bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term observation of the treatment of laser photocoagulation versus intravitreal bevacizumab in identical twins with aggressive posterior retinopathy of prematurity
Authors: Hee Jeon Seung , Jung Roh Young 
Published: December 2019

AbstractPurposeIn recent years, a number of studies have been reported comparing the results of the treatment with intravitreal bevacizumab injection. We report a case of comparing effects of laser photocoagulation versus intravitreal bevacizumab injection in identical twins with AP‐ROP.MethodsGA 28 + 2 weeks, identical twins were born with 0.97 and 1.02 kg. Twins were diagnosed as bilateral AP‐ROP and they were refered to different hospital due to the lack of hospital neonatal room, and they received different treatments. At the PMA 32 + 6 weeks, the older sister underwent bilateral intravitreal bevacizumab injection, younger sister underwent laser photocoagulation. Younger sister underwent bilateral laser photocoagulation at the PMA 34 + 4 weeks and received additional bilateral intravitreal bevacizumab injection after 1week. Older sister underwent second intravitreal bevacizumab injection at the PMA 42 + 2 weeks.ResultsAfter 9 years, older sister’s BCVA was checked 0.8 in the right eye, 0.25 in the left eye. Both eyes showed good angiogenesis to the periphery of the retina and fovea showed normal development on the OCT. And younger sister’s BCVA was checked 0.5 in the right eye, FC 50cm in the left eye. Laser was well applied at the periphery, but the retinal vessels didn’t grow even in the zone 1 main arcade, and the fovea on the OCT was irregular and undeveloped.ConclusionsIn this case, the intravitreal bevacizumab injection in the same twin with all the same conditions supports the efficacy of bevacizumab injections because of better long‐term outcome of anatomical and functional retinal vessel development. There is no reported case of different initial treatment in Identical twin, so it can be a meaningful case to compare long term results of two treatments.
Regulation of the glutamate release by pH and GABA at the axon terminal of rod photoreceptors
Authors: Gallego‐Ortega Alejandro , Liao Fei , Vidal‐Sanz Manuel , De la Villa Pedro 
Published: December 2019

AbstractPurposeRegulation of synaptic transmission at the rod synaptic terminal, between rods and rod bipolar cells (RBC) and horizontal cells (HC) is not well understood. The RBC depolarize as a consequence of the decrease in the calcium regulated glutamate release by the rod axon terminal. This effect is mediated by mGluR6 receptors coupled to Gi‐TRPM1 expressed in the RBC. We propose to investigate, in living animals, the modulatory effect by GABAergic HC on this synaptic transmission by means of electroretinogram (ERG) recordings.MethodsBinocular ERG were obtained from C57BL6/J adult mice in response to low intensity full field light stimuli (0.01 cd·s·m−2) (rod response). The right eye of each animal was injected with 1 μl of phosphate buffer solution (PBS) containing either GABA (100 mm), Glutamate (100 mm), Bicuculline (10 mm), DNQX (30 mm), APB (25 mm), Hepes (100 mm) or a combination of these drugs. The left eye of each animal was injected with 1 μl of PBS. Burian‐Allen corneal electrodes were used and responses from both eyes were compared.ResultsThe intraocular injection of APB produces the abolition of the rod response, which is explained by continued activation of mGluR6 receptors by APB. Stimulation by GABA and/or glutamate of membrane receptors expressed in HC produces a significant increase in the rod response (p < 0.05), while their antagonists (Bicuculline and DNQX) produce a significant response decrease (p < 0.05). These effects can only be explained by changes in the pH of the synaptic cleft, since the acidification of the synaptic space produces the blockage of the calcium channels expressed in the axon terminal of the rods. The acidification mechanism is justified since the intraocular injection of Hepes produces the same effect as the inhibition of HC.ConclusionRegulation of the pH in the triad of rod terminal synaptic cleft by GABA receptors seems to be an effective mechanism to control signal transmission from the photoreceptors to RBC.
Post‐DMEK bacterial interface keratitis treated with intrastromal and intracameral antibiotics
Authors: Lucas Janeschitz‐Kriegl Lucas , Dimacali Victoria , Sagri Despoina , Scholl Hendrik , Gatzioufas Zisis , Balidis Miltos 
Published: December 2019

Case Report
A 61–year old woman presented in our clinic complaining of blurred vision in the right eye (OD). Best‐corrected visual acuity (BCVA) OD was 0.05. Central corneal thickness was 794μm. She had undergone complicated phacoemulsification with sulcus‐placed intraocular lens in the affected eye six months ago, so we set the diagnosis of pseudophakic bullous keratopathy and decided to proceed with Descemet Membrane Endothial Keratoplasty (DMEK). DMEK with 20% SF6 gas was performed uneventfully on the right eye. On first postoperative day, slitlamp examination revealed a paracentral corneal infiltrate in the interface with intact overlying epithelium. We injected 0.1 mL of 0.5% vancomycin and 0.1 mL of 0.8% amikacin, adjacent to the infiltrate into the mid‐stroma. Intracameral injection of 0.1 mL of 0.5% vancomycin was also performed. Topical 5% vancomycin and 2.5% amikacin eyedrops were administered hourly in addition to moxifloxacin eyedrops four times a day and preservative‐free dexamethasone eyedrops two times a day. We observed complete resolution of the infection by the twelfth day after injection.In SummaryIntrastromal and intracameral antibiotic injection is an effective and safe treatment modality for post‐DMEK interface keratitis, which physicians should consider when managing such cases.
Evaluation of the results and techniques of cataract phacoemulsification in uncomplicated and complicated cases on various femtolaser installations
Authors: Malgin Konstantin 
Published: December 2019

AbstractPurposeTo compare results and techniques of cataract phacoemulsification in uncomplicated and complicated cases on various femtolaser installations.Material and methods560 patients (876 eyes) aged from 20 to 85 were observed. Visual acuity before surgery: UCVA ‐ 0.1 ± 0.05, BCVA ‐ 0.3 ± 0.1. Patients were divided into 3 groups. The first group included patients who underwent cataract phacoemulsification with IOL implantation with femtosecond assistance on multi‐function mobile low‐energy high‐speed femtolaser system ‐ Femto1 (Ziemer FEMTO LDV Z8). The second group ‐ patients with similar surgical intervention on stationary femto‐installation with built‐in intraoperative optical coherent tomograph and video microscope ‐ Femto2 (LenSx Laser System). The third (control) group ‐ patients who had their lens removed and replaced with IOL with phacoemulsification, but without prior femto stage.ResultsOn the first day after surgery UCVA in all the groups averaged 0.4‐0.6, BCVA ‐ 0.7‐1.0. Corneal incisions on Femto1 did not cause difficulties when opened. In some cases, paracenteses were immediately opened with cannula. In cataracts complicated by lens subluxation, both lasers showed greater efficiency of capsulorhexis and phacofractionation compared to the manual method. The integrity of ligaments in groups 1 and 2 was higher than in group 3. With pupil rigidity in the first group, in 5 cases, iris retractors were previously used to achieve 5.0 mm pupil diameter. Endothelial cell loss percentage remained fairly low (from 300 to 500 cells/mm2) in groups with femto assistance.ConclusionsPhacoemulsification method with femtolaser assistance on Femto1 and Femto2 devices proved effective and safe in surgical treatment of low and medium density cataracts, and with weak lens ligaments. Mobile and compact Femto1 is better than Femto2 in interface and for corneal incisions. Femto2 is slightly faster in the automatic stage OCT.
Ultrasound biomicroscopy of the anterior segment of the eyeball after implantation of a phakic IOL in patients with different refractive errors
Authors: Malgin Konstantin 
Published: December 2019

AbstractPurposeTo study the changes in of the anterior segment of the eyeball in the early and late postoperative periods after implantation of a phakic intraocular lens (PhIOL) in patients with different refractive errors using ultrasound biomicroscopy data.Material and methods32 patients (64 eyes) with moderate and high degree myopia (56 eyes) and hyperopia (8 eyes) without concomitant pathology were operated. The average age of the patients was 30 ± 5 years. Observation period: 1 day, 1 and 6 months after surgery. Complementary to standard diagnostic examination, ultrasound biomicroscopy was performed in all patients before and after surgery. The following parameters were estimated: anterior chamber depth (ACD), anterior chamber angle (ACA); iris profile; the position of the PhIOL, the distance between the PhIOL and the lens, the state of the Zinn’s zonules, the ciliary apparatus and the lens. Bilateral implantation of PhIOL was performed through 2.2 mm incision.ResultsOn day 1, in 31 patients (96.8%): ACD decreased by 0.67 ± 0.1 mm, ACA was open, iris profile–straight, PhIOL position‐in ciliary sulcus, distance between PhIOL and the lens‐0.57 ± 0.2 mm, Zinn’s zonules were saved, ciliary body‐within normal limits, lens‐transparent; in 1 patient with high hyperopia (preoperative data: ACD‐open, ACA‐3.17 mm (OD), 3.23 mm (OS)) anterior chamber was shallow (1.05 mm), ACA was covered with iris, 1/3 of the iris root was in contact with corneal endothelium, PhIOL dislocated in the frontal plane, distance between PhIOL and the lens was uneven. After 1 and 6 months in 31 patients, the state of anterior and posterior chambers’ structures remained satisfactory.ConclusionUltrasound biomicroscopy data of the anterior segment of the eyeball showed that implantation of PhIOL in patients with different refractive errors in early and late postoperative periods changes ACA, slightly decreases ACD, does not have contact with the anterior lens capsule.
Anti‐apoptotic properties of mesenchymal stem cells in mouse model of corneal injury
Authors: Kössl Jan , Bohacova Pavla , Hermankova Barbora , Zajicova Alena , Holan Vladimir 
Published: December 2019

AbstractLimbal stem cell deficiency (LSCD) is associated with the break of immune privilege of the cornea, a harmful local inflammatory reaction and a loss of corneal epithelium cells caused not only by damage after injury but also by the apoptosis in later phase. Apoptosis is caused by various factors including damaging of cell structures and chronic inflammation and may be one of the main causes of the failure of corneal regenerative mechanisms. Mesenchymal stem cells (MSCs) turned out to be a suitable source of stem cells for the therapy of bilateral LSCD. MSCs are well known for their anti‐inflammatory, anti‐apoptotic, regenerative, migration and differentiation properties. Antiapoptotic mechanisms are still not well described but their recognition could help for a long‐term regeneration of corneal epithelium after the injury or after the corneal transplantation in cases like LSCD.MSCs were obtained from murine bone marrow. Flow cytometry was used to characterize phenotypic markers of purified MSCs. For in vitro experiments, MSCs were cultured in plates for 24 hours. Excised corneas were added to the culture alone or in inserts and were stimulated by pro inflammatory cytokines. After a 48‐hour co‐cultivation the expression of genes for pro apoptotic and anti‐apoptotic molecules in corneas was detected using qPCR. Flow cytometry was used to detect phosphatidylserine on the surface of apoptotic cells by annexin V. In in vivo experiments, MSCs were seeded onto nanofiber scaffolds (allowed to adhere for 24 hours) and transplanted on the injured cornea (alkali burn)MSCs significantly decreased the number of apoptotic cells in the cornea with simulated inflammation in vitro or in injured corneas in vivo. MSCs also supressed the expression of the pro‐apoptotic molecules Bax and p53 and change the ratio of Bcl‐2 Bax expression in the cornea.Autologous MSCs suppressed apoptosis in in vitro and in vivo models of corneal injury and inflammation.
Retinal hemangioblastomas in Von Hippel‐Lindau germline mutation carriers: progression, complications and treatment outcome
Authors: Hajjaj Anass , van Overdam Koen , Oldenburg Rogier , Koopmans Anna , van den Ouweland Ans , Brosens Erwin , de Klein Annelies , Kiliç Emine 
Published: December 2019

AbstractPurposeEvaluating the phenotype, complications and treatment outcome of retinal hemangioblastomas (RH) and correlating this features with the genotype of Von Hippel‐Lindau (VHL) germline mutation carriers.MethodsRetrospective analysis of the medical and genetic records of 21 individuals with a VHL germline mutation and a diagnosis of RH. Germline mutation status was correlated to phenotype, complications, treatment methods and outcomes. Mutations were categorized in two genotypic categories: the truncating mutation (TM) group and the missense mutation (MM) group.ResultsFrom the 36 VHL germline mutation carriers, 21 VHL patients developed RH. Prevalence of RH in VHL disease was higher in TM carriers (15 of 21, 68.2%) vs. 40% of the MM carriers (6 of 15). The mean age of diagnosis of RH was 25.7 years. There was no significant difference in age of diagnosis of RH between genotypic categories (P = 0.931). Mean follow‐up duration was 16.3 years and did not differ significantly between the mutation groups (P = 0.383). Bilateral involvement was observed in 66.7% of the patients. Missense mutation (MM) carriers (n = 6) developed more RH (more than 5 RH: 50.0% vs. 38.5%), had a larger extent of peripheral retinal involvement of ocular VHL disease (66.7% vs. 35.7% all quadrants involved) and developed more progression‐related complications compared to TM carriers (n = 15) (100% vs. 46.7%). Complete tumor regression at last recorded visit was achieved in fifteen patients (71.4%). Moderate (VA 20/80 to 20/200) to severe (less than VA 20/200) visual impairment was observed in 53.3% of the eyes of MM carriers and 28.1% of the eyes of TM carriers at last recorded visit.ConclusionsGermline mutation status might play a role in the course of progression of RH in VHL disease. In our observational study, VHL missense mutation carriers had a more complicated progression of RH than carriers of a truncating mutation.
Circadian Control and Pinosylvin Treatment in the Disease Model of Age‐related Macular Degeneration
Authors: Tamminen Toni , Koskela Ali , Toropainen Elisa , Pitkänen Marja , Viiri Johanna , Paterno Jussi , Seppänen Anne , Koskelainen Ari , Kaarniranta Kai 
Published: December 2019

AbstractPurposeCircadian clocks in the eye are critical for normal visual function and they relate to periodical renewal of photoreceptor outer segments as well as oxidative stress. Impaired rhythm can thus contribute to the pathogenesis of age‐related macular degeneration (AMD). Chronic oxidative stress leads eventually to protein aggregation in combination with impaired autophagy. We hypothesise that pinosylvin, a polyphenolic compound, slows down the progression of AMD through autophagy induction.MethodsWe investigated the relative change in electroretinogram (ERG) metrics of mice raised in 12:12 h light‐dark cycle and after a 24 h two‐week dark period in wild type (WT; n = 10), PGC1‐α knock‐out (KO; n = 7) and Nrf2 KO (n = 7) mice aged 9.7 ± 3.4 months. From these, 9 WT, 5 PGC1‐α and 7 Nrf2 KO mice continued to be raised to an age of 17.3 ± 3.8 months and assigned to a treatment and control group and fed for 2 months with pinosylvin‐feed or regular‐feed prior to recording ERG.ResultsThe two‐week dark period resulted in significantly greater b‐wave amplitudes and shorter b‐wave latencies in WT mice in photopic ERG. Nrf2 KO and PGC1‐α/Nrf2 dKO mice exhibited b‐wave latency changes in the opposite. The dKO also had diminished b‐wave amplitudes. Scotopic ERG yielded no significant changes. Pinosylvin treatment in Nrf2 KO and PGC1‐α KO mice caused significantly increased b‐wave amplitudes in photopic ERG. In scotopic ERG, the pinosylvin treated mice had larger a‐ and b‐wave amplitudes in WT and Nrf2 KO mice, but not in PGC1‐α KO mice.ConclusionsPGC1‐α KO and Nrf2 KO mice showed different circadian rhythmicity. Pinosylvin treatment showed improved ERG signalling in aged NRf2 KO and WT mice.
Gonococcal conjunctivitis: a case report
Authors: Lopez Sangros Isabel , Marco Monzón Sara , Karlsruher Riegel Gisela , Montes Rodriguez Paula , Dolores Diaz Barreda Maria , Boned Murillo Ana , de los Angeles Del Buey Sayas Maria , Minguez Muro Enrique , Ascaso Puyuelo Javier 
Published: December 2019

AbstractPurposeA case report of ocular perforation secondary to gonococal queratoconjunctivitis is presented.MethodsA 49 year old man visited the Emergency Departement with redness, pain, and purulent secretion in his left eye of four days of evolution. He related a risky sexual relationship in the days before the clinic appeared, with direct inoculation of vaginal secretions in his left eye. At the slit lamp examination, he presented a significant corneal thining with ocular perforation in the upper part of the cornea. The direct microscopic examination of ocular secretions showed the presence of gram negative diplococci.Treatment with intravenous ceftriaxone, and topic ceftazidime was instaured. The patient underwent an urgent surgical intervention with a superior conjunctival covering of the upper of the cornea.ResultsThe evolution of the patient was favorable with surgical treatment and antibiotic therapy. The results of the culture of ocular secretions confirmed the growth of Neisseria gonhorreae. One month later, the patient underwent a penetranting keratoplasty and a phacoemulsification with intraocular lens implant in the posterior chamber. At the moment, the patient is stable without corneal reject signs and a visual acuity of 1/10 with his left eye.ConclusionGonococal queratoconjunctivitis is a serious infection that can cause significant corneal thining and ocular perforation. The incidence of this disease has increasead in the last years. For this reason it is important to make a differential diagnosis in presence of purulent queratoconjunctivitis asociated with risk factors.
Cyclodialysis cleft as a complication of cataract surgery: a case report
Authors: Lopez Sangros Isabel , Marco Monzón Sara , Karlsruher Riegel Gisela , Montes Rodriguez Paula , Dolores Diaz Barreda Maria , Boned Murillo Ana , Martinez Morales Juana , de los Angeles Del Buey Sayas Maria , Ascaso Puyuelo Javier 
Published: December 2019

AbstractPurposeWe describe a case report of hypotonic maculopathy secondary to cataract surgery with phacoemulsification and intraocular lens implant (IOL).MethodsA 68‐year‐old man, with medical history of prostatic hyperplasia, and surgical history of uneventful cataract surgery in his left eye (phacoemulsification and IOL implant), underwent cataract surgery in his right eye. Flopy iris syndrome was manifested, with the consequent traumatic manipulation of the iris. The surgery finished successfully with the IOL implantation in the posterior chamber. During the following postoperative visits, the patient presented a best‐corrected visual acuity (BCVA) lower than 1/10 in his right eye, and an intraocular pressure (IOP) of 4 mmHg. The slit‐lamp examination discarded the presence of leakage throught the corneal incisions. The funduscopic examination showed a macular hypotony with radial folds, wich was confirmed by optical coherence tomography. The examination with ultrasonic biomicroscopy, revealed the presence of a superior cyclodialysis of 180°. An anterior YAG laser capsulotomy was performed to release the anterior capsular fibrosis. Despite treatment with topical steroids and atropine for two months, hypotonic maculopathy remained unchanged. Finally, an encircling procedure was performed, 23 g pars plana posterior vitrectomy, an internal limiting membrane peeling, SF6 20% air‐gas exchange, and superior criopexy of the cilliary body at 3 mm of the corneal limbus.ResultThe postoperative evolution was favourable with resolution of the maculopathy, progressive elevation of IOP (12 mmHg), and resolution of the cyclodialysis cleft. The patient recovered a BCVA of 7/10 with his right eye.ConclusionOcular hypotony is an infrequent, yet potentially vision‐threatening entity. The diferential diagnosis is extense, involving any condition that may compromise aqueous humor dynamics or the integrity of the globe and sometimes following medical treatments or procedures.
Uveitis‐glaucoma‐ hyphema syndrome (UGH) as complication in the long‐term cataract surgery
Authors: Dolores Diaz Maria , Boned Ana , Martínez Juana , Marco Sara , López Isabel , Karlsruher Gisela , Montes Paula , Javier Ascaso Francisco 
Published: December 2019

AbstractPurposeAlthough uveitis‐glaucoma‐hyphema (UGH) syndrome was described as a postoperative complication associated with intraocular lenses (IOL) in the anterior chamber, cases with IOL in the posterior chamber have also been described in both into capsular bag, in sulcus as well as lenses anchored to the iris. The physiopathology is not clear but it seems that the mechanical friction produced by the IOL haptics, in contact with different structures, produces erosion, pigment dispersion and consequently anterior uveitis accompanied by elevated intraocular pressure (IOP) and hyphema. Different treatments have been proposed: topical or systemic drugs, YAG laser iridectomies, capsular tension rings, anti‐VEGF or IOL explantion.MethodsWe present the case of a 40‐year‐old man who came to our emergency department with painful red left eye and blurred vision since several hours. He had a history of left congenital cataract surgery when he was 14. The patient presented uveitis with elevated IOP that did not yield with topical treatment with mydriatics, corticoids, antihypertensive drugs and oral diuretic agent. 24 hours later, he showed hyphema, deciding to enter the hospital IV for treatment. Symptomatic control was achieved, being discharged with topical treatment. 15 days later he returned to A&E at the same clinic. He was treated in the same way and ultrasonic biomicroscopy (UBM) was performed.ResultsUBM demostrated a poorly positioned IOL.Then, we diagnosed him with UGH syndrome. After presenting a third episode a week after discharge, explantation exchange was decided. Since then it is in follow‐up and has not submitted incidents.ConclusionThe increase in cataract surgeries implies that a growth of the possible associated complications.UGH syndrome must be taken into account in all those patients who present their characteristic triad. Before suspicion a UBM should be performed.