bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optical imaging properties of multifocal IOL
Authors: Millán M.S. , Vega F. , Alba‐Bueno F. , Ríos‐López I. 
Published: September 2016

SummaryAn increasing demand of spectacle independence after cataract surgery or clear lens extraction has greatly stimulated the development of multifocal intraocular lenses (MIOLs). Optical design has played an essential role in this progress. Based on the principle of simultaneous vision, MIOLs overcome the loss of accommodation by providing at least two primary powers intended for distance and near vision. Diffraction‐based MIOLs have proved better optical performance than multizonal refractive MIOLs and accommodative IOLs. Some new designs of diffractive MIOLs attempt to direct light either to an intermediate focus location or to an extended focal segment for an improved visual acuity at intermediate distances. Although the patient primarily perceives the focused image, they can also experience disturbing visual phenomena, such as halos and glare. The optical imaging performance of MIOLs, as referred to some quality metrics, is assessed using in‐vitro as well as in‐vivo testing methods. This work reviews the objective imaging quality of a variety of MIOLs measured in an optical bench and compares the experimental results with those obtained in the clinical practice.
Use of OPA in ocular blood flow studies
Authors: Willekens K. , Van Keer K. , Vandewalle E. , Molenberghs G. , Pinto L.A. , Barbosa‐Breda J. , Stalmans I. 
Published: September 2016

SummaryThe ocular pulse amplitude (OPA) measured by dynamic contour tonometry is one of the vascular parameters often used in glaucoma research. Probably measuring the pressure wave caused by the shifting volume of blood inside the eye in accordance to the cardiac cycle, this measurement gives information about extra‐ as well as intraocular hemodynamics. The Leuven Eye Study (LES) is one of the largest studies investigating ocular blood flow in glaucoma combining several non‐invasive investigations like color Doppler imaging, enhanced depth imaging optical coherence tomography, oximetry and OPA. Three groups (primary open angle glaucoma – POAG, normal tension glaucoma ‐ NTG and healthy subjects) were selected from the database of the LES. The relationship between the OPA, choroidal thickness and retrobulbar blood flow was assessed and results were compared with recent findings in the literature.
Controversies between how to handle uveitis and glaucoma. The point of view of the uveitis specialist
Authors: Kestelyn P. 
Published: September 2016

SummaryUveitic glaucoma is often associated with high pressures and may damage the optic nerve faster than other forms of glaucoma. Therefore, early diagnosis and adequate treatment are essential. The key to successful treatment is an understanding of the pathogenetic mechanisms (secondary open‐angle, secondary angle closure, forward rotation of the ciliary body, etc.) Moreover, one should realize that combined mechanisms are more common in uveitic glaucoma than in other forms of glaucoma.Steroid‐induced pressure rise is common in uveitis patients and should be dealt with in a proper way: do not cut on steroids, but treat the glaucoma agressively. In those patients who have chronic uveitis and are steroid responders, surgery is a better option than medical treatment. Tubes are preferred over trabeculectomy with mitomycin in eyes with chronic inflammation.Contrary to some recommendations, prostaglandins should not be avoided in uveitis patients for fear of cystoid mcular oedema. They should be avoided however in uveitis of herpetic origin.
Applied genetic testing in ocular tumors
Authors: Coupland S. 
Published: September 2016

SummaryIncreasingly molecular pathology tests are being applied to ocular specimens, to aid the establishment of definitive diagnoses, to predict therapeutic responses, and to determine the prognoses in ocular oncology patients. This presentation will provide an overview of the most commonly used molecular tests in ocular oncology, outlining their strengths and weaknesses, and indicating when they are of appropriate use. The speaker will also provide recommendations for sample transport to the processing laboratory, in order to achieve best results in these often very small samples, and will explain how the reports are to be interpreted – when combined with morphological and immunophenotypical studies – for subsequent patient management.
Update on epidemiological evidence for an association between sun exposure and cataract
Authors: Wegener A. , Meyer L. 
Published: September 2016

SummaryThere is currently substantial evidence for an epidemiological association between long‐term daily sub‐threshold exposure of the eye to mid wavelength ultraviolet radiation (UVR) from the sun and cortical cataract. Initial observation of a potential association between exposure of the eye to UVR from the sun were limited to case reports in regions with abundant sun hrs. In the late 1900 cataract incidence was correlated to meterological recordings of intense exposure of UVR direct to the surface of the earth and lack of use use of spectacles. It was subsequently pointed out that the ocular exposure to UVR from the sun substantially depends on exposure of the eye to indirect UVR from the sun rather than direct, indicating that only meterological observations is not sufficient to establish an epidemiological association. This triggered attempts to make personal dose estimations based on both meterological observations and concomitant interviews of use of sun‐glasses, hats and behavior. An appropriate cross‐sectional case–control study with personal dose estimation and graded cataract measurement demonstrated an association between cortical cataract and intermediate UVR‐dose comparing Chesapeake Bay bay fishermen with mainland inhabitants in the same area in USA. A similar approach was later used in Australia and found a similar association. A Japanese group, using detailed monitoring of the distribution of light scattering in the lens demonstrated an association between incidence of lower nasal opacity in the lens and latitude spanning from the equator to Island. Later, a large number of epidemiological studies have confirmed an association between exposure to intermediate UVR and cortical cataract.
The view of the EGS and the subspecialty exam
Authors: Sunaric Megevand G. 
Published: September 2016

SummaryThis part of the SIS will deal with the question: ‘how do we define a glaucoma specialist today’.Since the creation in 1978, the EGS has been strongly involved in teaching and training glaucoma in Europe and worldwide. In order to implement the EGS mission statement for education: ‘Promotion of evidence‐based practice and life‐long learning through systematic, extensive and renewable training’ the EGS is constantly organizing and updating a large number of teaching‐learning activities; it hosts since 2007 a yearly 2‐day European Residents Glaucoma Course, gives travel support for 1‐year glaucoma fellowship program in leading European university hospitals, publishes and updates since 1998 the Terminology and Guidelines for Glaucoma, holds a biannual Glaucoma Congress and runs EBO‐accredited courses. While the EGS has not the authority to impose fellowship‐programs to different countries or institutions in Europe, it can set clear requirements and standards of knowledge that define a ‘glaucoma specialist’. Testing this knowledge by the EGS‐EBO subspecialty exam and providing the FEBOS diploma represents a logical continuation of the creation of sustainable education and glaucoma care within Europe.
Confocal microscopy findings in corneal dytrophies
Authors: Smedowski A. , Wylegala E. 
Published: September 2016

SummaryCorneal confocal microscopy in vivo is a diagnostic method that uses 670 nm laser beam to visualize the structures of the cornea with an accuracy of 1 μm and visualization of single cells with 63× magnification. Proper diagnosis of corneal diseases is often difficult. The use of confocal microscopy for the in vivo analysis of the microarchitecture of the cornea can provide rapid and highly specific differentiation of corneal pathologies.The aim of the course is to acquaint participants with the method – corneal confocal microscopy in vivo and to present its utility in diagnosis and management of corneal dystrophies. Course consists of description of epithelial‐basal membrane dystrophies, Bowman membrane dystrophies, stromal and endothelial dystrophies with respect to their typical histological features, differential diagnosis, evaluation and qualification for surgery and follow‐up with detection of possible recurrences and post‐surgical complications.
Retinal Oximetry and blood flow
Authors: Hudson C. , Rose K. , Kulasekara S. , Cheng R. , Wong B. 
Published: September 2016

SummaryThe retina has highest metabolic demand compared to any other tissue in the human body and regulation of the retinal blood flow, blood oxygen saturation (SO2) and thereby oxygen delivery (DO2) are crucial to preserve vision and function. The study reports inner retinal DO2 and consumption (VO2) during controlled and stable normoxia, hyperoxia and hypoxia in humans. Eleven subjects underwent measurement of total retinal blood flow (TRBF) and retinal blood oxygen saturation (SO2) using prototype methodologies of Doppler Spectral Domain Optical Coherence Tomography and Metabolic Hyperspectral Camera, respectively. TRBF decreased significantly (p = 0.010) from 43.17 μl/min (+12.7) to 36.23 μl/min (+4.6) during hyperoxia, conversely, TRBF increased significantly (p < 0.008) to 52.89 μl/min (+10.9) from baseline during hypoxia. The average inner retinal O2 delivery during normoxia was 8.48 mlO2/100 g/min and inner retinal consumption was 3.64 mlO2/100 g/min and these values changed during provocation to maintain a stable DO2 and VO2. Change in TRBF and SO2 reflect metabolic autoregulatory function of the retinal tissue indicating that retinal blood flow and SO2 are able to precisely compensate for changes in inspired oxygen.
Molecular genetics in ocular epidemiology
Authors: Den Hollander A. 
Published: September 2016

SummaryCommon ocular diseases, such age‐related macular degeneration (AMD), are often caused by a combination of genetic and environmental factors. Genome‐wide association studies (GWAS) can shed light on the disease pathogenesis and provide clues for treatment. GWAS have identified genetic variants at more than 40 genomic regions to be involved in AMD. The currently known risk factors have a moderate‐to‐high predictive value for AMD, with an area‐under‐the‐curve of 0.8–0.9. Based on the genes that have been identified, we now know that three main pathways are involved in AMD pathogenesis: the complement system, the lipid metabolism and the extracellular matrix. Higher levels of systemic complement activation have been detected in AMD patients compared to controls, which can partly be attributed to genetic variants in the complement system. Several antibodies targeting the complement pathway are currently in the clinical trial phase for AMD. In conclusion, AMD is a successful example of how genetic studies can lead to the development of new treatments, and such studies will also be valuable for understanding the disease mechanisms of other common ocular diseases.
Animal models for ocular gene therapies
Authors: Arsenijevic Y. , Kostic C. 
Published: September 2016

SummaryDisease‐causing variants of a large number of genes trigger inherited retinal degeneration leading to photoreceptor loss. Because cones are essential for daylight and central vision such as reading, mobility and face recognition, the presentation will focus on a variety of animal models for cone diseases. The pertinence of using these models to reveal genotype/phenotype correlations and to evaluate new therapeutic strategies will bediscussed. Interestingly, several large animal models recapitulate human diseases and can serve as a strong base to study the disease biology and to assess the scale‐up of new therapies. Examples of innovative approaches will be presented such as lentiviral‐based transgenesis in pigs. The models we will discuss permit to explore common mechanisms existing between different species and to highlight the pathways that may be specific to primates, including human.
Age‐related changes of cystatin C and effects on protein turnover in RPE cells
Authors: Paraoan L. 
Published: September 2016

SummaryEssential functions of the retinal pigment epithelium (RPE) rely on specific proteolysis processes that require efficient regulation both intra‐ and extracellularly. One of the most potent regulators of proteolysis, the cysteine proteinase inhibitor cystatin C, is among the top 2% abundantly expressed genes by RPE. The secretion profile of cystatin C in RPE cells suggests a role in relation to maintaining the structure and function of Bruch's membrane/choroid. Variant B cystatin C is associated with increased risk of developing exudative age‐related macular degeneration (AMD) and presents leader sequence‐related altered intracellular trafficking, leading to reduced efficiency of processing through the secretory pathway. The abundance of cystatin C is reduced with ageing in the macula region of the RPE/choroid and cystatin C expression and secretion are significantly decreased in response to the accumulation of advanced glycation end‐products (AGEs). Together the data point out to a likely role for the wild type cystatin C in regulating the proteolytic homeostasis in the retina/choroid, which is declining with age and the decline is accelerated in homozygous carriers of AMD‐associated variant B.
Lifetime Study in mice: 24 months follow up after low doses of ionizing radiation with Scheimpflug imaging and OCT
Authors: Dalke C. , Rößler U. , Neff F. , Greiter M. , Gomolka M. , Hornhardt S. , Garrett L. , Kunze S. , Unger K. , Rosemann M. , Kempf S.J. , Azimzadeh O. , Wurst W. , Aubele M. , Zitzelsberger H. , Hölter S.M. , Tapio S. , Hoeschen C. , Kulka U. , Atkinson M. , Graw J. 
Published: September 2016

SummaryAt the adult age of 10 weeks male and female hybrid mice (C57BL/6 × C3H F1) were acutely whole‐body irradiated with low doses of ionising radiation (0, 0.063, 0.125 and 0.5 Gy) using a 60Co source. Over the following 24 months the mice were examined monthly for lens opacities by Scheimpflug imaging and every four months for retinal effects by OCT (optical coherence tomography). To estimate the contribution of genetic effects, virtually healthy mice heterozygous for an Ercc2 mutation were compared to wild‐type mice of the same strain background.Additional groups of mice were sacrificed at various time points (4 and 24 h, 12, 18 and 24 months after irradiation) to investigate the underlying mechanisms of radiation‐induced effects on the eye and other organs. Histological and immunohistochemical analysis of the eyes are done.Even at the highest dose of 0.5 Gy, analysis of the Scheimpflug examinations in irradiated wild‐type mice did not show significant differences in lens opacity compared to the unirradiated control group or the heterozygous mutants up to 24 months after irradiation. OCT data showed a reduction of the retinal thickness in irradiated heterozygous mutants, but not in wild‐type mice.
Regulating gene expression towards solving ocular surface diseases
Authors: Moore T. , Atkinson S. , Maurizi E. , Schiroli D. , Mairs L. , Christie K. , McLean I. , Allen E. , Pedrioli D.L. , Moore J. , Nesbit A. 
Published: September 2016

SummaryTreatment of genetic eye disease poses significant medical and surgical challenges. We used a bioluminescent corneal reporter gene mouse model to assess efficacy and potency of a number of gene therapy approaches for corneal dystrophy. Various modalities were assessed for delivery of short interfering RNA (siRNA) targeting one of five mutant alleles present in the corneal bioluminescent mouse model enabling assessment of topical, subconjunctival and intrastromal delivery. Potent and sustained in vivo gene silencing >50% for up to 7 days was observed. This siRNA therapy only provides a transient silencing of the mutant allele, however, Type II Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/CRISPR‐associated nuclease 9 (Cas9) holds great promise to provide ‘one off’ permanent gene editing. Gene‐specific cleavage of the mutant allele, with DNA repair and frameshift mutations resulted in mutant allele knockout sustained over many weeks. Optimal delivery of our CRISPR system to all layers of the cornea was assessed. This gene editing treatment offers exciting potential for translation into clinical treatment for a wide range of genetic diseases of the eye.
Controversies between lymphoma and uveitis – the point of view of the neuro‐oncologist
Authors: Touitou V. , Houillier C. 
Published: September 2016

SummaryIt has been shown that elevated level of IL10 with an IL10/IL6 ratio greater than 1 is very evocative of Primary Vitreo Retinal Lymphoma (PVRL). However, other causes of uveitis can be accompanied with increased IL10 level, and on the other hand some pateints with PVRL may be characterized by normal levels of intraocular IL10 ((intraocular T‐cell lymphoma or subretinal lymphoma without vitreous infiltration). Currently, the decision to treat the patients cannot be based on the sole basis of increased IL10 level in aqueous humor. Systemic chemotherapy or radiation therapy can be associated with severe side effects, especially in elderly patients. In patients with a negative cytological analysis of the vietrous, the role of increased intraocular cytokines in the aqueous humor for the therapeutic decision is very debated and is currently not sufficient in order to confirm the diagnostic. However, the role of intraocular cytokine dosage in the aqueous humor to follow‐patients during and after treatment has to be discussed.
What limits normal visual performance in the dark?
Authors: Fitzke F.W. 
Published: September 2016

SummaryWhen patients describe difficulties in seeing in the dark we need to consider whether this refers to rod photoreceptor dysfunction and how this affects our vision. How can we reliably measure scotopic (rod mediated night) vision and what functional consequences would we expect from losses of scotopic vision? Are visual losses attributable to cell death of rod photoreceptors or to dysfunction of the Retinal Pigment Epithelium (RPE)? Since there are no rods in the central fovea we must consider the spatial distribution of rods, the contribution of the RPE and other factors on difficulties in seeing in the dark.
Mistakes in the diagnosis of children intraocular tumors
Authors: Cassoux N. 
Published: September 2016

SummaryThe first mistake is to consider normal a unilateral strabismus or a leucocoria in a baby or a child and don't performed a dilated funduscopy. Retinoblastoma is the first ocular tumor in childhood and often late diagnosed because professionals (pediatrician, GPs, or ophthalmologists) didn't believe parents that notice a white reflect in their kid's pupil. Clinically, on dilated fundus, one or more white tumors can be associated with exudative retinal detachment or subretinal or vitreal seedings. The disease can be unilateral or bilateral. Several forms can be more difficult to diagnosed (infiltrative retinoblastoma, inflammatory cellulitis associated with advanced retinoblastoma, neovascular glaucoma with buphtalmia associated with advanced retinoblastoma. The more frequent disorder that can stimulate retinoblastoma is coats disease especially in advanced forms, persistent hyperplastic primary vitreous, and other rare tumors (medulloepitheloima, leiomyoma or melanoma). The proper diagnosis can be done in referral centers with team trained to deal with these diseases and sometime with the help of US echography or MRI of the eye. In case of suspicion of ocular tumor, the child must be referred in emergency in a specialized center.
Intravitreal chemotherapy for intraocular lymphomas
Authors: Cassoux N. 
Published: September 2016

SummaryThe treatment of intra ocular lymphoma with methotrexate is currently used since a decade. The local treatment is effective but often suspensive. The most common dosage is 400 microg/0.1 ml twice a week for 4 weeks then once a week for 4 weeks then once a month. This treatment is not easy to monitor since there is no measurable mass into the eye. One option is to monitor the tumor response with the help of IL10 dosage in the anterior chamber regularly. The IL10 decrease is very well correlated to the decrease of tumoral cells into the eye. The controversy that remains is when to use this local treatment? Is it sufficient if the lymphoma is restricted to the eye? Or should we need to treat systemically the ocular involvement before the occurrence of cerebral tumor? If the patient is treated systemically but relapse only in the eye, the local treatment is a good option. To date there is no evidence based studies demonstrating that ocular lymphoma is better treated systemically or locally and this point remains controversial.
Fine needle aspiration biospy or not?
Authors: Cassoux N. 
Published: September 2016

SummaryThanks to the dramatic progress in the field of ophthalmic surgery (mini invasive surgery), sampling an eye is more and more used in ocular tumors. A biopsy can be done via a transcleral or transvitreal route to diagnosed difficult cases especially achromic ocular tumors. However, fine needle aspiration biopsy or biopsy with a vitrector handpiece is more and more used to stratified uveal melanoma patients into low risk, intermediate risk, and high risk of metastasis using genomic (using a‐CGA or MLPA) or gene expression profile (GEP). The biopsy can be done before irradiation or the last day of irradiation or after irradiation (during an endoresection of the tumor). Large series have shown that the procedure is safe and efficient. The main issue is to deal with the results since we don't have to date an effective treatment for metastatic patients. However, tumor prognostication is important to develop because there is a learning curve for surgeon and to establish a good collaboration with the histopathology or genetic laboratories and new molecules are in the pipe (targeted therapies, immunotherapies) to treat metastatic patients in a close future.
Treat and extend versus PRN in diabetic retinopathy
Authors: Pournaras C. 
Published: September 2016

SummaryVascular endothelial growth factor (VEGF) plays a key role in the pathogenesis of the neo‐vascular age related macular degeneration (nAMD) and the ischemic retinal microangiopathies. Targeting VEGF in retinal diseases became an effective therapeutic option.To optimize the benefit of risk ratio and cost effectiveness of anti‐VEGF agents, a number of flexible dosing strategies have being used in clinical practice.The treat and extend regiment (TE) is defined as an individualized proactive dosing regimen usually initiated by monthly injections until a maximal clinical response is observed, followed by increasing intervals between injections (and evaluations) depending on the disease activity. It appears as an effective approach to tailoring the dosing regimen and for reducing treatment visits and injections, compared with fixed monthly dosing or monthly visits with optical coherence tomography (PRN).The individualised anti‐VEGF TE regimen can improve and stabilise patient outcomes in diabetic macular oedema and nAMD. The potential to reduce healthcare resource burden incurred from fixed monitoring requirements, will be of benefit to health care, in the management of retinal diseases.