bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal bacterial infections: A practical approach
Authors: Gicquel J.J. 
Published: September 2017

SummaryBecause of their potential to permanently impair vision or perforate the eye, bacterial corneal ulcers are an ophthalmologic emergency. “ ey usually follow an insult (sometimes minor) in the corneal epithelium that provides an entry for bacteria. “ e increased use of soft contact lenses in recent years has led to an important rise in the occurrence of bacterial ulcers (especially aggressive Gram‐ bacteria). In this course you will learn about the new concepts in bacterial ulcers diagnosis and treatment.
Show me the money – funding opportunities for fellowships
Authors: Barbosa Breda J. 
Published: September 2017

SummaryIn a time when a fellowship can make a difference in a young ophthalmologist's curriculum, it is vital to know where to look for funding and plan ahead to be eligible for the opportunities.This talk will focus on potential sources for fellowship funding, providing links and information to attendees. It will cover both national and international funding sources, as well as an overview of specific funding for certain fields of Ophthalmology. Both research and clinical fellowships will be included in this overview.In the end, attendees are supposed to know where and when to look for funding opportunities.
Recurrent corneal erosions dystrophy (ERED) in a Finnish family is caused by a COL17A1 splice‐altering mutation
Authors: Turunen J. , Tuisku I. , Reetta‐Stiina J. , Kivelä T. 
Published: September 2017

PurposeThe epithelial recurrent erosion dystrophy (ERED) is a rare autosomal dominant corneal disease. Recently, mutations in collagen type XVII, alpha 1 (COL17A1) gene have been identified as the cause of ERED. Here we report a Finnish family with recurrent erosions with dominant inheritance pattern. We performed COL17A1 candidate gene sequencing.MethodsFive affected and five unaffected family members underwent standard ophthalmological examination, corneal topography, anterior segment optical coherence tomography and in vivo confocal microscopy. Next‐generation exome sequencing of peripheral blood was made in two of the affected individuals to identify mutations in the large COL17A1 gene. Sanger sequencing was used to verify the presence of the identified variant in the other family members.ResultsAffected patients reported recurrent corneal erosions beginning at the age of 4‐6 years. The frequency of erosions decreased in adult age. Corneal scarring and anterior stromal opacities were observed. The visual acuity slowly deteriorated. Exome‐sequencing revealed a synonymous splice‐altering variant c.3156C>T in COL17A1 in two affected patients. Sanger sequencing confirmed the presence of the same variant in four affected family members and its absence from two unaffected ones. The variant was not present in the Sequencing Initiative Suomi (SISu) database consisting of 10,490 Finns.ConclusionsThe variant c.3156C>T in COL17A1 is reported recently in five English, American, New Zealand, and Tasmanian families with ERED. Our finding of the same synonymous variant in yet another population strengthens the evidence this variant is a frequent cause of ERED.
Activity in eye surface sensory neurons is disturbed by inflammation, and vice versa
Authors: Gallar J. , Acosta M.C. 
Published: September 2017

SummaryOcular pain results from noxious stimulation of peripheral axons of functionally heterogeneous (Mechanonociceptors, polymodal nociceptors, and cold thermoreceptors) trigeminal ganglion neurons whose sensitivity to different stimulating agents depends on the expression of specific classes of membrane channels, evoking also different pain sensations.Inflammatory mediators increase the excitability (sensitization) of ocular polymodal nociceptors, enhancing pain sensations. In turn, excited polymodal nociceptors release locally neuropeptides, contributing to local inflammatory reaction (neurogenic inflammation). However, inflammatory mediators reduce the excitability of cold thermoreceptors.Regenerating nerve terminals damaged by ocular surgery, trauma, infections or systemic metabolic diseases, develop spontaneous activity and abnormal responses to natural stimulation, inducing changes in the experienced sensations (dysesthesia, neuropathic pain), and disturbances in tearing, blinking and ocular surface trophism. Besides, ocular tissues provide molecular signals that increase nerve regeneration.(Supported by ARREST‐BLINDNESS, GA No. 667400‐2, Horizon 2020‐EC, and in part by SAF2014‐54518‐C3‐1‐R, MINECO, Spain and FEDER‐EC)
The role of IL‐6 and IL‐6‐blockade in the pathogenesis and treatment of uveitic macular edema
Authors: Mesquida M. 
Published: September 2017

SummaryMacular edema (ME) is a leading cause of visual loss in uveitis patients. The pathogenesis of uveitic ME includes disruption of tight junction proteins and subsequent breakdown of the blood‐retinal barrier (BRB) that leads to accumulation of fluid within the macular retina. IL‐6 is a pro‐inflammatory cytokine that has been implicated in uveitic ME. Such a notion is supported by clinical cohort studies showing that IL‐6R blockade is beneficial in the treatment of uveitic ME. After studying the clinical efficacy of IL‐6 inhibition in uveitis patients, our group aimed to interrogate the effect of IL‐6 and its blockade with tocilizumab (TCZ) on the barrier properties of an in vitro model of the inner and outer BRB. Our preliminary in vitro data support the hypothesis that IL‐6 disrupts the BRB and contributes to the pathogenesis of ME. Indeed, IL‐6‐induced disrupted ZO‐1 expression was accompanied by an increase in paracellular permeability, and decreased transepitelial electrical resistance (TEER) of ARPE‐19 and human retinal microvascular endotelial cell (HRMEC) monolayers, whereas TCZ‐treated cells could restore IL‐6‐induced barrier disruption.
Clinical trials for inherited optic neuropathies
Authors: Karanjia R. , Poincenot L. , Sadun A.A. 
Published: September 2017

SummaryThe best scientific evidence for use of a clinical intervention is based upon data obtained from Phase III clinical trials. The robustness of a clinical trial is dependent on the quality of the metrics collected which in turn is dependent on the design of the study. Clinical trials involving inherited optic neuropathies such as Leber's Hereditary Optic Neuropathy (LHON) encounter some unique challenges which can be divided into two broad groups: patient‐centric factors and test‐centric factors. Patient‐centric factors include the heterogeneous phenotypic presentations in LHON with variable rates of spontaneous recovery and time to nadir and plateau. Test‐centric factors include the subjective nature of most visual metrics; intertest and intratest variability, which is compounded by patient adaptation to visual loss. Collectively these issues must be addressed when designing a clinical trial, especially in rare diseases where patient recruitment can be a challenge
Endophthalmitis: what role does vitrectomy play?
Authors: Rocha De Sousa A. , Mendonça C. , Alves‐Faria P. , Gouveia P. , Falcão M. , Falcão‐Reis F. 
Published: September 2017

PurposeTo evaluate predictors of visual outcome in a series of patients treated for postoperative endophthalmitis (PE) and analyze the role of therapeutic vitrectomy (TV).MethodsAll patients who were clinically diagnosed with endophthalmitis and underwent eye procedure less than six weeks before presentation were included. Visual acuity (VA) was assessed and intravitreal antibiotics administered at the time of diagnosis for all patients. Some of them underwent TV. Main outcomes were best VA after treatment and variation of VA.ResultsSixty‐one patients were included. Group of patients who underwent TV have a statistically significant greater proportion of patients with comorbidities (42.4% vs 17.9%) and median of VA after treatment was worse (2.1 LogMAR vs 0.5 LogMAR). Good VA, defined as ≤ 0.3 LogMAR, were reached only by 13 of 49 patients (26.5%). Presenting VA and performance of TV presented statistically significant differences in this analysis. On simple linear regression, we found that age, worse VA at diagnosis and the performance of TV were significantly associated to worse VA after treatment, and that longer time to the onset of symptoms and until TV are significantly associated with sorter variation of VA. Performing TV in the first 24 h after diagnosis presents a greater variation of VA than performing it after this time. After first 24 h, there seems to be increasingly worse outcomes with longer periods.ConclusionsOur findings are consistent with previous ones. TV should be done considering the overall clinical course and each patient's characteristics, but if it was the option, shouldn't be delayed
Portuguese prescription patterns of topical antibiotics in Ophthalmology: a yearlong analysis
Authors: Sousa D.C. , Leal I. , Nascimento N. , Abegão Pinto L. , Marques‐Neves C. 
Published: September 2017

PurposeScarce data is available regarding topical antibiotics prescribing patterns in Ophthalmology. We aimed to describe and analyze the nationwide prescription of these antimicrobials during the year of 2016.MethodsCross‐sectional study. A common electronic drug prescription system is used by all public or private hospitals and clinics in Portugal. We used this national database and included all the 2016 prescriptions of topical antibiotics used prophylactically or therapeutically in ophthalmology. Patients’ demographic data and medications prescribed were provided in an encrypted form and anonymously extracted. Results were stratified by region, physician specialty (ophthalmology vs. general practitioner) and public/private sector. Statistical analysis was performed using STATA v14.1.ResultsDuring 2016 in Portugal, a total of 458,638 topical antibiotic medications were prescribed to 324,683 different patients (47% male), corresponding to approximately 3.2% of the country population. Mean age was 46.4 ± 29.9 years. Of all prescriptions, 46.6% were from ophthalmologists, 31.9% from general practitioners and 11.3% from pediatricians. The most prescribed drugs were chloramphenicol (24.2%), ofloxacin (14.0%) and fusidic acid (9.0%). A similar rank was found in the public sector, but in private practice moxifloxacin was the third most prescribed. The prescription pattern was markedly different among the different country regions. Lastly, a seasonal effect is suggested, since more than 35% of the prescriptions were made from October to December.ConclusionsThis nationwide study revealed prescription's trends of topical antibiotic drugs in Portugal. These results might contribute for the development of a wiser use of antimicrobial drugs, thus promoting the best patient care and the whole system sustainability.
27 Gauge vitrectomy (pros & cons)
Authors: Stangos A. 
Published: September 2017

SummaryThe introduction of 23‐ and 25‐gauge systems was a game changer for vitreoretinal surgery. Recently, 27‐gauge systems have been commercialized. Only non‐complex cases would be suitable for surgery with the first generation 27‐gauge instrumentation. Recent enhacements however would allow the use of such systems even in very complex cases. In this special interest symposium we will discuss in depth the advantages and the limitations of 27‐gauge vitrectomy systems and ways to improve our outcomes.
Combined procedures
Authors: Pappas G. 
Published: September 2017

SummaryAimthe purpose of this presentation is to provide evidence for the necessity of combined vitrectomy and cataract removal in many casesMethodsWe reviewed the data of 850 phacovitrectomies performed under the same settings.ResultsWe evaluated and present the acceptance from the patients, the final outcome and the complications following the procedure. We will also present tips on how to achieve the best results.Conclusion: We will present the evidence to why we believe that phacovitrectomy is a easy, safe and necessary procedure
Conjunctival melanoma: association of cyclooxygenase‐2 tumour expression to prognosis
Authors: Pinto Proença R. , Santos M. , Fonseca C. , Fernandes J. , Gaspar M.F. , Proença R. 
Published: September 2017

PurposeConjunctival melanoma is a rare but potentially lethal tumour. Its biologic profile is still largely unknown, with recent studies aiming at establishing histopathological and genetic tumour profiles. The aim of this study was to analyse the association between clinicopathological characteristics and tumour expression of cyclooxygenase‐2 (COX‐2) to prognosis, assessing its usefulness as a possible prognostic marker.MethodsCase series of 50 patients from 1991 to 2008 with pathologically proven conjunctival melanoma. Demographic, clinical and pathological characteristics were evaluated by reviewing clinical files and pathology. Expression of COX‐2 was studied by immunohistochemistry of formalin‐fixed paraffin‐embedded tissue samples of 20 melanomas. Samples were classified in a score which included intensity of staining and percentage of cells with positive reactivity.ResultsClinicopathological features significantly associated (p < .05) with a poor prognosis (death) included involvement of fornix and tarsal conjunctiva, tumour thickness exceeding 2 mm, local tumour recurrence, lymph node and systemic metastasis. In the immunohistochemistry study (n = 20) all cases expressed COX‐2 although with different scores. However, only cases with score 4 were associated with a poor outcome. Multivariate association analysis revealed that recurrence rate, metastasis, corneal invasion and tumour thickness were associated with score 4 cases and, therefore, with a clinical profile with a higher risk of death.ConclusionsResults suggest that higher COX‐2 expression may be a negative prognostic factor in conjunctival melanoma. Further studies can address the potential use of anti‐COX‐2 drugs as adjuvant therapy of this disease.
Update in topical ciclosporine in VKC
Authors: Bremond‐Gignac D. 
Published: September 2017

SummarySevere allergic conjunctivitis in children may be severe causing loss of quality of life and visual impairment. Vernal keratoconjunctivitis and atopic keratoconjunctivitis are rare diseases but must be distinguished because of their evolution. Imaging of these diseases and systemic treatment are reviewed and developed. An overview of the innovating diagnosis, new imaging techniques and treatment is summarized for a better comprehension of severe allergic ocular surface diseases.
Posterior polymorphous corneal dystrophy; novel clinical and molecular genetic insights
Authors: Liskova P. 
Published: September 2017

SummaryPosterior polymorphous corneal dystrophy (PPCD) is a rare disorder inherited as an autosomal dominant trait. The general prevalence is unknown except for within the Czech Republic, where patients with PPCD have been systematically followed for decades. Currently there are over 125 living patients, leading to an estimated prevalence 1 affected individual per 80,000 inhabitants. Based on molecular genetic findings there are three subtypes recognized (PPCD1‐PPCD3). Recently OVOL2 promoter mutations have been discovered as causing PPCD1. As there is mutual inhibition relationship between OVOL2 and epithelial‐to‐mesenchymal (EMT) transition inducer ZEB1, encoded by an established gene implicated in the development of PPCD3, the disease mechanism seems to lie in imbalance of transcription factors involved in EMT. Clinically, individuals with PPCD3 typically show in comparison to PPCD1 patients abnormal corneal steepening and lower incidence of secondary glaucoma and necessity for corneal grafting. Supported by GACR 17‐12355S.
Tuberculosis
Authors: Khairallah M. , Khochtali S. , Mahmoud A. , Ben Amor H. 
Published: September 2017

SummaryThe diagnosis of intraocular tuberculosis (TB) is often presumptive, made on the basis of suggestive ocular features, evidence of latent or manifest TB, exclusion of other causes of uveitis, and positive response to antitubercular treatment (ATT). The most typical features include serpiginous‐like choroiditis and occlusive retinal vasculitis. When the posterior segment is involved, treatment relies on ATT, usually in association with systemic or periocular corticosteroids. Patients should be monitored for response of inflammation to treatment, recurrences, adherence to ATT and treatment side‐effects. Clinical assessment of ocular TB at presentation and during follow‐up includes grading of vitreous haze, characterization of choroidal involvement, retinal vascular involvement and optic disc changes, and evaluation of anterior chamber cells and flare. Laser flare photometry may be used to monitor anterior chamber inflammation. Ocular imaging tests including fundus autofluorescence, fluorescein angiography, indocyanine green angiography, SD and EDI optical coherence tomography (OCT), and OCT angiography may be very useful in analyzing and quantifying specific TB retinal and choroidal changes.
Acanthamoeba keratitis – pKP versus conservative treatment in a 20‐year follow‐up study
Authors: Fuchsluger T. , Scheumann A. , Roth A. , Klammann A. , Geerling G. 
Published: September 2017

SummaryThis presentation reports data from conservative versus surgical treatment of acanthamoeba cases collected at Dusseldorf University Eye Hospital over the last 20 years.
Prevention of selenite‐induced cataractogenesis by sildenafil in rats
Authors: Atalay H.T. , Üçgül A.Y. , Özel Türkçü Ü. , Özmen M.C. , Yılmaz N.S. , Bilgihan A. 
Published: September 2017

PurposeTo evaluate the effect of sildenafil on selenite‐induced cataract formation in a rat model.MethodsTwenty‐six Wistar rat pups were divided into four groups. Seven pups received only selenite on postpartum day 10 (group 1), 7 pups received selenite and additional high dose sildenafil on postpartum day 10 (group 2), 6 pups received selenite and additional low dose sildenafil on postpartum day 10 (group 3), and 6 pups received only saline (group 4, control). All pups were examined for the presence of cataract under the microscope, starting from the day their eyes opened. Nitrite oxide metabolites, advanced oxidation protein products and total sulfhydryl levels were evaluated in both serum and lenticular samples.ResultsIn group 3, the extent of lens opacification was significantly less than that of selenite‐injected untreated rats (group 1) (p < 0.05). None of the rats in group 4 developed any lens opacity. In lenticular samples, nitrite oxide metabolites level was statistically lower in group 3 compared to group 1 (p < 0.05). In serum, advanced oxidation protein products and total sulfhydryl levels was statistically lower in group 3 compared to group 1 (p < 0.05).ConclusionsLow dose sildenafil appears to inhibit selenite‐induced cataractogenesis in the rat model, and this seems to be caused by the prevention of oxidative damage.
Ocular inflammation as a motor for axonal regeneration in the optic nerve
Authors: Fischer D. 
Published: September 2017

SummaryRetinal ganglion cells (RGCs) normally fail to regenerate injured axons and die upon axotomy. However, induction of intraocular inflammation (IS), which is associated with an activation of retinal astrocytes and microglia transforms RGCs into a regenerative state. It delays neuronal degeneration and enables axon growth into the injured nerve. CNTF, LIF and IL‐6 released from retinal astrocytes have been shown to be critical for this stimulation. However, the role of microglia has not yet been investigated in this context. Using a pharmacological approach based on CSF1R inhibition we show that almost all microglia are eliminated in murine retinae and optic nerves without affecting peripheral monocytes/macrophages or other cells of the visual system. We surprisingly found that the time course and extent of RGC degeneration after optic nerve crush remained unaffected despite the presence of apoptotic RGC remnants after microglia depletion. In addition, microglia depletion neither affected the induction of regeneration associated genes upon optic nerve injury nor the increased regenerative potential of RGCs upon IS. Thus, microglia are not essentially involved in RGC degeneration or axonal regeneration after acute optic nerve injury.
Absence of nuclear Programmed cell death 4 as an indicator of poor prognosis in uveal melanoma patients
Authors: Ahmed I. , Kalirai H. , Angi M. , Coupland S. 
Published: September 2017

PurposeUveal melanoma (UM) is the most frequently occurring intraocular malignancy in adults. Arising from the uncontrolled proliferation of melanocytes in the choroid, ciliary body and iris, UMs have a strong propensity to metastasise to the liver, where they are fatal. In a previous study, proteomic examination of UMs at either a high or low risk of developing metastasis identified the down regulation of Programmed Cell Death 4 (PDCD4) levels with increasing metastatic risk.MethodsThis study examined PDCD4 protein expression and subcellular localisation in UM patient samples by immunohistochemistry (IHC). 165 primary (PUM) and 18 metastatic UM (MUM) samples with full clinical, histological and genetic data were included in the study. Slides were assessed and scored according to (A) percentage of tumour cells with cytoplasmic PDCD4 expression; (B) intensity of cytoplasmic staining and (C) percentage of PDCD4 positive tumour nuclei.ResultsIn PUM and MUM samples, PDCD4 was localised primarily to the cytoplasm. An equal percentage of primary and metastatic samples expressed nuclear PDCD4 (28%). Loss of nuclear PDCD4 was strongly associated with factors associated with a poor prognosis, in particular, monosomy 3 (p = 0.014) and loss of nuclear BAP1 (p = 0.012). PUMs with nuclear PDCD4 in ≥10% of tumour cells had an improved survival time compared with PUMs with <10% nuclear expression of PDCD4 (p = 0.105).ConclusionsThe tumour suppressor PDCD4 shuttles between the nucleus and cytoplasm to exert its effects in normal cells. In PUM samples, an absence of nuclear PDCD4 localisation was associated with a poor outcome. Further functional studies are necessary to determine how PDCD4 localisation influences UM cell behaviour.
Primary mitochondrial optic neuropathies
Authors: Barboni P. 
Published: September 2017

SummaryPrimary mitochondrial optic neuropathies are a genetically heterogeneous group of conditions, with autosomal dominat, recessive, X‐Linked and mitochondrial inheritance. These optic neuropathies are usually caracterized by bilateral, symmetrical, painless reduced visual acuity, color vision defects, central or centro‐caecal scotoma and optic disc pallor. The dominant (dominant optic atrophy, DOA) and the mitochondrial forms (Leber's hereditary optic neuropathy, LHON) are the commonest. The most frequent gene mutation responsable for DOA is the OPA1. OPA 1 is also associated with the allelic condition syndromic dominant optic atrophy, DOA+ syndrome.
Chronic progressive external ophthalmoplegia
Authors: Yu‐Wai‐Man P. 
Published: September 2017

SummaryChronic progressive external ophthalmoplegia (CPEO) is a slowly progressive extraocular muscle disorder characterized by bilateral, usually symmetrical, limitation of eye movements and ptosis. This classical manifestation of mitochondrial disease can develop either in isolation or more frequently, in association with other multisystemic features (CPEO plus). An expanding list of nuclear‐encoded mitochondrial genes is now known to cause CPEO phenotypes, predominantly in the context of multiple mitochondrial DNA (mtDNA) deletions, but also as part of mtDNA depletion syndromes. This genetic heterogeneity can result in diagnostic delays, which is further compounded by the clinical challenges inherent in distinguishing CPEO from other disorders that also present with external ophthalmoplegia and ptosis. Corrective ptosis surgery can be a highly effective treatment and alleviating symptoms of diplopia can make a significant difference to the patient's quality of life.