bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular surface improvement after conjunctivochalasis (CCH) surgery
Authors: Caramello C.M. , Mateo Orobia A.J. , Peiro C. , Del Buey M. , Perez Navarro I. , Almenara C. , Esteban O. , Ascaso J. , Cristobal J. 
Published: September 2015

PurposeTo evaluate symptomatology and ocular surface changes in patients with CCH grade III after excision surgery.MethodsProspective, interventional study in which 15 patients with CCH grade III were enrolled.Patients underwent CCH excision surgery: 8 patients underwent semiperitomy perilimbic with cauterization technique and 7 paste‐pinch‐cut conjunctivoplasty.The following ocular surface properties were studied preoperatory and 6 weeks after surgical intervention:

– Symptoms by using Ocular Surface Disease Index questionnaires (OSDI)

– Tear Osmolarity by using Tearlab Osmolarity System®.

– Tear Break Up Time (BUT)

– Tear clearance and Tear Function Index by using fluorescein test measure by schirmer strip stain. (Vico and Benitez del Castillo technique)

– Corneal and conjunctival stain:Lissamin green (0–3 grades) and Fluorescein: (0–3 grades)

ResultsOSDI questionnaire confirm symptomatology improvement after surgery. Fluorescein Test measure by Schirmer strip stain reveal a better tear clearance. Fluorescein corneal stain and lissamine green corneal stain decrease. Osmolarity ocular surface values and tear BUT normalise after surgery. There was not significant difference between semiperitomy perilimbic with cauterization technique and paste‐pinch‐cut conjunctivoplasty.ConclusionsCCH patients have an increase proteolytic activitiy in ocular surface. Conjunctival excess interfere with appropriate meniscus tear formation and translate to a deficient corneal tear film. Inflammation control and conjunctival mechanical restore by surgery decrease ocular surface symptomps, improve tear clearance and tear stability and normalize osmolarity values.
Prevalence of diabetic retinopathy in children and adolescents with type 1 diabetes in Helsinki, Finland, 7–15 years after diagnosis
Authors: Gräsbeck S. , Gräsbeck T. , Miettinen P.J. , Summanen P.A. 
Published: September 2015

PurposeThe study focuses on the prevalence of diabetic retinopathy (DR) in children and adolescents who were diagnosed from 1999 to 2004 in Helsinki with type 1 diabetes (T1D) under the age of 15 years and subsequently photographed in 2011–2014.MethodsFundus images of the patients were taken as a part of clinical follow‐up at the Department of Pediatrics if aged 10–18 years, and at Herttoniemi Hospital if older than 18 years. Of the 238 patients, 201 (84%) were included in this retrospective study (another 23 patients had moved from Helsinki, one patient never attended the fundus photography sessions, two had not yet been photographed due to young age, 10 patients who were transferred to adult care did not attend screening as planned, and one patient had died). The presence and severity of DR was determined from 60° fundus images taken with a digital Canon CF‐60UD camera with a green filter by one observer (SG) using ETDRS classification. The eye with more advanced DR level represented the patient.ResultsOf the 201 patients, 106 (53%) were males. The median age at diagnosis of T1D was 8 (range, 0.8–14) years. At the time of fundus imaging the median age was 19 (range, 10–28) years, and the median T1D duration was 11 (range, 7–15) years. Altogether 123 (61%; 95%CI, 54–68) patients had DR of whom the majority (113; 92%; 95%CI, 86–96) had mild DR (level 20 or 35). One patient had neovascularization on the retina. The age of the youngest patient with DR was 10 years. Of the 10 patients who did not attend fundus imaging in adult care, nine had had no DR and one had level 20 DR when analyzed in the pediatric unit.ConclusionsOur results indicate that over half of the young T1D patients in Helsinki have DR after a median duration of 11 years.
The added value of undiluted vitreous biopsy samples processed by the Cellient® tissue processor (Hologic) in unsolved uveitis
Authors: Van Calster J. , Van Ginderdeuren R. 
Published: September 2015

PurposeIn this prospective study, the added value of undiluted vitreous biopsy samples in the diagnosis of unsolved uveitis was evaluated. Vitreous biopsies are difficult to handle because of the paucity of cells and the gelatinous structure of the vitreous. Histopathological analysis of the vitreous is useful in challenging cases to differentiate uveitis from lymphoma or infection and to define the type of cellular reaction.Methods97 consecutive undiluted vitreous samples were isolated in patients with unsolved intermediate or posterior uveitis. A 1.5‐2.5cc sample was taken through a single 23G or 27G port using the EVA vitrectomy platform (DORC) with a twin duty cycle high speed cutter. The samples were analysed with the Cellient® tissue processor (Hologic). This machine is a fully automated processor starting from a specified container with PreservCyt® (fixative fluid) with cells to paraffin. Routine histochemical and immunostainings were evaluated.ResultsIn 94.8% of the cases, sufficient material was found to provide an added value in the diagnostic workup. In 34%, a Cytolyt® mucolytic wash was necessary to prevent clotting of the tubes in the Cellient® tissue processor due to the viscosity of the sample. In 7% the diagnosis was an acute inflammation (presence of granulocytes), in 42% chronic active inflammation (presence of T‐lymphocytes), in 36% low‐grade inflammation (presence of CD68 cells, with <5% T‐lymphocytes); and in 9% a malignant process (lymphoma). In 5% no diagnosis was found. In the chronic active inflammation group 39% was a granulomatous inflammatory process.ConclusionsThis standardized protocol for sampling and handling undiluted vitreous biopsies gives a superior result in morphology, number of cells, and possibility of immuno‐histochemical stainings. The diagnosis can be established or confirmed in 94.8% of cases.
Cyclin kinase inhibitor p27 is downregulated in conjunctival melanoma
Authors: Moulin A. , Schalenbourg A. , Zografos L. , Nicolas M. 
Published: September 2015

PurposeAs loss of cyclin dependent kinase inhibitors p27 and p21 have been identified in cutaneous melanoma and associated with a poorer prognosis, we decided to assess the expression of p27 and p21 in benign and malignant conjunctival melanocytic proliferations.MethodsThe expression of p27 and p21 was assessed by immunohistochemistry in 35 conjunctival naevi and 32 conjunctival melanomas. Statistical analysis was performed with JUMP 8.0 software. Immunohistochemistry was evaluated independently by two observers.ResultsThere was a concordance in 94.02% and 92.54% of the cases in the evaluation of the expression of p27 and p21, respectively. Discrepant cases were simultaneously reviewed to achieve complete agreement.There were 13 subepithelial nevi and 22 compound nevi. There were 14 females and 21 males with a mean age was 36.9 ± 3.6 yo (SEM). Nuclear expression of p27 was found in all the nevi. p21 was identified in only 4 nevi (11.4%).The melanoma group was composed of 18 females and 14 males with a mean age of 65.9 ± 3.38 yo (SEM). p27 and p21 were respectively lost in 18 cases (56.25%) and in 24 cases (75%). There was a significant downregulation of p27 in conjunctival melanoma compared to benign conjunctival nevi (p > 0.0001).In the melanomas, there was a correlation between loss of p27 expression and depth of invasion (p = 0.0141) as well as non‐bulbar tumor localization (p = 0.0279). Although the proliferation index was more elevated in melanomas with p27 loss, this was not significant.ConclusionsThe downregulation of p21 in benign melanocytic proliferations identified in the skin appears also to occur in the conjunctiva. Our results also demonstrate in vivo a significant downregulation of p27 in conjunctival melanoma. Restauration of p27 function in conjunctival melanoma might represent a potential therapeutical option for this tumor.
Meibomian Gland Dysfunction (MGD) and Tear Cytokines after Cataract Surgery according to Preoperative Meibomian Gland Status
Authors: Jung J.W. , Cho D. , Kyoung Yul S. 
Published: September 2015

PurposeTo investigate the possible mechanisms by which cataract surgery aggravates meibomian gland dysfunction (MGD), we evaluated the changes in tear cytokines and ocular surface parameters after cataract surgery according to the preoperative MGD grade.MethodsFifty patients who underwent cataract surgery were enrolled and classified into two groups: Group I had no or minimal MGD, and group II had grade 2–4 MGD. Ocular surface parameters were measured, including tear film break‐up time (TBUT), Schirmer I test, ocular surface staining, and Ocular Surface Disease Index (OSDI), and tear cytokine levels were measured.ResultsIn group II, preoperative MGD grade, ocular surface staining, TBUT, and OSDI were worse and mean interleukin (IL)‐2, IL‐6, and TNF‐α levels were higher than those of group I. MGD and ocular surface parameters were worsened to a greater degree after surgery in group II than in group I (P < 0.050). In group II, IL‐6 and TNF‐α levels significantly increased at postoperative 1 month, and there were significant correlations between changes in ocular surface parameters and tear cytokines (IL‐2, IL‐6, and TNFα; P < 0.050).ConclusionsThe extent to which the MGD grade was aggravated following cataract surgery differed based on preoperative MGD grade. In patients with definite MGD, which was associated with high cytokine levels, an increase of tear cytokines indicated an aggravation of severe MGD after cataract surgery. Preoperative MGD and ocular surface status should be carefully evaluated.
Evaluation of the Variation in Thickness of the Different Retinal Layers in Diabetic Patients with OCT
Authors: Vicente A. , Cardigos J. , Lívio C. , Proença R. , Santos A. , Cunha J.P. , Abegão Pinto L. , Ferreira J. 
Published: September 2015

PurposeTo present a comparison of the thickness variation of the different retinal layers in diabetic patients without diabetic retinopathy.MethodsA prospective observational study was performed. 175 eyes of 175 patients: 125 diabetic patients without diabetic retinopathy and 50 subjects without diabetes (age and gender matched) from the ophthalmology outpatient clinic were included. Optical Coherence Tomography (OCT SPECTRALIS®) was performed with high‐resolution macular scans. Automated retinal layer segmentation was performed using validated software and layers thicknesses were determined. The coefficient of variation of the different layers was calculated. A p value < 0.05 was considered statistically significant.ResultsDiabetic patients were in average 66.9 ± 9.3 years old. There weren't significant differences in the coefficients of variation between diabetic and non‐diabetic patients: total retinal thickness (9.3% vs. 9.3%; p = 0.39), RNFL (41.09% vs. 42.25%; p = 0.33), GCL (30.39% vs. 31.13%; p = 0.20), IPL (23.62% vs. 24.13; p = 0.40), ILN (21.26% vs. 19.86; p = 0.44).ConclusionsPrevious studies have demonstrated that choroidal thickness coefficient of variation is lower in diabetic patients. Nevertheless, in retinal layers no difference was found in diabetic patients without macular edema. There is a combination of choroid with diminished thickness coefficient of variation and retinal layers with normal thickness coefficient of variation. This suggests that vascular choroidal pathology precedes retinal layers dysfunction. Exudation and lipid accumulation associated with microvascular retinal dysfunction and changes in axonal homeostasis only appear at a second step. This study emphasizes the importance of the retinal layer thickness measurement with OCT in the evaluation of diabetic patients.
Nanomedicine and Ophthalmology: looking forward
Authors: Cordeiro Sousa D. , Ferreira Q. , Araujo M. , Morgado J. , Ferreira J. , Leal I. , Abegao Pinto L. , Marques‐Neves C. 
Published: September 2015

PurposeNanomedicine has been receiving greater attention in recent years due to the ability to use materials and devices at the size of intracellular structures and molecules, involving systems in the order of <100 nm. In particular, nanosized materials can provide substantial advantages when compared to current therapeutics that are used in the treatment of ocular diseases. Nanotechnology‐based approaches are being explored in order to enhance drug permeation, to control mechanisms of drug release and to improve the action of nanocarriers with specific targeting moieties. From biopharmaceuticals to continuous intraocular pressure biosensors and tissue regeneration, nanotechnology provides an impressive range of possibilities to explore and improve patient care.MethodsHerein, we review the most recent literature regarding nanotechnology applications in ophthalmology, highlighting their advantages and challenges to overcome, prospecting them in terms of clinical utility.ResultsNanocarriers, nanodevices and nanostructured biocoatings with applications in the treatment of ocular diseases are resumed and their impact in the evolution of ophthalmology is discussed. We present a recent study about nanostructured films composed of drugs encapsulated in nanocarriers with applications in glaucoma treatment. Our results suggest that nanocarriers improve drug delivery and that specific drug amounts can be released during controlled periods of time.ConclusionsOur research emphasizes new trends and applications of nanodevices in ophthalmology. Nanomedicine is definitely part of a paradigm shift in healthcare providing, making it possible to reach excellence in ophthalmological diagnosis and therapeutics.AcknowledgementsThe authors thank FCT–Portugal for financial support under the project UID/EEA/50008/2013 and Post‐Doc grant to QF.
A variant rs613872 in TCF4 gene is responsible for the higher risk for Fuchs endothelial corneal dystrophy development‐ the results of study in Polish patients
Authors: Udziela M. , Oldak M. , Ruszkowska E. , Sciezynska A. , Binczyk E. , Ploski R. , Szaflik J.P. 
Published: September 2015

PurposeThe aim of the study was to investigate the connection between rs613872 polymorphism in TCF4 gene and Fuchs Endothelial Corneal Dystrophy (FECD), and evaluation of TCF4 gene expression within corneas of patients with FECD and individuals of Polish population control group.MethodsGenomic DNA was extracted from peripheral blood. Polymorphism rs613872 was genotyped in 227 subjects with FECD and 312 controls using real‐time PCR and TaqMan sonds. Total RNA was isolated from Descemet's membranes, which were stripped during endothelial keratoplasty performed in patients with FECD (n = 24) and from fragments of donors’ corneas unused for transplantation (n = 22). The difference in TCF4 gene expression was estimated by quantitative method PCR.ResultsThe distribution of genotypes TT, GT, GG in control group was 74%, 23.4%, 2.6% and in FECD patients 21.6%, 64.8%, 13.7%, respectively. The rate of alleles T and G in patients’ group was 245/454 (54%) and 209/454 (46%). In control subjects the results were 535/624 (85.7%) and 89/624 (14.3%). Allele G was much more common in patients with FECD compared to control group (OR = 5.13, 95%CI: 3.84–6.86, χ2 = 132.63, p < 0.0001). Within corneas from patients with FECD the tendency to increased TCF4 gene expression was observed in comparison to the control group, but the disparity was not statistically significant.ConclusionsThe results of our investigations revealed the rs613872 variant in TCF4 gene to be significant associated with FECD in Polish patients. The influence of changing expression of TCF4 gene for FECD development requires the further studies.
Apparent Contradictions in Pupillomotor, Sensory Visual and Electrodiagnostic Findings in Chiasmal Compression
Authors: Krastel H. , Landauer M. , Diehm T. , Kubarko A. , Schlichtenbrede F. 
Published: September 2015

PurposeTo improve the understanding of pupillomotor and electrodiagnostic findings in correlation to visual sensory defects in chiasmal compression.MethodsFull and half field VEPs were recorded by the Roland Retiport system. Stato‐kinetic dissociation in visual field findings was demonstrated by Goldmann kinetic and Twinfield static perimetry. Low luminance conditions are applied with both kinetic and static perimetry. In addition, the he swinging flashlight pupil test was applied in different variants, to solve apparent contradictions in functional findings. Analyzed are two cases of chiasmal compression by aneurysms of the internal carotid artery and one case of a tuberculum sellae meningeoma, in which visual symptoms were the presenting ones.ResultsDespite sensory symptoms may be confined to one eye, contralateral involvement due to chiasmal compression may show up in perimetry – more early by static than by kinetic examination. Low luminance perimetry produces more significant field defects in chiasmal lesins than standard perimetry. The swinging flash comparison of pupil responses may miss the unilateral relative afferent defect, depending on the direction of the light stimulus. Comparing not only responses to OD and to OS stimulation but also pupil responses to upper and lower half field stimulation helps to not overlook relative afferent pupil defects. Comparing, on the other hand, upper and lower half field VEPs has to consider physiological differences in these responses.ConclusionsIn chiasmal compression, apparent contradictions in results of functional examinations may lead to false diagnostic conclusions or even to doubts concerning the somatic origin of visual complaints. The above mentioned extended toolbox of functional exams improves the diagnostic reliability.
Double‐hump sign on gonioscopy: definitive plateau iris? A cross‐sectional study using ultrasound biomicroscopy
Authors: Cordeiro Sousa D. , Leal I. , Caiado F. , Goncalves I. , Reina M. , Marques‐Neves C. , Prior Filipe H. , Abegao Pinto L. 
Published: September 2015

PurposePlateau iris configuration (PIC) is a rare condition involving an angle closure unrelated to pupillary block. It may be defined by a narrow angle and a double‐hump configuration on gonioscopy. Plateau iris syndrome (PIS) may lead to acute angle‐closure glaucoma due to an anterior displacement and rotation of the ciliary body. It has been proposed that ultrasound biomicroscopy (UBM) is helpful in PIC/PIS diagnosis. Our work aims to describe UBM quantitative and qualitative findings in patients whose gonioscopy suggested a PIC/PISMethodsCross‐sectional study involving patients with a double hump gonioscopic finding. UBM was then performed by a blinded observer and evaluated for the presence of following ultrasonographic (US) criteria: (1) a thick and flat iris, (2) a sharp, square root angulation on its insertion, (3) an anterior rotation of the ciliary body, (4) irido‐ciliary sulcus narrowing, (5) iris‐trabecular apposition and (6) a relatively normal anterior chamber (AC) depth. Only high‐quality images were acceptedResultsFrom September 14 to May 15, 35 patients (59 eyes) were recruited. Only 3 eyes presented the six US criteria, 23 eyes filled five of the criteria, 13 satisfied four criteria, 16 presented three criteria and 4 two criteria. The most commonly verified criteria (over 95% of them) were a thick and flat iris and a square root insertion. There was no association between any of these criteria and sex nor age (p > 0.10). Furthermore, the presence/absence of these criteria did not correlate with either anterior chamber depth, lens vault and lens length (p > 0.10)ConclusionsThe majority of patients presenting with clinical iris plateau syndrome do not fulfill the entire US criteria for this condition. However, the US‐based iris morphological parameters seem to be present in nearly all iris plateau patients.
The Liverpool Uveal Melanoma Prognosticator Online (LUMPO) for prognosing metastasis free survival in the absence of cytogenetic data after ruthenium brachytherapy for uveal melanoma
Authors: Rospond‐Kubiak I. , Wroblewska‐Zierhoffer M. , Twardosz‐Pawlik H. , Kociecki J. 
Published: September 2015

PurposeLiverpool Uveal Melanoma Prognosticator Online (LUMPO) is a tool developed by Eleuteri et al. to establish the prognosis for uveal melanoma patients according to the initial tumour characteristics and cytogenetic data. It has been validated with two separate cohorts of patients in United Kingdom and more recently in US. The aim of this study was to test the prognosticator in a homogenous group of patients treated with ruthenium brachytherapy where genetic analysis was not performed.Material and methodsThe records of the patients treated with ruthenium brachytherapy for uveal melanoma at the Department of Ophthalmology, Poznan University of Medical Sciences between 1994 and 2012 were retrospectively reviewed. The probability of 3‐, 5‐ and 10‐year metastasis free survival were obtained for each patient using the LUMPO accessed online and then compared with the existing follow‐up data.ResultsWe identified 102 patients, 60 women, 42 men in a mean age of 59 years. Mean largest basal diameter of the treated tumours was 9.29 (range: 4.04–18.9) mm, mean tumour thickness: 4.8 (range: 2.6–7.01) mm. Follow‐up ranged from 3 to 22 years, mean: 7.55 years. 33 patients died, 18 (17.65%) out of metastatic disease. The metastatic death was not related to patients’ age (p = 0.6866), LBD (p = 0.3049) or tumour thickness (p = 0.7063) alone. The probability of metastasis free survival according to LUMPO was significantly lower for the metastatic group comparing to the surviving group at 3 years (p = 0.0017) and 5 years post treatment (p = 0.0001).ConclusionsLUMPO is a useful tool for prognostication for uveal melanoma patients. However, the use of cytogenetic data makes this prognosis more precise.
Ophthalmologic manifestations of the granulomatosis with polyangiitis (Wegener)
Authors: Toutée A. , Touitou V. , Bodaghi B. , Lehoang P. , Saadoun D. , Hie M. , Schoindre Y. 
Published: September 2015

PurposeWegener's granulomatosis (WG) is a severe focal granulomatous inflammation with variable ophthalmic manifestationsMethodsPatients with a confirmed WG, seen in a single tertiary center between 2008 and 2014 were included retrospectively. WG was proven based on biological or histological analysisResultsFive patients (3W/2M) aged 26–55 years, were included. Clinical features included one scleritis with dacryoadenitis, one bilateral episcleritis complicated with uveo‐scleritis, one bilateral Mooren's ulcer and two orbital inflammatory pseudotumor. Time between the onset of symptoms and the diagnosis was 100 months (range: 1–276 months). All patients had anti‐cytoplasm antibodies to polynuclear neutrophils and underwent biopsies. Histological features included vasculitis inflammatory necrotizing granulomas. Extraocular features were pulmonary lesions (100%), rhinosinusal involvment (80%), renal disease (40%), neurological injury (40%). All patients were initially treated with high‐dose corticosteroids, wich were progressively decreased and received maintenance immunosupressive drugs. Immunosuppressive treatment was initiated on average 64 months after the onset of signs (range: 1–276 months)ConclusionsWG‘s ophthalmologic symptoms are variable. Scleritis remains the most common manifestation, followed by orbital inflammation. Atypical manifestations such as Mooren's ulcer or uveitis can delay the diagnosis. A multidisciplinary approach is mandatory to control this life threatening condition. WG should be considered in all cases of chronic orbital inflammation, scleritis or keratitis to ensure prompt diagnosis and improve the systemic prognosis.