: r = 0.43, p = 0.004). VA gain was not associated with OCT and not different between all groups.ConclusionsVA in LHON patients with recent disease onset can decrease during the first months of treatment with idebenone. The increase of VA after this nadir is comparable to the treatment effects observed in chronic patients and may be the result of a reactivated signal transduction in surviving dysfunctional ganglion cells.
Clinical outcomes after intracorneal ring segment implantation for keratoconus management in corneas with apical haze
Authors: Reinhold Aja , Panos Georgios D. , Khine Aye , Elalfy Mohamed , Hamada Samer , Scholl Hendrik , Gatzioufas Zisis 
Published: December 2019

AbstractPurposeIntracorneal ring segment implantation represents a safe and effective treatment option for visual improvement in patients with keratoconus. The presence of corneal scarring is considered to be an exclusion criterion for the use of intracorneal ring segments. The aim of this retrospective cohort study was to evaluate the clinical outcomes after intracorneal ring segment implantation for keratoconus in patients with corneal apical haze.MethodsSix eyes from 6 patients with keratoconus and corneal apical haze, who underwent femtosecond laser‐assisted Keraring implantation for keratoconus, were included in this study. All patients have had corneal crosslinking in the past. Uncorrected visual acuity (UCVA), corrected visual acuity (CDVA), Kmax, Kmean and thinnest corneal pachymetry have been evaluated preoperatively and 6 months after the Keraring implantation. Wilcoxon test was applied for statistical analysis with calculation of median value (lowest value – highest value). P values less than 0.05 were considered statistically significant.ResultsSix eyes of 6 patients (4 males and 2 females) were included in the study. Median age (years) was 33 (28 ‐ 38). UCVA (logMAR) and CDVA (logMAR) improved significantly from 1.05 and 0.75 preoperatively to 0.9 and 0.4 at 6 months postoperatively, respectively (p=0.03). Kmax (diopters) and Kmean (diopters) decreased from 54.5 and 47.85 preoperatively to 53.45 and 46.42 postoperatively, respectively (p=0.3). Changes in thinnest corneal pachymetry were not statistically significant (p=1.0). No complications occurred peri‐ or postoperatively.ConclusionOur study showed significant keratometric amelioration and visual improvement after intracorneal ring segment implantation for in patients with keratoconus and mild corneal apical haze at 6 months postoperatively. No complications occurred. These results suggest that the presence of mild corneal apical haze should not necessarily exclude the use of intracorneal ring segments in patients with keratoconus.
Cell Based Therapy for Corneal Endothelial Regeneration
Authors: Niazi Sana , Sanginabadi Azad 
Published: December 2019

AbstractCell based treatment, as an option in contrast to ordinary donor corneal transplantation, is foreseen to give a not so much intrusive but rather more successful helpful methodology for corneal endothelial dysfunction. The proliferative capacity of human corneal endothelial cells is seriously controlled, in this way making the foundation of ideal conditions for the development of human corneal endothelial cells a basic perspective for the clinical utilization of a cell based treatment. As of late, effective development convention of human corneal endothelial cells for clinical application which incorporates the utilization of Rho kinase (ROCK) inhibitor and the restraint of changing development factor beta flagging were accounted for to advance the cell multiplication and to help human corneal endothelial cell societies that show high cell thickness. Creature tests demonstrated that a cell‐infusion treatment joined with the utilization of a ROCK inhibitor advances developed corneal endothelial cell bond onto the back cornea, at last bringing about the recuperation of corneal straightforwardness. A pilot clinical examination was as of late started in Japan to research the viability of a cell‐infusion treatment for patients with bullous keratopathy.
A historical form of adenoid cystic carcinoma orbital: about a case
Authors: Abdi Rhizlane , Chariba Siham , Maadane Asmae , Sekhsoukh Rachid 
Published: December 2019

AbstractIntroductionAdenoid Cystic Carcinoma is a slow growing, locally invasive tumor of epithelial origin, mainly from the lacrimal gland. It is a rare tumor and the mortality rate has been found to be quite high (> 50%). Its usual development is done on salivary glands. Its orbital location on lacrimal glands is exceptional. We report the 55‐year‐old patient with advanced orbital cystic adenoid carcinoma.Case ReportA 55 years old female presented to our clinic with complaints of insidious onset, gradually worsening frontal region headache of 6 years duration, proptosis associated with decreased visual acuity, the evolution was marked 3 years ago by the appearance extended orbital mass to the frontal and maxillary region. The evolution was marked 3 years ago by the appearance of an extended orbital mass towards the frontal and maxillary region. The patient came to consultation at a very advanced stage with visual acuity at no light perception,at the inspection we observe an enormous frontoorbitofacial mass taking half of the left hemiface. The slit lamp examination exhibited exposure keratitis and the fundus: optic atrophy and retinal folds. Tomography computed scan revealed: the presence of an intra‐orbital tissue mass which includes the oculomotor muscles and the lacrimal gland measuring 67 * 16 mm pushing back the optic and infiltrating nerve in front of the left periorbital and left frontal palpebral soft tissues, with the presence of bone lysis of the different walls of the orbit . The assessment of extension found: pulmonary micronodules and vertebral lesions. A biopsy was performed and the histo pathological study revealed an adenoid cystic carcinoma. The patient was referred oncology for possible radio chemotherapy.ConclusionCystic adenoid carcinomas of the lacrimal gland are rare, they are malignant tumors that have a very high recurrence rate, and require early diagnosis and early management.
Bilateral anterior ischaemic optic neuropathy with macular star as first manifestation of Henoch‐Schönlein purpura (IgA vasculitis)
Authors: Kontou Evgenia , Bontzos Georgios , Ragkousis Antonis , Gkoumas Evangelos , Triantafyllou Dionysios , Bitza Penelope , Xirou Tina 
Published: December 2019

AbstractPurposeTo report a case of bilateral anterior ischaemic optic neuropathy with macular star in a patient with Henoch–Schönlein purpura (HSP).MethodsA 46‐year‐old man was referred to our clinic complaining of progressive decrease in visual acuity of the right eye (OD) since the last 10 days, and since 3 days in his left eye (OS). His visual acuity was ‘hand motion’ OD and 4/10 OS. Anterior segment examination was insignificant, while fundus examination revealed optic disc edema, and bilateral macular star. A relative afferent pupillary defect was present in his right eye with normal pupillary reflexes in the left eye. Laboratory analysis showed: Hematocrit: 22.1%, ESR: 140 mm/hr, CRP: 64.80 mg/dl, Creatinine: 4.4 mg/dl. Physical examination revealed presence of erythematous rash on the trunk and the extremities. The patient was admitted to the Nephrology department for treatment of his azotemia.ResultsDuring his hospital course we performed complete laboratory and imaging examinations for autoimmune diseases, vasculitis and infectious diseases, which were negative. Histologic findings of renal biopsy were compatible with IgA glomerulonephritis and thus HSP was diagnosed. The patient received oral methylprednisolone and intravenous cyclophosphamide therapy. Six months later his renal function had improved, the rash had subsided and his visual acuity was ‘counting fingers’ OD and 10/10 OS. Standard automated perimetry showed peripheral visual field depression bilaterally.ConclusionsHenoch–Schönlein purpura (HSP) is a small vessel vasculitis which is more common in children. Based on literature, ophthalmic manifestations of HSP usually involve the anterior segment and less frequently the posterior segment. Systemic vasculitis should be included in the differential diagnosis of bilateral optic disc edema.
Impact study of polarized light on the eye in a experimental model of dry eye disease
Authors: Shargorodska Iryna , Rykov Sergiy , Denysiuk Liubov , Liemienieva Anastasiia 
Published: December 2019

AbstractNow dry eye disease (DED) influences each tenth inhabitant of the planet. Current question of modern ophthalmology are the search for new therapies, one of which is the application of BIOPTRON‐PILER therapy.PurposeTo study of pathophysiological mechanisms of action and clinical efficacy of poly‐ and monochromatic BIOPTRON‐PILER‐light of dry eye disease.MethodsHere, we used rats with an experimental model of the dry eye induced by inflammation of eye anterior surface. BIOPTRON‐PILER therapy was performed using the red filter of the BIOPTRON (Bioptron AG, Zepter Group, Swiss) at 1 day after induction of DED. Only the right eye was treated from the distance of 30 cm for 3 min. Each animal received a course of treatment for 10 days.ResultsAre showed that a fluorescein test carried out immediately after alkali application and on 1, 5 and 10 days demonstrated a gradual increase in corneal epithelization and vascularization. We observed substantial and statistically significant increase of lacrimation in experimental rats on a 1 day after induction of inflammation compared to naïve animals. By the 7 day, the lacrimation decreased to a level with subsequent tendency to further decreased tear production. At the same time, there was no significant reduction in tear production on 7th day in a group of rats with the anterior surface inflammation that received polarized red light treatment, which may indicate a possible anti‐inflammatory effect of such treatment.ConclusionObtained evidence of the positive anti‐inflammatory effect of BIOPTRON‐PILER‐light in experimental model of the dry eye disease.
Contact lens wearers and dry eye symptoms: Ocular surface conditioning with Thealoz Duo
Authors: Peral Assumpta , Fernández Elena , Diz Elena 
Published: December 2019

AbstractPurposeContact lens use is associated with dry eye symptoms in approximately 50% of patients and can lead to discontinuation of their use. The aim of this study was to assess the effects of a combination of hyaluronic acid/trehalose eye drops on signs and symptoms of dry eye in contact lens wearers. Patient and care provider satisfaction were also evaluatedMethodsProspective, non‐controlled, pilot treatment trial was carried out in contact lens wearers with pre‐enrolement OSDI scores over 18. Following a week long washout period with sodium chloride eye drops 33 patients with contact lens related dry eye symptoms were recruited to receive 4 daily drops of a hyaluronic acid/trehalose eye drop for 12 weeks. TBUT, corneal and conjunctival staining, meniscus height and symptom questionnaires OSDI, DEFC and CLDEQ‐8 were performed at baseline, 5 weeks and 12 weeks.ResultsTreatment with hyaluronic acid/trehalose improved dry eye symptoms significantly as evidenced in reduction of questionnaire scores. Signs of dry eye improved most significantly for corneal fluorescein staining.ConclusionsHyaluronic acid/trehalose eye drops reduce the signs and symptoms of dry eye in contact lens wearers and are safe to use.