bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical management of Acute Retinal Necrosis (ARN): timing and outcomes
Authors: Mora P. , Tagliavini V. , Tedesco S. , Forlini M. , Carta A. , Gandolfi S. 
Published: September 2017

PurposeTo evaluate the demographics, etiology, clinical and surgical management, and functional outcomes of an Acute Retinal Necrosis (ARN) series from a referral Italian Centre. Both clinical characteristics and treatment strategies of ARN are valid and debated issues. Several dedicated articles appear every year in highly impacted medical journals.MethodsObservational series of biopsy‐proven ARN cases between January 2010 and March 2017. All the considered patients had the last visit in 2017. Soon after diagnosis patients had received systemic antiviral therapy according to the specific guidelines. No intravitreal injections or “early” (i.e. in the absence of retinal detachment, RD) pars plana vitrectomy (PPV) were adopted.ResultsSeven patients (5 men) were included with a mean age of 52 ± 18 years (range 31–78 years). HZV was detected in 4 cases, HSV in 2 cases, CMV in 1 case (the sole with positive serology for HIV). PPV was performed in 6/7 subjects, with a mean delay of 43±33 days since diagnosis. Only in 1 case silicone tamponade removal was successfully reached. A second PPV was required in 4/6 patients, because of RD recurrence or posterior bleeding. In one HSV case a complete healing was achieved with medical treatment. Visual acuity (VA) averagely improved in the whole cohort either between diagnosis (0.91 ± 0.25 logMAR) and the end of follow up (0.77±0.51 logMAR); or between preoperatively (1.15 ± 0.03 logMAR) and the end of follow up. In both cases, however, statistic was not significant (p > 0.05).ConclusionsThe efficacy of prophylactic laser in our series, as in the literature, remains unclear. VA improvement was achieved even without early PPV. This evidence, along with the possible adjuvant effect of intravitreal antivirals, warrant comparative discussion with literature data.
Case series and literature review: Is there a role for antiviral prophylaxis in patients who have had herpetic encephalitis?
Authors: Balendra S. , Sepetis A. , Rainsbury P. , Malem A. , Meredith P. , Farnworth D. , Lockwood A. 
Published: September 2017

PurposeTo report a case series involving two cases of acute retinal necrosis (ARN) presenting after treatment and resolution of herpes simplex virus (HSV) encephalitis. In neither case was antiviral prophylaxis after initial episode of encephalitis used. Literature review is presented to evaluate the benefit of prophylaxis in such cases.MethodsTwo case reports are described and fundus photos presented of patients presenting to the Ophthalmology Department of Queen Alexandra Hospital, Portsmouth, UK within the last 3 years. PubMed was used to conduct the literature review.ResultsA 67‐year‐old female presented with rapid painful unilateral visual loss. She had had a history of HSV encephalitis 6 years before, treated successfully with no recurrences. Clinical assessment was in keeping with ARN. She was admitted for intravenous acyclovir for 8 days followed by long‐term oral antiviral treatment. Her vision remained poor with a best‐corrected visual acuity (BCVA) of 6/60 in the affected eye.A 66 year‐old male presented with a 10‐day history of painful unilateral visual loss. He had had a history of HSV encephalitis 6 months before and a relapse 2 months later treated successfully with acyclovir. Clinical assessment demonstrated a panuveitis and retinitis in keeping with ARN. He was admitted for intravenous acyclovir then kept on long‐term oral treatment of 400 mg twice‐daily. The BCVA in his affected eye has remained at 5/60.ConclusionsHSV encephalitis has been widely documented as a risk factor for ARN and has been reported to occur up to 20 years after initial illness. The virus may reach the eye via a trans‐axonal route and reside in a reservoir awaiting re‐activation within retinal neurons. We propose that prophylaxis with long‐term low‐dose antivirals is necessary after all cases of HSV encephalitis to reduce the risk of ARN.
3D visualization systems
Authors: Pournaras J.A. 
Published: September 2017

SummaryPanoramic visualization systems offers new possibilities for all surgeons in the peroperative management of patients affected by vitreoretinal disorders. Ultradigital 3D heads up surgery offers enhanced 3D visualization with high‐definition resolution, image depth, clarity and color contrast while helping to minimize light exposure to the patient's eye. All surgical or patients advantages and inconvenients will be discussed.
Normal upper age‐limits for photopic and mesopic visual acuity and functional contrast sensitivity
Authors: Keuken A. , Subramanian A. , Barbur J.L. 
Published: September 2017

PurposeNormal, healthy aging causes a gradual worsening of vision with more pronounced effects at lower light levels (mesopic range). Normal spatial vision enables us to resolve fine spatial detail and to detect faint edges and boundaries that make up objects. Age‐related changes in the optics of the eye and diseases of the retina and / or systemic diseases that affect vision can also cause a loss of spatial vision. In order to separate the latter from the effects of normal aging, reliable, upper, normal limits of spatial vision are needed for both photopic and mesopic light levels. The purpose of this investigation was to measure visual acuity (VA) and functional contrast sensitivity (FCS) as a function of age in a large sample of normal subjects and to establish reliable, statistical limits to describe normal vision.Methods206 subjects (age range: 10‐77 years) have been investigated. A detailed medical and ocular history and eye examination were carried out. We measured photopic and mesopic VA and FCS in each subject under binocular and monocular viewing conditions with both positive and negative contrast using the Acuity‐Plus test (http://www.city.ac.uk/avot).ResultsThe best visual performance corresponds to ~ 15 to 35 years. The gradual increase in thresholds with increasing age was surprisingly small under all stimulus conditions below the fifth decade with significant differences between photopic and mesopic conditions.ConclusionsThresholds of VA and FCS increase gradually in normal aging. These preliminary results reveal a more pronounced effect between the fifth and sixth decade of life. On completion of this study, statistically‐reliable, upper, normal limits for VA and FCS will be determined as a function of age. These data will make it possible to detect reliable significant loss of spatial vision that cannot be attributed to normal aging.
Retinal vascular fractal dimension and cerebral blood flow, the CRESCENDO study
Authors: Nadal J. , Deverdun J. , Menjot De Champfleur N. , Villain M. , Creuzot Garcher C. , Le Bars E. , Daien V. 
Published: September 2017

PurposeThe retinal vascular fractal dimension (FD) is a marker of retinal complexity of vascular tree. It has been associated with neurodegenerative and cerebrovascular diseases. Arterial spin labelling is a non‐invasive technique to evaluate the cerebral blood flow (CBF). The purpose of this study was to explore the relationship between retinal vascular FD and CBF.MethodsCross sectional analysis comprising 29 individuals aged 65 years and over from the Cognitive REServe and Clinical ENDOphenotype (CRESCENDO) cohort of healthy older adults. Retinal vascular FD was measured from fundus photographs using semi‐automated standardized imaging software “Singapore Eye Vessel Assessment (SIVA)” system. CBF was estimated in various gray matter regions from a 2D Pulsed arterial spin labelling sequence from MRI.ResultsA higher venular FD was associated with higher CBF in all cerebral regions of interest (p < 0.01). No significant associations were found between CBF and other parameters derived from SIVA or the central retinal arterial or venular equivalent. This association was stronger for opposite eye to handedness (p = 0.03). No relationship was observed between arterial FD and CBF (p > 0.07).ConclusionsVenular FD was the main parameter associated to cerebral perfusion whereas retinal vascular calibers were not. It may be evaluated in clinical studies for early and non‐invasive detection of subclinical cerebro‐vascular pathologies including dementia and stroke.
Proteinics study: Relevance and interest for screening, follow‐up, etiopathogenesis of AMD
Authors: Gonzalez C. 
Published: September 2017

PurposeTo evaluate Proteinics study impact on AMD diagnosis, screening, follow‐up, etiopathogenesis.MethodsAMD: 40 patients,16 men,24 women,30 with AMD.4 Groups A,B,C,T. A:10 first stage AMD patients,B:10 Atrophy AMD patients(predominant atrophic areas),C:10 patients with Neovascular AMD,T:10 normal patients,control group. Ophthalmologic exam included ETDRS visual acuity(VA),complete ophthalmic examination,Fundus examination,autofluorescence imaging(FAF),(RegionFinderSoftware),optical coherence tomography(HRA Spectral Domain OCT)(OCTenFace software, M‐S software),Fluorescein angiography(FA)and ICG when Neovascular complication. Proteinics Study: Blood tests and analysis, proteinics qualitative and quantitative analysis,all the same for all patients,whatever group. Blood test is done during ophthalmologic exam. Plasma congelation,then Elisa technic,3 stages(SimpleStep Elisa kits)for detection and quantification of IL1β,IL6,IL10,TNFα,tau protein. Classic Elisa technic,2stages,for Amyloid peptid Aß1‐40.Each sample quadruplicate; MicroBCA analysis.ResultsAnalysis will determine proteinics quantitative values in each group of patients, and proportion, characterization, singularity of each of them: group A and C:similar results, higher for C; group T and B:similar results, lower for B. So, characterization, prevalence, specifics of and for each group, therefore a proteinics profile. Proteinics study'evaluation, identification, classification in AMD patients, and especially A, B, C groups allow AMD screening, follow‐up, particularly according to AMD type and stage. Proteinics study may have biomarker feature and let AMD preventionConclusionsProteinics study enhance AMD characterization, allow better diagnosis, follow‐up, screening. Interrelations, correlations between AMD and Proteinics lead to better etiopathogenesis understanding and therapeutics prospects.
Molecular diagnostics of ocular allergy
Authors: Vitte J. , Baye A. , Batellier L. , Doan S. , Bury T. 
Published: September 2017

SummaryOcular allergies may severely impact on daily activities and overall quality of life. Conventional allergy testing with skin prick tests and circulating serum immunoglobulin E often falls short of identifying the culprit ocular allergens. On the other hand, targeting the ocular milieu may prove valuable for ocular allergy diagnostics. Conjunctival provocation testing and specific immunoglobulin E detection in tear fluid provide data on local ocular hypersensitivity. We focused on specific IgE testing by means of a commercial allergen microarray (ISAC® 112, Thermo Fisher Scientific). We report here the contribution of allergen microarray testing to identifying the culprit allergen in a 42‐year old woman presenting with perennial allergic conjunctivitis.
Seeing the light: A perspective from a junior scientist on her journey from psychology to physics to ophthalmic research
Authors: Irsch K. 
Published: September 2017

SummaryWhile there is no magic formula or a single path to achieving independence in an academic research setting, apart from intellect and scientific ability, persistence, drive, and flexibility certainly belong to the mix of valuable skills. In a perspective from a junior scientist on her own journey to independence, this talk discusses some of the challenges and obstacles encountered along the way, and shares personal insights, in an attempt to aid the upcoming generation of early‐career scientists in their own journey.
Swept Source OCT Angiography after retinal detachment treatment with different techniques
Authors: Michalewska Z. , Nawrocki J. 
Published: September 2017

SummaryIntroductionThe aim of this study is to present Swept Source OCT Angiography images of eyes after retinal detachment treated with different techniquesMaterial and methods100 eyes of 100 patients were treated with pneumatic retinopexy, segmental buckling, cerclage, primary vitrectomy or combined scleral buckling and vitrectomy. In all eyes swept source OCT angiography was performed one week, one and three and six months after surgery. ILM was peeled in all vitrectomized eyes. 3 × 3 and 9 × 9 Swept Source OCT Angiography images were obtained.ResultsDeep retinal vessels were intact only in eyes after pneumatic retinopexy and plombae. After cerclage the density of deep retina vessels was decreased. After vitrectomy deep retina vessels were irregular and had decreased density.ConclusionsRetinal attachment might be obtained with all techniques when administered properly. Pneumatic retinopexy and segmental buckling are still the least invasive retinal detachment surgery, even in days of small gauge surgery. Vitrectomy was associated with most significant changes in retina vasculature, but it must be considered it was also chosen more often in eyes with more a severe disease.
Nanofibrous carrier for transplantation of retinal pigment epithelial cells
Authors: Ardan T. , Popelka Š. , Straňák Z. , Kozak I. , Lytvynchuk L. , Rais D. , Dušková M. , Motlík J. 
Published: September 2017

SummaryThe most common retinal degenerative diseases such as age‐related macular degeneration (AMD) and retinitis pigmentosa belong to serious eye diseases that cause dominant number of cases of impaired vision or even legal blindness. Because there is no treatment method to stop progression of these diseases or even treat them, it is supposable that cell therapy based on replacement of retinal pigment epithelial (RPE) cells can serve as an effective treatment for AMD and other degenerative diseases. The study was aimed at development of a new delivery technique for transplantation of RPE cells using two complementary delivery devices: a membraneous cell carrier and an injector as trans‐scleral implantation instrument. The design of the suggested nanofibrous carrier with a peripheral frame was optimized to provide a minimal diffusion barrier for the flow of nutrients in the subretinal space and at the same time to resist surgical handling. An implantation instrument together with the cell carrier ensured a safe transfer of an organized RPE cell monolayer into the subretinal space. Different designs of the carrier seeded with cultured RPE cells and the implantation instrument was assessed in both ex vivo and in vivo animal experiments.
Infectious keratitis: new concepts for old enemies
Authors: Pirani V. , Cesari C. , Carrozzi G. , Lassandro N. , Calamita R. , Neri P. 
Published: September 2017

SummaryMicrobial keratitis (MK) represents one of the main causes of blindness in the world due to corneal scarring, perforation and endophthalmitis. MK remains a challenging public health concern with the need for more effective treatments. Since resistance to therapies has developed over time to several pathogens, ophthalmologists should pay attention to diagnostic procedures. In order to achieve such goal, animal models and novel studies on disease signaling pathways and pathogenesis have given new therapeutic targets. The most common agents include bacteria (ie: Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae and Serratia species), fungi (ie: Fusarium, Aspergillus and Candida species), and protists, such as Acanthamoeba spp. Several innovative treatments have been proposed, such as lipid based therapy and microRNA based therapies. Corneal cross‐linking might become an alternative to standard antibiotic therapy for treatment of bacterial and fungal corneal infections, decreasing microbial resistance to antibiotics and other drugs. Moreover, deep anterior lamellar keratoplasty (DALK) seems to be more appropriate in herpetic infections than perforating keratoplasty (PK).
Ocular surface reconstruction in severe contact lens associated pathology
Authors: Wylegala E. , Dobrowolski D. , Wylegala A. 
Published: September 2017

SummaryLimbal stem cells insufficiency (LSCI) can be primary (PLSCI) or secondary. (SLSCI). LSCI can be total or partial. Sings and symptoms of LSCI are: decreased visual acuity, photophobia, pain, and corneal epithelial defects leading to the loss of transparency. Conjunctivilzation of the cornea is a symptom sine qua non of total SLSCI. 5–15% cases of SLSCI are after contact lenses wearing. The LSCI in long term contact lens wearers is caused by oxygen level reduction, mechanical irritation and / or inflammatory etiology of corneal limbus. Treatment includes the use of topical corticosteroids, cyclosporin A application of preservative free artificial tears eye drops. Surgical treatment includes: the autologous or allograft limbal stem cell transplantation. Autologous cultured limbal stem cell transplantation is a new method with standardized number of transplanted limbal stem cells. All surgical options of treatment will be discussed.
Robotic surgery ‐ a new way to perform cataract surgery
Authors: Chammas J. , Sauer A. , Bourcier T. 
Published: September 2017

PurposeTo demonstrate the feasibility of robot‐assisted simulated cataract surgeryMethodsWe performed cataract surgeries on a Kitaro cataract wet lab training system using simultaneously the DaVinci Xi robotic surgical system and a phacoemulsification system. For each procedure, duration and successful completion of the surgery with or without ocular complications were assessed.ResultsProcedures were successfully performed on 27 lens nuclei. Feasibility of robot‐assisted simulated cataract surgery is confirmed. The DaVinci Xi system provided the intraocular dexterity and operative field visualization necessary to perform the main steps of the phacoemulsification procedure: corneal incisions, capsulorhexis, grooving, cracking, quadrant removal and infusion‐aspiration of the viscoelastic. The intervention of a second surgeon was required for the intraocular injections of viscoelastic, balanced salt solution and intraocular lenses. Mean operative time was 26 minutes. All lens nuclei were removed. Inadvertent enlargement of the main corneal incision caused by the phaco hand piece was observed in 2 cases.ConclusionsExperimental robot‐assisted cataract surgery is technically feasible using the new DaVinci Xi robotic Surgical System combined with a phacoemulsification machine.
Contribution of microglia‐mediated neuroinflammation to retinal degenerative diseases
Authors: Boia R. , Madeira M.H. , Aires I.D. , Neves C.R. , Ambrósio A.F. , Santiago A.R. 
Published: September 2017

SummaryGlaucoma is characterized by optic nerve damage and retinal ganglion cell (RGC) loss. The onset of the disease is accompanied by microglia reactivity and neuroinflammation. Hence, therapeutic strategies designed at reducing microglia reactivity may offer therapeutic benefits to manage glaucomatous damage. We have been evaluating the ability of adenosine A2A receptors (A2AR) blockade in the control of retinal neuroinflammation and neuroprotection in experimental models of glaucoma.The pharmacological blockade or the genetic inactivation (siRNA in microglial cells or A2AR knockout animal) prevent microglia reactivity, retinal neuroinflammation, and RGC loss. Also, the treatment with a selective A2AR antagonist reverts inflammation and protects the retina. Furthermore, the intake of caffeine, a non‐selective antagonist of adenosine receptors, affords protection to the retina and prevents microglia reactivity.Our results open the possibility for the use of A2AR antagonists as therapeutic options in glaucoma.FundingFCT (PTDC/BIM‐MEC/0913/2012, PEst‐C/SAU/UI3282/2011‐2013, UID/NEU/04539/2013), COMPETE‐FEDER (FCOMP‐01‐0124‐FEDER‐028417), Centro 2020 Regional Operational Programme (CENTRO‐01‐0145‐FEDER‐000008: BrainHealth 2020), AIBILI
Why should you buy a Shack‐Hartman aberrometer for your everyday practice?
Authors: Gicquel J.J. 
Published: September 2017

SummaryQuality of vision is a new comprehensive set of measures that determines visual performance at near, far and in variable light conditions. Good vision is no longer defined by 20/20 vision. The necessity of evaluating vision beyond Snellen acuity has led clinicians and vision scientists to utilize contrast sensitivity, wavefront aberrometry and straylight measurement in most clinical trials related to vision.Recently,the advent of 3D movies and 3D TVs brought us new challenges regarding 3 3 Dimensional Quality of Vision.In this course, experts will share with you their experience on this new frontier of modern ophthalmology.
Nestin expression in primary and metastatic uveal melanoma
Authors: Djirackor L. , Shakir D. , Kalirai H. , Petrovksi G. , Coupland S. 
Published: September 2017

PurposeNestin, a member of the intermediate filament protein family, has been described as a putative cancer stem cell marker (CSC) in a variety of tumours. In particular, increased Nestin expression is associated with an aggressive and primitive tumour phenotype as well as a poor prognosis in cutaneous melanoma. In this study, we examined the expression of nestin in primary (PUM) and metastatic uveal melanoma (MUM) samples, and correlated the findings with histological, clinical and survival data.MethodsNestin expression was assessed by immunohistochemistry in 141 PUM and 26 MUM samples; 11 of the PUM cases were matched with their corresponding metastases. The percentage of tumour cells staining positively for nestin was scored by three independent observers. Statistical analysis of all data was performed with SPSSResultsIncreased levels of nestin in PUM samples were associated with known poor prognostic parameters, including epithelioid cells (p < 0.001), closed loops (p = 0.001),increased mitotic count (p < 0.001), monosomy 3 (p = 0.007) and chromosome 8q gain (p < 0.001). Positive staining was identified in both the cytoplasm and membrane of tumour cells. PUM with nestin expression levels above a cut‐off value of 10% (as determined by ROC analysis) were associated with a significantly reduced survival time (Log rank, p = 0.002). In the MUM, a higher nestin percentage combined with poor prognostic markers led to a shorter survival time following the development of metastases.ConclusionsIn conclusion, increased nestin expression in PUM is an independent predictor of a tumour phenotype associated with metastatic progression and reduced survival time at metastasis.
OCT Angiography
Authors: Leitgeb R.A. 
Published: September 2017

SummaryOCT has become already a standard diagnostic tool in ophthalmology. Despite its continuous improvement in performance, its tissue specificity is still limited, as the contrast mechanism relies on local backscattering changes only. Functional extensions of OCT, in particular Doppler OCT and angiography partially mitigate this limitation. Doppler OCT provides quantitative blood flow in a depth‐localized manner. Abnormal changes in total retinal blood flow have been related to major retinal diseases and their assessment might therefore be an early biomarker of disease onset. Recent developments overcome the necessity to determine the Doppler angle for flow quantification. Fast OCT sequences resolve the pulsatile blood flow in circumpapillary vessel cross sections, that allow to determine the total retinal perfusion in reliable manner. OCT Angiography (OCTA) has gained much attention, due to its easy operation, and impressive vascular detail. It operates in a fully non‐invasive manner, directly on OCT data, and as such as naturally co‐registered. Several examples are given to highlight recent developments to improve speed, field‐of‐view and penetration depth.