bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular mechanisms of immune privilege of the cornea – as a potential of Immune checkpoint therapy
Authors: Hori J. 
Published: September 2016

SummaryThe eye, which is endowed with immune privilege, is a rare organ that permits analysis of the regulatory mechanisms for inflammation in organs. In particular, studies using animal models of corneal transplantation have revealed the molecular mechanisms of corneal cell‐mediated immune privilege. Several molecules expressed in the cornea induce apoptosis of T cells and delete effector T cells in the cornea. Constitutive expression of Fas ligand and programed death ligand 1 (PD‐L1, B7‐H1) on corneal endothelial cells induce apoptosis of effector T cells via Fas and PD‐1, respectively. B7‐H3 is also constitutively expressed in the corneal endothelium and iris cilialy body and plays a role in the induction of anterior chamber associated immune deviation (ACAID). We have also found that constitutive expression of glucocorticoid‐induced TNF receptor family‐related protein ligand (GITRL) in the cornea mediates local expansion of CD25+CD4+T regulatory cells and suppresses conventional effector T cell function via GITR. These differently functioning molecules contribute to the local immune suppressive microenvironment in the cornea. The study for the roles of B7RP‐1 and Galectine‐9 expressed in the cornea are also introduced.
Relevance of the posterior corneal surface for detection of early keratoconus and post‐LASIK keratectasia
Authors: Wylegala E. 
Published: September 2016

SummaryWe present different display techniques for the anterior and posterior corneal surface such as axial or tangential power map, pachymetry map, height or enhanced height map or results of mathematical decomposition techniques such as Fourier or Zernike maps. We discuss the advantage and drawbacks of those maps for detection and evaluation of keratoconus severity. The variety of the output maps of different instruments such as the Orbscan IIz or TMS‐5, the Pentacam and the Casia‐1000 are shown and discussed in detail. Additional information of new parameters such as ratio of anterior to posterior surface curvature are introduced and the diagnostic value for evaluation of early forms of keratoconus will be tailored‐out.
Corneal tomographical changes following crosslinking
Authors: Zsolt Nagy Z. 
Published: September 2016

SummaryWe show the potential of Scheimpflug‐based tomographic indices for indication and postoperative monitoring of corneal collagen cross‐linking (CXL) performed in progressive keratoconus. The value of tomographic indices for validation of corneal flattening after CXL in the long term is being discussed. In addition, we will focus on keratoconus index (KI) and index of height asymmetry (IHA) provided by the Pentacam, which have been established in clinical routine for monitoring of the long‐term stabilization effect of CXL on the corneal architecture.
Surgical aspects of toric lens implantation and complication management
Authors: Barraquer R.I. 
Published: September 2016

SummaryIn this contribution we would like to give an overview in the spectrum of pseudophakic and phakic toric lenses currently on the market. The audience will be guided how to select the proper lens for the indivual patient. Perioperative marking, surgical technique, intraoperative positioning and validation of lens alignment will be addressed in detail. Techniques are shown how to prevent postoperative rotation, decentration or tilt of the lens. In a last step, we will demonstrate how and when to re‐position or re‐align (in axis) the pseudophakic or phakic toric lens implant in case of decentration, tilt or axis rotation. The add‐on value of modern intraoperative assistance / guidance functions for proper positioning of the toric lens implant or re‐positioning in terms of complication management is shown.
OCT angiography in Retinal Angiomatous Proliferation
Authors: Soubrane G. 
Published: September 2016

SummaryRetinal Angiomatous Proliferations (RAP) have been described initially on ophthalmoscopy as a chorioretinal anastomosis in a late stage of AMD and of MACTEL. Fluorescein angiography evidences a dilated perimacular retinal capillary with late profuse leakage of dye. ICG angiography is instrumental to detect Retinal Angiomatous Proliferation at an early stage of development, especially in AMD. A localized effraction of the RPE on OCT evidences the communication between retinal and choroidal circulation with massive fluid infiltration of the retina. The basic idea of OCT angiography was to separate moving objects from static tissue. This new technic is suitable for 3D segmentation and reconstruction of the retinal capillary layers. There are a number of questions that OCTA may help to solve. What is the participation of the deep retinal capillary plexus to the clinically visible RAP? Is the portion perpendicular to the retinal plane a capillary of the intermediate layer? Does RAP involving only the deep retinal plexus exist? Is the PED part of the process? OCTA may be of great value to the understanding of the pathophysiology of the early stage of the disorder and may offer noninvasive monitoring of the disease progression and activity, aiding for each treatment assessment.
Learning curves for strabismus surgery in two ophthalmologists
Authors: Moosang K. 
Published: September 2016

PurposeTo identify the average turning point by comparing the learning curves of two surgeons learningto perform strabismus surgery.MethodsPatients who underwent procedures to correctexotropia between January 2010 and December 2014 followed for at least 3 months were retrospectivelyassessed. The first 70 patients on whom each of two ophthalmologists (A and B) performed surgery to treatstrabismus were divided into 7 cohorts comprising 10 patients each based on the chronological order ofthe surgery. Factors, including patient age, preoperative angle of deviation, operative time, and success orfailure of the operation, were compared between the two surgeons. Learning curves were calculated basedon changes in operative time and operation success rate. Operation success was determined by measuringthe angle of deviation at a distance of 5 m 3 months after the operation.ResultsA turning point wasobserved after 40 cases for Surgeon A and 50 cases for Surgeon B based on the operative time learning curve. No turning point was observed in the operation success rate learning curve based on the absence of a specifictrend. Success rate by cohort was not significantly different between the two surgeons (p > 0.05). Surgeon B had a significantly longer mean operative time than Surgeon A (p = 0.045).ConclusionsApproximately 50 cases are required for an ophthalmologist to reach a turning point in strabismus surgery. This outcomecan be used as a guideline when training surgeons to perform strabismus surgery.
Correlation between intraocular pressure and bottle heights during vitrectomy
Authors: Moosang K. 
Published: September 2016

PurposeTo determine the correlation between intraocular pressure (IOP) and the bottle heights during vitrectomy usingTONO‐PEN®XL applanation tonometer and Icare® PRO rebound tonometer.MethodsTwenty‐four eyes of 24 patients who underwent 23‐gauge sutureless vitrectomy were evaluated. After complete vitrectomy, the IOP was gradually increased by lifting the irrigation bottle height from the trocar insertion site by 40, 45, 50, and 55 cm. The distance between the floor and patient's eye was consistent in all cases (105.5 cm). Before the removal of 23‐gauge microcannulas, IOP was measured five times using each of the two methods, Tono‐Pen®XL and Icare® PRO.ResultsThe mean IOPs were 8.25 ± 0.35 mmHg for TONO‐PEN®XL and 8.96 ± 0.32 mmHg for Icare® PRO at 40 cm bottleheight. As the bottle height increased, the differences in IOP was also increased, 10.71 ± 0.37 mmHg at 45 cm, 14.18 ± 0.39 mmHg at 50 cm and 17.93 ± 0.40 mmHg at 55 cm for TONO‐PEN®XL and 11.48 ± 0.31 mmHg at 45 cm, 14.64 ± 0.31 mmHg at 50 cm and 18.13 ± 0.38 mmHg at 55 cm for Icare® PRO. In TONO‐PEN®XL, the linear equation was Y = 0.65 X − 18.108 (R2 = 0.794, p = 0.000) and the quadratic equation was Y = 0.013 X2 − 0.569 X + 10.446 (R2 = 0.801, p = 0.000). In Icare® PRO, the linearequation was Y = 0.614 X − 15.842 (R2 = 0.820, p = 0.000) and the quadratic equation was Y = 0.010 X2 − 0.306 X + 5.688 (R2 = 0.825, p = 0.000). The results show correlation of the quadratic equation was stronger than the linear equation in bothtonometers.ConclusionsThe differences of IOP were positively correlated with bottle heights in the form of a curve during vitrectomy.Therefore, the patients who are susceptible to retina or optic nerve damage during vitrectomy should be closely monitored.
Patterned macular dystrophy as the first sign of maternally‐inherited diabetes and deafness (MIDD)
Authors: Esteban O. , Ascaso J. , Peiro B. , Martinez M. , Almenara C. , Perez I. 
Published: September 2016

PurposeMaternally inherited diabetes and deafness (MIDD) is a mitochondrial disorder characterized by the mutation of the mitocondrial DNA (mtDNA) at the 3,243 position. The prevalence accounts for 0.5–2.8% of all cases of diabetes. In more than 80% of cases it is associated with a good prognosis bilateral pattern macular dystrophy. We show the importance of ocular examination to diagnose MIDD.MethodsWe present a case report of MIDD.ResultsA 42 year‐old man was referred for a nonspecific blurred vision in both eyes since two months ago. Diabetes mellitus type 1 and migraine had been diagnosed at the age of 20. The patient wore a hearing aid because he had bilateral sensorineural hearing loss. Best‐corrected visual acuity (BCVA) was 20/20 in both eyes. Fundus examination revealed bilateral hyperpigmented lesions surrounding the macula combined with depigmented areas of retinal pigment epithelium (RPE). Spectral‐domain optical coherence tomography (SD‐OCT) showed hyperreflective dome‐shaped lesions corresponding to a hyperpigmented areas that seemed to originate from the RPE. Fundus autofluorescence (FAF) was characterized by a diffuse speckled appearance of the macula with decreased FAF signal in areas of RPE atrophy and irregular increased FAF signal between the areas of RPE atrophy. Results from automated static perimetry and magnetic resonance imaging (MRI) of the brain was unremarkable. We suspected MIDD and genetic testing of mtDNA confirmed a point mutation at the locus 3,243 with 85% heteroplasmy.ConclusionsOphthalmologists need to be aware in patients presenting patterned dystrophies of the RPE in the context of diabetes or deafness. It is possible that there are other family members with undiagnosed disorders related to mitochondrial mutation who would benefit from ophthalmic evaluation, auditory testing and screening for diabetes mellitus.
The long‐term effect of intravitreal bevacizumab injection in central serous chorioretinopathy
Authors: Mun S.J. , Choi C. , Jeong J.G. 
Published: September 2016

PurposeTo study the effect of intravitreal bevacizumab injection in patients with idiopathic central serous chorioretinopathy.MethodsWe had performed retrospective review on the patients who had been diagnosed as idiopathic central serous chorioretinopathy and had regular follow‐up for at least 12 months from the first injection, either undergone intravitreal bevacizumab injection (107 eyes of 100 patients) or observed without injection (46 eyes of 40 patients). Changes in the visual acuity and the serous neurosensory retinal and retinal pigment epithelium detachment were evaluated through the results of best corrected visual acuity and optical coherence tomography measured at initial presentation, after 1, 3, 6, 9 and 12 months of the first injection.Results87 males and 13 females with mean age of 45.4 ± 7.6 years were recruited in the intravitreal bevacizumab injection (IVB) group, and 34 males and 6 females with mean age of 47.2 ± 9.8 years were recruited in the observation group. There was significant difference in the mean duration of retinal detachment to disappear between the IVB group (2.5 ± 0.2 months) and the observation group (4.3 ± 0.7 months). There was no significant difference in the best corrected visual acuity and the central macular thickness after 12 months follow‐up between the IVB group and the observation group.ConclusionsIntravitreal bevacizumab injection was more effective and faster treatment for resolution of sensory retinal detachment than observation during the 12 months of consecutive follow‐up. Therefore, intravitreal bevacizumab injection can be considered as a significant and safe treatment modality for central serous chorioretinopathy when the patients need prompt visual improvement, such as depending on the morbid eye or requiring binocular vision for occupational cause.
Long‐term results of up to 6 years of mitomycin‐c augmented non‐penetrating deep sclerectomy for pseudoexfoliation glaucoma
Authors: Yazgan S. , Ates H. , Guven Yilmaz S. , Celik T. 
Published: September 2016

PurposeTo evaluate the long‐term efficacy of mitomycin‐c augmented non‐penetrating deep sclerectomy (NPDS) in patients with pseudoexfoliation glaucoma.MethodsIn this retrospective single‐center study a total of 72 eyes of 63 patients with pseudoexfoliation glaucoma were included. Perioperative and postoperative complications, additional procedures including laser goniopuncture, needling, selective laser trabeculoplasty (SLT) were recorded. Complete and partial surgical success were defined as an intraocular pressure (IOP) <18 mmHg and IOP between 18‐21 mmHg with or without medications, respectively.ResultsThe follow‐up time was 26.40 ± 20.06 months (range 1–80). Preoperative and postoperative IOP were 26.53 ± 7.71 and 18.69 ± 6.58 mmHg, respectively (p < 0.001). Preoperative and postoperative last visit mean RNFL were 61.82 ± 17.54 and 62.55 ± 17.39 micrometers, respectively (p = 0.081). The success rate for the IOP of 18–21 and <18 after first year were 88 and 87%, respectively, and after second years were 88 and 71%, respectively. The success rate for the IOP < 18 after 3 years was 60%, after 4 years was 55%, after 5 years was 49%, and after 6 years was 37%. The success of NPDS is not affected by age, gender, preoperative application of SLT, cup/disc ratio, preoperative IOP and medication numbers (p > 0.05). Hypotony was observed in 19 eyes. There were no serious complications including hypotony induced maculopathy, choroidal detachment, blebitis, and endophthalmitis.ConclusionsMitomycin‐c augmented deep sclerectomy is almost as effective as trabeculectomy in long‐term management of intraocular pressure in patients with pseudoexfoliative glaucoma in addition with lower complication rates with its well‐known excellent safety profile.
Normal values for amplitude of accommodation among a population of high school students in Iran
Authors: Yekta A.A. , Hashemi H. , Khabazkhoob M. , Forouzesh S. , Ostadimoghaddam H. , Heravian J. , Azimi A. , Nabovati P. , Yazdani N. , Yekta R. 
Published: September 2016

PurposeTo determine the normal values for amplitude of accommodation in a population of high school students in Iran.MethodsIn a cross‐sectional study, sampling was done from high school students in Kermanshah, Iran through a multi‐stage cluster sampling method. Eye examinations included ophthalmoscopy, refraction, visual acuity, amplitude of accommodation (AA) and cover test. Amplitude of accommodation was measured with Donder's push‐up method using Royal Air Force (RAF) near point rule. Examinations were performed on‐site at each sampled high school.ResultsOf the 1,070 selected students, 901 were included in the study. Mean age of the subjects was 14.4 ± 1.7 years and mean AA was 11.53 ± 3.02 diopters (D) (range, 5–28.5D). Mean AA was 15.33D in 11‐year‐olds and significantly decreased with age until it reached 10.40D in the 17‐year‐old age group. Mean AA in boys and girls were 10.09 ± 2.48D and 11.65 ± 3.03D, respectively. Based on the multiple linear regression model, younger age (coef = −0.774) and female gender (coef = 1.060) significantly associated with AA magnitude.ConclusionsThe results of this study indicated that the normal values of AA magnitude is lower in Iranian teenagers than that calculated with the Hofstetter's formula. It is important to take account of this point when making diagnostic and therapeutic decision.
The prevalence of refractive errors among underserved rural areas in Iran
Authors: Yekta A.A. , Hashemi H. , Khabazkhoob M. , Ostadimoghaddam H. , Malekifar A. , Nabovati P. 
Published: September 2016

PurposeTo determine the prevalence of myopia and hyperopia and related factors in underserved rural areas in Iran.MethodsIn this cross‐sectional study, two rural regions of north and south in Iran were randomly selected through a multi‐stage cluster sampling. After selecting samples, participants had non‐cycloplegic refraction, cycloplegic refraction (<20 years old age) and measurement of uncorrected and corrected visual acuity.ResultsOf the 3,851 invitees participated, 3,271 of them were examined in this study. The prevalence of myopia and hyperopia was 23% (95%CI: 19.6–26.4) and 21.59% (95% CI: 17.92–25.26), respectively in total sample. In those subjects ≤20 years of age, the prevalence of myopia and hyperopia based on cycloplegic refraction was 5.69% (95% CI: 4.42–6.96) and 3.25% (95% CI: 1.49–5.02), respectively. In over 20‐year‐olds subjects, these values were 29.47% (95% CI: 26.26–32.68) and 28.44% (95% CI: 24.40–32.49), respectively. Multiple logistic regression models indicted that myopia prevalence significantly correlated with age, education level, cataracts, and region of residence, and hyperopia prevalence correlated with age and region of residence.ConclusionsThe results of this study indicated that the prevalence of hyperopia and myopia were lower compared to the other studies in urban areas of Iran, but overall, hyperopia had a high prevalence in this study and other Iranian investigations. The prevalence of refractive errors significantly differs between northern and southern rural regions of Iran.
How to make better, safer and easier endothelial controls of long‐term stored corneas with Specular Microscopy?
Authors: Garcin T. , Bernard A. , Calyaka E. , Herbepin P. , Hor G. , He Z. , Gain P. , Thuret G. 
Published: September 2016

PurposeUnlike short term cold storage in which corneas remain clear and thin, long‐term organ cultured corneas cannot be rated by specular microscopy (SM) because of the storage‐induced stromal edema and deep endothelial folds. Aim: To present SM of corneas stored in our patented bioreactor (BR).MethodsHuman corneas were stored in our BR, with a commercial medium containing 2% foetal calf serum at 31°C. The BR restored the intraocular pressure while renewing the medium. By preventing from edema and folding, it improved endothelial cell (EC) viability in the long‐term. Two windows allowed easy multimodal corneal imaging. A new type of SM was developed (CMOS camera, ×10 objective, collimated LED, micrometric stage). For each cornea, 5 images (centre + 4 quadrants) were acquired at day 2 and 28 exactly in the same area, and treated with a custom‐made software and ImageJ to determine the EC density (ECD).ResultsAll corneas remained thin and clear, allowing SM without deconditioning nor deswelling in specific media. The field of view of 935 × 748 μm was 3 times greater than those of both commercial eyebank SM. At D2 and 28, despite shallow residual endothelial folds, large areas of ECs were clearly visualized. ECD could be determined on most images easily. Epithelial cells could also be observed.ConclusionsThe BR combines the advantages of cold storage (closed system) and organ culture (long‐term). SM allowed endothelial assessment of long term‐stored corneas in our closed BR: it could make endothelial controls safer, easier and increase the cell count reliability especially thanks to a wider field of view.
Transpalpebral near‐infrared LED transillumination for anteriorly located intraocular tumors imaging
Authors: Zadorozhnyy O. , Korol A. , Kustryn T. , Nasinnyk I. , Pasyechnikova N. 
Published: September 2016

PurposeTo study the possibilities of transpalpebral near‐infrared LED transillumination for intraocular tumors imaging.MethodsThis study was conducted on 35 people (35 eyes) with intraocular tumors of the ciliary body and iris. In all cases a color photo of the anterior eye segment, transpalpebral near‐infrared LED transillumination, ultrasound examination were made.The device for transillumination consists of compact wireless near‐infrared LED‐probe, monochrome camera able to capture video and images in the near‐infrared range, slit lamp adaptor and a computer with software. For transpalpebral transillumination were used near‐infrared light sources with a wavelength of 940 nm. Examination was performed without local anesthesia.ResultsIn all cases structures of the ciliary body were registered by transpalpebral near‐infrared LED transillumination. Monochrome images of the ciliary body structures of good diagnostic quality were captured during the infrared transillumination of the eye in all cases.In patients with intraocular tumors transpalpebral near‐infrared transillumination made it possible to visualize ciliary body structures and tumor shadows on sclera and to outline their borders. In all cases anteriorly located intraocular tumor shadow was detected and tumor localization in relation to the ciliary body structures was estimated.ConclusionsTranspalpebral near‐infrared LED transillumination provides imaging of the ciliary body and accurately estimates the projection of its structures to the sclera. Transpalpebral near‐infrared transillumination helps to visualize intraocular tumors and to determine their projection to the sclera and can be used for diagnostic purposes and during destruction of the tumor.
Experimental study of intraocular temperature distribution in the rabbit under various environmental conditions
Authors: Anatychuk L. , Pasyechnikova N. , Zadorozhnyy O. , Kobylianskyi R. , Nazaretyan R. , Myrnenko V. 
Published: September 2016

PurposeTo study ocular temperature distribution in the rabbit in dependence on ambient temperature in experiment.MethodsTo measure ocular temperature a thermoelectric device was developed; the latter consisted of a temperature recording microprocessor module, polytetrafluoroethylene microprobes (diameter – 0.6 mm) with thermocouple sensors, computer software for visualization and registration of temperature parameters in real time. The device allows measurements in the temperature range from 10 to 120°C with ± 0.05°C accuracy. The experiment was conducted on 21 rabbits (42 eyes) which were divided into 3 groups. Group 1 consisted of 11 rabbits (22 eyes) ocular temperature measurements of which were made at ambient temperature with the range of 23–24.5°C while Group 2 and 3 consisted of 5 rabbits (10 eyes) each with ambient temperatures with the range of 14.5–15.5°C and 30–32°C, respectively.ResultsThe lowest temperature was noted on the outer corneal surface, and then it increased gradually in the inner segments of the eye and reached its maximum in the retina and subtenon space. A temperature gradient between the outer corneal surface and the retina was 3.23, 4.68 and 3.85°C in Group I, II and III, respectively. No significant difference between temperatures in the left and right eyes of the experimental animals was observed. Data obtained in this study show the lowest correlation between temperatures of the anterior corneal surface and retina. The high correlation was observed between temperatures of inferior conjunctival fornix and retina.ConclusionsRaising and lowering of the ambient temperature increases the temperature gradient between the external and internal structures of the rabbit eye.