bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetic retinopathy – pathophysiology
Authors: Marques‐Neves C. 
Published: September 2015

SummaryDiabetic retinopathy (DR) is a common complication of diabetes and is a leading cause of visual impairment and blindness in many countries. This visual impairment results from long‐term accumulated damage to the small blood vessels in the retina. It takes several years before any clinical symptoms of retinopathy appear in diabetic patients. The definition of diabetic retinopathy is based on observation of vascular changes. The first recognizable vascular abnormalities are microaneurysms and small hemorrhages, followed by signs of vascular leakage, such as hard exudates and larger hemorrhages, vascular dropout, and neovascularizations. A number of hyperglycemia‐induced metabolic stresses have been implicated in the pathophysiology of DR. The microvasculature of the retina responds to hyperglycemia through a number of biochemical changes, including the activation of protein kinase C, increased advanced glycation end‐products formation, polyol pathway and oxidative stress. However, it has been long known that the neuroretina is affected at an early stage by diabetes‐induced metabolic changes. DR is now recognized as a neurovascular complication or sensory neuropathy resulting from disruption of the neurovascular unit.
Viral retinopathies: a spectrum of disease from East to West
Authors: Bodaghi B. 
Published: September 2015

SummaryViral retinopathies remain an absolute emergency among all other infectious entities. They may occur in immunocompromised or immunocompetent patients at any age. Most of the cases are associated with herpes viruses and happen to be necrotizing. Acute retinal necrosis has been initially described in Japan with important clinical characteristics. Molecular tools are of utmost importance in order to confirm the viral type. VZV seems more aggressive than HSV1 or 2. CMV retinitis occurs more frequently in immunocompromised patients. More recently, the nonnecrotizing type of viral retinopathy has been reported, masquerading as different autoimmune entities. Furthermore, other types of nonherpetic viral retinitis may be encountered in different geographical areas. Treatment is always challenging. Despite a few reports on the use of oral antivirals, most of the patients require intravenous therapy and intravitreal injections. Treatment is always long in order to prevent a relapse, especially in the second eye. Laser photocoagulation has not demonstrated its efficacy but may be proposed in selected cases. Primary vitrectomy should not be proposed in all patients as it may increase the risk of retinal detachment. Visual prognosis is guarded.
Silicone oil use in trauma
Authors: Weinberger D. 
Published: September 2015

SummaryThe use of Silicone oil and PFCL tamponades following vitrectomy in Penetrating ocular trauma and perforating injuries are highly advantageous due to their chemical‐physical properties which enables them to displace aqueous humor from the retinal surface and maintain the adhesion between retina and retinal pigment epithelium. There are different types of silicone oils to which their dynamics depends on the interaction between buoyancy, interfacial surface tension, and viscosity. Therefore, depending on the type of oil, a short‐ to long‐term tamponade would be provided to the retina. It has been shown that silicone oils and PFCL were successfully used to minimize the risk of postoperative bleeding, maintain the retina attached, and avoid phthisis in cases of hypotony following severely traumatized eyes. However, as in any vitreoretinal surgery, complications may occur such as re‐detachment and PVR under the oil, increased IOP and damage to the cornea and AC. Herein, we will discuss the use of different type of silicone oils and PFCL's their advantages and disadvantages in the use of ocular trauma surgeries.
Recent advances in drug delivery to the retina
Authors: Davis B. 
Published: September 2015

SummaryDrug delivery to the retina is presently one of the greatest challenges in ophthalmology due to the inherent limitations of ocular barriers. This therapeutic impediment affects many promising treatments including; anti‐VEGFs, which have revolutionised the management of age‐related macular degeneration, and have increasing indications for use as sight‐saving therapies in diabetes and retinal vascular disease. However, large molecular weight anti‐VEGF therapies such as ranibizumab and bevacizumab currently require invasive intravitreal (IVT) injections to bypass ocular barriers, and thus carry a risk of significant side effects. Despite this, the success of anti‐VEGF therapies has led to a dramatic increase in the number of IVT procedures, placing a high burden on healthcare resources. For these reasons, the development of non‐invasive ocular drug delivery systems has received considerable interest in recent years. This talk outlines the current understanding of anatomical barriers to ocular drug delivery and recent developments in overcoming these barriers for delivery of large drug cargo to posterior ocular tissues. Particular focus will be paid to the role of nanotechnology and annexin A5, which we recently reported to enhance the delivery of topically applied bevacizumab to the rabbit retina.
B27‐associated uveitis, Fuchs uveitis
Authors: Willermain F. 
Published: September 2015

SummaryB27‐associated uveitis is a very frequent form of non infectious intraocular inflammation which account for approximately 50% of acute anterior uveitis. Its main clinical features, natural history and association with seronegative arthritis are well known. Fuchs uveitis is another frequent cause of anterior and intermediate uveitis. Its natural history is well characterised as well as its association with intraocular production of anti‐rubella antibodies. Both diseases are thus often considered as easy diagnosis. However, several aspects of those diseases remain challenging and debated. In this interactive course, based on clinical cases, we will insist on those difficult aspects as well as on the more recent issues discussed in the literature.
Tear proteomics in health and disease
Authors: Beuerman R. 
Published: September 2015

SummaryPurposeTo evaluate the tear proteins in normal and diseased eyes to determine how the tear proteins reflect the health of the ocular surface. The tear proteome in normal and in specific pathological conditions has been determined using mass spectrometry.MethodsTears were collected by either fire polished micropipettes of 1–10 μl or Schirmer's Type I tear test, and prepared for mass spectrometry on a AB Sciex 5600.ResultsThe normal tear proteome has been found to contain more than 1300 proteins. Proteomic studies have been particularly successful in revealing key molecules associated with inflammatory diseases such as dry eye, Meibomium gland disease (MGD) and pterygium. In these studies S100 proteins were found to be upregulated, In MGD, levels of S100A8 and S100A9 were correlated to disease severity and levels of S100A8 protein were significantly correlated to sensations of grittiness, whereas S100A8 and S100A9 were correlated to symptoms of redness and transient blurring.ConclusionsIn each disease, the changing levels of disease associated inflammatory markers were found to be unique. Generally, more than one proteomic signal was useful for characterizing the disease state. Proteomic biomarkers must undergo thorough clinical trials for validation, but in the future could augment lengthy and often inconclusive clinical observations.
Estrogen as an antioxdant in the lens
Authors: Zetterberg M. 
Published: September 2015

SummaryFemale gender is a known risk factor for age‐related cataract, although the explanation for this is still largely unknown. We have demonstrated that physiologic concentrations of 17b‐estradiol (E2) protect cultured human lens epithelial cells (HLECs) from oxidative stress induced by H2O2, as evident by decreased production of reactive oxygen species (ROS) and a stabilization of the mitochondrial membrane potential. Total superoxide dismutase (SOD) activity was increased by these concentrations of E2 but no change in gene or protein expression of SOD was seen. In cataract patients and controls, a significant correlation between higher age and decreasing serum levels of E2 was found but no correlation between serum levels of E2 and SOD was demonstrated. Men exhibited higher E2 levels compared to postmenopausal women. To conclude, estrogen seems to exert antioxidative effects on human lens cells, possibly by affecting SOD activity, which may explain the difference in risk of cataract between genders. The finding that men have higher levels of E2 than postmenopausal women further supports the hypothesis that it is the decline in estrogen at menopause that causes the higher risk of cataract in women.
New and old drug delivery systems
Authors: Wilson C. 
Published: September 2015

SummaryEffective, prolonged and safe drug delivery to the eye in the treatment of ocular disease is a complex issue for clinical management. The approach to date has largely been adaptive: taking existing potent molecules which are active in reducing VEGF action and repurposing in new vehicles. From the point of view of a device, such materials may not be ideally druggable, the period of treatment too short or the true target involve more than one receptor. The dispersion of the dosage form is also an issue. Outside the eye, the drug may be lost by dilution and vascular/lymphatic clearance and inside, formulation debris at the back of the eye is a risk factor and may alter vision. The next generation of systems must address these concerns and utilize every tool at our disposal to improve efficacy. This includes the selection of better molecules, the use of modeling to better predict the disposition in the aged eye and perhaps the adoption of surgical procedures to increase drug flux more reliably. Up to now, we have relied on a singular approach – the drug‐ to solve the problem and now we realize that drug, vehicle and procedure must be integrated.
Establishing new OCT parameters: Is race‐specific phenotyping necessary?
Authors: Chauhan B. 
Published: September 2015

SummaryEstablishing phenotypes of the normal optic nerve head via normative databases is vitally important for clinicians. Attributing likelihoods for glaucoma based on single OCT examinations helps clinicians triage and assign resources for further or more intensive testing. It is recognized that significant race‐specific differences in optic nerve head parameters exist, however, it their utility has not improved diagnostics. One reason could be that these databases have thus far used only conventional parameters that do not exploit measurements now possible to characterize neuroretinal rim parameters that are anatomically and geometrically accurate, or the deep optic nerve head. This presentation will review the literature on race‐specific databases, postulate reasons for their inability to yield better diagnostics and present new alternative race‐specific OCT data that may enhance clinical glaucoma practice.
OCT angiography in CNV quantitative follow up
Authors: Lumbroso B. 
Published: September 2015

SummaryOptical coherence tomography (OCT) angiography is a novel imaging modality that uses intrinsic flow contrast and does not require any dye injection. It is a less invasive alternative to fluorescein angiography that is 3 dimensional. It is used to image and measure retinal, choroidal and optic disc circulations. Quantitative applications are possible. The angiograms are visualized as cross sections and en face views of separate retinal and choroidal layers. SSADA technology is used in this study.
Coming full circle: Canal surgery with/without implants
Authors: Grieshaber M. 
Published: September 2015

SummaryCanaloplasty, one of the latest ab externo, non‐penetrating procedures in glaucoma, reduces intraocular pressure by targeting the pathologically high resistance to aqueous outflow and restoring the natural outflow system. After (circumferential) viscodilation of Schlemm's canal, a polypropylene suture is looped through the canal and tightened to distend the trabecular meshwork; alternatively a new device, the Stegmann Canal Expander is implanted. The main advantage of canaloplasty over fistulating trabeculectomy is the independence of a filtering bleb. Furthermore, there is no need for antimetabolites and needling procedures. Canaloplasty as a stand‐alone procedure or combined cataract extraction is proven to be safe and efficient. Technically, the surgeon must understand and respect the microanatomy of the outflow system and the mechanics of the procedure itself. This presentation guides the surgeon through standard canaloplasty and the implantation of the Stegmann Canal Expander, highlights tips and pitfalls, and presents new clinical data.
Big Bubble DALK: The ladder to success, step by step
Authors: Katamish T. 
Published: September 2015

SummaryDeep anterior lamellar keratoplasty (DALK) has too many techniques to achieve, one of them and most reproducible is the big bubble technique. The steep learning curve known to this operation some times considered a barrier for many surgeons to try and master. However in my presentation I will try to go through the operation step by step giving my own personal tips and tricks for executing the perfect big bubble DALK. Special emphasis will be put on the following important steps: (1) Trephine adjustment and partial thickness trephination of the recipient cornea. (2) Technique of air injection and big bubble formation, which is considered the key step of this technique. (3) Safe opening of big bubble roof. (4) Cruciate incision and cutting of the reaming stroma after lamellar dissection of superficial corneal layers. (5) Descemet's membrane staining and stripping from donor cornea. Moreover, I will put a focus on the new anatomical pre‐ Descemet's layer (Dua's layer), describing and demonstrating by many video clips the different types (type 1, type 2 and mixed type) of big bubbles based on this new anatomical layer. The aim of my presentation is to allow the participants to perform big bubble DALK in a safe and reproducible way with very high percentage of success in obtaining the big bubble.
Angiography reveals novel features of the retinal vasculature in mice
Authors: Ruberte J. 
Published: September 2015

SummaryHere, we present a comprehensive characterization of the mouse retinal vasculature by SLO‐OCT fluorescein angiography. Using this clinical imaging technique, we report previously unrecognized variations in C57BL/6J vascular anatomy. All layers of the mouse retinal vasculature could be readily visualized during fluorescein angiography by SLO‐OCT. Blood vessel density was increased in the deep vascular plexus (DVP) compared with the superficial vascular plexus (SVP). When we examined different regions of the SVP and DVP, no differences in capillary density were observed between the inferior and superior hemispheres, or between different regions of the SVP. However, a small, but significant increase in capillary density was detected in the temporal hemisphere of the DVP compared with the nasal hemisphere of the DVP. Arteriolar and venular typologies were established and structural differences were observed between venular types. Unexpectedly, the hyaloid artery was found to persist in 15% of C57BL/6 mice, forming anastomoses with peripheral retinal capillaries.
Inflammation, wound healing and tear proteomics in glaucoma
Authors: Uusitalo H. 
Published: September 2015

SummaryWound healing is a complex process involved in ocular surgery, trauma and pathogenesis of several eye diseases. Due to the delicate and sensitive structures of the eye wound healing is playing a essential role in ophthalmology. In glaucoma surgery well controlled wound healing process is as important for the creation of a functioning passage to aqueous humor out of the eye. The state of the ocular tissues is of great importance for the success of ocular surgeries. Chronic topical glaucoma medication is an important risk for the ocular surface disease. It is also a risk for the failure in glaucoma surgery. The mechanism of failing glaucoma surgery is related to the presence inflammatory cells, accumulation of extracellular matrix proteins in the conjunctiva and the site of surgery, activation of matrix metalloproteinases and their tissue inhibitors and accumulation oxidized lipids in the conjunctiva and around the site of operation and glaucoma shunts. Tear fluid proteome is a novel technique to get detailed information about the processes of the anterior surfaces of the eye and could easily be performed. It has also proven to be a promising technique for detecting biomarkers for ocular surface disease, ocular inflammation and predicting thus the success of glaucoma surgery.
Physiology of retinal oxygenation
Authors: Stefansson E. 
Published: September 2015

SummaryThe retina receives O2 from retinal and choroidal circulations. Both vascular beds can now be imaged with noninvasive spectrophotometric oximetry in human subjects. This allows study of normal O2 metabolism and physiology and clinical research in retinal disease. Normal physiology: Technical and biological variability in retinal O2 saturation is low compared to most clinical parameters. Test‐retest studies show standard deviations of about 1% and in a healthy population the standard deviation is only 5–11% of the mean, low compared for example to IOP measurements. Retinal O2 saturation is relatively stable with age and shows only a minor reduction over decades of life. Retinal oximetry reliably detects retinal O2 saturation consumption due to changes in illumination. Retinal and choroidal oximetry data agree well with invasive studies in animals and human subjects. Ischemic retinopathies: Abnormal O2 saturation has been documented in diabetic retinopathy, retinal vein and artery occlusions and neovascular AMD. This agrees well with invasive PO2 studies and presence of Hypoxia‐Inducible‐Factor in these diseases. Atrophic retinopathies: Retinal atrophy in glaucoma and retinitis pigmentosa reduces O2 consumption and this is detected by retinal oximetry. Retinal oximetry may be a good method to quantify progressive retinal atrophy.
Information technology in ophthalmology. www.retinarisk.com
Authors: Stefansson E. 
Published: September 2015

SummaryA huge amount of epidemiological data has been accumulated in ophthalmology as in other fields of medicine. The use of these data in health care tends to be simplistic and makes too little use of information technology and mathematics. We have used published reports on risk factors for progression of diabetic retinopathy, DR, to create an algorithm that predicts an individual's risk of sight threatening DR. The prediction is based on the type and duration of diabetes mellitus, blood glucose and pressure, DR stage and gender; see www.retinarisk.com. It predicts 80% of the risk as seen as the area‐under‐curve on ROC plots. The software provides individual predictions based on these risk factors. It educates the patient about DR risk and allows estimation of the effect of improving risk factors such as blood glucose. It has motivational and educational value. Current norm in DR screening is annual examination (every other year for eyes without DR). Individualized risk assessment allows individualized determination of the frequency of eye screening. High risk eyes are screened more frequently and low risk eyes less frequently. This improves safety for the high risk eyes and saves on resources for the low risk eyes. When compared with annual screening this provides cost savings of about 50%.
Genetic variants in the TNFA are associated with Korean Dry Eye Disease
Authors: Yang S. , Na K.S. , Mok J.W. , Ju H.J. , Joo C.K. 
Published: September 2015

PurposeTo determine whether variations altering the function or expression of TNFA, contribute to the pathogenesis of dry eye disease.MethodsGenomic DNA was extracted from blood samples of unrelated dry eye disease patients (non‐Sjogren's syndrome patients (n = 200) and Sjogren's syndrome patients (n = 100). Polymerase chain reaction and direct sequencing were used to screen variations in promoter region of TNFA gene. One hundred fifty control individuals without corneal disease were selected from the general population.ResultsWe investigated 6 SNPs of TNFA; −1196 C>T, −1031 T>C, −863 C>A, −857C>T, −308 G>A (rs1800629) and −238 A>G (rs361525) in promoter. Among them, −1196 C>T, −857 C>T, rs1800629 and rs361525 were different between patient groups and control groups. The *A allele frequency of rs361525 in dry eye patients (2.6%) and Sjogrens’ patients (2.5%) were decreased compared with control subjects (5.1%). The *A allele frequency of rs1800629 was lower in Sjogrens’ patients (2.5%) than in the controls (4.8%). In −1196C>T variation, *T allele of both patient groups was decreased compared with control subjects. Whereas, the *T Allele frequency of −857 C>T was higher in the Sjogrens’ patients (30.0%) than in the controls (16.8%). The genotype distributions of all polymorphisms of TNFA among the control subjects and the affected individuals were in Hardy‐Weinberg equilibrium.ConclusionsOur results suggested that the genetic variations of TNFA gene seem to be associated with dry eye predisposition in a Korean.
Back to the future: The return of angle surgery
Authors: Sharkawi E. 
Published: September 2015

SummaryMicro invasive glaucoma surgery (MIGS) claims extremely high safety profiles and is a rapidly expanding field. In this session we will examine the efficacy and safety of ab interno angle surgery, and outline surgical tips and methods to maximize trabecular outflow in open angle glaucomas. We will also explore how angle surgery may improve results in angle closure eyes, over phacoemulsification alone. MIGS healthcare costs are not insignificant and efficacy can be limited. We will therefore examine cost effectiveness and quality of life issues that are paramount in moving this field forward. MIGS will be compared to more invasive glaucoma surgical approaches and real world indications discussed.
Long‐term cultivation of corneal stem cells – possible applications from benchside to bedside
Authors: Petrovski G. 
Published: September 2015

SummaryLong‐term cultures of corneal stem cells can be developed for future tissue engineering and clinical applications. Cornea limbal and stromal tissue explants can be cultivated and expanded for longer periods of time (months) under special conditions and without the use of scaffolds. Viable 3D cell outgrowth from the explants can be achieved within 4 weeks time. The outgrowing limbal epithelial stem cells (LESCs) revealed a unique fingerprint of markers specific for stemness, proliferation, limbal epithelial cells and differentiated cornea epithelial cells. Morphological and immunostaining analysis concluded that long‐term culturing can form stratified 3D tissue layers with a clear extracellular matrix deposition and organization of collagen, which was similar to that formed by corneal stromal stem cells (CSSCs). Overall, modelling 3D long‐term structures of corneal stem cells can be used for generating highly pluripotent, long‐standing 3D cultures from limbal and stromal stem cells, which can be used for further research purposes and clinical transplantation.