bluuebunny/crossref_metadata_2025_split huggingface dataset:
High‐intensity focused ultrasound cyclo‐coagulation: a prospective study from a tertiary center
Authors: Sousa D.C. , Pinto Ferreira N. , Marques‐Neves C. , Abegão Pinto L. 
Published: September 2017

PurposeHigh‐intensity focused ultrasound (HIFU) technology aims to achieve selective coagulation of the cilliary body, thus reducing aqueous humor production and lowering intraocular pressure (IOP). This study evaluated safety and efficacy of HIFU cyclo‐coagulation using EyeOP‐1® device in 44 glaucoma patients.MethodsGlaucoma patients with uncontrolled IOP despite optimal medication were scheduled for HIFU treatment and followed for 12 months. The primary efficacy and safety outcomes were IOP reduction and major adverse events, respectively. Statistical analyses were performed using STATA v14.1.ResultsFourty‐four patients (23 male) with a mean age of 70 ± 15 years were studied. Mean preoperative IOP reduced from 26.6 ± 3.8 mmHg to 17.7 ± 4.3 mm Hg at month 6 and 17.4 ± 3.3 mm Hg after 12 months (P < 0.01). Mean number of medications also decreased from 3.1 ± 0.8 at baseline to 2.4 ± 0.9 after 6 months and 2.3 ± 0.5 at month 12 (P < 0.01). More than 80% of the patients achieved an IOP‐reduction of more than 20% compared to baseline, being almost all cases within the target IOP range. One serious adverse event (hypotonia) was registered.ConclusionsThis innovative device seems to be effective in decreasing IOP and to contribute to decrease the number of administered glaucoma drops, with a good safety profile.
Socioeconomic deprivation status of patients undergoing Trabeculectomy surgery. A 9‐year review at Queen Alexandra Hospital, Portsmouth
Authors: Sepetis A. , Balendra S. , Meredith P. , Kirwan J. , Lockwood A. 
Published: September 2017

PurposeTo evaluate the socioeconomic status of patients undergoing Trabeculectomy surgery.MethodsThe study population consisted of all individuals who underwent Trabeculectomy surgery (TS) recorded on the Medisoft electronic database. Socioeconomic status was investigated by correlating each individual's postal address with the 2015 Index of Multiple Deprivation (IDM) decile from the UK national database. The IDM decile is a combination of seven indices; income, employment, education skills and training, barriers to housing services, crime, living environment, health and disability, where decile 1 is ranked as the most deprived. In order to account for the socioeconomic status of the population served by our unit, patients that underwent cataract surgery (CS) were used as controls.Results582 individuals that were recorded as having TS from Nov 2008 to Apr 2017; Male:Female 1.02:1, mean age 70.9 (SD 11.9) were compared to 39,805 individuals who underwent CS from Jul 2004 to Apr 2017; Male:Female 1:1.51, mean age 76.4 (SD 10.2). The percentage of the population of TS patients belonging to IDM decile 5 and below was 32.82% compared to 39.62% of CS patients. The percentage of TS patients belonging to IDM deciles 1 to 3 was lower than that of CS patients, but higher In IDM deciles 6 to 10. More specifically the percentage of TS patients belonging to decile 1(3.26%) and 2(4.64%) are significantly lower compared to CS patients of the decile 1(6.20%)*** and 2(6.85%)** (***p < 0.01, **p < 0.05, two‐tailed z‐test).ConclusionsOur results show that more deprived patients are less likely to have a TS compared to CS. This might indicate either that the more deprived individuals present with glaucoma late and cannot be treated surgically, or that the less deprived patients are more concerned about their vision or both.
Three year results of iStent + phacoemulsification cataract surgery for glaucoma
Authors: Lewis A. , Ramanathan D. , Wong C. , Imonikhe R. , Ansari E. 
Published: September 2017

PurposeTo evaluate long‐term safety and efficacy of iStent trabecular micro‐bypass stent implantation + cataract surgery (phaco) in glaucoma: A retrospective, interventional, open label study.MethodsCases of glaucoma who had phacoemulsification surgery planned, were included. Preoperative and postoperative evaluations included intra‐ocular pressure (IOP), topical ocular hypotensive agent use, best corrected visual acuity, perioperative complications and adverse events.ResultsA single trabecular micro‐bypass iStent was implanted at the time of phacoemulsification cataract surgery. A temporal incision approach was used in all cases. The results from 35 eyes in 25 patients were analysed for 3 years postoperatively. 49% (n = 17) were male. Mean age was 80 ± 7 (SD). 3 eyes had angle closure with previous peripheral iridotomies.Mean preoperative IOP was 18.5 ± 3.2 mmHg; this was significantly reduced at 12 months (p = 0.008), 24 months (p=<0.001) and 36 months (p=<0.001). Mean IOP was 15.9 ± 4.5, 15.0 ± 4.5 and 15.6 ± 3.6 respectively. The mean number of preoperative IOP lowering agents was 2.3 ± 1.0 and 2.5 ± 1.0 at 36 months. This was not significantly reduced at any follow up time period. Secondary interventions were required in three eyes. Cyclodiode laser was required in 2 patients. ALT was carried out in 2 eyes. There were no significant intraoperative complications and no post‐operative hypotony. At 36 months, visual acuity was ≥6/12 in 29 eyes (83%).ConclusionsTrabecular micro‐bypass stent implantation during cataract surgery is safe and effective for patients with glaucoma. We measured a sustained reduction in IOP over 36 months in the real world clinic setting.
Follow‐up of non‐complicated filtering surgeries under ambulatory care with no control at Day 1
Authors: Jeancolas A.L. , Conart J.B. , Trechot F. , Berrod J.P. , Angioi‐Duprez K. , Maalouf T. 
Published: September 2017

PurposeIn most cases, filtering glaucoma surgery is performed as an outpatient procedure and recommendations suggest performing follow‐up at least at Day 1, Day 8, Day 15 and Day 30. As many of our patients have difficulties to come to follow‐up and because of the economical cost of medical transportations we decided to evaluate the results of a group of patients without clinical control at Day 1.MethodsRetrospective monocentric study in the department of ophthalmology. All patients (naïve of surgical treatment for glaucoma) underwent of surgery of a primary open‐angle glaucoma in an ambulatory care unit between May 2014 and July 2016. A nurse made a phone call to the patients at Day 1. Clinical controls were due at Day 5 and Day 21. In case of problems detected during the phone call, patients were examined earlier.ResultsOne hundred and forty‐four eyes (126 patients) were consecutively included in our study. The mean preoperative IOP was 20.4 ± 6.4 mmHg. After the phone call, only five patients were examined before the first planned control at Day 5. For 3 of them the examination revealed the presence of a hyphema and their topical treatment was changed. The others two patients had no medical modifications. At Day 5, the mean IOP was 10.6 ± 5.9 mmHg. Thirty‐two eyes (22.2%) needed a change in their treatment at Day 5. The mean IOP at Day 21 was 12.9 ± 4.6 mmHg. Our success rate (IOP < 21 mmHg with no topical) at day 21 was 95.6%.ConclusionsWe replaced the Day 1 control with a phone call. We didn't notice a substantial rate of complications. The criteria of success of a filtering glaucoma surgery vary according to the different articles in the literature. Our success rate seems to be similar to those we find in the literature and may suggest that the control at Day 1 is not necessary if the surgery is not complicated.
Results of the Scleral Lens in Current Ophthalmic Practice (SCOPE) survey
Authors: Nau A. 
Published: September 2017

SummaryAn IRB approved, internet based, 19 question survey was administered via email to 4633 eye care providers. A total of 989 responses were collected representing a total of 84,735 patients. 723 responses from individuals living in 14 countries who had fit at least 5 patients with scleral lenses were analyzed. A summary of findings from this survey will include descriptions of lens characteristics, recommendations for wear time, disinfection systems, types of solutions used for insertion, demographic characteristics of fitters and incidence of complications.
Emerging applications of adaptive optics retinal imaging
Authors: Vabre L. , Chateau N. 
Published: September 2017

SummaryAdaptive optics (AO) is an optical technology used in astrophysics to compensate the turbulences of the atmosphere which alter the quality of the images.That principle has been applied to various image modalities (OCT, SLO, Flood, etc) permitting the observation of the retina's finest structures at the microscopic scale. The rtx1 is the first, and until now, the only compact AO retinal imaging medical device available on the market. Based on an en‐face near infrared imaging approach, the rtx1 allows to observe the cone photoreceptors mosaic, the lumen and the walls of the retinal arterioles, and the pores of the lamina cribrosa. It is now possible to detect the early signs of diseases and to follow‐up the effect of a treatment.Thanks to its ergonomy for the patient and the user, the rtx1 is more and more adopted by clinical research centers worldwide to investigate various medical fields. We will present here recent results in the field of ophthalmology but also in translational research using AO retinal imaging to investigate pathologies in cardio‐vascular and neurological diseases.
Small fatal choroidal melanomas: A survey by the European Ophthalmic Oncology Group
Authors: Jouhi S. , Jager M. , Desjardins L. , Eide N. , Rospond‐Kubiak I. , Caujolle J.P. , Grange J.D. , Kiilgaard J.F. , Scheen L. , Midena E. , Raffaele P. , Kivelä T. 
Published: September 2017

PurposeTo assess retrospectively characteristics of smallest choroidal melanomas that metastasized.MethodsTen ocular oncology services submitted data anonymously through a secure website. Eligible were patients with a choroidal or ciliary body melanoma <3 mm in thickness and <9 mm in diameter that developed metastases. Of 57 patients submitted, 49 fulfilled all eligibility criteria.ResultsAt treatment, median age was 57 years (range, 26–81), tumor thickness 2.3 mm (range, 0.4–3.0) and diameter 7.2 mm (range, 3.0–9.0). Fifteen tumors (31%) were observed before treatment, and 13 of them grew a median of 0.5 mm (range, 0.1–1.2) in thickness and 1.0 mm (range, 0–3.0) in diameter in a median of 7 months (range, 2.5 months–5.8 years). Fifty‐seven percent were >2 mm in thickness, 62% had subretinal fluid, 77% caused symptoms, 51% had orange pigment, and 79% a margin within 3 mm of the optic disk (25%) touched disk margin). The number of high risk characteristics was 0 for 10% of the tumours and ranged 1–5 for 12%, 29%, 31%, 14%, and 4%. Local recurrence developed in 18% of eyes. By study design, all developed metastatic melanoma. Cumulative incidence estimate for metastasis developing was 14% (95% CI, 6–25) by 2 years, 51% (95% CI, 36–64) by 5 years, and 86% (95% CI, 72–93) by 10 years after treatment. Median relapse‐free survival was 4.5 years.ConclusionsTen percent of the smallest choroidal melanomas that metastasized had no high risk characteristic for growth. One third was followed for growth, which may or may not have influenced outcome. We found only 5 melanomas in 10 centres that were <4.5 mm (3 DD) in diameter and none that was <3 mm and metastasized.
Radiation‐induced cataracts
Authors: Quinlan R. , Kalligeraki A. , Uwineza A. , Jarrin M. , Pal R. 
Published: September 2017

SummaryThe eye lens is not only a radiosensitive tissue, but also one where the response to ionising radiation (IR) is cell location specific. Moreover this behaviour affects the emergent properties of the cells in the lens epithelium causing deregulation of the normally geometrically constrained epithelial cells as that transition from the germinative zone to the meridional rows at the very periphery of the lens. Epithelial cells in the germinative zone are, however, much slower than either the central epithelial cells or isolated blood lymphocytes from the same animals in their repair of double strand breaks (DSBs). Here we describe the emergent cell behavior of peripheral lens epithelial cells that affects the “roundness of the lens”. This is an example of a nonlinear biological response induced by low dose IR exposure. It is a consequence of a non‐uniform increase in cell proliferation in the lens epithelium. The measurement of epithelial cell density and cell proliferation rates in the lenses of IR exposed animals is a key underpinning technology. We present a rapid imaging method to measure cell proliferation and density in the IR exposed lens and determine how IR affects the emergent properties of cells in the lens epithelium.
Inflammatory changes in aqueous induced by diabetes in open angle glaucoma patients
Authors: Pantalon A. , Constantinescu D. , Feraru C. 
Published: September 2017

PurposeComparative changes of inflammatory cytokines expression in open angle glaucoma and diabetes.MethodsA cross‐sectional study: 87 eyes, from 87 patients, distributed in 4 groups: 24 eyes from healthy subjects, 26 eyes from diabetic patients, 16 POAG eyes and 21 eyes from diabetic glaucoma patients. Aqueous was collected during conventional cataract surgery. 21 inflammatory markers were quantified and compared between groups using a Luminex® Performance Assay multiplex kit based on flowcytometric methods. Data on patient demographics, duration of glaucoma/diabetes, intraocular pressure as well as duration of anti‐glaucoma therapy were collected for correlations and prediction models.ResultsMolecules like CXCL5 (p = 0.008), CXCL8 (p = 0.048), IL‐1α (p = 0.005), IL‐2 (p = 0.015) and TNFα (p = 0.041) were found significantly higher if diabetes was present in POAG patients. Based on the same pathogenic pathway (TNFα stimmulation, Th1 lymfocytes), a prediction model was created for each glaucoma group. As such, levels of CXCL5, CXCL8, IL‐1α and IL‐2 could highly predict TNFα level for the POAG patients (r2 = 0.842, p = 0.000), whereas for the diabetic glaucomatous patients the prediction level was inferior (r2 = 0.618, p = 0.034). Therefore, we tested a second inflammatory model for this category. Presence of diabetes induced collateral stimmulation of TNFα via elevated GM‐CSF expression (stimmulation via Th2 lymfocytes). Molecules like TNFα, G‐CSF and VEGF were significant predictors for a GM‐CSF augmented expression (r2 = 0.758, p = 0.018) in this group; moreover a lineary dependence between GM‐CSF and TNFα was noted. No other parameter was signifficant in these models.ConclusionsInflammatory reaction in glaucoma patients was based on TNFα overexpression, induced either directly (POAG) or indirectly via collateral pathways GM‐CSF mediated (diabetic POAG).
Deep Sclerectomy – what I learned from my first 20 cases
Authors: Mercieca K. 
Published: September 2017

SummaryDeep Sclerectomy (DS) is a commonly performed procedure for many types of open angle glaucoma, particularly in mainland Europe. The procedure has also gained popularity throughout the UK over the last years, with more units and surgeons in different parts of Great Britain teaching and learning this technically challenging but very rewarding technique. Many glaucoma sub‐specialists undergo intense fellowship training before embarking on independent practice but no experience specifically prepares you for the first months of your solo career. Additionally, DS may not be ubiquitously performed and competition from more traditional surgeries (e.g. trabeculectomy) and Micro‐incisional Glaucoma Surgery (MIGS) can result in limited exposure (or none at all) to this type of procedure during the course of a fellowship and/or insecurity when performing the first few cases independently. This part of the SIS will provide expert tips and genuine advice from a newly appointed glaucoma consultants trained in DS and currently teaching the procedure within a large UK tertiary referral setting. The speaker will share videos and experiences from the first few cases as a solo glaucoma specialist. The course will include tips on preventing and handling complications, sharing of lessons and expected pitfalls, and pearls on how to properly and safely teach residents and fellows to perform this procedure.
The suppression of local cytokine production in experimental models of injured cornea after stem cell treatment
Authors: Kossl J. , Hermankova B. , Javorkova E. , Bohacova P. , Zajicova A. , Holan V. 
Published: September 2017

PurposeLimbal stem cell deficiency (LSCD) is associated with the break of immune privilege of the cornea, a harmful local inflammatory reaction, production of cytokines and a failure of corneal regeneration. The corneal transplantation is not sufficient treatment. In the case of bilateral LSCD the only therapeutic option is an allogenic transplantation of limbal tissue or cultured limbal stem cells (LSCs) with a systemic administration of immunosuppressive medication. As an alternative, mesenchymal stem cells (MSCs) turned out to be a suitable source of autologous stem cells (SCs).MethodsIn this study MSCs were obtained from murine bone marrow. Flow cytometry was used to characterize the phenotypic markers of such MSCs. LSCs were isolated from limbal tissue by trypsin digestion. For in vitro experiments SCs were cultured in 48‐well plates for 24 hours. Excised murine corneas were added into cultures and stimulated by proinflammatory cytokines, interleukin‐1β (IL‐1β), interferon gamma and by lipopolysaccharide or were pretreated with 0.25M NaOH for 20 seconds. After 48 hours of cocultivation of corneas with SCs, the expression of genes for inflammation cytokines and growth factors in the cornea was detected using real‐time PCR. In in vivo experiments, SCs were seeded onto nanofiber scaffolds (allowed to adhere for 24 hours) and transplanted on the damaged (0.25M NaOH, 20 seconds) cornea.ResultsWe showed that LSCs and MSCs have the ability to suppress the local expression of genes for IL‐1β, tumour necrosis factor‐α, vascular endothelial growth factor and inducible NO synthase in the damaged cornea in both in vitro and in vivo models and that transplantation of SCs supports corneal regeneration.ConclusionsWe suggest that MSCs can be a suitable substitute for ocular surface regeneration in cases when autologous LSCs are absent or difficult to obtain.
SS – OCT angiography in macular dystrophies
Authors: El Matri L. , Falfoul Y. , El Matri K. , Hassairi A. , Maamouri R. , Chebil A. 
Published: September 2017

PurposeTo assess the ability of swept source optical coherence tomography angiography (SS – OCT‐A) to identify abnormalities of the retinal and choroidal vascular network in macular dystrophies.MethodsOptical coherence tomography angiography and structural OCT were performed using a Swept‐source DRI OCT Triton (Topcon, Corporation, Japan) for patients with Stargardt disease, Best maculopathy, pseudo‐vitelliform dystrophy and progressive cone dystrophy. In our series, for every patient the clinical diagnosis was confirmed by the results of molecular genetic study.ResultsIn Stargardt patients, we found alterations especially located at the level of the deep capillary plexus and choriocapillaris. There were different degrees of choriocapillaris impairment, with no residual choriocapillaris inside area of retinal epithelium pigment atrophy in advanced stages. Large choroidal vessels and borders of the atrophy were well visualized. In patients with Best maculopathy and pseudo‐vitelliform dystrophy, OCT‐A revealed neovascularisation in the outer retina and the choriocapillaris while traditional multimodal imaging wasn't conclusive. In progressive cone dystrophy, there was a retinal vasculature signal reduction in both superficial and deep plexus associated with window effect in the outer retina and the choriocapillaris due to the retinal and RPE atrophy.ConclusionsIn inherited macular distrophies, OCT‐A may provide information of great interest. In stargardt disease, OCT‐A findings were in agreement with the results suggesting primitive severe involvement of choriocapillaris. In Best maculopathy and pseudo‐witelliform dystrophies, OCT‐A helps diagnose choroidal neovascularization. In Progressive cone dystrophies, it could be useful for gaining deeper Knowledge of both the pathogenesis and therapeutic implications.
The important role of OCT in the diagnosis of Oculocutaneous albinism
Authors: Berniolles J. , Ascaso Puyuelo F.J. , Bartolomé Sesé M.I. , Martínez Vélez M. , Esteban Floria O. , Sánchez J.I. , Idoate Domench A. , Marco Monzón S. , López Sangrós I. , Ibáñez Alperte J. 
Published: September 2017

PurposeOculocutaneous albinism (OCA) is a group of genetic diseases with an autosomal dominant pattern. It affects skin, hair and eyes, leading in an hypopigmentation of all these organs. In ophthalmology we can observe a low visual acuity, photophobia, nystagmus, foveal hypoplasia and retinal hypopigmentation. The hypopigmentation may also affect the iris with a characteristic iridian translucence. The disease is also associated with chiasm alterations.MethodssWe present the case of a 40 year old patient that was referred to our service to confirm the diagnosis of oculocutaneous albinism. The patient presents a severe hypopigmentation of the skin and hair. She also referred a low visual acuity since birth. She didn't presented family antecedents, or personal ophthalmologic history.ResultsThe best corrected visual acuity (BCVA) was 0.1 in both eyes. The patient presented horizontal nystagmus and iridian translucence. The fundus examination revealed an important retinal atrophy that showed the choroidal circulation.The optical coherence tomography (OCT) revealed a foveal hypoplasia, atrophy in the epithelial retinal epithelium.ConclusionsIn the patients that the diagnosis of oculocutaneous albinism is not clear, the use of an objective complementary test may be determinant before the genetic diagnosis. This case shows the utility of macular OCT to guide the molecular diagnosis.
Familial foveal aplasia
Authors: Murphy R. , Keegan D. , Flitcroft I. 
Published: September 2017

PurposeFoveal aplasia, or hypoplasia, refers to the lack of foveal depression with continuity of all neurosensory layers in the presumed location of the fovea. Whilst it is has been reported in cases of aniridia, albinism, microphthalmia and achromatopsia, foveal hypoplasia as an isolated entity is a rare phenomenon. We describe the presentation of a child and her mother with subsequent discussion on the spectrum of the disease.MethodsCase report and literary synthesis.ResultsA frustrated 16 year old girl was brought in by her mother for review following several attendances to opticians with best‐corrected visual acuity of 6/9 both eyes. Ophthalmic examination revealed bilateral subtle spoke like cataracts with a featureless macula. There was no nystagmus present. Optical coherence tomography demonstrated lack of a foveal pit without extrusion of the plexiform layers. There was appropriate outer segment lengthening with a widened outer nuclear layer. Although asymptomatic, examination of her mother demonstrated best corrected visual acuity of 6/7.5 both eyes, with foveal tomography confirming foveal aplasia.ConclusionsAlthough foveal aplasia typically presents with other ocular pathology, and most often exhibits nystagmus with decreased visual acuity, the entity can exist in isolation and without nystagmus. Familial cases, and those with pre senile cataracts, have been associated with PAX6 gene mutations and subsequent alterations in ocular morphogenesis.