bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of lingering fusional adaptation on the Bielschowsky head tilt test in superior oblique paresis
Authors: Irsch K. , Guyton D. , Ying H. 
Published: September 2015

PurposeTo investigate how fusion influences the Bielschowsky head tilt test (BHTT) in unilateral superior oblique paresis (SOP).MethodsIn eight fusing patients, we correlated haploscopic‐determined fusion mechanisms with BHTT differences (BHTTD).ResultsFive patients used the vertical recti for vertical fusional vergence and had a mean±SD BHTTD of 22 ± 8PD. After a 30‐minute patch test one of those, in whom the test was performed, showed a decrease of 10PD. Two patients used the “paretic” superior oblique muscle (SOM) and the contralateral superior rectus muscle (SRM) to fuse, and had a mean ± SD BHTTD of 6 ± 8PD. The BHTTD of one, in whom a patch test was performed, increased by 11PD. The remaining patient used the “paretic” SOM and contralateral inferior oblique muscle (IOM) to fuse, and had a BHTTD of only 3PD, increasing to 21PD after patching.One explanation for this behavior in the last patient involves lingering vergence adaptation of the “paretic” SOM and contralateral IOM, which makes these muscles more effective when activated on ipsilateral head tilt, lessening the expected increase in hyperdeviation. Similarly, in our patients with oblique/rectus‐mediated fusion, the vergence‐adapted “paretic” SOM and contralateral SRM are activated on ipsilateral and contralateral tilt respectively, lessening the hyperdeviation in both directions. In the other five patients, however, the vergence‐adapted ipsilateral IRM and contralateral SRM are activated on contralateral tilt, accentuating the BHTTD.ConclusionsFusion influences the BHTTD, either decreasing or increasing it depending on the particular muscles used for fusion. The absence of a positive BHTT should not be relied upon to rule out the diagnosis of SOP. In suspected SOP patients with fusion, performing the BHTT after a patch test may be necessary to bring out the BHTTD supporting the diagnosis.
Downregulating the Myocardin‐related transcription factor/ Serum response factor (MRTF/SRF) pathway is a novel therapeutic approach to prevent post‐surgical fibrosis in glaucoma
Authors: Yu‐Wai‐Man C. , Treisman R. , Khaw P.T. , Bailly M. 
Published: September 2015

PurposeGlaucoma is the first leading cause of irreversible blindness worldwide and fibrosis is the main cause of failure of glaucoma surgery. There are currently no available anti‐fibrotic treatments in the eye. We have previously described how the MRTF/SRF transcription pathway is intricately linked to all the key pathways in ocular fibrosis. We thus hypothesised that inhibiting the MRTF/SRF pathway would be a good therapeutic target to prevent fibrosis in the eye.MethodsMRTF and SRF expression were knocked down in human Tenon's fibroblasts using small interfering RNAs, and three‐dimensional fibroblast‐populated collagen gels were used to measure contraction in vitro. Cytotoxicity was assessed using the live‐dead assay. Live cell imaging was used to study the cell protrusive behaviour during contraction and quantification was performed using a custom parameter, the dynamic index. Reflection confocal microscopy and DQ collagen were also used to measure matrix degradation. Real‐time qPCR was used to compare the gene expression of key matrix metalloproteinases in contracting gels.ResultsMRTF and SRF silencing significantly decreased collagen matrix contraction by 80% and 87% respectively. MRTF silencing did not impair cell viability compared to controls. Knocking down MRTF markedly reduced the protrusive behaviour of human Tenon's fibroblasts (dynamic index = 0.19 as compared to 0.66 for controls). MRTF silencing also significantly decreased matrix degradation and the expression of MMP‐1, MMP‐2, MMP‐9, and MMP‐14 genes.ConclusionsOur study is the first to show that inhibiting the MRTF/SRF pathway significantly decreases collagen matrix contraction, cell protrusive behaviour of fibroblasts, and matrix degradation in the conjunctiva, and thus represents a promising new therapeutic approach to prevent post‐surgical fibrosis in glaucoma.
Semi‐automated reconstruction of inflammatory infiltration in infectious keratitis
Authors: Smedowski A. , Tarnawska D. , Wylegala E. 
Published: September 2015

PurposeTo perform reconstruction of inflammatory cells infiltration in infectious keratitis.MethodsFirst we performed in vivo confocal microscopy (HRT III, Rostock Cornea Module) in 118 patients diagnosed for the infectious keratitis (45 viral, 40 bacterial, 23 fungal, 10 amoebal). Inflammatory cytology has been analyzed according to morphology and size of cells forming infiltration. Microscopic scans were then processed with stereological software (MicroBrightField Inc, VT, USA) to track inflammatory cells within scans. Representative reconstructions of inflammatory cells infiltration has been created for each etiology of keratitis based on previous characterization of cells.ResultsOverall inflammatory cells densities showed no specificity for keratitis etiology, however there was clearly different participation of morphological types of cells depended on keratitis etiology. Leukocyte‐like, round cells represented approximately 4.4% of inflammatory cells in viral, 91.2% in bacterial, 50.4% in fungal and 54.4% in amoebal keratitis. Rest of cells were represented by different forms of dendritic cells, which were possible to track in stereology.ConclusionsIn vivo analysis of corneal epithelial cytology provides useful information about keratitis etiology. Reconstruction of inflammatory cells infiltration can help to create diagnostic algorithm for infectious keratitis diagnosis.
Management of unexplained haemorrhagic PVD at Southampton Eye Casualty Clinic
Authors: Shalaby A. , Tossounis C. , Andrew M. 
Published: September 2015

PurposeTo assess the management of unexplained haemorrhagic PVDs at the Eye Casualty Clinic and compare it with suggested management plans in the literature. Finally suggest possible changes which could improve outcomes.MethodsA retrospective review of patient electronic records at HICCS, e‐Documents and MEDISOFT databases over a 5‐month period (August 2014‐December 2014). All patients attending eye casualty clinic with a diagnosis of a haemorrhagic PVD were included. Patients with pre‐existing retinal neovascularisation or haemorrhagic ARMD and Macroaneurysms were excluded.ResultsThere were 43 patients recorded with unexplained haemorrhagic PVDs in 5 months. 28/43 (65.1%) patients were seen and Discharged at the Eye Casualty Clinic in Max 2 visits. The remaining 15/43 (34.9%) patients were referred to VR OPD for further review. Of these, 7/15 patients had a retinopexy performed prior to VR OPD visit. The patients were seen by different doctors every time and of varying clinical experience (SHO, SpR, Fellow, Associate Specialist, Locum Consultant).ConclusionsThe retinal break was missed in 3/8 (37.5%) of the patients presenting at the Eye Casualty Clinic with an unexplained haemorrhagic PVD and a break despite the presence of a good fundus view.A significant number of patients (28/43, 65.1%) were managed solely at the Eye Casualty Clinic effectively.All the patients that had a laser retinopexy were referred to the VR OPD in 2 weeks for a review.SuggestionsAll patients with unexplained haemorrhagic PVDs and no fundal view should be referred to the VR service the same day for possible early vitrectomyAll patients with no obvious retinal break and reasonable view of their fundus (unless having a very clear view) must be referred to the VR OPD within 1 week for a more detailed fundoscopy.
Hyperreflective Dots in Spectral Domain Optical Coherence Tomography as Phenotypic Marker in Uveitis‐Associated Cystoid Macular Edema
Authors: Sellam A. , Massamba N. , Fel A. , LeHoang P. , Bodaghi B. 
Published: September 2015

PurposeTo evaluate the agreement between hyperreflective dots (HRD) in retina layers by spectral domain optical coherence tomography (SD‐OCT) and laser flare photometry associated with best‐corrected visual acuity (BCVA) results in patients with uveitic cystoid macular edema (CME).MethodsAll patients referred to our tertiary care center for posterior uveitis had full examination including: BCVA, laser flare photometry, SD‐OCT, fluorescein and infracyanine angiography. §Causes of uveitis were multiple: infectious, inflammatory and unknown. The characteristics of the HRD were evaluated in all SD‐OCT scans. HRD were defined as small focal hyperreflective material scattered mainly in outer retinal layers but also spreading to all retinal layers observed in at least one available scan. Two different ophthalmologists counted HRD using a horizontal B scan cross section through the fovea. They were classified on the basis of quantity (i.e. absent, few if less than 10, moderate if between 10 and 20, or numerous if more than 20). Central macular thickness (CMT) was also evaluated.Results24 eyes of 18 patients were included. 8 men and 10 women with posterior uveitis were examined. Mean flare measurement was 25.1 (3–62). Mean BCVA was 20/63. Mean central macular thickness was 463 μm. 2 subgroups were identified. 13 eyes presented decreased BCVA, normal or elevated Flare, numerous HRD and increased CMT, corresponding to active posterior uveitis. Other 11 eyes presented decreased BCVA, increased CMT, normal laser Flare photometry, those results corresponding to chronic posterior uveitis. The difference with the two groups was numerically significant.ConclusionsHRD are correlated to CMT and BCVA but not with anterior chamber flare in active posterior uveitis. A large prospective study is needed in order to confirm these results.
Novel role of PELI3 as a potential biomarker for Sjogren's syndrome related dry eyes
Authors: Pilson Q. , Ni Gabhann J. , Murphy C.C. 
Published: September 2015

PurposeIn Sjogren's syndrome (SS) related dry eyes (SS‐KCS), reduced aqueous tear production and tear hyperosmolarity leads to inflammatory damage to the ocular surface. microRNAs (miR) are known to alter the expression of cytokines, which plays an important role in the pathogenesis and progression of SS. The aim of this study was to isolate miRs and mRNA from conjunctival epithelial cells (CEC) of patients with primary SS (pSS) to identify potential biomarkers that might aid diagnosis and future therapy in pSS.MethodsConfirmed SS‐KCS and healthy controls were recruited to this study. mRNA isolated from conjunctival impression cytology was sent for miR and mRNA microarray. Bioinformatic analysis was performed to identify predicted targets and comparison was made with the mRNA microarray data. Validation experiments were performed in HeLa cells following transfection with selected miR mimics and predicted genes were detected using qPCR.ResultsmiR and mRNA microarray found 32 differentially expressed novel miRs and 136 differentially expressed genes in pSS patients compared to healthy controls. Following bioinformatic analysis, novel miR‐A was chosen for further analysis. miR‐A was significantly increased in pSS (p = 0.0079) and bioinformatics suggested Pellino3 (PELI3), a negative regulator of inflammatory cytokines, as a predicted target. The mRNA microarray showed a decrease in PELI3 in pSS patients compared to healthy controls (p = 0.0731). Overexpression of miR‐A mimic in HeLa cells resulted in decreased expression of PELI3, suggesting that it is a direct target for miR‐A.ConclusionsWe have identified differentially expressed miRs and gene targets from CEC in pSS. PELI3, a potential target of novel miR‐A which is over expressed in pSS, is a negative regulator of cytokines that might have biomarker and therapeutic potential for pSS related dry eyes.
Posterior corneal surface: new insights in curvature and astigmatism
Authors: Patel S. , Wacker K. 
Published: September 2015

PurposeIn normal eyes, a fixed relationship between anterior and posterior corneal astigmatism is assumed, especially for lens power calculations. This study assessed the association between anterior and posterior corneal astigmatism and thickness.MethodsNormal corneas were examined by slit‐lamp microscopy and Scheimpflug imaging. The differences between vertical and horizontal thicknesses at 4‐mm and 6‐mm‐diameters were calculated. Anterior and posterior astigmatism were calculated as the difference between steep and flat powers based on the corresponding radii of curvature and refractive indices. Comparisons and significances of correlations were assessed by using generalized estimating equation models.ResultsFifty‐four subjects (101 corneas) aged 18–80 years were included. Peripheral corneas were thicker vertically than horizontally (p < 0.001) at 4 mm by 13.4 ± 9.4 µm (mean ± standard deviation) and at 6 mm by 8.6 ± 4.8 µm. Anterior corneal astigmatism was 1.08 ± 0.57 D and was aligned vertically (73%), horizontally (6%), or obliquely (21%). Posterior corneal astigmatism was −0.31 ± 0.13 D and was aligned vertically (94%) or obliquely (6%). Anterior and posterior astigmatism were correlated in eyes with vertical anterior astigmatism (r = 0.65; p < 0.001), but not in eyes with oblique or horizontal anterior astigmatism. The difference between vertical and horizontal corneal thickness correlated with posterior astigmatism at 4 mm (r = −0.58; p < 0.001) and at 6 mm (r = −0.61; p < 0.001).ConclusionsThe posterior cornea is normally ellipsoid in shape with a steep vertical meridian that corresponds to the cornea being thicker in the vertical paracentral region. Understanding the normal relationship between anterior and posterior corneal surfaces is important when assessing the same in corneal diseases.
Effect of intravitreal bevacizumab on choroidal thickness in eyes with retinal vein occlusion and diabetic macular oedema
Authors: Kuoliene K. , Malysko K. , Cimbalas A. , Asoklis R. 
Published: September 2015

AbstractPurposeTo evaluate choroidal thickness (CT) before and after intravitreal bevacizumab injections in eyes with macular oedema due to retinal vein occlusion and diabetic maculopathy.MethodsIn this pilot study, 18 eyes of 16 patients were treated with intravitreal bevacizumab injections. The central macular thickness was measured at baseline and after treatment with intravitreal bevacizumab using spectral domain optical coherence tomography (SD‐OCT). The choroid was evaluated using SD‐OCT with EDI mode (Spectralis® HRA+OCT, Heidelberg Engineering) at the fovea before and after intravitreal bevacizumab.Results18 eyes were treated with 1.25 mg of intravitreal bevacizumab every 4 weeks, with at least three injections per eye and then continued if oedema persisted. The mean number of intravitreal bevacizumab injections per eye was three. The subfoveal choroidal thickness was significantly thinner after intravitreal anti‐VEGF treatment (214.82 ± 62.67 μm) than at baseline (265.52 ± 87.67 μm, P < 0.001). The mean central macular thickness decreased significantly after treatment with intravitreal bevacizumab (265.53 ± 83.20 μm) compared to baseline (522.63 ± 305.62 μm, P < 0.005). Decrease in central macular thickness did not correlate with decrease in subfoveal choroidal thickness.ConclusionsIn eyes with macular oedema due to retinal vein occlusion and diabetic maculopathy, treatment with intravitreal bevacizumab significantly reduced subfoveal CT and central macular thickness.
Ptosis and diplopia after incidental botulinum powder exposure
Authors: Cho M. 
Published: September 2015

PurposeTo report the occurrence of an unilateral ptosis and diplopia not direct injection of botulinum but incidental botulinum power exposure.MethodsThis is a case report of botulinum powder's local effect.ResultsThirty years old woman visited our hospital due to ptosis and diplopia. She did botulinum powder purification at her laboratory and incidentally botulinum power was spattered to her right eye. Two days later, right lid ptosis was developed and the next day, diplopia was occurred. She also showed right eye pupil dilatation and hypotropia. She was taken brain MRI and we couldn't find pathologic lesion. One month later, the diplopia was disappeared and ptosis was much improved.ConclusionsIn addition to direct periocular injection, only botulinum power exposure can also make local effect, such as ptosis, muscle paresis, pupil dilatation.
Inflammasome activation by UVB irradiation in human corneal epithelial cells
Authors: Kauppinen A. , Korhonen E. , Piippo N. , Hytti M. , Kaarniranta K. 
Published: September 2015

PurposeCornea is the outermost layer of the eye and mainly responsible for the absorption of ultraviolet B (UVB) radiation. An acute painful inflammatory damage caused by UVB radiation on the corneal epithelium is known as photokeratitis, snow blindness, or welder's burn. We have previously shown that UVB induces inflammation by increasing the production of cytokines IL‐6 and IL‐8 in human corneal epithelial (HCE) cells and now, we have continued this study by exploring the effects of UVB on the inflammasome signaling.MethodsIn vitro‐cultured HCE cells were exposed to UVB radiation after priming with TNF‐α. Thereafter, inflammasome components and cytokines were determined using the ELISA, western blot, and activity assays.ResultsOur results suggest that UVB is capable of activating inflammasome signaling in HCE cells.ConclusionsIn addition to traditional pathways, UVB induces the activation of more recently found pro‐inflammatory signaling system in the human corneal epithelium.
Ultrastructural maintenance of decellularized corneas using dextran
Authors: Lynch A. , Wilson S. , Ahearne M. 
Published: September 2015

PurposeCorneal decellularization has emerged as a promising alternative to traditional tissue‐engineering strategies for the creation of corneal replacements for transplantation. However, decellularization methods can lead to swelling of the cornea, limiting its potential use as a scaffold. In this study, we propose the use of a complex polysaccharide, dextran, to reduce this swelling and maintain the native dimensions and architecture of the cornea.MethodsPorcine corneal buttons were treated with Triton X‐100, SDS and nucleases under constant rotation followed by a washing step. To prevent corneal swelling, the decellularization solution was supplemented with dextran. This solution was added to one group throughout the decellularization process and to a second group during the washing cycle. The resulting acellular scaffolds were systematically evaluated by histological and biochemical analyses, in addition, the ultrastructure of the cornea was examined by transmission electron microscopy (TEM).ResultsResults demonstrated that the combination of detergents and nucleases effectively removed the majority of cellular material from the cornea. Furthermore, the addition of dextran prevented significant swelling when used throughout the protocol or only during the washing process. After soaking in glycerol a degree of transparency was returned to all decellularized corneas suggesting maintenance of the extracellular matrix. However, TEM analysis confirmed that dextran must be present throughout the decellularization process to preserve the native ultrastructure of the cornea.ConclusionsThe findings of this study indicate that the addition of dextran to the decellularization process not only prevents significant corneal swelling but also enhances the maintenance of the native ultrastructure of the cornea.
The prevalence and incidence of glaucoma in Denmark in a fifteen year period: A nationwide study
Authors: Kolko M. , Horwitz A. , Thygesen J. , Jeppesen J. , Torp‐Pedersen C. 
Published: September 2015

PurposeThe purpose of the present study was to describe the prevalence, incidence and demographic variation of glaucoma patients in Denmark in the period from 1996 to 2011. Moreover, the aim was to identify the treatment pattern of glaucoma medication within the studied period.MethodsThe study population comprised all individuals living in Denmark in the period 1996‐2011. The National Prescription Registry was used to identify all claimed prescriptions for glaucoma medication.ResultsA total of 116,592 incident glaucoma patients were identified. Average age at onset was 66 years (range: 0‐105 year), 55% were women. The over all prevalence of glaucoma increased from 0.79% to 1.72% during the investigated period. In 2011, glaucoma affected 3.76% of the population above 50 years and 10% in patients above 80 years.The highest prevalence of glaucoma was found in capital region of Denmark. Within the studied period the use of prostaglandin analogs and combination drugs increased, whereas the use of b‐blockers, carbon anhydrase inhibitors and parasympathomimetic drugs decreased (p < 0.001). Finally, the use of a2‐adrenergic agonists remained unchanged within the studied period. A total of 75% of the patients were treated with two or more glaucoma medications.ConclusionsOver all, the present study is the first assessment of the frequency and the development of glaucoma in Denmark over a 15‐year period. Glaucoma affects a little less than 2% of the total population and increases with age to reach a prevalence of more than 10% amongst people above 80 years.
Optic nerve head hemorrhage and vitreous traction
Authors: Willekens K. , Pinto L.A. , Vandewalle E. , Stalmans P. , Stalmans I. 
Published: September 2015

PurposeDuring posterior vitreous detachment (PVD) the posterior hyaloid remains, for a certain period, attached to the optic disc. It can exert traction with development of optic nerve head hemorrhages (ONHH). ONHH are known to be associated with glaucomatous progression and retinal nerve fiber layer (RNFL) defects. Therefore this study aims at investigating the relationship between PVD formation and ONHH in open angle glaucoma patients.MethodsPatients presenting with an ONHH, from November 2014 on, were included. They underwent a comprehensive ophthalmological investigation, automated visual field test, confocal scanner (HRT III), OCT (HRT‐Spectralis) scan and stereographic photos of the optic nerve head. This study is part of a larger, clinicaltrial.gov (NCT02290795) registered, study investigating vitreopapillary traction (VPT).ResultsEighteen eyes of 18 patients (11 normal tension, 6 primary open angle and 1 secondary open angle glaucoma) were included. Seven out of 18 (38.9%) eyes had concomitant VPT and 7 had a complete PVD. Seven ONHH were located infero‐, 5 supero‐ and 6 temporal. In the non‐VPT subgroup 5 out of 11 (45.5%) eyes showed matching retinal nerve fiber layer defects, with 2 out of 7 (28.6%) in the VPT subgroup.ConclusionsVPT could be a confounding factor in glaucoma assessment and ONHH development.