bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macular OCT features in eyes with VKH disease
Authors: Diwo E. , Stoykova V. , Massamba N. , Le Hoang P. , Bodaghi B. 
Published: September 2016

PurposeTo describe choroidal and retinal patterns evaluated with SD‐OCT in patients with Vogt‐Koyanagi‐Harada (VKH) disease.MethodsWe included all patients with VKH disease according to the international workshop on VKH and referred to Pitie‐Salpetriere Hospital between December 2014 and June 2015, for whom SD‐OCT was performed. Data collection consists of assessing the best corrected visual acuity (BCVA), the dosages of corticosteroids and immunosuppressors as well as the description of retinal and choroidal thickness and architecture.ResultsThirty eyes of 15 patients, 12 females and 3 males, with an average age of 44.5 years were included. The main uveitis follow‐up was 7.1 years. Two thirds of uveitis cases were chronic. The mean VA was 0.42 logMar. OCT features were macular edema (16.7%), external limiting membrane disruption (36.7%), atrophy of nuclear layers (13.3%), ellipsoid line disruption (36.7%), retinal pigment epithelial hyperplasia and atrophy (26.7% and 16.7%), serous retinal detachment (16.7%), choroidal folds (13.7%), Sattler's and Haller's layers disorganisation (60% and 43%). Retinal and choroidal thicknesses were 259.3 μ and 325.1 μ respectively. The proportion of eyes with ellipsoid disruption, pigment epithelium atrophy and alterations of choroidal layers was more important in the group of eyes with VA superior or equal to 0.4 logMar. Uveitis duration in the first group was superior compared to the second group (5.2 vs. 11.2 years). The degree of inflammation, based on laser flare meter values, was similar.ConclusionsSevere retinal damages seem not to be so common and are frequently associated with poor visual acuity. Haller and Sattler layers alteration are common in acute and chronic cases of VKH disease. Starting rapidly corticosteroid treatment or/and immunosupressors is necessary to avoid these irreversible damages.
Hyperhomocysteinemia caused chorioretinal vasculopathy in an animal model
Authors: Lee Y.J. , Ke C.Y. , Lin P.K. 
Published: September 2016

PurposeMany reports have suggested that hyperhomocysteinemia is a risk factor for atherosclerosis. Some of the reports further indicated that hyperhomocysteinemia was associated with neural degenerative diseases and even age‐related macular degeneration (AMD). However, the pathogenesis of AMD has not been elucidated clearly yet. We therefore established an animal model to mimic hyperhomocysteinemia status in vivo. Morphological changes of chorioretina, and possibly involved growth factors were investigated in this study.MethodsThe hyperhomocysteinemia animal model was generated by administering various doses of homocysteine via intravenous injection to Sprague‐Dawley rats. Chorioretinal images from the rat models in the different treatment groups were recorded, and fluoresceine angiographies (FAG) were done. Histological examinations of the retina and choroid were also performed. Immunofluorescent studies were used to investigate the expression levels of vascular cell markers and different types of vascular endothelial growth factors (VEGF).ResultsSignificantly prominent choroidal vasculatures with congestion and retinal vascular disorders were observed in the chorioretinal images and FAGs of the hyperhomocysteinemic animals. The choroidal capillary plexuses were disclosed expanded and vascular endothelial cells proliferated in the histological examinations. We also found the expressions of VEGF and placental growth factor (PlGF) were both upregulated in the eyes of the animals.ConclusionsHyperhomocysteinemia caused choroidal vascular proliferation. VEGF and PlGF might mainly mediate this situation, and PlGF played a key role in that.
Update on IC3D classification
Authors: Nowinska A. 
Published: September 2016

SummaryThe lecture presents clinical, histopathological and genetic information on corneal dystrophies based on 2008 and 2015 International Classification of Corneal Dystrophies (IC3D). Corneal dystrophies are presented chronographically based on new, modified, anatomic classification proposed by the authors of the IC3D Classification. Clinical data of each dystrophy consists of former alternative names and eponyms, onset, course of the disease, signs, symptoms, optical coherence tomography and confocal microcopy analysis results. Genes and mutations linked to each CD would be presented as well as the histopathological data. The lecture also contains the summary of what was changed in the 2015 IC3D compared to the 2008 IC3D Classification.
The marine n−3 PUFA DHA evokes cytoprotection by inducing autophagy and NFE2L2 in human retinal pigment epithelial cells
Authors: Bjorkoy G. 
Published: September 2016

SummaryAccumulation of misfolded proteins is the hallmark of neurodegenerative diseases. Age‐related macular degeneration (AMD) is a leading cause of central blindness and improved primary prevention and treatment options are needed.The initial phase of AMD associates with accumulation of intracellular lipofuscin and extracellular protein deposits (drusen). Epidemiological studies have suggested an inverse correlation between dietary intake of marine n−3 polyunsaturated fatty acids (PUFAs) and the risk of AMD. Autophagy is a major cellular mechanism for degradation of damaged intracellular components and has a cytoprotective role. In human retinal pigment epithelial cells we find that the n−3 PUFA docosahexaenoic acid (DHA) induces a transient increase in the oxidative stress response regulator NFE2L2/NRF2. Simultaneously, there is a increase in autophagy of intracellular protein aggregates containing SQSTM1/p62. DHA rescues the cells from arrest induced by misfolded proteins or oxidatives stress in a autophagy and NFR2 dependent manner. These results suggest that DHA both induces endogenous antioxidants and mobilizes selective autophagy to reduce the risk of developing aggregate‐associate diseases like AMD.
Splice‐site mutation in the Bmpr1b gene of the mouse causes optic nerve head dysgenesis and retinal gliosis
Authors: Graw J. , Yan X. , Amarie O.V. , Puk O. , Sabrautzki S. , Klaften M. , Thiele F. , Fuchs H. , Hrabe de Angelis M. 
Published: September 2016

PurposeA novel splice‐site mutation of the Bmpr1b gene was characterized in offspring of N‐ethyl‐N‐nitrosourea (ENU) ‐treated mice; besides irregular limb morphology the mutants show an enlarged optic nerve head.MethodsEye development of Bmpr1b mutants was analyzed for Bmp signalling via SMAD1 and 5, and for the expression of PAX2 as a transcription factor important for proper optic nerve head development.ResultsBMP signalling indicated by the presence of phosphorylated SMAD1 and 5 was first observed in a few regions of the developing lens capsule and of the developing retina of mouse embryos at day 11.5 after fertilization. At this stage, no differences in SMAD1/5 phosphorylation have been observed between wild‐type mice and the mutants. However, at the end of embryonic development (E17.5) and in the first days after birth (P7), higher concentrations of phosphorylated SMAD1/5 proteins are found at the optic nerve head region, whereas in the Bmpr1b mutants, the BMP signalling is dramatically reduced indicated by a significant loss of pSMAD1/5 staining. The clear reduction of the pSMAD1/5 in heterozygous and homozygous Bmpr1b mutants leads to a stronger optic disc cupping and to the formation of retinal gliosis indicated by the presence of disorganized and activated astrocytes. Loss of BMP‐mediated signalling in the Bmpr1b mouse mutants is also accompanied by a decrease of Pax2 expression at the optic nerve head region towards the end of embryonic development resulting in an additional line of arguments for the rather specific effect at the optic nerve head.ConclusionsThe T‐G mutation in the splice donor site of exon 10 of the Bmpr1b gene leads to retinal gliosis and hypoplasia of the optic nerve head, which is mainly caused by the repression of BMP‐mediated signalling.
ROP laser treatment based on fluorescein angiography classification
Authors: Guagliano R. , Barillà D. , Bertone C. , Maffia A. , Verticchio Vercellin A.C. , Bianchi P.E. 
Published: September 2016

PurposeTo report laser treatment of babies with retinopathy of prematurity (ROP) based on diagnostic signs in the fluorescein angiography images (FA). FA reliability and accuracy were previously demonstrated [EJ opht 2013; 23(6):881–886].MethodsThis is a cross‐sectional study with retrospective diagnostic data from 72 eyes of 36 premature infants (average gestational age: 26 weeks; average birth weight: 742 g) with Type 1 ROP stage 2 evaluated by RetCam3 and FA. RetCam funduscopic images were compared with FA images. A grid with ocular fundus divided into 3 concentric zones (ICROP 1984–87) and into 4 quadrants centered on optic nerve was superimposed on 360° retina photomontages (Photoshop) obtained from the RetCam and FA images. The FA diagnostic signs included leakage, ischemic areas, peripheral plus disease and vascular anomalies. These signs were not detectable in the RetCam images of the same patients. A scoring system was derived considering the presence (1) or absence (0) of the diagnostic signs. The scores of each single sign were summed to obtain a total score for each quadrant. These scores were then summed to get the global score of each eye. Three different fluorangiographic categories were defined in ROP stage 2 (fundoscopic image): mild (score < 4), medium (4 ≤ score ≤ 10) and severe (score > 10).The decision of either laser‐treatment or observation was made based on this FA classification.Results58 eyes were classified as severe stage 2, 22 as medium and 14 as mild. Complete (360°) and partial (90° or 180°) laser‐treatments were performed in severe and medium ROP, respectively; for mild ROP closely observation was preferred.ConclusionsFA classification is a useful tool to detect early signs of ROP progression to threshold disease. It improves treatment timing and extension in order to obtain the best anatomical and functional outcomes.
Spectrum and outcomes of open globe injuries presenting to a tertiary Eye Centre in Singapore
Authors: Goh M.J. , Chaung J. , Koh V. , Sundar G. 
Published: September 2016

PurposeTo study the demographics and clinical outcomes of consecutive open globe injuries presenting to a tertiary centre in Singapore.MethodsData was prospectively collected for all open globe injuries presenting to a tertiary ophthalmology unit in Singapore between January 2014 and December 2015. Main clinical outcomes were the interval to surgical intervention and visual outcome at 6 months.ResultsWe collected 11 cases with a mean duration of follow‐up of 6.5 ± 3.9 months. The mean age was 42.9 ± 22.3 years and 81.8% were male. 10 cases (90.9%) were from industrial accidents and the remaining 1 (9.1%) was due to a fall. Eye protection was worn in only 27.3% (n = 3) of cases. Indications for surgery included penetrating injuries (n = 7), intraocular foreign bodies (IOFB) (n = 3) and globe rupture (n = 1). Nearly all cases (n = 10) sought medical attention within 7.4 ± 5.7 h of the injury, and the mean interval to surgical intervention in these cases was 4.1 ± 2.6 h. The remaining 1 case presented 1 week after the injury, and underwent surgery 5 days after presentation, for a metallic IOFB impacted in the sclera. No cases developed endophthalmitis. The mean number of surgeries required was 1.6 ± 0.7. At presentation, the mean visual acuity (VA) in the affected eye was 2.0 ± 1.1 logMAR and the mean ocular trauma score was 68.7 ± 17.5. There were 8 cases (72.7%) remaining to follow‐up at month 6, with a mean VA of 0.98 ± 1.12 logMAR, and 7 of 8 cases (87.5%) showed improvement in VA compared to presentation.ConclusionsIn our study, open globe injuries in Singapore are quite uncommon, occurred predominantly in males, often secondary to industrial accidents, and use of eye protection was often inadequate. In a tertiary ophthalmology practice, the majority received prompt surgical repair and had improvement in visual acuity at 6 months follow‐up.
Chondro‐keratoprosthesis: an alternative to OOKP?
Authors: Hoffart L. , Guyot L. 
Published: September 2016

PurposeTo evaluate the use of cartilage as a potential graft material in order to explore a new approach toward osteo‐odontal tissue replacement in keratoprosthesis surgeryMethodsWe describe a modification of the osteo‐odonto‐keratoprosthesis that involves the use of autogenous auricular conchal cartilage graft (ACCG) in 2 patients. In stage 1, ACCG was harvested via a posterior approach. Then, an optical polymethyl‐methacrylate cylinder was embedded into a double‐layered fragment of the conchal cartilage and secured by cyanoacrylate glue. The optical cylinder and cartilage complex were then implanted into the cheek. The stage 2, performed 2–4 months later, involved retrieval of the complex and implantation into the cornea, after reflection of the buccal mucosal flap, corneal trephination, iris and lens removal, and anterior vitrectomy. Cartilage specimens were then processed for histological evaluation after retrieval.ResultsWe report 2 cases of chondro‐keratoprosthesis (CKPRO) who underwent surgery with a 9 months follow‐up following a bilateral limbal stem cell deficiency associated with severe corneal changes. On patient 1, vision was improved to 20/100 J6 during the follow‐up. On patient 2, postoperative visual acuity stay limited to LP related to preoperative retinal lesions. During the follow‐up, any postoperative complication as extrusion, epithelial downgrowth, retrocorneal membrane or endophtalmia was observed.ConclusionsACCG could be a good alternative to replace osteo‐odontal graft in keratoprosthesis surgery especially in young patients with healthy teeth. ACCG has already been widely used for reconstructive surgery and provides safe and stable support to the optical cylinder. However, further comprehensive studies with larger sample size and longer follow‐up are required.
Nanoparticles for ocular surface drug and gene delivery
Authors: Kompella U.B. 
Published: September 2016

SummaryTopically applied liquid formulations disappear rapidly from the eye surface due to nasolacrimal drainage. Along with the drop, the drug molecules including small molecules as well as macromolecules such as gene medicines are expected to clear rapidly, depending on their tissue affinity and rate of entry. Nanoparticles offer unique approaches to enhance and sustain ocular drug delivery following topical administration, especially for drug molecules with poor solubility or poor permeability and partitioning in eye tissues. Additionally, drug administration by invasive approaches are also feasible for ocular surface drug and gene delivery. When a drug is administered in its soluble form, it is likely to disappear rapidly from the site of injection. Nanoparticles are useful in such circumstances to sustain drug delivery. This presentation will provide an overview of nanoparticles including those based on pure drug as well as carrier materials for enhancing and sustaining ocular surface drug and gene delivery following topical or invasive administration.
Retinal toxicity by intravitreal liquid perfluorocarbon
Authors: Montero Moreno J.A. , Ruiz‐Moreno J.M. , Fernandez‐Munoz M. , Amat‐Peral P. 
Published: September 2016

PurposeTo report retinal changes in a population of patients who had undergone vitreoretinal surgery using liquid perfluorocarbon (LPFC).MethodsSingle centre, retrospective study. The clinical records and images of patients who had undergone vitreoretinal surgery during the 36 months prior to the sanitary alert issued by the Spanish Health Authorities on ALA OCTA LPFC were revised.ResultsFour different brands of LPFC had been used during the 36 months period, including ALA OCTA. 128 patients were identified who had undergone vitreoretinal surgery with LPFC of whom 44 had been treated with ALA OCTA. None of the eyes fulfilled the diagnostic criteria of the sanitary alert issued by the Spanish Health Authorities (no light perception + retinal necrosis + optic disk atrophy). No sign of retinal necrosis or severe ocular inflammation was identified in any of the eyes treated with any of the brands during postoperative follow‐up or at the final visit. Optic disk atrophy was identified in 6 eyes, and limited venous sheathing was observed in one eye treated with ALA OCTA vs. no cases in eyes treated with other brands. SDOCT revealed retinal ganglion cell layer vacuolization in eight eyes and inner nuclear layer vacuolization in five eyes treated with ALA OCTA.ConclusionsA range of retinal lesions were identified in patients operated on with the aid of LPFC. These changes and lower final visual acuities were more frequently observed but were not exclusive among eyes treated by ALAOCTA LPFC. LPFC toxicity must be carefully evaluated in a case‐by‐case basis in order to elucidate the role of LPFC and other factors involved
Alterations of retinal vessel size after single injection of intravitreal anti‐VEGF for diabetic macular edema
Authors: Akpolat C. , Kurt M. , Cekic O. 
Published: September 2016

PurposeTo determine the affect of single injection of intravitreal anti‐vascular endothelial growth factor on the retinal vessel caliber in eyes with diabetic macular edema.MethodsOverall 32 patients were enrolled in ranibizumab group, 30 patients were included in bevacizumab group. Each of these groups also was divided into two others consisting of study group and control group. The study groups were composed of injected eyes while the non‐injected fellow eyes served as control group. The patients underwent complete ophthalmic examinations including optical coherence tomography and fundus fluorescein angiography. The primary outcome measures were central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE) and artery‐to‐vein ratio (AVR).ResultsIn ranibizumab study group (n = 32), pre‐injection mean CRAE (175.42 μm) decreased to 169.01 μm at one week and to 167.47 μm at one month (p < 0.001) while baseline CRVE (235.29 μm) decreased initially to 219.90 μm at one week then to 218.36 μm at one month (p < 0.001). In bevacizumab study group (n = 30), pre‐injection CRAE (150.21 μm) decreased to 146.25 μm at one week and to 145.89 μm at one month (p < 0.001) while baseline CRVE (211.87 μm) decreased initially to 204.59 μm at one week then to 205.24 μm at one month (p < 0.001). Pre‐injection AVR values changed significantly (p = 0.001) at one week and at one month in ranibizumab group, but no significant alteration of AVR was observed in bevacizumab group (p = 0.433). In the control groups of both ranibizumab (n = 32) and bevacizumab (n = 30), none of the three parameters altered throughout the study period compared to the baseline (p > 0.05).ConclusionsBoth ranibizumab and bevacizumab injection significantly constricted retinal vessel diameters in eyes with diabetic macular edema.
Choroidal nevi classification using swept source optical coherence tomography and infrared reflectance patterns at different wavelengths
Authors: Papastefanou V. , Vázquez‐Alfageme C. , Degli‐Esposti S. , Cohen V.M.L. , Patel P. , Sagoo M.S. 
Published: September 2016

PurposeRetrospective observational study attempting a classification of choroidal nevi according to the different reflectivity patterns on SS‐OCT and examining the differences on infrared imaging at two wavelengths (830 and 1050 nm) among categories.MethodsOCT and infrared images were obtained on 110 clinically diagnosed choroidal nevi from 108 different patients with two different devices: Spectralis SD‐OCT(Heidelberg) at 830 nm and Atlantis DRI SS‐OCT(Topcon) at 1,050 nm. Based on the reflectivity pattern displayed on SS‐OCT, the lesions were classified by a single grader into: Type A (high reflectivity with optical shadowing), type B (medium reflectivity with partial visualization of scleral boundary) and type C (homogeneous hyporeflectivity with visualization of scleral boundary). Infrared images of the lesions at 830 nm (NIR) and 1,050 nm (IR‐SS) were classified into hyper, iso or hyporeflective.Results110 choroidal nevi were classified as follows: 51 (46.4%) as type A, 19 (17.3%) as type B and 30 (27.3%) as type C. 10 lesions (9%) did not fall into either category. In type A, 48 lesions (94%) displayed low reflectance on IR‐SS, but hypereflectivity on NIR. In type B 13(68%) were hypereflective on NIR and iso or hyporeflective on IR‐SS. In type C 28 lesions (93%) were iso or highly reflective on IR‐SS and also iso or highly reflective on NIR.ConclusionsSS‐OCT allows visualization of the choroidal anatomy and characterization of choroidal nevi into three distinct patterns according to the reflectivity displayed. The reflectance pattern on infrared image was drastically different between the two different wavelengths across the OCT patterns. Type A and B showed opposite reflectance patterns between the two devices, while type C displayed similar hypereflectivity.
Evaluation of choroidal changes in patients with ocular toxoplasmosis using spectral domain optical coherence tomography
Authors: Akpolat C. , Murat M. , Celebi N. 
Published: September 2016

PurposeWe aimed to examine the choroidal changes in ocular toxoplasmosis with spectral domain optical coherence tomography (SD‐OCT) using the enhanced depth imaging (EDI) mode.MethodsThe clinical and laboratory data and SD‐OCT images of patients with ocular toxoplasmosis admitted to Dicle University Ophthalmology Department were analyzed retrospectively. The demographic properties as well as the outcomes of visual acuity, intraocular pressure, biomicroscopic findings and dilated fundus examination were noted. The patients were categorized into three groups: active toxochorioretinitis (TCR), inactive TCR and healthy controls. EDI‐OCT images of lesions and choroid in the subfoveal region were obtained in patients with active and inactive TCR; while only the EDI‐OCT images of choroids in subfoveal region were obtained in the control group.ResultsA total of 54 subjects were evaluated including 20 individuals in the control group (7 male, 13 female), 10 patients in active TCR group (8 female, 2 male) and 24 patients in inactive TCR group (16 female, 8 male). The study groups were comparable in terms of age, gender and intraocular pressure (p = 0.862, p = 0.682, p = 0.841). The best corrected visual acuity (logMAR) was significant lower in active TCR group compared to controls (p = 0.003). The best corrected visual acuity and average choroid thickness in the subfoveal region were significantly lower in the inactive TCR group compared to control group (p = 0.001). The average choroid thickness in lesion region was found significantly thicker in active disease compared to inactive ocular toxoplasmosis (p = 0.001).ConclusionsMonitoring of choroid is possible by EDI technique of SD‐OCT. This method is easily applicable and beneficial in the examining of ocular toxoplasmosis.