bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opacification of intraocular lens
Authors: Matsushima H. 
Published: September 2015

SummarySoft hydrophobic acrylic intraocular lenses (IOLs) are increasingly being used because they can be implanted through small incisions, provide good postoperative vision. However, long‐term postoperative follow‐up has identified various problems, including calcification, glistening and whitening.Calcium deposit on surface of IOLs are sometimes reported about hydrophilic acrylic materials. Calcification reduces the transmission of light and renders the fundus virtually invisible and decrease visual function easily.Glistening has been attributed to water retention in voids of hydrophobic acrylic materials and nonuniformity of polymer network structures. Whitening refers to the clinical appearance from sub surface nano glistenings (SSNG) of reflected white light due to light scattering as light encounters nano sized fluid filled vacuoles that occur at the anterior and posterior IOL surface. With a hydrophobic IOL, the fundus remains visible despite opacification and less effect of visual function. As a result, removal and replacement of IOLs is indicated in only a few cases. However, sever glistening and whitening increased glare and decreased contrast sensitivity.
Behçet's disease, VKH, sarcoidosis
Authors: Khairallah M. , Kahloun R. , Ksiaa I. 
Published: September 2015

SummaryOcular involvement associated with Behçet disease is characterized by a relapsing remitting panuveitis with diffuse vitritis, retinal infiltrates, and occlusive vasculitis. Proper management relies on the early use of immunosuppressive drugs in combination with corticosteroids and administration of biologic agent in resistant and severe posterior segment involvement. VKH disease is a bilateral panuveitis that may be associated with extraocular manifestations. Exudative retinal detachment, associated with typical imaging findings, is the most specific feature to acute VKH disease. Sunset glow fundus is typical to chronic VKH disease. Complications are more likely to occur in the chronic recurrent phase. The mainstay of treatment for acute VKH disease relies on systemic corticosteroid therapy for at least 6 months. Immunosuppressive therapy is mainly used in chronic recurrent disease. Main ocular features of sarcoidosis include bilateral granulomatous anterior uveitis, vitritis with snowballs, multifocal chorioretinitis, and segmental periphlebitis. Diagnosis may be challenging in the absence of apparent systemic involvement. Treatment of ocular sarcoidosis relies on corticosteroids and immunosuppressive agents, in severe cases.
Safety and effectiveness of intravitreal injections in the silicone oil‐filled eye
Authors: Ascaso F. 
Published: September 2015

SummarySilicone oil (SiO) use has gained acceptance in providing an effective long‐term tamponade in retinal detachments complicated with proliferative vitreorretinopathy. As the use of injectable therapeutics grows and their indications broaden, it is important to know the safety and effectiveness of intravitreal injections in eyes containing SiO as a vitreous substitute. Thus, whereas intrasilicone injection of bevacizumab is safe and effective to treat patients with iris neovascularization after vitrectomy for advanced proliferative diabetic retinopathy, triamcinolone injection into the SiO‐filled eye is inadequate given that it might significantly increase the IOP due to volume expansion. Furthermore, triamcinolone may not dissolve in SiO, preventing its diffusion to the macula surface, and its whitish crystals might opacify the visual axis. Unlike intravitreal triamcinolone, the DEX implant causes minimal volume expansion and no media opacity. It is biodegradable and injected without surgery and thus also advantageous over the fluocinolone implant. Additional studies are necessary to better understand the pharmacodynamics of sustained‐release drugs from devices implanted or inserted into eyes filled with SiO as vitreous substitute.
The changes of the retinal layers in diabetic patients without retinopathy
Authors: Ferreira J. , Costa L. , Proença R. , Vicente A. , Cunha J.P. , Abegão Pinto L. 
Published: September 2015

SummaryDiabetic retinopathy is considered to be a neurovascular disease. But in fact, retinal neurodegeneration is present before any microcirculatory abnormalities can be detected in ophthalmoscopic examination. We know this from functional studies documenting electroretinogram abnormalities, loss of dark adaptation, contrast sensitivity and color vision and abnormal microperimetry occur before any vascular abnormality is detected. Novel imaging devices have allowed this pre‐vascular damage to be quantified in a non‐invasive and reproducible way using spectral domain optical coherence tomography (SD‐OCT) that allows in vivo retinal layer thickness measurement. The extent to which this new technology can be used in the clinical setting for early screening in diabetic retinopathy will be the focus of this lecture. The review of the state of the art in this exciting new field of study may prove valuable in the management of this condition.
Sensory and motor fusion
Authors: Houtman A.C. 
Published: September 2015

SummaryThe basis of our understanding of binocular vision and amblyopia in clinical practice has not changed much since Claud Worth formulated three grades of binocular vision in 1903 – well over a century ago. Despite many scientific advances in the neuroanatomical and neurophysiological aspects of binocular vision it may – or may not – come as a surprise that the treatment of strabismus and amblyopia has not fundamentally changed since.This part of the Special Interest Symposium “contains nothing new” [p.1 Squint: its causes, pathology and treatment. Worth C. London, John Bale, Sons & Danielsson Ltd, 1903], to an extent, but is intended as a refresher of the anatomical and physiological basis of binocular vision and to prime the attendants for the symposium's subject: the presentation of recent advances in the research of the corpus callosum and its role in binocular vision.
Stromal choroiditis in East (VKH) and West (birdshot)
Authors: Herbort C.P. 
Published: September 2015

SummaryBackground and aimBoth Vogt‐Koyanagi‐Harada (VKH) disease and birdshot retinochoroiditis (BRC) are primary stromal choroiditis entities, meaning that the initial inflammatory process necessarily starts in the choroidal stroma. The aim here was to point out similarities and differences between these two stromal choroiditis entities and to show that early treatment is able to modify the phenotypes of both conditions.Patients and methodsTwo groups of patients respectively of VKH and BRC cases were analyzed and followed clinically and angiographically using dual fluorescein (FA) and indocyanine green (ICGA) angiography.Results: 13 of 28 BRC patients and 11 of 24 VKH patients had enough follow‐up data to be included in the study. Early diagnosis and treatment in both VKH (9/11) and BRC (6/13), allowed to avoid sunset glow fundus in the former and BRC fundus lesions in the latter. The main similarities and differenced will be pointed out.ConclusionVKH and BRC differ substantially from each other. However choroidal stromal inflammation is characterized by a similar process and responds equally to therapy.
Can ophthalmic technicians be used to deliver glaucoma care?
Authors: Kotecha A. 
Published: September 2015

SummaryThe presentation will describe the development of a technician‐delivered glaucoma screening and monitoring service introduced to help improve capacity and the patient experience within glaucoma outpatient clinics in a London hospital. The service involves the use of ophthalmic technicians to collect clinical data from patients, with a specialist reviewing these data remotely; thus, it removes the face‐to‐face doctor consultation. The nature of glaucoma detection and monitoring lends itself to a ‘remote review’ care model. The patient journey time in this clinic averages at around 50 minutes, compared with 163 minutes in the glaucoma outpatients department. The overall first visit discharge rate for the new patient screening service is 58%; the proportion of patients attending the Stable Monitoring Service who have been rebooked into the service is now 83%. Patient satisfaction with the new service is high. Early analysis suggests that there exists a discrepancy between consultant reviewer management decisions for stable patients, suggesting some may be more risk‐averse than others when managing patients seen within this model.
Prevention of herpes simplex stromal keratitis by a glycoprotein B‐specific monoclonal
Authors: Bauer D. , Dirks M. , Kasper M. , Buch A. , Dittmer U. , Giebel B. , Wildschütz L. , Busch M. , Goergens A. , Schneweis K.E. , Eis‐Hübinger A.M. , Sodeik B. , Heiligenhaus A. , Roggendorf M. , Krawczyk A. 
Published: September 2015

SummaryThe increasing incidence of acyclovir (ACV) and multidrug‐resistant strains in patients with Herpetic Stromal Keratitis (HSK) is a major health problem and often results in blindness. In the study we examined the effectivity of mAb 2c in preventing experimental HSK in BALB/c mice. Mice were infected with HSV‐1 (KOS) and subsequently either systemically or topically treated with mAb 2c. Systemic treatment was performed by intravenous administration of mAb 2c 24 h prior to infection (pre‐exposure prophylaxis) or 24, 40, and 56 hours after infection (post‐exposure immunotherapy). For topical treatment antibody‐containing eye drops or PBS as control was administered (5 times per day). Systemic antibody treatment markedly reduced viral loads and completely protected mice from developing HSK. The administration of antibody prior or post infection was equally effective. Topical treatment had no improving effect on the severity of HSK. In conclusion, our data demonstrate that mAb 2c proved to be effective for the treatment of corneal HSV‐infections and for prevention of HSK and blindness. Moreover, the humanized counterpart (mAb hu2c) was equally potent in protecting mice from HSV‐induced HSK when compared to the parental mouse antibody.
New software for an old problem
Authors: Diamond J. 
Published: September 2015

SummaryThere are huge benefits to be won by switching from old fashioned medical notes to paperless medical records: as a consequence, use of electronic patient records (EPRs) for glaucoma management has become more widespread in recent years.There are a number of different EPR systems in use in the glaucoma clinic, each of which has strengths and weaknesses. Before selecting a system, clinicians need to consider how and where the system will be used, paying particular attention to venue (hospital or community), primary user (ophthalmologist, optometrist, nurse or technician), compatibility with other equipment (visual fields and disc imaging), ability to archive older medical records and accessibility for virtual review.It is also of great importance to consider speed of data entry: most EPR systems are slower to use than old‐fashioned paper notes and if that differential is significant, the economics of switching to an EPR will be poor and uptake will suffer as a consequence.In his presentation Jeremy Diamond will consider these issues in more detail, providing helpful insights to those who wish to switch from paper to paperless working.
Radiation‐induced cataracts: governmental safety aspects
Authors: Ainsbury E. 
Published: September 2015

SummaryDespite relative ease of treatment, radiation induced cataracts are still the most frequent cause of blindness worldwide. Recent advances have demonstrated that the lens is more radiosensitive than was previously thought and that occupational radiation exposure leads to a small but genuine increase in the risk of radiation cataract for workers, for instance hospital based interventional radiologists and cardiologists. As a result of this and other work, the ICRP recommended to reduce the dose limit from 150 to 20 mSv/year (averaged over 5 years with no single year exceeding 50 mSv). This recommendation has recently been incorporated in the EU Basic Safety Standards in full, with member states required to comply from February 2018.This presentation will outline the epidemiological and mechanistic research upon which the new limits are based; consider the implications for radiation protection in terms of who will be affected, what will need to be measured and how individuals can be protected and, finally, discuss the specific scientific gaps and research needs in order for the relevant authorities to ensure individual radiation workers and members of the public are adequately protected against radiation induced cataracts.
Dominant Optic Atrophy plus phenotype caused by a deep intronic mutation and a modifier variant in the OPA1 gene
Authors: Wissinger B. , Bonifert T. , Gonzalez‐Menendez I. , Theurer Y. , Synofzik M. , Schoels L. 
Published: September 2015

SummaryMutations in OPA1 are a common cause of dominant optic neuropathy (DOA). Recent studies suggest that ~20% of patients carrying OPA1 mutations have additional neurological deficits (DOAplus phenotype). Such patients frequently carry missense mutations in the GTPase domain of OPA1 suggesting a gain‐of‐function effect as a major mechanism. We and others recently reported a series of DOAplus patients with biallelic OPA1 mutations as an alternative disease mechanism. Notably most cases were compound heterozygous for a null allele and the Ile382Met variant. The latter is not per se pathogenic but rather acts as a hypomorphic modifier allele that reinforces phenotypic expression in patients with null mutations on the opposite allele. In one biallelic DOAplus family we identified a deep intronic mutation (DIM) that causes a constitutive activation and inclusion of a cryptic frameshift‐inducing exon into OPA1 mRNA. Consistent with the DIM representing a null allele we observed reduced OPA1 protein amounts to about 50% of normal. Applying antisense oligonucleotides targeting the splice acceptor site of the DIM in patient fibroblasts we could efficiently rescue splicing of the mutant mRNA and re‐establish intermediate OPA1 protein levels.
The CD4/CD8 ratio in vitreous fluids is of high diagnostic value in sarcoisosis
Authors: Maruyhama K. 
Published: September 2015

SummarySarcoidosis is an idiopathic inflammatory disorder involving multiple organs, and ocular manifestation is one of the common features. A well‐known immunological feature in sarcoidosis is an increased CD4+ helper T cell type 1 lymphocyte subset in BALF. In this study, we investigated the vitreous lymphocyte subsets of sarcoidosis to elucidate the immunological features of this disorder in the eye. Our study enrolled 86 sarcoidosis patients. Diagnoses included 53 eyes with definitive sarcoidosis (D‐S) of 41 patients, 60 eyes with suspected sarcoidosis (S‐S) of 45 patients. Vitreous samples from the uveitis patients were analyzed with flow cytometry. Our result presented that the CD4/CD8 ratio was high in the D‐S/S‐S in the vitreous samples. Moreover, a high CD4+ population indicated sarcoidosis uveitis. Therefore, diagnostic vitrectomy using flow cytometric analysis may be a useful adjunct for the diagnosis of sarcoidosis, particularly in complex cases.
Atropine treatment
Authors: Grzybowski A. 
Published: September 2015

SummaryIn the last years, there has been a marked increase in the prevalence of high myopia in younger generations in developed countries in East and Southeast Asia, and there are signs of similar, but less pronounced increases in North America and Europe. In some parts of the world, 70–90% of children completing high schools are now myopic, and as many as 20% may be highly myopic. Topical Atropine have been quite extensively used in clinical practice in Asian countries, and recent reports suggest that low concentrated atropine, which has less severe side‐effects, is also effective. The beginning of an invasive treatment such as atropine drops, even at low doses, requires careful consideration of the risk of myopic progression. The current literature relevant to the prevention of myopic progression with atropine drops is reviewed.
Lifetime study in mice for radiation‐induced cataracts
Authors: Dalke C. , Rößler U. , Neff F. , Greiter M. , Gomolka M. , Hornhardt S. , Unger K. , Garrett L. , Rosemann M. , Kempf S. , Azimzadeh O. , Wurst W. , Aubele M. , Zitzelsberger H. , Hölter S. , Tapio S. , Hoeschen C. , Kulka U. , Atkinson M. , Graw J. 
Published: September 2015

SummaryWe initiated a lifetime study in mice focusing on non‐cancer effects after exposure to middle and low doses of ionizing radiation, particularly radiation‐induced cataracts and retinal disorders.Mice (males and females) were irradiated (0, 0.063, 0.125 and 0.5 Gy) and received in vivo examinations for lens opacities by Scheimpflug imaging monthly and for retinal effects by OCT every four months. To investigate the underlying mechanisms of radiation‐induced effects mice are sacrificed at different time points (4 and 24 hours, 12, 18 and 24 months after irradiation) for pathological and histological examinations.Beside wild‐type mice, heterozygous Ercc2/Xpd mutants are included in the study to estimate the risk of genetic susceptibility in virtually healthy mutant mice, while homozygous Ercc2 mutants develop cortical cataracts at early age. The ERCC2 protein has DNA helicase activity and is involved in general transcription and DNA repair.First analyses of the Scheimpflug examinations did not show significant changes within the groups up to 20 months after irradiation with 0 and 0.5 Gy, while OCT data showed a reduction of the retinal thickness in irradiated heterozygous mutants. This study is still in progress.
Myopic macular holes
Authors: Mura M. 
Published: September 2015

SummaryMyopic traction maculopathy is common in highly myopic patients and characterized by different stages: macular schisis (MS),macular detachment (MD) without macular hole (MH), and MD with MH. MH‐related retinal detachment is an uncommon complication associated with posterior staphyloma. Surgical management is based on transvitreal approach and posterior scleral procedure. Since the introduction of pars plana vitrectomy (PPV),retinal detachments with MH in highly myopic eyes were mostly treated with the transvitreal surgery. However,vitrectomy alone does not address the major risk factor of the macular schisis, which is the posterior staphyloma. To give a new shape and support to the posterior scleral wall by means of macular buckling has the advantage of releasing both the traction caused by the posterior staphyloma and the anteroposterior traction caused by the vitreous cortex. A more recent T‐shaped scleral buckle has been proposed by Devin et al.We performed this macular buckling combined or not with PPV as a primary surgery or with a previous failed surgical approach in patients affected by MH with MD and MH with or without MS.In our opinion a combined surgical approach could be the most effective way to treat this disease.
Congenital forms of nystagmus
Authors: Kaeser P.F. 
Published: September 2015

SummaryCongenital benign forms of nystagmus have to be recognized and distinguished from acquired forms caused by neurologic lesions, in order to avoid unnecessary investigations. This distinction can usually be made on clinical grounds. Congenital forms of nystagmus include idiopathic infantile, ocular (most commonly associated with albinism, macular or optic nerve hypoplasia, and congenital retinal dystrophies) and latent nystagmus of the congenital esotropia. At the end of the session, participants should be able to identify these specific forms of nystagmus.
Blood flow and oxygenation in atrophic diseases
Authors: Todorova M. 
Published: September 2015

SummaryThere is increasing evidence that alterations in retinal‐choroidal blood flow play a role in the pathogenesis of atrophic diseases. Studying the oxygen saturation of retinal vessels on patients affected by glaucoma and inherited diseases of the retina, suggest the oxygen metabolism to be altered. To which extend the role of the oxygen saturation contributes to the blood flow fluctuations and thus, to the progression of atrophic disease will be discussed in this presentation.
Epidemiology and the protective effects of time outdoors
Authors: Morgan I. , Rose K. 
Published: September 2015

SummaryThere is a major epidemic of myopia in developed countries in East and Southeast Asia, where the prevalence of myopia is now 80–90% in those completing secondary school. More importantly, the prevalence of high myopia is now 15–20%, exposing the future adult population to a much increased risk of pathological myopia and vision loss. In Europe and North America, the prevalence of myopia is also increasing, and now appears to be of the order of 40–60%. Genetic change cannot provide an explanation of these increases, which must involve changes in environmental exposures. The two key factors appear to be increasingly intensive education, with study pressures extending to increased homework loads and extensive use of tutorial colleges after school hours. The other environmental factor at work is the amount of time that children spend outdoors, with increasing amounts of time outdoors protecting from the onset of myopia. The time spent outdoors by children is particularly low in East and Southeast Asia, and two clinical trials have now shown significant delays to the onset of myopia by increasing the amount of time that children spend outside at school. Similar interventions could help to control myopia in other parts of the world.
Fundus autofluorescence and Photobleaching : Definitions
Authors: Mathis T. , De Bats F. , Cahuzac A. , Wolff B. , Scemama Timsit C. , Uzzan J. , Kodjikian L. , Mauget‐Faÿsse M. 
Published: September 2015

SummaryFundus autofluorescence (AF) imaging is a non‐invasivemethod for detection of fundus fluorophores. The 488 nm blue (short wavelength: SW) or the 787 nm near‐infrared (NIR) wavelenght are usually used to induce AF of fluorophores located in the retinal pigment epithelium (RPE). In case of excitation with SW light, the resulting AF comes predominantly from A2E located in the lipofuscin granules of the RPE. On the other hand, excitation with NIR light seems to highlight the melanin. Regardless of the type of fluorophore in the RPE, the exciting light has to pass first through the retina and especially through the photoreceptor layer. The photopigment absorbs a part of the light, which will not be transmitted to the RPE. Therefore, RPE fluorophores will be less AF. In the same time, photo‐isomerization of the 11‐cis‐retinal to 11‐trans‐retinal by the photon absorbance will be the beginning of the visual signal. Thereby, retinal photopigment loose its absorption property and the light will be easily distributed to the RPE fluorophores. This photoreceptor bleaching phenomenon could be used to better understand the origin of the hyper‐AF pattern: hyper‐AF of the RPE or lack of absorbance of signal due to photopigment loss