bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of metabolic control in patients with refractory diabetic macular edema treated with Ozurdex
Authors: Sanchez Ramon A. , Lopez Galvez M.I. , Ortega Alonso E. , Hernandez Rodriguez R. , Portilla Blanco R.R. , Roberts I. , Zarzosa Martin E. 
Published: September 2017

PurposeTo analyze the relationship between glycemic, lipid, and blood pressure control following the American Diabetes Association(ADA) goals, and the response of refractory diabetic macular edema (DME)in patients treated with Ozurdex.MethodsA retrospective, descriptive and observational study was conducted on patients with refractory DME treated with Ozurdex® in the University Hospital of Burgos, Spain, between 2012 and 2015.Results21 patients were included. Almost all (95%) patients had type 2 diabetes mellitus (DM), and 81% were treated with insulin. The mean time of evolution of DM in this series was 16 years (± 12). The mean HbA1c was 7.22 ± 1.06. The mean initial best corrected visual acuity (BCVA) was 0.72 (log Mar ±0.33) and improved to 0.58 (log Mar ±0.31) after 6 months of follow up. The initial central macular thickness (CMT) was 506μ ±99, and a reduction to 384μ ±128 was observed after 6 months of follow up. Taking into account the overall metabolic control of the patient, a statistically significant difference was found in the improvement in BCVA after 3 months of follow up in patients with good metabolic control. A greater central macular thickness reduction was observed in patients with a better metabolic control at six months of follow up. This study also suggests that patients with an optimum HbA1c control have a tendency to achieve a better visual acuity after an Ozurdex implantation. No statistical differences were found between blood pressure and lipid parameters, and the anatomic or functional response to Ozurdex.ConclusionsOzurdex is an effective and safe treatment in the treatment of DME in patients that did not respond or poorly responded to other therapies. The overall metabolic control of the patient following the criteria of the ADA is related to the success of the treatment with Ozurdex.
The place of OCT‐angiography in uveitis
Authors: Khairallah M. , Khochtali S. , Abroug N. 
Published: September 2017

SummaryOptical coherence Tomography (OCT) angiography is a newly developed, dye‐less, imaging method that provides high‐resolution, depth‐resolved en face images of the retinal and choroidal microvasculature. OCT angiography has shown to be helpful in evaluating retinal vasculitis. It is better than fluorescein angiography in detecting perifoveal retinal ischemia and other microvascular changes. In such cases, the deep capillary plexus appears to be more severely involved than the superficial capillary plexus. On the other hand, OCT angiography may play a critical role in the differential diagnosis, evaluation, and monitoring of various choroidal inflammatory diseases involving the macula. It may show evidence of choroidal flow reduction. In these conditions, the choriocapillaris seems to be the primary site of a reversible or persistent ischemic process. OCT angiography is also useful for noninvasive detection of inflammatory choroidal neovasculization, and for monitoring of its response to therapy. Further studies are needed to definitely establish the role of OCT angiography in the diagnosis and management of retinal and choroidal inflammatory conditions and in assessing predictive factors for visual outcome.
The potential impact of new OCT technology for the measurement of ocular inflammation
Authors: Pichi F. 
Published: September 2017

SummaryOne of the greatest challenges when caring for patients with sight‐threatening uveitis is the lack of objective markers of disease activity, whether in the context of routine clinical practice (to direct treatment) or for use in clinical trials (to establish efficacy of new therapies and standardization of care). For example, the use of slit‐lamp microscopy to grade anterior chamber cells is quiet subjective, depending on the empirical ability of the grader, thus nowadays spectral domain‐OCT can be used to highlight cells in the anterior chamber, and new automated algorithm are being developed to measure the number of cells in a 3D volume scan.In the anterior segment the iris tissue bed would also be a desirable site to monitor the progression of acute anterior uveitis, in which it is well known that the iris vessels dilate. OCT angiography is a novel technique that uses motion‐contrast imaging to non‐invasively create depth‐resolved angiographic maps of the vasculature. As such, OCT angiography can be used to analyze the iris vasculature in acute anterior uveitis, and new software are available to isolate the iris vessels, create a 3D rendering and measure the vasculature volume.
New protein drugs for retinal diseases: Attributes, efficacy, and safety
Authors: Behar‐Cohen F. 
Published: September 2017

SummaryOne of the major challenge in the field of retina is to reduce the need for frequent re‐injections of proteins in the vitreous. Sustained release of proteins is the eye remains an unmet need. To prolong the duration of protein efficacy, higher doses are injected, carrying the risk of off target effects and toxicity. Solid non biodegradable implants, dispersed polymeric systems, micro‐pumps have been proposed. Gene therapy has also appears as an appealing strategy to produce secreted proteins. Beside viral vectors, non viral vectors are also developped with this purpose in mind. We will detail the advantages and drwabacks of each technology and present the latest development of ciliary muscle electroporation of plasmid encoding therapeutic proteins, from pre clinical development to first in man. The regulatory developement and safety issues will also be described.
Does ethnicity and foveal morphology play a role in the spatial distribution of macular pigment?
Authors: Ctori I. , Huntjens B. 
Published: September 2017

SummaryWhile macular pigment optical density typically follows an exponential decline with eccentricity from the fovea, atypical profiles have also been described, including reports of increased prevalence of ring‐like and central dip profiles among non‐white ethnicities. However, classification of macular pigment (MP) profile phenotypes varies and is often based on subjective visualisation. We present data showing that compared to visual assessment, objective MP profiling (taking into account measurement repeatability) is a more reliable method that should be considered in future observational and interventional studies. We will also describe ethnic variations in MP spatial distribution (among white, black and South Asian individuals) in relation to variations in foveal architecture, including data regarding individual retinal layers, foveal width and pit slope taken from SD‐OCT images. Our data suggests that although ethnicity explains around 10% of the variance in MP profile, gender plays no significant role. In addition, although white subjects demonstrate thicker retinal layers than non‐whites, the significant differences in the amount and distribution of MP between ethnicities is not explained by variations in foveal morphology.
Proteomic tools for studying RPE functions
Authors: Hongisto H. , Jylhä A. , Nättinen J. , Rieck J. , Ilmarinen T. , Veréb Z. , Aapola U. , Beuerman R. , Petrovski G. , Uusitalo H. , Skottman H. 
Published: September 2017

SummaryHuman embryonic stem cell‐derived retinal pigment epithelial cells (hESC‐RPE) provide a promising cell source for studying retinal development, for disease modelling, and retinal cell replacement therapies. Several research groups, including ours, have demonstrated that hESC‐RPE structure, function, and physiology resembles that of native RPE regarding cellular fine structure and expression of many RPE signature genes and proteins. To characterize the hESC‐RPE proteome in larger scale, we have compared hESC‐RPE protein expression to primary human RPE using isobaric tags for relative quantitation (iTRAQ) technology. The hESC‐RPE proteome reflected that of native RPE with a large number of metabolic, mitochondrial, cytoskeletal, and transport proteins expressed. No adverse signs such as increased stress, proliferation, or retinal degeneration‐related changes were seen in hESC‐RPE, while proteins involved in key RPE functions such as visual cycle and phagocytosis were detected. Proteomics provides valuable tools for validation of hESC‐RPE, studying disease mechanisms, and discovery of new biomarkers and therapeutic targets.
Towards a shared care model for stable diabetic retinopathy patients: a feasibility trial in Singapore
Authors: Mathur R. , de Korne D.F. , Wong T.Y. , Chiang P.P. , Wong E.Y. , Goh D. , Chakraborty B. , Nguyen H. , Wai C. , Tan D.H. , Lamoureux E.L. 
Published: September 2017

PurposeWhile diabetic retinopathy (DR) is a chronic disease, patients in Asian’ health care systems are often managed within hospital settings. Aim of this feasibility study is to assess the quality of care and economic benefits of a shared care model managing patients with stable DR in a primary eye care clinic (PEC) compared with a current tertiary specialist outpatient clinic (SOC) in Singapore.MethodsA randomized equivalence feasibility trial was performed, to compare a PEC with a SOC. The trial patients included those previously seen at the SOC, and having no DR or stable mild non proliferative (NPDR) with no macular edema, no visual and DR deterioration. Primary outcomes were clinical management. Secondary outcomes were patient satisfaction and cost of consultation. Differences analysis used equivalence testing and generalized odds ratios (GOR).ResultsThe trial included 231 patients, 83.1% classified as no DR (PEC: 79.1%; SOC: 87.1%) and 16.9% as stable mild NPDR (PEC: 20.9%; SOC: 12.9%). DR management at PEC was significantly equivalent to that received at the SOC (rate difference 2.56%; CI:(−1.61% to 6. 74%)) and 4.29%;CI: (0.14%–8.45%), respectively. Patient satisfaction at the PEC was high when compared to SOC (GOR: 1.71; CI: (0.50–2.00)). Direct costs per patient visit were 45% lower at PEC compared to SOC.ConclusionsOur feasibility trial showed that patients with no or stable DR receive similar clinical care and management at a lower‐cost PEC setting, are equally satisfied with the service compared to tertiary eye care. A follow‐up study is necessary to validate these findings. Managing stable DR patients at a PEC may be a safe and effective shared care model to improve accessibility for patients while enhancing professional collaboration between hospital and community settings.
Leber's hereditary optic neuropathy: the ophthalmologist point of view
Authors: Barboni P. 
Published: September 2017

SummaryLeber hereditary optic neuropathy (LHON) is a maternally inherited genetic disorder, associated to mitochondrial DNA mutations, with incomplete penetrance and variable expresivity, usually leading to large bilateral centrocecal scotomas in otherwise healthy young adults. The smaller‐caliber fibers of the papillomacular bundle are selectively lost at a very early stage of the pathologic process. Clinically, most patients with LHON go through pre‐symptomatic ophthalmoscopic changes before the acute phase, including peripapillary microangiopathy, small vessel tortuosity, swelling of the retinal nerve fiber layer (RNFL). Once the disease becomes symptomatic, the vascular changes increase with swelling of the superior and inferior fiber arcades and rapid loss of the papillomacular bundle. As the pathologic process progresses, temporal pallor may become evident. Then nerve fiber swelling decreases concomitantly with the extension of optic disc pallor toward complete atrophy; vascular changes follow a similar pattern. By 6 months after onset, optic atrophy is usually evident, and visual loss stabilizes. The chronic phase is reached by 1 year after onset.
MSand optic neuritis
Authors: Normando E.M. 
Published: September 2017

SummaryNeurodegenerative disorders such as Alzheimer Disease, Parkinson Disease and Multiple Sclerosis present ocular manifestations which could precede general signs and symptoms. This correlation between the eye and the brain has been confirmed by recent advances in imaging technologies. Hardware and software improvements have given the possibility of examining structures previously inaccessible. The assessments of these structures could lead to novel diagnostic and therapeutic approaches. The first objective of this SIS is to generate a multidisciplinary discussion between ophthalmologists and non‐eye experts; novel synergic approaches to neurodegenerative conditions will be discussed. The second objective is to explore the current application of retinal imaging in neurodegenerative diseases.
INFLIXIMAB and ADALIMUMAB in uveitic macular edema
Authors: Lejoyeux R. , Diwo E. , Vallet H. , Bodaghi B. , Le Hoang P. , Fardeau C. 
Published: September 2017

PurposeTo compare the efficacy of infliximab versus adalimumab for the treatment of uveitis related refractory macular edema (ME).MethodsWe included in this retrospective case series patients diagnosed with uveitis related refractory ME and treated with infliximab (IFX) or adalimumab (ADA) at Pitie Salpetriere hospital between 2006 and 2016. All patients were assessed including best corrected visual acuity (BCVA), clinical inflammatory parameters, multimodality imaging, fluorescein angiography, ICG and SD‐OCT. Central foveal thickness (CFT) and retinochoroidal architecture were analysed with SD‐OCT at baseline, 6 and 24 months after treatment initiation. Findings of patients treated with IFX were compared with those of patients treated with ADA. Success was defined as a decrease of more than 50 microns of CMT.ResultsTwelve patients with a mean age of 40 years and 13 patients with a mean age of 46 years were respectively treated with ADA and IFX. At baseline, the mean BCVA of ADA patients was 0.59 logMar ((0; 1,3); median=0,54; SD=0,41) and the mean BCVA of IFX patients was 1,01 logMar ((0,52; 1,3) mediane=1; SD=0,31). The mean CFT of ADA patients was 417μ ((247; 732); median=350; SD=171) and the mean CFT of IFX patients was 450.4μ ((202; 617); median=521; SD=145). Six of the 12 patients (50%) were sucessfully treated by ADA at 6 months, and 8 of the 13 patients (61%) treated by IFX were successful at 6 months. At 6 months, CFT median decreasing from baseline was 61 microns for ADA groupe [range: 17; 136] showing no significant difference vs 92 microns for IFX [9; 165] showing no significant difference (p=0,32).ConclusionsAnti TNF alpha therapy seems to be an efficient treatment at 6 month for uveitis related refractory macular edema. No difference in efficacy was observed between IFX and ADA.
Results from the SAKURA program: central retinal thickness changes with intravitreal sirolimus in subjects with non‐infectious uveitis of the posterior segment and macular edema at baseline
Authors: Bodaghi B. , White S. 
Published: September 2017

PurposeTo evaluate the effects of intravitreal (IVT) sirolimus on central retinal thickness (CRT) in subjects with non‐infectious uveitis of the posterior segment (NIU‐PS) with macular edema (ME) in the SAKURA program.MethodsThe SAKURA program consisted of two Phase 3 international, randomized, double‐masked studies evaluating the efficacy and safety of every‐other‐month IVT sirolimus in subjects with active NIU‐PS. Inclusion criteria included vitreous haze (VH) ≥1.5 + . Subjects from both studies comprised the integrated intent‐to‐treat population evaluating IVT sirolimus 440 μg (n = 208) vs 44 μg (active control; n = 208). Primary endpoint: VH=0 at Month 5 (M5). Change in CRT at M5 was assessed in subjects with baseline ME (CRT ≥300 μm).ResultsIn the integrated analysis, 21.2% vs 13.5% of subjects in the 440‐ vs 44‐μg groups achieved VH=0 at M5 (p = 0.038). 68 (32.7%) subjects in the 440‐μg group and 65 (31.3%) in the 44‐μg group had ME at baseline (mean CRT 501.65 μm and 507.89 μm, respectively). Of these, 19.1% and 12.3% in the 440‐ and 44‐μg groups, respectively, achieved VH=0 at M5 (p = 0.282). M5 CRT data were available for 47 and 51 subjects not rescued before M5 in the 440‐ and 44‐μg groups, respectively, with corresponding median % CRT changes from baseline of ‐20.6% and ‐15.5%. Median % CRT changes at M5 were greatest in subjects in the 440‐μg group without epiretinal membrane: ‐55.6% vs ‐2.3% in the 440‐ vs 44‐μg groups (p = 0.029). Serious ocular adverse events were reported in 14.9% and 14.3% of subjects with baseline ME in the 440‐ and 44‐μg groups, respectively.ConclusionsAn integrated analysis of the SAKURA program demonstrated that the mTOR inhibitor IVT sirolimus 440 μg can result in statistically significant improvements in VH in subjects with active NIU‐PS and can improve CRT in subjects with ME.
OCT angiography in ONH disease
Authors: Schmetterer L. 
Published: September 2017

SummaryOCT angiography is a technique that has attracted much interest over the recent years. The main application is in retinal disease such as diabetic retinopathy or age‐related macular degeneration. The technique has, however, also been applied to patients with optic nerve head disease such as glaucoma or optic neuropathies. This talk summarizes what has been achieved so far and highlight problems such as quantification of perfusion.
Updates on retinal imaging technology for screening and diagnosis
Authors: Wong T. , Schmetterer L. 
Published: September 2017

SummaryThere has been a revolution in retinal imaging, allowing better screening, diagnosis, risk stratification and management of diabetic retinopathy (DR), age‐related macular degeneration (AMD), and retinal vascular disorders. In terms of DR screening, current imaging techniques employ fundus photography and skilled readers for DR assessment. There has been development of automated retinal image analysis software such as deep learning techniques using artificial intelligence. Current screening programs also do not effectively screen for diabetic macular edema (DME). Optical coherence tomography (OCT) can potentially provide cost‐effective solutions for improving DME detection. New screening techniques to image the peripheral retina such as ultra‐widefield imaging offers further potential.For diagnosis and risk stratification, spectral domain OCT (SD‐OCT) and swept source OCT (SW‐OCT) are increasing used to diagnosis AMD, DME, and other conditions. Traditionally, FFA is used to evaluate AMD and DR. OCT angiography (OCT‐A) technology is a major advance that offers the opportunity to non‐invasively visualize different retinal capillary layers without injection of dye. OCT‐A is primed to replace FFA for most clinical scenarios.
Targeted NGS: an effective approach for molecular diagnosis of hereditary vitreoretinopathies
Authors: Burin des Roziers C. , Rothschild P.R. , Barjol A. , Clément C.A. , Edelson C. , Derrien S. , Metge F. , Michau S. , Robert M. , Prévot C. , Dollfus H. , Layet V. , Delphin N. , Bernardelli M. , Ghiotti T. , Hanein S. , Fourrage C. , Bonnefont J.P. , Rozet J.M. , Brézin A. , Caputo G. , Brémond‐Gignac D. , Valleix S. 
Published: September 2017

SummaryHereditary vitreoretinopathies (VRPs), traditionally divided into the groups of exudative and degenerative VRPs, encompass a number of diseases affecting the vitreous and the retina. These disorders are the commonest cause of inherited retinal detachment with high risk of vision loss during infancy. We designed a next generation sequencing (NGS) assay including ATOH7, COL2A1, COL9A1, COL9A2, COL9A3, COL11A1, COL18A1, FZD4, KCNJ13, KIF11, LOXL3, LRP5, NDP, TSPAN12, VCAN and ZNF408 allowing an exhaustive genetic screening with the most frequently mutated genes reported to be associated with all inherited VRPs. The diagnostic performance of this new design was evaluated on a cohort of 166 probands with a suspected clinical diagnosis of exudative or degenerative VRPs comprising 47% of children under 15 years old. We identified a large spectrum of causative mutations (single nucleotide changes as well as copy number variants) diagnosing molecular defects for 60% of the patients. Our NGS panel is therefore a promising screening method to be used efficiently in routine practice, able to detect a higher number of molecular defects than Sanger sequencing, improving significantly the molecular diagnosis of inherited VRPs.
Scleral lens as lifeline for dissatisfied patients after refractive reshaping corneal surgery
Authors: Mekki M.B. , Yahiaoui S. , Titah O. , Belaoudmou R. 
Published: September 2017

SummaryWe present our experience of scleral lens fitting after refractive failure of corneal reshaping surgery. 100 eyes of 90 patients unsatisfied after corneal reshaping surgery: Lasik (55), PKR (15), Radial keratotomy (10) and intra corneal ring segment implantation (20) are enrolled in this retrospective study. Visual acuity outcomes, quality of life using the contact lens impact quality of life (CLIQ) questionnaire and complications of scleral lens wear are discussed.
Revisiting corneal collagen crossliniking (CXL) safety: Evaluation of the effect of ultraviolet‐A (UVA) radiation on the retina with multifocal electroretinogram (mf‐ERG) and optical coherence tomography (OCT)
Authors: Lazaridis A. , Tsamassiotis S. , Besgen V. , Sekundo W. , Wenner Y. , Droutsas K. 
Published: September 2017

PurposeThe evaluation of the effect of UVA radiation on the photoreceptors after CXL.MethodsSeventeen eyes of 17 patients with keratoconus (n=15), pellucid marginal degeneration (n=1) and post‐LASIK ectasia (n=1), underwent CXL (Dresden protocol). The patients were examined preoperatively, at 2 and 6 weeks postoperatively with mf‐ERG and OCT. The P1 amplitude of the photoreceptor response was documented in 4 concentric rings, with ring 1 (R1) representing the foveal response and rings 2–4 (R2‐R4) corresponding to the successive annuli of stimulation. Uncorrected (UDVA) and corrected distance visual acuity (CDVA), corneal densitometry and central retinal thickness were also recorded.ResultsThe preoperative mean values of P1 amplitudes for the 4 rings were R1=109.96±28.96 nV/deg2, R2=49.8±14.46, R3=29.85±8.9 and R4=19.33±6.3. At 2 weeks after CXL these values were R1=77.54±24.47, R2=36.55±12.53, R3=21.53±7.71 and R4=15.3±6.13, showing a statistically significant reduction for all rings (P<.05). At 6 weeks postoperatively P1 amplitudes were R1=99.8±31.23, R2=40.67±16.39, R3=24.98±7.13 and R4=16.35±4.84, showing for each ring no significant differences compared to preoperative values (P>.05). Corneal densitometry increased to statistically significant level at 2 (P<.001) and 6 weeks (P<.001), demonstrating a weak negative correlation with the postoperative P1 amplitudes. UDVA and fovea thickness showed no significant changes at 2 and 6 weeks.ConclusionsThis is to our knowledge the first study assessing the photoreceptor response after CXL with the Dresden protocol. Although a temporary dysfunction of the photoreceptors the first postoperative weeks cannot be excluded, the increase of 6‐weeks‐P1 amplitudes at preoperative (physiologic) values confirms the safety standards of the duration and intensity of UVA radiation as proposed by the Dresden protocol.