bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of efficacy and safety of dexamethasone intravitreal implants between vitrectomized and non‐vitrectomized eyes in a real‐life study
Authors: Rezkallah A. , Malcles A. , Dot C. , Voirin N. , Agard E. , Vie A.L. , Denis P. , Kodjikian L. 
Published: September 2017

PurposeTo compare the efficacy and safety of dexamethasone intravitreal implant (Ozurdex) between vitrectomized and non‐vitrectomized eyes in real‐life conditions and to evaluate the change in intravitreal DEX‐implant efficacy before and after pars‐plana vitrectomy (PPV) in patients vitrectomized during follow‐upMethodsThis was a bicentric, retrospective, observational study. Four hundred and one eyes in 361 patients were enrolled between October 2010 and February 2015. Sixty‐seven eyes were vitrectomized at baseline, 301 had no vitrectomy at the last visit. Fifteen eyes were vitrectomized during follow‐up and had at least one DEX‐implant intravitreal injection before and after PPV. Eighteen eyes vitrectomized during the follow‐up were excluded because these eyes did not have at least one intravitreal injection of DEX‐Implant after pars‐plana vitrectomy. Three hundred eighty‐three eyes in 343 patients were studied. We evaluated the efficacy and safety of OzurdexÓ between vitrectomized and non‐vitrectomized eyes and before and after PPV in patients vitrectomized during follow‐up. Main outcome measures included changes in best‐corrected visual acuity, central macular thickness and incidence of adverse effects.ResultsVariations of BCVA and CMT were not significantly different neither between non‐vitrectomized eyes and baseline‐vitrectomized eyes nor before and after PPV in patients vitrectomized during follow‐up. The IOP profile was the same between non‐vitrectomized eyes versus baseline‐vitrectomized eyes and before versus after PPV in patients vitrectomized during the follow‐up.ConclusionsThis large cohort shows that vitrectomy seems not to influence the efficacy and safety profile of DEXimplant regardless of the indication.
Imaging in uveitis: modalities and applications
Authors: Herbort C.P. 
Published: September 2017

SummaryUveitis has become a precise clinical science, in part thanks to the development of performing imaging methods. Laser flare photometry (LFP), although not an imaging method “stricto sensu”, measures back‐scattered photons from the anterior chamber produced by a laser beam and so establishes the exact level of intraocular inflammation at any time and allows precise monitoring of uveitis. Fluorescein angiography (FA) has been used for more than 50 years and gives indications on inflammation of superficial structures of the fundus, optic disc and the retinal pigment epithelium. Indocyanine green angiography (ICGA) became available in the early 1990ties and is essential in the precise investigation of the inflammatory, otherwise occult reaction in the choroidal compartment, giving panfundal information that is otherwise not available. Optical coherence tomography (OCT) analyses both the retina and choroid (in the enhanced depth mode ‐ EDI) of the posterior pole. Ultrasound biomicroscopy (UBM) is useful to analyse inflammation in the retro‐iridal space. Other imaging methods such as fundus autofluorescence (FAF) or OCT‐angiography are still being evaluated for their utility in uveitis.
Retinal microvascular imaging with adaptive optics
Authors: Kalitzeos A. 
Published: September 2017

SummaryThe human eye provides an accessible, transparent “window” to its retinal structures that can be examined in vivo. Retinal images obtained with conventional modalities such as optical coherence tomography (OCT), scanning laser ophthalmoscopy (SLO) and fundus imaging are degraded because even an emmetropic eye is optically imperfect and fraught with aberrations.By implementing adaptive optics (AO) to the aforementioned imaging modalities (AO‐OCT, AOS0LO, AO flood‐illumination camera, respectively) we are able to measure and compensate for these aberrations in the living human eye in real time. Retinal structures including (but not limited to) the capillary vasculature, photoreceptors, the retinal pigment epithelium, the nerve fiber layer and ‐recently‐ the ganglion cell layer have been succesfully resolved with AO systems down to a cellular scale.Here the focus is AOS0LO systems and imaging techniques currently available in 1) visualising the retinal microvasculature and 2) quantifying blood flow. Both confocal and non‐confocal AOS0LO detection schemes will be discussed.
Static vessel parameters in health and disease
Authors: Heitmar R. 
Published: September 2017

SummaryNon‐invasive observation of the retinal circulation in vivo has seen more and more interest in clinical applications in recent years, not only because of ease of acquisition but also due to improved analysis software. Standardized semi‐automatic analysis of vessel calibers are useful markers in systemic vascular disease and have been shown to be linked with disease progression and future cardiovascular events. In recent years new vessel segmentation algorythms and analysis software has made it possible to assess not only vessel calibers but also parameters such as tortuosity, vessel density and branching patterns.In summary these vessel parameters in conjunction with measurements of retinal metabolism, vessel dynamics and retinal structure allow us to gain a better insight into normal retinal physiology and retinal pathophysiology due to systemic vascular disease.
Transcriptional dynamics, denucleation, and gene regulation in embryonic lens development
Authors: Cvekl A. , Limi S. , Zhao Y. , McGreal R. , Zheng D. 
Published: September 2017

SummaryTranscription of genes occurs in apparently irregular pulses of activity termed transcriptional bursts. In contrast, cellular differentiation is marked by coordinated gene expression of batteries of genes required for cellular specialization. Ocular lens is comprised of two compartments: the lens epithelium and lens fibers. Position of individual cells within the lens is directly related to their differentiation status, marked by expression of individual crystallin genes. Another hallmark of lens fiber cell differentiation is organized degradation of their organelles. It is currently not known how transcription is terminated in the disintegrating lens fiber cell nuclei and what are the external and internal components of this process critical for lens transparency. Onset of expression of different crystallins follows the temporal pattern Cryaa > Crybb1 > Cryga in differentiating lens fibers. Surprisingly, expression of Cryaa is terminated in “normal” fiber cell nuclei while expression of Cryga persists even in highly condensed nuclei just about to be disintegrated. Differentiation influences both transcriptional burst size and frequency as well as spatial pairing of different chromosomes that carry crystallin genes.
Scanning laser ophthalmoscopy – basic optical principles
Authors: Irsch K. 
Published: September 2017

SummaryScanning Laser Ophthalmoscopy (SLO) produces an ocular fundus image by moving a focused laser beam via scanning mirrors over the retina in a grid pattern and registering the reflected light from each scanned point. In confocal SLO, a pinhole is placed in front of the detector to cut off scattered or defocused light coming from outside the point of interest, which otherwise can blur the image. This results in a focused, high‐contrast image of a single tissue layer located at the focal plane. Tomographic information can be extracted by moving the plane of the pinhole. The use of various wavelengths allows for different applications, such as fluorescein angiography, indocyanine green angiography, and autofluorescence imaging. This lecture will present the basic principles of SLO, as well as discuss notable applications and variants of the technology.
Adaptive optics – basic optical principles
Authors: Irsch K. 
Published: September 2017

SummaryAdaptive Optics (AO) refers to a technique to compensate for distortions caused by optical aberrations in the media between the camera and the object being imaged. It was originally developed for use in astronomical telescopes to compensate for optical distortions induced by the inhomogeneous earth atmosphere. It has since evolved to become a powerful clinical tool in ophthalmology. In the eye, a “wavefront sensor” (aberrometer) measures the distortion of incoming light induced by inhomogeneities within the cornea and crystalline lens, which is then “undistorted” via reflection by a deformable mirror. AO thus enables imaging of the human retina with unprecedented resolution in vivo, such as revealing individual photoreceptors or the walls of blood vessels. One should note that AO by itself does not provide an image; rather an AO subsystem is incorporated into an existing imaging device. AO subsystems have thus far been successfully integrated into three ophthalmic imaging devices: fundus cameras, scanning laser ophthalmoscopes, and the OCT device. This lecture will introduce the basic principles of AO, illustrate its value with state‐of‐the‐art clinical examples, and discuss potential future applications in ophthalmology.
Vision improvement in dry and wet Age‐Related Macular Degeneration (AMD) patients after treatment with new corneal CPV procedure for light redirections onto the retina
Authors: Serdarevic O. , Tasindi E. , Dekaris I. , Berry M. 
Published: September 2017

PurposeTo evaluate in two clinics vision improvement in AMD patients treated with a new corneal elastic modulus‐altering procedure (CPV) for light redirections onto multiple retinal areas.MethodsTen eyes (6 wet, 4 dry), with best‐corrected near and distance visual acuities (CNVA and CDVA) between 20/80 and 20/400, without pathological retinal morphology completely affecting the central 10° (3 mm) on OCT, were given a single treatment of CPV and were examined for 12 months post‐CPV.ResultsLogMAR Mean CNVA and CDVA in treated eyes improved (p < 0.01) from pre‐CPV 0.957 and 0.942 to 0.512 and 0.638, 0.544 and 0.602, 0.531 and 0.672 at 1, 6 and 12 m, respectively. The number of ETDRS letters gained in mean binocular CNVA/CDVA were 22/15, 25/19, 25/18 at 1, 6, and 12 m, respectively. Administered NEI VFQ‐25 at 3 m improved from pre‐CPV. No CPV complications or adverse events occurred.ConclusionsCPV effectively, safely, rapidly and comfortably redirects light onto functional retinal areas after a single treatment to provide, without visual training, significantly improved monocular and binocular near and distance vision without causing peripheral field restriction or diplopia in patients with atrophic or neovascular AMD with poor vision, including after anti‐VEGF therapy to which CPV is complementary and for which CPV may improve compliance because of improved vision restoration.
Macular thickness after intraocular pressure reduction following trabeculectomy
Authors: Drukteiniene E. , Strelkauskaitė E. , Kadziauskienė A. , Ašoklis R. , Schmetterer L. 
Published: September 2017

PurposeThe aim of the study was to assess changes of macular thickness after trabeculectomy and compare them in respect to the usage of preoperative prostaglandins and status of diabetes mellitus.MethodsThe prospective observational study included 93 glaucomatous eyes (90 patients) that underwent trabeculectomy. 81 (87.1%) patients were on prostaglandins treatment preoperatively. 5 (5.38%) patients had type 2 diabetes. The foveal and sectoral macular thicknesses were measured preoperatively, 1 week, 6 months and 12 months after the surgery using spectral domain optical coherence tomography. Retinal thickness was compared across the follow‐up visits and in respect to the preoperative use of prostaglandins and diabetes.ResultsThere was a reduction in mean ± SD intraocular pressure of 18.5 ± 8.6mmHg 1 week, 15.4 ± 7.9 mmHg 6 months and 14.4 ± 8.3 mmHg 12 months after trabeculectomy (p < 0.001). 1 week postoperatively retinal thickening was observed in all macular subfields (p < 0.001); the central macular thickness increased from 267.23 ± 19.20 μm at baseline to 271.12 ± 19.59 μm. 6 months postoperatively macula remained slightly thicker in central, nasal, inner superior and outer temporal sectors (2.10 ± 5.97 μm, p < 0.001 in central subfield). 12 months after trabeculectomy retina showed thinning in the outer nasal and superior subfields (‐3.54 ± 8.57 μm; ‐1.94 ± 7.02; p < 0.01, respectively). There were no differences in the changes of macular thickness when compared in respect to preoperative prostaglandins (p > 0.05). The retinal changes did not differ between diabetic and nondiabetic patients (p > 0.05).ConclusionsTrabeculectomy induced mild macular thickening, more pronounced in the early postoperative period. Neither diabetes nor the use of prostaglandins before surgery had impact on these changes regardless their potency to increase vascular permeability.
Alternated intra‐arterial and intravitreal chemotherapy: successes and failures of advanced intraocular retinoblastoma treated without systemic chemotherapy
Authors: De Francesco S. , Hadjistilianou T. , Borri M. 
Published: September 2017

PurposeTo report the efficacy of combined intravitreal chemotherapy (IViC) and intra‐arterial chemotherapy (IAC) for the treatment of advanced stage retinoblastoma.MethodsThe medical records of twenty patients affected by unilateral advanced retinoblastoma (Reese‐Ellsworth stage Vb/D of ABC classification). After clinical and ophthalmoscopic evaluation, they underwent MRI to exclude local and CNS dissemination. The IAC was given to treat retinal masses and intravitreal injections to treat vitreous seeding. Patients had received two cycles (six infusions) of IAC, and from six up to ten melphalan injections into the vitreous, with an interval of 7–10 days between them.ResultsAll patients underwent to bimonthly MRI examination, during treatment and every 3 months for 1 year after last injection, to exclude orbital dissemination. Successful control (57.8%) of tumor masses and vitreous seeds was achieved in all cases at 12 up to 60 months follow‐up. No permanent complications have been reported. Transient omplications disappeared throughout the months. No intraocular or orbital tumor recurrence or retinoblastoma metastases were observed.ConclusionsSequential IAC and intravitreal melphalan for advanced retinoblastoma is a good tool to provide retinal and vitreous seed control.
OCT‐A et critères d'activité
Authors: Coscas G. , Lupidi M. , Coscas F. 
Published: September 2017

SummaryOptical coherence tomography angiography (OCT‐A) might be a useful tool to describe different morphological findings in treatment‐naive exudative AMD (eAMD) before and after VEGF‐trap intravitreal injections. Trough a prospective case series of 60 consecutive treatment naïve eAMD eyes diagnosed with different types of CNV a micro‐structural analysis, based on 5 Activity Criteria (shape, branching pattern, presence of anastomoses, vessel's termini and presence of perilesional halo) was performed. Treatment‐induced changes in choroidal neovascularization, CNV area and greatest linear dimension were assessed along with the variation in subretinal and/or intraretinal fluid. After treatment tiny branching vessels, anastomoses and peripheral arcades reduced from 100% of the cases to 40%, 50% and 30% respectively. Considering still‐active lesions, persistent tiny vessels were observed in 75% of the cases, anastomoses in 60% of the cases and a residual activity of CNV was associated with a peripheral arcade in 100% of the cases. OCT‐A Activity Criteria and quantitative findings, may help in the diagnosis of CNV, guiding decisions for treatment, as well as in monitoring the evolution of CNV and its response to treatment.
OCT‐A and Diabetic maculopathy; automated assessement
Authors: Lupidi M. , Cagini C. , Coscas F. , Coscas G. 
Published: September 2017

SummaryA fully automated quantitative assessment of OCT‐Angiograms is a useful imaging system for detecting diabetic‐induced focal vascular impairment both in retinal and choroidal layers. Through a retrospective case series of 48 DM eyes and 47 healthy controls evaluated by Spectralis HRA‐OCT2 (Heidelberg Engineering, Heidelberg, Germany) it was shown that capillary density values were significantly lower (p < 0.05) in all retinal vascular layers and choriocapillaris of DM patients compared with healthy subjects. Moreover retinal and choroidal vascular networks, although distinct entities, seem functionally interconnected: varying the degree of perfusion may be a mutual compensatory mechanism in response to an ischemic injury.
Doctor is there anything else that I can do for my glaucoma?: Alternative therapy for glaucoma, what is the evidence?
Authors: Sunaric Megevand G. 
Published: September 2017

SummaryThe usual algorithm for the treatment of glaucoma consists of medical or/and laser therapy, followed by surgical intervention if the IOP does not lower to the target or the disease progresses despite maximal medical therapy. Understandingly, just as for many other chronic diseases, patients are willing to do more for their glaucoma in order to prevent progression and ultimately blindness. The question: “Doctor is there anything else that I can do for my glaucoma?” is therefore often asked. Several studies have suggested that some lifestyle habits or alternative therapies may influence glaucomatous neuropathy and many patients admit using them either in conjunction or as replacement of their prescribed glaucoma medication. This talk will focus on the evidence that is behind these therapies. Education of ophthalmologist and patients is of great importance in order to avoid misleading beliefs and erroneous therapies with the risk to harm patients visual function.
Flat‐mount preparation of cornea
Authors: Thuret G. , He Z. 
Published: September 2017

SummaryFlat mounting of the whole cornea has two main advantages over conventional cross sections: it provides an overview of the whole tissue while allowing precise subcellular localization. We first described how to improve immunostaining for the analysis of the endothelial cells of flat‐mounted corneas, by using fixation with methanol or 0.5% PFA at room temperature, and not the conventional fixation with 4% PFA. We then applied a similar technique for the multilayered epithelium. Flat mounting is essential to study the distribution of rare cells inside large area of cells.
Flat‐mount preparation of lens epithelium
Authors: Löfgren S. 
Published: September 2017

SummaryThe lens capsule with its attached epithelium is a relatively accessible epithelial model system, suitable for various cell culture assays, histology, and histochemical assays. The optical requirements for imaging of lens capsule‐epithelium can be challenging, especially if the tissue is not flat. The lecture will cover various techniques for preparation of flat‐mount capsule‐epithelium, including differences among species, removal of cortical tissue, and fixation of the capsule‐epithelium to various base materials.
Flat‐mount of retina, including preparation of choroid and iris
Authors: Andre H. 
Published: September 2017

SummaryFlatmount methods have been applied to multiple animal models to grant a panoramic view of specific tissues. Mouse models of retinopathy of prematurity (oxygen‐induced retinopathy) and age‐related macular degeneration (laser‐induced choroidal neovascularization and iodate‐induced geographic atrophy) have generally been assayed from whole‐tissue flatmount studies. We have recently developed a method for mouse iris flatmounts as a model of rubeosis iridis, a clinical diagnosis associated with proliferative diabetic retinopathy and neovascular glaucoma. The aim for the course is to illustrate technical aspects of mouse retinal, choroidal, and iris flatmounts, as well as methods for analysis and interpretation of results.
The 8‐fold quadrant dissection method for ex vivo human interventional retinal experimentation
Authors: Murali A. , Ramlogan‐Steel C. , Andrzejewski S. , Dhungel B. , Steel J. , Layton C. 
Published: September 2017

PurposeRetinal research relies on animal and in‐vitro models which lack many of the characteristics of human retina. We have instead established a reproducible ex‐vivo model of primary retinal explants derived from human donor eye cups.MethodsA dissection strategy performed independently by two investigators was designed to maximize retinal tissue whilst maintaining experimentally reproducible fragments of retina suitable for experimental purposes. The retina was divided into 4 quadrants through the fovea and equivalent distribution of photoreceptors between quadrants was confirmed with CD73 staining in 7 pairs of donor eyes with flow cytometry. In the 8 quadrants from each of the 7 donors, the standard error in proportion of photoreceptors was 0.8–2.3%.ResultsCellular composition of free floating retinal explants were followed for 2 months in 10 retinas with quadrant dissection and 8 with random dissection. Explants could be maintained for 2 months with live populations of photoreceptors, ganglion cells and Müller cells detected by flow cytometry. In contrast, amacrine and horizontal cells, decreased by 90% at 7 days. Only quadrant dissection from the same patient showed reproducible and reliable proportions of cell populations between dissections at any time point. There was no statistically significant relationship between the proportion of any cell population and donor age, time after death, time to storage or time in storage.ConclusionsThe 8 fold quadrant dissection method from a single donor forms an attractive human experimental model for interventional testing in retinal research. We demonstrate the utility of this model in a simple neuroprotection study, showing that insulin protected against CoCl2 induced hypoxia in human photoreceptors.
Electrical direct current stimulation affects retinal vessel diameter and vasodilation in healthy subjects
Authors: Freitag S. , Klee S. , Haueisen J. 
Published: September 2017

PurposeElectrical stimulation (ES) of the human eye is an emerging technique in the treatment of ophthalmic diseases since several studies showed improvements of visual functions in patients. Neuroprotective effects are assumed to cause beneficial impacts of ES. We investigated the acute effects of ES on retinal vasculature in healthy subjects using dynamic vessel analysis (DVA). This method enables continuous measurements of vessel diameters and assessment of flicker‐induced vasodilation.MethodsDVA was performed in 7 healthy subjects (5 females, 25.7±1.7 years, one eye) to examine retinal vessel behavior. Two primary vessel segments were analyzed in each eye (temporal artery (tA) and vein (tV)) regarding baseline vessel diameter (BLD) and vasodilation provoked by flicker (VD). For non‐invasive ES a ring‐shaped rubber electrode surrounding the eye and a square rubber electrode at the occiput were used. Positive direct current (800μA) was applied for 20min at the eye. Each subject participated in two experimental trials in random order, applying real and sham ES (rES/sES) once. DVA was conducted before and immediately after rES/sES to observe changes in BLD and VD. Results were analyzed using paired t‐test to check for changes in BLD and VD due to rES/sES on a level of p=0.05.ResultsAll subjects showed retinal vessel reactions to flicker in DVA. BLD decreased significantly after rES for tA (‐3.4±1.7%; p=0.003) but not for tV (‐0.2±1.6%; p=0.814). In contrast, VD of tA showed an upward trend (+0.7±1.2%; p=0.162), while VD of tV was reduced after rES (‐0.4±1.6%; p=0.547). For sES no significant changes of BLD and VD were observed.ConclusionsReal ES affects both arterial BLD and VD by narrowing tA in resting state and enhancing vessel reaction to flicker provocation. These results provide evidences for beneficial effects of ES on circulatory processes.