bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herpes and Zoster infections update
Authors: Labetoulle M. 
Published: September 2017

SummaryHerpes Simplex Virus (HSV) and Varicella‐zoster Virus (VZV) are two leading causes of sight‐threatening keratitis. Following a period of latent infection in the trigeminal ganglia, the virus can reactivate, and new viral particles finally reach the ocular tissues.Episodes of HSV keratitis may occur spontaneously or following a triggering factor like immunosuppression (including topical steroids), topical inflammation and nerve injuries. Ocular surgery, which combines several of these factors, is a strong risk factor of HSV keratitis recurrence. In case of exposure to one of these triggering factors, prevention with oral antiviral drugs reduces the risk of relapse of HSV keratitis. To date, there is no vaccine against HSV that has proved its clinical relevance.For VZV, the main risk factor of keratitis is the occurrence of chickenpox or herpes zoster ophthalmicus (HZO) some days to weeks before. The prescription of oral antiviral drugs at the time of cutaneous rash is efficient for reducing the risk of ocular complications of HZO. However, the most efficient way to prevent VZV‐keratitis is probably to reduce the risk of chickenpox and eventually herpes zoster, by the mean of the existing vaccines dedicated to these both diseases.
Principles of wound healing – knowledge transfer to cornea
Authors: Järvinen T. 
Published: September 2017

SummaryThe closure of both corneal and skin wounds occurs when epithelial cells migrate from the edge of the wound and re‐epithelialize the injured area. Syndecan‐4 (SDC4) is a heparin sulfate proteoglycan (HSPG). A natural cell migration‐pathway triggered by SDC4 has been identified and proven to contribute to skin wound closure (Bass et al., Dev. Cell 2011). We have previously identified a wound‐homing peptide (CARSKNKDC; dubbed CAR; Järvinen & Ruoslahti, Am. J. Pathol. 2007) that requires HSPGs for its cell‐binding and penetrating activity. CAR peptide stimulates wound re‐epithelialization and its cell binding and internalization are both dependent on SDC4. Its wound healing‐promoting activity (stimulation of re‐epithelialization) is dependent on SDC4. Thus, CAR peptide subverts normal SDC4 function to promote wound healing by enhanced re‐epithelialization. CAR peptide may provide a new way of enhancing skin wound healing, and perhaps tissue regeneration in general. This therapeutic approach is dependent on the naturally occurring SDC4 dependent cell migratory pathway, which is up‐regulated in skin wounds. Whether the SDC4 ‐cell migratory pathway is available in corneal wound healing remains to be studied and could be therapeutic.
Choosing your fellowship and getting the most out of it ‐ advice from Fellows
Authors: Lukic M. 
Published: September 2017

SummaryThe aim of this lecture is to present young ophthalmologists the process of getting fellowship at Moorfields Eye Hospital in London, UK. The presentation will contain important facts and advice for application process, interview and opportunities when someone become a fellow. Likewise, it will be mentioned the procedure and requirements to get GMC registration and licence to practice which is mandatory to be able to apply for any fellowship in the UK and eventually to work in the UK as a medical doctor. Then, I will show the recent audit results about fellows’ opinion on MR fellowship at Moorfields Eye Hospital and show a few testimonials from my colleagues fellows. Lastly, I would like to give some additional information about finding out the accommodation and general costs of living in London which is important before someone decides to move in to London.
Segregation of novel p.(Ser270Tyr) MAF mutation and p.(Tyr56*) CRYGD variant in a family with dominantly inherited congenital cataracts
Authors: Liskova P. , Dudakova L. , Stranecky V. , Hlavova E. , Vincent A. 
Published: September 2017

PurposeTo identify the molecular genetic cause in a three generation family with the occurrence of congenital cataracts, variably associated with iris colobomata and microcornea.MethodsWhole‐exome sequencing was performed in three affected family members, one unaffected first degree relative, and one spouse. Sequence variants previously reported as disease‐causing, and novel sequence variants within genes listed in CatMap (http://cat-map.wustl.edu/) were given a priority for further evaluation. Verification of possibly pathogenic sequence variants was performed by conventional Sanger sequencing.ResultsSequence variant c.168C>G; p.(Tyr56*) in CRYGD, previously reported as pathogenic, and a novel mutation c.809C>A; p.(Ser270Tyr) in MAF, were identified in two affected family members; the grandmother, and half‐brother of the proband. The proband inherited only the MAF mutation, whereas her clinically unaffected sister had the CRYGD change. In silico analysis supported a pathogenic role of p.(Ser270Tyr) in MAF, which was absent from publicly available whole‐exome datasets, and 1,161 Czech individuals. The frequency of CRYGD p.(Tyr56*) in the ExAC dataset was higher than the estimated incidence of congenital cataract in the general population.ConclusionsOur study highlights that patients with genetically heterogeneous conditions may exhibit rare variants in more than one disease‐associated gene, warranting caution with data interpretation, and supporting parallel screening of all genes known to harbour pathogenic mutations for a given phenotype. The pathogenicity of sequence variants previously reported as cataract‐causing may require re‐assessment in light of recently released datasets of human genomic variation.Supported by AZV 17‐30500A.
Tips and tricks in pediatric retina surgery
Authors: Ozdek S.O. 
Published: September 2017

SummaryPediatric vitreoretinal surgery has a different philosophy from adult surgery. It has its own rules, own complications, does not forgive faults, does not accept apologies. The eye is very small, there is a narrow space for maneuvers (15‐19mm). Lens is relatively large, vitreous‐retina relation is different, pars plana has not developed, sclera is thin and elastic. Posterior hyaloid is tightly attached. PFCL and Silicon oil is rarely used. They do not obey the head positioning! Retinal breaks usually ends up with surgical failure. PVR is frequent and severe! There is an additional amblyopia problem. We will talk about the details of these problems and the solution of them in ROP, PFV, Coats and FEVR cases.
Inflammatory markers but not symptoms are a strong predictor of temporal artery biopsy outcome – the Portsmouth experience
Authors: Meredith P.R. , Sepetis A. , Balendra S. , Jawed M. , Lockwood A.J. , Maclean H. 
Published: September 2017

PurposeTo investigate the correlation of biopsy proven temporal arteritis with clinical symptoms and inflammatory markers.MethodsRetrospective study of all patients (n = 89) referred for temporal artery biopsy (TAB) over a 30‐month period. Ten patients were excluded due to inconclusive biopsy or insufficient data. Correlation of presenting symptom (localised headache LH, jaw claudication JC, pain over temporal artery PTA, constitutional symptoms CS) and inflammatory marker level (ESR, CRP) with histological outcome (presence of giant cells) were assessed using a two‐tailed unpaired t‐test.Results50 cases had a negative (−ve) biopsy result and 29 positive (+ve). Mean age (SD) for each group was 71 yrs (10) and 77 yrs (6) respectively. No significant correlation was found between presenting symptom and biopsy result (−ve:+ve LH 88%:79%, PTA 46%:62%, CS 40%:59%) except for jaw claudication (36%:62%, p < 0.05). Inflammatory marker result was found to significantly correlate with biopsy outcome. Mean ESR (SD) was 23 (21) in the −ve and 34 (24) in the +ve (p < 0.05) and mean CRP (SD) was 33 (40) in the −ve and 98 (81) in the +ve group, (p < 0.001). Mean ESR+CRP (SD) was 55 (52) in the −ve and 132 (87) in the +ve (p < 0.0001). There were no significant differences in duration of steroid treatment prior to TAB or time to TAB between the two groups. One patient had normal ESR and CRP with a positive biopsy result.Treatment with steroids was continued for 48% of patients with −ve biopsy on clinical grounds.ConclusionsElevated ESR and CRP are strongly predictive of positive TAB outcome. Combining ESR+CRP increases the significance of the correlation. Further studies with larger patient numbers may identify an appropriate cut‐off level which, combined with age and clinical features, may provide a clinical score to aid decision making regarding which patients require TAB.
Submacular hemorrhage management
Authors: Pournaras C. 
Published: September 2017

SummarySubmacular haemorrhage (SMH) is a sight threatening complication that can occur in exudative age related macular degeneration (AMD). Left untreated, SMH carries a grave visual prognosis. Diagnosis and effective management of this complication are important.The treatment strategies for SMH include displacement of blood from the fovea, usually by injection of an expansile gas, pharmacologic clot lysis such as with recombinant tissue plasminogen activator (rtPA) and treatment of the underlying choroidal neovascularization (CNV), such as with antivascular endothelial growth factor (anti‐VEGF) agents. These three strategies have been employed in isolation or in combination, some concurrently and others in stages.In cases presenting early, pneumatic displacement alone with anti‐VEGF may be sufficient. rtPA has demonstrable effect on the liquefaction of submacular clots but there are remaining uncertainties with regards to the dose, safety and the timing of initial treatment. Potential side effects of rtPA include pigment epithelial toxicity, increased risk of vitreous haemorrhage and systemic toxicity. Anti‐VEGF monotherapy is a treatment option particularly in patients with thinner SMH and those who are unable to posture.
Comparing anterior segment optical coherence tomography and ultrasound biomicroscopy with histopathology in measurement of corneal and bulbar conjunctival tumors depth
Authors: Lauwers N. , Janssens K. , Mertens M. , Mathysen D. , De Keizer R.J.W. , De Groot V. 
Published: September 2017

PurposeCorneal and bulbar conjunctival tumors can be visualized and measured by Anterior Segment Optical Coherence Tomography (A‐OCT) and Ultrasound Biomicroscopy (UBM). We compared tumor depth measured by histopathology (HP) with measurements by UBM and A‐OCT to investigate whether the two techniques are as accurate as HP.Methods35 patients with 42 corneal or conjunctival bulbar tumors were imaged with A‐OCT and UBM. 11 of the tumors were excised and analyzed on histopathology. The correlation of the depth measurements on HP versus A‐OCT and UBM was statistically analyzed. When the tumor was not excised, depth measurements on A‐OCT versus UBM were compared.ResultsStatistical analysis showed that UBM and HP measurements of tumor depth are positively correlated, as are UBM and A‐OCT measurements. It was not possible to obtain statistically significant data for the correlation between HP and A‐OCT measurements because of the small study population. Image quality was overall better with A‐OCT than with UBM, but in 12 tumors, depth measurement on A‐OCT was impossible because of tumor shadowing (thick or highly pigmented tumor).ConclusionsUBM can measure tumor depth as accurately as HP. Tumor depth measurements on A‐OCT and UBM are positively correlated. A larger study is needed to investigate whether measurement of tumor depth with A‐OCT is as accurate as HP. Because of drawbacks of depth measurements on histopathology, we believe that A‐OCT and UBM could become the golden standard for measuring corneal and bulbar conjunctival tumor depth. We advise to use A‐OCT if the tumor is not too thick or too pigmented, and to use UBM in case of posterior tumor shadowing on OCT.
Role of GSK3 activity in optic nerve regeneration
Authors: Fischer D. 
Published: September 2017

SummaryRetinal ganglion cells (RGCs) do not normally regenerate axons upon optic nerve injury. However, inflammatory stimulation (IS) significantly enables axon growth in the injured optic nerve. Here, we demonstrate that optic nerve crush strongly induces inhibitory phosphorylation of GSK3α and GSK3β in RGCs. To investigate the role of GSK3 in this context we tested IS induced regeneration and neuroprotection in conditional GSK3α and GSK3β knockout mice (GSK3α‐/‐, GSK3β‐/‐) as well as GSK3αS/A and GSK3βS/A mice expressing resistant GSK3 isoforms to this inhibitory phosphorylation. In contrast to GSK3α‐/‐, GSK3β‐/‐ markedly potentiated IS induced optic nerve regeneration. On the contrary, IS mediated regeneration was significantly reduced in GSK3S/A mice. These findings suggest that active GSK3 intrinsically limits the outcome of CNS axon regeneration. Thus, treatments activating the intrinsic growth state combined with GSK3β inhibition might be suitable to further improve the regenerative outcome after CNS injury.
Contact lens and ocular surface ‐ After all, its still a foreign body
Authors: Knop E. 
Published: September 2017

SummaryContact lenses, as indicated by the name, are in direct contact with the ocular surface. CL are swimming within the tear film, between eye ball & palpebral conjunctiva ‐ in the middle of the Ocular Surface Unit. Interactions thus have direct impact on tear film & tissues with the risk of potential side effects (for details please see: WWW.OSCB‐BERLIN.ORG).One main impact is increased mechanical friction by the ′additional structure′. Friction increases during eye movements and blinks when the lid border moves over the contact lens rim and along its anterior lens surface. Limited diffusion of nutritients can occur through the lens, particularly the supply with oxygen is critical for the cornea that depends on gas diffusion – Modern materials have meanwhile decreased this risk. Chemical impacts occur by the lens material or by solutions for lens cleaning & storing.
How to deal with Keratokonus – are there Contact Lens Related Problems in Sclerals?
Authors: NAU C. , Shorter E. , Nau A. , Harthan J. , Fogt J. , Schornack M. 
Published: September 2017

SummaryScleral lenses have become a popular early treatment choice for patients with keratoconus. In a recent SCOPE (Scleral Lenses in Current Ophthalmic Practice: an Evaluation) study group finding, 34% of practitioners, of 629 survey respondents, chose scleral lenses as their first treatment option for patients with corneal irregularity. Among all treatment choices for corneal irregularity, scleral lenses ranked second only to corneal rigid gas permeable lenses, from those responding. The SCOPE study group then polled a group of keratoconus patients wearing scleral lenses. Of 79 keratoconus patients reporting scleral lens wear in both eyes, 85% were somewhat or very satisfied with their vision. However, these patients also reported experiencing cloudy vision (59%), lens discomfort (67%), and difficulty with lens handling (63%) at some time over the previous two years.
Optical properties shape visual cortical population receptive fields after cataract surgery independently from subjective quality of vision
Authors: Rosa A. , Miranda Â. , Miguel P. , Harvey B.M. , Silva F. , Castelo‐Branco M. 
Published: September 2017

PurposeTo study the impact of changed optical properties on cortical population receptive fields (pRF), psychophysical function and participant reported quality of vision after cataract surgery.MethodsWe studied 30 patients after recent bilateral sequential cataract surgery, using functional magnetic resonance imaging and pRF modelling methods to assess pRF sizes across early visual regions. Ophthalmological and psychophysical evaluation was also performed, and a quality of vision questionnaire was obtained.ResultsWe found that subjects with worse optical properties had larger pRF sizes. pRF sizes in the primary visual cortex were also larger for operated subjects with worse contrast sensitivity (p = 0.038). Surprisingly, patients who were more bothered by dysphotic symptoms showed lower pRF size fitting interception (p = 0.012) and pRF size fitting slopes (p = 0.020), showing that objective and subjective quality of vision may dissociate.ConclusionsOptical properties of the eye influence PRF sizes and both dissociate from subjective quality of vision, suggesting that patients with better cortical resolution may have augmented dysphotic perception, and consequently more visual complaints, in spite of improved optical quality.
“Inflammaging” in the zebrafish visual system
Authors: Moons L. , Bollaerts I. , Van houcke J. , Vanhunsel S. , Beckers A. , Lemmens K. , De Groef L. 
Published: September 2017

SummaryAppropriate modulation of neuroinflammation upon central nervous system (CNS) damage is known to trigger a regenerative response, but the underlying cellular and molecular mechanisms remain elusive. Zebrafish possess high regenerative abilities, yet, also gradually age. They are ideally suited to study the contribution of neuroinflammation to successful regeneration, also in an aging context.First, we followed the inflammatory response in fish subjected to optic nerve crush (ONC) and revealed a timed induction and resolution of microglia/macrophage (Mi/MΦ) activation. Next, both immunostimulatory/suppressive paradigms indicated that, as in mammals, axon regeneration is stimulated by an induced inflammatory response. Studies addressing Mi/MΦ activation and polarization state will provide further insights. In a second approach, we investigated whether an aged cellular environment affects neuronal survival/axonal regeneration. Detailed analyses in aged fish revealed altered numbers and distributions of Mi/MΦ, indicative of ‘inflammaging’, as well as a significant delay in axon outgrowth after ONC. Ongoing studies suggest phenotypic changes of senescent Mi/MΦ underlie this decelerated regeneration capacity in the aged zebrafish CNS.
The eye according to Byzantines medical writers
Authors: Trompoukis C. 
Published: September 2017

SummaryThe scientific foundation of ophthalmology as a medical specialty can be located in the Alexandrine period, since it is there we find evidence of diagnosis and therapy in the systematic knowledge of the eye. Many of the documents from that period have been lost, but the knowledge was preserved in the writings of Galen (129‐216 AD) and his successors. Byzantine medicine (324‐1453 AD) preserved ancient medical knowledge and transferred it either directly, or via an Arabic translation, into Latin. This was the natural connection between antiquity and the Renaissance, one that has been greatly appreciated in studies of the history of medicine. This study presents a detailed analysis of early Byzantine medical sources and the ancient medical tradition upon which they drew. There follows a discussion of knowledge relating to the eye, its clinical description, diagnosis and treatment.
The role of the Shh signaling pathway in radio‐induced cataractogenesis
Authors: De Stefano I. , Giardullo P. , Tanno B. , Leonardi S. , Pasquali E. , Babini G. , Saran A. , Mancuso M.T. 
Published: September 2017

SummaryBesides the well‐known role in cancer, Shh signaling pathway direct cell proliferation, cell fate determination and EMT, remaining largely expressed in the stem cell compartment of adult tissues. Recently, we proposed Ptch1+/‐ mice as a relevant radiation‐induced cataract mouse model. These mice, develop cataract with a very high incidence (45.2%) and short latency after irradiation with 3 Gy of x‐rays, when radiation is delivered during the early stage of postnatal lens development. Molecular analyses suggest that Shh and TGF‐ß signaling cooperate to promote Ptch1‐associated cataract development by activating EMT and converging on Nanog. Furthermore, using a range of decreasing radiation doses to assess the cataract response in these mice, nonlinear biological responses were observed using doses ≤ 1 Gy, with a suggestion for borderline effects at 2 Gy, both for gross cataract development and for activation of the genetic pathways involved in the molecular pathogenesis of Shh‐associated cataract.These findings highlight a novel function of Shh signaling unrelated to cancer and provide a new animal model to investigate the molecular pathogenesis of cataract formation.
Surgical management of diabetic macular edema – For
Authors: Pournaras J.A. 
Published: September 2017

SummaryDiabetic retinopathy may require surgical management in case of vitreomacular interface disorders. Indications and prognostic factors will be discussed.Furthermore, after many anti‐VEGF without any reduction of diffuse macular edema, surgical approach may be proposed. In histopathological analysis, myofibroblasts have been detected and cause the contraction of vitreoretinal interface disorders affecting visual acuity. Removal of epiretinal membrane associated with ILM peeling is essential in these cases in order to eliminate the contractile elements.
Qualitative early signs of microglial activation in mice retinas contralateral to experimental glaucoma
Authors: Ramirez J.M. , Salobrar‐Garcia E. , Ajoy D. , Gonzalez‐Martin R. , de Hoz R. , Salazar J.J. , Rojas B. , Triviño A. , Ramirez A.I. 
Published: September 2017

PurposeTo analyze qualitative retinal microglia signs of activation after 24 h of unilateral laser‐induced ocular hypertension (OHT) in OHT‐eyes and their contralateral eyes.MethodsAlbino Swiss mice were divided into two groups, naïve (n=6) and lasered (n=9). Retinal whole mounts were immunolabeled with antibodies against Iba‐ 1 and MHC‐II.ResultsBoth in OHT eyes and in contralateral eyes Iba‐1+ cells: i)had morphological signs of activation, being these more intense in OHT eyes than in the contralateral eyes. Iba‐1+cells showed hypertrophy, soma displacement both in their own retinal layer and towards the nearest one and in some instances, reoriented microglial processes from being parallel to being perpendicular to the retinal surface. ii) were dystrophic in some instances in the photoreceptor layer (PRL); iii) in the outer plexiform layer sent processes to the PRL and this was mainly found in contralateral eyes; iv) overall, did not up‐regulate the expression of MHCII .Only in OHT eyes MHCII+ rounded cells were observed in the nerve fiber layer‐ganglion cell layer, being more numerous in the peripheral superior zone of the retina and near the optic disc. These cells were surrounded and phagocyted by numerous ameboid Iba‐1+ cells. In addition, beneath the retinal areas where this event was occurring, microglial cells of the inner plexiform layer and outer plexiform layer oriented their processes towards those areas and surrounding them.ConclusionsAt 24 h after unilateral OHT, microglial features of activation were observed not only in OHT eyes but, interestingly, also in the contralateral untreated eyes. Whether this activation favors neuroprotection or neurodegeneration needs to be clarify.
Application of OCT in diagnosis and treatment of keratoconus patients
Authors: Wylegala E. , Dobrowolski D. , Wylegala A. 
Published: September 2017

SummaryOCT optical coherence tomography is a noninvasive imaging modality. Morphological and morphometric data can be obtain using this technique. Cross‐linking is a method commonly used in reducing the progression of keratoconus and severe infectious diseases of the cornea. OCT can be useful in qualification patients for cross‐linking, during surgery and in the management of patients after cross‐linking. Different OCT systems (time‐domain, spectral domain and swept source) will be presented on the basis of clinical examples.
Crosslinking and corneal biomechanics
Authors: Fuchsluger T. , Brettl S. , Geerling G. , Philipp F.Z. 
Published: September 2017

SummaryThis presentation will demonstrate data on corneal biomechanics measured with the CORVIS ST (Oculus GmbH, Wetzlar, Germany) to evaluate normal corneas, non‐crosslinked and crosslinked corneas. Characteristics of biomechanical parameters are explained.