bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hermenegildo Arruga (1886‐1972): an example that the improvement in retinal surgery goes on
Authors: ASCASO FJ 
Published: August 2014

AbstractHermenegildo Arruga (1886‐1972) was a versatile Spanish ophthalmologist who specialized in retinal surgery. He designed numerous surgical instruments and introduced significant improvements in ophthalmic surgical techniques. Thus, he was among the first ophthalmologists to advocate the intracapsular cataract extraction. Furthermore, he refined several surgical procedures such as dacryocystorhinostomy, corneal transplantation, evisceroenucleation and pterygium excision. But, above all, Arruga was fascinated with the retinal detachment surgery. He perfected Gonin´s operation and contributed significantly for retinal detachment surgery to be put in place. Later, he adopted the injection of air at the end of retinal surgery. In the 1950s, Arruga simplified the technique of equatorial cerclage using a suture to encircle the equator of the eye. Even though ocular surgery has also developed significantly after Arruga’s time, his achievements played a significant role when they were presented and they formed a good foundation for subsequent developments.
Photocoagulation: early pioneers, pitfalls and progress
Authors: GRZYBOWSKI A 
Published: August 2014

AbstractLaser photocoagulation is currently a crucial therapy for numerous retinal diseases. Although the effect of solar light on the retina has been known for centuries, the earliest thermal burns in the animals’ retinas by using a concave mirror and a convex lens to focus sunlight through dilated pupils of rabbits, were described by Czerny (1867) and Deutschmann (1882). The first experimental photocoagulation of the human retina was performed in 1927 by Maggiore. It has been nearly completely forgotten that in 1945, the Spanish ophthalmologist José Morón had the idea to close retinal tears using a light source through pupil to produce a retinal burn similar to that of diathermy. Finally, the German ophthalmologist Gerd Meyer‐Schwickerath conceived the idea of using photocoagulation to make burns in the retina to seal holes and prevent retinal detachment and developed in 1947 a sunlight photocoagulator, an instrument of mirrors and lenses that used sunlight.
Natural history and epidemiology of myopic macular disease
Authors: KOURENTIS CHR 
Published: August 2014

AbstractPathological myopia (PM) is characterized by a refractive error of ‐6 D and above and/or an axial length of 26.5 mm and above with concomitant degenerative changes in the posterior segment of the eye. The prevalence of PM differs between ethnicities. Myopic retinopathy includes a choroidal pallor pattern in the macular area, a posterior pole ectasia, lacquer cracks in Bruch’s membrane and posterior staphyloma, focal areas of chorioretinal thinning or atrophy and geographic areas of atrophy and choroidal neovascularisation (CNV). PM is the second commonest cause of choroidal neovascularization (CNV) after age related macular degeneration (AMD) and the most common cause of severe visual impairment in myopic patients younger than 50 years old. CNV occurs in 4% to 11% of patients with high myopia, and is the most common vision threatening complication of high myopia. The natural history of untreated myopic CNV is poor with a visual acuity of 20/200 or less. Apart from the macular degeneration there are other causes of visual dysfunction in PM, such as macular hole, retinal detachment associated with macular hole, posterior staphyloma and retinoschisis.
Diagnostic evaluation for myopic macular disease
Authors: KABANAROU S , XIROU T 
Published: August 2014

AbstractMyopic macular disease (MMD) characterises a spectrum of structural changes of the macula such as epiretinal membranes, posterior tractional detachment, foveoschisis, macular holes, myopic choroidal neovascularisation (mCNV) and chorioretinal atrophy. Review of current literature regarding diagnosis of MMD and an appraisal of older (fluorescein angiographgy and indocyanine green angiography) and modern imaging tools (optical coherence tomography) are being presented. Fundus fluorescein angiography is the gold standard for diagnosis of patients with mCNV and remains an important imaging technique for their follow up. However in the era of spectral domain OCT macular pathology, such as epiretinal membranes, macular holes, foveoschisis, or pathology of the vitreoretinal interface, is better documented and evaluated. The additional use of enhanced depth imaging OCT (EDI‐OCT) and recently developed swept‐source OCT (SS‐OCT) are also employed to evaluate macular pathology further. The diagnostic evaluation of MMD has evolved as the diagnostic tools have become increasingly more sophisticated allowing better visualization and documentation of macular pathology and any alterations occurring after medical and surgical intervention.
Surgical management and treatment outcomes of myopic macular hole retinal detachment
Authors: ZAMBARAKJI H 
Published: August 2014

AbstractPathological myopia (PM) complicated by macular hole retinal detachment (MHRD) may lend itself to surgical correction, however severe axial elongation of the globe, the presence of a posterior staphyloma and atrophy of the RPE and choroid make these cases challenging. Whilst vitrectomy has been the mainstay of treatment, macular buckling (MB) was also developed in order to treat the posterior staphyloma. Macular hole closure rates using OCT monitoring have been reportedly low at 10‐72% and retinal reattachment rates have varied from 40‐93%. The reports of surgical outcomes of MB for MHRD are limited, but reported retinal reattachment rates are as high as 93% after primary surgery and 100% after secondary surgery. Surgical and visual outcomes appear better than those seen with PPV surgery but visual acuity improvements were modest in a long term series with a mean log MAR improvement of 1.80 to 1.00. We carried out a survey of the British and Eire Association of Vitreoretinal Surgeons (BEAVRS) to research the UK practice patterns for the management of MHRD secondary to PM. Anatomical and visual outcomes showed variable success rates. A review of the current literature and results of the BEAVRS will be presented.
What is good pressure control
Authors: STEVENS A 
Published: August 2014

AbstractThe diagnosis of glaucoma is based on morphological and functional parameters and not on IOP level, whereas treatment is centered on adequate IOP control. Good IOP control implies that IOP is brought down to values at which no further damage occurs or to values that slow the rate of progression in order to maintain acceptable visual function during the patient’s lifetime. Target pressure for an individual patients will depend on the age of onset of the disease, the amount of damage at diagnosis, the level of untreated IOP, and the rate of progression. The longer the life expectancy, the more severe the functional damage, the lower the untreated IOP and the faster the rate of progression, the lower the target pressure should be and vice versa. An additional number of systemic (blood pressure, family history) and ocular risk factors (disc hemorrhages, PEX, myopia, corneal thickness) should be taken into account. Further follow up will indicate whether the initially chosen target pressure needs adjustment. The determination of target pressure is a dynamic process and from the available evidence it seems that there is a wide gap between preferred practice patterns and real life.
IOP fluctuation and its measurements
Authors: POURJAVAN S 
Published: August 2014

AbstractThis SIS is focusing on the different factors which could cause progression of glaucoma despite correct/good IOP control. One of these factors could be the fluctuations in IOP and its measurements.The variations in IOP can be unpredictable and its behavior over the short and long term is still not fully known. These questions are still unanswered: How does IOP fluctuate over 24 hours? Does the fluctuation follow a repeating pattern? how can we assess this variability? And does the fluctuation affect the course of glaucoma progression? During this session we will discuss different theories and expert's opinions in light of our current understanding.
Femtosecond laser‐assisted anterior lamellar keratoplasty for keratoconus
Authors: PASHTAEV A , MALYUGIN B 
Published: August 2014

AbstractWe report the results of several femtosecond (Fs) laser‐assisted anterior lamellar keratoplasty modifications including Fs‐ALK (11 eyes) and Fs‐DALK (34 eyes). The control group consisted of the manual air‐viscobubble DALK (35 eyes). Optimal Fs‐laser parameters for corneas trephination and lamellar cuts were studied in the donor cadaver eyes. The quality of lamellar interface after laser dissection was assessed with atomic microscopy. Clinical data collected included the numbers of intra‐ and postop complications, VA with and without correction, postop astigmatism, corneal hysteresis and corneal resistance factors (ORA), EC loss and graft long‐tern survival rates. Mean follow‐up was 18.6±5.1 months. Fs‐DALK with optimized cutting algorithm resulted in fastest visual recovery, lesser postop astigmatism and better BCVA. The outcome difference in between the Fs‐DALK and manual DALK was borderline. Fs‐ALK provided the lowest visual outcomes (BCVA was 0.2±0.07 @12 months) due to irregularities and light scattering at the donor‐recipient interface.
Multiple malignancies in uveal melanoma patients ‐ the LOOC experience
Authors: HEUSSEN FM , DAMATO B , KALIRAI H , COUPLAND SE , HEIMANN H 
Published: August 2014

AbstractPurpose To identify the prevalence of multiple primary tumors in a patient cohort with uveal melanoma and describe the cohort's characteristics.Methods A data query for all cases of uveal melanoma seen at the Liverpool Ocular Oncology Center (LOOC) since 1993 was performed. Based on systemic information only cases with multiple primary tumors were included. Demographic and clinical information data were analyzed.Results A total of 5140 (2615 males, 50.9%) patients with uveal melanoma were found, of which 228 (4.4%) were noted to have at least one other primary malignancy. 15 cases (0.6%) had at least 3 primary tumors recorded. The gender breakdown is: 125 males (54.8%) and 103 females. Of 125 men, 45 (36%) had been diagnosed with prostate cancer; 30 with unspecified skin tumors; 8 with systemic lymphoma; 7 with bladder carcinoma; 6 with colon carcinoma; and the remaining patients with less common tumors. Of 103 females, 45 (44%) had suffered breast carcinoma; 19 had unspecified skin tumours; 7 renal cell carcinoma; 5 lung carcinoma; and the remaining patients, other less common tumor types. 43 of the 125 (34.4%) males and 39 of the 103 females (37.9%) were deceased by time of data analysis. The incidence of the commonest tumors in males (e.g. prostate cancer: 45/2615, 1.7%) and females (e.g. breast cancer: 45/2525, 1.8%) in this cohort of patients with uveal melanoma did not differ from the incidence of these tumors in the general UK population.Conclusion Although rare, additional malignancies can occur in association with uveal melanoma; therefore, the patient history taking should include this aspect. Aside from demographic and clinical data, genetic testing in these cases with multiple malignancies may yet reveal unique common patterns.
Can we trust the biopsy for prognostication in patients with choroidal malignant melanomas?
Authors: KIILGAARD J , BAGGER M , TOLSTRUP ANDERSEN M , HEEGAARD S , KLARSKOV ANDERSEN M 
Published: August 2014

AbstractPurpose The purpose was to validate the minimal invasive TransVitreal‐RetinoChoridal (TVRC) biopsy as prognostic tool for uveal melanoma.Methods Thirty‐six patients treated for choroidal melanoma at Rigshospitalet, Copenhagen from 1st January 2009 to 31st December 2011 were included. All patients had a minimal invasive TVRC biopsy performed to confirm the diagnosis before the eye was enucleated. Fluorescence in situ hybridization (FISH) for chromosome 1, 3, 6 and 8 as well as multiplex ligation‐dependent probe amplification (MLPA) were performed on all biopsy samples. Paraffin embedded sections of the enucleated eye were then divided into 3 mm hexagons. Each hexagon were then individually analyzed with MLPA in order to elucidate eventual heterogeneity of chromosomal status of the tumor. The MLPA results from the tumor were then compared to the results from the biopsy.Results This is an ongoing study and so far results from 6 eyes have been obtained. All tumors showed heterogeneity of their chromosomal status. In 5 of 6 tumors more chromosomal abnormalities were found in the vicinity of the optic nerve compared to the periphery. In 4 of 6 tumors there was a complete correspondence between biopsy result and worst chromosomal status of the tumor. The remaining 2 biopsies underestimated the chromosomal changes, but it did not affect the prognostic value.Conclusion Minimal invasive TVRC biopsy technique for choroidal melanoma seems to be useful for prognostic purposes.
SF3B1 and EIF1AX mutations in uveal melanoma: a protective factor, or not?
Authors: KILIC E , KOOPMANS AE , YAVUZYIGITOGLU S , VAARWATER J , VAN IJCKEN WFJ , PARIDAENS D , DE KLEIN JEMM 
Published: August 2014

AbstractPurpose The recent identification of mutations in the splicing factor SF3B1 and translation initiation factor EIF1AX prompted us to investigate the occurrence of these mutations in our uveal melanoma (UM) cohort.Methods Nineteen tumours were subjected to whole exome sequencing. In addition, the SF3B1 (exon 14) and EIF1AX (exon 1 and 2) mutation status was determined in 95 UM by Sanger sequencing.Results Mutations in SF3B1 were identified in 26% of UM and 19% harboured a mutation in either exon 1 or 2 of the EIF1AX gene. SF3B1 and EIF1AX mutations correlated significantly with good prognostic features such as spindle cell type, absence of closed vascular loops, positive BAP1 immunohistochemistry staining and disomy 3. Univariate analyses of EIF1AX mutated cases compared to those without EIF1AX mutations showed a significantly increase in disease‐free survival (DFS). Overall, the SF3B1 mutated cases did not show a significant difference in DFS compared to SF3B1 wild types. After stratifying for chromosome 3 status, patients with a disomy 3 UM and a SF3B1 mutation had a worse DFS compared to those with a disomy 3 UM and a wild type SF3B1 (P < 0.01).Conclusion SF3B1 and EIF1AX mutations occur in approximately a quarter of UM. Mutations in these genes associate with favourable prognostic features. In our study, we also reveal that patients with a normal chromosome 3 UM and a SF3B1 mutation have a higher risk of developing late metastasis.
Identification and characterization of melanin in choroidal melanoma by electron paramagnetic resonance spectroscopy (EPR)
Authors: ROMANOWSKA DIXON B , KLONOWSKA A , PLONKA P , SARNA T 
Published: August 2014

AbstractPurpose The purpose of this study was to determine the quantity and type of melanin in choroidal melanomas in correlation with patient’s clinical characteristics.Methods Melanoma‐containing samples were obtained after enucleation surgery, performed because advanced choroidal melanoma was diagnosed, not qualified to preserving eye therapy. Frozen samples were examined at liquid nitrogen temperature by EPR spectroscopy.Results Examination showed that choroidal melanoma cells had a low eumelanin to pheomelanin index. In most of investigated melanoma‐containing samples the presence of pheomelanin was determined. Also strict correlation between patient’s clinical characteristics such as skin phototype, iris and hair color and melanin type in tumor were observed. No correlation however were found between histopathological type and quality and quantity of melanin in choroidal melanoma. Macroscopic analysing cases of choroidal melanoma were characterized by wide pigment variations. The presence of tide correlation between tumor color and type of melanin was observed.Conclusion Pheomelanin fenotype occurred in tumors with low content of pigment. Tumors intensively pigmented (black, dark brown) belong to eumelanin tumors.
Optico‐reconstructive surgery after blockexcision of iridociliar tumors
Authors: SAAKYAN S , ANDREEVA T , CHENTSOVA E 
Published: August 2014

AbstractPurpose To estimate the possibilities and indication for optico‐reconstructive surgery after blockexcision of iridociliar tumors.Methods 68 patients with iridociliary tumors and complicated cataract were treated. 41 patients underwent combined surgery – block excision with cataract extraction (IOL implantation performed in 37 cases). In 14 of these patients iridectomy was performed using a tunnel corneal incision (in cases of small tumors of iris pupillary margin) followed by simultaneous phacoemulsification+IOL. The other patients underwent cataract extracapsular extraction. Simultaneous operations were carried out only in benign tumors. 27 patients underwent delayed cataract extraction after blockexcision (9 patients with malignant tumors, 18 patients ‐ benign). In 5 cases surgery were performed with implantation of artificial iris, in 17 cases ‐ with IOL implantation.Results In all cases we detected increase the visual acuity, depending on the type of surgery and the tumor’s sizes.Conclusion Indications for simultaneous optico‐reconstructive surgery are benign tumors, for delayed – even malignant ones. In cases of small benign tumors of iris papillary margin simultaneous surgery could be done using FEC + IOL, for large benign tumors (no more than 1/3 of iris) – with simultaneous cataract extracapsular extraction, if more than 1/3 of iris – delayed surgery with implantation of artificial iris.
Intravitreal aflibercept for macular oedema due to branch retinal vein occlusion
Authors: CLARK WL , BROWN D , STEMPER B 
Published: August 2014

AbstractPurpose To evaluate the efficacy and safety of intravitreal aflibercept (IVT‐AFL) injection compared with macular grid laser photocoagulation for the treatment of macular oedema secondary to Branch Retinal Vein Occlusion (BRVO).Methods VIBRANT was a double‐masked, Phase 3 trial with a duration of 52 weeks in which patients with macular oedema secondary to BRVO were randomised 1:1 to receive IVT‐AFL 2 mg every 4 weeks or grid laser from baseline to Week 20. The primary efficacy endpoint was the proportion of eyes that gained ≥15 letters in best‐corrected visual acuity (BCVA) from baseline at Week 24.Results The proportion of eyes that gained ≥15 letters from baseline to Week 24 was 52.7% and 26.7% (P<0.001) in the IVT‐AFL and laser groups, respectively. The mean improvement in BCVA from baseline to Week 24 was 17.0 and 6.9 letters (P<0.0001), respectively. The most common ocular adverse events (AEs) in the IVT‐AFL and laser group were subconjunctival haemorrhage (19.8%) and eye pain (5.4%), respectively. There were no cases of intraocular inflammation in either treatment group. One death due to pneumonia and one Anti‐Platelet Trialists' Collaboration (APTC)‐defined event of nonfatal stroke occurred during the first 24 weeks of study, both in the laser group. Week 52 data will be presented.Conclusion In this study, monthly IVT‐AFL provided statistically significant and clinically meaningful visual benefits which were superior to macular grid laser photocoagulation in eyes with macular oedema due to BRVO over 24 weeks. Compared to IVT‐AFL’s known profile no new safety signals were observed.
Commercial interest
Pathophysiology of vitreoretinal interface disorders
Authors: POURNARAS C 
Published: August 2014

AbstractPathologic changes at the vitreoretinal interface and vitreomacular tractions lead to phenotypic lesions such as epiretinal membranes (ERMs), idiopathic macular holes, vitreomacular traction syndrome (VMTS) and myopic foveoschisis. In the presence of clinically evident posterior vitreous (PVD), remnants of vitreous collagen fibers and/or cellular proliferations of fibrous astrocytes or glial cells, migrate outward from the retina. Migration occuring on the inner vitreo‐retinal interface through the internal limiting membrane(ILM), in the presence of growth factors such as laminin or fibronectin, may contribute to the fibrocellular proliferation at the retinal surface. Most studies regarding idiopathic or diabetic epiretinal membranes or late stages of macular holes, described the presence of fibrocytes or myofibroblasts. More recent studies confirmed those observations by using antibodies against alpha smooth muscle actine (a‐SMA). Based on the mechanistic association between a‐SMA expression and a tractional force generation, there is little doubt that these cells represented the source of traction during the evolution of those pathologies.
Enzymatic vitreolysis
Authors: LE MER Y 
Published: August 2014

AbstractOne year after the official approval of ocriplasmin in the indication of symptomatic vitreo‐macular adhesion, the results and potential complications of enzymatic vitreolysis in « real life » are better understood. The best candidates for intravitreal injections seem to be the younger phakic patients with a symptomatic, focal and isolated (i.e. without associated epiretinal membrane) vitreous traction. The vast majority of traction release occurs before the end of the first week after injection. Ocriplasmin allow to close 40% of the small macular holes with vitreous traction, thus avoiding surgery with intraocular tamponade. The rate of complications is low but a specific one raises some concerns. A few cases of visual impairment, most of the time transitory even if long lasting, have been reported with modifications on OCT and ERG. An enzymatic cleavage of intraretinal laminin is a biologically plausible mechanism. Although rare, the potential complications of ocriplasmin have to be well known to avoid any unjustified risk in its clinical use. The better indications are now defined and to keep a good benefit/risk ratio, it would not be justified to take any chance by using enzymatic vitreolysis in the less favorable cases.
Commercial interest
Orphan drug for acanthamoeba keratitis (ODAK) project: validation of an acanthamoeba polyphaga keratitis model
Authors: GUEUDRY J , RAZAKANDRAINIBE R , HUMBERT C , AIFA A , FRANCOIS A , LE GOFF L , FAVENNEC L , MURAINE M 
Published: August 2014

AbstractPurpose Acanthamoeba keratitis is a sight‐threatening infectious disease.The ODAK project (Orphan Drug for Acanthamoeba Keratitis) is a European research project, the objective of which is to assess safety and efficacy of PHMB (polyhexamethylene biguanide) eyedrops to provide the basis for marketing authorisation. The aim of our study is to develop a rat model of Acanthamoeba polyphaga keratitis suitable for this project.Methods Sprague‐Dawley rats were injected in the left cornea stromal layer with Acanthamoeba polyphaga. A subconjunctival injection of 0.57 mg long‐acting betamethasone was administred and clinical examination was performed weekly. One rat was injected with culture media as sham. Corneal scrapings were performed for bacterial and parasitological cultures and real‐time PCR analyses. Paraffin‐embedded corneas were analysed after hematoxylin‐eosin and Schiff periodic acid staining.Results Clinical infections were observed in 7/9 rats (78%). Trophozoites and/or cysts were detected in axenic culture after 1 month in 7/9 rats (78%). Acanthamoeba polyphaga DNA was detected in 7/9 rats (78%) by real‐time PCR. No clinical or microbiologic infection was detected in sham. Histological studies detected trophozoites and/or cysts only in 3/9 rats.Conclusion In this study, a rat model of Acanthamoeba polyphaga keratitis was obtained with good correlation between clinical findings, culture and/or PCR findings. This model was found suitable for assessment of PHMB in animals. The research leading to these results has received funding from the European Union Seventh Framework Programme ([FP7/2007‐2013] under grant agreement n° 305661.