bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eye of Horus
Authors: Grzybowski A. 
Published: September 2017

SummaryHorus was the Egyptian god of light, the son of Osiris and Isis. He was regarded as the rising sun, born afresh daily and the symbol of renewed life. In cultures that practiced magic eyes were the symbol of great importance. The ability to see enables to experience and explore the surrounding world and interact with it. In ancient cultures stars especially the sun and the moon were called the eyes of heaven. The sun was the face or eye of Indian solar deity Surja, the eye of German deity Odin or Iranian deity Ahuramazda. The right eye of Egyptian God Horus represents the sun, left eye the moon. In The “Book of the Dead” (around 1500 B.C.) which is a collection of spells which enable the soul of the deceased to navigate the afterlife, it is written: the eye of god Horus gives eternal life and protects me when it is closed”. The eye of god Horus became the symbol of the power of healing and revival. It was believed that a talisman representing the eye of Horus has the power to protect from charm and therefore was used by witch doctors for healing session and during funeral ceremonies.
Ocriplasmin in the treatment of vitreomacular traction – against
Authors: Zambarakji H. 
Published: September 2017

SummaryOcriplasmin is an enzyme that dissolves vitreal proteins as well as possibly proteins associated with visual function in the retina, choroid, and lens. The MIVI trials concluded that intravitreal Ocriplasmin was superior to an injection of placebo in altering the vitreoretinal interface of affected eyes, although it was accompanied by some, mainly transient, ocular adverse events. There are anecdotal reports of adverse events as well as early reports in the literature of previously unreported side effects, such as enlargement of the macular hole, zonular instability, and localised non‐rhegmatogenous retinal detachment. A recent BEAVRS survey in the UK reported lower macular hole closure rates and higher than expected adverse events. Furthermore, there have been conflicting views on the safety of Ocriplasmin with changes in the ellipsoid zone seen on OCT and changes seen on ERG indicating photoreceptor damage. The practical question asked by the retina specialist is the following: observe, inject or operate? Increased numbers of real world experience with Ocriplasmin and post marketing surveillance studies are needed.
Anti‐VEGF intravitreal injections in the management of radiation maculopathy ‐ for
Authors: Sagoo M. 
Published: September 2017

SummaryRadiation maculopathy is a sight threatening complication of radiation treatments for tumours of the eye and surrounding tissues. Many treatments have been tried for radiation maculopathy to variable success and the choice of agent depends on a judgement of risk to benefit. The use of lasers and steroids has become less prominent in recent years. Current first line has become anti‐VEGF injections, after the success in other macular disorders that are prone to neovascular or exudative vasculopathy. Large prospective and retrospective series and case controlled studies show efficacy in maintaining or improving visual acuity and reducing the extent of macular edema. In addition, the preventive use of anti‐VEGF injections will also be discussed.
Effects of docosahexaenoic acid on the viability of human tenon's fibroblasts
Authors: De Lazzer A. , Acar N. , Bretillon L. , Bron A.M. , Creuzot Garcher C. 
Published: September 2017

PurposeExcessive scarring of the conjunctiva is the major cause of failure of the surgical treatment for glaucoma. The activation of human Tenon's fibroblast (HTFs) is supposed to be responsible for wound healing and scar formation. Antimetabolites are used to inhibit subconjunctival fibrosis but these molecules may lead to serious complication. Previous studies have shown that omega‐3 polyunsaturated fatty acids (PUFAs) such as docosahexaenoic acid (DHA) have anti‐inflammatory, anti‐proliferative and anti‐angiogenic properties. The aims of this study were to evaluate DHA as a potential inhibitor of human Tenon's fibroblasts.MethodsPrimary HTF cells were obtained from patients during glaucoma surgery and were cultured in DMEM medium. After stimulation with TGF‐β2, HTFs were treated with MMC (0.01 mg/mL) and different concentrations of DHA (50, 100 and 200 μM) for 48 hours. Lipid profile of HTFs was determined by gas chromatography, cell proliferation by Ki67 assay, cell migration was evaluated by videomicroscopy and cell toxicity by MTT assay. The expression α‐SMactin and MAPK p38, ERK, JNK in their non‐phosphorylated and phosphorylated forms was determined by western blotting.ResultsMMC reduced proliferation, migration compared to control but showed important toxicity suggested by the increased respiratory rate of mitochondrie in cytotoxicity assay and confirmed by a G2 arrest in cell cycle. DHA had no significant impact on cellular viability. DHA at 200 μM showed an efficacity similar to MMC. A reduction of the ability of cells to migrate was observed with DHA in a dose‐dependent manner. DHA efficiently dicreased α‐SMactin expression of myofibroblasts. Proteins from the Smad signaling pathway could not be observed.ConclusionsThese findings indicate that DHA inhibits migration and differentiation of HTFs to myofibroblats.
Effects of Caveolin‐1 ablation in the inner retina under healthy and experimental glaucoma conditions
Authors: Abbasi M. , Gupta V. , Dheer Y. , Joseph C. , Vanderwall R. , Graham S.L. 
Published: September 2017

PurposeVariations in Caveolin1/2 (Cav1/2) gene loci has been identified a risk factor in glaucoma. Cav‐1 is the prominent signature protein of caveola and is implicated in various signal transduction pathways. Cav‐1 ablation has previously been shown to impair the retinal function and our study established that it is involved in regulation of BDNF/TrkB signalling in the retinal ganglion cells. This study aimed to investigate the role of Cav‐1 specifically in the inner retina in both healthy and experimental glaucoma conditions.MethodsCav‐1−/− and the age matched wildtype mice were used in the study (n = 32). Experimental glaucoma model was generated by weekly intracameral microbead injections to induce high intraocular pressure (IOP) for 2 months. Retinal functional changes were assessed by electroretinogram (ERG) and positive scotopic threshold response (pSTR) recordings. H&E staining carried out on retinal sections to evaluate histological differences in retinal laminar structure.ResultsCav‐1−/− mice showed significantly lower pSTR amplitudes when compared with WT mice (n = 18, p < 0.05). ERG amplitudes in Cav‐1−/− were smaller than WT mice as reported previously. Following 2 months of elevated IOP (Control, 10.81 ± 0.4; High IOP 25.71 ± 3.2 mmHg), WT mice demonstrated a significant decrease in pSTR amplitudes (n = 8, p < 0.05) while the Cav‐1−/− mice showed a less fall in the pSTR. Histological assessment of glaucomatous retinas also revealed significantly greater decrease in the number of cells in ganglion cell layer in WT compared to Cav‐1−/− mice (n = 16, p < 0.05).ConclusionsCav‐1 plays a critical role in the maintenance of inner retinal integrity under normal conditions. Cav‐1 ablation was associated with functional and structural protection of the inner retina under chronically elevated IOP conditions.
Aqueous inflammatory proteasome in open angle glaucoma in Caucasian patients
Authors: Pantalon A. , Feraru C. , Constantinescu D. 
Published: September 2017

PurposePrimary open‐angle glaucoma is characterized by loss of retinal ganglion cells and their axons, resulting in optic nerve cupping and visual field loss. Until now, no specific cause was attributed to POAG development, but multiple pathogenic theories have been approached, beside IOP elevation and aging.The aim of this study was to assess the inflammatory and immune dysregulation theory in POAG.MethodsWe included in a cross‐sectional study 40 eyes, from 40 patients: 16 eyes with POAG and 24 eyes from healthy subjects. Aqueous was collected during conventional cataract surgery. 21 inflammatory markers were quantified and compared between groups using a Luminex® Performance Assay multiplex kit based on flowcytometric methods.ResultsMean age in POAG group was 75.69 ± 5.54 years vs 72.33 ± 11.26 years in controls (p = 0.23). Mean IOP in healthy controls was 14.21 ± 2.68 mmHg compared to 18.19 ± 4.3 mmHg in glaucoma patients, controlled by 3 ± 0.87 topical substances. Mean MD level in POAG group was ‐13.59+/‐9.35 dB, whereas PSD mean level was 4.25 ± 4.22dB. Cytokines expression in glaucoma patients compared to healthy controls was found significantly different for CXCL5 (p = 0.008), CXCL8 (p = 0.048), IL‐1α (p = 0.005), IL‐2 (p = 0.015) and TNFα (p = 0.041). Therefore, a prediction statistical model for these cytokines was created. All markers point out a common inflammatory pathway that triggeres TNFα release. A mathematical model proved that CXCL5, CXCL8, IL‐1α and IL‐2 can accurately predict TNFα level in this study (r square = 0.842, p = 0.000).ConclusionsOur results show that in POAG patients there is an increased production of inflammatory cytokines in aquoeous humor. Moreover our statistical predictions point out TNFα molecule and its signalling pathways as the determinant pathogenic pathway involved in the inflammatory compound of POAG caucasian patients.
Association of apolipoprotein E with a risk of primary open‐angle glaucoma
Authors: Szaflik J.P. , Nowak A. , Rozpędek W. , Siwak M. , Szymanek K. , Szaflik M. , Szaflik J. , Majsterek I. 
Published: September 2017

PurposeGlaucoma is classified as a neurodegenerative disorders. It is characterized by loss of retinal ganglion cell (RGC) and changes in the structure of the optic nerve. The exact mechanism of RGC death is multifactorial and unclear. Many reports have focused on the possible role of apolipoprotein E (APOE) in the development risk of glaucoma.MethodsThe study involved 30 patients with primary open‐angle glaucoma (POAG) and 30 age‐matched healthy subjects. Material for the study was the whole blood and the aqueous humor. The main goal of this study was to assess the expression level of APOE in whole blood and serum of patients with POAG compared with a control subjects without glaucoma. Moreover, we evaluated the expression level of APOE protein in the aqueous humor in POAG patients. The level of mRNA expression was determined by QRT‐PCR and the protein level was evaluated by ELISA. The statistical analysis was performed using the non‐parametric Mann‐Whitney U test.ResultsThe results of APOE mRNA expression level in the blood have shown no statistical differences between POAG patients and control subjects (p > 0.05). However, the analysis of protein level in the serum has showed a higher expression of APOE of POAG patients compared with the control group (p ≤ 0.05; 5106.07 ng/ml vs 4294.70 ng/ml). Additionally, we have observed a tendency to increase in concentration of APOE in the aqueous humor in POAG patients (262.12 ng/ml) compared with controls (173.83 ng/ml).ConclusionsOur research suggests that altered level of APOE may be related to the development of primary open angle glaucoma.
Surgical treatment of Persistent Fetal Vasculature (PFV)
Authors: Lytvynchuk L. , Lorenz B. 
Published: September 2017

PurposePersistent fetal vasculature (PFV), or persistent hyperplastic primary vitreous (PHPV), is a congenital ocular disorder caused by incomplete regression of the embryonic hyaloid vasculature (associated with cataract and glaucoma). Our aim is to overview primary surgical approaches in treatment of PFV with anterior disease based on literature review and two consecutive cases.MethodsReview of published cohort studies and case reports was performed with PubMed Search engine (keywords: PFV, PHPV, lensectomy, vitrectomy, anterior disease). Two consecutive cases of unilateral PFV with anterior disease treated with lensectomy and vitrectomy were analyzed regarding surgery timing and surgical steps.ResultsLiterature review showed limited follow‐up (mean 22–76 months) in cohort studies, as well as variation of timing, surgical approaches, and correction of aphakia. During surgery protection of corneal endothelium, removal of capsular remnants and endodiathermy of the hyaloid artery are critical.ConclusionsTiming of primary surgery in PFV and proper surgical intervention are crucial for the best visual outcome possible. Postoperative period has to include thorough monitoring of intraocular pressure and amblyopia treatment.
Glaucoma Drainage Device (tube) surgery ‐ what I learned from my first 20 cases
Authors: Anand N. 
Published: September 2017

SummaryMany glaucoma sub‐specialists undergo intense fellowship training before embarking on independent practice but no experience specifically prepares you for the first months of your solo career. Additionally, tube surgery may not be ubiquitously used and competition from more traditional surgeries (e.g. trabeculectomy) and Micro‐incisional Glaucoma Surgery (MIGS) can result in limited exposure to GDI surgery during the course of fellowships and insecurities when performing the first few cases independently. This part of the SIS will provide expert tips and genuine advice from young glaucoma consultants from across Europe who will share videos and experiences from their first few cases as solo glaucoma specialists. This will include tips on preventing and handling complications, the sharing of lessons and pitfalls to be expected, specific advice on how to handle complications and pearls on how to safely teach residents and fellows.
Ab interno glaucoma surgery ‐ what I learned from my first 20 cases
Authors: Au L. 
Published: September 2017

SummaryThere are many abinternal glaucoma procedure nowadays, ranging from schlemm canal stenting to goniotomy; from suprachoroidal stenting to endoscopic cycloablation. Most of these procedure requires the use of intraoperative gonioscopy which is often a new skill for glaucoma specialist. this talk would focus of tips and tricks in acquiring accurate and reproducible intraoperative gonioscopy, methods to highlight schlemm canal and aids to help identify angle structures. It'd cover the techniques of istent, Hydrus stent, goniotomy with KDB knife, abinternal canaloplasty as well as Cypass suprachoroidal stenting. Careful case selection would be discussed to maximise surgical success and minimise risk and complications.
Falls re‐audit
Authors: Manzar H. , Sheriff I. , Yusuf A. , Igwe C. , McIntosh D. , O'Sullivan E. , Kailani O. 
Published: September 2017

PurposeThe economic burden and health consequences of falls are underestimated. Forty per cent of over 65 year olds will fall at least once each year, with half of these having multiple episodes. Visual impairment is common in the elderly and is associated with a higher falls risk. NICE recommends visual testing as part of a ‘multifactorial falls risk assessment’. However, during a recent audit on three elderly care wards at a central London teaching hospital, only 11% of patients who presented with a fall had visual assessment during their admission.MethodsA series of interventions were delivered in December 2016 to ‘Educate, Equip, and Emphasise’ clinicians. These included displaying posters on the wards, checking whether bedside equipment e.g. Snellen charts were available and facilitating replacement if missing, and a teaching presentation delivered to the elderly care team. A re‐audit was performed in February 2017 to ‘close the audit loop’.ResultsIn this cross‐sectional re‐audit, 9/64 of patients on the three wards (14%) originally presented with a fall (mean age 85.9 years; 6 were female; 3 were aided (i.e. used spectacles). 9/9 (100%) were visually impaired (best corrected visual acuity ≤ 6/12), most to a significant degree, however 0/9 (0%) had an assessment of vision during their admission. None of these patients were known to ophthalmic services previously.ConclusionsThe interventions were shown to be unsuccessful in improving adherence to guidelines. This highlights the need for awareness of the association between visual impairment and falls, and suggests education in training programmes may be necessary. The small sample size is a limitation to extrapolating the results on a national scale. Visual assessment and prompt referral to the eye clinic when necessary may prevent patients having future falls and readmissions to hospital.
Optical coherence tomography angiography in retinitis pigmentosa
Authors: Hassairi A. , Falfoul Y. , Matri K. , Ben Lassoued O. , Chebil A. , El Matri L. 
Published: September 2017

PurposeThe aim of this study is to describe macular vascular abnormalities in patients affected by retinitis pigmentosa using Optical coherence tomography angiography (OCT‐A).MethodsPatients with a clinical diagnosis of retinitis pigmentosa underwent 3 × 3 Swept Source OCT‐A scans using a Swept‐Source DRI OCT Triton (Topcon Corporation, Japan). Scans with artifacts were excluded. Retinal vascular supply was estimated at the level of the superficial (SCP) and deep (DCP) capillary plexus, choriocapillaris and choroid.ResultsSix patients (12 eyes) were included in this study. Five were females (83.33%) and the mean age was 28.66 years. Mean best corrected visual acuity was 0.5 ± 0.3 LogMAR. Two patients presented bilateral macular edema on Swept Source‐OCT and showed focal dislocations in the vascular network at the level of the DCP on the OCT‐A, corresponding to the serous intraretinal cysts displacing the vascular plexus and the neural tissue. Qualitative analysis of OCT‐A at the macular area revealed a reduction of vessel density in the SCP and DCP. The DCP and especially the temporal area are more affected. Three patients (50%) showed an enlarged foveal avascular zone at the DCP level.ConclusionsUsing OCT‐A, we have demonstrated reduction of vessel densities especially located in the DCP. This vascular depletion could be an early event in the disease, which eventually causes ischemia, tissue loss and affects the macular function. Morphological vascular evaluation in patients affected by retinitis pigmentosa allows better understanding the pathogenesis of this disease and can have direct therapeutic implications for the future practical management of retinal dystrophies.
Effects of intravitreal aflibercept and ranibizumab on retinal vessel diameter measured using fluorescein angiography
Authors: Cho A.R. , Min J.K. , Park J.H. , Yang H.S. 
Published: September 2017

PurposeTo investigate the effect of intravitreal (IVT) aflibercept and ranibizumab on retinal vessel diameter in patients with neovascular age‐related macular degeneration (N‐AMD).MethodsForty eyes of 40 consecutive participants with treatment‐naïve N‐AMD were included. Two groups of 20 eyes received three consecutive monthly treatments of IVT aflibercept or ranibizumab. Retinal vessel diameter was measured using fluorescein angiography (FA) before the first IVT injection and 1 month after the third injection. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were calculated to represent average retinal vessel diameters.ResultsRetinal vessel diameter significantly decreased in aflibercept‐treated patients; CRAE and CRVE reduced from 106.7 ± 22.9 μm to 96.1 ± 24.1 μm (P = 0.028) and from 148.8 ± 19.6 μm to 140.8 ± 19.6 μm (P = 0.003), respectively. Pre‐injection and post‐injection arteriovenous ratios were 0.71 ± 0.08 and 0.71 ± 0.11, respectively (P = 0.733). However, retinal vessel diameter was not significantly reduced in ranibizumab‐treated patients; CRAE changed from 107.1 ± 23.3 μm to 104.4 ± 22.0 μm (P = 0.073) and CRVE from 139.0 ± 13.8 μm to 139.2 ± 14.2 μm (P = 0.794). Pre‐injection and post‐injection arteriovenous ratios in the ranibizumab‐treated group were 0.74 ± 0.14 and 0.72 ± 0.14, respectively (P = 0.163).ConclusionsIVT aflibercept treatment had a significant vasoconstrictive effect in eyes treated for N‐AMD; on the other hand, IVT ranibizumab did not significantly affect retinal vessel diameter. The aflibercept‐mediated reduction in diameter was not vessel‐specific.
Acute macular neuroretinopathy type 2: an unusual case
Authors: Cellini M. , Sebastiani S. , Campos E. 
Published: September 2017

PurposeAcute Macular Neuroretinopathy (AMN) is a rare retinal disease distinguished in two different types. In type 1 the lesion occurs above the outer plexiform layer (OPL) interesting the inner nuclear layer (INL), differently in type 2 the lesion occurs below the OPL interesting the outer nuclear layer (ONL). Type 1 is more common among elderly, males, and associated with cardiovascular risk factors while type 2 is more usual in young and females.MethodsA 68 years‐old white man presented to Ophthalmic Emergency Room complaining the acute‐onset of a paracentral superonasal scotoma in his left eye. His medical history was significant for systemic arterial hypertension in good control with diuretics and sartans. He also refers primary open angle glaucoma in treatment with prostaglandin analogous in both eyes. We performed fluorescein and indocyanine green angiographies, spectral domain‐Optical Coherence Tomography (SD‐OCT), OCT angiography (OCTA), standard automated perimetry (SAP), microperimetry, and multifocal electroretinogram (mfERG).ResultsFluorescein and indocyanine green angiographies were unremarkable. SD‐OCT revealed a focal hyperreflective band that involved the OPL and ONL localized in the parafoveal inferior region. The SAP showed a superonasal scotoma that was confirmed by the mfERG trace decrease and the inferotemporal reduced retinal sensibility at microperimetry. OCTA revealed a deep retinal capillary plexus perfusion defect area inferotemporally to the fovea.ConclusionsOur case describes an unusual AMN type 2 that occurs in an elderly male patient affected by systemic arterial hypertension typical for type 1. These evidences suggest a closer pathogenic relationship between the two forms of AMN. Further studies will be able to determine whether AMN type 1 and AMN type 2 rapresent single or multiple entities.
Regenerative therapies with combined axoprotectants in AGE‐exposed retinas
Authors: OSHITARI T. , Bikbova G. , Baba T. , Yamamoto S. 
Published: September 2017

PurposeTo examine the best effective combination of axoprotectants in AGE‐exposed rat retinas in culture.MethodsSeven SD rats were used in this study. Retinal explants were three‐dimensionally cultured in collagen gel and incubated in serum free media, AGEs, AGEs+100 mM citicoline, AGEs+100 mM TUDCA, AGEs+10 ng/ml NT‐4, AGEs+citicoline+TUDCA, and AGEs+citicoline+TUDCA+NT‐4. The numbers of neurites were counted after 7 days of culture, followed by TUNEL staining and immunostaining of phosphorylated JNK and active‐form of caspase‐9.ResultsAll of the axoprotectants decreased TUNEL‐positive cells, p‐JNK and caspase‐9 immunopositive cells, and increased the numbers of neurites. However, the number of neurites was significantly higher in the retinas incubated with combined three agents.ConclusionsCombination solutions containing citicoline, TUDCA, and NT‐4 should be considered regenerative therapy for AGE‐related retinal degeneration.