bluuebunny/crossref_metadata_2025_split huggingface dataset:
New intraocular therapies for non‐infectious uveitis
Authors: Albini T. 
Published: September 2017

SummaryTraditional local treatment of non‐infectious uveitis was limited to steroids with side effects such as cataract and ocular hypertension. Intravitreal (IVT) sirolimus is a novel, non‐steroid, locally delivered mTOR inhibitor under investigation. The SAKURA Program, which represents the largest study of non‐infectious uveitis to date, was comprised of two Phase III (one pivotal, one supportive) multinational randomized double‐masked studies evaluating sirolimus 440 μg vs 44 μg active control in subjects with active NIU‐PS. 80% of subjects had Multiple Measures of Inflammation (MMI) at baseline, defined as vitreous haze (VH) ≥1.5+ and ≥1 of the following: systemic corticosteroids (overall prednisone‐equivalent dose ≥7.5 mg/day), BCVA ≤ 75 ETDRS letters, and/or presence of macular edema. In the integrated ITT population, 21.2% vs 13.5% of subjects receiving 440 μg vs 44 μg achieved VH=0 at Month 5 (p = 0.0381). Among subjects with MMI at baseline, 21.1% vs 8.0% in 440 and 44 μg, respectively, achieved VH = 0 (p = 0.0007). In the SAKURA Program, treatment with 440 μg IVT sirolimus demonstrated statistically significant improvements in VH in subjects with active NIU‐PS, including in subjects with MMI at baseline.
Photophobia in neuro‐ophthalmic disorders
Authors: Kawasaki A. 
Published: September 2017

SummaryThis course examines various neurologic conditions which are associated with excessive light sensitivity. These conditions vary from lesions compressing the chiasm to brainstem degenerative disorders. In the absence of corneal lesions or retinal photoreceptor disease, the basis of photosensitivity with intracranial disease remains yet undetermined. A hypothesis is proposed.
Aqueous humor cytokines report in congenital cataract
Authors: SAUER A. 
Published: September 2017

SummaryCongenital cataract and glaucoma are an important cause of lifelong visual impairment. The management of these diseases is specific because of physiological and anatomical features of the children eye and changes related to growth. Compared to the management in adults, the strong inflammatory tissue reactivity following surgery is particularly noteworthy and challenging in post‐operative care. The presence of postoperative fibrinous uveitis is thus not uncommon in children, notably after cataract surgery. Many intraoperative and post‐ operativetherapeutic options have been considered to minimize post‐operative inflammation, but none of these is formally recommended. The occurrence of post‐operative complications should be analysed in regard to intraocular inflammation. The aim of the presentation is to describe cohorts of congenital cataracts and glaucomas, to measure cytokines levels in operated eyes and to compare these levels to control groups (senile cataract). These datas will be discussed taking into account clinical determinants and previously published studies. These analyses may open new axes for the understanding of the pathogenesis of congenital cataract and glaucoma, based on inflammatory processes.
MabThera use and efficacy in patients with active moderate to severe Graves’ Orbitopathy: a multicentre retrospective study of 40 cases
Authors: Lebranchu P. , Deltour J.B. , Cariou B. , Vabres B. , D'Assigny M. , Drui D. 
Published: September 2017

PurposeThe efficacy of MabThera to treat Graves'orbitopathy (GO) is actually controversial, because of opposite results of the 2 randomized controlled trials (Stan M et al. J Clin Endocrinol Metab 2015; Salvi M et al. J Clin Endocrinol Metab 2015).MethodsReal‐life use and efficacy of Mathera in GO in a multicentre retrospective study. Patients were enrolled in case of cortico‐dependant/resistant GO, with the help of endocrinologists of the French Thyroid Research Group. GO were classified according 3 components: inflammatory (CAS ≥3), muscular (constant diplopia) and neurological (visual acuity<20/40). Success was defined by the improvement of one component of the orbitopathy, without any deterioration of others.Results40 patients were included. 5 of the 8 patients treated simultaneously by mabthera and orbital decompression (visual threatening disease) had favourable evolution. 32 were treated because of corticoresistant disease (mean cumulative corticoid dose of 8 g; mean disease duration of 19,1 months). 6 months success was achieved for 67,5% of this group. Initial CAS (3,28 ±1,57) was significantly reduced after 3 and 6 months (1,61 ±1,1; p< 0,01). Initial visual acuity improved significantly after 3 months. All diplopic patients remained diplopic. Logistic regression revealed that initial CAS ≥3 were associated with positive treatment response (OR 3.43); smoking status was a negative pronostic factor (OR 10).ConclusionsWe present the largest cohort of patients treated by Mabthera for GO. Our mean decrease of CAS after 6 months (1.68) is better than Stan's study (1.2), but not as good as Salvi (3.8). This could be explained by our delay before treatment initiation, quicker than Stan (28.9 months) but longer than Salvi (4.5 months). Mabthera could be useful second line treatments in case of recent and still active GO.
Retinal re‐modelling following ILM flap technique for FTMH
Authors: Stappler T. , Hussain R. , Heimann H. , Wong D. 
Published: September 2017

IntroductionSurgical challenges remain for large macular holes, long standing holes as well as repeat surgery for non‐closed macular holes. For these indications the success rate drops dramatically. The role of ILM flaps in anatomical and visual rehabilitation remains controversial.MethodOCT‐based longitudinal cohort study of ILM flaps mapping OCT changes over time. Inclusion criteria were macular holes larger than 500 μm. Primary outcome measure: anatomical macular hole closure. Further outcome measures: OCT‐based longitudinal assessment of ELM as well as ellipsoid layer.ResultsWe present a case series of (n = 33) patients who underwent ILM flap surgery between June 2015‐Jun 2016. All holes 33/33 have been anatomically closed. OCT's were recorded and anatomical and functional changes mapped. 23/33 regained a distinguishable ELM by 3/12 (70%) and 22/33 regained the ellipsoid layer by 3/12 (67%). Follow up was between 4‐6/12.DiscussionThe ILM flap technique for FTMH clearly helps hole ‘closure’ since all holes showed anatomical closure. The regeneration of outer retinal layers seems to help visual outcome. Yet the significance of the amorphous flap tissue remains undetermined and the study cannot yet predict postoperative vision.
Sub‐conjunctival drainage
Authors: Ratnarajan G. 
Published: September 2017

SummaryMinimally invasive glaucoma surgery (MIGS) has a favourable safety profile compared to traditional filtering glaucoma surgery. The term MIGS was originally coined to utilize the eyes natural outflow pathways. Newer subconjunctival surgeries have shown much promise in the published literature thus far whilst still maintaining excellent safety, and therefore the remit of MIGS has expanded. Xen surgery is an ab‐interno implant that has internal lumen of 45 microns and total length of 6mm. It is inserted via both gonioscopic and external visualisation penetrating sclera 3mm from the limbus usually in the superior nasal quadrant. I will discuss strategies to try and achieve reproducible sub‐conjunctival placement of the Xen implant to achieve and maintain target IOP and reduce the risk of encapsulation and further post‐op manipulations. Innfocus micro‐shunt is an ab‐externo implant. Its internal lumen is 70microns and total length is 8mm. Its placement involves a periotomy and dissection of tenon's to create a potential space for drainage. It is inserted 3mm from the limbus and can be placed in any quadrant of the eye. Pearls on intra‐operative and post‐operative management will be discussed in the symposium.
Age related changes of the crystalline lens
Authors: Navarro R. 
Published: September 2017

SummaryThe crystalline lens has a double function to aid the cornea in focusing light rays on the retina and to accommodate to focus near objects. The refractive power of the lens is about half of that of the cornea, but a young lens can increase its power by more than 50%. Its gradient refractive index (GRIN) provides additional refractive power and amplitude of accommodation (AA). The optical properties of the lens change dramatically with age. The lens continues to grow throughout life (lens thickness increases about 0.024 mm/year) which has a strong impact on its optical properties. With ageing most of the GRIN tends to concentrate near the surface, which causes a decrease of both power and AA. The lens also gets stiffer with age. The maximum AA is reached early (ages 8‐12 years) and then declines at a mean rate of 0.25 D/year; accommodation becomes residual after 50 years. The optical quality of the lens suffers a strong age‐related deterioration: progressive lens yellowing tends to filter short wavelengths, stray light increases with age, which strongly increases the probability of cataracts. Spherical and other higher order aberrations of the lens increase so that they can duplicate their RMS value from 35 years to 75 years.
Novel genes associated with isolated optic nerve hypoplasia in 6 family trios ‐ a clinical and exome study
Authors: Bitoun P. , Boland Auge A. , Bacq Daian D. , PIpiras E. , Benzacken B. , Kuzbari S. , Renault V. , Parfait B. , Deleuze J.F. 
Published: September 2017

PurposeOptic nerve hypoplasia (ONH) is a rare blinding malformation,ONH is often syndromic with MRI pituitary anomalies. We explore genetic causes of isolated ONHMethodsProbands (2F/4M) 0.5‐6 yrs with normal pituitary MRI were enrolled after consent with Pediatric, dysmorphologic and ophthalmologic endocrine examinations SNP aCGH, WES & Sanger validation sequencing. Ophth. exam: VEP,ERG,fundoscopy, color & acuity testing. Male patients tested for HESX. DNA extracted from lymphoblastoid lines or blood. DNA sequenced 30X in > 92% on Illumina platform; QC used Sam, Picard, Bed tools, variant call GATK, annotation snpEff/snpSift; filter using Autosomal Dominant hypothesis, absence in 1k, 65k 19 genomes,Exac databases. Variants present in subjects but not parents were selected and tested using polyphen2, Sift and mutation taster. 2nd approach for variant filtering using ANOVAR yielded 197 variants with strong deleterious effect; variants present in at least 2 pedigrees were then prioritizedResultsPatients followed 2‐15 yrs had normal intelligence, eye examination showed normal ERG with abnormal VEP, dyschromatopsia VA ~20/200. 3 had learning difficulties, One F severe dyspraxia, and one M GH, Cortisol testosterone deficit and micropenis. 3 had sleeping disorders treated with melatonin. No HESX mutations were identified. All parents were healthy but 3 fathers were unavailable for blood sampling.SNP array CGH revealed a paternally inherited single 410,4 kb deletion of the 2p26.1 VRK2 gene described in complex intellectual disability. 5 genes showed deleterious missense mutations identified and being confirmed by Sanger sequencingConclusionsA 2p16.1 inherited deletion variant of unknown significance was identified on array CGH. WES analysis identified 5 candidate genes confirmed by Sanger sequencing which will need confirmation in a different dataset
Ocular traumas in the Finnish elderly‐ Helsinki Ocular Trauma (HOT) Study
Authors: Sahraravand A. , Haavisto A.K. , Holopainen J.M. , Leivo T. 
Published: September 2017

PurposeTo describe epidemiology, causes, treatments, and outcomes of all ocular injuries in southern Finland among people aged 61 and older.MethodsAll new ocular trauma patients, admitted to the Helsinki University Eye Hospital, during one year in 2011–2012. The data was from hospital records and prospectively from patient questionnaires. The follow‐up time was three months.ResultsThe incidence for ocular injuries among the elderly was 38/100,000/year. From 118 patients 69% were men. The mean age was 70.9 years old (median 67). Hospitalization rate was 14%. Injury types were minor traumas (48%), contusions (22%), chemical injuries (10%), eyelid wounds (8%), open globe injuries (OGI) (7%), and orbital fractures (5%). The injuries occurred at home (58%), in institutions (12%), and in other public places (12%). The main causes of ocular injury were falls (22%), sticks (19%), superficial foreign bodies (18%), and chemicals (12%). All OGI and 88% of contusions needed a life‐long follow‐up. A permanent visual or functional impairment occurred in 15 (13%) patients. Of these 53% were OGI, 40% contusions, and 7% chemical injuries. The causes of permanent injuries were falls (7 cases, 47%), work tools, sports equipment, sticks, chemicals, and eyeglasses.ConclusionsMinor trauma was the most frequent type, and home was the most common place of eye injuries. Falls were the most frequent and serious cause, but behavioral causes (alcohol consumption and assaults) were not significant. Preventive measures should be directed towards the main identified causes and risk factors of the eye injuries in the elderly.
Corneal nerves as a biomarker of peripheral neuropathy : the example of transthyretin amyloidosis
Authors: Rousseau A. , Cauquil C. , Dupas B. , Labbé A. , Baudouin C. , Lacroix C. , Guiochon‐Mantel A. , Benmalek A. , Labetoulle M. , Adams D. 
Published: September 2017

Transthyretin amyloidosis (TTR‐A) is a rare autosomic disease associated with severe sensorimotor and autonomic neuropathy. A practical and objective method for the clinical evaluation of TTR‐A neuropathy is needed to improve the management of this disease.We conducted a study on 15 patients and 15 controls to determine the correlations of sensorimotor and autonomic neuropathy with corneal nerve parameters in TTR‐A patients. We found that corneal nerve fiber length (CNFL) measured using IVCM was inversely correlated with the severity of autonomic and sensorimotor neuropathy, assessed both with clinical and paraclinical tests, including intra‐epidermal nerve length in skin biopsy.In these 15 subjects, IVCM measurement permitted rapid, non‐invasive evaluation of small‐fiber alterations in TTR‐A patients and could be used to assess neuropathy. CNFL could be measured in all patients, thus avoiding the floor effect seen with other neuropathy measures. Through the example of this rare disease, our study illustrates the emerging idea that corneal nerve parameters assessed with IVCM could become a potent surrogate biomarker for peripheral neuropathy.
OCT in age related macular degeneration
Authors: Mantel I. 
Published: September 2017

SummaryThis part of the special interest symposium gives an overview about the features on OCT that can be seen in the context of age‐related macular degeneration (AMD). The role of OCT in diagnosis, treatment guidance, and the functional relevance are the topics approached. In addition, the signs that need to be distinguished in order to avoid misleading interpretation are presented. The overview focuses on topics with clinical relevance, using numerous imaging examples.
OCT in retinal and choroidal inflammatory disease
Authors: Vaudaux J. 
Published: September 2017

SummaryOCT angiography (OCT‐A) is a novel method of retinal imaging enhancing visualization of retinal and choroidal vascular components. OCT‐A clinical applications are increasingly described in various retinal and choroidal diseases such as diabetes, AMD and vascular occlusive conditions. Its use in retinal and choroidal inflammatory diseases begins to be acknowledged, but clinical descriptions remain few in the literature. OCT‐A allows for more detailed analysis of normal retinal vascular networks and pathological conditions of the retina and choroids, particularly when neovascularization is suspected. It may contribute to a better understanding of the pathogenesis of certain retinal and choroidal inflammatory conditions, and may turn out to be a very useful tool in the follow up and monitoring of therapy. However, additional studies and experience will be required to further describe the fundamental semiology of OCT‐A in retinal and choroidal inflammatoy diseases.
Nanoparticle eye drops: A new generation of corticosteroid eye drops
Authors: Stefansson E. 
Published: September 2017

SummaryNanotechnology solves the main obstacles in topical drug delivery. Nanotechnology provides increased solubility of lipophilic molecules in tear fluid and sustained release for several hours.Cyclodextrin nanoparticles containing dexamethasone increase solubility of dexamethasone in tear fluid 30 fold and the drug stays in tear film for 6 hours compared with minutes for conventional eye drops. The high concentration gradient from tear film into eye wall creates a flux which is active for many hours following eye drop application. This delivers approximately 10 times more drug into the eye and reaches the posterior segment in significant concentration. At the same time relatively less drug is absorbed systemically.Several clinical trials have demonstrated the efficacy of the cyclodextrin nanoparticle platform both for posterior and anterior segment use.Two clinical trials in 41 patients have shown significant improvement in visual acuity and retinal structure in diabetic macular edema. Two reports show compelling effect on intermediate/posterior uveitis with cystoid macular edema. Once a day treatment following cataract surgery is effective and the dexamethasone nanoparticle eye drops can replace mitomycin C in trabeculectomy.
Anterior vitreo‐lenticular interface in children
Authors: Tassignon M.J. 
Published: September 2017

SummaryTo demonstrate that developmental cataract involves more than opacification of the lens: the anterior vitreo‐lenticular interface plays an important role in the surgical approach.All babies and children operated for congenital cataract since 2004 using the bag‐in‐the‐lens technique, which requires both anterior and posterior capsulorhexis, independently of the presence of persistant hyperplastic primary vitreous or fetal vasculature.By reviewing the surgical video's the relationship between anterior hyaloid and posterior capsule, defining Berger's space, shows a large variety of anatomical particularities. It is possible to carefully dissect these structures in an attempt to reduce anterior vitrectomy to a minimum. Bridges between anterior hyaloid and posterior capsule can easily be ruptured by ocular viscoelastic dissection.Better knowledge of the anterior vitreo‐lenticular interface would largely increase the surgical outcome of developmental cataract. Currently medical devices allowing to visualize this interface prior to surgery are lacking. Dissection of primary vitreous from posterior capsule is time‐consuming but feasible. Chemicals, like microplasmin, may be of some benefit for the cataract surgeon to optimize the separation.
Protein analysis of the plaques in congenital cataracts
Authors: Van Looveren J. , Van Gerwen V. , Schildermans K. , Laukens K. , Baggerman G. , Tassignon M.J. 
Published: September 2017

PurposeTo identify the protein composition of posterior capsular plaques (PCP) in congenital idiopathic unilateral cataract with anterior vitreolenticular interface dysgenesis (AVLID).MethodsSamples of PCP's were collected during cataract surgery in children with congenital unilateral cataract presenting with a PCP and with vitreolenticular adherences observed during posterior capsulorhexis procedure. Proteome analysis was performed on the collected PCPs.ResultsPCP collection and proteome analysis was feasible from four children. A large portion of the proteins found in the PCPs were similar to the proteins known to be present in lens epithelial cells and fibers. Proteins like vimentin, fibronectin, actin, collagen type I, collagen type VI, lumican and keratin were also found which typically are present in mesenchymal tissue but not in lens tissue or capsule.ConclusionsCases of unilateral idiopathic congenital cataract with AVLID typically present with a PCP. The protein composition in these PCPs, measured by means of proteome analysis, includes atypical proteins for lens and lens capsule and may be suggestive for an epitheliomesenchymal transformation (EMT).
Contact lens service in pseudophakic and aphakic children
Authors: ROSENSVÄRD A. 
Published: September 2017

SummaryIn Sweden cataract surgery is performed at two specialized centers during the first 2 years of life. Intraocular lenses (IOL) are implanted if possible. Amblyopia treatment and contact lens (CL) service is also provided for at these centers for the youngest. At the clinic the patient meets a team; an orthoptist, an optician and a pediatric ophthalmologist. Newborn aphakic children first get a standard CL +37 D. Children with IOL are made hyperopic with the ambition to obtain emmetropia in adult life. CL are prescribed after retinoscopy finding. Infants are corrected to a slight myopia. From 2 years of age the correction is for emmetropia and near addition of 2,5 diopters are prescribed in bifocal glasses. Aphakic children combine CL with bifocals and the children with IOL have only bifocals. The CL are inserted every morning and removed and cleaned every evening. Some children learn to handle their CL themselves (video). There are advantages with CL in comparison to glasses such as visual fields, aberration, flexibility and cosmetic. PECARE (PEdiatric CAtaract REgistry) is a web‐based national register in Sweden for children operated for cataract. Many of the congenital bilateral cases develop vision enough for driving licence.
Ocular inflammatory diseases in ebola survivors
Authors: Hereth E. , Resnikoff S. , Fardeau C. , Bah M.O. , Sagno I.C. , March L. , Izard S. , Lama P.L. , Ouendeno N.A. , Delaporte E. 
Published: September 2017

PurposeThe last Ebola outbreak severely affected West Africa and led to 2543 deaths and 1268 survivors in Guinea, where it began. The survivors faced various symptoms and disorders including ocular pain and erythema, itching, tearing, photophobia and blurry vision. The purpose of our study was to describe uderluing ocular diseases.MethodsThis is a prospective observational multicenter cohort study initiated in March 2015 which included survivors followed up in the infectious disease ward of Conakry and Nzérekoré. The patients received multidisciplinary medical follow‐up that included an eye examination.ResultsSystematic examination of 341 survivors highlighted 46 cases of uveitis (13.5%), six episcleritis (1.8%), and three interstitial keratitis (0.9%). Uveitis were more unilateral (78.3%) and anterior (47.8%) and occurred within the 2 months following discharge from the Ebola treatment center. Moreover, relapses were found up to 13 months after healing. Eleven eyes with anterior chamber inflammation presented with cataracts and visual acuity ≤ 5/10. Ten eyes with chorioretinal scars presented decreased visual acuity ≤ 5/10. Among 46 survivors with uveitis, 13 (28%) suffered from visual alteration on at least one eye.ConclusionsNearly 17% of Ebola survivors presented ocular disorders that may be very delayed in some patients. Moreover our study brought out relapses. We were not authorized to take intra‐ocular samples to identify the virus. The mechanism behind these uveitis is probably is an association between a direct cytopathic impact of the virus and an immune reaction to it. The corticosteroid therapy that is actually recommended by WHO can't be used safely during the acute infection but seems to be efficient in survivors. The current issue is to perform safely cataract surgery in survivors.