bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital prevalence of visual of visual impairment caused by diabetic retinopathy
Authors: Rocha De Sousa A. , Tavares‐Ferreira J. , Perestrelo S.P. , Lima‐Ramos P. , Batista A.M. , Santana R. , Macedo A.F. 
Published: September 2015

PurposeTo investigate cases of visual impairment caused by diabetic retinopathy (DR) in a hospital population.MethodsAs part of an observational study to estimate the prevalence and costs of visual impairment in Portugal (PCVIP study), clinical records of all patients attending the ophthalmology department of a tertiary hospital were analysed looking for patients meeting the inclusion criteria. Inclusion criteria were: (i) presenting visual acuity in the better eye <5/10 (20/40) and/or (ii) visual field <20°. Diagnosis of cases with VI were classified according with ICD9. Results reported here were selected from the total number of patients with VI by filtering ICD9 codes staring by 362.ResultsIn 12 weeks, 1920 cases of VI were detected, 586 (31%) caused by any type of DR. From those: 54% were caused by non‐proliferative‐DR, 40% by proliferative‐DR and 6% by diabetic macular oedema. The mean age of the patients with VI caused by DR was 69.4 (sd = 9.5) years and 57% were female. The estimated hospital prevalence (for 52 weeks) of VI caused by DR is 39% (95%CI = 38–41).ConclusionsOur results show that DR remains the leading cause of VI in the population attending our hospital. Information about the number of patients reaching VI will be fundamental to assess the cost‐benefits of treatments and public health campaigns to reduce the burden of diabetic retinopathy in Portugal.
The Four Seasons of Dry Eye Disease Seasonal Variations in Presenting Symptoms and Signs of Dry Eye Disease in Norway
Authors: Eidet J.R. , Ræder S. , Chen X. , Badian R. , Utheim Ø. , utheim T.P. 
Published: September 2015

PurposeTo investigate the seasonal variations of presenting symptoms and signs of dry eye disease (DED) in NorwayMethods930 DED patients examined between August 2012 and May 2015 at the Norwegian Dry Eye Disease Clinic in Oslo, Norway, were consecutively included. All patients underwent a comprehensive ophthalmological examination. Presenting symptoms and signs were related to the season according to when each patient had been examined. Weather report data from the exact day of examination in Oslo, including mean temperature, relative humidity, hours of sunshine, and mean wind, from the Norwegian Meteorological Institute, were also compared with the presenting symptoms and signs.ResultsMean seasonal temperatures for Oslo during spring, summer, fall and winter were 7°C, 16°C, 7°C, and −2°C, respectively. Compared to the rest of the year, tear film break‐up time (TFBUT) was highest during summer (P < 0.001), ocular protection index (OPI) lowest during winter (P = 0.013), Schirmer I lowest during summer (P = 0.004), tear meniscus height was highest during winter (P = 0.004), meibum quality least pathological during winter (P = 0.001), the percentage of patients being diagnosed with meibomian gland dysfunction lowest during winter (P < 0.001), and intraocular pressure highest during winter (P = 0.001). Weather report data correlated the strongest with meibum quality and intraocular pressure, which both were associated with mean temperature (r = 0.24; P < 0.001 and r = −0.21; P < 0.001). Self‐reported symptom load and dry eye severity level (DESL) did not differ between seasons.ConclusionsParameters for assessing DED show seasonal variations, which are important to consider when examining patients with DED. Moreover, contrary to common belief, our results suggest that meibomian gland function appears to improve during winter and with low temperatures.
Homonymous hemimacular thinning in retrochiasmal lesions
Authors: Cunha J.P. , Proença R. , Dias‐Santos A. , Vicente A. , Anjos R. , Costa L. , Cardigos J. , Ferreira J. , Amado D. 
Published: September 2015

PurposeTo evaluate the thickness of macular retina and determine which retinal layers are most affected by retrochiasmal visual pathways lesions.MethodsMean retinal thickness utilizing automated intraretinal layer segmentation of spectral domain optical coherence tomography scans was performed in 40 eyes of 40 patients with retrochiasmal visual pathways lesions and compared with 60 eyes of control subjects.Multiple linear regression analysis was used to determine the relationship between retinal thickness and follow‐up, age and gender.ResultsGanglion cell and inner plexiform layer was thinner in the temporal hemiretina ipsilateral and in the nasal hemiretina contralateral than in healthy controls.The mean thickness was significantly reduced in lesions over 6 months of duration, with no differences in correlations with age or gender.ConclusionsThis study demonstrate ganglion cell and inner plexiform thinning in the hemimacular area. These results support the concept that transneuronal retrograde degeneration of the retinal ganglion cells can be detected by OCT in humans with retrochiasmal visual pathways lesions.This homonymous hemimacular thinning in OCT represents an imaging biomarker that can be of valu in diagnosis, prognosis and clinical trials of neuroprotectives therapies.
Anterior chamber and refractive parameters in diabetic patients according to metabolic status
Authors: Costa L. , Cardigos J. , Vicente A. , Borges B. , Ferreira J. , Cunha J.P. , Amado D. 
Published: September 2015

PurposeDiabetes Mellitus is associated with changes in refractive parameters. Some aspects already studied were the corneal biomechanics and lens thickness. Although, the discussion about anterior chamber angle and depth is still open.The author objective was to analyze and correlate the anterior chamber depth, lens vault and lens thickness with disease duration and metabolic status.MethodsProspective case–control study. The anterior chamber and refractive parameters were studied using the Visante OCT and the differences between diabetic patients with metabolic control and disease stability were determined (group 1), without (group 2) and group‐control (3). The metabolic control is based on HbA1c levels. The cut‐off considered was 7%.ResultsA total of 64 patients were evaluated (group 1 – n = 21; group 2 – n = 20; group 3 – n = 23). The mean age was 64.32 ± 7.55 years and approximately 5 years of disease duration. In both groups of diabetic patients we found thicker lens, narrow anterior chamber and higher lens vault compared to control group. There was a difference between diabetic groups exists, but it was not statistically significant.ConclusionsThe anterior chamber angle and lens vault are influenced by the serum glucose levels. Further studies will be necessary to clarify the physiopathology mechanism responsible for the anterior segment modifications.
Therapautic options: how does it work?
Authors: Pournaras C.J. 
Published: September 2015

SummaryVisual acuity, in diabetic patients, is decreased due to the development of macular edema (DMO), capillary non‐perfusion, and vitreous hemorrhage secondary to retinal neovascularization. Clinical therapeutical approaches using focal photocoagulation and intravitreal treatments offer new insights for the managmenet of DMO and the preservation of vision. The inhibition of the endothelial growth factor (VEGF) and the inflammatory factors, alone or in association to focal laser, have an important impact on the reversal of the inner blood‐retina barrier (BRB) diabetic abnormalities. Laser photocoagulation induces in addition, an improvement of the macular hemodynamics, a reversal of tissue hypoxia, a downregulation of the VEGF and inflammatory factors expression and an occlusion of the permanent microvascular abnormalities.
Genotype and phenotype correlation of monogenic corneal dystrophies in population of central Poland
Authors: Udziela M. , Oldak M. , Sciezynska A. , Ploski R. , Szaflik J.P. 
Published: September 2015

PurposeTo assess the genotype‐phenotype correspondence in monogenic corneal dystrophies caused by KRT,TGFBI and UBIAD1 genes mutation.Methods61 patients from 30 Polish families with clinically diagnosed epithelial and stromal corneal dystrophies participated in the study.Corneal phenotypes were assessed by slit lamp, AS‐OCT,and confocal microscopy in vivo. Genomic DNA was obtained from blood samples and respective exons (hot spots) were PCR amplified and sequenced on both strands.ResultsMolecular genetic testing revealed heterozygous missense p.E498V mutation (exon 7) of KRT3 in one family with Meesmann corneal dystrophy phenotype, p.R555W (exon 12) mutation in 19 patients diagnosed with granular type I dystrophy (GCD1). In two patients p.R124H mutation (GCD2, Avellino) was found. In three patients (2 families) heterozygous p.R124L (exon 4) mutation was identified and diagnosed as Reis‐Buecklers dystrophy. In two unrelated patient p.R555Q (exon 12) mutation typical for Thiel‐Behnke dystrophy was found. Heterozygous p.R124C (exon 4), p.T538R (exon 12) and p.H626R (exon 14) mutations were identified, respectively, in 10 patients diagnosed with lattice corneal dystrophy (LCD1). A novel p.L565P mutation was found in one family with late‐onset LCD.Among 18 idividuals (4 families) suffering from stromal Schnyder corneal dystrophy (SCD) molecular genetic testing revealed 3 different UBIAD1 gene mutations: p.N102S, p.D112N, p.T120R.ConclusionsThe genotype typical for monogenic corneal dystrophies caused by KRT and UBIAD1 genes mutation corresponds with its clinical phenotype. TGFBI is associated with phenotype heterogenity and in some cases only genetic tests may confirm the proper diagnosis.This indicates that a relatively straightforward molecular analysis can be a practical use in diagnosis of these conditions and associated genetic counseling.
Healing of a resistant neurotrophic corneal ulcer using a new matrix therapy agent (RGTA): A case report
Authors: Zghal I. , Zahaf A. , Fekih O. , Zayani M. , Bouguila H. , Nacef L. 
Published: September 2015

PurposeWe report a case of a resistant neurotrophic corneal ulcer successfully treated by the matrix regenerating agent (RGTA) Cacicol(®).MethodsWe report a case of an 18‐year‐old female patient, who developed a persistent epithelial ulcer after cataract surgery complicated by endophthalmitis, with no improvement despite 4 weeks of artificial tears. A new ophthalmologic solution based on a regenerating agent (RGTA, Cacicol20®) was then used, with a dosage of two eye drops per week for 8 weeks.ResultsImprovement was observed in 2 weeks, and complete healing was obtained in <5 weeks, with no side effects.ConclusionsThis heparin mimetic, which may stimulate extracellular matrix healing, may be a possible alternative therapy to autologous serum or amniotic membrane transplantation in severe neurotrophic ulcer. However, randomized studies are necessary to confirm this encouraging result.
Upgrading wide field contact specular microscope
Authors: Hor G. , Gavet Y. , Gain P. , Thuret G. , Bernard A. , Pinoli J.C. 
Published: September 2015

PurposeNon‐contact specular microscopes (SM) developed 25 years ago highly facilitated image acquisition while eliminating contaminations risk. Nevertheless their very small field of observation (SM Topcon SP2000: 0.1 mm2) constitute major limitations for the assessment corneas.AimTo upgrade a wide field contact SM with a digital camera and dedicated software.MethodsThe original camera film was replaced by a digital camera (Canon EOS 6D with full‐frame 35 mm sensor) connected to a computer. The new camera was fixed on the SM (Konan SP5500, ×40 zoom) with 3D print custom adaptor and uses its optics. After acquisition of wide field images (0.6 mm2), they were processed using a segmentation algorithm (watershed with markers method). Software, using several libraries (ITK, OpenCV, Qt, MySQL), has been developed allowing the acquisition of images (camera control), image processing, and storage of results in a database.ResultsA segmented image showing only cell borders in black over white background and document which presents ECD number (1000 cells counted) and cell's characteristics showing quality of cells (regarding their size). Stored in a database, these results are available for operators.ConclusionsThe upgraded wide field contact SM counts a great number of cells. Consequently, it estimates the ECD with less bias than other methods. Also, it can be used for the assessment of heterogeneous endothelium like in Fuchs corneal endothelial diseases for which noncontact SM are obviously unsuited. GRANT: ANR 2012 CORIMMO project.
Therapeutics course of childhood noninfectious uveitis
Authors: Tarfaoui N. , Lala E. , Uettwiller F. , Marot Y. , Hoarau C. , Lelez M.L. , Arsene S. , Pisella P.J. 
Published: September 2015

PurposeChildhood noninfectious uveitis is a relatively uncommon but severe disease. All cases seen at the Tours's Hospital were included in this study and were equally followed by the multidisciplinary consultation to evaluate our practice over time.Methods44 children followed from 2003 to 2013 were included. Demographic criteria (gender, age, type of uveitis, initial and final clinical description) and therapeutic outlines were recorded. A vision quality questionnaire Eye–Q associated with a tolerance questionnaire were sent to all patients.Results66% were girls, the average age of diagnosis is 6.5 years and 48% of cases were JIA. Average final visual acuity was approximately 20/20. The initial treatment was topical corticotherapy alone in 47% of cases, and 42% associated with oral corticosteroids. Since the introduction of our multidisciplinary consultation, the delay in determining the change in treatment has been decreased (p = 0.001) without modifying neither the duration nor the dose of corticosteroid therapy. 16% developed new ocular complication during average follow‐up of 39 months. 60% of the ocular complications de novo could be topical corticosteroid related. The response rate was 62% and 66% with preserved quality of vision. The Eye – Q score was correlated with the visual acuity but not with the duration or the doses of any treatments.ConclusionsOur population showed similarity to that of the literature, except for the early support. Our Visual and inflammatory results were satisfactory, which could be explained by the introduction of our multidisciplinary consultation allowing a faster adaptability of therapeutics.
Evolution of hiperreflective points after intravitreal dexamethasone implant injection in patients with macular edema associated with retinal vein occlusion
Authors: Almenara Michelena C. , Ascaso F.J. , Idoate A. , Caramello C.M. , Sánchez J.I. , Berniolles J. , Cristobal J. 
Published: September 2015

PurposeTo analyse the evolution of macular hyperreflective points (HRP) detected by spectral‐domain optical coherence tomography (SD‐OCT) in eyes with macular edema secondary to retinal vein occlusion (RVO), following treatment with intravitreal dexamethasone implant (Ozurdex®).MethodsRetrospective observational study of 45 consecutive cases of RVO‐associated macular edema: 13 central RVO and 32 branch RVO treated with Ozurdex®. The relationship between best corrected visual acuity (BCVA), central macular thickness (CMT) and the presence of HRD in SD‐OCT before treatment and two months post‐injection was determined.ResultsCMT decreased significantly following treatment (527.7 μm vs 308.3 μm, p < 0.001). Although there was a visual acuity improvement in 18 of the 45 eyes (40%), the mean BCVA difference was not statistically significant (p = 0.373). Numerous HRP were detected in 24 patients (53.3%), disappearing in 10 of them (41.7%) after corticosteroid intravitreal therapy.ConclusionsDisappearance of HRP after an intravitreal dexamethasone impant would support the hypothesis that HRP could represent some inflammatory cells.
Myofibroblasts in proliferative diabetic retinopathy can originate from infiltrating fibrocytes and through endothelial‐to‐mesenchymal transition (EndoMT)
Authors: Abu El Asrar A. , De Hertogh G. , van den Eynde K. , Alam K. , Van Raemdonck K. , Opdenakker G. , Van Damme J. , Geboes K. , Struyf S. 
Published: September 2015

PurposeThe fibrovascular epiretinal membranes from patients with proliferative diabetic retinopathy (PDR) are characterized by the accumulation of a large number of myofibroblasts. We explored the hypothesis that proliferating endothelial cells via endothelial‐to‐mesenchymal transition (EndoMT) and/or bone marrow‐derived circulating fibrocytes contribute to the myofibroblast population present in PDR membranes.MethodsEpiretinal membranes from 14 patients with PDR were studied by immunohistochemistry. In addition, we investigated the phenotypic changes that take place in human retinal microvascular endothelial cells following exposure to transforming growth factor‐β (TGF‐β1), connective tissue growth factor (CTGF) and the proinflammatory cytokines interleukin‐1β (IL‐1β) and tumor necrosis factor‐a (TNF‐a).ResultsAll membranes contained neovessels expressing the endothelial cell marker CD31. CD31+ endothelial cells co‐expressed the fibroblast/myofibroblast markers fibroblast‐specific protein‐1 (FSP‐1) and a‐SMA, indicative for the occurrence of endoMT. In the stroma, cells expressing FSP‐1, a‐SMA, the leukocyte common antigen CD45, and the myelomonocytic marker CD11b were detected. Double labeling showed co‐localization of CD45 with FSP‐1 and a‐SMA and co‐localization of CD11b with a‐SMA and matrix metalloproteinase‐9, demonstrating the presence of infiltrating fibrocytes. Retinal microvascular endothelial cells changed morphology upon cytokine exposure, lost the expression of endothelial cell markers (endothelial nitric oxide synthase and vascular endothelial‐cadherin) and started to express mesenchymal markers (calponin, snail, transgelin and FSP‐1).ConclusionsThese results suggest that endothelial cells as well as circulating fibrocytes may differentiate into myofibroblasts in the diabetic eye and contribute to pathologic fibrosis in PDR.
Multicenter Clinical Trial of High‐Intensity Focused Ultrasound Treatment in Glaucoma Patients without Previous Filtering Surgery
Authors: Aptel F. , Denis P. , Rouland J.F. , Renard J.P. , Bron A.M. 
Published: September 2015

PurposeTo evaluate the efficacy and safety of the ultrasonic circular cyclocoagulation procedure in patients with open‐angle glaucoma naïve of previous filtering surgery.MethodsProspective non‐comparative interventional clinical study conducted in five French University Hospitals. Thirty eyes of 30 patients with open‐angle glaucoma, intraocular pressure (IOP) >21 mmHg and with no previous filtering glaucoma surgeries were sonicated with a probe comprising six piezoelectric transducers. The six transducers were activated with a 6‐s exposure time. Complete ophthalmic examinations were performed before the procedure and at 1 day, 1 week, 1, 2, 3, 6 and 12 months after the procedure. Primary outcomes were surgical success (defined as IOP reduction from baseline ≥20% and IOP >5 mmHg with possible retreatment and without hypotensive medication adjunction) at the last follow‐up visit and vision‐threatening complications. Secondary outcomes were mean IOP at each follow‐up visit compared to baseline, medication use, complications and retreatments.ResultsIOP was significantly reduced (p < 0.05) from a mean preoperative value of 28.2 ± 7.2 mmHg (n = 3.6 hypotensive medications) to 19.6 ± 7.9 mmHg at 12 months (n = 3.1 hypotensive medications and n = 1.1 procedures) (mean IOP reduction of 30%). Success was achieved in 63% of eyes (19/30) at 12 months (mean IOP reduction of 37% in these eyes). No major intra‐ or postoperative complications occurred.ConclusionsThe ultrasonic circular cyclocoagulation procedure seems to be an effective and well‐tolerated method to reduce IOP in patients with open‐angle glaucoma without previous filtering surgery.
Changes in lamina cribrosa and prelaminar tissue in anterior ischemic optic neuropathy
Authors: Munoz‐Negrete F.J. , Rebolleda G. , García‐Montesinos J. , Oblanca‐Llamazares N. , De Juan V. , De Dompablo E. 
Published: September 2015

PurposeTo determine changes in lamina cribrosa (LC) and prelaminar tissue in patients with unilateral non‐arteritic anterior ischemic optic neurophaty (NAION) using enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD‐OCT).MethodsSeventeen eyes of 17 patients with NAION were prospectively studied. SD‐OCT scans using EDI technology were obtained at the acute episode and at 2 and 6 months after the ischemic event. The OCT device was set to image a 15 × 10° vertical rectangle centered on the optic disc. The scan in LC was seen clearliest was selected for analysis. The vertical distances from three equidistant points on the reference line (Bruch's membrane opening‐BMO) to the anterior prelaminar tissue surface, and to the anterior and posterior surfaces of the LC were measured.ResultsAt diagnosis, mean prelaminar tissue was significantly thicker and anterior LC surface more posteriorly placed in NAION eyes than in non‐involved eyes. During the follow‐up, in NAION eyes there was a significant prelaminar thinning and an anterior LCreversal (P = 0.001 and P = 0.002 at 2 and 6 months respectively). BMO significantly reduced during follow‐up (P = 0.008 and P = 0.034 at 2 and 6 months respectively). Both prelaminar tissue thickness and BMO changes correlated with retinal nerve fiber layer thickness measurements.ConclusionsOHN is a dynamic structure that undergoes biomechanical changes in eyes suffering NAION. A significant prelaminar tissue thickening and posterior lamina cribrosa displacement occurred during the acute ischemic optic neuropathy, that reverse as the edema resolves.
Epiretinal membrane peeling for eyes with asteroid hyalosis: a case–control study
Authors: Mouna A. , Conaert J.B. , Kurun S. , Ameloot F. , Berrod J.P. 
Published: September 2015

PurposeTo evaluate anatomical and functional results of epiretinal membrane peeling for patients with asteroid hyalosis (AH) comparing with those of a control population without AH.MethodsRetrospective, case–control study, of a cohort of 1104 patients operated from an epiretinal membrane (EM) between January 2002 and February 2014. Forty‐four consecutive patient were included in the EM associated with AH group and were compared to 44 control patient without AH, matched for: age, sex, date of surgery, and axial length. The best corrected visual acuity (BCVA) and central macular thickness on OCT (CMT) were measured at baseline and postoperatively at 1, 6 and 12 months. Intraoperative and/or postoperative complications were also analyzed.Results34 men and 10 women were included in the AH group. Respectively, the mean initial BCVA was 0.49 ± 0.21 logMar for the AH group vs 0.44 ± 0.21 logMAR for the control group (p = 0.2), and the mean initial CMT was 415 ± 71 µm vs 422 ± 73 µm (p = 0.6). No significant difference was found regarding the final BCVA, with respectively a mean of 0.37 vs 0.24 logMAR (p = 0.26) at 1 month, 0.27 vs. 0.23 logMAR (p = 0.5) at 6 months, and 0.17 vs 0.2 logMAR (p = 0.26) at 12 months. Also, no difference was found regarding the evolution of CMT, with respectively a mean of 368 vs 353 µm (p = 0.5) at 1 month, 347 vs 358 µm (p = 0.61) at 6 months, 345 vs 349 µm (p = 0.87) at 12 months. Only a single macular hole was recorded in the AH group in the follow up.ConclusionsThe presence of asteroid hyalosis does not constitute a factor of poor prognosis for visual recovery after epiretinal membrane peeling.