bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular chronic graft‐versus‐host disease after allogeneic haematopoietic stem cell transplantation in Denmark (1971–2011): Incidence and risk factors in adults
Authors: Jeppesen H. , Sengeloev H. , Eriksson F. , Kiilgaard J.F. , Lindegaard J. , Julian H.O. , Heegaard S. 
Published: September 2017

PurposeOcular chronic graft‐versus‐host disease (cGVHD) is a bothersome complication to allogeneic hematopoietic stem cell transplantation (HSCT). The objective of this study was to assess incidence and risk factors of developing ocular cGVHD.MethodsA retrospective study of 1021 consecutive patients who underwent HSCT at a single institution. The patients were examined by an ophthalmologist before HSCT, annually up to five years after HSCT and more frequently if ocular symptoms occurred. Ocular cGVHD was diagnosed using the criteria proposed by The International Chronic Ocular GVHD Consensus Group. Myeloablative(MA) and non‐myeloablative(NMA) transplants were analysed separately due to great differences in patient age, conditioning regimen and stem cell source.ResultsOut of 1021 patients 99 (9.7%) had dry eye disease before HSCT. The 5‐year cumulative incidence of ocular cGVHD was 0.16(95%CI 0.13–0.19) in the MA group and 0.30(95%CI 0.25–0.36) in the NMA group. In adjusted cox regression models, we identified five risk factors of developing ocular cGVHD in the MA group: Schirmer's test ≤10 mm/5 min before transplantation; malignant disease; peripheral blood as stem cell source; female donor and the use of an unrelated donor. Risk factors in the NMA group were: Schirmer's test ≤10 mm/5 min before transplantation, higher recipient age and the use of an unrelated donor.ConclusionsThe 5‐year cumulative incidence of ocular cGVHD was 16% after MA conditioning and 30% after NMA conditioning. A low Schirmer's test before transplantation is a potential predictive factor of ocular cGVHD. Surprisingly, many of the patients had dry eye disease already before transplantation. Special attention should be directed toward patients with malignant disease, older age and patients receiving graft from peripheral blood and the use of a female donor or an unrelated donor.
A novel in vivo model of puncture‐induced iris neovascularization
Authors: Locri F. , Beaujean O. , Aronsson M. , Kvanta A. , André H. 
Published: September 2017

PurposeTo assess iris neovascularization by uveal puncture of the mouse eye and determine the role of angiogenic factors during iris neovascularization.MethodsUveal punctures were performed on BalbC mouse eyes to induce iris angiogenesis. VEGF‐blockage was used as an anti‐angiogenic treatment, while normoxia‐ and hypoxia‐conditioned media from retinal pigment epithelium (RPE) cells was used as an angiogenic‐inducer in this model. Iris vasculature was determined in vivo by noninvasive methods. Iris blood vessels were stained for platelet endothelial cell adhesion molecule‐1 and vascular sprouts were counted as markers of angiogenesis. Expression of angiogenic and inflammatory factors in the puncture‐induced model were determined by qPCR and western blot.ResultsPunctures led to increased neovascularization and sprouting of the iris. qPCR and protein analysis showed an increase of angiogenic factors, particularly in the plasminogen‐activating receptor and inflammatory systems. VEGF‐blockage partly reduced iris neovascularization, and treatment with hypoxia‐conditioned RPE medium led to a statistically significant increase in iris neovascularization.ConclusionsThis study presents the first evidence of a puncture‐induced iris angiogenesis model in the mouse. In a broader context, this novel in vivo model of neovascularization has the potential for noninvasive evaluation of angiogenesis modulating substances.
Biological model of Zebrafish‐ a new research trend in ophthalmology, for an antiangiogenic treatment
Authors: Danieluk K. , Święch‐ Zubilewicz A. , Osęka M. , Mackiewicz J. 
Published: September 2017

PurposeZebrafish is an ideal biological model for studying human diseases because of many similarities with the human genome. The structure of zebrafish eye is also very comparable to the human eye. We focused on new therapies for wet age‐related macular degeneration (wAMD) and proliferative diabetic retinopathy (PDR). The aim of the study was to present the influence of dopamine's agonist on the angiogegesis of Zebrafish larvae in comparison with anti‐angiogenic effect of bevacizumabMethods3 substances were used: bromocriptine, pergolide, cabergoline in concentrations from 1 nmol to 2,5 umol. Process of angiogenesis was observed for 5 days in larvae of genetically modified Zebrafish Fli with labelled, luminescent blood vessels. Photo documentation was taken under the fluorescent microscope Stereo discover v8, fluorescence 200c hxp. Carl Zeiss Microscopy GmbH.ResultsTested substances had inhibitive impact on process of angiogenesis in Zebrafish larvae. The strongest one was pergolide. We observed the diferences in Zebrafish vessels. Patological vessels were observed not only in the retina but also in the whole body of Zebrafish.ConclusionsZebrafish is getting more and more common model for pharmacologic research. Inhibition of angiogenesis by dopamine's agonist may be new therapeutic option in treatment of diseases, complicated by neovascularization like AMD and proliferative diabetic retinopathy.
Optic nerve cupping and lamina cribrosa sclerae depth as a resultant of translaminar pressure difference
Authors: Czak W. , Piróg‐Mulak M. , Nowakowski J. , Misiuk‐Hojło M. 
Published: September 2017

PurposeThe aim of the research was to evaluate correlation between translaminar pressure difference (TLPD) and optic nerve head (ONH) morphology parameters: lamina cribrosa sclerae depth (LCD) and optic nerve cupping (ONC).MethodsStudy included 42 eyes of 25 patients qualified to undergo lumbar puncture (LP) due to neurological circumstances. LCD, ONC and intraocular pressure (IOP) were measured 1–3 h prior to LP during ophthalmic examination. IOP was measured using Goldmann applanation tonometry. ONH morphology parameters: LCD and ONC were assessed using enhanced depth imaging optical coherence tomography (EDI‐OCT). CSFP was measured during lumbar puncture. TLPD was calculated as a difference between IOP (mmHg) and CSFP (mmHg).Results20 female eyes and 22 male eyes were included in the study. Mean age of female subjects was 44.1 ± 18.00 while the mean age of male subjects was 54.73 ± 13.57. LCD was revealed to be significantly deeper in male population (mean 365.83 μm vs. 296.07 μm). Statistical analysis revealed a strong positive correlation between LCD and TLPD (p < 0.0001, R = 0.78) and between LCD and ONC (p < 0.0001, R = 0.71).ConclusionsThere is a strong positive correlation between TLPD and ONH morphology parameters. LCD and ONC should therefore be viewed as a resultant of two pressure compartments: IOP and CSFP. Intraocular pressure is since many years a confirmed modifiable risk factor for development and progression of glaucomatous neuropathy. CSFP was also proved to be significantly lower among primary open angle glaucoma subjects. In future LCD and ONC as a resultant of TLPD could therefore play a role in assessing the risk of glaucomatous neuropathy progression. According to significant correlation between TLPD and ONH morphology parameters, combined LCD and IOP measurement could moreover play a role as a non‐invasive CSFP assessment tool.
Acute retinal ischemia
Authors: Ambresin A. 
Published: September 2017

SummaryRetinal ischemic injuries may occur in various clinical conditions. Untill recently, funduscopy and dye angiography were the only exams to evaluate the extention of occlusive damages. Acute arterial occlusive disorders can be clinically obvious such as in branch or central arterial occlusion but in more localised ischemic injuries, these exams can be silent. Recently, Bscan OCT allowed visualisation of hyperreflective lesions in various retinal layers suggesting ischemia of the related retinal plexus. The recent advance of OCT angiography allows us today to differentiate various depths of retinal ischemic injuries. Illustrations of paracentral acute middle maculopathy will be discussed.
Tube surgery techniques
Authors: Gandolfi S. 
Published: September 2017

SummaryTube surgery has has moved from the bottom line in the glaucoma treament stepladder, to be more conveniently placed as a surgical first‐line option.This presentation will focus on (a) the mechanisms of action of tubes, (b) the most recent scientific evidences on efficacy and safety of tube surgery and (c) the technical still unmet needs to be addressed in the near future.
Ocular pharmacokinetics and pharmacodynamics
Authors: Urtti A. , Del Amo E. , Pelkonen L. , Rimpelä A.K. , Kidron H. , Reinisalo M. 
Published: September 2017

SummaryOcular pharmacokinetics is of crucial importance in ocular drug delivery and pharmacodynamics. Posterior segment drug pharmacokinetics is particularly important, since it seriously limits the applicable routes of drug delivery in the retinal treatment. In this presentation, some important aspects of posterior segment pharmacokinetics will be discussed, such as the role of blood retina barrier, drug transporters, and melanin binding. Quantitative and systematic pharmacokinetics approaches will be presented and discussed in the light of pharmacodynamics and drug delivery.
Iontophoretic targeting of drug delivery in the eye via the suprachoroidal space
Authors: Jung J.H. , Chiang B. , Prausnitz M. 
Published: September 2017

SummarySuprachoroidal space (SCS) injection has been developed using a microneedle to increase bioavailability of drugs. For many indications, the site of action is near the posterior pole, so targeting delivery within the SCS toward the back of the eye is of interest. Therefore, we hypothesize applying electric current (i.e., iontophoresis) can drive drugs having charge to specific areas within the SCS.To test this hypothesis, we injected fluorescent particles using a 30G hollow microneedle into rabbit eyes ex vivo. First, negatively charged particles were infused using the microneedle embedded a Ag/AgCl electrode, and then iontophoresis was applied to generate an electric current (0.14 mA for 3 min) between the injection site and the optic nerve where the other Ag/AgCl electrode was attached.After injection of 100 μL without iontophoresis, we found 38% of particles were in the most anterior quadrant of the SCS (<3 mm from the limbus) and 9% of particles were in the most posterior quadrant of the SCS (>9 mm from the limbus). In the presence of iontophoresis, the number of particles found in the most anterior quadrant was almost cut in half to 20% and the number of particles in the most posterior quadrant was almost doubled to 17%.
Ophthalmic ophthalmology
Authors: Mccarty C. 
Published: September 2017

SummaryHow Do Patients Respond to Genetic Testing for AMD?The goal of this project was to conduct a pilot AMD genomic medicine study. Eligible patients aged 50‐65 with no personal AMD history gave informed consent and DNA samples were genotyped for 5 single nucleotide polymorphisms (SNPs) in the CFH gene, 1 SNP in the ARMS‐2 gene, 1 SNP in the C3 gene and 1 SNP in the mitochondrial ND2 gene. The study optometrist provided risk scores and counseling for personal protective behaviors. 101 (85%) participated; 78 (77.2%) were female. The smoking status was: 67 (66.3%) never smoked, 31 (30.7%) former smokers, and 3 (3.0%) current smokers. More than half (n=48) of participants said they were motivated to participate because they had a family member with AMD or another eye or genetic disorder. Despite low risk levels, many participants made changes as a result of the genetic testing. Twenty‐seven people reported making specific changes, including wearing sunglasses and brimmed hat, or taking vitamin supplements. Another 16 people said that they were already doing the recommended activity(ies). Interest in genetic testing for future risk of AMD was high in this population and led to continuation or improvement of eye health behaviors.
Surgery of iris melanoma
Authors: Mouriaux F. 
Published: September 2017

SummaryThe most effective treatment for iris nevus and melanoma remains debatable. Typically, a melanocytic iris nevus is monitored until growth is identified. With documented growth, radiotherapy or surgical resection is usually performed. Surgical resection consists of iridectomy, which is characterized by removal of part of the iris with the tumor.Rates of cataract and glaucoma development after treatment are generally higher following proton beam and plaque radiotherapy relative to surgical resection. Moreover, radiotherapy carries the risk of limbal stem cell deficiency. Finally, surgical resection does carry the rapidity of tumor removal.Thus, localized, circumscribed, or discrete lesions that demonstrate growth are excellent candidates for conservative surgical resection.
Radiotherapy of iris melanoma
Authors: Lumbroso L. 
Published: September 2017

SummaryIris melanomas represent 2 to 3% of uveal melanomas. Conservative management is often possible, with either excision of the tumor or irradiation. Proton beam irradiation for iris melanoma is used since several years, for selected small circumscribed iris melanomas. The results are excellent in terms of local control and eye preservation. The main side effect is cataract formation (45%). Progressively larger tumors have been treated with whole anterior segment irradiation (large tumors or lesions associated with extensive pigment dispersion or iridocorneal angle invasion). Local control is also excellent in this setting. For these larger lesions side effects consisting in corneal alterations and glaucoma are frequent than for localized lesions, especially if there was high ocular pressure anterior to the treatment. Glaucoma, can be challenging to treat leading to vision loss. For all patients the survival is excellent. Proton beam irradiation allows the treatment and avoids surgery of small circumscribed iris melanomas with very little side effects and excellent local tumor control. For larger, not resectable lesions, it allows ocular preservation with good local control, corneal alterations and glaucoma are frequent.
Suspicious naevi: treat
Authors: Desjardins L. , cassoux N. , LumbrosoLeRouic L. , Levy C. , Dendale R. 
Published: September 2017

SummaryAccording to the study performed by Shields the risk factors for growth of small melanocytic lesions are the presence of symptoms, subretinal fluid,proximity of ON, orange pigment, thickness of more than 2 mm and diameter of more than 7 mm. Performing genetic test on small melanocytic lesions is not always useful, as it has been shown that a good prognosis lesion can grow and change in a bad prognosis. In a recent European study, metastasis have been observed for lesion of 6 mm in diameter and 2, 3 mm in thicknessOphthalmologists are always trying to preserve vision as a rule. Nevertheless with possibly malignant lesions, the metastatic risk has to be considered before a therapeutic approach is decided. Factors like age of the patient, number of risk factors for growth and location of the tumor should be taken in account. Thus the practician should advise the patient and discuss and explain the decision. We usually recommend treatment if there are at least 3 risk factors and if the patient is young and the lesion away from the posterior pole. In all different situations we usually recommend close follow up for suspicious lesions and treatment in case of documented growth.
Update in low vision reeducation
Authors: Atilla H. 
Published: September 2017

SummaryIn pediatric age group, diagnosis of retinal diseases require detailed clinical evaluation, mostly under general anesthesia and comprehensive diagnostic tests such as electroretinography, genetic tests, and systemic examination. With the advances in treatment modalities for premature retinopathy vision can be restored even in very low birth weight babies. Advances in chemotherapy result in higher survival rates in retinoblastoma. For hereditary dystrophies gene therapy is promising. However in spite of advances in therapies for retinal diseases, it is still one of the main reasons of low vision. In infants with low vision and normal ocular structures, retinal disorders such as hereditary dystrophies, should be considered. Neurological and developmental problems may be associated with retinal abnormalities and detailed evaluation are needed in these babies and children in order to increase vision and quality of life.
New insights on the anatomy and function of the retina in sickle cell disease
Authors: Martin G.C. , Brousse V. , De Montalembert M. , Albuisson E. , Grevent D. , Denier C. , Michel S. , Abadie V. , Chalumeau M. , Boddaert N. , Bremond‐Gignac D. , Robert M.P. 
Published: September 2017

IntroductionThe recent rise of OCT showed that asymptomatic atrophy of the median temporal raphe of the retina (ATR) was a frequent occurrence in sickle cell disease (SCD). However, the prevalence, mechanisms and significance of ATR is not known, especially in the paediatric field.MethodsSCD‐children prospectively underwent a fundus examination and an OCT of the macula and the temporal retina. Atrophy of the MTR was quantified on thickness maps. Data from brain imaging were collected in SS‐type SCD children.ResultsEighty‐one children were studied; 64.2% exhibited ATR, while 29.2% had peripheral SCD retinopathy. ATR was often limited to areas located temporally from the usual macular map OCT programs, so that it could be missed with these programs. Patients with peripheral retinopathy were more likely to also exhibit ATR (p = 0.02). While peripheral retinopathy was significantly associated with the children age (p = 0.02), ATR was not.ConclusionATR seems to occur very early in children with SCD and to display most distinct features from the well‐known peripheral SCD retinopathy.
Scleral lenses ‐ What we don't (but should) know
Authors: NAU A. 
Published: September 2017

SummaryAdvances in scleral lens technology have resulted in a surge of practitioners wanting to offer this modality for patients with ocular surface diseases and, increasingly, normal refractive issues. The current literature consists primarily of case reports and case series, with few prospective clinical trials. This leaves significant gaps in our understanding of how these devices interact with the tissues of the ocular surface, and offers significant opportunity for further study. Areas of research interest which could deepen our knowledge of how and when to fit (or avoid) scleral lenses will be reviewed in this lecture.
Long term outcome of Intrastromal corneal ring segment in keratoconus
Authors: Kang M.J. , Lee J.H. , Choi M.H. , Joo C.K. 
Published: September 2017

PurposeThe Intrastromal corneal ring segment (ICRS) has been widely used to correct the astigmatism and to halt the progression in keratoconus. Although short term outcomes are well known to be effective, long term outcomes have been rarely reported and showed no consensus. Therefore, we planned to evaluate the effectiveness of ICRS in keratoconus for 5 years.MethodsThe retrospective chart review was done. In total, 23 eyes of keratoconus which received ICRS were included. Visual acuity, refraction, keratometer, thinnest corneal thickness and higher order aberration were evaluated at preoperative, 2 months, 1 year, 3 years and 5 years of postoperative day.ResultsBoth uncorrected (UCVA) and best corrected visual acuity (BCVA) was improved at 1 year and maintained until 3 years (p < 0.05). UCVA worsened at 5 years but similar to preoperative measurement. On the other hand, BCVA maintained until 5 years (p < 0.05). Spherical equivalent and anterior corneal keratometer were improved at 2 months and maintained until 3 years, but it was worsened similar to preoperative level (p < 0.05). Vertical coma was improved consistently for 5 years (p < 0.05).ConclusionsBoth Refractive and topographic findings were improved at 2 months and the effect was maintained until 3 years. Although both of it have worsened at 5th year, the level of the measurements was not worsen than that of the preoperative day. The ICRS in keratoconus is effective in correcting astigmatism and visual acuity for 3 years and also helpful in halting the progression for 5 years.
Optimisation of novel small molecule inhibitors of SRPK1‐mediated VEGF‐A splicing through modelling of permeability properties required for trans‐scleral eye drop delivery
Authors: Batson J. , Toop H. , Daubney J. , Liddell S. , Stewart E. , Bourne J. , Blackley Z. , Morris J. , Bates D.O. 
Published: September 2017

PurposeDevelopment of non‐invasive therapies for wAMD and DME has not yet been successful due to poor PK/PD properties. SRPK1 is a novel target that controls VEGF‐A splicing. Delivery of potent small molecules to the retina as eye drops is an unmet need due to lack of insight into drug required properties. We used rational medicinal chemistry and permeability models to identify physicochemical properties for retinal delivery.MethodsPorcine eyes were dissected, and full thickness tissue clamped into a scaffold with drug formulations facing the sclera. Tissue sections were dissected after 24 hours and compound extracted and analysed by mass spectrometry. Efficacy, toxicity and PK were evaluated in C57/Bl6 mice. PK was assessed in pigmented and albino rabbits.ResultsHighly potent and selective SRPK1 inhibitors with improved permeability (×10‐6 cm/s) ex vivo (Compound A 1.47, Compound B 4.07) had improved PK in in vivo models. SRPK1 inhibitors did not inhibit retinal function yet inhibited laser‐CNV following eye drops given to mice (EC50s<0.5 μM, n = 6–8, p < 0.05, One‐way ANOVA).ConclusionsEx vivo screening enabled modelling and design of novel compounds with improved permeability and optimisation for in vivo retinal delivery.
Real‐life Experience with glaucoma surgical training using SOS eyes
Authors: Mercieca K. 
Published: September 2017

SummarySurgical training in Europe is very different according to each region. National regulations, different settings and allocated resources allow for a great heterogeneity in surgical opportunities. The equation of providing adequate training and performance levels to the surgeon while upholding the best possible practices of maximizing patient safety is a difficult task. Throughout Europe, surgeons are increasingly resorting to solutions that allow them to train in simulated scenarios before being confronted with a real life scenario. From wet‐labs to electronic simulations, there is a wide range of solutions that could be adapted to each reality. In this section of the symposium we look at real life experiences using specifically designed advanced ‘dry lab eye’ models (Simulated Ocular Surgery, or SOS, eyes) from the perspective of residents, glaucoma fellows and consultant trainers/supervisors. Videos and first hand experiences will be shared with the audience with useful tips, practical advice and potential drawbacks presented and described by a young qualified consultant trainer from one of the largest and oldest ophthalmic teaching hospitals in the U.K.