bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automatic method to distinguish manifestation areas of early diabetic retinopathy from image artefacts by using L*u*v* colour space
Authors: Suzuki N. , Yamane K. 
Published: September 2015

PurposeThe RGB colour space was converted into seven different colour spaces: XYZ, CMY, HSL, HSV, HSI, L*a*b* and L*u*v*. The L*u*v* colour space presented optimal results, with the highest sensitivity and best reproducibility. We employed three‐dimensional analysis of L*u*v* colour spaces to detect early diabetic retinopathy.MethodsSix patients with small haemorrhages, hard exudates and photocoagulation marks were evaluated using fundus photography, which revealed image artefacts in the fundi of some patients. We constructed an experimental device similar to the optical system of a fundus camera, and created artificial eyes of the fundus, which were painted with four different colours. The image artefacts were photographed under each artificial eye using the experimental device. We analysed all images using Scilab 5.4.0 and SIVP 0.5.3 software. The software interpreted the values of the L*u*v* colour space as a three‐dimensional graph, which was modified using a Gaussian filter.ResultsWe calculated the difference between the manifestation and perimanifestation areas and image artefact and periartefact areas using the L*u*v* values. The L*u*v* values’ ratios of the image artefact to manifestation areas in the human eye were as follows: haemorrhage (6.2, 11.4, 7.4); hard exudate (3.2, 7.7, 2.5) and photocoagulation mark (8.1, 3.9, 6.2).ConclusionsL*u*v* colour space is an effective mean of differentiating between small haemorrhages, hard exudates and photocoagulation marks from image artefacts.
Intratarsal injection of kenacort in the treatment of severe cases of VKC
Authors: Lazreg S. 
Published: September 2015

PurposeTo treat refractory cases of Vkc with intratarsal injections of trialcinolone.MethodsWe treated Severe cases of Vkc that have already experienced different anti allergic treatments and topical steroids with frequent relapses and dependancies to steroids with intratarsal injection of 40 mg of dexametasone, the follow up visits were performed at D0, D3, D7 and D30 (slit lamp examination, corneal staining, ocular pressure).Results87 severe cases of Vkc 63 males, mean age 10.4±3.5 years, 90% bilateral, and 100% of corneal involvement. 70% mixed forms and 15% of tarsal forms, the mean follow up was 20 ± 7 months. at D3 we had a decrease of all ocular signs (photophobia, redness and pruritis) at D7 decrease of corneal staining and trantas nods, and at d30, total remission of the Vkc, the mean duration of the efficacy of the treatment was 10.4 ± 2.6 months, no adverse event was observed.ConclusionsIntratarsal injection of steroids is very effective in severe and resistant cases of Vkc, especially in our countries where this disease is very severe, frequent and when topical cyclosporine is not available.
Comparison of preservative‐free latanoprost and bimatoprost in a multicenter, randomized, investigator‐masked cross‐over clinical trial
Authors: Stalmans I. , Cordeiro F. , Hommer A. , Oddone F. , Ribeiro L. , Sunaric Mégevand G. , Rossetti L. 
Published: September 2015

PurposeTo investigate the efficacy and safety of Bimatoprost Unit Dose Preservative Free (BUDPF) and Latanoprost Unit Dose Preservative Free (LUDPF) in a clinical setting.MethodsProspective, randomized, investigator‐masked, cross‐over comparison. Patients with ocular hypertension or open angle glaucoma (OAG) with an IOP ≤21 mmHg with a preserved prostaglandin monotherapy at screening were washed out and randomized to receive BUDPF or LUDPF for 3 months and were then switched to the other respective treatment for another 3 months. IOP curves were performed at baseline and after each treatment period, and safety and tolerability were assessed at the two latter timepoints.ResultsBoth drugs were effective in lowering IOP, both at 3 and at 6 months (estimated differences compared to baseline pressures: −4.0 ± 0.5 for both BUDPF and LUDPF, p < 0.01 at 3 months; −5.2 ± 0.5 for BUDPF, −3.4 ± 0.5 for LUDPF, both p < 0.01 at 6 months). Analysis at 6 months (primary endpoint) showed a difference of 1.6 ± 0.5 mmHg between the two groups, favoring BUDPF (p < 0.01). An intra‐subject IOP difference of 0.9 ± 0.2 mmHg in favor of BUDPF was observed (p < 0.01).ConclusionsThis study demonstrate a superior efficacy of BUDPF over LUDPF in lowering IOP.
Immunohistochemical characterization of a retinal hamartoma
Authors: Van Ginderdeuren R. , Stalmans P. 
Published: September 2015

PurposeTo describe the immunohistochemical features of a retinal hamartoma.MethodsA 38 year old man was referred for preretinal fibrosis on his right eye. There was loss of vision for more than 8 years with metamorphopsia. The left eye was normal. Oct imaging showed an epiretinal fibrosis with extensive macular oedema. A 27Gauge vitrectomy was performed. The lamina limitans interna (ilm) was peeled after staining with Membrane Blue Dual and sent for histopathology.ResultsAfter removal the epiretinal membrane was immediately fixed with PreservCyt® in a ThinPrep® container. The specimen was routinely processed by the Cellient® embedding system. Microscopy showed a folded Pas positive membrane, recognized as ilm with on one side some glial remnants and on the other side a cuboidal non‐pigmented epithelium. The glial remnants stained with glial fibrillar protein (gfap), the epithelium with prekeratin AE1/AE3. CD 34 stain was positive in preretinal capillaries.ConclusionsA strange retinal fibrosis consisted of glial tissue and a row of superficial cuboidal non‐pigmented epithelium cells. This kind of hamartoma with immunohistological description was never investigated or published.
Leuven Eye Study – Baseline and Methods
Authors: Abegao Pinto L. , Willekens K. , Van Keer K. , Shibesh A. , Vandewalle E. , Molenberghs G. , Stalmans I. 
Published: September 2015

PurposeGlaucoma is known to be associated with vascular dysfunction. However, integrating this knowledge in the clinical setting has been limited, considering the majority of vascular oriented studies have been either underpowered or only addressed a small segment of the vascular parameters in strictly selected patients. The Leuven Eye Study aims at bridging this gap by prospectively collecting the largest amount of vascular oriented data in a large real‐life glaucoma clinic setting.MethodsProspective, cross‐sectional, case–control hospital‐based study. Patients with primary open‐angle glaucoma (POAG), normal tension glaucoma (NTG), glaucoma suspect or ocular hypertension (OHT) and healthy volunteers were recruited. In addition to an ophthalmological examination, a vascular‐oriented questionnaire was completed and ocular blood flow assessment (color Doppler imaging of retrobulbar vessels, retinal oximetry, dynamic contour tonometry, optical coherent tomography enhanced depth imaging of the choroid) was performed in each subject.Results620 subjects (297 male) were recruited between March and December 2013 (POAG: 214, NTG: 192; glaucoma suspect: 41; OHT: 27; healthy controls: 146). Mean age was 68.4 ± 12.9 years. Other than IOP, there was no difference in demographic variables between glaucoma groups and healthy volunteers. Values for the ocular blood flow parameters are in line with the current literature.ConclusionsThe Leuven Eye study stands as the largest clinical trial on ocular blood flow in glaucoma. The creation of this vast database may help integrate the vascular aspects of glaucoma into the clinical practice of glaucoma.
Relapsing Polychondritis and its Orbital Manifestations
Authors: Teo L. , Choo C.T. 
Published: September 2015

PurposeWe describe a 73 year old Chinese Gentleman with bilateral relapsing, remitting orbital inflammatory disease associated with Relapsing Polychondritis (RP).MethodsWe reviewed the current literature available on the diagnosis and management of orbital inflamamtory disease in RP.ResultsOur patient first presented with right orbital inflammation that did not improve despite antibiotic treatment. Computer tomography (CT) of the orbits showed a soft tissue mass along the roof of the orbit, which was biopsied, revealing acute on chronic inflammation. There was complete resolution of his orbital inflammation within 2 weeks of initiating systemic steroid treatment. He subsequently developed recurrent bouts of left orbital inflammation. One year later, he was diagnosed with relapsing polychondritis and subsequently developed multiple myeloma 7 years later.ConclusionsIn summary, recurrent orbital inflammatory disease should prompt the Oculoplastics surgeon to exclude a systemic autoimmune disease and hematological malignancy. The course of orbital inflammation in RP can be relapsing and remitting. Co–management with a rheumatologist will be helpful to achieve control of the disease with judicious use of immunosuppression. Long‐term follow‐up of the patient will be necessary to monitor for malignant transformation of the orbital lesion, as well as the development of hematologic malignancies.
The diameter regulation of retinal arterioles during systemic hypoxia is impaired in diabetic patients without retinopathy
Authors: Petersen L. , Bek T. 
Published: September 2015

PurposeDiabetic retinopathy (DR) is characterized by retinal lesions related to disturbances in retinal vascular supply that may lead to retinal hypoxia. Additionally, the metabolic activity of cyclooxygenase (COX) and nitric oxide synthase (NOS) have been found to be changed in patients with diabetes mellitus. Therefore, the purpose of the present study was to investigate the effects of inhibiting the COX and the NOS enzymes during hypoxia.MethodsTwenty patients with type 1 diabetes mellitus and no visible diabetic retinopathy were studied. Using the Dynamic Vessel Analyzer the diameters of retinal arterioles at rest and during isometric exercise and flicker stimulation were studied before and during systemic hypoxia induced by breathing a hypoxic gas mixture. The examinations were performed before and during i.v. infusion of the NOS inhibitor L‐NMMA and all examinations were repeated on a second day after topical administration of the COX‐inhibitor diclofenac.ResultsHypoxia reduced the vasodilatation induced by flicker stimulation (p = 0.0003) and the vasocontraction induced by both isometric exercise (p = 0.001) and NO synthesis inhibition (p < 0.0001), whereas COX inhibition had no significant effects on the diameter responses.ConclusionsIn diabetic patients, hypoxia reduces the diameter response of retinal arterioles secondary to changes in blood pressure and retinal metabolism, and the response depends on nitric oxide synthesis. This may potentially point to targets for intervention on retinal flow disturbances in patients with diabetic retinopathy.
3D model of pterygium and corneal limbus: Investigating histopathology and stem cell distribution
Authors: Blom N. , Andreasen A. , Heegaard S. , Hjortdal J. , Nielsen K. 
Published: September 2015

PurposeThis study aims to create a complete histological 3D computer model of pterygium in situ, mapping the anatomy of the disease tissue, its relation to the corneal limbus and the distribution of limbal stem cells.MethodsOne human eye affected with pterygium was obtained from a cornea donor post mortem. The anterior part of the eye was cut into 900 consecutive horizontal sections. Every other section was stained with HE to be digitized, aligned and 3D reconstructed using interactive 3D visualization software. Immunohistochemistry targeting CK19, MMP‐1, p63 and VEGF was performed on the remaining sections alternating across the structure so as to create evenly distributed overlaying models.ResultsUsing the sections a high‐resolution model of the pterygium and limbus was created, and in aligning the immunostained sections to the model, a spatial map of the staining was created. Analyzsing the model we found a mostly normal temporal limbus with intact architecture, however nasally the limbus was found to be buried under the pterygial mass and only partly intact, showing a number of pathological changes.ConclusionsThe limbal degeneration underneath the pterygium appears to be a precondition for a consequence of the pterygial growth.
The Protective Effect of Anti‐blue Lens Against Photo‐induced Cell Death
Authors: Yu W.Y. , Shan S.W. , To C.H. , Chan H.H.L. 
Published: September 2015

PurposeAnti‐blue lenses that selectively block the harmful portion of the blue light spectrum become commercially available recently. This study aimed to evaluate the protective effect of anti‐blue lens on cultured porcine primary retinal pigmented epithelial (RPE) cells against photo‐irradiation.MethodsPrimary RPE cells were isolated from porcine eyes and cultured to confluence. The cells were characterised by RPE65 using Western Blot. White and blue light emitting diode (LED) light sources as well as the transmittance of the anti‐blue and anti‐UV lenses were characterised by a spectroradiometer. The RPE cells were exposed to ~1.8 × 104 cd/m2 white (peak wavelength at 443 and 533 nm) or blue (peak wavelength at 448 and 523 nm) LED light for 16 hours, with anti‐blue, anti‐UV lens or without lens. Control cells were incubated in the dark. Cellular viability under the different lighting conditions with the anti‐blue or anti‐UV lenses were compared using trypan blue staining and MTT assay.ResultsTrypan blue staining showed that the RPE cellular viability under no light, white light and blue light conditions without any lenses were 94.8 ± 0.4%, 93.7 ± 1.1% and 88.7 ± 2.0% respectively. Blue light irradiation significantly induced more cell death when compared to no light (p = 0.001) and white light (p = 0.005) conditions. MTT assay also revealed significant difference under blue light when compared to no light (p = 0.002) and white light (p = 0.014) conditions. When comparing the effect of anti‐blue and anti‐UV lenses on cell survival, we found that anti‐blue lens showed significantly elevated viability (93.4 ± 1.4% vs 90.6 ± 1.4%) using trypan blue (p = 0.022) and MTT assay (p = 0.029).ConclusionsBlue light exposure induced significant cytotoxicity on RPE cells. The anti‐blue lens significantly reduced the harmful blue spectrum and showed protective effect on RPE cell survival.
Randomised, controlled study of the efficacy and safety of a new eye‐drop formulation for moderate to severe dry eye syndrome
Authors: Doan S. , Baudouin C. , Khairallah M. 
Published: September 2015

PurposeThe aim of this study was to compare the efficacy and safety in Dry Eye Disease (DED) of T2762, a new product containing an innovative bioprotective molecule trehalose (molecule finds in plants resistant to dissication with osmoprotectant properties) and hyaluronic acid, to Vismed®MethodsPhase III, randomized, active‐controlled, Investigator‐masked, multicentric study in France and Tunisia. 105 Adult patients (≥18 years) with moderate to severe DED were included and received one drop of either T2762 (N = 52) or Vismed® (N = 53) 3–6 times per day for 84 days. The primary efficacy variable was the Oxford grading score at Day 35. Ocular Surface Disease Index (OSDI), dry eye symptoms, Schirmer test, TBUT, conjunctival hyperaemia, and global performance were assessed as secondary efficacy criteria at baseline, Day 35 and Day 84. Safety assessments were standardResultsNon‐inferiority of T2762 to Vismed® for Oxford grading score was demonstrated at Day 35. For secondary efficacy parameters, reductions in OSDI, dry eye symptoms and investigator/patient assessments of global performance were better for T2762. There were no clinically meaningful between‐group differences for the other secondary criteria. Both treatments were well tolerated. Interestingly, there were fewer ocular symptoms upon instillation and fewer AEs with T2762ConclusionsT2762 is effective and safe, with better patient satisfaction than existing hyaluronate‐only eye drops, and offers a therapeutic advancement in the treatment of moderate to severe DED.
Contribution of Optical Coherence Tomography (OCT) with real‐time OCT of the Femtosecond laser, and per operative OCT of the microscope in deep anterior lamellar keratoplasty (DALK) for keratoconus: a new technique
Authors: Nguyen D.T. , Stephan S. , Gleize S. , Cochereau I. , Gabison E. 
Published: September 2015

PurposeDeep anterior lamellar keratoplasty (DALK) is a treatment of choice for keratoconus. We evaluate the contribution of a new technique associating femtosecond laser with real‐time OCT, and per‐operative OCT on the microscope, in DALK surgeries for keratoconus.MethodsAfter training on artificial anterior chambers of corneal grafts to evaluate the reproducibility of cuts, pre‐cuts of human anterior corneal lamellae during DALK of keratoconus were realized using the femtosecond laser (Victus, Bausch and Lomb) with real‐time OCT and a curved applanation's surface. The depth was caculated around 60% of the thinnest pachymetry. Surgeries were realized using the per‐operative OCT with the Rescan system of the microscope (Lumera 700, Zeiss).ResultsCurved applanation and visualization with real‐time OCT of the cuts’ depth enabled the realization of reproducible lamellar cuts on 200 µ thick corneas, without modifying the laser‐cornea interface neither using masking agents. Femtosecond laser cuts allowed the big‐bubble formation on 10/10 ex‐vivo corneas. In human surgeries, real‐time OCT visualization allowed controlling non‐penetrating cuts, and the curved applanation limited folds formation on the residual stroma. Each surgical step was controlled by per‐operative OCT, with visibility of tissues’ structure and thickness, and instruments in cross section. The Anwar‐air dissection technique permitted the “big‐bubble” formation in 7/7 case, clearly visible on OCT, with only 1 or 2 injections of air. Residual posterior stroma was resected realizing pre‐descemetic lamellar grafts.ConclusionsThis new technique, femtosecond laser associated with per‐operative OCT, appears to be safe, effective, reproducible and time‐saving in DALK surgeries, facilitating the “big‐bubble” formation. It may be proposed for the management of keratoconus and other indications.
Optic disc swelling: Prospective study of sixty‐seven patients
Authors: Sitbon C. , Fel A. , Bodaghi B. , Le Hoang P. , Touitou V. 
Published: September 2015

PurposeTo assess the clinical features and etiologic work‐up of patients presenting with optic disc swelling (ODS) in the emergency room.MethodsPatients seen in the ophthalmology emergency department of a single tertiary center between November 2014 and October 2015 were prospectively included. Each patient underwent an etiologic work‐up including a brain‐MRI, blood work, fluorescein angiography, and visual evoked potential.Results67 patients (39 female and 28 male) were included in this study. Average age was 46 years (17–86 years). ODS was unilateral in 45% of cases and bilateral in 55% of cases. The average time between the onset of symptoms and diagnosis of papillary edema was 80 days (3 days to 8 months). The mean initial visual acuity was 0.2 logMAR, and the mean final VA was 0.1 logMAR. Final diagnosis was intracranial idiopathic hypertension (43%), anterior ischemic optic neuropathy (25%), inflammatory or infectious papillitis (22%), compressive optic neuropathy (2%) and unknown in 3 cases (8%). The etiologic work‐up was contributive for the final diagnosis in 10% of cases for fluorescein angiography; 35% for MRI of the optical nerve; 32% for laboratory tests; 67% for visual evoked potentials; 90% for the visual field of Goldman. Findings of Goldman's visual field included central or caecocentral scotoma (32%), exclusion or enlarged blind spot (41%), inferior altitudinal scotoma (19%), and bitemporal quadrantanopia (5%).ConclusionsOur results demonstrate that causes of ODS could be identified in 92% of patients presenting with ODS. According to the clinical features at presentation, the etiologic work‐up can be further adjusted but a standard minimal etiologic work‐up is usually efficient to state the diagnosis.
Two Sisters with Congenital Blindness caused by Osteoporosis‐pseudoglioma Syndrome due to new Mutations in the LPR5 Gene
Authors: Welinder L. , Robitaille J.M. , Boerkoel C.F. , Rupps R. , Lyons C. 
Published: September 2015

PurposeTo discover the reason behind two sisters being born blind with retinal detachment and microphthalmia with later findings of severe osteoporosis with low impact fracturesMethodsMolecular testing identified biallelic lipoprotein receptor‐related protein 5 (LRP5) mutations (NM_002335.3:c. [889dupA]; [2827 + 1G4A]) confirming a diagnosis of osteoporosis–pseudoglioma (OPPG) syndrome.ResultsTwo new mutations in the LPR5 gene were each found in the unrelated parents of the girls and were found heterozygote in the girls. Both parents were then discovered to have osteopenia, as did several relatives, who all started preventive treatment.ConclusionsOPPG is a autosomal recessive disease almost uniformly causing blindness from very early age with severe osteoporosis and low impact fractures, which was also the case of our two sisters. The diagnosis of OPPG was confirmed by sequencing the LPR5 gene, where two new mutations were found.
The use of intraoperative spectral domain optic coherence tomography in vitreoretinal surgery: The evaluation of efficacy
Authors: Lytvynchuk L. , Glittenberg C. , Binder S. 
Published: September 2015

PurposeTo evaluate the feasibility of intraoperative spectral domain optic coherence tomography (iSD‐OCT) in challenging cases during pars plana vitrectomy (PPV).MethodsIntraoperative imaging was performed using the first commercially available iSD‐OCT system Rescan 700, fully integrated into the surgical microscope OPMI Lumera 700 (Zeiss, Oberkochen, Germany). The feasibility of iSD‐OCT was assessed during three 23‐gauge PPV cases: large macular hole (MH) with inverted internal limiting membrane (ILM) flap technique (Case #1), vitrectomy for asteroid hyalosis with age‐related macular degeneration (Case #2), vitrectomy for morning glory syndrome with retinoschisis and exudative retinal detachment (Case #3).ResultsCase #1. The use of iSD‐OCT facilitated to safely initiate ILM flap, to form inverted flap, to invert the flap into the MH, to control position of the forceps concerning retinal layers, and to confirm the MH covering with the ILM remnants at the end of the surgery. Case #2. Standard OCT was not available before the surgery due to opaque vitreous. Intraoperative SD‐OCT imaging assisted to reveal epiretinal membrane (ERM), retinal pigment epithelium detachment, intraretinal fluid and drusen. These findings required additional surgical steps: ERM removal and injection of anti‐VEGF at the end of the surgery. Case #3. In the case of morning glory syndrome iSD‐OCT facilitated to remove the strongly adherent posterior hyaloid, to control ILM flap initiation, to perform the peeling over the detached retina, to aspirate residual fluid after fluid/air exchange.ConclusionsThe use of iSD‐OCT facilitates real‐time simultaneous to surgical workflow visualisation of tissue behaviour and surgical manoeuvres during pars plans vitrectomy. The obtained information can improve surgical technique and influence the decision making in difficult cases.