bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of visual quality parameters after Descemet membrane endotelial keratoplasty (DMEK)
Authors: Gavin Sancho A. , Romero Sanz M. , Idoipe Corta M. , Mateo Orobia A. , Sanchez Perez A. , Garcia‐Martin E. , Satue Palacian M. 
Published: September 2017

Purpose and ObjectivesTo evaluate progressive changes in visual quality parameters in patients who underwent DMEK for Fuchs endotelial dystrophy (FED), and to compare the visual quality results with healthy controls without corneal pathology.MethodsFourteen eyes with FED who underwent DMEK were evaluated for corneal topographic changes using Pentacam (OCULUS, Iberia SL), preoperatively, at 1 month and at 6 months after surgery. Mean keratometry (Km), corneal density (1‐2 mm, central and total), high order aberrations (HOA), low order aberrations (LOA) and total aberrations (total RMS) were analyzed in the anterior and posterior cornea. Fourteen healthy subjects were evaluated using the same protocol and compared with the patient's final evaluation data.ResultsSignificant improvement was observed in patients at 1 month after surgery in the posterior Km (p=0.005), central posterior density (p=0.034), 1‐2 mm posterior density (p=0.006) and central anterior density (p=0.045), and anterior LOA (p=0.026) and total aberrations (p=0.020). After 6 months all densities (anterior and posterior) had improved compared to preoperative results (p<0.05) as well as all posterior aberrations (total, HOA and LOA, p<0.05). Posterior and anterior Km values and corneal densities did not show significant differences compared to healthy subjects (p>0.05). Corneal aberrations (anterior and posterior)remained significantly higher in DMEK subjects (p>0.05)ConclusionsDMEK surgery improves corneal visual quality parameters in FED patients after the first month postoperatively. Corneal density and mean keratometry values are not different from healthy corneas at 6 months after DMEK. However, despite corneal aberrations decrease after surgery they remain higher than those values found in healthy corneas.
Femtolaser‐assisted vs manual anterior lamellar keratoplasty in patients with keratoconus
Authors: Kazakbaev R. , Bikbov M. , Usubov E. , Kazakbaeva G. 
Published: September 2017

PurposeTo evaluate anatomic and functional results of ALK using different technics for end‐stage keratoconus.MethodsAnterior lamellar keratoplasty was performed in 21 eyes with progressive keratoconus of IV stage of disease according to the Amsler classification. In 1st group (12 cases) keratoplasty was performed using a femtosecond laser LDV8. Removed corneal disc diameter ‐ 7.5‐8.0 mm, thickness ‐ 250‐300 mc. In 2nd group (9 cases) manual dissection of anterior stroma was performed. Partial trepanation without penetration of anterior chamber (diameter 7.5‐8.0 mm) was done at depth 250 mc using Barron trephine. Corneal graft was fixated by 10/0 sutures. The follow‐up was 6 months.ResultsSignificant improvements of UCVA and CVA was up to 0.2 and 0.5, respectively, in 1st group. In 2nd group UCVA and CVA improved up to 0.08 and 0.3 in early postop period. Mean corneal astigmatism was 4.6±1.2 D in 1st group and 7.7±2.4 D in 2nd, respectively. In 1 case after manual technic (2nd group) hazing and graft rejection was observed in 2 months after surgery.ConclusionsThe use of femtosecond technologies in anterior lamellar keratoplasty increases the efficiency of the operation due to the greater predictability and accuracy of the procedure and the optimal donor‐recipient juxtaposition. This leads to better visual and refractive outcomes by reduction of corneal astigmatism due to good wound apposition, biomechanical stable incision.
Ocular cicatricial pemphigoid secondary to intravitreal implant of ranibizumab: a case report
Authors: López Sangrós I. , Marco Monzón S. , Bartolomé Sensé I. , Berniolles Alcalde J. , Sanchez Marin J.I. , Idoate Domenech A. , Ascaso Puyuelo J. , Del Buey Sallas M.A. 
Published: September 2017

PurposeMucous membrane pemphigoid is a systemic disorder that primarily affects mucous membranes. When localized to conjunctiva, it is know as ocular cicatricial pemphigoid (OCP), a potentially blinding desease resulting in progressive conjunctival fibrosis and ocular surface failure.Women are affected more than men by a ratio of 8:1. Age on onset is usually age 60 to 80 and rarely younger than 30. We describe the case of a patient with OCP secondary to intravitreal implant of ranibizumab.MethodsWe describe the case of a patient with OCP secondary to intravitreal implant of ranibizumab.ResultsA 85 years old woman with bilateral macular degeneration, treated with intravitreal implants of ranibizumab in the right eye, began with a non specific queratoconjunctivitis in the right eye after the second administration of intravitreal ranibizumab. In numerous ophthalmology follow‐ up appointments the patient presented red right eye and increased amount of tears. Six months later, after another intravitreal implant of ranibizumab, the patient presented a subepithelial fibrosis, as fine gray‐white striae in the inferior fornix. The patient was treated with topic corticosteroid, cyclosporin 0,2%, autologous serum eye 20% with a significant improvement. A systemic treatment with 15 mg methotrexate once a week and the suspension of intravitreal implants of ranibizumab was necessary to control the progression of the OCP.ConclusionsIn some patients, systemic drugs (practolol, D penicilamine…), have triggered the onset of OCP. The term pseudopemphigoid or drug‐induced pemphigoid may be used to describe these cases. There are not cases of POC secondary to ranibizumab described on the literature.
Softacort®, preservative‐free hydrocortisone 0.335% drops: A new anti‐inflammatory drop with minimal effects on intraocular pressure
Authors: Shortt A. , Rolando M. 
Published: September 2017

PurposeThe aim of this study was to compare the changes in intraocular pressure (IOP) after instillation of a new preservative‐free hydrocortisone 0.335%(Softacort®), prednisolone 1% (Inflanefrane® Forte), loteprednol etabonate 0.5% (Lotemax®) and rimexolone 1% (Vexol®) in comparison with dexamethasone 0.1% (Maxidex®) in a rat model of glucocorticoid‐induced ocular hypertensionMethodsSixty albino female rats were divided into 5 treatment groups and drops administered twice daily from Day 1 to Day 36. Clinical examination, body weight, and IOP measurements were assessed once weekly during 5 weeks.ResultsAnimals treated with Softacort®, Lotemax® or Vexol® had a similar body weight gain. Inflanefran® Forte‐treated animals showed a lower body weight gain. Maxidex®‐treated animals gained weight up to 7 days but there after lost weight as expected. Animals treated with Softacort®, Lotemax®, Inflanefran® Forte or Vexol® had a similar IOP profile with a slow increase in the mean IOP up until Day 15, and then stabilization at +2 mmHg above baseline throughout the remainder of the study Maxidex®‐treated animals showed, as expected, an increase of the mean IOP until Day 36 reaching +4.4 mmHg and progressively increasing.ConclusionsThis study shows significant differences in the IOP rise and therefore greater safety of this new preservative‐free hydrocortisone and other soft corticoids when compared to Maxidex. Twice daily instillation of Softacort® induced a slight IOP elevation which stabilized after 2‐weeks whilst dexamethasone treatment led to a significant continuing IOP increase and drastically reduced body weight gain. Thus, Softacort®, a preservative free hydrocortisone 0.335%, shows a good balance between efficacy and minimal side effects and has just obtained the Marketing Authorization in Europe.
Association of incidental epithelialization of corneal endothelium with endothelial barrier impairment
Authors: Smedowski A. , Mazur R. , Tarnawska D. , Wylegala E. 
Published: September 2017

PurposeTo identify patients with incidental epithelialization of corneal endothelium (IECE) detected in in vivo confocal microscopy (IVCM) and analyze its association with corneal decompensation.MethodsWe performed a retrospective analysis of IVCM (Rostock Cornea Module, HRT III) scans of 327 patients treated in outpatients clinic for various corneal diseases. After identification of cases with IECE, visual acuity (VA), central corneal thickness (CCT) data, endothelial cell density, as well as slit‐lamp photographs were collected. CCT measurements were obtained using Pentacam (Oculus).ResultsFrom among of 327 IVCM examinations, IECE was visible in 8 patients associated with Posterior Polymorphous Corneal Dystrophy (PPCD) in 3 out of 6 patients with an IVCM diagnosis of PPCD; Fuch's Endothelial Dystrophy (FED) in 3 out of 12 FED patients with available IVCM scans. One patient was diagnosed with unilateral IECE after the incident of facial UV‐light burn (tanning salon) with the unilateral mild burn of the ocular surface. One patient presented unilateral IECE in superior half of the cornea due to epithelial ingrowth after cataract surgery. PPCD patients with presence of IECE developed corneal edema and greater endothelial cell loss, in contrast to age‐matching PPCD patients without IECE. Patients with FCD or cornea guttata developed corneal decompensation and visual impairment at the earlier age (before 50 y.o.) than FCD patients without IECE. Advanced IECE observed in the patient with ingrowth syndrome, as well as epithelial metaplasia after UV‐light burn resulted in severe visual impairment.ConclusionsDiagnosis of corneal diseases should be supplemented by IVCM examination. IECE observed in IVCM could be considered as a prognosis factor of visual impairment in corneal endothelial diseases, however it requires more research.
Recombinant human heat shock protein 27 can inhibit ultraviolet B‐induced differentiation in pterygial‐derived fibroblast
Authors: Kim J.Y. , Moon C.H. , Shin J.A. , Kang S.S. , Kim E.S. , Tchah H. 
Published: September 2017

PurposeTo investigate the effect of recombinant human heat shock protein 27 (rhHSP27) on the differentiation of human pterygial‐derived fibroblast.MethodsHuman conjunctival and pterygial fibroblasts were isolated and cultured from specimens of normal conjunctiva and pterygium head, which were donated during pterygium excision. Cultured conjunctival and pterygial fibroblasts were exposed to 20 mJ/cm2 of ultraviolet‐B (UVB) irradiation with and without 4 ug/mL rhHSP27 pre‐treatment. Western blot analyses of α‐smooth muscle actin (α‐SMA), a marker for myofibroblast, were performed in each group and quantified using Image Gauge 4.0 software. The ratios of α‐SMA / GAPDH and phosphorylated HSP27 / GAPDH were compared.ResultsThe α‐SMA level in Pterygial fibroblasts showed 2.85 ± 0.11 fold greater than that of normal conjunctival fibroblasts (P < 0.001). The level of α‐SMA was increased by 1.92 ± 0.02 times (P < 0.001), when normal conjunctival fibroblasts were exposed to UVB irradiation without rhHSP27 pre‐treatment. However, when normal conjunctival fibroblasts were exposed to UVB irradiation with rhHSP27 pre‐treatment, the fibroblasts demonstrated 0.82 ± 0.04 fold smaller α‐SMA level than control did (P = 0.04).ConclusionsThe rhHSP27 revealed inhibitory effects on the UVB irradiation‐induced differentiation from normal conjunctival fibroblasts to pterygial myofibroblast. The rhHSP27 can be a preventive treatment against pterygium growth.
Trabeculectomy: evaluation of the area exposed to mitomycin C
Authors: Pinto Ferreira N. , Sousa D. , Mano S. , Medeiros Pinto J. , Barata A. , Abegão Pinto L. 
Published: September 2017

PurposeMitomycin C (MMC) is used to increase the durability of filtering procedures in glaucoma. However, the ideal time and area of exposure, as well as the associated side effects remain to be fully understood. This study aims to analyse the association of the MMC‐exposed area in trabeculectomy with safety and efficacy outcomes.MethodsProspective, interventional pilot study of 25 eyes of 25 open‐angle glaucoma patients enrolled for a primary trabeculectomy with MMC 0.4 mg/ml. The antimetabolite solution was visually highlighted by mixing it with a vital dye (trypan blue 0.1%). The area of MMC application was evaluated using a software analysis program (ImageJ). The primary outcome was the association of surgical intraocular pressure (IOP) lowering efficiency with the area of MMC application. Absolute success was defined as 30% IOP reduction and less than 18 mmHg, with no further medication. Relative success was similarly defined but IOP‐lowering medication was used.ResultsThe mean MMC‐exposed area was 122.6 ± 40.0 mm² (median 116 mm²). The mean time of follow‐up was 7.2 ± 4.8 months. Mean IOP reduction after trabeculectomy was 12.5 ± 8.0 mmHg with absolute and relative success rates of 60% and 76%, respectively. Overall, no relationship between the MMC‐exposed area and parameters of efficacy nor safety were observed (p = 0.40). Interestingly, all patients with a MMC exposure area >150 mm² had a 100% absolute success rate. All failed trabeculectomies (6 eyes, 24% of the total) had a MMC‐exposed area <150 mm². Lastly, only (but one) patients with MMC‐exposed area <150 mm² needed more than on laser suture lysis.ConclusionsOur study gives an approximate absolute value of the MMC‐exposed area during trabeculectomy and suggests it may be related to the hypotensive efficacy, with exposed MMC areas >150 mm² being associated with better IOP‐lowering outcomes.
First real‐life data of use of the new PF‐MD glaucoma device (EasyGrip®): results of the ISY study from Spain and France
Authors: Denis P. , Duch S. 
Published: September 2017

PurposePreserved eye drops can cause local side effects, some of which appear more rapidly, that can impact the patients’ quality of life. The new availability of the first Preservative‐Free (PF) Dorzolamide/Timolol (DT) Fixed Combination (FC) in a new MD bottle (EasyGrip®) could improve patient satisfaction, treatment compliance and ultimately treatment efficacy.MethodsISY is an international, multicentre, observational and cross‐sectional study. It is still ongoing to recruit a total of 1880 glaucoma patients from DK, FI, FR, DE, NO, ES and SE. The patients were treated and stabilised for at least 28 days with the PF‐MD DTFC (Duokopt®/Dualkopt® ‐ Laboratoires Théa‐France). The questionnaire is divided in two parts to be completed independently by the ophthalmologist and the patient during one routine visit. The primary endpoint is the prevalence of patients satisfied with the new PF‐MD bottle. Other parameters: medical history; intraocular pressure (IOP); use of the new PF‐MD bottle; ophthalmologist satisfaction; assessment of compliance and persistence; and visual acuity.ResultsThe results of the first 268 patients (188 Spain, 80 France) are presented here for the first time. 97.5% of ophthalmologists are satisfied or very satisfied to prescribe the new PF‐MD device with DTFC. 79.0% of patients, who were previously using a preserved MD bottle, are satisfied enough to continue with the new PF‐MD device. 44.5% of patients declared the new PF‐MD bottle better or much better than the previous preserved MD eye drop.ConclusionsThe first results of ISY study confirm the interest of switching from a preserved MD glaucoma treatment to a PF‐MD device EasyGrip® whilst keeping the efficacy.
Persistent pupillary membrane associated with cataract
Authors:  IDOATE A. ,  Sanchez Marín J.I. ,  Bartolome Sese I. ,  Berniolles Alcalde J. ,  Marco Monzon S. ,  Lopez Sangros I. ,  Ascaso Puyuelo J. ,  Ibañez Alperte J. 
Published: September 2017

PurposePersistent pupillary membranes represent remnants of the tunica vasculosa lentis. In general, it does not affect vision, although cases of deprivation ambliopia have been described. There are few reported cases of associations with other ocular pathologies.MethodsInterventional case report showing bilateral Persistent Pupillary Membrane associated with cataract.ResultsA 17‐year‐old male underwent routine ophthalmologic examination. Best corrected visual acuity (BCVA) was 0.2 (+4.25, −4.50ª 90º) in the right (RE) and 1.0 (−0.50, 0.75 to 40°) in the left eye (LE). Slit‐lamp biomicroscopy examination demonstrated a bilateral persistent pupillary membrane associated to cataract in the RE. Goldmann applanation intraocular pressure (IOP) and fundoscopy were normal. In order to improve visual acuity we performed a membranectomy with cataract extraction. Nevertheless, BCVA following surgery showed no changes.ConclusionsWe describe the association of bilateral persistent pupillary membrane to unilateral cataract, as well as to hyperopia and anisometropic amblyopia. Conservative management should be considered in patients whose visual development has concluded. Surgery entails risks and visual gain may not be significant.
Case of IgG4‐related eye disease requiring differentiation from carotid‐cavernous fistula
Authors: Yamagishi A. , Oshitari T. , Tawada A. , Yamamoto S. 
Published: September 2017

PurposeWe report our findings in a case of IgG4‐related eye disease that was confused with carotid‐cavernous fistula (CCF).MethodsCase report: A 61‐year‐old man visited to our department for exophthalmos with dilated conjunctival vessels in both eyes. He had hyperthyroidism. At the first visit, his ocular movements were disturbed, and MRI showed funicular‐like appearance of the superior ophthalmic veins. However, enlargements of the extraocular muscles were not detected, and thyroid ophthalmopathy was excluded. Cerebral angiography showed no flow from either internal carotid arteries to the cavernous sinus, and CCF was also excluded. Blood tests showed high level of IgG4 (281 mg/dl) and a IgG4‐related eye disease was considered. Systemic examinations showed no other lesions. Although histological examinations could not be performed, we treated the patient with 30 mg prednisolone as a possible IgG4‐related eye disease. However, the reduced vision and critical fusion frequency did not improve. Then we switched to steroid pulse therapy, and all findings including the MR images were improved. A biopsy could not be performed because of the high risk of bleeding. Thus, malignant lymphoma could not be completely excluded. The patient is being followed continuously to detect any recurrences.ResultsConclusionsWe report our findings in a very rare case of IgG4‐related eye disease with funicular‐like appearance along the superior ophthalmic veins requiring differentiation from CCF. Ophthalmologists should consider IgG4‐related eye diseases in cases with signs and symptoms of CCF and thyroid ophthalmopathy.
Human ex vivo model of iris angiogenesis
Authors: Andre H. , Pesce N. , Plastino F. , Kvanta A. 
Published: September 2017

PurposeTo assess iris angiogenesis using human explants and determine the role of hypoxia during iris neovascularization.MethodsHuman irises were isolated post‐mortem from human research consented donnors. Explants were seeded onto extracellular matrix (ECM), and kept at normal oxygen concentrations (normoxia, 20% O2) or exposed to hypoxia (1% O2) in standard tissue culture conditions for 48 h. Iris angiogenesis was analyzed by quantifying the neovascular area. Furthermore, iris neovascular structures were characterized by immunofluorescence.ResultsHuman iris ex vivo neoangiogenesis could be observed within 48 h after the explants were seeded onto ECM, and was defined as vascular sprouts and/or tufts. Vascular sprouts were more common in normoxia, while vascular tufts were mostly formed in hypoxia. A significant increase in vascular area was observed in irises exposed to hypoxia when compared to normoxia. Positive immunoreactivity to specific endothelial cell markers confirmed human iris neoangiogenesis ex vivo.ConclusionsOur data shows the first human ex vivo neoangiogenesis assay, using iris. The method here presented could have potential use in testing pro‐ and anti‐angiogenic drugs in an human ocular context.
Can optical coherence tomography be used in lacrimal gland imaging?
Authors: Mrazovac D. , Juri Mandic J. , Ivkic P.K. , Mandic K. , Jukic T. 
Published: September 2017

PurposeLacrimal gland is a serous gland, bi‐lobed in shape, situated superolateral to the eye. The gland continually secretes tears which moisten, lubricate and protect the surface of the eye. Excess tears drain into small ducts which empty into the nasal cavity. Even in healthy subjects, the palpebral lobe is seen through the conjunctiva when the upper eyelid is elevated. The structural features of lacrimal gland are usually analyzed with ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI). Purpose of this study was to explore the possibilities of the lacrimal gland imaging using optical coherence tomography.MethodsOur study included 10 healthy subjects, aged between 25 and 30 years. Images of the palpebral portion of the lacrimal gland were made using optical coherence tomography, anterior segment module. We have obtained B‐scans of the lacrimal gland, longitudinally and transversely to the exposed palpebral lobe. With the obtained images we analyzed structures of the lacrimal gland.ResultsIn this study we obtained photographs of the palpebral lobe of the lacrimal gland. We were able to identify conjunctiva, subconjunctival connective tissue, blood vessels, excretory ducts and glandular parenchyma.ConclusionsPreliminary results of our study show that optical coherence tomography offers a possibility of structural differentiation in attempt to analyse morphology of the lacrimal gland. With the development of modern technologies, such as OCT, analysis in vivo of ocular adnexa is placed directly into the domain of ophthalmologists, which, in cases of patients with systemic diseases, facilitates diagnostic process and treatment.
Multifocal electroretinogram and optical coherence tomography to evaluate parafoveal fixation
Authors: Vilades Palomar E. , Orduna Hospital E. , Ciprés M. , Obis J. , Rodrigo SanJuan M.J. , Satué M. , Garcia‐Martin E. 
Published: September 2017

PurposeSpatial resolution of the human visual field changes depending on the distance from the fovea and fixation point. The visual field is divided in three areas: foveal, parafoveal and peripheral. The highest visual acuity (AV) is obtainded at the foveal area, covering approximately 2 °, then parafoveal area covers 2 ° to 5 °, and the peripheral vision from 5 ° to the edge of the visual field, but the AV decreases progressively in each area .MethodsWe analyzed two cases of parafoveal fixation by SD‐Spectralis OCT (Heidelberg Engineering), Triton Swept‐Source OCT (Topcon) and multifocal electroretinogram (mfERG) with RetiPort / Scan (Roland Consult). The structure and function of retinal cells have been correlated using OCT images and the three‐dimensional map of mfERG.ResultsCase 1: Patient with 100% ETDRS VA equal to 0,0 in both eyes (OU), contrast sensitivity (CS) Pelli Robson 1,35 in right eye (OD) and 1,20 in left eye (OS), presents Parafoveal fixation <1º.Case 2: Patient with previous episode of optic neuritis in OD and parafoveal fixation of 3º in OS, which presents VA ETDRS 100% of 0.7 in OD and 0.1 in OS, CS PelliRobson of 1,05 in OD and 1,20 OS.Both cases present a reduced macular peak seen at the mfERG, and a fixation point out of the foveal at the OCT.ConclusionsWe can see how VA and CS decreases as the fixation eccentricity increases, as can be clearly seen in the three‐dimensional mfERG map. CS seems to be the quickest parameter to be affected.