bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of dexamethasone implant on macular morphology and visual function in patients with different diseases
Authors: Lopez Sangros I. , Marco Monzon S. , Honrubia Grijalbo A. , Sanchez Marin I. , Idoate Domenech A. , Bartolome Sese I. , Berniollles Alcalde J. , Ascaso Puyuelo J. 
Published: September 2017

PurposeTo evaluate the effects of dexamethasone implant in patients with different retina diseases.MethodsIn the study 194 eyes of patients treated with Dexamethasone implant were included restrospectively in the study. Best‐corrected visual acuity (BCVA) measurement, complete ophthalmic evaluation with Intraocular pressure (IOP), and spectral‐domain optical coherence tomography (OCT) were performed at baseline and 30 days after treatment.ResultsWe have analyzed the results of the administration of dexamethasone implant in 194 eyes, during the years 2015 and 2016. The main indications for the treatment with dexamethasone implant were central retinal oclusion (54.20%), diabetic macular edema (35.35%), Irvine Gass syndrome (4.71%), uveitis (3.03%), macular degeneration (2.02%), vitreous‐ macular traction syndromes (0.33%) and neovascularization of the anterior segment (0.33%). The best visual acuity and the IOP before the administration of dexamethasone implant were respectively 0.21(+/‐ 0.15) and 16 mmHg. After the treatment the best visual acuity improves to 0.27 (+/‐ 0.2) and the IOP was 18.9 mmHg (+/‐6.28). The macular thickness has been reduced to 519.72 micron (+/‐ 157.86) to 429.96 microns (+/‐153.98) after the dexamethasone implant.ConclusionsIntravitreal dexamethasone implant showed an early and fast effect in reducing CRT and moderatly improving BCVA. There are IOP variations, but it rarely exceeds normal limits.
Neural degeneration mechanisms in diabetic retinopathy: The role of apoptosis and autophagy
Authors: Amato R. , Dal Monte M. , Cervia D. , Catalani E. , Cammalleri M. , Casini G. 
Published: September 2017

PurposeThat neuronal injury plays a major role in diabetic retinopathy (DR) is gaining increasing recognition. In particular, we have recently shown, using an ex vivo model of early DR, that neuroprotection may also reduce the expression of proangiogenic factors. Given the importance of neuronal health in DR, we chose to better analyze the mechanisms of cell death involved in this disease. Our hypothesis was that the balance between neuronal death and survival may depend on a similar equilibrium between apoptosis and autophagy: in this context, a neuroprotective treatment would act by influencing this equilibrium.MethodsEx vivo mouse retinal explants were treated with high glucose (HG, 75 mM) for 10 days and the somatostatin analog octreotide (OCT, 1µM) was used as a neuroprotectant. Chloroquine (CQ, 10µM) was used as an autophagy inhibitor. Apoptotic and autophagic markers were evaluated using Western blot and immunohistochemistry.ResultsConsistent with our previous observations, HG‐treated retinal explants displayed a significant increase of apoptosis. Concurrently, HG treatment caused a significant decrease of the autophagic flux, which was likely to be due to increased activity of the autophagy regulator mTOR. Treatment with OCT rescued HG‐treated retinal explants from apoptosis and determined an increase of autophagic activity with concomitant mTOR inhibition. Blocking the autophagic flux with CQ completely abolished the anti‐apoptotic effect of OCT.ConclusionsApoptosis and autophagy seem to play opposite roles and a delicate balance between apoptotic and autophagic fluxes is responsible for the death or survival of retinal neurons in stressing conditions like HG. Consistently, the data obtained with CQ suggest that the anti‐apoptotic effect of OCT in HG‐treated retinas is mediated by an increase of the autophagic flux.
Retinal vessel geometry and oxygen saturation in patients suffering from diabetes mellitus and/ or cardiovascular disease
Authors: Heitmar R. , Blann A. 
Published: September 2017

PurposeTo explore the association of retinal vessel parameters such as calibres, reactivity and complexity with vessel oxygen saturation in patients with Diabetes Mellitus and/ or cardiovascular disease.MethodsAll 123 patients underwent a full eye examination including IOP and dilated fundus photography. Retinal oxygen saturation of arteries and veins were measured from dual wavelength retinal photographs (IMEDOS Oxygen module). A‐V saturation was calculated as an estimate of oxygen consumption. Retinal vessel calibre's, tortuosity and fractal dimension were measured using a semi‐automated software to determine CRAE and CRVE (Visualis, IMEDOS and Iflexis, Vito).ResultsPatients mean ranged in age from 32 to 85 years (77 out of the 123 were diabetic). Principal component analysis was performed to establish if the cohort should be split into sub‐groups for further analyses but showed a clear overlap of all patients with no distinct clustering. Subsequently a stepwise forward multiple regression analysis was conducted to explore the relationship between retinal vessel geometry and saturation parameters. Following adjustment for axial length (to account for magnification errors), diastolic blood pressure, retinal vessel fractal dimension and intraocular pressure were significantly associated with A‐V saturation (all p<0.05) meaning a retinal vascular network with a lower fractal dimension (i.e. less vessel density and branching) showed a lower A‐V saturation.ConclusionsThe current study shows that in patients suffering from Diabetes Mellitus and/ or cardiovascular disease, the amount of oxygen used is depending on the complexity of its vascular bed as well as on local and global pressure parameters. These findings could be useful to explore in patients over time or those diabetic retinopathy manifest in different retinal locations.
Effect of intravitreal bevacizumab and aflibercept on retrobulbar blood flow in injected and uninjected sound eyes of patients with neovascular age‐related macular degeneration
Authors: Sebastiani S. , Corcioni B. , Pazzaglia A. , Gaudiano C. , Cellini M. , Golfieri R. , Campos E.C. 
Published: September 2017

PurposeTo evaluate early changes in retrobulbar blood flow following intravitreal injection of anti‐vascular endothelial growth factor (VEGF) agents.MethodsTen patients affected by neovascular age‐related macular degeneration in 1 eye were enrolled. Five eyes received intravitreal bevacizumab (1.25mg/0.05mL) and 5 eyes aflibercept (2mg/0.05mL). Retrobulbar blood flow was examined by color doppler ultrasonography (Aplio 500, Toshiba Medical System, Tokyo, Japan). Peak systolic velocity (PSV) and resistivity index (RI) was measured from ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) in both injected and uninjected sound eyes, before and 21 days after treatment.ResultsBefore and after intravitreal bevacizumab mean retrobulbar blood flow parameters significantly change in PCA: PSV 15.24±3.96 cm/sec vs 12.90±2.63 cm/sec (p=0.0012), RI 0.74±0.02 vs 0.77±0.07 (p=0.009) and in CRA: PSV 14.16±1.8 cm/sec vs 12.29±1.54 cm/sec (p=0.005), RI 0.77±0.03 vs 0.79±0.03 (p=0.029). In the sound fellow eyes, significant changes resulted in PCA: PSV 17.26±3.45 cm/sec vs 13.63±3.3 cm/sec (p=0.003), RI 0.74±0.05 vs 0.79±0.03 (p=0.026). Before and after intravitreal aflibercept measured data significantly change in PCA: PSV 12.8±3.09 cm/sec vs 7.20±0.62 cm/sec (p=0.023), RI 0.68±0.03 vs 0.77±0.03 (p=0.007) and in CRA: PSV 14.28±1.2 cm/sec vs 11.04±0.77 cm/sec (p=0.037), RI 0.73±0.03 vs 0.78±0.05 (p=0.022). In the sound fellow eyes, significant changes resulted in PCA: PSV 12.44±2.89 cm/sec vs 9.18±1.42 cm/sec (p=0.044), RI 0.69±0.05 vs 0.75±0.02 (p=0.028).ConclusionsIntravitreal injections of bevacizumab and aflibercept significantly reduce ocular hemodynamic parameters both in treated and in untreated eyes. These evidences suggest a possible systemic effect.
Modulation of iris sphincter and ciliary muscles by Urocortin 2
Authors: Rocha De Sousa A. , Ferreira D. , Tavares‐Silva M. , Raimundo A.R. , Barbosa‐Breda J. , Leite‐Moreira A. 
Published: September 2017

PurposeUrocortin 2 (UCN2) is a peptide related to corticotropin‐releasing factor, capable of activating CRF‐R2. Among its multisystemic effects, it has actions in all 3 muscle subtypes, either increasing or decreasing contractility.This study's aim was to determine its potential role in two of the intrinsic eye muscle kinetics and to study the likely subcellular pathways involved.MethodsStrips of iris sphincter (rabbit) and ciliary (bovine) muscles were dissected and mounted in isometric force‐transducer systems filled with aerated‐solutions, subjected to 0.5 mN and 1.0 mN preloads, respectively. Contraction was elicited using carbachol (10–6M for iris sphincter, 10–5M for ciliary muscle), prior to all testing substances.ResultsUCN2 induced relaxation in iris sphincter muscle, being the effect maximal at 10‐7M concentrations (‐12.2% variation, versus control, n = 6). This effect was abolished with incubation of indomethacin (n = 8), antisauvagine‐30 (n = 7), chelerytrine (n = 6) and SQ22536 (n = 8), but preserved with L‐nitro‐L‐arginine (n = 9). In carbachol pre‐stimulated ciliary muscle, UCN2 (10‐5M) enhanced contraction (maximal effect of 18.2% increase, versus control, n = 10 pairs); pre‐contraction studies were negative.ConclusionsUCN2 is a new neurohumoral modulator of iris sphincter relaxation, dependent on CRF‐R2 activation, synthesis of prostaglandins (COX pathway) and both adenylate cyclase and PKC signaling pathways, but independent of nitric oxide production. Regarding ciliary muscle, UCN2 enhances carbachol‐induced contraction, in higher doses.
Micro‐instillation of fluorescein with an inoculation loop for ocular surface staining in dry eye syndrome
Authors: Renault D. , Courrier E. , Kaspi M. , Marcon A. , Lambert V. , Garcin T. , Chiambaretta F. , Garhofer G. , Thuret G. , Gain P. 
Published: September 2017

PurposeTo describe and validate the micro‐instillation of fluorescein on the ocular surface by a disposable calibrated inoculation loop in order to improve corneal and conjunctival staining quality.MethodsProspective interventional non‐randomized low risk study performed in the Department of Ophthalmology at Saint‐Etienne University Hospital. Twenty patients (40 eyes) suffering from dry eye syndrome were enrolled. Accuracy and precision of 0.5% sodium fluorescein collected by a disposable 1 μL‐calibrated inoculation loop were measured using a precision balance. Fluorescein was instilled in patients’ eyes with the loop, and slit lamp images were taken within 30 seconds using cobalt blue light with and without a yellow barrier filter. For comparison, after a washout period, the same images were retaken after instillation of one drop of fluorescein from a single‐dose unit. The main outcome measure was the staining quality assessed by three experts, blind to the instillation method and to discomfort felt by patients.ResultsThe mean amount collected by the loop was 1.18 ± 0.12 μL, compared with 33.70 ± 6.10 μL using the single‐dose unit. Tolerance was excellent. The loop avoided excess dye responsible for unpleasant tearing, masking of lesions, and rapid diffusion into the stroma. Micro‐instillation greatly improved image quality without losing information. The yellow filter further improved image contrast.ConclusionsThe 1 μL‐calibrated inoculation loop is a safe, convenient, inexpensive, disposable, sterile, well‐tolerated tool for reproducible micro‐instillation of commercial fluorescein. By greatly improving staining quality, it will help standardize assessment of dry eye severity.
Refractive Lenticule Transplantation (RLT) for correction of iatrogenic hyperopia and high astigmatism afterLASIK
Authors: Lazaridis A. , Reinstein D.Z. , Archer T.J. , Schulze S. , Sekundo W. 
Published: September 2017

PurposeTo describe a novel technique for intrastromal transplantation of stromal lenticules with specific refractive power for correction of post‐LASIKinduced hyperopia and astigmatism.MethodsA 28‐year‐old patient was referred for consultation after complicatedLASIKfor moderate myopia and astigmatism. The refractive error of the right eye was severely overcorrected due to a data entry error. Post‐LASIKrefraction showed high astigmatism (OD:+6.50/‐9.00/84 ) andCDVAof 20/32. The corneal thickness was 282 mm. Due to contact lens intolerance, poor visual acuity and severe anisometropia a Refractive Lenticule Transplantation was performed. A toric and myopic lenticule, obtained from a donor using the ReLEx®FLEx technique, was implanted under the flap, in order to reduce the refractive error and restore the corneal volume.ResultsSix weeks after surgery the donor lenticule was spread smoothly in the interface with a minor temporal decentration in relation to the pupil centre. The refraction showed a reduction of astigmatism as expected, but a stronger myopisation compared to preoperative calculations (OD:‐6.50/‐4.0/70 ). At three months, theCDVAreturned to preoperative value of 20/32. One year postoperatively corneal tomography showed no signs of ectasia and biomicroscopy showed no signs of rejection. After an additional implantation toric myopicICLthe patient regained anUDVAof 20/40 and a full stereopsis.ConclusionsThe Refractive Lenticule Transplantation technique offers a solution for rare cases of post‐LASIKhyperopia and astigmatism while restoring the volume of very thin corneas. Moreover, it is a reversible procedure with low probability of rejection.
Confocal characterization of recurrent corneal erosion syndrome suspects
Authors: Smedowski A. , Mazur R. , Tarnawska D. , Wylegala E. 
Published: September 2017

PurposeTo characterize and differentiate recurrent corneal erosion syndrome (RCES) suspects according to cytological findings using in vivo corneal confocal microscopy (IVCM).MethodsWe performed IVCM (Rostock Cornea Module, Heidelberg Engineering Retina Tomograph III) in 58 patients recommended to outpatients clinic with symptoms of recurrent corneal allodynia. First, patients underwent slit‐lamp examination with anterior segment photographs. The IVCM was performed with an examination frame of 400x400 μm. Screening, full‐thickness corneal scans were performed to evaluate general condition of corneal architectonic. Focal scans aimed to analyze localized changes within corneal epithelium in all corneal quadrants.ResultsFrom among of 58 analyzed cases, 18 (31%) presented dot‐map‐fingerprint confocal changes involving epithelial basal membrane. Eight of patients (14%) presented cystic degeneration of epithelial cells, 26 patients were diagnosed with epitheliopathy of inflammatory origin – 13 patients (22%) with Thygesson keratitis and 13 patients (22%) presented features typical for post‐adenoviral keratitis. Three patients (5%) suffered from allodynia related to epithelial instability after corneal refractive procedures. There were also 3 (5%) casual cases of allodynia – 1 patient with epithelial squamous cell metaplasia, 1 patient with corneal changes associated with pemphigus vulgaris and 1 patient with post‐traumatic neuroma of corneal superficial nerve plexus. The initial clinical diagnosis of RCES was confirmed with IVCM in 34 patients (59%), other 25 patients suffered from recurrent corneal allodynia due to other than RCES causes, mostly inflammatory.ConclusionsIVCM of corneal epithelium allows differentiating patients with RCES from other causes of recurrent corneal allodynia, which can determine therapeutic decisions.
Corneal clarity measurements in patients with myopia undergoing laser assisted in situ keratomileusis and laser assisted sub‐epithelial keratectomy
Authors: Alzahrani K. , Din N. , Brahma A. , Carley F. , Hillarby M.C. 
Published: September 2017

PurposeTo compare the preoperative and postoperative corneal densitometry of patients undergoing Laser Assisted in Situ Keratomileusis (LASIK) and Laser Assisted Sub‐epithelial Keratectomy (LASAK) and to determine how result differed between the 2 types of surgery.MethodsA retrospective and comparative study was performed at Manchester Royal Eye Hospital,UK. Preoperative and postoperative corneal densitometry data were collected from the Oculus Pentacam. The data were taken at 3 corneal depths (anterior,centre and posterior) and at 3 corneal annulus ring diameter (0‐2 mm, 2‐6 mm and 6‐10 mm). Postoperative data were collected at the time 6 weeks, 3 and 6 months post treatment.Quality of vision pre and post‐surgery was determined by BCVA.ResultsData of 60 eyes from 16 LASIK and 14 LASEK patients were collected with a mean age of 37.06 ± 10.0 and 37.7 ± 6.6 respectively. There was statistically significant increase of corneal densitometry in all concentric zones in all corneal layers after 6 weeks in the LASIK treatment group (p < 0.05). There was a statistically significant increase in densitometry after LASEK but only in the central and posterior layers at all concentric zones (p < 0.05). Pre and Postoperative BCVA did not significantly differ after LASIK but found statistically difference at 6 weeks and 3 months in post LASEK (p < 0.05).BCVA post treatment was significantly different between groups at 6 weeks (p < 0.0001) and 3 months (p = 0.001).ConclusionsCorneal wound healing plays an important role in determining corneal transparency and may be responsible for an increase in corneal haze following refractive surgery.This response differs based on the type of procedure used shown by the increased haze in the anterior layer of the LASIK group which corresponds to the region where the flap was cut which will lead to increased would healing and inflammation.
Corneal clarity after Descemet membrane endothelial keratoplasty versus Descemet stripping endothelial keratoplasty: Two‐year outcomes
Authors: Lazaridis A. , Giallouros E. , Sekundo W. , Kymionis G. , Papaconstantinou D. , Chatzistefanou K. , Droutsas K. 
Published: September 2017

PurposeTo compare the course of Scheimpflug corneal densitometry (CD) after Descemet membrane endothelial keratoplasty (DMEK) versus Descemet stripping automated endothelial keratoplasty (DSAEK) versus age‐matched controls.MethodsFrom two consecutive series of 130DMEKand 49DSAEKcases, 54DMEKand 25DSAEKcases without prior corneal surgery, complicated intraoperative or postoperative course or vision‐limiting ocular comorbidities were included in this study. Pseudophakic eyes of age‐matched subjects were recruited as controls (n=20). ScheimpflugCDof the optically relevant zones (0‐2 mm and 2‐6 mm), best‐corrected visual acuity (BCVA) endothelial cell density (ECD) and central corneal thickness (CCT) were evaluated preoperatively and at 3, 6, 12 and 24 months postoperatively.ResultsCDwas significantly lower afterDMEKat 3 and 6 months compared toDSAEK(P≤0.012). The two groups reached similar levels ofCDat 12 and 24 months after surgery (P≥0.056). Compared to healthy pseudophakic controls, centralCDat 24 months afterDMEKdid not differ significantly (P=0.152). PostoperativeBCVAwas significantly higher afterDMEKfor every examination time point compared toDSAEK(P<0.001).ECDwas similar in both groups (P≥0.081).ConclusionsThe first 6 postoperative monthsCDwas lower andBCVAhigher afterDMEKcompared toDSAEK. Notably, althoughCDreached similar levels in the midterm after bothDMEKandDSAEK,BCVAremained significantly better afterDMEK. Two‐yearCDafterDMEKwas similar toCDof healthy pseudophakic eyes indicating an excellent restoration of corneal clarity in the midterm.
Ultraestructural analysis of human pre‐Descemet's tissue
Authors: GONZALO‐SUAREZ B. , Ramirez A.I. , de Hoz R. , Salazar J.J. , Rebolleda G. , Casas‐Llera P. , Rojas B. , Triviño A. , Ramirez J.M. 
Published: September 2017

PurposeTo analyze the elastic component of the posterior corneal stromal using electron transmission microscopy and inmunohistochemical techniques.MethodsFour pieces of cornea and sclero‐corneal angle were included in the study which were obtained from three deceased donors. The mean age was 57,67 years. From each piece a sample of tissue was processed for transmission electron microscopy examination and another sample was paraffin‐embedded for their study using optic microscopy. The optical sections were immunostained with anti‐fibrillin1 antibody.ResultsThe ultrastructural study showed that the posterior corneal stroma was comprised of fibrillary collagen lamellae.The number of lamellae vary from 3 to 10 in a random distribution from the line formed by the last queratocytes to the Descemet′s membrane. Mainly, the lamellae were separated by type IV collagen and elastic tissue. There were no differences between fibrillary collagen lamellas of the stroma anterior and posterior to the last line of queratocytes.In all cases, an electrodense band was observed alongside being closely related to the Descemet's membrane. This band was interrupted with gaps between the interruptions that vary in size and shape, like stitching. This band was continued towards the trabecular meshwork, where this material was located principally inside the trabecular sheets. This material appeared to be elastic tissue, this was confirmed by inmunostaining with anti‐ Fibrillin 1 antibody.ConclusionsPosterior stroma does not constitute a special layer of the cornea. However, a band of elastic tissue is observed close to the Descemet membrane that is continued into the trabecular meshwork. This elastic band could contribute notably to corneal biomechanical properties.
IOP‐lowering efficacy of prostaglandin analogues adjunctive to a Supercilliary Micro‐Stent (CyPass®)
Authors: Uzunov R. , Landry T. , Dickerson J. 
Published: September 2017

PurposeMinimally invasive glaucoma surgery (MIGS) procedures are proving to be a safe, efficacious alternative to medical management of glaucoma. Most frequently employed concomitantly with cataract surgery, they add little if any additional risk while, in many instances, decreasing or even eliminating the need for ocular hypotensive medication. The optimum target intraocular pressure (IOP) varies from patient to patient and is dependent on multiple factors including degree of glaucomatous damage, rate of progression, age and race, central corneal thickness. The purpose of this work is to investigate IOP lowering effect of PGAs added to MS in patients with mild to moderate POAG.MethodsIn a recent large randomized controlled trial (the COMPASS Trial; n = 505, 374 micro‐stent, 131 control), the supracilliary micro‐stent (MS) used in conjunction with phacoemulsification demonstrated superior IOP lowering effectiveness at 24 months compared to phacoemulsification alone (CON) and allowed 85% of patients to remain off of all ocular hypotensives. Despite this success, 8 (2%) patients in the MS group and 15 (11%) in the CON group required a prostaglandin (PGA) in addition to the MS to reach their IOP target. Mean pre‐PGA IOP for MS and CON groups were 24.4 and 18.7 mmHg.ResultsAddition of the PGA resulted in mean percentage IOP reductions of 23% and 18.5% for the MS and CON groups respectively. Measurement of IOP post‐PGA was at 24 months post‐surgical visit so that the duration of treatment with the PGA was variable but was initiated over 3 months earlier, on average, in the CON group than in the MS group.ConclusionsAddition of a PGA in MS patients provided IOP reductions at least as good and numerically better than for CON patients, albeit somewhat less than IOP reductions observed (~ 30%) for PGA monotherapy when used in the overall OAG population.