bluuebunny/crossref_metadata_2025_split huggingface dataset:
XEN in extreme cases
Authors: Djavanmardi Shirin , Milla Elena 
Published: December 2019

AbstractPurposeThe Xen implant allows to perform a filtering procedure using a collagen tube of 6 mm in length and 45 microns of lumen usually placed in the upper nasal quadrant. Its main indication is primary open angle glaucoma, however, its versatility has allowed it to be used in other types of glaucoma cases. The aim of this communication is to present some cases in which the Xen implant has been used to treat complex situations.Methods & ResultsCase 1 ‐ A 31‐year‐old woman with congenital glaucoma, a history of goniotomy and a drainage device carrier of double‐plate glaucoma who presented intraocular pressure (IOP) of 17 mmHg with maximum topical and oral treatment and severe toxic ocular disease. As the upper nasal quadrant was occupied, a XEN device was implanted in the inferior nasal quadrant. During the postoperative period, displacement of the implant towards the anterior chamber was evident, but no endothelial cell loss was observed and control of the IOP was maintained at 1 year of follow‐up with a significant reduction in medication and improvement of the ocular surface. Case 2 ‐ A 34‐year‐old man presented with contusive trauma in his left eye complicated by 2‐mm hyphema and (IOP > 40 mmHg ) that could not be controlled with maximum medication. After performing a drainage of the hyphema a XEN implant was placed in the upper nasal quadrant. Since then, IOP was controlled and the visual acuity completely reestablished. Case 3 ‐ A 58‐year‐old woman with severe scleromalacia affecting all four quadrants. She had a history of trabeculectomy in the upper quadrant and a superior nasal sector of healthy conjunctiva that was normocolored and mobilizable was observed. After placing the Xen in the upper nasal sector, the patient has remained with an IOP of 16 mmHg with a beta‐blocker medication.Conclusions1. The Xen implant can be useful in the management of glaucoma in some challenging situations. 2. The inferior nasal location of the Xen is raised exceptionally. It can make it more susceptible to displacement, although this does not necessarily affect its functioning. 3. The Xen device can be useful in acute uncontrolable ocular hypertension (ex trauma) in the context of an open angle.
Development of a new animal model of radiation retinopathy using an experimental radiation platform
Authors: Villaret Jeremie , Pouzoulet Frederic , Thomas Carole , Crisanti Patricia , Delaunay Kimberley , Cassoux Nathalie , Matet Alexandre , Behar‐Cohen Francine 
Published: December 2019

AbstractPurposeChoroidal melanoma is the most frequent malignant intraocular tumor. Radiotherapy using various modalities is the standard conservative treatment for confined lesions. It allows globe preservation in most cases, but 50% to 60% of irradiated eyes develop radiation retinopathy, secondary to multiple retinal vascular occlusions, leading in the most severe cases to neovascular glaucoma and secondary enucleation. The purpose of this experimental study was to create and test a new model of radiation retinopathy in the rat retina, and to explore potential pathways involved in the early pathogenesis of radiation retinopathy.MethodsWe used the Small Animal Radiation Research Platform (SARRP, Xstrahl, UK) to build a dose‐response model of retinal irradiation. Long‐Evans rats were irradiated with an X‐ray source, after exorbiting the eye. Only one eye was irradiated for ethical reasons. There were 4 groups of 4 animals according to the radiation dose received. Group 1 received one 15‐Gray fraction of, Group 2 received two 15‐Gray fractions, Group 3 received three 15‐Gray fractions, and Group 4, the control group, received one sham irradiation fraction.Multimodal imaging with OCT, color fundus photograph, and fluoresceine angiography (Micron 4, Phoenix Researchlabs, USA) was performed at baseline and seven days after irradiation.Animals were sacrificed 8 days after irradiation. Eyes were either fixated for inclusion and sections, fixated for flat‐mounts of retina/RPE, or milled for Western Blot analysis.ResultsIrradiating of rat retinas using SARRP was successful. At day 7, there were no specific features on angiography, but OCT revealed inconsistent features in the peripheral retina of one animal (Group 3 fractions). In two animals, exorbitation was not possible due to variations of periocular morphology (Groups 2 and 3 fractions). Both animals developed corneal opacifications attributed to lacrymal gland damage.ConclusionsSARRP is a simple and efficient tool to model radiation retinopathy in small animals. Further work is required to improve our understanding of this potentially blinding complication of ocular irradiationReferencesRamos MS, Echegaray JJ, Kuhn‐Asif S, Wilkinson A, Yuan A, Singh AD, Browne AW.Animal models of radiation retinopathy ‐ From teletherapy to brachytherapy.Exp Eye Res. 2019 Apr;181:240‐251. Rothschild PR, Salah S, Berdugo M, Gélizé E, Delaunay K, Naud MC, Klein C, Moulin A, Savoldelli M, Bergin C, Jeanny JC, Jonet L, Arsenijevic Y, Behar‐Cohen F, Crisanti P. ROCK‐1 mediates diabetes‐induced retinal pigment epithelial and endothelial cell blebbing: Contribution to diabetic retinopathy. Sci Rep. 2017 Aug 18;7(1):8834.Rousseau M, Gaugler M‐H, Rodallec A, Bonnaud S, Paris F, Corre I. RhoA GTPase regulates radiation‐induced alterations in endothelial cell adhesion and migration. Biochem Biophys Res Commun. 2011;414(4):750‐755.
Electrical synapses interconnecting axons in the optic nerve head–a novel model of optic nerve function
Authors: Pietrucha‐Dutczak Marita , Akhtar Saeed , Liu Xiaonan , Podracka Lucia , Toropainen Elisa , Alkanaan Aljoharah , Ruponen Marika , Urtti Arto , Varjosalo Markku , Kaarniranta Kai , Lewin‐Kowalik Joanna , Smedowski Adrian 
Published: December 2019

AbstractPurposeAxons in the optic nerve are arranged in bundles and conducting action potential with resistance related to their membrane. Here, we aim to characterize the function of newly identified gap junctions coupling optic nerve axons with each other’s.MethodsProximal and distal rat optic nerve stumps were processed for immunostainings, electron microscopy (EM), RT‐PCR and western blots (WB). Additional 20 animals were deeply anesthetized, and stainless‐steel screw electrodes were drilled in skulls in standard locations to record fVEPs. Recordings were performed in untouched animals, after retrobulbar injection of saline (negative control) or meclofenamic acid solution (gap junctions’ blocker). Human paraffin cross‐sections of eyeballs for immunostainings were obtained from the Human Eye Biobank for Research, University of Toronto, Canada.ResultsImmunostaining of rat and human samples revealed presence of Cx45 and 36 in axonal membranes, colocalizing with β3‐tubulin, but not with GFAP. In WB, Cx36 content in optic nerve was approximately halved when compared with retina (0.58 ± 0.005 ‐ proximal stump; 0.44 ± 0.02 ‐ distal stump), Cx45 showed higher levels (0.68 ± 0.0003 ‐ proximal stump; 0.9 ± 0.07 ‐ distal stump). Additionally, we detected transcript of Cx45 and Cx36 in RT‐PCR analysis of optic nerve homogenates. In immunogold‐EM of optic nerve sections, we found electric synapses (formed mostly by Cx45) that are directly coupling neighboring axons. In fVEPs, blocking of gap junctions’ with meclofenamic acid resulted in prolongation of the latency of P1 wave up to 140% after 5 min from retrobulbar injection of this blocker (p < 0.001) and 170% after 30 min (p < 0.001).ConclusionsOptic nerve axons do not form absolutely independent conductive channels. They are directly coupled by gap junctions formed in majority by neuronal Cx45. Coupling of axons allows to reduce axonal membrane resistance and accelerates transduction of visual signal.
Unilateral unifocal advanced intraocular retinoblastoma: is reasonable to adopt intra‐arterial chemotherapy as single therapeutic choice?
Authors: De Francesco Sonia , Leonini Sara , Galluzzi Paolo , Bracco Sandra , Gennari Paola , Maria Pinto Anna , Neri Giovanni , Barchitta Matteo , Renieri Alessandra , Hadjistilianou Doris 
Published: December 2019

AbstractPurposeTo report the outcome of 30 naive unilateral unifocal retinoblastoma cases treated with intra‐arterial chemotherapy alone.MethodsFrom 2008 to 2019, 192 eyes affected with retinoblastoma have been treated with intra‐arterial chemotherapy (IAC). 100 out of 192 (52%) eyes were naive advanced unilateral unifocal retinoblastoma (Group B‐E). 30 out of 100 (30%) received intra‐arterial chemotherapy alone. All patients underwent genetic testing at diagnosis. MR was performed at diagnosis, during treatment (when necessary), 3 months after last infusion and annually to evaluate eyeball growth.ResultsTumor control and globe salvage was achieved in 100% of the reported cases (follow‐up ranged from 11 years to 9 months). New tumors or relapse have not been detected. No further local or systemic therapies were necessary. Procedure complications and local and systemic effects are reported. No intraocular or orbital tumor recurrence or metastatic disease have been observed observed.ConclusionsThe outcome will be correlated to genetic analysis, doses and drugs used (alone or in combination) and number of infusions received.
Length and width of the peripapillary scleral flange in relation to axial length
Authors: Jonas Shefali , Panda‐Jonas Songhomitra , Jonas Jost 
Published: December 2019

AbstractPurposeThe peripapillary scleral flange is the continuation of the posterior sclera after separating from the optic nerve dura mater and serves as the biomechanical anchor for the lamina cribrosa from which it is separated by the peripapillary border tissue of Elschnig. In view of its biomechanical importance for the optic nerve head, we determined the dimensions of the peripapillary scleral flange and its associations with axial length.MethodsThe study included human globes which had been enucleated due to malignant melanomas or end‐stage secondary angle closure glaucoma. Histologic slides were histomorphometrically examined.ResultsThe study included 202 eyes of patients with a mean age of 61.7 ± 13.7 years (range: 24–89 years) and a mean axial length of 24.9 ± 2.5 mm (range: 20.0–35.0 mm). The mean thickness of the peripapillary scleral flange was 0.37 ± 0.10 mm (median: 0.38 mm; range: 0.10–0.76 mm), and a mean length of 0.54 ± 0.43 mm (range: 0.05–2.14 mm). Peripapillary scleral flange thickness was inversely correlated with longer peripapillary scleral flange length (p = 0.001; standardized regression coefficient β: −0.46) and longer axial length (p = 0.001; β = −0.23). Correspondingly, peripapillary scleral flange length increased with longer axial length (p < 0.001; β = 0.49).ConclusionsAxial elongation is associated with a marked elongation and corresponding thinning of the peripapillary scleral flange. With the PSF being the biomechanical anchor of the lamina cribrosa, the findings may be of interest for the biomechanics of the optic nerve head in axial myopia.
ARREST BLINDNESS: a brief overview from the project coordinator
Authors: Lagali Neil 
Published: December 2019

AbstractARREST BLINDNESS was the first cornea research project funded under the EU Horizon 2020 program, with the goal of developing advanced next‐generation corneal regenerative and restorative therapies, offering hope to patients where no suitable therapy exists. Here, a brief summary will be given of the main goals, deliverables and milestones of the project. Work packages within the project were aimed at developing next‐generation regenerative and restorative therapies to treat corneal pathologies focusing on technologies applied at the molecular, cell, and tissue levels. Molecular‐level therapies include novel topical neuro‐regenerative and anti‐angiogenic agents, cell therapy includes xenogenic‐free cultivated limbal stem cell transplantation for unilateral and bilateral limbal stem cell insufficiency and cultivated endothelial cell sheet development for endothelial transplantation, while tissue‐level therapies include a collagen‐derived biopatch, collagen‐based stromal replacement implants, and angio‐ablative strategies. Within the past four years all technologies have advanced from laboratory testing through preclinical stages, where further development continues or the technologies have progressed to first‐in‐man clinical studies, where four such clinical studies were undertaken during the project. Milestones achieved, technology status, and clinical study updates will be given in six separate talks, each focusing on a specific project work package aimed at developing and translating a novel advanced regenerative therapy into eventual clinical application.
Indocyanine green angiography for identifying telangiectatic capillaries in diabetic macular edema
Authors: Castro Farías Daniela 
Published: December 2019

AbstractAimsDuring diabetic macular edema (DME), a spectrum of capillary abnormalities is commonly observed, ranging from microaneurysms to large microvascular abnormalities. Clinical evidence suggests that targeted photocoagulation of large microvascular abnormalities may be beneficial, but their detection is not done in a routine fashion. It was reported that they are better identified by indocyanine green angiography (ICGA) than by fluorescein angiography. Here, we investigated the prevalence and ICGA and OCT features of large microvascular abnormalities in a group of patients with DME.MethodsObservational study. The fundus photographs, ICGA and structural and angiographic OCT charts of 35 eyes from 25 consecutive patients with DME were reviewed.ResultsTwenty‐two eyes (63%) had at least one focal area of microvascular abnormalities showing prolonged ICG staining (i.e. beyond 10 min after injection). In particular, all eyes with circinate hard exudates (n = 9) showed foci of late ICG staining in the center of exudates. These areas appeared either as isolated globular capillary ecstasies or as a cluster of ill‐defined capillary abnormalities. They were located at a median distance of 2708 µm from the fovea (range: 1064–4583 µm). Their diameter ranged from 153 to 307 µm. During ICGA, 94% of such large lesions showed an increase in their contrast and apparent size in late frames relative to early frames, while 77% of microaneurysms showed reduced contrast on late frames. OCTA appeared as poorly contributive for the detection of ICG stained lesions.ConclusionLate ICG staining revealing large microvascular abnormalities is commonly observed during DME. Because of their specific angiographic and OCT features relative to microaneurysms, we propose to name them telangiectatic capillaries.
The London Project at 10 years: Have we found a cure?
Authors: Coffey Pete 
Published: December 2019

AbstractThe London Project to Cure Blindness is a collaboration between Professor Pete Coffey and Dr Lyndon da Cruz from University College London and Moorfields Eye Hospital. The project aims to use Stem Cell technology to restore sight, prevent progression and ultimately improve the quality of life for patients with Age‐Related Macular Degeneration (AMD) and other retinal and macular disorders, combining cutting edge knowledge and technology from the laboratory, clinic and operating theatre.
Intraoperative OCT guided peeling of ERM
Authors: Georgiadis Odysseas 
Published: December 2019

AbstractThe integration of Optical Coherence Tomography (OCT) into the automated operating microscope has introduced a new era for the operating viewing systems in ophthalmic surgery. By adding a real‐time cross‐sectional visualization to the traditional en face operating view it has been reported to improve the efficacy and safety of both the anterior and posterior segment intraocular surgeries. Furthermore, it has opened the field for novel techniques and experimental surgical approaches with enhanced operative precision. Numerous vitreoretinal procedures have been described utilizing intraoperative OCT (iOCT), with the epiretinal membrane (ERM) peeling being amongst the most common. From the early studies with hand‐held iOCT prototypes that led to the discovery of residual membranes after the initial peeling, to the recent multi‐surgeon prospective studies with microscope‐integrated scanners that involved hundreds of operations, the use of the iOCT has been demonstrated to affect or even alter the surgeon’s decisions in a significant percentage of the studies cases. Specifically for ERM, iOCT‐guided peeling seems to have resulted in a significant improvement of post‐operative visual acuity, reduction in macular thickness and lower rates of recurrence. Preliminary results are encouraging; nevertheless further investigation with randomized comparative trials is still required to determine the probable advantages of the iOCT‐guided ERM surgery over the standard visualization techniques.
Treatment paradigms for mitochondrial optic neuropathies
Authors: La Morgia Chiara 
Published: December 2019

AbstractThe most common mitochondrial optic neuropathies are Leber’s Hereditary Optic Neuropathy (LHON) and Dominant Optic Atrophy (DOA). Both diseases are characterized by retinal ganglion cell loss resulting in optic atrophy and are characterized by a complex I defect. The current available therapeutic option for LHON is the recently approved in Europe Idebenone‐©Raxone for patients with a disease duration of 1 year or less. Moreover, gene therapy trials for patients carrying the 11778/ND4 LHON mutation are ongoing in Europe, US and China. Potential therapeutic options for LHON include also EPI‐743, elamipretide, estrogens and drugs aimed at increasing mitochondrial biogenesis and anti‐apoptotic agents such as cyclosporine A. Moreover, the possibility of mitochondrial replacement therapy for female LHON carriers of childbearing age can be offered to prevent the maternal transmission of pathogenic mtDNA mutations. The current active clinical trials on LHON will be presented. For DOA there is no approved drug available at the moment. A potential beneficial effect of idebenone has been suggested, but randomized controlled trials are still needed to confirm these preliminary data. Interestingly, for DOA, a gene therapy approach has been recently successfully used to alleviate retinal ganglion cell loss in a OPA1‐mouse model.
Treatment of dry eye disease
Authors: Jacobi Christina 
Published: December 2019

AbstractThe major goal of dry eye disease (DED) therapeutic management is to restore homeostasis of the ocular surface by breaking the vicious cycle of the disease and offering long‐term treatment options.TFOS DEWS II Report recommends a specific evidence‐based treatment approach:Step 1: education regarding DED, modification of local environment, potential dietary modifications, identification and modification of offending medications (systemic/topical), ocular lubricants, lid hygiene, warm compresses.Step 2: non‐preserved ocular lubricants, tea tree oil treatment for Demodex, tear conservation (e.g. punctal occlusion), overnight treatments (ointment, moisture chamber devices), in‐office physical heating and expression of the Meibomian glands, device‐assisted therapies, in‐office intense pulsed light therapy, prescription drugs: topical corticosteroids (limited duration), topical antibiotics or antibiotic/steroid combinations applied to the lid margins for blepharitis, topical secretagogues, topical non‐glucocorticoid immunomodulatory drugs (e.g. cyclosporine), topical LFA‐1 antagonist drugs, oral macrolide or tetracycline antibiotics.Step 3: oral secretagogues, autologous serum eye drops, therapeutic contact lenses.Step 4: topical corticosteroids (longer duration), amniotic membrane grafts, surgical punctal occlusion, other surgical approaches (e.g. tarsorrhaphy).Careful follow‐up strategies are important to monitor changes in patients` symptoms and signs and to ensure that patients are applying the recommended management options successfully. Moreover, therapies should be applied over a certain period of time before it can be concluded that no improvement will occur. It is essential to understand the multiple pathogenetic processes in dry eye patients to select effective therapies, especially as DED is a complex condition that varies in severity and character from patient to patient.
Autologous cell regeneration of the crystalline lens
Authors: Michael Ralph 
Published: December 2019

AbstractRegeneration of ocular tissues using stem cells is currently under investigation for the cornea and the retina. Some more recent studies focus also on the regeneration of the crystalline lens. The lens consists of only two cell types, epithelial cells, which can differentiate and act as progenitor cells to the other cell type, fiber cells. Lens epithelial cells are very active, and due to this it is difficult to prevent their proliferation, migration and differentiation when they develop posterior capsule opacification (PCO) after cataract surgery. We have compared the morphology and histopathology of PCO developed in‐vivo with a PCO model of in‐vitro tissue culture. Our in‐vitro tissue culture showed some volumetric growth of cells which expressed the potential to form lens fiber cells. Some, but not all in‐vivo formed PCO showed doughnut shaped lens like structures with anterior epithelial cells, a lens bow and lens fiber like cells, very similar to the natural lens. Special surgical procedures of lens removal have been applied in rabbits and tested to treat human congenital cataract. Both were capable of regenerating the lens to some extent. These studies on PCO and in‐vivo surgery, demonstrate the potential to regenerate the crystalline lens in humans.
Disease penetrance in LHON ‐ unravelling the puzzle
Authors: Karanjia Rustum 
Published: December 2019

AbstractLebers Hereditary Optic Neuropathy (LHON) is the most common hereditary mitochondrial optic neuropathy. The reported incidence is about 1:50 000 but the risk of conversion from the carrier to affected state is in part dependent on the sex of and age of the patient. The proposed reasons for this apparent skewed rate of conversion will be discussed in this presentation.
The role of vitrectomy in uveitis
Authors: Krepler Katharina 
Published: December 2019

AbstractIn uveitis patients therapy usually depends on the aetiology of the disease and a correct diagnosis is therefore important. A diagnostic vitrectomy with laboratory workup of vitreous specimens can improve the likelyhood of diagnosis. In therapeutiv vitrectomy, removing infiltrated vitreous helps in diagnosis by restoring fundus view and removes potentially harmful inflammatory and infectious material from the eye. Visual acuity has been reported to improve in 70%‐90% of cases depending on aetiology. Secondary retinal problems such as Epiretinal membranes with macular traction, macular holes or retinal breaks and detachment can be successfully treated. Additional treatment with intravitreal steroids can be considered.Combining modern microincisional vitrectomy surgery with phacoemulsification is a safe option.
Refractive surgery in glaucoma
Authors: Vastardis Iraklis 
Published: December 2019

AbstractLaser‐assisted refractive corrections, phakic IOL implantations and refractive Lens exchange constitute a large part of the ophthalmic surgeries that take place every year. According to many surveys the incidence of glaucoma is increasing steadily over time worldwide. It is not uncommon today that glaucoma patients or patients unaware of their condition seek consultation for refractive surgery. As a result, a significant number of patients with altered corneal properties is emerging. These patients will require glaucoma follow‐up and probably additional surgery in the future. The reshaped post refractive surgery cornea poses a challenge in the diagnosis, follow‐up, and management of glaucoma patients for the physician. This presentation highlights the do's, don'ts and pitfalls when consulting or treating patients with these characteristics.