bluuebunny/crossref_metadata_2025_split huggingface dataset:
Graft blues: case report
Authors: Thuret G. , Marcon A. , Perillat N. , Jullienne R. , Garcin T. , He Z. , Peoc'H M. , Gain P. 
Published: September 2017

PurposeTo describe unusual inadvertent persistent staining of stromal structures by trypan blue (TB) after penetrating keratoplasty (PK) and Descemet membrane endothelial keratoplasty (DMEK) performed in patients suffering from lattice corneal dystrophy (LCD)MethodsCase report of patients suffering from LCD and having received intracamerular TB. Series 1: retrospective study on 85 consecutive triple procedures (PK+cataract+IOL) performed by a single surgeon (PG) in a tertiary care university hospital during 7 years. 0.4% TB was systematically used. Series 2: case report of a DMEK (stained with TB) performed after a late endothelial failure of a previous PK realized 5 years before for advanced LCD. Six weeks after DMEK, the patient was hospitalized for acute rejection that appeared unusualResultsSeries 1: Only patients with LCD (n = 18 eyes in 17 patients) presented an isolated intense blue staining of the graft host interface (blue ring). It persisted during 18‐24 months and had no consequence. Series 2: during the acute rejection, intense blue staining was observed in spindle shaped small structures located in the first third of the whole stroma. The DMEK was partially detached. Stromal edema almost completely resolved after intense steroid therapy but the stromal blue staining persisted (9 month follow‐up) with impaired vision.ConclusionsAbnormal amyloid protein characterizing LCD can be stained by TB in vivo. In PK it stains a ring in the recipient stroma and has no consequence. However, during DMEK performed after a PK, TB may also stain the protein accumulated in the graft stroma during slow recurrence of the disease. TB‐stained DMEK should therefore be avoided in late endothelial failure of a PK initially performed for LCD.
Modulation of Muller cell membrane organization by 24S‐hydroxycholesterol
Authors: Gabrielle P.H. , Gambert S. , Masson E. , Leger‐Charnay E. , Ferrerro A. , Vannier A. , Gendrault C. , Lachot M. , Creuzot‐Garcher C. , Bon A. , Gregoire S. , Leclere L. , Martine L. , Lucchi G. , Truntzer C. , Bretillon L. 
Published: September 2017

PurposeMuller glial cells (MGC) are involved in the retinal homeostasis and they are sustaining cholesterol homeostasis. A lack or an excess of cholesterol in neurons can cause neuro‐degeneration. Cholesterol is eliminated from the retina mainly as 24S‐hydroxycholesterol (24S‐OHC). 24S‐OHC is produced by 24S‐hydroxylase (CYP46A1) in retinal ganglion cells (RGC) and is overexpressed during glaucoma. the objective of this study was to determine whether 24S‐OHC triggers MGC membrane dynamics involving lipid rafts and contribute to gliosis at early and late time points.MethodsMGCs were grown in vitro from retinas of young rats. They were treated with 24S‐OHC (10 μM) for 2 min or 6h. Lipid rafts of MGC membranes were obtained after 1% lubrol lysis and 20h‐ultracentrifugation at 180,000 g in a sucrose gradient. The expression of caveolin‐1, Flotillin‐1, GFAP, Vimentin, Connexin‐30, Connexin‐43, phosphorylated and non phosphorylated p38 and p42‐44 MAPK was analyzed by Western‐blotting. High‐performance liquid chromatography coupled with mass spectrometry (LC‐MS) was used to estimate the levels of ganglioside GM3 (monosialodihexosylganglioside), and protein pathways were analyzed by nanoLC‐MS/MS in raft and non raft fractions from MGCs after treatment with 24S‐HOC.ResultsCholesterol, sphingomyelin and saturated fatty acids C15:0, C16:0, C17:0 and C18:0 were enriched in the rafts fractions in MGCs. Structural proteins, Caveolin‐1 and flotillin‐1, and functional proteins, Connexin‐30 and ‐43, were localized in the MGCs rafts. Ganglioside GM3 showed a characteristic enrichment in the raft fractions. Protein implicated in adhesion or oxidative stress pathways in the raft and non‐raft fractions were up and down‐regulated by treatment with 24S‐OHC.ConclusionsOur data showed that 24S‐OHC induced early changes in protein distribution in raft microdomains.
Critical points in scientific retinal imaging
Authors: Felszeghy S. , Viiri J. , Kettunen M. , Kositinen A. , Kai K. 
Published: September 2017

SummaryImages obviously are one of the most important category among the available data in everyday clinical ophthalmology and the visualization of different layers of retina. In experimental eye research it also play pivotal role in understanding of different biological processes of retina. This talk will focus on image capturing and analysis of mouse retina with different genetic background. In our project, we have focused on retinal pigmented epithelium (RPE) obtained from different degenerative mouse models mimicking cellular changes observed in Age‐related Macular Degeneration (AMD). The 2D and 3D of RPE images were acquired through different types of microscopy. We deliver results on modern methods of absolute nucleic acid or protein quantification (q‐PCR, WB, ELISA), but highlight the importance of imaging of the bio‐molecular processes by a range of powerful imaging weapons (stereo/light/confocal/EM/microMRI). We have carried out do novo, in and ex vivo analyzis at micro and ultrastructural level to describe the molecular fingerprints of mouse RPE features in AMD.
Different light spectra to better visualize retinal detail
Authors: Uusitalo H. , Lensu L. , Hauta‐Kasari M. 
Published: September 2017

SummaryRetinal imaging provides a unique opportunity to directly visualize central nervous system and its blood vessels and analyze their structural and functional changes with modern technologies. Retinal imaging has been used for the diagnosis and follow‐up of various eye diseases like glaucoma and age‐related macular degeneration. Also in many systemic diseases like diabetes retinal imaging has been developed as the state of art diagnostic tool. It is one of the most sensitive tools to detect diabetic complications and screening programs to detect retinal complications has been set‐up worldwide. To provide a proper care for increasing numbers of patients is an enormous burden to the health care and will need a new thinking and technologies. Personalized health care, individualized follow‐up and automated self‐testing technologies will neccesary tools to beat these challenges. Re‐engineering retinal imaging with photonics and computational science is a multidisciplinary approach based on spectral imaging and analysis of human retina. It has realized a spectral eye fundus imaging device, spectrally tunable light source device and spectral image database of eye fundus images with clinical expert markings.
Anterior to posterior “tour” of ocular disease processes
Authors: Van Ginderdeuren R. 
Published: September 2017

SummaryIn this part of the course the most important pathology of the internal eye structures will be explained from front to back side of the eye. The malignant tumours of adults (melanoma, metastasis, lymphoma) and children (retinoblastoma) will be covered, but also the differential diagnosis and important consequences of non‐malignant diseases (sympathetic ophthalmia). Newer technologies can be incorporated in the pathologic examination which can have far reaching consequences for the patients. Enucleation and the difference with evisceration specimens will be discussed. Newer methods for fine needle aspiration biopsy (in solid tumours) and vitreo‐retinal biopsies in malignant and inflammatory processes will be explained.
Pre‐receptoral filters in the eye and their effect on vision
Authors: Barbur J. 
Published: September 2017

SummaryAdvanced Vision and Optometric Tests (www.city.ac.uk/avot) were employed to study changes in macular pigment optical density and visual performance following three months of daily supplementation with carotenoids. The subject investigated was earlier diagnosed with type 2 diabetes, but recovered through diet and exercise, to the point of being free of diabetes.Before supplementation, the tests revealed borderline performance for photopic and mesopic visual acuity (VA), functional contrast sensitivity (FCS) and red / green (RG) colour vision. The subject's thresholds for yellow‐blue (YB) colour vision and rod sensitivity were, however, just above normal, age‐matched limits.Post supplementation, the results revealed increased macular pigment levels in the central retina. In addition, the results also revealed significant improvements in several, other aspects of vision, particularly at lower light levels. VA and FCS improved, but this outcome depended on whether the stimuli were of positive or negative luminance contrast. Rod and cone mediated vision showed significant changes with large improvements in rod sensitivity. Thresholds for detection of RG and particularly YB colours were also significantly lower post‐supplementation.
Circadian regulation of outer segments phagocytosis by RPE cells: more complexity than meets the eye
Authors: Nandrot E. 
Published: September 2017

SummaryDaily clearance of aged photoreceptor outer segments (POS) extremities is one of the main functions of retinal pigment epithelial (RPE) cells. Absence or deregulation of this process leads to early‐onset or age‐related retinal pathologies. Despite the permanent tight contact between POS and RPE microvilli, phagocytosis occurs only once a day. Over the years, the main molecules implicated in POS tethering and subsequent internalization have been identified. POS tips expose phosphatidylserines on the outer membrane portion to be cleared. Timely recognition of POS tips and phagocytosis synchronization are mediated by the MFG‐E8–alphavbeta5 integrin ligand–receptor couple. This triggers intracellular signaling pathways leading to the activation of the MerTK internalization receptor. While this draws a sequential scheme of events, things are far from being that simple. Recently new roles for MerTK and implication of new receptors have been suggested. In contrast to macrophages that share a similar phagocytic machinery, the continuous contact between both cell types requires the strict regulation of phagocytosis launch and stop to ensure lifelong retinal function. Thus, at this point the puzzle is about to get much more complicated.
Leber's hereditary optic neuropathy: the neurologist point of view
Authors: Carelli V. , La Morgia C. 
Published: September 2017

SummaryLeber's hereditary optic neuropathy (LHON) is a neurodegenerative disorder that selectively affects the retinal ganglion cells (RGCs), consequently leading to optic atrophy and loss of central vision. The primary cause is a metabolic dysfunction of mitochondria due to mitochondrial DNA mutations affecting the respiratory complex I. Despite the metabolic defect is systemic and measurable in post‐mitotic tissues, the disease is usually limited to the RGCs and leads to profoundly impaired vision. However, adjunctive neurological features may be present in a subset of LHON patients defining the so‐called “plus” variant phenotype. The most frequent neurological features may be a multiple‐sclerosis‐like disease, basal ganglia involvement with dystonia or spastic dystonia and bilateral striatal necrosis, myoclonus, parkinsonism, peripheral neuropathy, migraine and sensorineural hypoacusia. Neurological exam, brain MRI, MR‐spectroscopy and other ancillary exams may be needed to well characterize the “plus” phenotype of LHON patients. The genetic bases of these LHON “plus” cases are currently unclear, but private mtDNA mutations and nuclear genetic variants may be relevant.
Uveal melanoma biopsy or not (against)
Authors: Caujolle J.P. 
Published: September 2017

SummaryBiopsy for diagnostic or prognostic purposes are still controversial issues. The arguments depend on the biopsy technic used and the reason why? Concerning the biopsy, different complications could occur such as intravitreal or tumoral hemorrhages, retinal detachment, cataract, endophthalmitis and the last one tumoral cells spreading. All these complications must be taken into account concerning the possible benefits of a biopsy. In ocular oncology units, the diagnosis accuracy reported with noninvasive technics is over 98% with big tumors requiring enucleation. This rate could probably be similar with medium tumors. However in routine, difficult diagnosis concern small uveal tumors less than 3 mm in thickness. In a few countries physicians perform biopsy for such tumors but not in France. Our management is periodical follow up until a proof of growth. That is why, we do not really need a biopsy to diagnose an uveal melanoma!!! On one hand, we are not able to make a prognosis in 12 to 24% of cases of cytogenetic analysis. On the other hand, nowadays, we do not have a successful proven adjuvant therapy to propose to our high risk patients. How many patients depending on their origins would like to know whether they will die or not?
Endoresectiopn of uveal melanoma without radiotherapy
Authors: Damato B. 
Published: September 2017

SummaryEndoresection of choroidal melanoma without neoadjuvant radiotherapy is controversial because of concerns about iatrogenic local tumor seeding and systemic metastases. However, several authors have reported that local tumor recurrence and seeding are rare. Further, there is no evidence that metastatic disease is increased following endoresection. Recent insights into uveal melanomas indicates that metastasis depends on the genetic tumor profile and not on surgical interventions. It would seem, therefore, that the large majority of patients experiencing ocular morbidity from neoadjuvant radiotherapy are doing so unnecessarily. This problem persists because those favoring neoadjuvant radiotherapy are skeptical of the results published by authors who hold a different view from their own. There is scope for randomized clinical trials of endoresection with and without neoadjuvant radiotherapy. If the required equipoise for such trials is lacking, an ethical way should be found to allow independent inspectors to review original patient case notes and verify all the scientific claims that neoadjuvant radiotherapy is unnecessary.
Comparison of four technics of surface roughness assessment of corneal lamellar cuts
Authors: Gain P. , Jumelle C. , Hamri A. , Egaud G. , Mauclair C. , Reynaud S. , Dumas S. , Pereira S. , Thuret G. 
Published: September 2017

PurposeSurface roughness of corneal lamellar cuts is a crucial quality criterion, because smother is the cutting plan, better will be the visual recovery. Nevertheless, despite several studies published in the last years, it remains difficult to reliably quantify the differences between a microkeratome (MKT) and a femtosecond laser (FSL). A possible reason could be that the different studies employed different technics to assess surface roughness. AimTo directly compare 4 microscopy technics of surface roughness assessment of corneal lamellar cuts.MethodsStromal lamellae were cut in organ cultured human corneas with a Moria MKT or a FSL. Environmental scanning electron microscopy (eSEM), standard SEM and chromatic confocal microscopy (CCM) were first used to verify that dehydration and metallization of samples did not artefactually alter the surface state. Three 3 quantitative methods (Atomic Force Microscopy (AFM), CCM and Focus‐Variation Microscopy (FVM)) were then compared using the same stromal lamellae. Lamellae with low or high surface roughness were selected with sSEM. The Bowman membrane was used as a smooth control. Roughness quantification was done with Mountains, a validated software.ResultsCompared to eSEM, sSEM provided better image contrast allowing better visualization of the surface roughness. Dehydration and metallization did not change the surface appearance with eSEM and sSEM, and did not modify the roughnesses measured by CCM. Only CCM and FVM were able to reveal significant differences between lamellae of different roughness. CCM allowed acquisition of larger areas, allowing a better characterization of heterogeneous surfaces.ConclusionsCCM seems to be particularly suitable for quantifying the roughness of cutting plans obtained in the cornea.
Local steroidal treatments: what's new
Authors: Lowder C. 
Published: September 2017

SummaryLocal Steroidal TreatmentsSevere vision loss occurs in 25%‐33% of all uveitis cases. Repeated bouts of inflammation increase risk of severe vision loss.Local Treatment Options

Periocular steroids

Intravitreal steroids

Intravitreal drug delivery

Dexamethasone 700 ug implant (Ozurdex) up to 6 months – short term therapy
Fluocinolone acetonide 0.59 mg implant (Retisert) up to 36 months – long term therapy
Undergoing Clinical Trial
Fluocinolone acetonice 0.19 mg implant (Psivida) up to 36 months – long term therapy

How to choose the appropriate treatment?

If there is systemic disease that requires anti‐inflammatory therapy, maximize immunomodulatory therapy (IMT) rather than treating both locally and systemically for extended periods of time

“Breakthrough” cystoid macular edema in disease otherwise controlled with IMT may benefit from local therapy with Ozurdex, posterior subtenon Kenalog, intravitreal triesence or VEGF inhibition.

Disease that needs short term treatment should not be treated with long lasting implant (fluocinolone acetonide).

Disease likely to need many years of treatment should not be given repeated short lasting implant (dexamethasone) or intravitreal triamcinolone injections.
Red light provides partial protection against retinal ganglion cell degeneration in a mouse model of dominant optic atrophy through the activation of NFkB
Authors: Votruba M. , Beirne K. , Rozanowska M. 
Published: September 2017

PurposeMutations in OPA1 are the leading cause of dominant optic atrophy, a disease in which a progressive loss of retinal ganglion cells (RGCs) leads to blindness. In the B6;C3‐Opa1Q285STOP mouse, an Opa1 mutation causes a decrease in ATP production and a progressive loss in visual acuity, which coincides with pruning of the predominantly ON‐centre RGC dendrites. Explanting the retina, initiates further dendritic pruning. Red light has been shown to increase ATP production and provide neuroprotection. We hypothesised that 670 nm light can delay ex vivo dendritic pruning in the B6;C3‐Opa1Q285STOP mouse.MethodsWe therefore monitored the effects of 670 nm light (radiant exposure of 26.4 J/cm2) on RGC dendritic pruning in retinal explants from B6;C3‐Opa1Q285STOP mice, after 16 hours ex vivo.ResultsThe area under the Sholl curves, the peak of the Sholl curves and the total dendritic length of ON‐center RGCs showed statistically significant reductions by 28% (p<0.05), 27% (p<0.05) and 29% (p<0.05), respectively, from 0 to 16 hours ex vivo, with sham treatment but no statistically significant reductions were seen with 670 nm light treatment. An increase in the nuclear‐cytoplasmic ratio of transcription factor, NfkB, but not Nrf2, was found in the ganglion cell layer with 670 nm light treatment.ConclusionsThe results demonstrate the ability of 670 nm light to partially prevent ex vivo dendropathy in the B6;C3‐Opa1Q285STOP mouse retina, and that the transcription factor NfkB, but not Nrf2, plays a role. The findings suggests that 670 nm light may also delay the RGC dendritic pruning that occurs in vivo in the B6;C3‐Opa1Q285STOP mouse and ultimately provide neuroprotection against RGC degeneration in patients with dominant optic atrophy.
Attitudes of parents toward eye care in children under 7 years old in the Republic of Ireland
Authors: Conway M. , Subramanian A. , O Donoghue E. , Donaldson L. 
Published: September 2017

PurposeVarious factors have been highlighted as affecting the uptake of eye care services around the world. We surveyed the parents and guardians of children under seven years old, in the Republic of Ireland, to investigate barriers to and knowledge of eye care. A secondary objective was to determine if either varies according to parent's socioeconomic status, ethnicity or level of education.MethodsIn 2015, one thousand surveys were distributed to the parents of 4 to 6 year old school children in the Republic of Ireland.Results446 surveys were completed (44.6% response rate). Chi‐square revealed a significant relationship between ethnicity and how to access eye care X2 (4, n = 437) =27.13, P < 0.001. Analysis of the raw data revealed that the majority of Asian parents, 6 out of 7 respondents (86%), did not know how to access eye care appropriate for their child's age. Thirty percent of parents/carers (n = 134) reported having at least one barrier to accessing eye care. Respondents were assigned a ‘barrier score’‐ zero barriers to a maximum of 10 reported barriers. A Mann‐Whitney U test disclosed that parents from lower income families n = 84 (19%) had significantly higher number of barriers to eye care (U = 12273, P = 0.002) than those from higher income households n = 356 (81%). Each respondent was assigned a ‘children's eye care knowledge score’. The maximum knowledge score was 5 and the minimum 0. Kruskal Wallis X2 (2, n = 438) =11.34, P = 0.003 revealed a significant relationship between knowledge of eye care and level of parental education. Inspection of the mean rank of groups suggest that those with higher levels of education n = 314 (77%) had the highest eye care knowledge score.ConclusionsThis research has shown that there are significant barriers to eye care in the Republic of Ireland which need to be addressed when designing future eye care pathways.
Schlemm canal stenting
Authors: KERR N. 
Published: September 2017

SummaryIn primary open‐angle glaucoma, the juxtacanalicular trabecular meshwork and inner wall of Schlemm canal are believed to be the site of greatest resistance to aqueous outflow. Recently several new minimally invasive devices have been developed to bypass this tissue and provide direct access to low resistance collector channels in the outer wall of Schlemm canal. These devices are inserted via an ab interno approach, usually at the time of cataract surgery, and are designed to lower intraocular pressure and reduce or eliminate the need for glaucoma medications. This Special Interest Symposium reviews the growing evidence base and covers techniques and pearls for the insertion of both the iStent and iStent Inject (Glaukos Corporation, Laguna Hills, CA, USA) as well as the Hydrus intracanalicular scaffold (Ivantis Inc., Irvine, CA, USA).
What to look for? Monitoring guidelines
Authors: Angi M. 
Published: September 2017

SummaryMolecularly targeted agents are commonly used in oncology practice, and many new targeted agents are currently being tested in clinical trials. As many of the molecules targeted by anticancer agents are also expressed in ocular tissues, a wide spectrum of ophthalmologic toxicities has been reported, ranging from conjunctivitis and keratitis to sight‐threatening conditions such as retinal vein occlusion and optic neuritis. It is important for the Ophthalmologist to be aware of the adverse ocular events that have been reported for different drug types, in particular tyrosine kinase inhibitors and anti‐cytotoxic T‐cell lymphocyte antigen‐4 antibodies, as they may require dose reduction or interruption. A full ophthalmologic examination is recommended, including visual acuity, tonometry, and fundoscopy. For agents with the potential to cause retinal adverse effects, optical coherence tomography, retinography and visual field examination should also be considered. For agents with the potential to induce anterior segment pathology, a slit lamp examination with fluorescein staining and Schirmer test should be routinely performed.