bluuebunny/crossref_metadata_2025_split huggingface dataset:
The epidemiology of refraction
Authors: Ohlendorf A. 
Published: September 2017

SummaryBoth, ophthalmologist and vision researcher are aware that refractive errors are a major risk factor for the development of ocular diseases and therefore, their epidemiology is not only of interest for academia. The refractive state of an eye is determined by the distance between the position of the focal plane and the photoreceptor plane, when accommodation is relaxed. When focal plane and photoreceptor plane coincide, the refractive state is zero, a condition called emmetropia. If refractive errors develop, typical visual functions such as visual acuity or contrast sensitivity are affected, which results in blurry distance vision in the case of myopia. As myopia has become a major concern worldwide due to its increasing prevalence especially in Asian countries and with its known major implications on ocular health that also considerably affect the economy, epidemiological studies are especially focused on the elongation of the eye. This talk will summarize epidemiological findings regarding the development of all the ocular components that influence the refractive state (cornea, crystalline lens, axial length) and geographic (environmental) influences.
What do we really mean by emmetropisation
Authors: Morgan I. 
Published: September 2017

SummaryOne of the distinctive features of refractive development is the establishment of a tight distribution of refraction by the age of 2. This can be explained by work on animal models showing that hyperopic defocus promotes, while myopic defocus slows, axial elongation, with precise compensation for the imposed refractive error. It has therefore been assumed that the end‐point of human refractive development is tightly defined emmetropia, with an active mechanism for maintaining emmetropia. But in fact, human refractions generally stabilize in the mildly hyperopic range – a state which can be maintained until adult life. With educational pressures, many children become transiently emmetropic, but then progress to myopia, consistent with evidence that early emmetropia is a major risk factor for myopia. Recent work has demonstrated another control over axial elongation, based on increased release of dopamine by bright light which slows axial elongation. Refractive development in humans can be better explained if myopic defocus signals weaken after the age of 2, and once loss of lens power has slowed, the only process able to counter axial elongation associated with education is provided by the light‐dopamine pathway.
Choosing your fellowship and getting the most out of it – advice from Fellows
Authors: Sousa C. , Breda J. 
Published: September 2017

SummaryChoosing a place for fellowship can be challenging. Every young ophthalmologist looks for a rewarding experience, trying to improve his/her knowledge in a specific area. Achieving this might be dependent on multiple factors. First, it's important to do some research about places where our area of interest can be mastered. After this, comes the “geographic” decision. Time away from family and friends is important for most people, and so is being able to visit them. Besides this, it's crucial to have at least a basic knowledge of the main language that will be spoken. English is widely spoken in most fellowship opportunities, but in my case it was of master importance to be fluent in the local language. Another factor to consider is the size of the hospital/clinic. Is it better to choose a big center with a lot of other residents or is it worth to choose a one‐on‐one experience, where you can sit side by side in an everyday basis with your tutor? For me, this second option worked perfectly and I will explain why. According to my expectations and personality, all the objectives were achieved. I'll try to explain this experience in every important detail and will also discuss some pros and cons of different types of opportunities.
Tips and tricks in macula surgery
Authors: Michalewska Z. , Nawrocki J. 
Published: September 2017

SummaryThe presentation will focus on the following macula diseases: epiretinal membranes, lamellar macular hole, full thickness macular hole, haemorrhagic AMD, diabetic macular oedema.All presented cases will be illustrated with spectral domain or swept source OCT or swept source OCT angiography.In epiretinal membranes and lamellar macular holes a guide to select proper cases for surgery will be presented. In full thickness macular holes the inverted ILM flap technique will be discussed. In this technique the ILM is not completely peeled, but a small fragment is left in order to cover the macular hole. Repeated surgery with autologous ILM flap transplants will follow.In haemorrhagic AMD subretinal rTPA injections will be presented with results of following long‐term anti‐VEGF treatment.In diabetic macular oedema the surgical tip would be ILM peeling followed by subretinal fluid injection.
Automatic tool for quantification of nerve fibres in corneal confocal microscopy images
Authors: Malik R. 
Published: September 2017

SummaryFailure after failure of phase 3 clinical trials in diabetic neuropathy has led to the realisation that potentially effective treatments have failed because of inadequate end‐points in clinical trials. Our pioneering studies showed that corneal confocal microscopy (CCM) had excellent diagnostic potential in diabetic somatic and autonomic neuropathy. We and others subsequently used CCM to diagnose peripheral neuropathies in obesity, impaired glucose tolerance, hereditary neuropathy (CMT1A, Friedreich's ataxia), Fabry's disease, amyloid neuropathy, CIDP, HIV etc. Of significant potential as a surrogate end‐point, we have shown that CCM detects nerve fibre regeneration within 6 months of pancreas transplantation in diabetic patients and after 24 months of an improvement in glycaemic control, blood pressure and lipids, continuous subcutaneous insulin infusion and after bariatric surgery. We have shown nerve repair in several phase 2b trials of ARA290, a peptide derivative of erythropoietin, in patients with sarcoid neuropathy and diabetic neuropathy. We have also shown that CCM detects axonal pathology which relates to the severity of neurological deficits in patients with Parkinson's disease, multiple sclerosis and dementia.
The corneal nerves in glaucoma and ocular surface diseases
Authors: Labbe A. , Liang H. , Baudouin C. 
Published: September 2017

SummaryIn addition to their important sensory function, corneal nerves provide protective and trophic functions and also regulate corneal epithelial integrity, proliferation and wound healing. The well‐defined in vivo confocal microscopy (IVCM) appearance of the subbasal corneal nerves has facilitated their quantitative in vivo analysis in ocular surface diseases. Although patients with dry eyes and patients treated for glaucoma experience similar ocular surface signs and symptoms, different correlations between corneal sensation and nerve morphology were observed in these two groups of patients. The relationship between corneal nerve function and structure remains complex, and nerve alteration and/or dysfunction could be different among different ocular surface diseases. Improvements in IVCM image acquisition and analysis will be an important step to further evaluate the role of corneal nerves in physiological and pathological ocular surface conditions.
OCT and OCTA: new technology, new terminology
Authors: Ambresin A. 
Published: September 2017

SummaryThis topic will introduce the course “current contribution of OCT angiography in clinical practice”. OCT angiography is a recent device that has already reached a wide acceptance among ophthalmologists in real life practice. Nevertheless, the images interpretation often remains a challenge for practioners. A overview about the OCT angiography technology will be given and the new terminology to interpret an OCTA will be exposed. Clinical examples will be presented using the suitable terminology.
The role of OCT algorithms and OCT A in glaucoma care
Authors: Mansouri K. 
Published: September 2017

BackgroundThe role of blood flow in the pathogenesis of glaucoma is not well understood.ObjectiveTo discuss applications of OCTA in glaucoma diagnosis and management.MethodsReview of literature and presentation of ongoing clinical trials.ResultsMore than 50 peer‐reviewed publications on OCTA in glaucoma are available. Data demonstrate good reproducibility and repeatability of OCTA measurements in glaucoma patients. Good correlation to structural and functional measures of glaucoma have also been found. Preliminary data have not found a demonstrated effect of IOP‐reduction of OCTA‐derived vessel density measurements. At present, studies on the long‐term role of OCTA in glaucoma evaluation are ongoing.ConclusionsOCTA measurements of vessel density in glaucoma are reliable. Good correlation to structure‐function has been demonstrated. Available data suggest a role of OCTA for better understanding of the pathophysiological processes in glaucoma. It is unclear, at present, how this technology can be integrated into the long‐term management of glaucoma patients.
Ocular surface inflammation, nerves and brain: dangerous interactions?
Authors: Ferrari G. , Bignami F. , Rama P. 
Published: September 2017

SummarySensory nerves have been typically studied for their sensory functions. It is now clear, however, that in the cornea they are relevant inflammatory modulators. Specifically, functional activation, or, on the other hand, disruption of corneal nerves is associated with highly prevalent ocular disorders, including infectious keratitis, and dry eye disease. Although the modulatory activity of nerves on inflammation has been demonstrated in peripheral tissues, it is not clear whether peripheral disruption of nerves in the cornea could induce modifications also in the central nervous system. In order to test this hypothesis, we have used a well‐known animal model of ocular surface injury. Then, we have quantified the inflammatory response, with in vivo magnetic resonance imaging and ex vivo, in the cornea and in the trigeminal ganglion. As a result, we observed increased leukocyte infiltration following ocular surface injury. Pro‐inflammatory cytokines IL1‐beta, TNF‐alpha and VEGF were also increased. Interestingly, inflammatory cytokine expression were also augmented in the trigeminal ganglion contralateral to the damaged cornea. Our findings support involvement of central nervous system following acute injury to the ocular surface.
An introduction to the tests and clinical interpretation
Authors: Holder G. 
Published: September 2017

SummaryThis lecture will introduce the standard tests used in routine electrophysiological practice, namely full‐field, pattern and multifocal electroretinography, and electro‐oculography. Although the Course will concentrate on disorders of retinal function, the cortical visual evoked potential will also be briefly addressed. The origins of the signals will be discussed and common disorders used to illustrate the principles of clinical interpretation ie the separation of rod and cone system function; localisation of disease either to photoreceptors or inner retina; and the distinction between localised macular disease and generalised retinal dysfunction, always relating the nature of the electrophysiological abnormalities to the underlying pathophysiology.
How to handle the posterior lens capsule in children
Authors: Barraquer R.I. 
Published: September 2017

SummaryOne of the multiple challenges posed by pediatric cataract surgery relates to the special management of the posterior capsule (PC).The risk of PC opacification is much higher in children, nearing 100% in the course of a few months with the standard techniques and intraocular lenses (IOL), even with a thorough capsular bag polishing. As the performance of a Nd:YAG laser capsulotomy can be impractical in children, an intraoperative solution is advisable. This normally involves a posterior capsulorhexis, with or without anterior vitrectomy, and either with a standard IOL or a special design such as the bag‐in‐the‐lens concept or using techniques as posterior capture of the optic.Pediatric cataracts frequently include special features as in opacities a the PC level, which can range from cellular to fibrotic, with different degrees in the maturity of fibrous membranes. In some cases as with posterior polar cataracts there may be an extreme weakness or absence of the central PC. Other situations may involve additional materials as in persistence of anterior hyperplastic primary vitreous.This presentation reviews the decision process, surgical options, and possible risks involved in dealing with the PC in pediatric cataract surgery.
Genetic anomalies in congenital cataract
Authors: Bremond‐Gignac D. , Burin des Roziers C. , Beugnet C. , Fourrage C. , Moriniere V. , Robert M. , Valleix S. 
Published: September 2017

SummaryDevelopmental anomalies of the anterior segment of the eye encompasse a spectrum of disorders affecting the cornea, iris, lens, ciliary body, and/or the trabecular meshwork. Besides, nonsyndromic congenital cataract (CC) is a common cause of visual disability in children. All these genetic disorders are highly clinically and genetically heterogeneous, making challenging a proper diagnosis based solely on a phenotype‐based approach. We develop a genotype‐based approach by using a targeted Next‐Generation Sequencing panel including 50 known genes. A cohort of 150 French index patients were recruited after detailed ophthalmic examination. All exons of the 50 genes were amplified using the kit TrueSeq Custom Amplicon (TSCA, Illumina). The subsequent amplified libraries were sequenced using a MiSeq (Illumina, Inc, San Diego, CA, USA) sequencer. All pathogenic variants were confirmed by Sanger sequencing, and familial analyses were performed. A large spectrum of molecular defects were identified with numerous novel variants. This NGS approach is an efficient tool to improve molecular diagnosis, and provides insight into the genotype‐phenotype correlation of all these ocular disorders in a cost‐effective way.
Normal and abnormal corneal innervation
Authors: Dua H.S. , Al‐Aqaba M. 
Published: September 2017

SummaryThe objective of this talk is to provide an understanding of the latest view on corneal innervation and the changes that occur during disease processes and their possible role in corneal pathology. The cornea is innervated essentially by the 5th cranial nerve. The nerves enter the limbus equally all around the circumference, travel as stromal nerves and undergo dichotomous branching to form sub Bowman's nerves that penetrate the Bowman's zone and end in terminal bulbs. From these, the neuritis of the subasal plexus arise. There is also a signifiant sympathetic innervation of the cornea. There is very little knowledge on the histological changes in corneal nerves during disease process to IVCM studies are many. Recent studies have shown remarkable changes that occur in the stroma, and epithelila nerves in conditions such as bullous keratopahty, corneal grafts, keratoconus, and following refractive surgery. This indicates that corneal nerves are not passive bystanders but contribute actively to corneal pathology.
Changes in axial length in adult eyes
Authors: Rozema J. , Zakaria N. , ní Dhubhghaill S. 
Published: September 2017

PurposeIt is generally assumed that axial length remains constant in adults, although there have been reports of gradual axial length decreases with age. These findings are often considered with scepticism by the authors themselves, however. This work investigates the cause for this apparent decrease and looks into any other factors that may influence axial length measurements.MethodsThe analysis reviews the literature on non‐myopic axial length changes with age in adults and correlates these changes against year of birth and average level of education obtained from United Nations reports. Furthermore a series of calculations were performed to assess how optical biometry methods respond to the thickening of the crystalline lens, while its equivalent refractive index decreases, as well as how they respond to refractive index increases due to cataract.ResultsThe literature analysis shows that axial length does not significantly decrease with age (linear regression, p = 0.071 for the linear term). Axial length does increase with the year of birth, especially in Western countries that all saw similar economic developments during the 20th Century. In non‐Western countries, where the economic development was more diverse, the changes were less pronounced. The correlation of the axial length increase with the increasing education level that occurred in all countries on the other hand was very high (r² = 0.681; p < 0.001). Optical axial length measurements appear to increase by 0.07 mm between 20‐80 years of age due to internal media changes, even if the actual length remains constant. Apparent increases due to cataract are of the same order of magnitude.ConclusionsThe reported axial length decrease with age is an artefact caused by the gradual myopization of the population. Optical artefacts due to changes in the optical media have very little effect.
Micro‐CT study of Bomirski melanoma growing in hamster eye
Authors: Leszczyński B. , Śniegocka M. , Elas M. , Wróbel A. , Sojka‐Leszczyńska P. , Urbańska K. , Pędrys R. , Romanowska‐Dixon B. 
Published: September 2017

PurposeThe Bomirski Hamster Melanoma (BHM) cell line has been successfully used as an eye tumor animal model in the studies on tumor vascular network, metastasis and radiation treatment. Visualization and modeling of neoangiogenesis is crucial for further ocular tumor research. This work presents visualization and image analysis of BHM eyeballs using X‐ray microtomography (micro‐CT).MethodsMicro‐CT is a nondestructive preclinical imaging method with isotropic micron resolution suitable for small ex‐vivo samples. This technique provides 3D distribution of linear attenuation coefficient realized as a stack of cross‐sectional images. The micro‐CT scanning and analysis protocol was optimized for simultaneous visualization of normal ocular tissues, and pathological vasculature of BHM. Micro‐CT image contrast was enhanced using iodine (Lugol's solution) staining technique. In this investigation the Bruker SkyScan 1272 micro‐CT system was used.ResultsThe iodine staining method provided well contrasted images presenting a globe anatomy in fine details. Advanced malignancy, with the tumor occupying the entire anterior chamber and the pathological disorganized irregular tumor vascular network was also visualized. Image analysis and processing allowed to distinguish grey level range corresponding to the particular globe and tumor structures. Quantitative analysis of BHM vessel size distribution and complexity level was performed.ConclusionsMicro‐CT enhanced with Lugol solution staining method has a great potential in preclinical eye tumor research using small animal models.
Application of label‐free 2‐photon fluorescence lifetime imaging microscopy to measure endogenous melanin profiles in human eye melanocytes, naevus and melanoma cells
Authors: Sitiwin E. , Madigan M. , Jager M. , Conway R. , Cherepanoff S. , Macmillan A. 
Published: September 2017

PurposeThe progression of choroidal melanoma (CM) is complex, involving genetic and immune‐related factors. Melanin/pigmentation genes and forms (eumelanin/dark and pheomelanin/light) can also impact on CM progression. In this study, an optimised 2‐photon fluorescence lifetime imaging microscopy (FLIM), with phasor analysis, was used to identify melanin fluorescence lifetime (FL) profiles in formalin‐fixed, label‐free paraffin sections of human melanoma and naevus, with surrounding heterogeneously pigmented melanocytes.MethodsSections of ‘light CM’ (n = 3) with ‘mixed surrounding melanocytes’ and ‘dark naevi’ (n = 3) with ‘dark surrounding melanocytes’ were imaged with FLIM (3 sampled regions). Fluorescence lifetimes were measured at every pixel of captured FLIM images, Fourier transformed and presented in a ‘fit‐free’ phasor plot. These plots were segmented by 7 phasor clusters of linearly increasing fluorescence lifetimes mapped to intracellular melanin in melanocytes, naevus and melanoma cells. The mean fraction of FLIM image pixels linked to each melanin‐mapped cluster was obtained for all sampled regions to form melanin FL profiles.ResultsThe measured sampled regions displayed distinct intracellular melanin (eumelanin:pheomelanin) profiles with varying dominant melanin‐mapped clusters. The dominant ‘highest pixel fraction’ cluster measured in ‘light CM’ mapped to long FLs, implying a low eu:pheo ratio. The ‘mixed pigmented melanocytes around CM’ showed a mixed eu:pheo content based on the dominant mid‐valued FL cluster. The ‘dark naevi and surrounding melanocytes’ were mapped to mostly short FLs (high eu:pheo ratio).ConclusionsOur FLIM‐phasor method provides a fast ‘model‐free’ way to unmix melanin fluorescence lifetimes in melanocytes, naevi and CM, and provides a basis for exploring the role of melanin forms in eye melanoma pathogenesis.
Idiopathic multifocal choroiditis
Authors: NERI P. , Pirani V. , Lassandro N. , Nicolai M. 
Published: September 2017

SummaryIdiopathic multifocal choroiditis (IMFC) is an umbrella term used to describe a specific phenotype of uveitis, which presents multiple inflammatory foci in the retino‐choroidal tissue. In the past, such disease has been described with a number of different names, such as punctate inner choroidopathy, multifocal choroiditis with panuveitis and progressive subretinal fibrosis and uveitis syndrome. This chronic, progressive, bilateral inflammatory chorioretinopathy has been recently identified as a unique entity with a variable phenotype both in terms of clinical expression and severity. The sites which are affected most are the retinal pigment epithelium (RPE), outer retinal spaces and choriocapillaris, while the choroidal stroma has a marginal involvement. During the acute stage, choroidal neovascularization (CNV) can occur, representing the most severe complication in such disease. Albeit there is not general agreement for the treatment strategy, steroids and immunesuppressive agents, with or without intravitreal anti‐vascular endothelial growth factor (VEGF) drugs depending on the presence of CNV, represent effective methods for the control of IMFC.
Irradiation induced optic neuropathy
Authors: Zografos L. 
Published: September 2017

SummaryIrradiation induced optic neuropathy is a major complication of conservative management of intra‐ocular tumors. An irradiation dose of 20 Gy or more delivered on the optic disk is the major risk factor. The final visual acuity in case of irradiation induced optic neuropathy is 0.2 or more only in 25% of the cases. Vascular damage can be located in the retrobulbar arteriovenous network, on the choroidal peripapillary network and on the central retinal artery or vein. In case of retinal ischemia, panretinal photocoagulation and intravitreal anti‐VEGF medication is currently used. The preventive use of anti‐VEGF and steroids is still controversal.
Corneal crosslinking in microbial keratitis
Authors: Szentmary N. 
Published: September 2017

SummaryThe effect of crosslinking (CXL) on microorganisms and on viral, bacterial, mycotic and acanthamoeba keratitis is summarized. Experimental studies have shown that herpes simplex virus will be reduced on a LogMar scale by 4‐5 lines, of Staphylococcus aureus, Pseudomonas aeruginosa or Candida albicans strains by 1‐2 lines. Previous clinical studies have shown that CXL may heal bacterial, mycotic or even acanthamoeba keratitis, but leads to corneal necrosis in herpetic keratitis. Acanthamoeba cysts also survive CXL therapy. Therefore, CXL may be used as an alternative treatment option in bacterial, mycotic and acanthamoeba keratitis, if they are therapy resistant.