bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of intra‐operative sub‐Tenon injection of 2% lidocaine in cases of unexpected intra‐operative floppy iris syndrome (IFIS)
Authors: KLYSIK A , KORZYCKA D 
Published: August 2014

AbstractPurpose To report safety and efficacy of intra‐operative injection of 2% lidocaine during small incision cataract surgery in cases of unexpected intra‐operative floppy iris syndrome.Methods 4 patients, undergoing routine cataract surgery, who were exposed to alfa‐adrenergic inhibitors, and it was not known pre‐operatively, and in whom intra‐operative floppy iris syndrome occurred unexpectedly. 2.5 ml of 2% lidocaine was injected into the sub‐Tenon space in response to intra‐operative iris prolapse and pupillary constriction. Injection was performed following hydrodissection in 3 of 4 cases and hollowing capsulorrhexis in 1 of 4 cases. The surgery was video‐taped from the beginning of the injection.Results No further iris prolapse was noted in any case, nor further pupillary constriction. Iris plane was stabilized. There were no further complications of cataract surgery. Patients were comfortable and pain free for the rest of the procedure.Conclusion Intra‐operative injection of 2% lidocaine into the sub‐Tenon space is a safe way of reversing iris floppiness and the tendency to iris prolapsed in cases of unexpected intra‐operative floppy iris syndrome. It is an alternative to other intra‐operative techniques to manage IFIS, which provides pain relief as well as iris stabilization.
Topical caffeine induces mydriasis in animals under ketamine‐xylaxine anesthesia
Authors: SÖDERBERG P , YU Z , TALEBIZADEH N , KRONSCHLÄGER M 
Published: August 2014

AbstractPurpose To determine the effect of topically applied caffeine on the pupil diameter during ketamine‐xylazine anesthesiaMethods Six‐week‐old Sprague‐Dawley rats were anesthetized with ketamine xylazine intraperitoneally. Caffeine, 72 mM, dissolved in vehicle, 9 mg/ml, hydroxypropylmethyl cellulose dissolved in water, or the vehicle only, was topically applied. Animals were kept under room light conditions. In experiment I, caffeine in vehicle was topically applied to one eye and vehicle only to the other eye in 10 animals. In experiment II, caffeine in vehicle was applied to both eyes in one group of 10 animals and vehicle only to another group of 10 animals. In both experiments, pupil diameter was measured on both eyes. Measurements were taken immediately after initiation of the anesthesia, and 10, 20, 40 and 60 min. later.Results In experiment I, vehicle only caused a slight transient increase of pupil diameter, peaking around 20 min. after initiation of anesthesia and then decreased below baseline. Caffeine in vehicle caused an initial fast decrease in pupil diameter and the decrease rate leveled out towards 60 min. after initiation of anesthesia. In experiment II, vehicle to both eyes induced a transient increase in pupil diameter that returned to baseline. Caffeine and vehicle on both eyes induced an exponentially declining decrease towards asymptote miosis. The miosis reversed to mydriasis after topical application of tropicamide 5 mg/ml.Conclusion Topically applied caffeine induces miosis in a ketamine‐xylazine anesthetized rat. There is some systemic effect on pupil diameter of the currently used topical application of caffeine. The miotic effect of topically applied caffeine is reversed by tropicamide.
Müller cells ‐ structural and physiological functions
Authors: REICHENBACH A 
Published: August 2014

AbstractIn 1851, Heinrich Müller discovered what he called ‘radial fibers’ and what we now call Müller cells, as the principal glial cells of the vertebrate retina. During the past decades it became evident that they are essential constituents of the retinal tissue. Müller cells appear to constitute the ‘core’ of columnar units of clonally and functionally related groups of neurons. Their primary function is to support neuronal functioning (by increasing the signal‐to‐noise ratio of information processing) and survival (by maintaining a metabolic ‘symbiosis’ with the neurons). Much of this dual role of glial cells involves specific homeostatic mechanisms. Current progress in the field is achieved by the application of various novel experimental methods (cellular electrophysiology, imaging methods, optical and biomechanical measurements, and others). Herewith it was shown that Müller cells increase the signal‐to‐noise ratio of retinal information processing by, for instance, (i) guiding the light towards the photoreceptor cells, (ii) removing excess neurotransmitter molecules from extracellular space, and (iii) performing an efficient clearance of excess extracellular potassium ions after neuronal excitation.
Microglial cell reaction after optic nerve lesions
Authors: VILLEGAS PEREZ MP , GALINDO‐ROMERO C , VALIENTE‐SORIANO FJ , JIMENEZ‐LOPEZ M , SOBRADO‐CALVO P , AGUDO‐BARRIUSO M , VIDAL‐SANZ M 
Published: August 2014

AbstractMicroglial cells may be involved in the degeneration and regeneration processes of Retinal Ganglion Cells (RGCs). Optic nerve (ON) lesions induce microglial cell activation both in goldfish (an animal with important regeneration capabilities; Salvador‐Silva et al., 2000) and rodents (animals with limited regenerating capabilities; Sobrado‐Calvo et al., 2007; Galindo‐Romero et al., 2013). The microglial cell reaction after an ON lesion is common to all the animal models studied and typically includes: increased enzyme activities, morphologic changes and cell hyperplasia. Because these reactions are found in regenerating and non‐regenerating animal models, they may represent a general response of the microglia that is directed towards helping the regeneration process. However, the location, severity and timing of the reaction varies depending on the animal model, amount of RGC death and type of lesion used and on other factors such as whether other eye lesions, trophic or other factors are administered concomitantly. Therefore the microglial cell reaction after an ON lesion can be modified externally and may subsequently influence the degeneration and regeneration processes.
The influence of ocular hypertension on retinal glial cells
Authors: ROJAS B , GALLEGO B , DE HOZ R , RAMIREZ AI , SALAZAR JJ , TRIVINO A , RAMIREZ JM 
Published: August 2014

AbstractWe describe the effects of unilateral laser‐induced ocular hypertension (OHT) in the macroglia and microglia of eyes with OHT and their contralateral normotensive untreated eyes. In both eyes, the glia was reactive even though, contrary to OHT‐eyes, no retinal ganglion cell loss or abnormalities in the electroretinogram were found in contralateral eyes. With respect GFAP immunostaining there were differences between contralateral and OHT‐eye. Signs of microglial activation in contralateral and in OHT‐eyes affected all retinal layers, including: morphological changes, migration, increased cell number, upregulation of activation markers and quantification of the area occupied by Iba‐1+ cells and of the arbor area of Iba‐1+ cells. In microglia, MHC‐II upregulation in contralateral eyes was similar to that in OHT‐eyes. By contrast, MHC‐II upregulation in macroglia was observed mainly in astrocytes in contralateral eyes and in Müller cells in OHT‐eyes. Only eyes with OHT had rod‐like microglia and rounded Iba‐1+ CD68+ CD86+ cells. Glial differences between contralateral and OHT‐eyes could help us to understand glaucoma pathophysiology and develop new strategies for treatment.
Ocular immunology and vitreoretinal surgery “face to face"
Authors: NERI P , ARAPI I , PIRANI V , CARBONARI G 
Published: August 2014

AbstractThe clinical assessment of most of vitreo‐retinal (VR) inflammations is often challenging: the clinical picture of such diseases can be overlapping and, despite the advances in medical technologies, the diagnostic tools might not provide data which can be conclusive. At this point, the possibility to take a vitreous tap via pars plana can help the ocular immunologist to differentiate between different sub‐sets of infectious diseases and masquerade syndrome. The term "Masquerade Syndrome" was first used in 1967 to describe a case of conjunctival carcinoma that manifested as chronic conjunctivitis. Masquerade syndromes are disorders that occur with intraocular inflammation and are often misdiagnosed as a chronic idiopathic uveitis. Very often mesquerade syndrome is a synonymous of intraocular lymphoma which can present insidious clinical pictures, which are very often confused. The possibility to test the interleukines' ratio and to analyze the cytology represents a great scientific advance. A clearer role of VR surgery is played for all the complications of uveitis, such as uveitic retinal detachment, inflammatory macular pucker and dense persistent vitritis. VR surgery can warrant an important contribution to the clinical outcome.
Vitrectomy in uveitis
Authors: MARIOTTI C , SAITTA A , NICOLAI M 
Published: August 2014

AbstractToday, pars plana vitrectomy (PPV) for ocular inflammatory diseases represents a powerful tool for those cases non responding to medical treatment. PPV has been increasingly performed for both diagnostic and therapeutic purposes in the management of patients with uveitis. PPV offers a surgical option in clearing vitreous opacities and repairing inflammatory related complications, such as epiretinal membrane, retinal detachment, vitreous haemorrhage, cyclitic membrane removal for non‐responsive hypotony. The evolution of both technology and surgical techniques for PPV has been very important in order to develop a step forward in approaching and treating ocular inflammatory diseases.
The role of retinal and choroidal biopsy
Authors: DA CRUZ L 
Published: August 2014

AbstractChorio‐retinal biopsy is relatively infrequently used for the diagnosis of infiltrative processes of the posterior segment. It is used in cases where local and systemic clinical features are insufficient to determine whether the infiltration is inflammatory, infective or neoplastic. In most of the few cases described in the literature the aim is to exclude or diagnose lymphoma. The cases published to date suggest the diagnostic pick‐up rate is good relative to vitreous biopsy and it is possible that the diagnosis is confirmed from Chorioretinal tissue biopsy when the vitreous biopsy from the same operation is negative. Diagnoses of many types of pathology including viral and non‐viral retinitis, lymphoma, tuberculosis and non malignant inflammatory infiltration have all been described in the literature. In the majority of cases reported in the literature the diagnosis of lymphoma is clearly made or excluded definitively. The technique of carrying out the surgery has been well described and the reported morbidity of the procedure is minimal. In this presentation The technique, surgical issues and complications will be discussed as well as the outcomes from the published literature concerning these cases.
Clinical manifestations of NMO
Authors: YU‐WAI‐MAN P 
Published: August 2014

AbstractNeuromyelitis optica (NMO), also known as Devic’s disease, is an idiopathic inflammatory demyelinating disease of the central nervous system (CNS) that preferentially targets the optic nerve and the spinal cord. Due to the significant risk of permanent visual and neurological impairment in NMO, rapid diagnosis and the prompt initiation of the most appropriate treatment are essential The current diagnostic criteria require a clinical history of optic neuritis and transverse myelitis accompanied by at least two of the following three supportive criteria: (i) brain MRI not diagnostic of multiple sclerosis (MS); (ii) spinal cord MRI with contiguous lesion over three or more vertebral segments; and (iii) IgG seropositivity against the aquaporin‐4 (AQP4) water channel. The development of optic neuritis and transverse myelitis can be simultaneous or sequential. In this presentation, the classical clinical features of NMO will be reviewed and put in the context of other demyelinating CNS disorders. Recent clinicopathological studies have revealed striking differences between NMO and prototypic MS, establishing them as distinct entities, and with important practical implications for the management of these two disorders.
Overview of treatment of NMO
Authors: DE SEZE J 
Published: August 2014

AbstractRecent studies has shown that neuromyelitis optica (NMO) is clearly a different disease compared with multiple sclerosis (MS). Several MS drugs may increase inflammation process in NMO, especially interferon beta, natalizumab and fingolimod. This fact has 2 important consequences : First the diagnosis of NMO has to been done as soon as possible in order to differentiate NMO and MS patients. Second, as NMO is an antibody mediated disease immunosuppressive grugs should be proposed if the diagnosis is done. First step therapy is based on azathioprine, mycophenolate mofetil and methotrexate. Second step therapy are Rituximab, cyclophosphamide and mitoxantrone. Several drugs (with atarget on complement subunites or several cytokine, especially IL6 or IL17) are currently tested in phase II or III trials. Symptomatic treatments directed against fatigue, urinary or bowel dysfunctions, pain remains also of importance.
Commercial interest
Dysregulated para‐inflammation in the pathogenesis of AMD
Authors: XU H 
Published: August 2014

AbstractPara‐inflammation is an adaptive response of the immune system to low‐degree noxious tissue insults. The physiological purpose is to maintain homeostasis and restore functionality. During ageing, retina suffers from low levels of sustained oxidative insults. As a result, a para‐inflammatory response characterised by microglial activation, subretinal migration and complement activation, is initiated. We propose that a dysregulated para‐inflammatory response may turn into a detrimental chronic inflammation, which may contribute to tissue damage and disease progression. The role of dysregulated para‐inflammation in the pathogenesis of age‐related macular degeneration will be discussed in this presentation.
Testing vision: one cone at a time
Authors: ROORDA A 
Published: August 2014

AbstractIn humans, gaining experimental access to single sensory receptors ‐ photoreceptors specifically ‐ is a challenge, yet it is crucial for learning how the signals arising from each receptor are transformed into perception. By combining adaptive‐optics microstimulation with high‐speed eye tracking, we show that retinal function can be probed at the level of the individual cone photoreceptor in living eyes. This talk will describe the development and applications of our adaptive optics confocal imaging system which we use to track, target and deliver visible light stimuli to single cones or selections of cones. Highlighted applications will include our ongoing efforts to learn about the neural circuits that underlie human spatial and color vision.
Secondary polypoidal choroidal vasculopathy (PCV)
Authors: DONATI G , POURNARAS C 
Published: August 2014

AbstractPolypoidal choroidal vasculopathy (PCV) was first described as polypoidal, subretinal, vascular lesions associated with serous and hemorrhagic detachments of the retinal pigment epithelium (RPE) in a series of patients (10/11 were women) by Yannuzzi. PCV is most commonly diagnosed in patients between the ages of 50 and 65 years. Although more frequently being an primary disease associated to high blood pressure, it may also be secondary to others diseases such as AMD, Central Serous Chorioretinopathy (CSC), ocular radiotherapy, Pseudoxanthoma Elasticum not related to systemic hypertension. Secondary PCV was first reported to occur in AMD patients. Prevalence rates of 4%, 7.8%, 8.2%, and 9.8% have been reported in Caucasian patients with presumed age‐related macular degeneration (AMD). In Asian patients with diagnosed AMD the prevalence rates are even higher, between 23.9% and 54.7%. PCV was categorized as a subtype of neovascular AMD. Vascular proliferative changes associated with PCV in AMD form a network of vessels ending with saccular polypoidal lesions. ICG angiography can be used to distinguish it from classic or occult CNV as usually seen in AMD. PCV is demonstrated by ICG angiography as a prominent vascular network in the early stages of the study and an area of clearing or so called “washout” of the dye in the late stage. On OCT examination the polypoidal lesions are seen as more steep domelike elevations of the highly reflective RPE layers with underlying moderate reflectivity then seen in PEDs. The regions of the branching choroidal vascular networks are visualized as double reflective layers comprising nodular RPE and another highly reflective layer beneath the RPE. According to the EVERST and LAPTOP studies either Anti‐VEGF monotherapy alone or associated to Photodynamic therapy is the best therapeutic option actually available to treat PCV in AMD patients and should be considered as first line therapy in all secondary cases.
Genetics in polypoidal choroidal vasculopathy
Authors: ZERBIB J , SEMOUN O , LALLOUM F , SIKORAV A , TILLEUL J , COSCAS G , SOUIED E 
Published: August 2014

AbstractGenetic factors have been identified these last years in polypoidal choroidal vasculopathy. Because genetic factors play an important role in the pathogenesis of AMD and because AMD and PCV share similarities, the genes involved in AMD have been investigated in PCV. To date, a lot of studies and even reviews have been published on the genetic of PCV, trying to answer if the genetic background between PCV and AMD could help classifying PCV as a subtype of AMD or a distinct disease. Several genes associated to AMD have been analyzed in PCV showing significantly association such as rs10490924 of ARMS2, Y402H of CFH, C2 and C3 genes… But some differences, in particulary, in the rs10490924 of the ARMS2 gene in the allele frequency and the oddsratio between PCV and AMD are observed. The genes associated with PCV are the same genes than those associated with AMD, underligning that PCV and AMD share common pathway of development. Genetic results to date do not help clearly to answer the controversy whether PCV is a subtype of AMD or a specific entity but show interestingly that AMD and PCV, share, at least partially similar molecular mechanisms. Additional genetic and environmental factors might be implicated in the pathophysiology of PCV
Handheld reflectance in vivo confocal microscopy for the diagnosis of conjunctival tumors
Authors: GRIVET D , HAOUAS M , JULIENNE R , PERROT JL , LABEILLE B , CAMBAZARD F , FOREST F , DUMOLLARD JM , PEOC'H M , GAIN P , THURET G , CINOTTI E 
Published: August 2014

AbstractPurpose We evaluated whether the handheld in vivo confocal microscope (IVCM) that has been recently developed for the study of skin tumors is suitable for the diagnosis of conjunctival tumors.Methods Prospective study, observational case series. We prospectively evaluated the IVCM features of 53 conjunctival lesions clinically suspicious of tumors of 46 patients referred to our University Hospital, by using the handheld device (vivascope 3000, Caliber/Mavig). Twenty‐three lesions were excised (3 nevi, 10 melanomas, 5 squamous cell carcinoma, 2 lymphomas and 3 pinguecula/pterygium) while the other 30, presenting no IVCM malignant features, were under follow‐up for at least 1 year. Clinical, IVCM and histological diagnosis were compared. Sensitivity and specificity of the IVCM for the diagnosis of conjunctival malignant tumors was calculated using as reference 1) the histolological diagnosis and 2) the histological diagnosis plus the clinical diagnosis at follow‐up greater than one year.Results IVCM showed sensitivity and specificity for malignant tumors of 100% using both methods.Conclusion IVCM with a handheld dermatology‐dedicated microscope can play a rôle in the non‐invasive diagnosis of conjunctival lesions. Further studies should be performed to better define the diagnostic ability of this technique. Grants: GIRCI2012
Peripheral neuropathy in chronic renal failure: an in vivo confocal microscopy study
Authors: VIEIRA L , ANJOS R , SOUSA H , SOUSA A , BORGES A , BRANCO P , ALVES N , MADURO V , CANDELARIA P 
Published: August 2014

AbstractPurpose To analyse corneal nerve morphology alterations in patients with chronic renal failure by in vivo corneal confocal microscopy (CCM).Methods A prospective study was conducted in 30 patients (30 eyes) with pre‐dialysis chronic renal failure (CRF) and 30 aged‐matched healthy volunteers (30 eyes). A complete ophthalmologic examination, esthesiometry (Cochet‐Bonnet esthesiometer), in vivo CCM (Heidelberg Retina Tomograph II/Rostock Cornea Module) and neurological evaluation were performed.Results Corneal sensation was reduced in pre‐dialysis CRF patients compared with control subjects. Nerve fiber density, length and branch density were reduced and tortuosity was increased in the CRF group (p<0,05). These parameters were related with severity of neuropathy.Conclusion In vivo CCM may be a valuable method for diagnosis of uremic neuropathy and may be used to grade its severity.
Mathematical model of corneal reendothelialization after inadvertent descemetorhexis
Authors: TRONE M , JULIENNE R , RANNOU K , BERNARD A , HE Z , GAVET Y , THURET G , GAIN P 
Published: August 2014

AbstractPurpose To report a case of inadvertent descemetorhexis during phacoemulsification and our conservative approach based on the endothelial cells (EC) self‐healing capacityMethods A 85‐year‐old man presented with an unusual complication of cataract surgery. During visco injection, the Descemet was accidentally dissected and removed during the capsulorhexis. On the next day, a massive corneal edema was observed. Based on the self‐healing capacity of the residual peripheral ECs, we proposed to observe the natural course. The posterior corneal surface geometry was measured in OCT (CASIA‐SS‐1000) and the residual endothelial area was calculated from a mathematical hemi‐ellipsoid model. Considering the EC density (ECD) from the fellow eye, we estimated the theoretical residual EC pool and thus the final post redistribution ECD in the patient.Results The theoretical ECD after endothelial cell redistribution was 1680 cells/mm2, reinforcing the wait and see strategy. Visual acuity improved from counting fingers initially to 20/40 at 8 months. The central cornea was clear and 540µm thick. Specular microscopy and confocal microscopy confirmed the repopulation of the central defect by the ECs over the denuded posterior stroma. The central ECD measured at 5 months and 8 months were 550 and 516 cells/mm2 respectively.Conclusion The ECD was less than expected suggesting a higher traumatic loss and a larger defect. The originality lies in the mathematical modeling of the spontaneous self‐healing capacity of the endothelium, deferring penetrating or endothelial keratoplasty. Interestingly, despite the 85 years old, ECs keep important migration and enlargement capacities. Grant: ANR/CORRIMO3D