bluuebunny/crossref_metadata_2025_split huggingface dataset:
How accurate are optometrist referrals for glaucoma in the NICE era?
Authors: Bobat H. , Begum S. , Lockwood A. , Kirwan J.F. 
Published: September 2015

PurposeTo determine if the reason(s) stated by the optometrist affect the positive predictive value (PPV) of referrals for suspected glaucoma.MethodsOptometrist referrals in Portsmouth are streamlined though the Glaucoma Referral Refinement Scheme (GRRS). We retrospectively analysed 100 ‘positive’ and 100 ‘negative’ referrals to the GRRS. Positives: those referred on to a secondary care glaucoma clinic; negatives: those discharged from the GRRS. Reason(s) for referral were determined and classified: intraocular pressure (IOP) optic disc changes (OD), visual field defect (VF), shallow anterior chamber depth (ACD). Since negative referrals to GRRS are four times more prevalent than positives, we calculated a ‘corrected’ PPV for each reason by multiplying the number of negatives by 4.ResultsThe overall PPV was 0.16. 70.4% cases were referred for a single reason (47.2% IOP, 12.2% OD, 8.8% VF, 2.4% ACD); the PPV was 0.11 for IOP and for OD, 0.05 for VF, 0.17 for ACD. 26.2% were referred for two reasons; the PPV was 0.47 for IOP + OD, 0.21 for OD + VF and 0.14 for IOP + VF. 4.2% were referred for IOP + OD + VF with a PPV of 0.62. Positive family history of glaucoma (21.4% referrals) did not increase PPV. The GRRS increased the PPV to 0.8.ConclusionsThe majority of patients are referred for a single reason, yet the chance of a positive diagnosis is low. Accuracy is increased when IOP is reported in combination with OD, but VF adds little value as a second parameter. The highest PPV is found when all three reasons are stated (IOP + OD + VF). The proportion of referrals for IOP alone is similar to that found prior to the NICE guidelines. However, the PPV is considerably lower; 0.11 compared to 0.3–0.4 found in previous studies. In the NICE era, refinement schemes play an important role in reducing false positive referrals.
Preoperative intravitreal bevacizumab effects on the course of Pars Plana vitrectomy in diabetic vitreous hemorrhage
Authors: Zahaf A. , Zghal I. , Fekih O. , Zayani M. , Mahjoub A. , Bouguila H. , Nacef L. 
Published: September 2015

PurposeTo compare the rate of rehemorrhage in patients with diabetic vitreous hemorrhage (VH) undergoing pars plana vitrectomy (PPV) with versus without preoperative intravitreal bevacizumab (IVB) injectionMethodsForty patients with proliferative diabetic retinopathy (40 eyes) with an indication for primary vitrectomy were randomized to IVB group (20 eyes) or control group (20 eyes). Intravitreal bevacizumab group received intravitreal injection of 1.25 mg/0.05 mL bevacizumab, 1 week before vitrectomyResultsThe frequency of postoperative recurrent vitreous hemorrhage (5%, 1/20 vs. 40%, 8/20, P = 0.017) were significantly lower in IVB group than in control group .The number of intraoperative endodiathermy spots (0.63 ± 1.0 vs. 1.3 ± 1.4, P = 0.028) were also significantly lower in IVB group than in control group while mean bleeding frequency in IVB group was 0.7 ± 0.78 times/case with range between 0 and 2 bleeding attacks/case and mean bleeding frequency in control group was 3.12 ± 1.31 times/case with range between 3 and 6 bleeding attacks/case and the difference was statistically significant as (p < 0.001). The frequency of reoperation due to recurrent vitreous hemorrhage within 4 weeks after surgery was significantly lower (P = 0.022) in IVB group (5%, 1 patient) than in control group (35%, 7/20)ConclusionsIntravitreal injection of 1.25 mg/0.05 mL bevacizumab 1 week before vitrectomy blocked vascular endothelial growth factor production in vitreous and significantly reduced the incidence of reoperation due to early postoperative recurrent vitreous hemorrhage.
Evaluation of the lamina crivosa thickness and depth, the prelaminar nerve tissue thickness and the Bruch's membrane opening‐based minimum rim width in eyes with and without primary open‐angle glaucoma: an enhanced depth imaging OCT study of the optic nerve head and the correlation between anatomy and function
Authors: Gama I. , Almeida L. , Gonçalves I. , Monteiro‐Grillo M. 
Published: September 2015

PurposeTo evaluate the lamina crivosa (LC)thickness (LCT), depth (LCD), prelaminar thickness (PLTT) and Bruch's membrane opening‐based minimum rim width (BMO‐MRW) in primary open‐angle glaucoma (POAG) and normal eyes (NE) and their correlation with function (MD).MethodsThis observational study included 45 eyes (25 eyes with POAG; 20 normal eyes),which were evaluated clinically, by applanation tonometry, pachymetry, Octopus perimetry and by enhanced depth imaging‐optical coeherence tomography (EDI‐OCT). A grid scan of the optic herve head (ONH), averaged 80 scans, to image the LCT, LCD and PLTT in center, mid‐inferior (I‐ONH), and superior positions and a nerve fiber layer (NFL) scan were done. LCT was the distance between borders of the LC. LCD was the distance between BMO reference line‐anterior LC border. BMO‐MRW was the shortest distance between BMO and internal limiting membrane. All values were compared between both groups and correlations between variables were tested.ResultsGlobal LCT was lower in POAG (132.9 ± 40.1 µm) than in control group (235.9 ± 36.8 µm, p < 0.05). Mean LCD was higher in POAG (572.2 ± 195.2 µm). Mean PLTT was lower in POAG (91.9 ± 49.9 µm, p < 0.05), as occurred with BMOMRW. In all eyes, the global LCT was correlated to NFLT (R = 0.61) and BMOMRW (R = 0.67; p < 0.001). In POAG eyes, global NFL was correlated to BMOMRW (R = 0.67) and the PLTT (R = 0.386). In I‐ONH scan, PLTT was correlated with LCD (R = −0.502) and inferior‐temporal (IT)‐NFLT(R = 0.479, p = 0.015). MD was correlated with PLTT(R = −0.597) and MBOMRW (R = −0.670, p < 0.01).ConclusionsGlaucoma can cause a decrease in LCT, PLTT, BMOMRW and increase in LCD, being potential markers of glaucomatous damage. Some ONH‐OCT parameters correlated with function, as measured by the MD. ONH EDI‐OCT imaging with automatic segmentation would be useful in glaucoma evaluation.
Efficacity and safety of TOXO KO vaccine to prevent ocular toxoplasmosis in congenital murine model
Authors: Tarfaoui N. , Morisse S. , Lemee G. , Dimier‐Poisson I. , Seche E. , Pisella P.J. 
Published: September 2015

PurposeToxoplasmosis is a worldwide zoonotic disease caused by the protozoa Toxoplasma gondii and is a major cause of abortions but also of ocular lesions. Thus, ocular toxoplasmosis is a major health issue in certain parts of the world, especially in South America and Africa.MethodsWe have studied the efficacy of a live attenuated strain of T. gondii (i.e. Toxo mic1‐3 KO mutant) as a vaccine against ocular toxoplasmosis in a congenital toxoplasmosis model in mice. Mice were vaccinated with Toxo mic1‐3 KO strain, mated and infected during pregnancy. Nonvaccinated mice infected at mid gestation with T. gondii were used as control. One month after delivery, pups were sacrificed and ocular fundus, cytokine production in intra‐camerular tissue and cysts formation in eye and in brain were analysed.ResultsWe have demonstrated that: Retinal T. gondii cysts were detected in 71% of pups born to nonvaccinated dams (2.54 ± 4.10). A significantly smaller number of cysts in retinal tissue was seen in pups born to vaccinated dams 0.56 ± 1.18 (>86% reduction in cysts in ocular tissue). Clinical signs of ocular infection were detected in 73.2% of pups born to non vaccinated dams against 19% of pups born to vaccinated dams.ConclusionsIn conclusion, Toxo mic1‐3 KO is an effective vaccine against ocular toxoplasmosis in a congenital mice model. This strain could be a promizing vaccine.
A pilot study of survey on patient satisfaction and its meaning in an Glaucoma outpatient
Authors: Pourjavan S. , Vanhaecht K. 
Published: September 2015

PurposeTo assess the degree of patient satisfaction and its correlation with the subjective satisfactory score of the ophthalmologist.Outcomes:

The % of satisfied patients.

The correlation between doctor‐patient perception of care.

The impact of the interpersonal chemistry and the mood of care provider.

MethodsA prospective, blind study. A simple and short questionnaire is given to the patients. Patients were asked to fill in the questionnaire including 4 questions with a 1 (lowest) to 5 (highest satisfaction) scores.

The score the “care”?

the ophthalmologist?

Recommend of the outpatient?

Recommend of the specialist?

The ophthalmologist gives her subjective score in three fields:

The quality of consultation (QoC).

The interpersonal “click” with the patient.

Her “mood”

The consented patients will be called for more spontaneous explanation.ResultsPatient's score: 98% gave high scores >3.Ophthalmologists score: neg. click with 15%, natural: 48% and good click: 36%, her mood was 33% each in 3 scores (bad, natural and hyper), Her objective QoC was 95% high scores.The click was significantly related with her mood and her mood was significantly related with QoC. The only correlation was between click & the high score on Q3.On telephonic enquete were good outcome of the surgery, optimal care, location and their “like” for the specialist, important.ConclusionsAll patients had a high satisfaction score & not influenced “Mood” or “QoC”. Upon spontaneously explaining of the patients, the most important factors for their satisfaction were; good operation outcome, optimal care, correct diagnosis but the geographical location (nearby, parking space) and their affection for the specialist were also very important reason for their satisfaction.
Reproducibility of intraocular pressure self‐measurement by ICare Home rebound tonometer and comparison with Goldman applanation tonometer
Authors: Gaillard R. , Fenolland J.R. , Bonnel S. , Rosenberg R. , Marill A.F. , Bostanci K. , Giraud J.M. , Renard J.P. 
Published: September 2015

PurposeTo compare the intraocular pressure (IOP) measurements and reproducibility of the new ICare Home® rebound tonometer (RT) with Goldman applanation tonometer.Methods36 healthy eyes of 36 patients were enrolled. Three IOP measurements were performed with ICare Home by an ophthalmologist (RT‐O) then by the patient (RT‐P), and with GAT and non‐contact tonometry (AIR). All of the subjects underwent an examination including: slit lamp examination, keratometry, and optical measurements of ocular axial length and central corneal thickness.ResultsResults of mean IOPs were 16.3 ± 4.8 mmHg (RT‐O), 16.2 ± 4.7 mmHg (RT‐P), 15.1 ± 2.6 mmHg (GAT) and 16.0 ± 2.9 mmHg (AIR). There was no statistically difference between the 4 methods with random one‐way ANOVA or repeated measures (P = 0.09) and no difference between each couple of methods after Bonferroni correction for multiple comparisons. Correlation between the tonometers were: r = 87.4% between RT‐O and RT‐P, r = 63.4% between RT‐O and GAT and r = 65.0% between RT‐P and GAT. The intraclass correlation coefficients (ICC) were 0.924 for RT‐O, 0.854 for RT‐P and 0.887 for GAT. Bland Altman plots showed a good agreement between the different methods.ConclusionsIOP measurements with ICare Home by the patient or the ophthalmologist were well correlated to GAT without statistically significant differences. Reproducibility was good and with a good agreement between the differents methods of measures.
The effect of glucose and insulin on the susceptibility of cultured photoreceptor‐like cells to hypoxia
Authors: Layton C. , De Moraes G. 
Published: September 2015

PurposeDiabetes causes a retinal neuropathy, however whether glucose itself is beneficial to stressed retinal neurons is controversial. This investigation aimed to assess the effect of glucose on the resilience of cultured photoreceptor‐like cells to hypoxia.Methods661W cells were cultured in serum free media and 5 mM glucose. Cellular insult and damage after CoCl2 induced hypoxia was measured by caspase 3/7 activation, annexin V binding and propridium iodide marking on flow cytometry and confirmed by immunofluorescence. hif 1α, VEGF expression and akt phosphorylation were assessed with primary conjugated antibodies and flow cytometry.ResultsIn 5 mM glucose, hypoxia increased hif 1α activation and led to cell death by both apoptosis and necrosis in a dose dependent manner. Higher glucose levels increased hypoxia induced apoptosis and cell death. Photoreceptor‐like cells expressed the insulin receptor, and the increase in apoptosis associated with 25 mM glucose was blocked by insulin treatment, which increased intracellular levels of phosphorylated akt, decreased VEGF production and decreased caspase 3 activation and Annexin binding. However in increased necrosis resulted in no significant difference in hypoxic cell death compared with 5 mM glucose. These effects of insulin were partially blocked by the PI3K inhibitor wortmannin, but not by PKC inhibition with chelerythrine.Conclusions661W photoreceptor‐like cells were less resilient to hypoxia in “diabetic” glucose conditions. Insulin decreased apoptosis to levels equivalent to “non‐diabetic” hypoxic cells, but increased necrosis led to no change in the percentage of dead cells. An insulin induced shift to cell death by necrosis in hypoxic photoreceptors may be one mechanism of the initial exacerbation of diabetic retinopathy with intensive treatment.
Intravitreal chemotherapy in advanced retinoblastoma: results and complications
Authors: Hadjistilianou T. , Borri M. , De Francesco S. , Sparagna C. 
Published: September 2015

PurposeTo describe the technique and evaluate the efficacy of intravitreal melphalan in advanced retinoblastoma with focal or diffuse vitreous seedingMethodsThis is a retrospective non‐comparative study. Our analysis was conducted at our referral center of retinoblastoma, Siena, Italy. The study included 19 eyes of 19 patients with naïve, persistent or recurrent vitreous seeding in advanced retinoblastoma. All eyes received intravitreal injection (20 μg) of melphalan under general anaesthesia .Outcome measures included vitreous seeding control and eyeball preservation, treatment complications and drug toxicityResultsWe used concomitant therapy, including systemic chemotherapy, intra‐arterial chemotherapy and peribulbar chemotherapy. All patients are alive without evidence of extraocular dissemination and global salvage was attained in 83% of cases. Complications included central vein thrombosisConclusionsThis study suggests that intravitreal melphalan injection for naïve, persistent and recurrent vitreous seeding can provide seeding control and avoid enucleation with minimal toxicity and complications.
OCT angiography for the evaluation of macular ischemic micro‐angiopathies
Authors: Pournaras C.J. , Frountzou E. , Donati G. 
Published: September 2015

SummaryThe management of maculopathies related to the retinal vascular micro‐angiopathies, has been significantly improved since the initiation of intravitreal therapeutical approaches. A detailed evaluation of the vascular abnormalities by Optical coherence tomography (OCT) angiography offers an accurate evaluation of the therapeutical indications and their beneficial anatomical effects. OCT angiography has several advantages, such as 3D visualization of retinal and choroidal circulations (including the choriocapillaris). Using this non‐invasive alternative method, ischemia, microaneurysms, intraretinal microvascular abnormalities and the detection of neovascularization can be clearly visualized by a closer observation of each layer of the retinal capillaries. As an alternative to dye‐based angiography, in addition to the 3D tomographic macular imaging, OCT angiography may be clinically useful to evaluate the microvascular status and therapeutic effect of treatments for macular ischemic microangiopathies.
Effects of smoking during pregnancy on retinopathy of prematurity
Authors: Rodrigo M.J. , Fernández S. , De la Mata G. , Ara M. , Prieto E. , González‐Viejo I. , Ferrer C. , Pueyo V. 
Published: September 2015

PurposeBackground: Tobacco smoking during pregnancy is the first preventable cause of adverse birth outcomes such as vascular and neurodevelopment disturbation.Aims: To asses how smoking during pregnancy would affect retinal vascularization causing retinopathy of prematurity.Design: An observational cross‐sectional study.MethodsRecords of preterm newborns (n = 293) and tobacco expossure were reviewed. Retinopathy of prematurity (ROP) grading was evaluated in accordance with the International Classification of Retinopathy of Prematurity. Factors were evaluated using a multivariate logistic regression analysisResultsAlthough most children did not develop ROP (74.1%), 10.9% has mild, 9.6% severe and 5.5% aggressive posterior retinopathy. Twenty percent of mothers smoked during pregnancy and 10.2% smoked ≥5 cigarettes per day. Children of smoking mothers showed higher rate of Anterior Progressive ROP (6.9%) than those who were not expossed (5.1%), and as much severe as higher number of cigarettes (10.9% vs 5.1%). However, these results were not statsically significative (p > 0.05).ConclusionsA tendency to higher severity grades of ROP in connection with heavy tobacco exposure during pregnancy was observed.
Suprachoroidal pocket to collect drugs for treatment of ocular diseases
Authors: Rodrigo M.J. , Prieto E. , Idiope M. , García‐Martin E. , Otin S. , Polo V. 
Published: September 2015

PurposeWe present the progressive improvement of a surgical procedure for suprachoroidal (sc) administration of drug, as an alternative route for drug administration to the posterior segment of the eye.Methods25 New Zealand albino rabbit eyes were used in the study. Fifty microliters volume of different increasing viscosity formulations were tested: balanced saline solution (BSS), 0.5% sodium hyaluronate solution (SH) and a formulation with patent to be register. Catheters of several gauges (25Gs, 27 Gs and 22 Gs) and different materials: metal cannula or flexible intravenous catheter were tested. Different architecture of the scleral‐sc pocket were assayed: large quadrangular area with sutures, rectangular area with small port without stitch and conic with small entrance without stitch.ResultsFollowing items were analyzed: (1) Reflux post‐administration: depending on the formulation; BSS and SH 0.5% (100%) versus Formulation (73.33%), on the surgical instrument for administration; 25G and 27G (100%) vs 22G (20%), and on different pocket architecture; quadrangular and rectangular (100%) vs conic pockets (73.33%). (2) Signs of ocular irritation: higher grades of hiperemia and secretion were observed in pockets with stitches (3) Ocular perforation: 1 eye in quadrangular pocket with stitch. (4) Surgical time: longer in sutured pockets.ConclusionsThe possibility of perform a sc pocket with a large conic area, small port and without stitches, permits us to use it as a receptacle for high viscosity formulations or implants for sustained drug delivery, avoiding the risks of intravitreal devices and allowing an easier removal of the implant in case of adverse reactions.
Three dimensional meibography for diagnosis of dry eye syndrome
Authors: Byun Y.S. , Yoo Y.S. , Eom T.J. , Na K.S. , Joo C.K. 
Published: September 2015

PurposeThe dysfunction of meibomian glands which secrete components of lipid layer in tears is currently pointed out as one of the main causes occurring dry eye. The distribution of that is more than 70% in Asian, especially. This brought out the importance for the dysfunction of meibomian glands. Our study was aimed to confirm the efficacy of 3D meibography to evaluate the structures of meibomian glands.MethodsThis study is a cross sectional study for patients who had diagnosed as dry eye disease associated with the dysfunction of meibomian glands at Seoul Saint Mary's Hospital from July to October, 2014. To confirm the structure of dry eye patients, 3D images using 3D OCT (optical coherence tomography) and 2D images using infrared camera were obtained. Patients who had the drop‐out lesion in 3D and 2D images were divided as two groups, and differences between them were analyzed. At the same time, to find the clinical signification for structural changes of meibomian glands, all patients had an ocular surface and a tear function examination to define the degree of dry eye.ResultsAs compared between 3D and 2D images for dry eye patients who had the drop‐out lesion on meibomian glands, 3D images was more useful for diagnosis of dry eye than 2D, especially in dry eye related with mild meibomian gland disease.ConclusionsOur study confirmed that the structural change of meibomian glands was reflected in optical coherence tomography 3D images. Especially, 3D meibography was more powerful than 2D infrared camera to find out the real state of drop‐out lesion on meibomian glands. But, there was no statistical significance between the location of drop‐out lesions; such as near lid margin, middle area, near superior conjunctival fornix, and clinical features in these study.
Biomechanical properties of eyes with asymmetrical glaucoma defect
Authors: Cellini M. , Gizzi C. , Finzi A. , Campos E.C. 
Published: September 2015

PurposeTo evaluate biomechanical properties in eyes of patients affected by primary open angle glaucoma (POAG) with marked asymmetrical defects by means of Ocular Response Analyzer (ORA) and Spectral Domain OCT with Enhanced Depth Imaging (EDI SD‐OCT) function.MethodsWe studied 20 patients (mean age: 56 ± 12) with asymmetrical POAG. One eye was classified as mild glaucoma (MG) and the sound eye as severe glaucoma (SG) by visual field indexes: MD −4.21 ± 1.51 vs −16.56 ± 5.76 dB; p = 0.011 and PSD 3.54 ± 0.87 vs 10.95 ± 3.51 dB; p = 0.007. An EDI SD‐OCT centered on the optic nerve head and an ORA examination were performed on each eye of every subject before and during a IOP increase of 12.5 ± 2.1 mm/Hg induced by a compression of the globe with an ophthalmodinamometer. Corneal histeresis (CH), corneal resistence factor (CRF) and laminar displacement (LD) were statistically analyzed by Wilcoxon's rank sum test and Spearman's correlation test considering significant a p < 0.05.ResultsAfter IOP increase we found a decrease of CH: 9.3 ± 3.66 vs 6.92 ± 3.04 mm/Hg; p = 0.012 in SG and 8.62 ± 2.16 vs 7.23 ± 2.29 mm/Hg; p = 0.176 in MG. CRF instead increase: 8.61 ± 2.31 vs 12.38 ± 3.65 mm/Hg; p = 0.016 in SG and 9.02 ± 1.48 vs 12.22 ± 5.68 mm/Hg; p = 0.041 in MG. LD was positive in MD: 29.08 ± 19.28 μm and negative in AG‐ 6.58 ± 16.09 μm. In AG eyes we found a correlation between LD and CRF (r = −0.658; p = 0.019) and between LD and Scleral Rigidity (r = −0.693; p = 0.012).ConclusionsThis study demonstrates that in asymmetrical glaucoma the IOP increase changes the eye biomechanics with stiffening of the eye structures that involves not only the lamina cribrosa but also the corneal tissue.