bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innovative treatments for MGD ‐ EVER more important for ocular surface disease
Authors: KNOP N , KNOP E 
Published: August 2014

AbstractThe 2011 TFOS MGD Report has translated into several new developments in the therapy of Dry Eye Disease with a focus on MGD. Lipid supplementation is recognized as crucial for dry eye therapy either as liposomal spray or in many new tear substitutes. Physical therapy is recognized as a causative treatment in order to re‐liquify inspissated secretum before the application of mechanical pressure in order to eventually release obstructed glands. Since the application of adequate heat is time consuming and tricky, pre‐heated gel applicators or controlled heating googles can be used but must still be repeated every day. Even then, manual expression of the multitude of meibomian glands can be painful or ineffective. A new automated device that allows the computer controlled application of heat and pressure under the supervision of the ophthalmologist in his practice presently occurs as the most advance and effective therapy option that can lead to longterm restoration of meibomian gland function over several months. Azithromycin, a new topical drug has, besides a long‐term tissue uptake, not only an antibiotic but also an anti‐inflammatory and a newly observed promotive effect on gland function and is widely used for MGD.
Restoration of meibomian gland function in severe dry eye disease due to obstructive MGD with an automated physical therapy device
Authors: FINIS D , HAYAJNEH J , KÖNIG C , BORRELLI M , SCHRADER S , GEERLING G 
Published: August 2014

AbstractWe compared the effectiveness of a single Lipiflow® treatment with combined lid warming and massage in patients with Meibomian gland dysfunction (MGD) in a prospective, randomized, crossover, observer‐masked trial. Subjects were randomized to receive either a single 12‐min Lipiflow® treatment or to perform combined twice‐daily lid warming and massage for 3 months. All subjects received an examination pattern of subjective symptoms, lipid layer thickness, Meibomian gland assessment, tear break‐up time, tear osmolarity, corneal and conjunctival staining, Schirmer test values, and tear meniscus height before, and 1 and 3 months after initiation of treatments. A total of 31 subjects completed the 3‐month follow up. At 1 and 3 months, patients in the Lipiflow® treatment group had a significant reduction in subjective symptomes compared with those in the lid‐margin hygiene group. With regard to objective parameters, both treatments produced a significant improvement in expressible Meibomian glands; no other significant differences were noted between the two groups. Results of our study show that both a single Lipiflow® treatment and a 3‐month, twice‐daily lid margin hygiene regimen are effective therapies for MGD.
Commercial interest
Interventions to slow the progression of myopia
Authors: OHLENDORF A 
Published: August 2014

AbstractPurpose The purpose of the talk is to assess the effectiveness of different strategies, including optical refractive corrections with either spectacles or contact lenses as well as pharmaceutical approaches, to control the progression of myopia. Methods Interventions that have been explored to slow the progression of myopia include monofocal, bifocal and multifocal spectacles, cycloplegic drops, drugs to lower the intraocular pressure, muscarinic receptor antagonists and contact lenses. The scientific background for the different interventions will be presented and results of clinical trials will be reviewed. Results Clinical trials have shown negligible positive effects of progressive additional and bifocal lenses on myopia progression compared to single vision lenses. Observed beneficial effects of rigid gas permeable contact lenses could be related to the ethnicity of participants. The largest positive effects for slowing myopia progression were exhibited with anti‐muscarinic medications. Conclusion Further investigations of myopia control must be conducted in order to find treatments which are clinically meaningful and beneficial. The leading potential candidates at this time are anti‐muscarinic topical medications.
Commercial interest
Experiences with developing virtual clinics in a specialist centre
Authors: KOTECHA A 
Published: August 2014

AbstractA challenge facing many ophthalmology departments is how to manage the increasing numbers of glaucoma patients efficiently without compromising patient care. There are a number of approaches to meeting the increasing demand for services. One is to increase clinic capacity, which is not a viable long term solution. Another is to implement community eye care schemes, whereby ‘stable’ patients may be discharged from secondary care to be followed up within the community. However, there will always be a number of patients who are not suitable for, or who do not want, community monitoring. These patients need to be managed efficiently within the secondary‐care hospital setting. The 'virtual clinic consultation' has traditionally thought of as a model to manage patients in remote areas, who have limited access to specialist care. However, as information technologies improve, there is scope for this style of 'consultation' to be used within the hospital setting. This talk will discuss the practical aspects of developing a 'virtual' service within a UK National Health Service hospital, the challenges faced, and overcome, when developing the service, and the overall impact the service has had within the Glaucoma Service itself.
Customised amniotic membrane: a surgeon's dream come true
Authors: HOPKINSON A 
Published: August 2014

AbstractAmniotic membrane (AM) is a proven ophthalmic clinical adjunct, but crude manufacturing and cold chain storage, damage its functional properties and greatly restricts clinical access. Overcoming these problems, Nottingham have developed an innovative, effective and accessible ophthalmic bandage with enhanced wound healing properties. Their AM is produced in a dry, stable and sterilised format, which allows long‐term room temperature storage and distribution, creating an ‘off the shelf’ product. Their AM has improved function over conventional frozen AM, and has the potential to become the first effective, scientifically and clinically validated, low cost treatment for ocular injury. As well as a conventional surgical adjunct for chronic indications, their pre‐clinical data suggests a ‘first of its kind’ acute and emergency application to treat superficial ocular surface injuries. It can potentially be opened and applied directly to the surface of the injury without the need for expensive surgery. As well as pain relief and protecting the wound from infection, the greatly improved profile of trophic factors of their AM facilitates wound healing to limit visual loss and reduce the burden of long‐term clinical treatment.
Proton beam radiotherapy of uveal melanomas
Authors: DESJARDINS L 
Published: August 2014

AbstractAbstract: Proton beam therapy is a conservative treatment of choroidal melanoma. This study reports our results in terms of overall survival, metastasis‐free survival and secondary enucleation in 3404 patients We present a retrospective, single‐center study of patients treated for choroidal melanoma with proton beam therapy between January 1992 and December 2010 (total dose of 60 cobalt Grays equivalent delivered in 4 fractions over 4 days). The initial clinical tumor characteristics, treatment and follow‐up were recorded prospectively. Overall survival, metastasis‐free survival and enucleation free survival and their prognostic factors were statistically analyzed. 3404 patients were included during this period. The median follow‐up was 98 months. The overall survival rate, metastasis‐free survival rate, local recurrence and secondary enucleation at 5 years were respectively 64%, 74%, 3.82%, 6.79%. The prognostic factors for metastasis‐free survival: the location, the diameter and tumor thickness, and cytogenetic factors body. Risk factors of secondary enucleation are essentially tumor size (diameter, thickness and TNM). Treatment with proton therapy provides excellent local control of choroidal melanoma.
Irradiation treatment of metastatic tumors and lymphomas
Authors: SCHALENBOURG A 
Published: August 2014

AbstractIntraocular metastases are usually uveal, secondary to breast or lung carcinoma. Lymphoma is most frequently vitreoretinal, in a context of primary central nervous system lymphoma, while a uveal location points towards systemic lymphoma. Management is influenced by a palliative context and bilateral ocular involvement. Close collaboration with the oncologist is required as to the histopathology of the primary tumor, its global extent, oncologic treatment strategy and life expectancy. Stereotactic irradiation is often the principal ocular treatment. A circumscribed treatment of individual lesions carries the risk of local recurrences. The hemato‐ocular barrier often prevents chemotherapy from being effective within the uvea. Radiotherapy usually allows a quick reattachment of the retina and preservation of vision. Evolution towards a painful globe and enucleation should be avoided. With the increasing life expectancy of oncologic patients, treatment of ischemic retina with anti‐VEGFs and PRP becomes more indicated. Conclusion: Irradiation of intraocular metastases and lymphomas is the most important tool in preserving vision and the eye(s). Its indication should be made within a global oncologic treatment strategy.
Regenerating the retinal vasculature using endothelial progenitor cells
Authors: STITT A 
Published: August 2014

AbstractHypoxia‐related stimuli from oxygen‐deprived retinal neurons and glia networks can drive expression of growth factors and cytokines which induce leakage from the surviving vasculature and/or pre‐retinal and papillary neovascularisation. Current therapies for ischemic retinopathies include laser photocoagulation, injection of corticosteroids or VEGF‐antibodies and vitreoretinal surgery. Unfortunately these treatments fail to address the underlying retinal vasodegeneration and they also involve significant side effects. An alternative approach is to regenerate the retinal vasculature using endothelial progenitor cells (EPCs) to promote vascular repair and reversal of ischemia. This presentation emphasises the molecular and phenotypic nature of EPCs and how they become altered in disease. There will also be discussion about the potential for some EPC sub‐types to be harnessed for cell therapy and the building evidence for how these cells could eventually lead to exciting new therapeutic options for retinal ischemia
Matrix wound healing in the optic nerve
Authors: O'BRIEN C 
Published: August 2014

AbstractThe risk factors associated with optic disc cupping in glaucoma include intraocular pressure and ocular perfusion pressure. The mechanisms of optic disc cupping result in significant extra‐cellular matrix alterations for the lamina cribrosa. A number of cell types play a key role in this ECM re‐modelling including lamina cribrosa cells and astrocytes. A dysfunction in these cell types include high intra‐cellular calcium, mitochondrial dysfunction, and oxidative stress. A greater understanding of the mechanisms involved lead to new therapeutic approaches.
Glial cells as producers of VEGF and opponents in the retina
Authors: EICHLER WOLFR 
Published: August 2014

AbstractVascular endothelial growth factor (VEGF) is a key cytokine for the development of pathologic neovascularization in the retina. While Müller glial cells upregulate VEGF in the ischemic retina they constitutively secrete anti‐angiogenic factors such as pigment epithelium‐derived factor (PEDF) and transforming growth factor (TGF)‐β2, thereby determining an anti‐proliferative milieu for microvascular endothelial cells. Neutralization of PEDF or TGF‐β partially abrogates the angiostatic action of Müller cells. PEDF and TGF‐β2 are able to control retinal endothelial cell proliferation via suppressing the activity of ERK‐1/‐2 MAP kinases, even in VEGF‐stimulated cells. TGF‐β2 exerts its anti‐proliferative effect through increased Smad phosphorylation. Exposure of retinal endothelial cells to TGF‐β2 or Müller‐cell derived secreted factors causes an increased activation of Smad2/3, which leads to a decreased ERK‐1/‐2 phosphorylation. Given their impact on endothelial signaling and cell growth, Müller cells have emerged as an important cellular element for the control of angiogenesis and retinal neovascularization.
Simulated Ocular Surgery (VR)
Authors: HAYNES R 
Published: August 2014

AbstractSimulation of ocular surgery has advanced in recent years with the advent of high quality virtual reality platforms such as the Eyesi vitreoretinal module, which simulate the look and feel of ocular tissues & various pathological conditions encountered during pars plana vitrectomy surgery. However, computer simulation has not yet extended to the simulation of Cryobuckling surgery that is used to treat retinal detachment & involves techniques & manoeuvres that are often outside the comfort zone of even quite senior ophthalmic trainees. This session will demonstrate how model eyes can be used to train surgeons in all of the steps involved in cryobuckle surgery, including the location & treatment of retinal breaks with the indirect ophthalmoscope, peritomy incisions, slinging of rectus muscles, marking the external location of breaks, measuring the break position & choosing an appropriately sized buckle, placing scleral buckle sutures of the correct length & depth, & tightening them with the appropriate tension to create an adequate indent effect. Transcleral drainage of subretinal fluid & injection of intraocular gas can also be practiced, reducing the stress of performing these crucial steps when first performed for real.
Simulated ocular surgery: cataract, glaucoma, strabismus and VR surgery
Authors: FERRIS J 
Published: August 2014

AbstractThe emergence of high fidelity virtual reality simulators has helped to raise the profile of simulation for cataract and vitreoretinal surgery. However, with the advent of the EYESi there is a misconception that all simulation needs to be high tech and expensive and is out of the reach of many training units across the globe. We will describe how innovative model eyes, can be used to teach the same skills and in many instances offer a more realistic and versatile simulation experience than virtual reality simulators and how to incorporate this form of simulation into your training programmes. With reference to cataract surgery we will demonstrate how the building blocks of phacoemulsification, such as wound construction, continuous curvilinear capsulorhexis, nucleus sculpting and IOL implantation can be practice on the model eyes. We will also demonstrate how one can simulate intraoperative complications of cataract surgery, such as posterior capsule rupture with vitreous loss, zonular dialysis and suprachoroidal haemorrhage. We will also show how these eyes can be used to simulate rectus muscle and oblique muscle surgery in a highly life‐like fashion.
Commercial interest
Plastic eye surgery simulator for trabeculectomy
Authors: MCNAUGHT A 
Published: August 2014

AbstractGlaucoma surgical training is becoming difficult for surgical trainees to access, because of increasing subspecialisation, reduced practical experience in suturing using 10‐0 nylon, and a proliferation of new glaucoma surgical procedures. Traditional early practical experience eg surgical wet‐labs, using perhaps porcine eyes, are not always easily accessible. The presentation outlines the continued importance of training in trabeculectomy surgery, and describes recent innovations in plastic artificial eye technology. Parallels between actual trabeculectomy surgery in patients, versus modern plastic eye simulated trabeculectomy surgery are described. The potential value, and easy availability, of this new simulated eye surgery training is highlighted.
The science from ocular war injuries
Authors: SCOTT ROBER 
Published: August 2014

AbstractApproximately 10% of war injuries with major trauma have eye injuries. Primary ocular blast injuries are from the transfer of kinetic energy from the explosive blast wave alone. Secondary ocular blast injuries are the most common type of blast injury (42%) from the impact of shrapnel from the explosive device itself or from exogenous debris propelled by the explosion. Tertiary ocular blast injuries (1%) are caused by indirect damage to the eye when an individual is thrown by the blast wind. Quaternary blast injures (3%) are from any other mechanism related to the blast, usually thermal burns. Quinary blast injuries are a new entity that describes a hyperinflammatory state occurring after an explosion that is thought to cause retinal vascular occlusion. IOFB injuries are given prophylactic systemic antibiotics to protect against endophthalmitis, before surgical removal. Combat eye protection (CEP) significantly reduces secondary and tertiary blast injuries, but increased the proportion with commotio retinae. We rehabilitate blind patients with the BrainPort (Wicab, USA) vision device that substitutes the sense of sight with electrotactile stimulation of the tongue and improves navigation and object recognition
Ophthalmic combat injuries in the German Sector of Northern Afghanistan 2003 ‐ 2013
Authors: GÜMBEL H 
Published: August 2014

AbstractDuring the last decade the German Armed Forces (Bundeswehr) were needed in various missions. Especially in Afghanistan the German Army found their greatest challenge on military medicine. The medical treatment of injured soldiers of all nations, who were on missions, with the highest possible quality, relies to a great extent on the unbroken chain at emergency and trauma therapy from the theater of deployment up to the following medical care and rehabilitation in the homeland. In this talk we will tell the story how to manage the mass of casualities in ophthalmology or how to deal with difficult cases we have seen during our mission. So mostly we have to deal with simple irritations of the cornea by constructions in the camp, but on the other hand blunt trauma by IED (improvised explosive devices) play a key role in case of emergency We report about our experience in Field Hospitals (Role 3) which provide in‐patient and out‐patient specialist medical care. In severe ophtalmic casualities patients were stabilised for direct evacuation back to Germany by StratAIRMedEvac. So we could give you a follow up of the further treatment of patients and casualities who have been evacuated from the area of deployment.
Learning about herpes infections by using animal models
Authors: ATHERTON S 
Published: August 2014

AbstractOcular infections caused by members of the herpesvirus family may have serious and sometimes, sight‐threatening, consequences. As has been for so many disease processes, animal models have been used to better understand the pathogenesis of herpetic keratitis and retinitis in human patients. While no animal model has absolute fidelity to its human counterpart, careful interpretation and extrapolation of results from animal studies may provide valuable information/insight about the pathogenesis of human disease. This presentation will provide an overview of animal models of keratitis and retinitis, summarize the strengths and weaknesses of the models, and discuss how what has been learned from these models has advanced our knowledge of the mechanisms of human ocular disease and/or has led to new therapeutic approaches to these diseases.
Animal models in ocular oncology
Authors: CASSOUX N , JAGER M 
Published: August 2014

AbstractRetinoblastoma is a rare cancer in childhood. The goal of current and future therapeutic strategies is to conserve the eye and visual function without using external beam radiotherapy that increases the risk of second cancer in genetically predisposed patients. Multimodality therapy (usual intravenous but also, intra‐arterial, intra‐vitreal chemotherapy, transpupillary thermotherapy, cryotherapy, brachytherapy) has recently improved eye salvage rate and allowed decreased need for external beam radiotherapy. However treatment of advanced intraocular retinoblastoma remains a real challenge, especially in case of vitreous and sub‐retinal seeding. There is a need of alternative and less toxic therapy and a need of new ways for administration of the drugs. Animal models are an integral part of preclinical research in the field of oncology. This paper described the different xenograft rodent models published in the literature. We have also developed a new orthotopic xenografted retinoblastoma model in immunodeficient mice, suitable for pre‐ clinical assays.
Corneal stromal cells: A potential cell source for ocular surface regeneration
Authors: SIDNEY LE , BRANCH MJ , MCINTOSH OD , DUA H , HOPKINSON A 
Published: August 2014

AbstractPurpose Keratocytes of the corneal stroma are quiescent, dendritic cells, which maintain the extracellular matrix. It is believed that there is a subpopulation of keratocytes that act as multipotent progenitor cells. These cells repopulate the stroma after damage and may play a role in the regeneration of other layers of the cornea, such as the epithelium. Optimisation of culture of these cells is integral for developing potential cell therapies.Methods Primary human corneal stromal stem cells (hCSC) were extracted from the limbal region of the cornea. A range of culture media were tested for the effect on stem cell phenotype and differentiation potential. The effect of extended passaging and three‐dimensional culture of the cells as spheroids was assessed by RT‐qPCR and immunocytochemistry.Results The phenotype of hCSC is strongly affected by extraction, passage and the culture medium. The cells form spheroids and upregulate markers, such as CD34. Under the correct conditions, hCSC show potential as a multipotent stem cell, expressing the indicative markers and differentiating in vitro down osteogenic, chondrogenic and adipogenic lineages. The CD34+ population of hCSC demonstrate a higher stem cell potential and differentiate to corneal epithelial cells, with a rounded morphology and high expression of key markers such as cytokeratin 3, HES1 and desmoglein 3.Conclusion Corneal stromal stem cells demonstrate a multipotent stem cell potential, independent of the role they are traditionally associated with in the cornea. In vitro, this potential depends on the culture environment and on isolation of certain subpopulations. In future, these cells show potential in the regeneration of the ocular surface in cases of disease or trauma.