bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional and anatomical changes after standard and half dose verteporfin PDT in central serous choroidopathy
Authors: Montero Moreno J.A. , Ruiz‐Moreno O. , Garcia‐Martinez J. , Sierra‐Rodríguez M.A. , Ruiz‐Moreno J.M. , Gonzalez Uruena C. , Calvo Perez P. , Ruiz del Tiempo P. , Lopez Gaona A. 
Published: September 2016

PurposeTo report the anatomical and functional changes occurring in patients with central serous choroidopathy (CSC) treated by standard or half dose photodynamic therapy (PDT) with verteporfin.MethodsRetrospective, interventional, multicenter study. The clinical files, optical coherence tomography (OCT) and autofluorescence (AF) images of patients with CSC treated by standard or half dose PDT were revised.ResultsA total of 152 patients were identified (111 males). Patient's mean age was 50 years (standard deviation 10, range 30–68) and the average follow‐up was 21 months (SD 12, range 3–54). Mean baseline corrected visual acuity (VA) was 64 ETDRS letters (SD 18, range 2–85) and final VA was 72 letters (SD 16, range 2–85). The average central macular thickness (CMT) determined by automated OCT software at baseline was 293 μm (SD 85, range 115–615) and 221 μm (SD 45, range 41–615) by the end of follow up. Eighty‐two patients were treated by standard, full dose PDT and 70 patients were treated by half dose verteporfin PDT. The average number of required PDT sessions was 1.13 (SD 0.47, range 1–4) for standard PDT vs. 1.30 (SD 0.52, range 1–3) for half dose PDT (p = 0.009; Student's t test for unpaired data). Both groups did not differ in terms of age, previous lapse since diagnosis, baseline VA, final VA, and final CMT (p = 0.72; p = 0.18; p = 0.41; p = 0.30; p = 0.85; Student's t test for unpaired data). However, they differed in terms of basal CMT (mean CMT in the standard PDT group was 320 vs. 262 μm for the half dose group). The PDT laser spot could not be observed in the AF images in any of the groups.ConclusionsAccording to our findings, standard, full dose PDT provides similar visual outcomes as half dose verteporfin PDT with a lower rate of re treatments and no differences in CMT or AF patterns.
Vitreous and serum Hsp 70 levels in rhegmatogenous retinal detachment
Authors: Sozen‐Delil F.I. , Cekic O. , Haklar G. 
Published: September 2016

PurposeHeat shock proteins (Hsp) are ubiquitous proteins that protect cells from different kinds of stress. Retinal detachment (RD) is a critical eye situation after that death of photoreceptors by apoptosis and necrosis occurs. Despite the best anatomical result following the surgery visual acuity may not improve. The objective of the present study was to detect possible correlations of Hsp 70 levels between vitreous and serum of the patients with RD.MethodsTotally 15 eyes of 15 patients were included. The study group consisted of 11eyes with rhegmatogenous RD and the control group consisted of 4 eyes with macular hole or epiretinal membrane without RD. All eyes underwent pars plana vitrectomy. Vitreous and serum samples were obtained at the time of vitrectomy. The levels of Hsp 70 were analyzed using Enzyme linked immuno‐sorbent assay. Total vitreous proteins and total serum proteins were also measured. Mann–Whitney U and Spearman correlation tests were performed for the statistics. The significance was set to <0.05.ResultsIn sum total (n = 15), higher mean vitreous Hsp 70 level (±standard deviation) were detected in eyes than that of serum (184.41 ± 154.4 pg/ml vs. 85.43 ± 27.47 pg/ml, p < 0.001). In the study group, vitreous Hsp 70 levels are higher than those of serum (209.33 ± 175.12 pg/ml vs. 83.95 ± 26.95 pg/ml, p < 0.001) as well as serum and vitreous Hsp 70 levels were not correlated (p > 0.05). In the control group, serum and vitreous Hsp 70 levels were similar (89.49 ± 32.72 pg/ml vs. 115.87 ± 22.05 pg/ml, p > 0.05), and serum and vitreous Hsp 70 levels were not correlated (p > 0.05).ConclusionsElevated vitreous Hsp 70 levels in the eyes with rhegmatogenous RD could be due to increased endogenous synthesis to prevent stressed retina from apoptosis.AcknowledgementThis project was supported by Marmara University, Scientific Research Projects Committee.
Normative values for optical coherence tomography parameters in children and inter‐examiner agreement of choroidal thickness measurements
Authors: Erkan Turan K. , Taylan Sekeroglu H. , Baytaroglu A. , Bezci F. , Karahan S. 
Published: September 2016

PurposeTo determine normative values for central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (CT) in healthy children and to investigate their relationships with axial length (AL), central corneal thickness (CCT), refractive errors and intraocular pressure (IOP).MethodsA total of 120 eyes of 120 healthy children (72 girl, 48 boys, 11.95 ± 2.26 years) underwent detailed ophthalmologic examination and optical coherence tomography (OCT) measurement (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany) in a cross‐sectional study setting. CT was measured by two independent examiners in 3 separate points.ResultsThe mean global RNFLT was 98.75 ± 9.45 (79.0–121.0) μm. The mean CMT was 232.29 ± 29.37 (190.0–376.0) μm. The mean subfoveolar CT was 344.38 ± 68.83 (148.0–572.0) μm measured by examiner 1 and 344.04 ± 68.92 (141.0–573.0) μm measured by examiner 2. Inter‐examiner agreement was % 99.6–99.8 for CT in 3 separate points. The mean AL was 23.72 ± 0.73 (22.14–25.56) mm. The mean IOP was 13.70 ± 1.63 (11–19) mmHg. The mean spherical equivalent was −0.26 ± 0.73 (−2.25 to +1.50) diopters. The mean CCT was 555.95 ± 26.59 (498–614) μm. CMT was found to increase with AL (r = 0.245, p = 0.007). CT was demonstrated to increase with age (r = 0.291, p = 0.001) and decrease with AL (r = −0.191, p = 0.037). Global RNFLT was found to decrease with AL (r = −0.247, p = 0.007) and increase with CCT (r = 0.208, p = 0.022). Global RNFLT was positively correlated with CT (r = 0.354, p < 0.001).ConclusionsOCT parameters seem to show a wide range of variability in children. RNFLT, CMT and CT are either interrelated or correlated to age, CCT and AL. Furthermore, CT manual measurements with enhanced depth imaging OCT showed very high inter‐examiner agreement. It should be borne in mind that normative values are unique in children when considering OCT results.
The role for the Xen gel stent implant in glaucoma treatment
Authors: Stalmans I. 
Published: September 2016

SummaryTrabeculectomy is till the gold standard in glaucoma surgery because it is an effective technique to lower intra‐ocular pressure. However, this surgical technique is associated with a risk of vision‐threatening complications. Therefore, great efforts have been made in the past decade to develop a safer alternative. A plethora of surgical implants have been developed, targeting Schlemms canal, the suprachoroisal or the subconjunctival space.The XEN gel implant is a collagen‐derived device which is implanted ab‐interno using an inserter with a hollow needle. This is the only minimally invasive glaucoma surgery (MIGS) which targets the subconjunctival space, thus creating a filtering bleb. During this lecture, the techology, implantation technique and practical tips and tricks for per‐ and postoperative management will be discusssed. Moreover, the one‐year efficacy and safety results of an ongoing phase IV trial (the APEX study) will be presented.
Intraarterial and intravitreal chemotherapy in the combined treatment in children with group C and D intraocular retinoblastoma
Authors: Saakyan S. 
Published: September 2016

PurposeTo evaluate the outcomes of Rb with group «C» and «D» after the combined treatment.Methods45 patients, 22 (49%) male and 23(51%) female were included in study, age ranging from 1 to 42 months (median −13.5 ± 10.4 months). Children with age under 1 year – 62%. All 45 children received systemic chemotherapy VEC from 3 to 6 courses (median – 5 courses). 4 children were undergone primary enucleation (group E). For the treatment of the eyes groups C and D Rb (n = 49) local chemotherapy was added SIAC and/or IVCT on the average after the third course of VEC. Focal therapy was used if need to consolidate treatment (TTT and/or brachytherapy). IVCT was used in 32 patients for 34 eyes with vitreous disease with median number of courses 2 (1–6). SIAC was used in 41 patients for 45 eyes with retinal or subretinal disease with or without vitreous seeding with median number of courses 2 (1–3).ResultsIn 27 of 49 eyes after systemic chemotherapy the significant resorbtion of the tumor foci were revealed using chemotherapy, the other 22 eyes underwent additional treatment – in group C (TTT‐4 eyes, brachytherapy – 5 eyes) and in group D (TTT – 6 eyes, brachytherapy ‐6eyes). The patients with Rb of groups «C» and «D» had disease free survival (DFS) of 56.1 ± 8.9% with a median period of follow‐up 26.9 ± 2.5 months. 44 of 45 patients with Rb of groups «C» and «D» are alive with no metastatic disease (median follow up of 20 months (range 3–43 months)). One of 45 patients died due to second malignant tumor – acute leukemia.14 of 15 eyes (93.3%) with group «C» and 31 of 34 eyes (91.2%) with group «D» were preserved by combined chemotherapy and focal therapy.ConclusionsCombined chemotherapy (VEC + SIAC + IVCT) with focal therapy allowed saving the eyes that enucleated earlier.
Eleven year review of risk factors and visual outcomes of patients with posterior capsule rupture (PCR) as a complication of cataract surgery at a district general hospital
Authors: Begum S. , Penwarden A. , Saunders D. , Balendra S.I. , Schulz C. , Hunter M. 
Published: September 2016

PurposeTo report risk factors and visual outcomes of cataract surgery complicated by posterior capsule rupture (PCR) at Portsmouth Hospital over an 11 year period (2004–2015)MethodsA search of all cataract surgery complicated by PCR was performed on our Electronic Patient Record (EPR). Clinical data was extracted from the EPR, patient case notes and clinical letters. Only patients with a minimum of 3 months VA recorded were included.ResultsIn total 366 patients were identified. The mean number of cataract operations performed per year was 3,832 giving an overall PCR rate of 0.98%. Of the cases affected the average age was 74 years and 56% were female. The most common risk factors were dense cataract (15%), high myopia (8%) and previous vitrectomy (6%). Thirty five percent of PCR cases occurred during a trainee surgical list. Initial mean best corrected VA in all patients was 0.68, 0.62 at 3 months and 0.46 at 1 year. The mean length of follow up was 35 months and the mean VA was 0.36 at the final visit.ConclusionsPCR rate at Portsmouth is almost half the national rate. We found in our cohort of patients, previous vitrectomy was a common risk factor which was not reflected in the Royal College of Ophthalmologists’ National Database. Over a third of PCR occurred during trainee lists, emphasising the need for risk stratification preoperatively to identify difficult cases.
Intravitreal bevacizumab as an adjuvant treatment of choroidal metastasis
Authors: Costa J. , Braga J. , Neves F. , Meira D. , Ribeiro L. 
Published: September 2016

PurposeMetastatic tumours are the most common intraocular malignancy. Although rare, lung and breast cancers are two of the predominant tumours to metastasize to the eye. The choroid, an highly vascularised structure, is the intraocular site most commonly affected. Recent case reports point intravitreal bevacizumab as an option in the treatment of these tumours. The authors present a case of choroidal metastasis secondary to breast carcinoma treated with intravitreal bevacizumab.MethodsA patient with choroidal metastasis was treated with intravitreal bevacizumab. Clinical and tumour response was observed and documented for a period of 24 months.ResultsA 55‐year‐old female patient, with an history of localized breast carcinoma treated nine years previously, presented with decreased visual acuity in the right eye. She had a best corrected visual acuity (BCVA) of counting fingers at 10 centimetres. Examination revealed a choroidal metastatis in the temporal region of the posterior pole as well as serous macular detachment. The off‐label treatment with intravitreal bevacizumab was proposed and the patient underwent three consecutive (one month interval) intravitreal injections, as an adjuvant to the chemotherapy with paclitaxel. With just one IVB, the patient reported an improvement of her visual acuity and one month after the third IVB she had a BCVA of 6/10. At this time, significant tumour and subretinal fluid regression was confirmed by fundus examination and optical coherence tomography. Until the present time (two years follow‐up). the patient remained clinically stable with no need of further IVB. There were no ocular or systemic complications with the treatment instituted.ConclusionsThe combination of intravitreal bevacizumab and systemic chemotherapy seems to be effective and safe for management of choroidal metastasis from breast carcinoma.
Clinical and morphometric investigation of retinopathy in children with retinoblastoma treated with chemotherapy
Authors: Saakyan S. 
Published: September 2016

PurposeTo analyze the results of clinical and morphometric investigation of retina in children with retinoblastoma treated with systemic and local chemotherapy in comparison with children with primary untreated tumor.Methods55 children (87 eyes) with retinoblastoma treated with systemic chemotherapy, intra‐arterial, intravitreal chemotherapy and 19 patients (38 eyes) with primary tumors before treatment were examined. All patients were examined by ophthalmoscopy using Ret Cam and spectral optical coherence tomography.ResultsAfter systemic chemotherapy fundus examination revealed retinal edema, retinal artery narrowing, focal and/or diffuse choroidal blanching, pigmented foci of small and medium sizes. On tomograms – hyperreflective loop luminal narrowing, a significant decrease in the caliber of retinal blood vessels as compared to the norm of 16 ± 4.1 μm; waviness photoreceptor layer and its destruction. In macula – 42.6% on tomograms – maculopathy, manifested disorganization RPE, cystoid edema, smoothness papillomacular beam forming beak shaped fovea and retinal thickening. In patients treated with primary systemic and intra‐arterial chemotherapy diagnosed increase in retinal vascular caliber up to 116 ± 8.1 μm. The clinical picture after systemic chemotherapy and intavitreal chemotherapy in 14 eyes characterized by atrophy with the formation of small whitish and pigmented lesions. On tomogramms‐ unevenness and destruction of the inner layers of the retina and epiretinal membranes little‐pointedhyperreflective tricks in the inner layers of the retina.ConclusionsThe results of clinical and morphometric studies of the inner shells eyes, arising under the influence of chemotherapeutic agents are of interest in terms of predicting the visual functions of the child after the complete destruction of the tumor.
Effects of TRPM8 and TRPV1 agonists on the neural activity of corneal cold thermoreceptors in tear‐deficient guinea pigs
Authors: Quirce S. , Luna C. , Acosta M.C. , Kovacs I. , Belmonte C. , Gallar J. 
Published: September 2016

PurposeTo characterize the effects of menthol and capsaicin on the activity of corneal cold thermoreceptors in tear‐deficient guinea pigsMethodsThe main lachrymal gland was surgically removed in anesthetized animals. Four weeks later, cold‐sensitive nerve terminal impulse (NTI) activity was recorded from the superfused cornea. The spontaneous and stimulus‐evoked NTI activity was analysed. For thermal stimulation, temperature of perfusion solution was changed from 34°C (basal) down to 20°C (cooling ramp) or up to 50°C (heating ramp). TRP agonists (50–200 μM menthol, 1–10 μM capsaicin) were also added to the perfusion solution. The characteristics of the spontaneous and stimulus‐evoked NTI activity recorded in tear‐deficient and intact corneas before and during perfusion with TRP channel agonists were compared.ResultsRemoval of the lachrymal gland caused sustained reduction of basal and reflex tearing. NTI activity was significantly higher in cold thermoreceptors from tear‐deficient corneas compared with naïve corneas. Response to cooling ramps was also increased. Menthol increased ongoing and stimulus‐evoked activity of all cold thermoreceptors in both intact and tear deficient corneas. Menthol at high concentrations first excited and then inactivated cold thermoreceptors. Only 10% of thermoreceptors were activated by capsaicin.ConclusionsChronic tear deficiency alters the activity of corneal sensory nerve fibers, leading to the development of increased spontaneous activity and abnormal responsiveness to natural stimulation. These changes are particularly prominent in cold thermoreceptor fibers, whose injury‐evoked neuropathic firing seems to be due to altered expression of Na+ and K+ channels involved in impulse generation without changes in the activity of TRP channels involved in sensory transduction.
Topical cyclosporine‐A in Vernal Keratoconjunctivitis, when how and how long
Authors: Bremond‐Gignac D. 
Published: September 2016

SummaryVernal keratoconjunctivitis (VKC) is a severe ocular allergic disease occurring in children and adolescents. This chronic, allergic and inflammatory severe condition in children may result in visual impairment. Two forms of VKC may be observed, tarsal form and limbal form. Symptoms as itching, tearing, Topical antihistamine and mast cells stabilizers, as classical treatment, are regularly ineffective and topical steroids are required. However, steroids may be iatrogenic in this chronic condition. The anti‐inflammatory effect of a topical cyclosporine allows topical steroids sparing. Different forms of ciclosporin will be detailed as oily preparation or cationic emulsion. Adjustment of the dosage and duration is essential to match the form. Risks of visual impairment justify to integrate topical cyclosporine treatment. Practical aspects of the treatment may provide better quality of life for children and parents.
Dry eye syndrome following proton therapy of ocular melanomas
Authors: Maschi C. , Sara L. , Peyrichon M.L. , Baillif S. , Herault J. , Thariat J. , Caujolle J.P. 
Published: September 2016

PurposeSome institutions contra‐indicate proton therapy (PT) for ocular melanomas of temporal superior location (TS) owing to lacrimal gland irradiation and the risk of dry eye syndrome (DES) and advocate brachytherapy. We investigated whether PT can be safely performed in TS melanomas.MethodsLocation, DES grade and dose to the lacrimal gland estimated from Eyeplan blindly by two operators were correlated in consecutive patients treated from 1999 to 2014 with 52 GyResultsOf 1473 patients, 13.6% had DES, including 5.4% with severe DES (sDES). Temporal superior and temporal melanoma patients had a higher risk of DES than patients with melanomas in other quadrants (p < 0.001). Severe DES was noted in 18.6% of TS melanoma patients (versus 5.4% in patients with melanomas in all other quadrants) and 12.3% of temporal melanoma patients (versus 3.0%) (p < 0.001). sDES was more frequent in ciliary versus choroid melanomas, advanced versus early stage (p < 0.001), and higher percentages of eye surface, lens periphery or ciliary body (p < 0.001), cornea irradiated at any dose level (p = 0.002). sDES was associated with more eyelid dermatitis or alopecia (p < 0.001), and glaucoma/rubeosis (p = 0.002). Vision changes were similar in patients with TS melanoma or other locations, including for patients experiencing severe DES (+1.15 vs. +1.14 logMAR). No patient underwent enucleation for complications of DES.ConclusionsDES and sDES were more frequent in TS melanomas incriminating the lacrimal gland but temporal melanomas experienced more DES. In addition to correlation sDES and lens, cornea and lid irradiation, this suggests involvement of such structures as the limbus cells, conjunctival glands and long ciliary nerves. Rates of sDES compared favorably with the literature and DES was manageable. Tumor location should not contraindicate PT.
Neuro‐ophthalmological manifestations of Behcet's disease
Authors: Alghamdi A. , Bodaghi B. , Wechsler B. , Cacoub P. , LeHoang P. , Saadoun D. , Touitou V. 
Published: September 2016

PurposeBehcet's disease (BD) is an inflammatory disease characterized by recurrent oral aphthous ulcers (major criteria), genital ulcers, uveitis and skin manifestations (minor criteria). Neuro‐ophthalmological manifestations (NOM) are rare. The aim of our study is to report the spectrum of NOM of BD, and evaluate their prognosis.MethodsMedical records of patients with neuro‐Behcet, seen in a single tertiary center between 1987 and 2015 were retrospectively reviewed. Patients with NOM were included in the study. The diagnosis of neuro‐behcet disease was based on neuro‐imaging and lumbar puncture. All patients were evaluated both in the internal medicine and ophthalmology departments.ResultsOut of the 217 patients diagnosed with neuro‐BD, 29 presented with NOM. The M/F ratio was 1.2. Mean age at diagnosis was 25.3 years. Clinical NOM included papillitis (27.5%), papilledema (51.7%), retrobulbar optic neuritis (10.3%), optic disc atrophy (31%) and cranial nerve palsy (27.5%). All patients were treated with corticosteroids and immunosuppressive drugs were required in 23 patients. Initially, 79% of patients had a decreased visual acuity, and 79% had visual field defects. After treatment, vision improved or stabilized in 66.7% and worsened in 33.3%. The mean ± SD LogMAR visual acuity improved from 0.4 ± 0.3 at diagnosis to 0.2 ± 0.3 after therapy. 10.3 and 3.4% patients were respectively legally blind at diagnosis and at the end of follow‐up.ConclusionsAlthough NOM of BD are rare, they are potentially severe and disabling. Recognition of NOM is crucial for establishing an early diagnosis. Prompt treatment is the main prognostic factor for the visual outcome for these patients.
Optical coherence tomography findings of retinal folds in nanophthalmos
Authors: Atilla H. 
Published: September 2016

SummaryNanophthalmos is a rare form of congenital microphthalmos and it can be seen in siblings due to genetic transmission. The eye is small in overall dimensions including short axial length (16–18.5 mm) with shallow anterior chamber and almost normal lens size. Typically high hyperopia is seen. Posterior findings include; cupless and crowded optic disc, and elevated papillomacular retinal folds. Optic Coherence Tomography (OCT) can reveal retinal fold with normal retinal pigment epithelium and choriocapillaris. It is presumed that the retinal folds in nanophthalmos result from a redundancy of the retinal layer caused by retarded growth of the scleral, choroidal, and retinal pigment epithelial layers and OCT can demonstrate papillomacular retinal folds that are confined to the neurosensory retina.
Early childhood blindness – etiologies and comorbidity
Authors: Löfgren S. , de Verdier K. , Ek U. , Fernell E. 
Published: September 2016

PurposeTo identify etiologies and developmental comorbidity in children with congenital or very early blindness.MethodsChildren with congenital or early blindness in Sweden during a 20 year period were identified through registers. Major causes for the blindness and developmental disturbance were collected from patient records.ResultsFour causes of blindness amounted to 65% of all etiologies: retinopathy of prematurity, optic nerve hypoplasia, Leber congenital amaurosis, and optic nerve atrophy, in falling order of frequency. Nearly three out of four children had at least one additional impairment besides blindness; the most common being intellectual disability and autism spectrum disorder. More than half of the population had more than one additional impairment.ConclusionsBlindness in itself entails considerable implications for a child's development and learning. When blindness is combined with other developmental disorders, there is a significant need for support and adaptation. It is important to understand the developmental effects of both the blindness and other coexisting disabilities in order to correctly interpret the behavior and needs of the children.