bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular surface anatomy and physiology underlying scleral lens application
Authors: KNOP E , KNOP N 
Published: August 2014

AbstractContact lenses (CL) are in the public interest mainly for cosmetic reasons. Because of supposed simplicity of fitting, adaption, care and safety, soft CL are the predominant type world‐wide. Only few rigid gas permeable (RGB) CL are applied even though it may appear that they have less side effects. Another type of CL rests on the sclera and is hence termed scleral lenses. In contrast to the aforementioned CL, that cover only the cornea (RGB) or extend just beyond, scleral lenses have a wide diameter and cover also a large part of the bulbar conjunctiva. This leads to different impact on the anatomy, physiology and pathology of the ocular surface. Below their apex is a deep tear pond that allows to cover even major deformations of the cornea as occur in keratokonus, recurrent surface defects or scars without touching them. New sophisticated diagnostic techniques e.g. for measuring ocular surface topography as well as advanced designs and materials of standard or custom made lenses have significantly improved the fitting and the wearing comfort of scleral lenses. Therefore, scleral lenses have emerged in recent years as a new and EVER more exciting medical tool for the dedicated ocular surface specialist.
Scleral Lenses in the United States
Authors: JACOBS D 
Published: August 2014

AbstractThere is growing acceptance of scleral lenses by ophthalmologists, optometrists, and patients in the United States. Options among mini‐scleral and scleral lenses will be reviewed. PROSE treatment (prosthetic replacement of the ocular surface ecosystem) as a therapeutic approach will be introduced. Success rate for PROSE treatment among patients with ectasia/astigmatism and in patients with ocular surface disease will be presented, as will experience with PROSE treatment in pediatric patients. Evidence for reversal of corneal scarring with PROSE treatment of ocular surface disease will be presented. Scleral lens and PROSE treatment are important alternatives to keratoplasty for corneal scarring and to tarsorrhaphy for exposure. Clinicians and researchers should be aware of scleral lens and PROSE treatment as important options for patients with ocular surface disease or contact lens intolerance, who may be at at higher risk of complications, contact lens dependence, or graft failure with penetrating keratoplasty.
The rebirth of sclearl lenses in Europe – 20 years of experience in treating ocular surface disease with scleral lenses
Authors: MANCZAK H 
Published: August 2014

AbstractConcept of scleral lens implementation in diseased corneas can be probably dated at 1859 when William White Cooper used “glass mask” in patient with chemical burn. Scleral lens implementation was greatly limited due to oxygen deprivation under glass lenses then PMMA lenses causing significant adverse reactions. First article on implementation of GP scleral lens was published in 1983. Since then many designs of scleral lenses where developed. Besides neutralizing irregular astigmatism while fitting cases of KC, PMD, post trauma post PK etc. scleral lenses are used to heal and protect corneal epithelium and at the same time to correct refractive error. Scleral lenses have wide medical indications among them: Lagophthalmos, Ocular Cicatricial Pemphigoid, TEN Syndrome, Neurotrophic Ulcer, Chronic GVHD, Bullous Keratopathy. In the presentation: visual, healing and comfort outcomes of scleral lenses implementation in above diseases will be described and illustrated with pictures. In addition rotationally asymmetrical changes enabling achievement of designs which provide a maximally customized fit for each cornea will be discussed. Such modifications are the solution to overcoming the need for fitting compromises in distorted corneas.
Retinal vessel pathologies in a rat model of periventricular leucomalazia
Authors: LORENZ B , STECK J , BLUEML C , KAMPMANN S , GERSTNER B , MAIER RF , STIEGER K 
Published: August 2014

AbstractPurpose Alternating oxygen levels during delivery and supplemental oxygen therapies can cause pathological vascularization of the retina (retinopathy of prematurity, ROP) and/or loss of oligodendrocytes in the periventricular area of the brain with subsequent white matter damage (periventricular leukomalacia (PVL). The aim of this study was to examine retinal vessel pathologies in the standard PVL rat model in order to identify uniform damage pathways.Methods Ischemia was induced in post natal day (P) 6 Long Evans rats with unilateral (left side) carotid ligation (UCL) and exposure to different oxygen concentrations. In total, four different groups were examined: (A) hypoxia/ischemia (UCL + 6% O2, 1 h), (B) hyperoxia (80%O2, 24 h), (C) hypoxia/ischemia + hyperoxia (UCL + 6% O2, 1 h + 80% O2, 24h), (D) normoxia. Morphological analysis of vessel development was performed at P11 and P21. Quantitative PCR was performed at P7, P11, and P21 (VEGF, HIF1a, EPOR, TNFa, iNOS and BMP‐9).Results Distinct retardation in deeper vascular plexus development was observed most prominent in left eyes of groups A and C. Diameters of big retinal arteries were significantly increased in central retinae at P21 and showed retardation in vascular remodeling. Left retinae of groups A and C at P11 displayed reduced capillary free zones (CFZ) and an increase in the number of branching points (BP). Quantitative gene expression analysis showed down regulation of angiogenic factors at P7.Conclusion This is the first report on concurring damage to the retina that was evaluated in a model of white matter injury in the neonatal brain. We observed mild damage to the vessel development and maturation, which is the basis for a model for moderate forms of ROP.
Incidence and characteristics of congenital cataract surgery in France from 2010 to 2012
Authors: DAIEN V , ELIAOU‐MALRIEU C , LEPAPE A , HEVE D , VILLAIN M 
Published: August 2014

AbstractPurpose Prevention of visual impairment due to congenital cataract is an international priority. Estimates of incidence are required for implementation and assessment of preventive strategies, but are lacking, despite routine monitoring of birth defects at a national level in many industrialized countries. The purpose of this study was to determine the incidence of congenital cataract in France between 2010 and 2012. Secondary objective was to assess the proportion of unilateral and bilateral cataract surgeries, age of surgery and implantation of intraocular lens or not.Methods All children who undergo cataract surgery before 1 year of age in France between January 2010 and December 2012 were identiﬁed using the french national database of information systems. Incidence rate per year was estimate using the French database from the national institut of statistics.Results In 3 years, 590 eyes in 464 children with 46.6 % of girls had a cataract surgery with 27.0 % of them having a bilateral surgery. In the first year of age, cataract surgery incidence was 1.87 / 10 000 birth in this period. Age (median [interquartile]) of surgery was 3.5 (2.2‐4.8) months. Among the 590 operated eyes, 28% (168 eyes) were not implanted with intraoculair lens.Conclusion The incidence of congenital cataract in France is close to what was previously assessed in literature in industrialized world. Median age of surgery corresponds to recommendations. An important proportion of children was not primary implanted with an intraoculair lens.
Neosynephrine and tropicamide eyedrops for pupil dilation in premature infants is almost twice as efficient as tropicamide eyedrops alone
Authors: LUX AL , GUILLOIS B , DEGOUMOIS A , MOURIAUX F , DENION E 
Published: August 2014

AbstractPurpose Retinopathy of prematurity screening requires pupil dilation of premature infants. While essential for reliable fundus examination, proper dilatation may sometimes be difficult to achieve in this population. The aim of our study was to compare the efficacy of two mydriatic regimens: one consisting in three drops of tropicamide 0.5% and the other one consisting in two drops of tropicamide 0.5% with one drop of phenylephrine 5%.Methods Thirty premature infants were enrolled and each infant was dilated with one regimen in one eye and the other regimen in the other eye. The side of each regimen was determined by randomization. A photograph of each eye was taken. The photographs were anonymised and randomly presented to two independant readers. The effect of the two regimens was determined by calculating the ratio of pupil diameter divided by cornea diameter. Assuming that pupil and cornea are circle‐shaped, we calculated the ratio of pupil surface area relative to cornea surface area for both regimens.Results The pupil to cornea diameters ratio was 46.7% (+/‐8.8) with tropicamide alone and 65.2%(+/‐6.0) with tropicamide‐phenylephrine combination. The ratio of pupil to cornea surface areas was 21.8% with tropicamide alone and 42.6% with tropicamide‐phenylephrine combination. In other words, the pupil surface area was 1.95 fold greater with tropicamide‐phenylephrine combination than with tropicamide alone.Conclusion The use of a combination of two drops of tropicamide 0.5% with one drop of phenylephrine 5% is far more efficient than tropicamide alone to achieve proper pupil in premature infants.
Myopia and high myopia ‐ genetics and environmental factors
Authors: MORGAN I 
Published: August 2014

AbstractPrevention of myopia is now urgent, since there is an epidemic of high myopia, as well as ordinary myopia, in East Asia. The prevalence of high myopia is now around 20%, compared to about 1% in older generations. This new, acquired, high myopia has an unusual developmental pattern, sitting at around 1% up to the age of 11‐13, and then increasing over the next 10 years, presumably as a result of early onset environmental myopia progressing to high myopia. A critical unanswered question is whether this acquired high myopia carries the same pathological burden as the older genetic form. This question is generally important, because the prevalence of myopia appears to be rising in Europe and North America, and the prevalence of high myopia is probably increasing as well. Fortunately, it is now generally accepted that environmental change in educational pressures and the time that children spend outdoors must be responsible for the 3‐4‐fold increase in the prevalence of myopia in East Asia. In contrast, identified SNPs currently account for less than 5% of phenotypic variation. Recent trials based on increasing the amount of time that children spend outdoors suggest that incident myopia, and hence high myopia, can be prevented.
Scleral crosslinking as a therapeutic approach to treat progressive myopia
Authors: ISELI HP 
Published: August 2014

AbstractIntroduction Elongation of the bulbus is the main cause of high myopia. Light induced scleral crosslinking is suggested as a therapeutic approach to prevent extensive eye elongation . Data about efficient light intensities and light‐induced damage threshold of retinal tissue are not conclusive. There are no data available about the effect on eye growth of light induced crosslinking in an animal model. Material an methods In vitro and in vivo experiments in rabbits were performed with riboflavin/blue light application for scleral crosslinking. Mechanical stiffening effects were studied by means of rheology and tissue damage threshold were characterized by histology and electron microscopy. Results Collagen Crosslinking by riboflavin/blue light stiffens the scleral tissue and induced a significant reduction of eye growth in young rabbits without damaging effects on retinal tissue. Conclusion Riboflavin/Blue light treatment might be a promissing treatment to control eye growth and therefore, to prevent high myopia. More investigations are needed to establish optimal treatment parameters.
Commercial interest
Brachytherapy of uveal melanomas
Authors: KIVELÄ T 
Published: August 2014

AbstractRadioactive plaque brachytherapy is currently the most common treatment modality for primary uveal melanoma. The American Brachytherapy Society consensus guidelines for brachytherapy of uveal melanoma, revised in 2014, are summarised. Several isotopes are used for brachytherapy of the eye, such as strontium‐90 and ruthenium‐106 (beta rays, embedded within the plaque) and palladium‐103 and iodine‐125 (gamma rays, seeds attached to the plaque). The isotope determines how thick tumours can be irradiated (strontium up to 3 mm, ruthenium up to 6 mm, iodine and palladium over 6 mm) and to which extent scatter radiation will affect neighbouring tissues. The plaque is implanted under local or general anaesthesia, localising the tumor by indirect ophthalmoscopy and scleral depression or transillumination. The size and shape of the plaque are chosen according to the size and shape of the melanoma. Most common complications are radiation cataract, retinopathy and optic neuropathy, depending on the location of the tumour, and iris rubeosis and neovascular glaucoma when managing larger tumours. Brachytherapy results for small melanomas irradiated with ruthenium and large melanomas irradiated with iodine are presented as examples.
Anti‐VEGF in the retina
Authors: NG E 
Published: August 2014

AbstractVascular endothelial growth factor A (VEGF‐A) was initially discovered as an endothelial cell‐specific growth factor, and current evidence suggests that it also plays numerous roles outside the vasculature, perhaps most significantly in the nervous system. We previously determined a neuroprotective role for both exogenous and endogenous VEGF‐A in the adult rodent retina during acute ischemia‐reperfusion injury. Furthermore, we demonstrated that endogenous VEGF‐A is critical for maintaining neuron survival in normal adult retina, that long‐term systemic and local VEGF antagonism resulted in significant loss of retinal ganglion cells. More recently, a primary retinal ganglion cell culture model was used to investigate the molecular basis of VEGF‐A’s neuroprotective function, and the importance of VEGF‐A to neuron survival was evaluated in models of glaucoma. Our findings reinforce the essential role for VEGF‐A in retinal neuron survival and have potential implications for therapeutic anti‐VEGF‐A in conditions associated with retinal ganglion cell distress.
French military ophthalmologists experience in Afghanistan War ‐ 2006 ‐ 2013
Authors: GIRAUD JM , EL CHEHAB H , VALERO B , VIGNAL R , RENARD JP 
Published: August 2014

AbstractFrench military ophthalmologists were deployed in Kabul, Afghanistan, since 2006 till december 2013. Their activity first focus was traumatic ocular injuries, concerning NATO forces and Afghan National Army soldiers. They also provided humanitary support to Afghan civilians, offering medical and surgical care. Kabul’s NATO French leaded hospital was equipped with high level examination, investigation and surgical treatment facilities, giving possibility to care all type of ocular emergencies. During 7 years, ophthalmologists realised 1000 surgical interventions. One third were done for traumatic injuries, the two other thirds were mainly cataract surgeries for Afghan population. 95% of all surgeries were for Afghan peoples and 5% interested NATO soldiers and contractors. Consultations were 25% for NATO forces, foreign civilians from embassies, international organisations and contractors and 75% for Afghan population. 10% of patients presented post traumatic ocular pathologies. The high level of equipement in the new NATO Hospital offered possibility to recieve Afghan ophthalmologists for mentoring and practical training.
Animal models of glaucoma
Authors: BRON AM 
Published: August 2014

AbstractAnimal models of glaucoma are still useful to better understand the pathogenesis of glaucoma, to decipher biochemical pathways and to evaluate drugs at a preclinical development. Many species have been used but due to practical and economical reasons, rodents have been the most studied. We will detail the methods used to mimic glaucoma with the most common techniques with an elevation of IOP or not. Then we will review the in vivo endpoints mostly used to assess IOP elevation and glaucoma damage. Rebound tonometry has been a great improvement in the IOP recording accuracy in rodents. Electrophysiology is a surrogate of retina and optic nerve function in these animals. The structure is mainly evaluated with optic disc photography, fluorescein angiography SLO and more recently with OCT. We will end this presentation with the pros and cones of different in vitro techniques mainly used to characterise glaucoma damage at the level of the retina and the optic nerve head.
Pigmentary retinopathy
Authors: ASCASO FJ 
Published: August 2014

AbstractNumerous medications can cause pigmentary retinopathies (PR). Firstly, we discuss the retinal toxicity in patients taking quinolones (chloroquine and hydroxychloroquine), which are traditional antimalarial agents now used to treat autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. Both medications bind to melanin in the retinal pigment epithelium (RPE), altering normal physiologic function and developing a bilateral bull's‐eye maculopathy. PR has also been shown to be related to high dosages of typical antipsychotics, including chlorpromazine and specially thioridazine. The frequency of occurrence of retinal effects seems to be proportional to the total amount of drug used over a long period of time. Furthermore, deferoxamine, an iron‐chelating agent used to treat conditions with excessive serum iron levels, produces a toxicity which is reversible with drug cessation. Other drugs such as etetrinate, quinine, methoxyflurane, didanosine, and clofazimine can be implied in PR. Psychiatrists, ophthalmologists, rheumatologists and patients need to be aware of any medication‐induced PR. Early prevention and intervention can avoid most of the serious and potentially irreversible ocular toxicities.
Retinal vasculopathies
Authors: GRZYBOWSKI A 
Published: August 2014

AbstractDrug‐induced retinal vasculopathies constitute a group of rare disorders, most often produced by quinine, aminoglycosides, hormone preparations, and interferon. IFN‐ associated retinopathy includes cotton wool spots, retinal hemorrhages and retinal micro aneurysms. Aminoglycosides were often used subconjunctivally after different ocular surgeries as a postoperative prevention of endophthalmitis and intravitreally as a method of endophthalmitis treatment. Both clinical and animal studies have shown vascular changes, including whitening of the retina, retinal hemorrhages, multiple areas of vascular leakage and macular infarction. Although the true pathogenesis remains unknown, the clinical presentation of capillary nonperfusion has suggested a primarily vascular mechanism. The mechanism of quinine‐induced retinal toxicity, although still not well understood, includes probably ischemic/ occlusive type of events occurring in the posterior retinal circulation with relative sparing of choroidal circulation. Hormone‐related retinopathy, mainly due to oral contraceptives, include among others retinal hemorrhage or emboli, macular edema, and papillary edema.
Retinal drug toxicity in the absence of visible fundus changes
Authors: LAWRENSON J 
Published: August 2014

AbstractA variety of systemic medications cause retinal drug toxicity associated with characteristic ophthalmoscopic changes e.g. pigmentary retinopathies, crystalline retinopathies, retinal vasculopathies, or retinopathies associated with macula edema. However, altered retinal function can occur in the absence of visible fundus changes. For example, the cardiac glycosides, digoxin and digitoxin, are frequently associated with disturbances of colour vision mediated through the inhibition of sodium‐potassium ATPase. Similarly, phosphodiesterase inhibitors such as sildenafil can also act on the photoreceptor transduction cascade to cause reversible changes in colour perception, blurred vision and increased glare sensitivity. Exposure to antiepileptic drugs that modulate GABA, can also lead to altered visual function. The most significant adverse reaction occurs with vigabatrin which can cause irreversible concentric visual field loss in susceptible individuals. It is important for eye care professionals to be aware of the potential for adverse reactions associated with systemic drugs and consider the use of functional vision tests for their detection and monitoring.
Glaucoma pathology: an eye on the brain
Authors: DEKEYSTER E , AERTS J , VALIENTE‐SORIANO FJ , DE GROEF L , SALINAS‐NAVARRO M , VIDAL‐SANZ M , ARCKENS L , MOONS L 
Published: August 2014

AbstractPurpose Glaucoma is a group of optic neuropathies characterized by loss of retinal ganglion cells (RGC). Since ocular hypertension (OHT) is one of the main risk factors, current therapies are merely based on lowering eye pressure. As a subset of treated patients continue losing vision, more research into the pathological mechanisms underlying glaucoma is needed in order to develop novel therapeutic strategies. Here, we studied the impact of OHT on the main visual areas in the mouse brain: superior colliculus (SC) and primary visual cortex (V1).Methods Temporary monocular hypertension (5 days) was induced in mice by lasering the episcleral and perilimbal vessels. The impact on the retina and its target areas was examined via immunohistochemistry (Brn3a, VGluT2 and GFAP). Alterations in neuronal activity in V1 were assessed via in situ hybridization for zif268.Results Transient OHT resulted in diffuse and sectorial RGC death. In the SC contralateral to the OHT eye, we detected a strong decrease in synaptic connections at 1 week after lasering, which was retinotopically linked to RGC degeneration patterns in the retina. Similar retinotopic dropouts were discerned in activity patterns of V1 at 1 week post lasering, while V1 activity resumed 3 weeks later. In the SC, however, no recovery of synapse density was observed and inflammation was not resolved at 4 weeks post lasering. Nevertheless, SC neurons appeared healthy and cell density and cell morphology looked normal.Conclusion Besides RGC death, OHT also induces loss of synaptic connections and neuronal activity in visual brain centers, accompanied by extensive immune responses. This stresses the importance of including the whole visual system in glaucoma research.