bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central serous chorioretinopathy misdiagnosed as posterior uveitis
Authors: Khairallah M. , Kahloun R. , Jelliti B. 
Published: September 2016

SummaryCentral serous chorioretinopathy (CSCR) is a common disease characterized by serous detachment of the neurosensory retina and/or retinal pigment epithelium that often involves the macula. Atypical and chronic or recurrent forms of CSCR may be overlooked or misdiagnosed as chorioretinal inflammatory conditions, including Vogt Koyanagi Harada disease, sympathetic ophthalmia, posterior scleritis, multifocal choroiditis, serpiginous choroiditis, idiopathic posterior uveitis, or other uveitic entity that all usually require corticosteroid treatment. The use of systemic corticosteroids in such cases is not only ineffective, but it usually exacerbates the condition, leading to bilateral, severe, and chronic CSCR with irreversible chorioretinal damage and visual impairment.A careful clinical examination and appropriate use and interpretation of multimodal imaging are mandatory to differentiate CSCR from any chorioretinal inflammatory condition and to prevent severe and irreversible visual damage resulting from misdiagnosis and management mistakes.
Photochemical reversal of cataract
Authors: Kessel L. 
Published: September 2016

SummaryGlobally, cataract is the second leading cause of blindness. Current treatment consists of surgical removal of the lens of the eye. Although sight‐threatening complications are rare they do occur. Opting for a non‐surgical treatment would abolish the risks associated with a surgical procedure (e.g. infection, bleeding, retinal detachments). Cataract is caused by a clouding of the lens due to accumulation of large protein aggregates. We have proposed to photochemically reverse the optical deterioration of the aged human lens. We have shown on human donor lenses that irradiation with visible light significantly improves the transmission of light through the lens. Although these results are promising, visible light may not be an attractive option for photochemical reversal of cataract due to the risk of retinal light induced damage. To overcome this obstacle, we have shown that the same effects can be obtained via two‐photon photolysis using a safe infra‐red femtosecond pulsed laser. Clinically relevant effects (up to 15 years of optical lens rejuvenation) have been demonstrated.
From time domain to high resolution and angio‐OCT: an historical perspective
Authors: Neri P. , Mariotti C. , Pirani V. , Bisceglia P. , Giovannini A. 
Published: September 2016

SummaryOptical coherence tomography (OCT) is a non‐invasive tool that allows in vivo imaging of almost all the structures of the eye. It was introduced into the clinical practice more than twenty years ago. The advances in OCT technology are mainly based on ultra high‐resolution, adaptive optics, eye‐tracking, and changes in signal detection. Regarding this last aspect, the technology has evolved from time‐domain (TD) to spectral‐domain (SD) detection, providing a higher definition of the analyzed structures. Today, SD OCT has become a part of the routine practice. Apart from its diagnostic value, OCT has allowed an objective assessment of treatment response. In addition, it has provided predictive value for visual recovery and prognosis of several diseases. Recently, SD‐OCT has given to the ophthalmic researchers a renewed enthusiasm: a special processing algorithm has been developed for high‐speed OCT devices. This OCT technique, known as OCT angiography, can produce images of capillary‐level blood flow in the retina and choroid. OCT technology continues to develop further and this will provide new insights for the pathogenesis of several eye diseases.
Latest diagnostic possibilities in unsolved uveitis, suspicious for malignancy
Authors: Neri P. , Arapi I. , Pirani V. , Giovannini A. , Mariotti C. 
Published: September 2016

SummaryVitreo Retinal Lymphomas (VRL) are rare malignancies that display a wide spectrum of clinical patterns. Almost all VRL are non‐Hodgkin's lymphomas, B‐cell sub‐type. Since the clinical presentation of VRL might be confused with a non‐responder eye inflammation, VRL are also known as ‘masquerade syndromes’. On the basis of the potential severity of such disease, vitreous biopsy might be indicated for all the cases which can be potential VRL. Since vitreous biopsy is not diagnostic in all cases, further techniques can provide further essential data. Immunohistochemistry can be used for identifying important Cluster of Differentiation (CD) such as CD45 for leukocytes, CD20, CD79a, PAX‐5 for B‐cells, CD45RO for T‐cells, and CD68 for macrophages. Furthermore, clonality can be established by using antibodies targeting the kappa and lambda light chains. Polymerase chain reaction gene rearrangement studies can identify monoclonality of the heavy chain variable (V), diversity (D), and joining (J) immunoglobulin gene segments. Recently, measurement of Interleukin (IL)‐6 and IL‐10 in aqueous and/or vitreous fluid can lead to the correct diagnosis, even though an elevated IL‐10/IL‐6 ratio is not specific for VRL.
Counting microglial cells in the adult rodent retina
Authors: Gallego B.I. , De Garcia P. , Sebastian A.I. , De Hoz R. , Salazar J.J. , Rojas B. , Trivino A. , Ramirez J.M. 
Published: September 2016

SummaryGlaucoma is a chronic optic neuropathy linked to the damage and death of retinal ganglion cells. Microglial cells seem to play a critical role on glaucomatous physiopathology, and their proliferation has been considered a hallmark of neurodegenerative diseases ongoing, also in the retina. Quantitative microglial studies require big sets of images analysed. Because manual cell counting methods are tedious and time consuming, computational approaches have been developed for counting cells in the nervous system. Nonetheless, microglial complex morphology makes difficult proper cell identification with standard methods. We present a new and interactive algorithm implemented in MATLAB for quantitative analysis of Iba‐1+ microglial cells in adult mice retinas. Without any computation knowledge, this technique enabled a fast quantification of microglial cells with reliability similar to manual method, in both non‐proliferative and in a proliferative state in a mouse model of unilateral laser‐inducer ocular hypertension. Although this algorithm has been developed for retinal microglial analysis in a specific model, some parameters can be modified in the interactive interface for its application in other retinal pathologies or either tissues.
Role of glial cells in regulating retinal blood flow during flicker‐induced hyperemia and systemic hyperoxia‐induced hyporemia in cats
Authors: Nagaoka T. 
Published: September 2016

SummaryBackgroundTo investigate the role of glial cells in the regulation of retinal circulation in response to flicker stimulation, which is related to neurovascular coupling, and systemic hyperoxia in the retina.MethodsUsing laser Doppler velocimetry, we measured the retinal blood flow (RBF) in first‐order retinal arterioles in anesthetized cats. After intravitreal injection of l‐2‐aminoadipic acid (LAA) as gliotoxic compound, we examined the changes in RBF in response to flicker stimulation of 16 Hz for 3 min and systemic hyperoxia induced by the inhalation of 100% oxygen for 10 min.ResultsThe RBF increased gradually and reached a maximal level after 2–3 min of flicker stimuli in the PBS group. In the LAA‐treated eyes, the increases in RBF during the flicker stimulation were significantly attenuated by one third of those in the control eyes. During hyperoxia, the decreases in RBF in response to hyperoxia were significantly attenuated in the LAA‐treated eyes compared with the control.ConclusionsThe current results suggest that the retinal glial cells play an important role in the regulation of retinal blood flow during Flicker‐Induced Hyperemia and Systemic Hyperoxia‐Induced Hyporemia.
Follow‐up: which one and for whom?
Authors: Damato B. 
Published: September 2016

SummaryIn theory, surveillance of patients with uveal melanoma is aimed at detecting and treating ocular recurrence and morbidity as well as systemic metastases. In practice, the scope of such follow‐up is uncertain and controversial. Regular examination by an ocular oncologist can be difficult for patients who live far from the oncology center whereas inexpert ophthalmologists close to the patient's home may fail to detect tumor recurrence and other ocular morbidity in a timely manner. Screening for metastatic disease is expensive, can expose patients to harmful ionizing radiation, and only rarely seems to result in prolongation of life. Follow up protocols also have psychological impacts on patients, both positive and negative. There is scope for evidence‐based guidelines, which at present are lacking. The aims of this presentation are to consider the benefits and costs of ocular and systemic surveillance and to propose suggestions for personalized care.
Repairing the ageing brain – neural ECM in regeneration and rehabilitation
Authors: Kwok J. 
Published: September 2016

SummaryPerineuronal nets (PNNs) are meshed‐like extracellular matrix structures present on the surface of sub‐populations of neurons and are involved in regulating plasticity in the central nervous system (CNS). PNNs are formed at the end of the critical period during development and their formation closes the critical period for plasticity, as demonstrated in ocular dominance plasticity. One of the major components of PNNs are chondroitin sulphate proteoglycans (CSPGs), a family of inhibitory molecules for neuronal growth and regeneration. CSPGs are highly up‐regulated after injury in the CNS, including spinal cord and optic nerve. Enzymatic removal of CSPGs in the PNNs enhances plasticity, allows re‐organisation of circuitry and improves functional recovery. Recently, we also observed specific changes in chondroitin sulphate composition in ageing brains when compared to young adult brains. This change may underlie the loss of plasticity in ageing animals. We shall discuss the role of PNNs in regulating plasticity, regeneration and rehabilitation in the CNS, including the visual system in this talk.
Retina proteomics provide new insights in glaucoma
Authors: Funke S. , Perumal N. , Schmelter C. , Teister J. , Markowitsch S. , Beck S. , Pfeiffer N. , Grus F.H. 
Published: September 2016

SummaryProteomic alterations have been studied in retina samples of glaucoma and non‐glaucoma control donor eyes (N = 5/group) by use of a bottom up proteomic platform implementing LC ESI LTQ Orbitrap XL MS analysis and label‐free quantification following functional analysis using gene ontology (GO) annotation. Furthermore, candidate abundances were examined in porcine retina and optic nerve head preparations (N = 12/tissue type). Approximately 10% of identified proteins (>600, FDR < 1%) showed significant level alteration (p < 0.05) or distinct tendencies in glaucomatous retinae, predominantly encircling mitochondrial and nucleus residing proteins. Thereby, new candidates, e.g. ADP/ATP translocase 3 and methyl‐CpG‐binding protein 2 could be proposed to be associated to glaucoma. Numerous candidates, e.g. retinol‐binding protein 3 show characteristic distribution of abundance comparing optic nerve head and retina proteomes in porcine model eyes (p < 0.05). In conclusion, distinct proteomic alterations could be documented in the human glaucomatous retina highlighting new retinal protein candidates. Moreover, characteristic distribution of ocular proteins and candidates could be revealed.
Severe clinical features in Vernal Keratoconjunctivitis
Authors: Lazreg S. 
Published: September 2016

SummaryVernal keratoconjunctivitis (VKC) is a severe form of ocular allergy, that can causes severe visual complications, it is more frequent on warm climates. VKC occurs mainly in children, the incidence is higher in males by a ratio of 3 to1, and usually appears seasonally, from early spring untill automn. Clinically we can observe 3 forms, tarsal VKC, limbal and mixed forms, tarsal forms are the most common, with a giant papillae in the tarsal side of the conjunctiva, limbal forms may be oeudematous or nodular with trantas nods. Cornea is very frequently involved, and corneal lesions are various from punctuate keratitis to ulcers and in some cases to vernal plaques. Most of the patients presents an irregular astigmatism, and some of them keratoconus probably due to eye rubbing. The first step of the treatment is to identify the allergens by the allergologist, to avoid them or to begin desensitization. Medical treatment consists on topical steroids during acute phases, associate to topical mast cell stabilizers; for severe cases topical ciclosporine 2% is prefered to steroids, when it is available, if not, intratarsal injection of triamcinolone can help to improve corneal healing, vernal plaques must be removed surgically.
How can we improve?
Authors: Sunaric Megevand G. 
Published: September 2016

SummaryHow can we improve glaucoma training in Europe?In Europe teaching and training in ophthalmology is very heterogenous. The EBO (European Board of Ophthalmology), as the official educational working body of the UEMS has gained respect in working on improvement of standards in the field of general ophthalmology by organizing a yearly EBO exam and providing to successful candidates the FEBO – diploma. Recently EBO has introduced the project of Fellow of the European Board of Ophthalmology Subspecialty Diploma (FEBOS) examinations. The EGS was the first European society invited to actively take the lead in organizing and chairing FEBOS examinations in Glaucoma. While EBO remains the ‘umbrella organization’, EGS has received the responsibility to determine clear eligibility criteria for candidates to sit the exam. Among other documents, EGS has elaborated a detailed log‐book, requirements defined as ‘mandatory’ or ‘suggested’ in theoretical and clinical knowledge. By setting these requirements reflecting high standards of knowledge in the field of glaucoma EGS aspires to influence in future fellowship‐programs in glaucoma‐teaching centers in Europe.
Accommodative IOLs: an update on recent developments
Authors: Vega‐Estrada A. , Alio J. 
Published: September 2016

SummaryPurposeTo compare the clinical results of the Lumina accommodative intraocular lens (IOL) with a standard monofocal IOL.MethodsClinical study including 86 eyes that underwent cataract surgery. The study group included 61 eyes implanted with the Lumina. The control group included 25 eyes implanted with an Acrysof monofocal IOL. Visual function, contrast sensitivity (CS) and accommodation with an open‐field autorefractor were measured during 1 year.ResultsUncorrected near visual acuity (UNVA) was 0.07 ± 0.08 LogRAD for the Lumina group and 0.37 ± 0.19 in control group (p < 0.01); corrected distance near visual acuity (CDNVA) was 0.11 ± 0.12 for the Lumina group and 0.41 ± 0.15 for the control group (p < 0.01). Defocus curves showed significant better results for the Lumina group for defocus ranging from −4.50 to −0.50D (p < 0.01). Accommodation was 0.63 ± 0.41, 0.91 ± 0.51 and 1.27 ± 0.76D for the Lumina group and 0.10 ± 0.15, 0.06 ± and 0.07 ± 0.10D for the control group at accommodation stimuli of 2.0, 3.0 and 4.0D, respectively. CS was the same for both groups (p ≥ 0.26).ConclusionsThe Lumina accommodative IOL effectively restores the visual function and accommodation after cataract surgery with no influence on the postoperative CS.
Euthyroid Graves’ Orbitopathy
Authors: Boschi A. 
Published: September 2016

SummaryEuthyroid GO is defined as an orbitopathy without present or past thyroid dysfunction Euthyroid GO is a rare condition (+/−10% of GO).The phenotype of Euthyroid GO is still undetermined. Usually reported as a unilateral mild and poorly active GO, but no difference between GO with or without thyroid dysfunction have also been described. Antibodies anti‐TSH receptors, as imaging, usually contribute to the diagnosis.We will review and discuss the clinical, radiological and biological features that are helpful for differential diagnosis.
OPA analysis – oscillatory and autonomic influence
Authors: Schmidl D. 
Published: September 2016

SummaryDynamic contour tonometry allows for a measurement of the ocular pulse amplitude. This parameter can relate to a number of local and systemic variables that can influence the fluctuation of intraocular pressure (from ocular rigidity to axial length and intraocular pressure itself).Generating this pulse in ocular pressure mostly involves the flow pattern of the terminal branches of the carotid artery (ultimately responsible for 80% of ocular blood volume fluctuation). The pressure pulse can thus be analyzed from the systemic variables influencing the systolic volume injection, thus allowing for the interpretation of the oscillatory and autonomic input through the use of a local, eye‐related device.
Tear lipids in corneal stress and inflammation
Authors: Holopainen J. 
Published: September 2016

SummaryTraditionally, ophthalmology was based on observing, trying, deducing and remembering. Yet, this view is rapidly changing. Research in the field of cornea and ocular surface has made significant advances in recent years. In this field major advances have been made in understanding the pathophysiology of common corneal and ocular surface disorders and moreover, we are beginning to understand that fats or lipids play a major role in the pathogenesis of these diseases. This has only been possible because of translational applications and approaches as well as methods to investigate ‘big data’. This talk will provide a short summary of some of the translational research performed in our lab in understanding the pathogenic mechanisms and the role of lipids in corneal diseases.
Specific gene in microphthalmia
Authors: Rozet J.M. , Fares‐Taïe L. , Chassaing N. , Gerber S. , Kaplan J. , Ragge N. , Calvas P. 
Published: September 2016

SummaryAnophthalmia and microphthalmia (A/M) are early‐eye‐development anomalies resulting in absent or small ocular globes, respectively. Genetically determined A/M are characterized by major genetic heterogeneity. In addition, there is a genetic overlap with some genes being involved in both anophthalmia and microphthalmia. Recently, we reported that mutations in the gene encoding the A3 isoform of the aldehyde dehydrogenase 1 (ALDH1A3) cause A/M with occasional orbital cystic, neurological, and cardiac anomalies in three consanguineous families. ALDH1A3 is a key enzyme in the formation of a retinoic acid (RA) gradient along the dorso‐ventral axis during early eye development. Although the role of (RA) signaling in eye development is well established, these findings provided genetic evidence of a direct link between RA‐synthesis dysfunction and early‐eye‐development anomalies. Since the original report, A/M has been ascribed to homozygous ALDH1A3 mutations in sixteen additional consanguineous families describing variable clinical expression, within and between families, ranging from silent expression to multisystemic diseases. The variable expression of ALDH1A3 mutations which are a leading cause of A/M will be discussed.
Gene transfer of E2F2 induces in situ regeneration of retinal pigment epithelium
Authors: Luhmann U. , Kampik D. , Nishiguchi K. , Basche M. , Smith A.J. , Ali R.R. 
Published: September 2016

SummaryThe retinal pigment epithelium (RPE) interacts closely with photoreceptors and is important for maintaining visual function. In degenerative diseases such as age‐related macular degeneration (AMD), the leading cause of blindness in the developed world, RPE cell loss is followed by photoreceptor cell death. RPE cells can proliferate under certain conditions, suggesting an intrinsic regenerative potential, but so far this has not been utilised therapeutically. Here we use E2F2, a potent transcriptional regulator of cell proliferation, to induce RPE regeneration in vitro and in vivo. Gene transfer of E2F2 induced upregulation of Ki67 and uptake of BrdU in growth arrested ARP19 cells in vitro. In both, young and old C57Bl/6 mice, subretinal lentiviral delivery of E2F2 to the RPE caused a 40‐fold ±27.2 increase in E2F2 positive RPE cells that correlated with a 10‐fold ±4.7 increase in BrdU positive cells and a mean increase of RPE cell density. E2F2 also induced BrdU uptake and increased cell density in the central RPE of RPECreER/DTA mice, where pathology, induced by the activation of diphtheria toxin‐A, was strongest. These results provide proof of concept for a strategy to treat progressive RPE cell loss by in situ regeneration.
How to perform a vitreal, retinal or choroidal biopsy? What justifies an invasive technique?
Authors: Van Calster J. 
Published: September 2016

SummaryA first question to ask is: what justifies the risk to be invasive? Although the risk profile of biopsy procedures has been reduced due to improvement of the technique, operating on an inflamed eye induces a higher perioperative risk. The technique, results and limitations of a single port vitreous biopsy procedure will be discussed, and compared with the diagnostic outcome after a full vitrectomy. Finally, the approach to obtain a chorioretinal biopsy will be highlighted, including risk profile and management of complications.
How to recognize a masquerade syndrome? What is the differential diagnosis?
Authors: Van Calster J. 
Published: September 2016

SummaryIn masquerade syndromes, the clinical picture is mimicking uveitis. They are simulating a chronic idiopathic uveitis, but the underlying primary cause is not immune mediated. In most cases, there is a limited response to corticosteroid treatment. Being great masqueraders, infectious causes have to be ruled out first. Other causes of masquerade syndromes will be discussed, emphasizing malignant processes.
OCT as a Novel useful tool in corneal transplantation
Authors: Thuret G. , Gabison E. , Guindolet D. , Lepine T. , Rolland J. , Gain P. 
Published: September 2016

SummaryFast and high‐resolution cross sectional imaging of the cornea by OCT proves essential in corneal graft: (i) during Eye Banking: non‐contact safe and accurate thickness measurements are available to guide pre‐cutting of DSAEK and control cut regularity; (ii) diagnosis and follow‐up of corneal diseases undoubtedly benefit from OCT that can help establishing indication for graft; (iii) after endothelial keratoplasty (EK), OCT shows graft position and adherence to the recipient bed and endothelial function through corneal thickness; (iv) after all grafts, OCT provides topography, thickness (useful during rejection and late endothelial failure), and images of donor/host interface and irido‐corneal angle; (v) The place of Iintra operative OCT expands rapidly, allowing an easy control of EK orientation, improving the safety of DALK or femtosecond laser‐assisted keratoplasty, and allowing the development of new techniques like intrastromal lamellar graft. Exciting perspectives will be illustrated with 2 examples: (i) an Optical Coherence Microscope that combines the large field of OCT and the cellular resolution of confocal microscopy; (ii) the monitoring of thickness during storage in a innovative bioreactor that restores the intra ocular pressure.