bluuebunny/crossref_metadata_2025_split huggingface dataset:
A high oxygen demand in normal tension glaucoma
Authors: Turksever C. , Todorova M. , Orguel S. 
Published: September 2015

PurposeTo evaluate relationship between vascular dysregulation and retinal oxygen demand in normal tension glaucoma (NTG).MethodsRetinal vascular responses of 27 eyes of 18 Caucasian (10♀ :8♂) individuals with NTG were measured. Subjects were grouped based on their median vascular responsiveness. In each group, retinal vessel oxygen saturation was measured in arterioles (A‐SO2) and in venules (V‐SO2) within the peri‐papillary annulus with the oximetry tool of Retinal Vessel Analyser (IMEDOS Systems UG, Jena, Germany).Retinal nerve fiber layer thickness (RNFL) was measured with spectral domain optical coherence tomography (Carl Zeiss Meditec, Dublin, CA, USA) and visual field (VF) with Octopus perimeter (Haag‐Streit International, Switzerland). Retinal oxygen concentration per micron of nerve fiber layer thickness (O2‐C) was calculated as follows; the difference of aretrio‐venous oxygen saturation (A‐V SO2) was divided to the mean RNFL thickness. A linear mixed‐effects model was applied (IBM SPSS®)ResultsThe eyes were grouped based on their vascular responsiveness (group1 ≤ 2.90%; n = 13, group 2 > 2.90%; n = 14). In group1 and in group2, mean A‐ SO2, V–SO2 and A‐V SO2 were 96.50%(±4.38); 97.77% (±3.03) (p=0.517), 62.89% (±6.23); 60.71% (±6.28) (p = 0.391), 34.64%(±4.51); 36.68% (±5.27) (p = 0.294), respectively. Subjects in group 1 showed higher O2‐C 0.488%/µ (±0.0848) than in group2 0.434%/µ (±0.0551) (p = 0.027). Mean age (65.45 y (±11.7)) and VF(dB) defect (4.7 dB (± 3.6), 3.4 dB (±5.2) were not statistically different between groups (p = 0 > 141). In group 1, RNFL thickness was significantly less than in group 2 (72.23 µm (±12.1); 85.31 µm (±13.67) (p=0.014).ConclusionsOxygen demand was increased in patients with excessive vascular dysregulation, while mean SO2 values were not related to age and/or flicker responses. This conclusion remains to be conformed in further studies.
Our experience with anti‐VEGF treatment on central serous retinopathy
Authors: Papavasileiou E. , Younis S. 
Published: September 2015

PurposeTo evaluate the short‐term efficacy of intravitreal anti‐VEGF for the treatment of subretinal fluid (SRF) and/or pigment epithelium detachment (PED) secondary to chronic central serous chorioretinopathy (CSR).MethodsSixteen patients were treated with intravitreal injections of anti‐VEGF at 6‐ to 8‐week intervals until SRF and/or PED resolved. Main outcomes were Best‐Corrected Visual Acuity (BCVA), central retinal thickness (CRT) measured with optical coherence tomography (OCT), performed at 6‐ to 8‐week intervals and number of injections. Fluorescein angiography was performed at baseline visit and thereafter depending on clinical and OCT findings.ResultsPatients received 3.16 (range: 1–15) intravitreal injections of anti‐VEGF on average during a follow‐up of 22 +/‐ 2 weeks. Mean BCVA increased by 11.2 letters and mean CRT decreased significantly over follow‐up from 396.68 µm at baseline to 250.36 µm on last visit. 5 patients (31.25%) showed complete resolution of subretinal fluid and PED, 6 patients (37.5%) had persistent SRF and 5 patients (31.25%) had persistent PED.ConclusionsAnatomic and functional improvement following intravitreal anti‐VEGF injections suggest that vascular endothelial growth factor (VEGF) may be involved in fluid leakage in patients with chronic CSR. The results suggest a possible role for anti‐VEGF agents in the treatment of chronic CSR.
Risk of trabeculectomy with an initial diagnosis of glaucoma versus ocular hypertension in Gloucestershire, UK
Authors: McNaught A. , Turner S. , Ivanova K. , Crabb D. 
Published: September 2015

PurposeGloucestershire is a rural county in the UK, with a population of ~300,000 > 40 years. Importantly, almost all glaucoma and OHT patients attend the Gloucestershire Eye Unit, under the care of one of two glaucoma specialists. Those treated privately will also be treated by the same clinicians: any audit of all the clinical activity of both might reasonably be extrapolated across the whole county. We use this approach to estimate risk of trabeculectomy in patients with an initial diagnosis of glaucoma versus OHT.MethodsAn audit of the case notes of all trabeculectomies performed between 2010 and 2012 was undertaken. The initial clinical diagnosis at presentation was recorded e.g. whether POAG, NTG, ACG, secondary glaucoma or OHT, as was the initial untreated IOP/severity of visual field loss (MD). Time elapsed between initial diagnosis and eventual surgery was calculated.ResultsConsidering only open‐angle glaucomas and OHT, there were 127 trabeculectomies in 119 patients over the two years of the audit. Secondary glaucomas (n = 14) were excluded. Annual risk of trabeculectomy in POAG was 2% per year based on an estimate of ~3000 glaucoma patients in the eye clinic. Median time from diagnosis to trabeculectomy: OHT (n = 4) 131 months, POAG (n = 93), 112 months, NTG (n = 14) 89 months, and PEX (n = 8) 55 months. Relative risk of trabeculectomy was 70 times higher in POAG compared with OHT, assuming prevalence of 2% POAG, 5% OHT in people >40 years (95% CI of RR 20‐290).ConclusionsWhen compared with POAG, people with an initial diagnosis of OHT are 70 times less likely to need surgery. Patients with PXF had surgery much sooner than those with OHT. This audit provides prognostic predictions for glaucoma and OHT patients, and further, might suggest more resources be directed to patients with glaucoma, perhaps at the expense of patients with OHT.
Frequency‐Doubling Perimetry in Type2 Diabetes without Retinopathy
Authors: Aldaham S. , Martín‐Ridura M.D.C. , Pérez‐Carrasco M.J. , Palomo‐Álvarez C. , Carballo‐Álvarez J. , Puell M. 
Published: September 2015

PurposeFrequency Doubling Technology (FDT) perimetry has been utilized to detect visual field (VF) changes in type 1 diabetics with no retinopathy. However, it has not been tested in type 2 diabetes. The purpose was to assess FDT perimetry and its diagnostic capacity in type 2 diabetics without retinopathy.MethodsThis comparative cross‐sectional study included thirty‐one controls and nineteen age‐matched patients with type 2 diabetes without retinopathy, well controlled glucose level and onset duration >4 years. Full threshold C‐20 program was used for VF testing in the FDT perimeter. Mean sensitivities for each VF location, mean deviation (MD), pattern standard deviation (PSD), and test duration were compared. Area under the curve (AUC) of a Receiver Operating Characteristic (ROC) was calculated to assess the diagnostic value of the FDT perimetry.ResultsMean sensitivities for some VF locations were significantly lower in the diabetic group. The mean MD was worse in diabetics (−3.35 ± 2.02 dB) than controls (−1.95 ± 1.70 dB) (p < 0.05). Neither the mean PSD nor the testing time was significantly different between the two groups. AUC values for MD and PSD were 0.29 and 0.69, respectively, (standard error = 0.076, p = 0.024).ConclusionsFDT perimetry has a diagnostic capacity as a clinical tool for the detection of early retinal dysfunction in Type 2 diabetics before the onset of retinopathy.
Cataract surgery in adult patients with uveitis
Authors: Bacquet J.L. , Fel A. , Butel N. , Remond A.L. , Le Hoang P. , Bodaghi B. 
Published: September 2015

PurposeTo determine current challenges and visual results in patients with uveitis who underwent cataract surgery in 2013.MethodsWe retrospectively collected data from every consecutive uveitis patient who underwent cataract surgery during the year 2013 and studied demographic data (age, gender) along with uveitis etiology and therapeutic management. Pre and post operative anterior chamber flare was evaluated by laser flare photometry. Postoperative rate of macular edema (ME), ocular hypertension, epiretinal membrane (ERM) was also evaluated. Every patient was operated by the same surgeon (BB) and received a subconjunctival injection of dexamethasone at the end of the procedure. Use of perioperative oral prednisone was noted.ResultsTwenty eight eyes of 24 patients were operated. The mean age was 57.6, and 24 were female (85.6%). Preoperative mean best corrected visual acuity (BCVA) was 0.90 logMar. A week after surgery mean BCVA was improved to 0.26 logMar. A month later, mean BVCA was 0.26 logMar. BCVA was 0.38 logMar at 6 months and 0.27 logMar at one year. The mean preoperative flare value was 26.4 ph/ms. It increased to 42.8 ph/ms at one day and 35.0 ph/ms at one week. ME was noted postoperatively in 11 eyes (39%), of which 4 were preexistant. Four eyes (14.3%) had inflammatory glaucoma and ERM was noticed on OCT examination in 6 eyes (21.4%). Oral prednisone was used prior to surgery in 6 patients (25%) and after surgery in 10 patients (41.6%).ConclusionsCataract surgery in adult patients with uveitis has a satisfactory outcome in most of the cases. It is important to achieve a strict preoperative control of ocular inflammation. The incidence of complications such as macular edema, epiretinal membrane or glaucoma has been dramatically reduced by an appropriate management of the disease.
Angiotensin Receptor Blockade in Retinopathy of Prematurity: An Experimental Study
Authors: Nath M. , Kumar A. , Chandra P. , Singh B. , Deorari A.K. , Velpandian T. 
Published: September 2015

PurposeRetinal renin angiotensin (RRAS) system has been reported to play a vital role in the retinal angiogenesis pathway. Present study was conducted to evaluate the modulation of RRAS components by quantitative gene expression studies in retina and to evaluate the effect of angiotensin receptor1 (AT1) blockade in the oxygen induced retinopathy (OIR) experimental model.MethodsNeonatal Wistar rat pups were exposed to high oxygen saturation (75% ±2%) chamber, from postnatal day (PD) 7th to postnatal day 12th. On PD 12th the pups were randomised into four groups (n = 9) viz. disease control (saline treated), AT1 receptor blocker (ARB) treated (telmisartan), antibody against VEGF (AAV) treated positive control (bevacizumab) and pups grew up in normoxia. On Day 17th Rat pup retina was assessed through fundus imaging and electroretinogram (ERG) by MICRON III. Rat pups were then sacrificed and retinas were extracted to study the gene expression of RAS components (renin, angiotensinogen, AT1 receptor & ACE), VEGF and HIF 1α in various test groups. Flat mounted ADPase stained retinas were subjected for light microscopy. Rat pups plasma, vitreous and retina were subjected for LC‐MS/MS.ResultsExamination of rat pup retina through fundus imaging, ADPase staining and ERG showed the reduction in tortousity index,vessel density of the retinal vasculature and improved “b” wave. Gene expression analysis revealed that treatment with ARB was able to normalise the expression of all the genes to a significant level except renin levels. ARB concentration in the retina was found to be therapeutically effective.ConclusionsPresent study shows Intervening in the over activated RRA system through angiotensin receptor 1 blockade was able to regulate this system in experimental model of ROP. Further studies are in progress to understand the RRAS mechanisms involved in ROP.
Evaluation of a cyclosporine A ophthalmic ointment in an experimental mouse model of dry eye
Authors: Cimbolini N. , Antonelli S. , Mauro V. , feraille L. , Elena P.P. 
Published: September 2015

PurposeDry eye syndrome is a common disease with multifactorial causes. Symptoms typically include irritation, dryness, burning and decreased or fluctuating vision. Anti‐inflammatory drugs are widely used for the treatment of the inflammation produced by the disease with corticoid or cyclosporine A (CsA). Restasis® (Allergan), a CsA emulsion, was approved by the FDA but is not available in Europe. Here we propose to show the action of Optimmune® (MSD Animal Health) a marketed veterinary ophthalmic ointment that contains CsA in an experimental mouse model of dry eye induced by scopolamine, a tropane alkaloid drug with muscarinic antagonist effects.MethodsAnimals were divided in three groups of ten pigmented mice: Two groups were exposed to desiccating conditions (relative humidity <25%, air‐flow 15 L/min, temperature 20‐22°C) with transdermal scopolamine administration (0.5 mg/72 h) for 14 days. Animals were treated topically three times a day with 0.2% CsA ointment or vehicle. Controls were saline‐treated animals placed in a normal environment. Tear production was measured with the phenol red thread test, corneal defects were examined by slit‐lamp observation using blue light after 0.5% fluorescein eye drop. These examinations were performed in both eyes before exposure and on days 3, 7 and 14. A histological study was performed at the end of the study.ResultsCyclosporine A eye ointment appeared to show efficacy in this model.ConclusionsCyclosporine A eye ointment significantly reduced clinical signs of dry eye by decreasing corneal defect more than cyclosporine A ophthalmic emulsion (internal studies).
Switching to ranibizumab for diabetic macular edema with persistent fluid on bevacizumab: Who is likely to benefit from the switch?
Authors: Lee J.H. , Lee W.K. 
Published: September 2015

PurposeTo evaluate the efficacy of switching from bevacizumab to ranibizumab in patients with diabetic macular edema (DME).MethodsThe medical records of 41 DME eyes which showed persistent fluid after at least three monthly bevacizumab injections, and switched to ranibizumab injection were reviewed. Each patient received a single ranibizumab injection and followed up at 1 month. Anatomic responders to ranibizumab were followed up monthly and given ranibizumab injections on an as‐needed basis until 3 months.ResultsAt 1 month, the mean central foveal thickness (CFT) decreased from 431 μm to 349 μm (P < .001), and mean best‐corrected visual acuity (BCVA) improved from 20/53 to 20/48 (P = .062). Twenty‐six eyes (65.9%) were classified as anatomical responders, and the mean CFT improved and maintained until 3 months (439 μm to 320 μm, P < .001) after repeated injections (mean number: 2.8), while the mean BCVA stabilized (20/59 to 20/54, P = .075) in these eyes. Dry macula were achieved in 9 of 26 eyes at least once during the follow‐up period. Favorable anatomic response to ranibizumab at month 1 was related with previous partial response to bevacizumab.ConclusionsSwitching to ranibizumab may present an alternative option in the treatment of DME with persistent fluid after repeated bevacizumab injections, and the switch was more effective in eyes that showed partial response to previous bevacizumab.
Ocular fundus changes in patients with Down syndrome and pulmonary hypertension
Authors: Leys A. , Delcroix M. , Willems A. , Wirix M. , Nijs I. 
Published: September 2015

PurposeThe ocular and visual problems in Down syndrome are due to refractive errors, poor accomodation, strabismus, keratoconus, cataract, optic disc and retinal structural anomalies and brain changes. Pulmonary hypertension (PH) is associated with high mortality and morbidity and ocular complications may occur. PH associated central serous choroidopathy‐like maculopathy, venous thrombosis and neovascular glaucoma have been described in case reports but no large studies of ocular complications are available. Improved non‐invasive imaging with optical coherence tomography (OCT), enhanced depth OCT and OCT angiography without dye allow a detailed study of the retinal and optic disc changes.MethodsA cross sectional study of 180 adult patients with PH included 9 Down patients with congenital heart disease. Age of the Down patients was 25–44 years. The fundus changes included PH associated and Down associated anomalies.ResultsPH associated mild changes included episcleral and retinal vein dilation and a thick choroid. None of the Down patients had severe complications of PH. The Down associated fundus changes included absence of optic disc cup, supranumerary optic cisc vessels,and structura lmacular anomalies with small capillary free zone. Two eyes were functionally lost due to complications of hydrops keratoconus.ConclusionsNon‐invasive imaging with OCT allows a detailed analysis of fundus changes in Down patients with or without PH.
Clinical experience with Idebenone (Raxone®) in the treatment of patients with Leber's Hereditary Optic Neuropathy (LHON)
Authors: Metz G. , Klopstock T. , Gallenmüller C. , Catarino C. , von Livonius B. , Lob F. , Meier T. 
Published: September 2015

PurposeLHON is an orphan mitochondrial disorder affecting the retinal ganglion cells leading to permanent blindness from which recovery is rare. An increasing body of evidence indicates that idebenone has therapeutic potential for the treatment of LHON. Data from a randomized placebo‐controlled study (RHODOS), from a number of case reports and retrospective cohort studies demonstrate that patients with established vision loss may benefit from idebenone treatment and recover visual acuity (VA).This study reports VA outcomes for patients with recent onset of vision loss who received idebenone treatment under an ongoing global Expanded Access Program (EAP) where currently 82 patients are enrolled and have been treated for an average of 15 months. The outcomes will be compared with findings of the RHODOS study and a Case Record Survey collecting VA data from untreated patients.MethodsAnalyses are performed to assess recovery from the VA nadir. Clinically relevant recovery was defined as (i) improvement from nadir by at least 10 letters on the ETDRS chart or (ii) improvement from “off‐chart” at nadir to being able to read at least 5 letters on‐chart. Furthermore, the prevention of vision loss for patients with residual vision below 1.0 logMAR (20/200) at start of therapy was analysed.ResultsA high proportion of patients (about 50% at submission of the abstract) treated with idebenone under this global EAP experienced a clinically meaningful recovery of vision. In addition, in patients with residual vision below 1.0 logMAR at start of therapy, loss of VA to above this level could be prevented in a large number of patients (about 60% at submission of the abstract).ConclusionsThe therapeutic potential of idebenone in the treatment of LHON is further demonstrated by the clinical experience in a large cohort of patients under a global EAP.
Anterior lens epithelium in cataract patients with retinitis pigmentosa ‐ scanning and transmission electron microscopy study
Authors: Andjelic S. , Draslar K. , Hvala A. , Hawlina M. 
Published: September 2015

PurposeIn retinitis pigmentosa (RP) patients, relatively minor lens opacity posteriorly centrally may cause disproportionate functional symptoms requiring cataract operation. To investigate possible structural reasons for this opacity development, we studied the structure of the lens epithelium of RP patients.MethodsThe anterior lens capsule (aLC: basement membrane and associated LECs) were obtained from cataract surgery and prepared for scanning and transmission electron microscopy (SEM and TEM).ResultsBoth SEM and TEM show the holes in the anterior lens epithelium of cataract patients with RP. Mainly, the holes appear as thinning and degradation of the epithelium, with the dimensions from less than 1 μm to more than 10 ηm and covering the region of several aLECs. A step towards the formation of denuded regions with the dimensions even bigger than 50 ηm may be the detachment of the lens epithelium. Other type of holes in size up to 20 ηm, may be formed by gradual stretching of the lens epithelium. Another type of holes is formed between adjacent LECs where lateral connections are absent, with dimensions 0.1‐2 ηm × up to 10 ηm.ConclusionsShowing of holes in the anterior lens epithelium supports the hypothesis that disturbed structure of the lens epithelium plays a role in water accumulation in the RP cataractous lens. We suggest that the lens epithelium has a role in the development of the cataract in RP patients.
SRPK1 inhibitors as novel anti‐angiogenic therapeutics for wet age‐related macular degeneration (wAMD)
Authors: Batson J. , Toop H. , Rowlinson J. , Allen C. , Gibbons B. , Zhang J. , Wearmouth S. , Knapp S. , Morris J. , Bates D. 
Published: September 2015

PurposeAnti‐angiogenic VEGF inhibitors are the standard of care for wAMD but must be administered by intraocular injection and non‐specifically inhibit all VEGF isoforms. We aim to develop SRPK1 inhibitors as eye drops that specifically inhibit pro‐angiogenic VEGF‐A isoform‐driven angiogenesis underlying wAMD.MethodsNovel compounds, synthesized based on the structure of SRPK1, were tested in kinase assays, thermal shift binding assays and immunoprecipitation, immunoblotting and immunofluorescent assays. Retinal toxicity and efficacy were evaluated by Ganzfeld ERG and laser‐CNV. PK was evaluated in vivo and in ex vivo penetration assays using mass spectrometry.ResultsNovel compounds selectively bind to SRPK1 and dose‐dependently inhibit SRPK1 kinase activity (IC50s<10 nM), SRSF1 phosphorylation and nuclear localization and increase anti‐angiogenic VEGF‐A165b levels. SRPK1 inhibitors did not inhibit retinal function yet potently inhibited laser‐CNV following eye drop administration in mice (EC50s<0.5 µM, n = 6‐8, P < 0.05, One‐way ANOVA). Compounds were detected in the sclera, choroid and retina following eye drop administration in vivo in rat and mouse and in ex vivo penetration assays in human, pig and rabbit eyes.ConclusionsWe developed SRPK1 inhibitors that specifically target pro‐angiogenic VEGF‐A‐driven choroidal neovascularization and can be delivered to the retina following eye drop administration. These compounds potentially offer more specific, efficacious and safer therapeutics for patients with wAMD.
Late ocular changes after closantel (Flukiver) poisoning
Authors: Asoklis R. , Augyte A. , Cimbalas A. 
Published: September 2015

PurposeTo describe late ocular changes in 5 women after harmful use of donated closantel (Flukiver).MethodsThe study included 5 women from the report published by Hoen and Hodgkin in The Lancet journal in 1993 about 11 cases of donated veterinary drug closantel use in Lithuania. We analysed medical records from 1993 to 2015 and performed eye examination of 5 suffered patients 22 years after the event.The study was conducted at the Centre of Eye Diseases,Vilnius University Hospital Santariškių Klinikos,it adhered to the tenets of the Declaration of Helsinki.Eye examination included best corrected visual acuity (BCVA), perimetry, colour vision(CV), tonometry, slit lamp evaluation, fundus photography and optical coherent tomography.ResultsIn 2015 the mean age of the patients was 49.4 years In 1993 BCVA varied from 0.08 to 1.0.Right eye (RE)in average‐ 0.66, left eye(LE) – 0.68. In 2015 BCVA varied from 0.1 to 1.0.RE in average – 0.7 and LE – 0.6.22 years after the event average visual field defect in the right eye was 24.13 dB and in the left eye ‐ 23.85 dB.CV Ishihara test showed decreased green color perception in 3 patients and 2 were not able to perform it, because of the visual field defects.The average central macular thickness 216.0 ± 36.1 µm in RE and 196.0 ± 42.0 µm in LE, retinal nerve fiber layer respectively 86.0 ± 11.0 µm and 93.2 ± 5.4 µm. Ophthalmoscopy showed atrophy of the optic nerve and changes of the retina reminding those in retinitis pigmentosa.ConclusionsClosantel is veterinary drug causing decades lasting damage of the optic nerve and retina in humans. Visual functions don't correlate with central macular and retinal fiber layer thickness.Fundus photography and perimetry reveal changes similar to retinitis pigmentosa. To our knowledge this is the first report about the late outcomes of closantel toxicity in humans.