bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preclinical validation of an innovative corneal bioreactor versus organ culture for long term storage: a randomized controled study
Authors: Garcin T. , Forest F. , Verhoeven P. , Pugniet J.L. , Peyragrosse T. , Rogues F. , Herbepin P. , Perrache C. , Acquart S. , He Z. , Gain P. , Thuret G. 
Published: September 2017

PurposeThe organ culture (OC) is a passive corneal storage, gold standard in Europe for decades. The bioreactor (BR) is a sterile transparent device that allows active storage: transcorneal pressure gradient and fluid renewal. Aim: To compare quality of human corneas stored for 1 month in our BR versus (vs) OC.MethodsRandomized controled preclinical study, authorized by the French Biomedicine Agency and an IRB, including only fresh scientific paired human corneas >2000cells/mm2 and <10% difference between both corneas at day (D)2. Immediately at retrieval, one cornea was randomized and stored in OC and the other in BR, both with the same commercial medium (CorneaMax). At D26 only OC corneas were transferred to a deswelling medium (CorneaJet). We calculated that 49 pairs were needed to show a difference of 500 viable cells/mm2 between groups. Assessments were performed at D2, 26, 28. Main criterion: viable ECD (vECD) determined by triple staining Hoechst/Ethidium/Calcein at D28, blind of storage method. Secondary criteria: average transparency (T), central corneal thickness (CCT) and microbiology.ResultsWe retrieved 60 pairs, included 52 pairs at D2, analyzed 50 pairs (1 contamination per group). At D2 ECD in BR was 2607±340 vs 2576±357cells/mm2 in OC (p=0.243). At D26 ECD was >2000cells/mm2 for 92% of corneas in BR vs 58% in OC (p<0.001). At D28 vECD was higher in BR 2188±379 vs 1687±389cells/mm2 in OC, with 76% of corneas >2000 viable cells/mm2 in BR vs 22% in OC (p<0.001); T didn't differ and CCT was higher in BR with 684±52 vs 608±53μm in OC (p<0.001).ConclusionsRestoring IOP and renewing medium significantly improves endothelial cell survival while avoiding deleterious deswelling necessary in OC: after 1 month‐storage, the BR provides much more corneas suitable for transplantation and higher quality grafts that could survive longer in recipients.
Protective effects of sulforaphane on STZ‐induced diabetic retinopathy via activation of Nrf2/HO‐1 antioxidant pathway and inhibition of NADPH oxidase
Authors: He M. , Luan L. , Zhang Y. , Nan Y. 
Published: September 2017

PurposeTo investigate the protective effects of sulforaphane, an Nrf2 activator, on streptozotocin (STZ)‐induced diabetic retinopathy.Methods8 wk male C57BL/6 mice were intraperitoneally injected with streptozotocin (STZ, 45 mg/kg) for 5 consective days. Animals with fasting blood glucose higher than 13.89 mmol/L were considered diabetes and used for further study. Two weeks after STZ injection, animals were intraperitoneally injected with sulforaphane (12.5 mg/kg) for 8 wks, 3 times per week and retinas were harvested at the tenth‐week. Reactive oxygen species (ROS) in retina were detected by DHE staining. The expression of heme oxygenase‐1 (HO‐1) and Nox2 in retina was detected by Western blotting. Immunofluorescent staining was used to detect the expression of RNA binding protein with multiple splicing (RBPMS)and choline acetyl transferase (ChAT), which could specifically mark the retinal ganglion cells (RGCs) and amacrine cells (ACs), respectively. Acellular capillaries in retina were observed by using periodic acid‐Schiff and hematoxylin staining.ResultsThe fasting blood glucose of the mice injected with STZ was increased rapidly, accompanied by significantly decreased body weight. STZ‐injection induced increased ROS generation, increased RGCs and ACs loss, and increased formation of acellular capillaries, which could all be reversed by SF treatment. Meanwhile, HO‐1 and Nox2 expression were increased by STZ‐injection. SF treatment could further enhance STZ‐induced HO‐1 expression, whereas decreased STZ‐induced Nox2 expression.ConclusionsSF treatment could protect mice retina from STZ‐induced oxidative stress and cellular damage, possibly through the activation of Nrf2 antioxidant pathway and inhibition of Nox2 expression.
OCT‐A based management and treatment of RVO
Authors: Coscas F. , Coscas G. , Souied E.H. 
Published: September 2017

SummaryCorrelations in retinal vein occlusion (RVO) patients between macular vascular densities in the superficial and deep capillary plexuses obtained using OCT‐Angiography (OCTA) and the data from conventional examination (visual acuity and peripheral retinal non perfusion on fluorescein angiography) might reveal new insights in the pathogenesis of vascular damage. Through a retrospective, observational study of RVO patients with who underwent a comprehensive ophthalmic examination including FA and OCTA a significant correlation between automatically quantified macular vascular density on OCTA and peripheral non‐perfusion on FA was demonstrated; OCTA could help in identifying high‐risk RVO patients who may benefit from further evaluation using FA.
ECP ‐ limbal & pars plana techniques
Authors: Bloom P. 
Published: September 2017

SummaryCyclo‐photocoagulation is a well‐recognised and powerful therapeutic modality for the reduction of intraocular pressure. Externally applied laser treatment (TransScleral Cyclo‐Photocoagulation, TSCP) may cause collateral destruction of local tissue and can induce considerable inflammation so until recently the use of diode laser cyclo‐photocoagulation was restricted to poorly sighted eyes.Endoscopically applied diode laser (Endoscopic Cyclo‐Photocoagulation, ECP) is a newer, more controlled, titratable, minimally destructive treatment that treats only the target tissue. One of the first MIGS procedures, ECP allows for a quick and simple additional step to be added to routine cataract surgery (Phaco‐ECP), offering the potential to treat cataract and glaucoma simultaneously.In addition, ECP is of considerable value in treating cases of advanced, refractory glaucoma; this area will be discussed in detail during this part of the symposium, via both limbal and pars plana approaches. ECP may be used before or instead of drainage device surgery, or afterward to further augment IOP control.
Molecular techniques in ocular pathology
Authors: Moulin A. 
Published: September 2017

SummaryWith the advancement of imaging modalities in ophthalmology encompassing OCT, angio‐OCT, confocal microscopy, high definition MRI, the correct diagnosis can often be reached without a biopsy. In ocular oncology, ocular biopsy remains however crucial not only for the diagnosis, but also to assess the possible response to specific therapy. This course will review the recent development in diagnostic and molecular pathology. It will be based on practical routine examples and clinico‐pathologic correlations of adnexal, orbital, conjunctival and intra‐ocular biopsies.
Novel roles for voltage sensitive ion channels in retinal pigment epithelium and phagocytosis
Authors: Nymark S. , Johansson J. K. , Skottman H. , Ihalainen T.O. 
Published: September 2017

SummaryPhotoreceptors of the retina undergo a daily renewal process where they shed 10% of their outer segment disks that are then digested by the retinal pigment epithelium (RPE). Recent work demonstrated that L‐type calcium channels in RPE are important for the diurnal regulation of this process. We investigated the regulatory role of several ion channels of the RPE in phagocytosis using human embryonic stem cell (hESC)‐derived RPE and freshly isolated mouse tissue. The ion channels were first characterized by patch clamp recordings. The localization of photoreceptor outer segments (POS) and different ion channels during phagocytosis were studied by incubating hESC‐derived RPE with purified POS particles or by dissecting mouse RPE during the physiological peak of POS shedding. Our phagocytosis assays and subsequent immunolabeling showed a promising co‐localization between certain voltage sensitive ion channels, opsin and proteins involved in the phagocytosis pathway. Moreover, blocking the activity of these channels significantly reduced the efficiency of the process. Overall, several types of ion channels appear to be involved in the phagocytosis pathway. Yet, more work is required to assess their specific role.
Vitrectomy with fibrovascular membrane delamination for proliferative diabetic retinopathy with or without preoperative Avastin
Authors: Garnavou‐Xirou C. , Papavasileiou E. , Velissaris S. , McHugh D. , Jackson T.L. 
Published: September 2017

PurposeTo describe and compare 1. the changes in intraretinal microstructure using serial spectral domain optical coherence tomography (SD‐OCT) preceding and following pars plana vitrectomy and delamination of fibrovascular membranes and 2. Intraoperative and postoperative complications in patients with proliferative diabetic retinopathy (PDR) who had preoperative Avastin (group A) or not (group B).MethodsThis retrospective, interventional case series includes 113 eyes. Outcome measures included LogMAR distance best‐corrected visual acuity (BCVA), SD‐OCT integrity of photoreceptor inner and outer segments junction (IS/OS), and integrity of external limiting membrane (ELM), intraoperative and postoperative complications.ResultsPre‐operative central macular thickness (CMT) was significantly correlated with the final post‐operative LogMAR BCVA in group A. Both groups were also categorised into three sub‐groups based on post‐operative IS/OS integrity (group 0: IS/OS intact; group 1: IS/OS irregular but not completely disrupted; group 2: IS/OS completely disrupted). Mean BCVA improved significantly and IS/OS integrity and ELM integrity postoperatively, were significantly and positively correlated with final BCVA in group A. Intraoperative complications such as iatrogenic tears and haemorrhage and postoperative such as vitreous haemorrhage and neovascular glaucoma where significantly less in group A compared to group B.ConclusionsPre‐operative Avastin reduces the risk of intraoperative and postoperative complications and results in better postoperative anatomic and functional outcomes in fibrovascular delamination surgery for patients with PDR.
Uveitic macular edema: efficacy and safety of subconjonctival triamcinolone injections
Authors: Vermuso L. , Gueudry J. , Ngo C. , Portmann A. , Muraine M. 
Published: September 2017

PurposeTriamcinolone acetonide is a prolonged‐release corticosteroid with a maximum effect until approximately 3 months. The aim of this work is to evaluate its effectiveness and side‐effects in uveitic macular edema treatment.MethodsThis is a single institution retrospective study. From October 2014 to September 2016, 44 eyes of 44 patients who had subconjunctival triamcinolone acetonide injections for an uveitic macular oedema were included. The main outcome measures were the best corrected visual acuity and the central macular thickness measured in optical coherence tomography (OCT). These parameters were evaluated at baseline, 1 month, 3 months, 6 months and 10 months after first injection. Intraocular pressure, introduction of anti glaucoma medication, and appearance of cataract during follow‐up were also notedResultsA statistically significant improvement of visual acuity was observed as early as one month, and the benefit continuing up to 10 months. Initial visual acuity was 0.59 ± 0.49 logMAR and 0.35 ± 0.43 logMAR at 10 months. Initial macular central thickness was 460 ±124 μm, it significantly decreased to 333 ±78 μm at 1 month. Macular thickness was rapidly reduced to 1 month, and then seems relatively stable up to 10 months. The mean intraocular pressure at baseline was 14.8 ± 3.6 mmHg and significantly increased at 1 month to 17.6 ± 6 mmHg and to 17.2 ± 4,3 mmHg at 3 months. There were 9 intra ocular hypertension cases (20%) treated with glaucoma medication. No filtration surgery was required. There was one case of cataract but no surgery.ConclusionsSubconjonctival triamcinolone acetonide injections thus provide a visual acuity gain and a decrease of uveitic macular oedema. They appear to be an alternative to intravitreal and subtenon injections, less invasive and easier to achieve.
Uveal melanoma biopsy or not (pro)
Authors: Shields C. 
Published: September 2017

SummaryThere will be a debate on fine needle aspiration for uveal melanoma cytogenetic testing. Dr. Carol Shields will argue for biopsy. There are several reasons that biospy is important in identifing tumor cell type, genetic profile and understading risks for metastasis. If high risk, systemic therapies can be effective for reducing risk. If low risk, the patient is comfortable with piece of mind. To not do needle biopsy for melanoma is like living in the Dark Ages and never knowing what the future holds. Fine needle aspiration biopsy for uveal melanoma cytogenetic profile is smart medicine.
Suspicious naevi: observe
Authors: Zografos L. 
Published: September 2017

SummaryDifferential diagnosis of large choroidal nevi and small choroidal melanomas may be challenging. The diagnostic approach is guided by various clinical criteria including tumor thickness, presence or absence of subretinal fluid, orange pigment, presence or absence of symptoms, presence or absence of drusen and pin points. In case of doubt, a periodical observation can confirm the correct diagnosis. Taking in account that an irradiation treatment of tumors located close to the macula or the optic disk can produce major irradiation induced complications and visual loss, a carefull periodic observation in selected cases appears as the best diagnostic option.
Nanoparticle delivery for diabetic macular edema
Authors: Stefansson E. 
Published: September 2017

SummaryNanotechnology solves the main obstacles in topical drug delivery and delivers drugs by eye drop to posterior segment of the eye.Cyclodextrin nanoparticles containing dexamethasone increase solubility of dexamethasone in tear fluid 30 fold and the drug stays in tear film for 6 hours compared with minutes for conventional eye drops. The high concentration gradient from tear film into eye wall creates a flux which is active for many hours following eye drop application. This delivers approximately 10 times more drug into the eye and reaches the posterior segment in significant concentration. At the same time relatively less drug is absorbed systemically.Several clinical trials have demonstrated the efficacy of the cyclodextrin nanoparticle platform both for posterior and anterior segment use. Two clinical trials in 41 patients have shown significant improvement in visual acuity and retinal structure in diabetic macular edema. The clinical effect of the eye drops is similar to that of intravitreal anti‐VEGF injections and steroid implants. Two reports show compelling effect on intermediate/posterior uveitis with cystoid macular edema.Nanotechnology has broken the age old dogma that eye drops cannot reach the retina.
SOS – Simulated Ocular Surgery website and applications
Authors: Mcnaught A. 
Published: September 2017

SummaryThere is growing interest in simulation training for learning surgery: there are huge benefits to patient safety if trainees can gain essential skills before they attempt surgery on real patients. In ophthalmology, traditional simulation attempts have included practicing simple surgical techniques on animal eyes, or perhaps cadaveric human tissue. These approaches, whilst undoubtedly useful, have some disadvantages e.g inability to practice in a completely realistic surgical environment, which would ideally be the trainee surgeon's own operating theatre, also, cadaveric human tissue, whilst excellent, is expensive to obtain, and store. In the last few years, advances in virtual reality, and plastics technology have stimulated widespread interest in more realistic, and less expensive surgical simulation systems, many of which, especially plastic eyes, allow the surgeon to practice in their own operating theatre, in the office using table‐top binocular microscopes, or even practice at home using loupes. I present our experiences with the ‘Simulated ocular surgery’ (SOS) system, across the full range of ocular surgery, with supporting videos of trainees using this system. For further information: simulatedocularsurgery.com.
Simulation in Mainland Europe – the present and future
Authors: Abegao Pinto L. 
Published: September 2017

SummarySurgical training in Europe is very different according to each region. National regulations, different settings and allocated resources allow for a great heterogeneity in surgical opportunities.The equation of providing adequate training and performance levels to the surgeon while upholding the best possible practices of maximizing patient safety is a difficult task. Throughout Europe, surgeons are increasingly resorting to solutions that allow them to train in simulated scenarios before being confronted with a real life scenario. From wet‐labs to electronic simulations, there is a wide range of solutions that could be adapted to each reality. We will explore these options, its applicability, its advantages and drawbacks, in order to promote a discussion on the validity of each option in each setting.
Biologic therapy: let the Copernican revolution begin!
Authors: Neri P. , Gorgoni F. , Gennari G. , Cesari C. 
Published: September 2017

SummaryNon‐infectious uveitis can be a potentially sight‐threatening disease. The advent of biologic drugs has represented a Copernican revolution for ocular inflammatory diseases therapies: biologic treatments are a great opportunity for those patients affected by severe, non‐responder, sight threatening uveitis. The availability of such drugs has significantly improved the uveitis outcome. Several publications have reported the efficacy of biologic agents in a progressively larger number of refractory uveitides, suggesting a central role for biologic drugs in selected cases. On the other hand, the medical literature has not provided yet significant numbers and most of the biologic drugs available have been reported in small case series. The anti‐tumor necrosis factor (TNF)‐α is the category with the most consistent medical literature in uveitis and, very recently, Adalimumab has recently obtained the indication for the treatment of non‐infectious posterior, intermediate, pan‐uveitis, representing the first on label biologic agent used in ophthalmology for the therapy of uveal inflammation.
Pediatric tumors of the iris
Authors: Hadjistilianou T. 
Published: September 2017

SummaryThe Author in this report provides an overview of the clinical features and frequency of iris tumors in children. Iris tumors are broadly classified into cystic or solid lesions. Cystic lesions are generally benign. Solid lesions are most often melanocytic. Iris nevus is the most common solid iris tumor in all age groups .The most common diagnoses in the pediatric group include iris nevus,IPE cyst, iris stromal cyst,juvenile xanthogranuloma,and melanoma. The author report the personal experience and presents rare tumors like melanocytoma,medulloepithelioma and choristoma of the iris.
Mutation detection of Pakistani families with autosomal recessive retinal dystrophies
Authors: Ravesh Z. , Wissinger B. , Ansar M. 
Published: September 2017

PurposeHereditary retinal dystrophies (RD) are a group of heterogeneous disorders caused by mutations in over 200 genes. RDs can be subdivided into different groups based on the primary degeneration of rod or cone photoreceptor cells. This study was conducted to investigate the underlying RD genes and mutation in consanguineous families from Pakistan.MethodsFamilies were recruited after informed consent. Peripheral blood was collected and genomic DNA was extracted according to standard procedures. Homozygosity mapping was performed using Affymetrix Gene Chip Human Mapping 250 K‐NspI arrays. The data were analyzed using Homozygosity Mapper software. Primers for amplifying all exons and intron boundaries of all genes were designed with Primer3plus software followed by PCR and Sanger sequencing. Minigene splicing assay and DNA walking were performed on respective samples.ResultsHomozygosity mapping identified a novel locus in family A, one novel gene (C8ORF37) in family B and a large novel genomic deletion of the (LCA5) gene in family C.ConclusionsOur study indicates the heterogeneous nature of retinal dystrophies in Pakistan. Although earlier studies have explored a number of RD families, but underlying genes are still unknown for significant proportion of Pakistani families. Theoretically the traditional screening methods (homozygosity mapping based candidate gene sequencing) were successful, however SNP based genome wide scan were further implemented to improve the detection of underlying variations responsible for Retinal Dystrophies. Therefore the amalgamation of traditional and modern molecular techniques is required for accurate identification of mutations. It is anticipated that these findings will contribute to future genetic testing in Pakistani families to minimize the risk of recessive disorders.
ERM management
Authors: Tranos P. 
Published: September 2017

SummaryEpiretinal membranes are disorders which involve the vitreoretinal interface inducing tangential tractional forces on the retina. Although they may be associated with underlying ocular conditions, the majority of epiretinal membranes are idiopathic. Deformation of the inner retinal surface is a common consequence resulting in symptoms which range from symptomatic to severe metamorrphopsia and visual reduction. Epiretinal membranes are commonly classified according to their density and contractile characteristics. Optical coherence tomography (OCT) is the gold standard diagnostic tool and certain OCT features have been associated with ERM natural course and its postoperative visual prognosis. Pars plana vitrectomy and removal of ERM is indicated for symptomatic vision debilitating membranes. Surgical controversies including the extent of ERM removal, the use of vital dyes and the necessity of inner limiting membrane peel are still under investigation.
New technologies in the investigation of macular interface disorders
Authors: Tsakpinis D. , Pappas G. 
Published: September 2017

SummaryThe aim of this presentation is to show the use of the new technologies in the investigation of Macular Interface Disorders Methods: I will present various cases with the most common vitreomacular interface pathologyResults: I will demonstrate tips in order to make the new technology more useful in the investigation of Macular interfaceDiscussion: in the era of new technology Macular interface become an easier to investigate subject in order to choose the best treatment for the patient.
Myopia ‐ biological mechanisms and unresolved questions
Authors: Schaeffel F. 
Published: September 2017

SummaryResearch in animal models has consistently demonstrated that the retina extracts magnitude and sign of defocus in the projected image. Focussing errors trigger changes in axial eye growth, initiated by the retina, to reduce these error signals. Growth control occurs at each position in the retina, but the fovea, although very important in sharp vision, covers only a small fraction of the visual field and has therefore little input. Instead, the fovea controls accommodation, shifting the image plane similarly in the center and periphery. At the end, only a complete description of the focus error signals all over the visual field and over time will finally explain the development of myopia. Myopia is tightly linked to education, with 0.5 D more myopia per year of studies. Since extensive education is mandatory in our societies, its development can only be delayed and slowed down. Three evidence‐based approaches are promising at present to slow myopia progression: (1) increasing exposure to outdoor lighting, preferentially before myopia starts later at school, (2) “fooling” the retina about the true plane of focus (i.e. by multifocal contact lenses) and (3) low dose (0.01% or less) atropine eye drops.