bluuebunny/crossref_metadata_2025_split huggingface dataset:
Satellite in transit metastases in a case of loco‐regional metastatic conjunctival melanoma
Authors: Malaise Denis , Matet Alexandre , Beaulaton Clément , Lévy Christine , Lumbroso Livia , Gardrat Sophie , Barnhill Raymond , Cassoux Nathalie 
Published: December 2019

AbstractPurposeTo report the clinical and histopathological findings of satellite in transit metastases in one case of conjunctival melanoma with cervical and parotid lymph node spreading.MethodsCase report of a patient initially examined at Institut Curie, Paris, on September 2018, with histopathological analysis, review of the literature and discussion.ResultsA 82 year‐old woman was referred for additional treatment after the removal of a 3mm thick pigmented infiltrating conjunctival melanoma in the temporal bulbar conjunctiva of the left eye. Proton beam irradiation was planned but finally declined by the patient. TEP‐CT was prescribed and revealed cervical and parotid lymph‐node infiltration, treated by external radiotherapy in another radiotherapy center. She was referred again 8 months later for local recurrences in the left conjunctiva. We observed 11 pigmented conjunctival nodules in the temporal and supero‐nasal quadrants. We surgically removed them and proton beam irradiation of the entire invaded area was planned. Histopathological analysis of some conjunctival nodules revealed well‐delimitated subepithelial nodules of melanoma cells. These nodules were extravascular and aligned along microvascular channels, suggesting angiotropism and extravascular migratory metastases.ConclusionAngiotropism and extravascular migration seem to be implicated in satellite in transit metastases in conjunctival melanoma. It has to be recognized as according to literature it could be a marker of rapid metastatic disease progression and death of the patient.
Ocular surface evaluation using as‐oct and in vivo confocal microscopy in patients with primary sjögren’s syndrome
Authors: Luís Maria Elisa , Cardigos Joana , Barcelos Filipe , Carvalho Helena , Hipólito Diogo , Crisóstomo Sara , Vaz‐Patto José , Alves Nuno 
Published: December 2019

AbstractIntroductionDry eye disease severity is classically obtained through an evaluation of tear film stability and tear production, lid margin disease, ocular surface damage and tear osmolarity. Other parameters for severity classification are know being used for a more accurate follow‐up and managing. The purpose of this study is to evaluate the tear meniscus (TM) and corneal sub‐basal nerve plexus (SBNP) in a population with pSS, using anterior segment optical coherence tomography (AS‐OCT) and in vivo Confocal Microscopy (ivCM).Material and MethodsObservational cross‐sectional study of 50 patients with pSS and 20 healthy controls. All patients were submitted to Schirmer test I without anaesthesia, tear break‐up time and corneal fluorescein staining evaluation. Anterior segment optical coherence tomography (AS‐OCT) was used for TM height and area analysis. In vivo Confocal Microscopy (IVCM) was performed for corneal SBNP density, length and tortuosity. Differences in pSS ophthalmic features were analyzed according to phenotype profile.ResultsTM height was significantly lower in pSS in contrast to healthy controls (p < 0.001). Corneal SBNP density and length were significantly lower and tortuosity significantly higher in pSS patients (p < 0.001, p = 0.004 and p = 0.001, respectively).ConclusionThe diagnosis of Primary Sjögren’s Syndrome (pSS) is sometimes challenging, taking into account the clinical heterogeneity and diagnostic criteria fulfillment variability. AS‐OCT and IVCM may be useful in additional evaluation of lachrymal unit dysfunction in pSS.
Validation of a predictive model for retinal vascular resistance and blood flow by means of Laser Speckle Flowgraphy
Authors: Pappelis Konstantinos , Choritz Lars , Jansonius Nomdo 
Published: December 2019

AbstractPurpose(1) To mathematically predict retinal vascular resistance and blood flow from minimal input; (2) to validate the model predictions in a healthy population using Laser Speckle Flowgraphy (LSF).MethodsFundus photographs, OCT and OCT‐angiography scans, and systolic/diastolic blood pressure (SBP/DBP) and intraocular pressure (IOP) measurements were performed in 32 healthy subjects. Predicted vascular resistance (PVR) was determined from the central retinal artery and vein equivalents, the fractal dimension of the vasculature, and population‐based hematocrit values, according to the Poiseuille law and an adapted version of the fractal model proposed by Takahashi et al. (2009). Predicted blood flow (PBF) was calculated as OPP/PVR, where OPP is the ocular perfusion pressure. For validation, the mean blur rate (MBR; measure of velocity) of large vessels inside the optic disc and waveform parameters (heart rate [HR], flow acceleration index [FAI], skew, acceleration time index, blowout score and time, fluctuation, rising rate, falling rate [FR]) were recorded by means of LSF. Linear models reduced by the Akaike Information Criterion were used to assess the relationship of PVR and PBF with the LSF parameters.ResultsIn the reduced multivariable model, PVR was higher with higher DBP (p < 0.001), FAI (p < 0.001), and FR (p = 0.042), as well as with lower skew (p < 0.001), MBR (p = 0.001), and fluctuation (p = 0.103). PBF was higher with higher skew (p < 0.001) and MBR (p = 0.040), as well as with lower FAI (p < 0.001) and HR (p = 0.055). The R2 of the models was 0.83 and 0.58, respectively. PVR correlated with retinal nerve fiber layer thickness (RNFLT), but not with macular volume (r = −0.53, p = 0.002; r = −0.218, p = 0.23). PBF correlated with macular volume, but not with RNFLT (r = 0.382, p = 0.031; r = 0.326, p = 0.068).ConclusionsPVR can be used as a surrogate of vascular resistance. PBF provided a lesser fit with the LSF parameters and partially describes retinal blood flow.ReferenceTakahashi T, Nagaoka T, Yanagida H, et al. (2009). A mathematical model for the distribution of hemodynamic parameters in the human retinal microvascular network. J Biorheol 23:77‐86
Trabeculectomy: An assessment of the quality and readability of online patient information
Authors: Donnelly Aaron 
Published: December 2019

AbstractMany patients now refer to the internet as a source of patient information. We wanted to assess the quality and readability of online information pertaining to trabeculectomy. We interrogated 3 popular search engines for the terms “trabeculectomy” and “glaucoma surgery”. We analysed the websites against the EQIP (ensuring quality information to patients) and the Flesch Kincaid reading ease score. We found that the mean quality of puplications was poor with a higher than recommended reading grade. Academic sources had a high quality score compared to sources with a commercial interest. It is importat that we guide patients to high quality sources of information on the internet.
Differences in the retina of patients with confirmed diagnosis of multiple sclerosis versus isolated clinical syndrome
Authors: Viladés Palomar Elisa , Orduna Elvira , Beatriz Cordón , Perez‐Velilla Javier , José Vicente Maria , Jesús Rodrigo‐Sanjuan Maria , Satué Maria , Garcia‐Martin Elena 
Published: December 2019

AbstractPurposeTo assess the differences in the retina nerve fiber layer (RNFL) and the ganglion cell layer (GCL) in subjects with multiple sclerosis (MS) versus subjects diagnosed as clinically isolated syndrome (CIS).Methods58 eyes of healthy controls, 67 eyes of MS patients (<10 years) and 10 eyes of patients diagnosed with CIS (<10 years) were included in the study. Measurements were taken using the Posterior Pole Retinal Thickness Map protocol [shows the thickness of the retina throughout the posterior pole (volumetric examination of 30° × 25° OCT]) with the Heidelberg Spectralis optical coherence tomography (OCT) device. We analyzed the 8x8 grid placed along the fovea symmetrically with the papilla. We analyzed the average thickness of the RNFL and the GCL in the 64 cells obtained.ResultsBoth groups, EM and CIS, present a significant thinning of the RNFL (27 and 32 cells respectively) and the GCL (45 and 20 cells respectively) with respect to the healthy controls. On the other hand, there has been a significant thinning of the RNFL in patients with MS (9 cells) versus GCL and a slightly significant thinning of the GCL (3 cells) in MS patients with CIS.ConclusionsOCT is able to detect significant changes in the retina of patients who do not meet dissemination criteria in time and space for the diagnosis of MS. These CIS patients present a significant thinning of the RNFL and the GCL with respect to healthy controls and there are slightly differences between MS and CIS in the RNFL and the GCL.
The epidemiology of myopia in school children worldwide.
Authors: Grzybowski Andrzej , Kanclerz Piotr , Tsubota Kazuo , Lanca Carla , Saw Seang‐Mei 
Published: December 2019

AbstractPurposeBoth genetic and environmental factors play a role in the increasing prevalence of myopia. This modern rise mirrors the trend of children spending a considerable amount of time reading, studying or—more recently—being glued to computer and smartphone screens. The aim of this study is to present an update on the current epidemiology and risk factors for myopia in school children in different countries around the world.MethodologyPubMed and Medline were searched for the following keywords: prevalence, incidence, myopia, refractive error, risk factors, children and visual impairment. English language articles published between Jan 1, 2013 and Nov 30, 2018 were included in the study. Studies were critically reviewed for study methodology and robustness of data. Seventy‐nine studies were included in the review.ResultsPrevalence remains higher in Asia (60%) compared with Europe (40%) using cycloplegic refraction examinations. Studies reporting on non‐cycloplegic measurements show exceptionally high myopia prevalence rates in school children in East Asia (70%–80%) compared with North America (42.2%). Low prevalence under 10% was described in African and South American children. New risk factors, apart from outdoor time and near work exposure, such as dim light, the use of LED lamps for homework, low sleeping hours, reading distance less than 25 cm and living in an urban environment were described in recent studies.ConclusionsThe high rates of myopia prevalence among school children, especially Asian populations, are strongly influenced by particular lifestyle habits. Increase in outdoor time remains the best strategy to prevent myopia onset. Additional epidemiological studies should be carried out on implementation of public health strategies to tackle and avoid myopia onset. High‐risk populations with high myopia prevalence might need a combined approach of increased outdoor time, changes in near distance activities in preschool children and treatment to control myopia progression.
Genotype‐phenotype correlation in a French cohort of aniridia
Authors: Bremond‐Gignac Dominique 
Published: December 2019

AbstractCongenital aniridia consists in a complex malformation of the eye with congenital absence of iris. Aniridia is a rare panocular disorder affecting, beyond iris, cornea, angle structures, lens and fovea, and possibly associated with other anomalies.This genetic rare disease can cause severe visual impairment occurring from various mechanisms as glaucoma, limbal insufficiency and foveal hypoplasia. PAX6 gene is mainly involved in the disease. We aim to understand the features of patients with congenital aniridia, identifying the characteristics phenotypes of the disease and its associated anomalies. We analyse our patient cohort who underwent a complete ocular examination with ophthalmic exploration and who had genetic molecular analysis. Specific analysis of each ocular feature (as aniridia‐related keratopathy, glaucoma, cataract, foveal hypoplasia, optic nerve hypoplasia and other features) is detailed with early clinical signs that can be observed. An evaluation of risk factors is required for the follow‐up of aniridia patients in order to get a better therapeutic orientation.
Pattern of RGCs loss in toxic optic neuropathies
Authors: Barboni Piero 
Published: December 2019

AbstractToxic optic neuropathies are characterized by bilateral visual loss, papillomacular bundle damage, central or centrocecal scotoma and color vision defect. Multifactor causes play important role in disease manifestation, and nutritional and/or genetic defects (such as mitochondrial DNA mutation) could trigger the disease. Toxic optic neuropathies cause defect to mitochondrial metabolism with consequent damage of retinal ganglion cells with higher energy (ATP) demand. The pattern of RGC and RNFL loss follow a specific pattern characterized by preferential involvement of fibers of papillo‐macular bundle anatomical distribution, the typical feature of mitochondrial diseases.
Part 4: Laser photocoagulation of macroaneurysms: clinical cases in DME
Authors: Dupas Bénédicte 
Published: December 2019

AbstractPrevalence of capillary telangiectatic capillaries (TelCaps) is estimated to be around 30% of cases in patients with diabetic macular edema (DME). TelCaps may be occult, or barely visible on fundus, because they are frequently associated with haemorrhages, exsudates or because of their transparency. TelCaps can take several appearances: round light red lesion, surrounded by a white ring (corresponding to a thickened wall), or isolated dark red lesions. They can be isolated, or multiple, and are predominant in the macular area. ICG‐angiography allows the detection of the TelCaps, and precise their location compared to larger retinal vessels. Media opacities (such as cataract), or eye movements, or non visualization of TelCaps on fundus, might prevent from efficient photocoagulation. Baseline laser parameters to start with are: spot size 60 µm, spot duration: 50–100 ms, power : 100 mW. Several shots can be performed. If the targeted TelCap is missed, a white burn is visible on the retinal pigmentary epithelium. The TelCaps to close to the fovea (i.e., located <500 µm from the center) should not be treated. We will present several clinical cases to illustrate the photocoagulation technique.
Update on keratoconus diagnosis and treatment
Authors: Modis Laszlo 
Published: December 2019

AbstractThe diagnosis of keratoconus has changed revolutionary during the past years. With the appearance of 3D corneal tomography and OCT devices even subclinical forms of the disease can be detected. Similarly, a wide range of interventions has been introduced in the treatment modalities as well. Earlier, nearly only rigid gas permeable contact lens and penetrating keratoplasty were the solutions. Nowadays, either conventional epithelium‐off or epithelium‐on collagen cross‐linking (CXL) treatment targets the cause of the disease. Intracorneal ring segments, toric IOLs, and keratorefractive procedures are also available sometimes in combination with CXL to treat certain forms of the disease. Surgical treatment shifted to deep anterior lamellar keratoplasty, which preserves the integrity of the globe. Postoperative immune rejection is less frequent, endothelial cell count reduction is less as compared to penetrating keratoplasty. Corneal hydrops, a special form of the disease usually requires conservative treatment and after the healing process surgery can be performed if necessary.
Iatrogenic dry eye disease
Authors: Horwath‐Winter Jutta 
Published: December 2019

AbstractDry eye disease (DED) can be caused by a variety of iatrogenic interventions. Major causes of the iatrogenic DED are systemic or topical drugs, contact lens wear, and ophthalmological surgical procedures, including cataract, corneal refractive, lid, glaucoma and vitreoretinal surgery as well as keratoplasty. Furthermore, botulinum toxin injections and cosmetic applications, e.g. eye makeup, eyelash growth, fillers, conjunctival whitening, tattooing, and jewellery/piercing are also considered risk factors for iatrogenic DED. Indirect procedures such as continuous positive airway pressure and radiation treatment as well as non‐ophthalmic conditions (e.g. GvHD) will also be discussed. Appropriate tear film and ocular surface evaluation at pre‐ and post – intervention as well as improved knowledge of pathophysiological mechanisms, therapeutic options and prophylactic measures will contribute to the elucidation of unmet medical needs in patients suffering from still underestimated iatrogenic DED.
Changes in cell density as an early marker for low dose ionising radiation‐ induced cataractogenesis
Authors: Uwineza Alice 
Published: December 2019

AbstractEpidemiological data correlates exposure to low dose ionising radiation (IR) and cataractogenesis later in life. Our understanding of the underlying biological mechanisms is still in its early stages as we seek to explore the applicability of the linear no‐threshold model in these low dose and low dose rate exposures. A single layer of epithelial cells (LECs) covers the anterior hemisphere of the lens. Central and peripheral regions (PR) are designated on the basis of position and cell density. The PR is considered the most radiosensitive region of the epithelium. To understand how LECs manage IR‐exposure at low dose levels and rates, mice of various genetic backgrounds were exposed to 0.5, 1 and 2 Gy using Co60 gamma‐rays at dose rates of 0.3 or 0.063 Gy/min. The cell density and cell proliferation of LECs were analysed at specific time points post‐IR. A differential LECs organisational structure and response to IR in the various mice strains was observed in a dose rate and gender dependent manner. Our data indicate that low dose IR‐effects require a relatively long latency period, in line with epidemiological data from longitudinal studies and evidencing the importance of such studies particularly with respect to human health, occupation, environment and unintended exposures. Longitudinal studies are essential to understand IR‐induced cataract. The mechanisms and processes of IR‐induced cataract formation are incomplete at present, but our data call into question the applicability of the linear no‐threshold model at these low dose/dose rate levels.
An update on effects of ionizing radiation exposure on the eye
Authors: Hamada Nobuyuki 
Published: December 2019

AbstractOver the past half century, the International Commission on Radiological Protection (ICRP) has considered that the lens is the most radiosensitive ocular structure, and has recommended dose limits for the lens to prevent occurrence of vision impairing cataracts (VICs). Epidemiological evidence that doses much lower than previously thought produce cataracts led ICRP to recommend reducing dose threshold for VICs and reducing the equivalent dose limit for the lens in 2011, when only a single threshold of 0.5 Gy was recommended. Based on epidemiological evidence, no dose rate effect was assumed and it was assumed that minor opacities progress into VICs. This contrasts with previously recommended separate thresholds each for different exposure scenarios, and for minor opacities and VICs. The absence of dose rate effect was based on the observed similar thresholds for protracted exposures in Chernobyl cleanup workers and in the Japanese atomic bomb survivors. Progression was assumed predicated on similar risks of cataracts and cataract surgery. Since 2012, there has been mounting epidemiological evidence for cataracts, also for other ocular diseases (e.g., glaucoma, diabetic neuropathy and macular degeneration). This presentation deals with the scientific basis of the ICRP 2011 recommendation, discusses the plausibility of two assumptions considering emerging scientific evidence, and considers radiosensitivity of the lens among ocular structures.
miRNA profile in normal and aniridia conjunctival cells versus severity of aniridia‐associated keratopathy
Authors: Latta Lorenz 
Published: December 2019

AbstractPatients with congenital aniridia develop aniridia‐associated keratopathy (AAK), most of them exhibiting a similar disease mechanism namely haploinsufficiency of the PAX6 gene. The clinical onset and progression of AAK is quite diverse across patients. MiRNAs may act as regulatory elements affecting AAK progression. In mouse animal models the role of miRNAs controlling corneal vascularization has come into research focus. Interestingly, some of the miRNAs involved in neovascularization of the cornea, such as miR‐204, are regulated by PAX6 expression. The aim of this study was to identify deregulated miRNAs in conjunctival cells of AKK patients compared to unaffected controls, also in context with PAX6 haploinsufficiency. We further attempted to correlate miRNA expression with clinical severity of AKK (Staging ranging from 0 intact limbus, no pannus, clear cornea to 4 – end‐stage, thick, white, opaque vascularized pannus). We analyzed the miRNA expression profile in conjunctival cells of 20 patients with AKK and 20 age and sex matched controls using microarrays. We identified 10 down‐ and 11 upregulated miRNAs, including downregulated miR‐204‐5p and upregulated mir‐375. The latter miRNA has been reported to bind in PAX6 3′ UTR. Two patients showed mir‐204‐5p expression levels similar to healthy controls. These patients had mutations in PAX6 flanking genes likely affecting PAX6 regulatory regions and 0‐1 severity of AAK phenotype. Our results show strong expression changes in miRNA profile of Aniridia patients.
Technique of laser photocoagulation of TelCaps; clinical cases in DME and other diseases
Authors: Delyfer Marie‐Noelle 
Published: December 2019

AbstractThe control of the duration of macular edema is a key‐factor to prevent irreversible neuro‐retinal lesions. Pharmacological studies have demonstrated the interest of early intravitreal treatments (either anti‐VEGF or dexamethasone) to control vascular macular edema, especially in diabetic macular edema and retinal vein occlusions. However, in some cases, pharmacological therapy fails to control retinal exudation, either at once or after a while. The remodeling of the retinal capillary network secondary to chronic vascular disturbances can indeed maintain the exudation. Telangiectatic capillaries is one of modifications of the vascular network that can be involved in persistent or recurrent vascular edema. TelCaps may be identified on the fundus as dark‐reddish round lesions often with white borders. They may be either isolated or gathered in clusters. In some cases, however, TelCaps remain barely visible. ICG‐angiography remains the most efficient imaging mode for TelCaps detection, enabling to precise their number and location towards the fovea. Our presentation will focus on clinical presentations of such TelCaps in vascular diseases: diabetic retinopathy, retinal vein occlusions, Coats’ disease. Both management and outcomes will be discussed.
Posterior uveitis: Vitrectomy on eyes with bag‐in‐the‐lens IOL
Authors: Lytvynchuk Lyubomyr 
Published: December 2019

AbstractImplication of the bag‐in‐the‐lens IOL implantation into uveitic cataract surgery became an alternative approach that has change the course of postoperative period. The use of bag‐in‐the‐lens IOL in patients with uveitis has certain advantages, including less postoperative inflammatory reaction and decreased risk of posterior synechia. In combined surgery the clear optic IOL area allows for improved visualization during the vitrectomy. However, the uveitic eyes can present with additional challenges which have to be reconsiderd.