bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modifications in corneal biomechanics and intraocular pressure after deep sclerectomy
Authors: Ibanez J. , Martinez J. , Perez D. , Sanchez I. , Idoate A. , Berniolles J. , Bartolome I. , Lopez I. , Ascaso Puyuelo F.J. 
Published: September 2017

PurposeTo compare preoperative and postoperative measurements of corneal biomechanical properties and intraocular pressure (IOP) using Goldmann applanation tonometry (GAT) and the ocular response analyzer (ORA, Reichert Inc, Depew, NY) in eyes undergoing deep sclerectomy with implant (DSCI).MethodsNinety eyes of 90 glaucomatous patients undergoing deep sclerectomy with SNOPER® implant and and 30 eyes of 30 normal subjects were included were included. Goldmann applanation IOP, central corneal thickness (CCT), and ORA measurements [corneal compensated IOP (IOPcc), Goldmann‐correlated IOP (IOPg), corneal resistance factor (CRF), and corneal hysteresis (CH)] were taken the day before deep sclerectomy with collagen implant and on days 1, 8, and 30 and three months after surgery.ResultsPreoperative CH and CRF values of the glaucomatous patients were statistically significantly lower than the values in normal subjects. Corneal hysteresis values increased significantly on day 1 after DSCI, and then showed a statistically significant decrease up to day 30. GAT IOP and all the other ORA parameters changed significantly on day 1 after DSCI, but there was no time effect variation up to 3 months. Only CH showed variations up to 3 months after surgery.ConclusionsCH statistically increased between preoperative and postoperative day 1 DSCI. On days 8 and 30, the change in CH values was statistically significant.
Glaucoma in screening of diabetic retinopathy programme
Authors: Summanen P. , Kivelä T. , Sipilä V. , Uhlenius N. , von Wendt G. 
Published: September 2017

PurposeTo assess the proportion of new glaucoma suspects among diabetic patients aged 18 years or older attending photographic screening for diabetic retinopathy arranged by the City of Helsinki.MethodsTwo 60 degree monochromatic digital fundus images, one macula and the other disc centered were taken with Canon DF‐60 DSi Digital Fundus Camera using a green filter by trained nurses after instillation of mydriatic drops (tropicamide and if needed, cyclopentolate). All images with abnormalities were analyzed by one ophthalmologist. Patients screened during the year 2012 were included in the analysis. Glaucoma suspicion was based on disc hemorrhage and/or glaucomatous cupping and nerve fiber defects.ResultsOf 6937 patients attending fundus photography for screening of diabetic retinopathy, 24 (0,3%) had glaucoma diagnosed earlier and two were currently under examination for glaucoma suspicion. Altogether 520 patients were referred to further examination (7.5%, 95% confidence interval (CI) 6.9‐8.1), and of them the cause for referral was glaucoma suspicion in 50 (9.6, CI 7.3‐12.5). Excluding the known glaucoma patients or those currently under examination, the suspicion of new glaucoma, 50 out of 6911, was 0.72% (95% CI 0.55‐0.95). Ten patients had disc hemorrhage, one advanced nerve fiber defect and the rest suspiciou disc cupping. The majority, 44 patients with glaucoma suspicion had type 2 diabetes, 5 had type 1 diabetes and one had secondary diabetes.ConclusionsDiabetes is a risk factor of glaucoma and changes related to it are thus not unusual in diabetic population, especially in elderly patients with type 2 diabets. Glaucoma suspicion constituted ca. 10% of all referrals. Graders of fundus images need to be aware of these changes. Known glaucoma patients in ophthalmologist's follow‐up are, however, not expected to attend screening programme.
ISNT rule applicability based on optical coherence tomography parameters in a normal Portuguese population
Authors: Barata A. , Teixeira F. , Pinto F. 
Published: September 2017

PurposeWe aim to determine the applicability of the inferior, superior, nasal and temporal neuroretinal rim (NRR) area characteristic configuration (ISNT rule) in adult normal Portuguese population based on spectral‐domain optical coherence tomographic (SD‐OCT) and assess demographic variations by age, sex, race and relation to optic disc area.MethodsProspective study with 188 eyes of 94 patients that underwent SD‐OCT with the new glaucoma module premium edition software (v.6.0). Patients with confirmed or suspected glaucoma, visual field defects, other optic disk or retinal abnormalities were excluded. Optic Nerve Head parameters such as Minimum Rim Width (MRW), Bruch's membrane opening (BMO) and thickness of peripapilar nerve fibre layer (RFNL) on four quadrants were analysed.ResultsThe mean age group was 55 years, 44% were men, 83% Caucasian and 17% melanodermic. Mean spherical equivalent was 0.10 (min −6.5, max +5), and mean best‐corrected visual acuity was 20/20 (min 20/40, max 20/16). NRR thickness area (MRW) was 376.0 μm ± 75.9, 345.4 μm ± 81.8, 365.1 μm ± 86.8, 240.5 μm ± 57.4, respectively on inferior, superior, nasal and temporal quadrants and ISNT rule was present in 23%. When excluding nasal quadrant (inferior > superior > temporal (IST) or inferior > superior (IS)) such configuration was present in 71% and 73% of patients, respectively. Mean age and mean optic disk/scleral area was higher in those with ISNT rule present (58.8 vs 53.7 years and 2.08 mm² ± 0.4 vs 1.98 mm² ± 0.5, respectively) but was not significant (p > 0.05) as were not sex and race differences.ConclusionsISNT rule in normal population is not confirmed by SD‐OCT assessed with ONH parameters and it is only present in 23% of eyes. The authors propose that a “IS/IST rule” seems more representative in a normal population as exclusion of nasal quadrant consideration increases prevalence.
Enzymatic Activity of CYP1B1 in primary congenital glaucoma goniodysgenesis and its relation with histological alterations
Authors: Ramirez A.I. , Garcia‐Anton M. , Salazar J.J. , de Hoz R. , Rojas B. , Garcia‐Feijoo J. , Triviño A. , Escribano J. , Ramirez J.M. 
Published: September 2017

PurposeTo analyze de CYP1B1 genotype activity, the histological findings and the clinical phenotypes in human primary congenital glaucoma (PCG).MethodsTransmission electron microscopy was used to study surgical pieces from trabeculectomy from PCG patients (n = 5) and normal cadaver donors sclerocorneal rims (n = 3). Genomic DNA was extracted from the peripheral leukocytes of the same patients for the CYP1B1 study.ResultsThe histological analysis allowed us to classified patient samples into three groups depending on goniodysgenesis findings: A) no visualization of the Schlemm's canal (SC); B) presence of the SC and no visualization of the collector channels (CC); C) presence of the SC and CC. Patients from groups A and B had extensive trabecular endothelial cell necrosis, and abnormal trabecular beam and null enzymatic activity of CYP1B1. Patients from group C in addition to presence of the SC and CC, showed a more developed trabecular meshwork than groups A and B and trabecular endothelial cells alive and with signs of phagocytic. This group showed a 60% of enzymatic activity of CYP1B1. All groups shared an abnormal insertion of the ciliary muscle although in group C the insertion was in a more posterior position.ConclusionsIn the samples analyzed, it seems to have a relationship between enzymatic activity of CYP1B1 and histological changes. The lower the CYP1B1 gene enzymatic activity, the greater the goniodisgenesys and the trabecular endothelial cell death extent. A greater understanding of histological changes associated with the enzymatic activity of CYP1B1 could be useful for clinicians to plan treatment strategy. This data could be useful for clinicians to plan treatment strategy
Glaucoma assessment tools used by clinicians: old or gold?
Authors: Marques R.E. , Sousa D.C. , Leal I. , Sens P. , Marques‐Neves C. , Pinto L.A. 
Published: September 2017

PurposeGlaucoma is the main cause of irreversible blindness worldwide. Early detection and personalized management is the key to prevent or slow disease progression. Our group previously evaluated the quality of within‐hospital referral to a glaucoma subspecialty department (GSD), raising awareness to the importance of doing applanation tonometry (AT), gonioscopy and visual fields (VF) before referral. The aim of this work was to perform an audit cycle, one year after the awareness training session in December 2015.MethodsRetrospective analysis of a random sample of within‐hospital referrals to the GSD, in Lisbon Academic Medical Center (January 2016 to May 2017). Electronic records were screened for clinical data, exams, medical and surgical treatments prior to referral. Descriptive statistics were performed with SPSS.ResultsA total of 150 patients (69 males) were included in this analysis, with a mean age of 65 years [range 10–93]. Mean intraocular pressure (IOP) was 19.8 mmHg. Almost 20% of patients were not on any IOP‐lowering drugs, while nearly half were under ≥2 classes of treatment. AT and VF were performed respectively in 43% and 59% of the referred patients, both versus 49% in 2015 (p > 0.05). Gonioscopy was described for 23% of patients, more than the 12% mentioned in 2015 (p = 0.014). Optical coherence tomography (OCT) was performed in the large majority, 85%, as in the first analysis. Only 6% of patients had all AT, gonioscopy and VF; and 19% were referred with none of these exams, comparing to the 22% in the original 2015 screening (p > 0.05).ConclusionsOverall, training session did not significantly improve the quality of GSD referral, though more physicians reported gonioscopy results. It seems many clinicians still prefer more expensive and sophisticated exams as OCT, often forgetting valuable and simpler tools.
Changes in the X‐ray diffraction pattern of porcine lens before and after simulated accommodation
Authors: Al‐Atawi S. , Albon J. , Meek K. , Hayes S. , Bell J. , Regini J. 
Published: September 2017

PurposeDuring the accommodation process, the morphology of the lens changes. The crystallin proteins within the lens fibres are the primary structural unit of organisation at the cellular level, and play a major role in maintaining transparency and refractive power. All the structural information about the lens from X‐ray scattering techniques have so far been performed on samples in the relaxed accommodated state. It is thought that largest structural changes occur in the lens nucleus during accommodation.AimsTo measure any changes in the average distance between the crystallin proteins, and their ordering within the lens fibres before and after stretching using small angel x‐ray scattering.MethodsFresh porcine lenses were mounted into a commercially available lens stretching device (Bioniko, Florida, USA). Samples were placed in the X‐ray beam at the Diamond synchrotron and 2D grid scans performed. Scans were taken in the same lens in both the accommodated and unaccommodated states, before and after a stretching.ResultsAll patterns show a reduction in both the X‐ray intensity and in the average spacing between the crystallin proteins, in the centre of the lens compared with the periphery. This is consistent with the increase of protein concentration from the lens cortex to the nucleus. No significant changes in the average spacing between the crystallin proteins was observed upon stretching. Substantial changes in both the X‐ray intensity, and in the ordering of the proteins were recorded at the peripheral margins of lenses in the stretched state.ConclusionsThe changes in the X‐ray intensity, and in the ordering of the crystallin proteins at the peripheral margins of the lens are somewhat in contrast to the notion that the nucleus under goes the largest structural changes.
Serum adiponectin associates with aging rather than neovascular AMD
Authors: Paterno J.J. , Kauppinen A. , Kaarniranta K. 
Published: September 2017

PurposeTo study whether adiponectin serum levels are changed in neovascular AMD. Adiponectin, secreted primarily by adipocytes, modulates cellular energy metabolism. Adiponectin participates also in retinal homeostasis and autophagy. Adiponectin receptors are abundant in RPE‐choroid level. We have previously reported that ADIPOR1‐gene variant associates with advanced AMD in Finnish population. Here, we evaluate the role of peripheral adiponectin in AMD.MethodsAfter obtaining written informed consent, venous blood samples were collected from 145 neovascular AMD patients (mean age: 79.4 ± 6.1 years) and 90 controls (mean age: 74.6 ± 6.3 years) in a cross‐sectional design. Other causes of macular oedema were excluded. Serum adiponectin levels were quantified using a commercial ELISA kit.ResultsSerum levels of adiponectin in neovascular AMD group (12.0 ± 9.5 μg/mL) did not significantly differ from levels in control group (11.1 ± 7.8 μg/mL; t‐test p = 0.423). Adiponectin levels increased with aging (rs = 0.237, p = 0.01). Women had higher mean adiponectin levels (13.2 ± 9.4 μg/mL, n = 175) compared to men (7.8 ± 6.2 μg/mL, n = 70; t‐test p = 0.001), but no difference was detected between AMD‐patients and controls when analyzed separately by gender (women: 13.2 ± 8.6 μg/mL vs. 13.2 ± 9.9 μg/mL, respectively; t‐test p = 0.959; men: 8.3 ± 7.5 μg/mL vs. 7.2 ± 4.0 μg/mL, respectively; t‐test p = 0.439).ConclusionsOur findings suggest that serum adiponectin levels are not altered in neovascular AMD. However, adiponectin may be considered more like a general serum biomarker of aging. As already known, gender can influence the adiponectin level in elderly.
The investigation of the distribution of nerves, blood vessels and immune cells on the fresh human corneal surface using optimized protocols for immunostaining of flat mounted whole cornea
Authors: He Z. , Guindolet D. , Forest F. , Cognasse F. , Acquart S. , Perrache C. , Gabison E. , Bergandi F. , Gain P. , Thuret G. 
Published: September 2017

PurposeTo present a reliable protocol for the immunostaining of flat mounted corneas and provide a map of the distribution of nerves, blood vessels and immune cells on fresh human corneal epithelium and conjunctiva.MethodsOrgan‐cultured human corneas were used for our technique development. 15 fixatives and 5 antigen retrieval (AR) methods were assessed using 4 ubiquitous proteins with different, well‐characterized subcellular localization: ZO‐1 (membrane), actin (cytoplasm), hnRNP L (nucleosol) and histone H3 (chromatin). The distribution of nerves (Neurofilaments and tubulin β3), blood vessels (CD31 and α‐SMA) and immune cells (CD45, CD4, CD8, CD68) in fresh human corneas (without any preservation in culture medium) was then investigated using these optimized protocols.Results0.5% paraformaldehyde (PFA) and pure methanol were selected as the most efficient fixatives. Using our optimised protocol, we revealed not only superficial cells (cytokeratin 3, E‐cadherin), but also basal cells (ΔNp63, PAX6). Nerve fibers were mainly stained by tubulin β3 on epithelium and by Neurofilament on conjunctiva. CD31 stained only the capillaries situated at the limbus, whereas α‐SMA stained all types of vessels on the corneal surface. Numerous immune cells were detected on conjunctival and capillary loops below the limbus. A few immune cells were observed on central epithelium.ConclusionsTissue fixation with 0.5% PFA or pure methanol, without any subsequent AR techniques, were found to produce the best results. Compared to IHC on cross sections, immunostaining of flat mounted cornea allows a precise localization of targeted cells through the full thickness of the corneal epithelium and conjunctiva. The distribution of nerves, blood vessels and immune cells on the corneal surface has therefore been mapped.
A holistic dynamic concept on the pathophysiology in dry eye disease
Authors: Knop E. , Knop N. 
Published: September 2017

AbsrtactPurposeDry Eye Disease (DED) is still insufficiently understood because it is a complex alteration of the functional anatomy of the ocular surface. Current concepts are often oversimplified and a new realistic model is developed that reflects all relevant aspects.Methods. A NLM PubMed based review of the literature on DED was performed. Pathogenetic mechanisms were identified and arranged in a patho‐physiologic hierarchy of causative relations that reflects clinical findings but is independent of assumed ′importance′.ResultsBasic primary causative factors for DED are structural and functional alterations of the ocular surface integrity. This concerns a deficiency of (A) tear component SECRETION by the secretory elements and of (B) tear FILM FORMATION by the eye lids and blinking mechanism. Together this leads to the two main pathologies of (1) TEAR FILM DEFICIENCY and thus insufficient permanent wetting of the interpalpebral surface that causes (2) the well‐known SURFACE TISSUE DAMAGE that gives rise to signs and symptoms. Both pathologies are governed by several interacting secondary pathogenetic factors. Typical for the complex disease mechanism are self‐enforcing vicious circles ‐ in contrast to present over‐simplified models they do not necessarily depend on inflammation and there are in fact several, different, interacting vicious circles instead of just one. The disease process is influenced by an impairment of regulatory systems (innervation, endocrine system, immune system) of the body & by negative internal and external risk factors.ConclusionsThis new holistic dynamic concept on the pathophysiology DED incorporates long established as well as new mechanisms in the pathophysiological order. It is complex but not complicated ‐ intuitively understandable and suitable to assist basic scientist, patients, and clinical practitioner alike.
Macrogilal retinal cells show a bilateral early activation in a mouse model of unilateral laser‐induced experimental glaucoma
Authors: Salazar J.J. , de Hoz R. , Ramirez A.I. , Salobrar‐Garcia E. , Rojas B. , VidalSanz M. , Triviño A. , Ramirez J.M. 
Published: September 2017

PurposeTo describe macroglial morphological features of activation after 24 h of unilateral laser‐induced ocular hypertension (OHT) in OHT‐eyes and their contralateral eyes.MethodsAlbino Swiss mice were divided into two groups, naïve (n = 6) and lasered (n = 6). Retinal whole‐mounts were immunolabeled with antibodies against GFAP and MHC‐II.ResultsWith respect to naïve, OHT eyes and contralateral eyes showed different features of macroglial activation in some retinal areas: i) Müller cells were reactive and expressed GFAP; ii) astrocytes were more robust and had more primary and secondary processes; and iii) MHCII was up‐regulated in astrocytes and in some Müller cells. In contralateral eyes, these signs were observed mainly in the periphery. In addition, in the OHT eyes: i) in some retinal vessels near the optic disc, the astroglial reactivity was so intense that the entire vascular walls were sheathed by astroglial cells; ii) in some areas of the retina, astrocytes and Müller cells formed glial scars. iii) MHC‐II immunoreaction in astrocytes varied depending on the retinal area; in those in which MHC‐II immunostaining was less intense, only astrocyte primary processes could be recognized;ConclusionsAt 24 h after unilateral OHT, macroglia showed features of activation not only in OHT eyes, but also in untreated contralateral eyes. Early up‐regulation of MHC‐II in macroglial cells in both OHT retinas and contralateral retinas, suggest an immune system‐related inflammation early after the induction of ocular hypertension.
Choroidal thickness measurements around the optic disc in healthy subjects using Swept‐Source optical coherence device
Authors:  Ciprés Alastuey M. ,  García Martín E. ,  Bambó Rubio M.P. ,  Vilades Palomar E. ,  Rodrigo Sanjuan M.J. ,  Satué Palacián M. ,  Orduna Hospital E. ,  Obis Alfaro J. 
Published: September 2017

PurposeTo measure the peripapillary choroidal thickness in an extensive area around the optic nerve and several established sections in healthy subjects using a swept‐source optical coherence tomography (SS‐OCT) device.MethodsA total of 86 healthy subjects were included in the study. An optic disc 6.0 × 6.0 mm three‐dimensional scan of the right eye was obtained using the Deep Range Imaging (DRI) OCT Triton. Centered in the optic disc a 26x26 cube‐grid was generated to automatically measure the choroidal thickness. Seven choroidal zones were established and analysed: 3 superior (temporal, central, and nasal), 3 inferior (temporal, central, and nasal) and the optic nerve headResultsPeripapillary coroidal thickness was significantly thinner in the central superior, nasal superior, and nasal inferior zones in healthy eyes. Choroidal thickness in the central superior zone was 156.17 ± 80.89 μm; in the nasal superior zone was 168.34 ± 73.45 μm and in the nasal inferior zone was 137.47 ± 65.96 μm.ConclusionsPeripapillary choroidal thickness in healthy subjects is higher in the temporal and superior zones around the optic disc. SS‐OCT could be a useful tool to evaluate choroidal thinning.
Cabin pressure aboard commercial aircraft and non‐arteritic ischemic optic neuropathy
Authors: Nazarali S. , Liu H. , Syed M. , Ter‐Zakarian A. , Karanjia R. , Sadun A.A. 
Published: September 2017

PurposeTo evaluate variations in pressurization of commercial aircraft at cruising altitude. Most aircraft are pressurized between 6,000 and 8,000 feet (ft.), depending on the type of aircraft and composite materials of the fuselage. Patients with NAION may note transient obscurations of vision in concert with low partial pressures of oxygen associated with high altitude.MethodsAltimeters were used to measure the altitude and cabin pressure at cruising altitude aboard 83 commercial aircraft, including 38 narrow‐body and 45 wide‐body planes. Single‐aisle aircraft with a fuselage width of 10‐13 ft. were considered narrow‐body, while twin‐aisle aircraft with a fuselage width of 16‐20 ft. were qualified as wide‐body. There were six types of narrow‐body and seven types of wide‐body aircraft studied.ResultsThe mean cabin pressure among all flights was 6,200 ± 970 ft. Narrow‐body aircraft had a significantly greater mean cabin pressure of 6,634 ± 965 ft. compared to wide‐body aircraft with a mean cabin pressure of 5,834 ± 818 ft. (p < 0.001). With respect to service date, newer generation aircraft had a mean cabin pressure of 5,999 ± 949 ft., which was lower than the mean cabin pressure of older aircraft 6,462 ± 946 ft. (p = 0.03).ConclusionsInnovation in flight design has offered the ability for aircraft to fly at greater altitudes, while maintaining lower cabin pressures. Those at high risk of hypoxia induced complications such as NAION may consider aircraft type when air travel is required. Although all flights studied maintained pressurization below suggested United States Federal Aviation Administration (FAA) guidelines, the possibility for oxygen desaturation remains with current flight practices, especially in those at high risk.