bluuebunny/crossref_metadata_2025_split huggingface dataset:
Descemets membrane endothelial keratoplasty (DMEK)
Authors: Katamish T. 
Published: September 2015

SummaryDescemet's membrane endothelial keratoplasty (DMEK) has emerged as the superior technique for endothelial keratoplasty (EK) in routine cases to selectively replace diseased endothelium in patients with Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. Despite all the advantages of DMEK the overall procedure is challenging for the surgeon. Crucial yet difficult steps of DMEK include: (1) Preparation of an intact donor lamella (D.M. and endothelium), (2) Transfer of the graft into the anterior chamber, (3) Unfolding and orientation of the graft, and (4) Final successful attachment after air filling. In my presentation I will demonstrate clearly how to perform these different steps safely and reproducibly.
Improving vision and comfort of patients with corneal deformations with implementation of ultraHealth and ultraHealth FC S‐H Hybrid Lenses
Authors: Manczak H. 
Published: September 2015

SummaryIn spite of the quadrant specific lens designs, fitting GP lenses to protruded corneas is a greater fitting compromise compared with fitting regular shaped corneas with GP corneal lenses. Also as GP corneal lenses have direct mechanical impact on unhealthy, more vulnerable KC epithelium, they are more likely to induce erosions, abrasions and other mechanical changes. Additionally, due to lack of centration evoked by misalignment of the tip of the cone and optical axis of the cornea, the visual outcome of GP corneal lens wear in patients with corneal irregularity in comparison to GP wear in regular shape corneas patients is usually worse. Synergeyes UltraHealth and UltraHealth Flat Curve hybrid lenses are designed to reduce or eliminate interaction between the part of the cornea within the area of the protrusion, and the back surface of the lens. In addition, size of Synergeyes hybrid lenses is 14.5 mm what usually results in better centration over the visual axis which leads to a reduction of HOA; thus they give a better visual quality outcome. Hypoxia, one of major drawbacks of former hybrid lenses, is greatly alleviated with the new materials that are available. Therefore, currently it is possible to diminish or in some cases entirely exclude complications enhancing the visual outcome at the same time.
Candidate Retinal Biomarkers in CNS Neurodegenerative Disease
Authors: Hudson C. 
Published: September 2015

SummaryTo institute early prevention of the common CNS neurodegenerative diseases, including Alzheimer's Disease (AD), Parkinson's Disease (PD), Lewy Body Disease and Vascular Cognitive Disorders, cost‐effective, non‐invasive early diagnostic biomarkers are essential. Early detection of these diseases is critical given the growing evidence that new therapies will only be effective in pre‐symptomatic or prodromal stages of the degenerative process. Retinal imaging by spectral domain optical coherence tomography is currently used to evaluate morphological neurodegenerative changes caused by ophthalmic disease. Evidence suggests that this technique may also provide a biomarker in AD and PD, revealing changes in the retinal nerve fibre layer that correlate with cortical thinning and possibly prior to emergence of clinical symptoms. This presentation will up‐date the evidence supporting the use of non‐invasive retinal imaging as a pre‐symptomatic prognostic biomarker of CNS neurodegenerative disease.
Imaging in uveitis: techniques and indications
Authors: Herbort C.P. 
Published: September 2015

SummaryThis tutorial will address the main complementary imaging techniques used in the field of (posterior) uveitis. In case imaging work‐up is decided, fluorescein angiography (FA) is performed routinely since a few decades. FA gives information on the superficial structures and lesions of the fundus including pathology of the retina, retinal vessels, optic disc, and subretinal fluid collection, as well as the RPE for which it is the examination method of choice, and the choriocapillaris in the first seconds of angiography. Most of the time it only confirms and gives the precise extension of lesions already identified by the clinical examination. The choroid is however involved at least as often as the retina and often all or part of choroidal lesions are occult and not detected by the clinical exam or FA. Only indocyanine green angiography (ICGA) gives visual access to choroidal inflammatory pathology where it can distinguish stromal choroidits (birdshot, VKH) from choriocapillaritis (MEWDS, APMPPE, etc). So if angiography is deemed necessary during initial appraisal of a case dual FA/ICGA should be performed as choroiditis can not be excluded à priori. Other methods addressed will be OCT, UBM, FAF as well as anterior segment OCT.
Comparison of corneal topographic indices of keratoconus versus normal eyes by using pentacam imaging
Authors: Yekta A.A. , Khabazkhoob M. , Hashemi H. , Bakhshi S. , Ostadimoghaddam H. , Heravian J. , Rezvan F. , Yekta R. 
Published: September 2015

PurposeTo compare the corneal topographic indices of keratoconus versus normal eyes by using pentacam imaging.MethodsOne hundred and fifty patients (300 eyes) from keratoconus clinic based on inclusion criteria and 149 nominees (298 eyes) for refractive surgery with normal cornea were selected from the Noor Eye Hospital, Tehran, Iran. Pentacam scheimflug measurements were performed for both groups based on standard measurement factors. Pentacam topography indices were recorded for each case.ResultsAverage of topographic indices were evaluated and compared between two groups with T‐test. The difference between two groups was significant. Effective indices in discrimination suspect from normal were evaluated by logistic regression. Sensitivity and specificity of indices were plotted by ROC curve. In order to diagnose suspect keratoconus, index of height decentration (IHD) and index of height asymmetry (IHA) had the most sensitivity and specificity values.ConclusionsThe results of this study showed that the index of IHD and IHA were the most sensitive and specific criteria in the diagnosis and discrimination between keratoconus and normal eyes. Based on sensitivity and specificity criteria, the given cut‐points for each indices play an important role in detecting subclinical keratoconus from normal eyes.
Detecting and managing blindness risk in glaucoma
Authors: McNaught A. 
Published: September 2015

SummaryGlaucoma patients are sometimes described as a homogeneous disease group, with the implication that the ‘a priori’ lifetime risk of visual impairment is similar for all patients, or that predicting the eventual risk of visual impairment is problematic. This is an oversimplification of the true situation. The risk of eventual visual impairment can be substantially different between individual patients, with these differences being evident at the first visit to the glaucoma clinic: a diagnosis of secondary glaucoma e.g. PXF, or angle closure glaucoma, is a an important adverse risk factor, as is the initial severity of visual field loss, height of presenting IOP, and, perhaps most important of all, the age of the patient at presentation. The risk of eventual significant visual loss for patients presenting as OHT is low, though, research work, notably the OHTS study, has highlighted risk factors evident at diagnosis which aid more accurate estimation of the visual prognosis. The prognostic importance of the initial findings at diagnosis, and a review of the literature is presented: including new insights from a recent UK audit of a countywide clinical population detailing the annualised relative risk of individual glaucoma patients requiring glaucoma surgery, segregated by presenting diagnosis.
Involvement of mitochondrial dynamics in the physiopathology of Dominant Optic Atrophy
Authors: Lenaers G. 
Published: September 2015

SummaryDominant Optic Atrophy is a blinding disease due to the degeneration of the Retinal Ganglion Cells (RGC) that form the optic nerve. Since our discovery of OPA1 gene in 2000 and novel genes more recently, we now know that mitochondrial dynamic is a key process for RGC physiology, as all DOA genes are primarily or secondarily related to mitochondrial dynamics. I shall present these genes and their respective involvement in mitochondrial fusion or fission, and then put emphasis on the importance of mitochondrial dynamics for the maintenance of RGC physiology, taking into account the two different myelinisation status of RGC axons in the retina and optic nerve. Analysis of these parameters in wild type mice and animals mutated for the DOA genes will be presented to illustrate the consequences of impairing mitochondrial dynamics on mitochondrial structure in axons and RGC survival. We believe that our data provide the first example of a mitochondrial disease, for which a clear rational explanation can justify the high specificity of the cell type affected in this disease.
OCT in assessing glaucoma progression
Authors: Garway‐Heath D. 
Published: September 2015

SummaryOCT imaging enables the measurement of various structures in the optic nerve head (ONH) and retina which may be progressively damaged in glaucoma. Examples include the neural rim and lamina cribrosa at the ONH and the retinal nerve fibre layer (RNFL) in the peripapillary region of the retina and ganglion cell layer (and associated structures) in the macula. Most of these can be measured with high precision (low variability), which makes them good candidates for identifying progression and quantifying rates of progression. The presentation will provide a critical review of the literature for the application of OCT imaging to measure progression in glaucoma, considering the various potential anatomical targets. The application of OCT imaging in clinical practice will be discussed, including pitfalls in relation to image quality and artifacts. The presentation will also discuss the clinical relevance of OCT‐measured change in relation to vision function and how imaging outcomes should be interpreted.
En Face OCT and OCT‐Angiography in ocular oncology
Authors: Zografos L. 
Published: September 2015

SummaryEn Face OCT and OCT Angiography are two innovative diagnostic modalities which were adapted for the diagnosis, therapeutic decision and observation of the evolution following conservative management in ocular oncology. En Face OCT is particulary useful for (1) The definition of the extend of serous retinal detachment and the documentation of its variations (2) The definition of the internal anatomical structure of unpigmented choroidal tumors (3) The definition of the limits of flat and diffused choroidal melanomas in order to define the target volume of the irradiation. Angio‐OCT in ocular oncology is mainly used for the definition of retinal vascular lesions observed in radiation induced optic neuropathy and radiation induced maculopathy. This allows a better definition of the therapeutic strategies with anti‐VEGF drugs in order to preserve visual function.
Corneal nerves maintain the immune privilege of the cornea
Authors: Hamrah P. 
Published: September 2015

SummaryThe aim of the current study is to investigate if neuronal dysfunction leads to the loss of corneal immune privilege. After trigeminal axotomy, corneal cytokines were measured by multiplex bead assay. Corneal hem‐ (HG) and lymph‐angiogenesis (LG), as well as immune cell infiltration and phenotype were assessed by immunohistochemistry staining. Trigeminal axotomy was performed in recipient mice one week prior to corneal transplantation and allospecific delayed‐type hypersensitivity (DTH) was used to compare results between groups. Axotomy resulted in significant increase of CD45+ cells and up‐regulation of MHC‐2. Pro‐inflammatory cytokines in the cornea were significantly increased. The area of corneal HG and LG were significantly increased by 6.3 fold and 5.7 fold respectively. Axotomy before corneal transplantation resulted in rejection of all grafts, and donor‐specific DTH response in these mice was positive at 2 weeks, as compared to transplanted mice without prior axotomy.Neurogenic immune homeostasis is a critical process, whereby the peripheral nervous system directly maintains corneal immune privilege.
Uveitis ‐ the classic masquerade in adults
Authors: Kivelä T. 
Published: September 2015

SummaryThe classic masquerade syndrome in adults is vitreoretinal lymphoma mimicking bilateral uveitis – in about one third of cases, before any evidence of an intracranial lymphoma. It is, however, not the sole neoplastic disease that can lure the clinician to diagnose uveitis. Other examples include posttransplant lymphoproliferative disorder, multiple myeloma, leukemia, histiocytosis, and carcinoma or another amelanotic tumour metastatic to the anterior segment of the eye, and certain paraneoplastic disorders. Making the correct diagnosis needs prior knowledge, a high index of suspicion, careful systemic workup and, quite often, a confirmatory fine needle aspiration biopsy. A further caveat is that in some of these disorders, immunosuppressive treatment may initially appear to be effective. Notably, this apparent effect will prove only temporary, whereas posttransplant lymphoproliferative disorder actually calls for less intensive immunosuppression. This talk will introduce these principles using clinical examples.
Endothelial cell loss after phacoemulsification according to different anterior chamber depths measured by IOL master
Authors: Hwang H. , Lyu B. , Yim H. , Lee N. 
Published: September 2015

PurposeTo compare the loss of corneal endothelial cells after phacoemulsification according to different anterior chamber depths (ACDs), as measured with the IOL Master.MethodsWe conducted a prospective, randomized clinical study on 135 eyes of 135 patients with senile cataracts. Eyes with nuclear density grades of 2 to 4 were divided into three groups according to ACD: ACD I, 1.5 < ACD < 2.5 mm; ACD II, 2.5 < ACD < 3.5 mm; or ACD III, 3.5 < ACD < 4.5 mm. Intraoperative ultrasound time (UST), mean cumulative dissipated energy (CDE), and balanced salt solution (BSS) use were measured. Clinical examinations included central corneal thickness (CCT), endothelial cell count (ECC), and corrected distance visual acuity (CDVA) preoperatively, and 1 day, 1 month, and 2 months postoperatively.ResultsThere were no significant differences in CDE among the ACD groups (P > 0.05). The percentage of endothelial cell loss was significantly higher in ACD I than ACD III in the grade 3 and 4 cataract density groups 2 months after phacoemulsification (P < 0.05). There were also more changes in CCT in all of the cataract density groups in the ACD I group compared to the ACD II and III groups 2 months postoperatively, but the difference was not statistically significant.ConclusionsEyes with shallow ACDs, especially those with relatively hard cataract densities, can be vulnerable to more corneal endothelial cell loss in phacoemulsification surgery. Thus, more attention is needed to avoid corneal decompensation in cataract surgery on patients with shallow ACDs and hard nucleus densities.
Biomechanical properties of eyes with asymmetrical glaucoma defect
Authors: Cellini M. , Gizzi C. , Finzi A. , Campos E.C. 
Published: September 2015

PurposeTo evaluate biomechanical properties in eyes of patients affected by primary open angle glaucoma (POAG) with marked asymmetrical defects by means of Ocular Response Analyzer (ORA) and Spectral Domain OCT with Enhanced Depth Imaging (EDI SD‐OCT) function.MethodsWe studied 20 patients (mean age: 56 ± 12) with asymmetrical POAG. One eye was classified as mild glaucoma (MG) and the sound eye as severe glaucoma (SG) by visual field indexes: MD −4.21 ± 1.51 vs −16.56 ± 5.76 dB; p = 0.011 and PSD 3.54 ± 0.87 vs 10.95 ± 3.51 dB; p = 0.007. An EDI SD‐OCT centered on the optic nerve head and an ORA examination were performed on each eye of every subject before and during a IOP increase of 12.5 ± 2.1 mm/Hg induced by a compression of the globe with an ophthalmodinamometer. Corneal histeresis (CH), corneal resistence factor (CRF) and laminar displacement (LD) were statistically analyzed by Wilcoxon's rank sum test and Spearman's correlation test considering significant a p < 0.05.ResultsAfter IOP increase we found a decrease of CH: 9.3 ± 3.66 vs 6.92 ± 3.04 mm/Hg; p = 0.012 in SG and 8.62 ± 2.16 vs 7.23 ± 2.29 mm/Hg; p = 0.176 in MG. CRF instead increase: 8.61 ± 2.31 vs 12.38 ± 3.65 mm/Hg; p = 0.016 in SG and 9.02 ± 1.48 vs 12.22 ± 5.68 mm/Hg; p = 0.041 in MG. LD was positive in MD: 29.08 ± 19.28 μm and negative in AG‐6.58 ± 16.09 μm. In AG eyes we found a correlation between LD and CRF (r = −0.658; p = 0.019) and between LD and Scleral Rigidity (r = −0.693; p = 0.012).ConclusionsThis study demonstrates that in asymmetrical glaucoma the IOP increase changes the eye biomechanics with stiffening of the eye structures that involves not only the lamina cribrosa but also the corneal tissue.
HLA‐A*02:06 and PTGER3 polymorphism exerts additive effects in cold medicine‐related Stevens‐Johnson syndrome with severe ocular complications in Japanese and Korean populations
Authors: Ueta M. , Tokunaga K. , Sotozono C. , Sawai H. , Yoon K.C. , Kim M.K. , Seo K.Y. , Joo C.K. , Kinoshita S. 
Published: September 2015

PurposeWe reported that PTGER3 SNPs were associated with Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) with severe ocular complications (SOC). We also reported that about 80% of our SJS/TEN patients had taken cold medicines within several days before disease onset and designated them cold medicine related‐SJS/TEN (CM‐SJS/TEN) patients, and that HLA‐A*02:06 was significantly associated with CM‐SJS/TEN in Japanese and Korean populations. Moreover, we documented that HLA‐A*02:06 with TLR3 polymorphisms exerted more than additive effects in SJS/TEN with SOC. In the current study we focused on CM‐SJS/TEN with SOC and analyzed an interactive effect between PTGER3 SNPs and HLA‐A*02:06 in Japanese and Korean populations.MethodsSamples from 132 Japanese patients with CM‐SJS/TEN with SOC were collected and 221 healthy Japanese volunteers were also recruited as controls. Samples from 30 Korean patients with CM‐SJS/TEN with SOC were collected and 120 healthy Korean volunteers were also recruited as controls. Genotyping of PTGER3 gene SNPs was performed using the TaqMan SNP genotyping assay or the DigiTag2 assay. HLA‐A genotyping was performed using using commercial bead‐based typing kits, WAK Flow.ResultsIn Japanese population, we found an interaction with additive effects between HLA‐A*02:06 and the high‐risk genotypes PTGER3 rs1327464 GA or AA (OR = 10.8, p = 2.56 × 10−7). Moreover, we also found an additive effect between HLA‐A*02:06 and the high‐risk genotypes PTGER3 rs1327464 GA or AA (OR = 14.2, p = 5.58 × 10−6).ConclusionsThese finding might show that the combination of these two polymorphisms could give improvements for a genetic testing as compared to using only one susceptibility gene.
Expression of Tissue inhibitor of metalloproteinase in ocular Stevens‐Johnson Syndrome: An Immunohistochemical Study
Authors: Venugopal R. , Sen S. , Kashyap S. , Sharma A. , Agarwal T. , Sharma N. 
Published: September 2015

PurposeTissue inhibitor of metalloproteinase‐1 (TIMP‐1) forms complexes with Matrix Metalloproteinases to inhibit tissue degradation and extracellular matrix (ECM) accumulation. Involvement of TIMP‐1 in Stevens ‐Johnson syndrome (SJS) ocular pannus formation remains unexplored. Therefore, this study aims to evaluate the expression of TIMP‐1 in SJS ocular sequelae patients.MethodsPannus tissues of 18 SJS patients excised during ocular surface reconstruction surgeries were collected. Clinical and histopathological parameters were examined. Immunohistochemistry (IHC) was performed on all cases for TIMP‐1 and evaluated on the basis of epithelial/stromal staining intensity. Expression of TIMP‐1 was statistically correlated with the histopathological and clinical parameters.ResultsMean age was 25.6 ± 13.10 years. There was a male preponderance. Antipyretics (38%) were the most common cause of ocular SJS. Mean duration from onset of systemic episode to first presentation was 8.3 ± 6.2 years. Mean BCVA was 2.72 logMAR ± 0.47, mean Schirmer's value was 0.27 ± 1 mm. Epithelial hyperplasia was found histologically in 88.8% and stromal vascularization in 55%. Stromal fibrosis was indentified in 22%. TIMP‐1 expression was found in pannus epithelium in 13 cases and in stroma in 15 cases. Epithelial TIMP‐1 expression was statistically significant with epithelial hyperplasia, epithelial keratinization, squamous metaplasia, inflammation and stromal fibrosis (p < 0.05). Stromal TIMP‐1 positivity correlated significantly with epithelial keratinization (p = 0.0134).ConclusionsTIMP‐1 protein expression correlated with the histopathological factors in ocular manifestations of SJS. This indicates TIMP‐1's contribution in pannus formation which involves ECM modifications. This may help TIMP‐1 to be considered as a possible therapeutic target in SJS.
Rescue of photoreceptor degeneration by progesterone in an animal model of retinitis pigmentosa
Authors: Miranda M. , Benlloch‐Navarro S. , Trachsel‐Moncho L.C. , Ramírez D.T. , López‐Pedrajas R. , Almansa I. , Silvestre D. 
Published: September 2015

PurposeRetinitis Pigmentosa (RP) is a neurodegenerative disease, resulting in progressive death of photoreceptors. rd10 mice are a model of RP that have a mutation on the cGMP phosphodiesterase codifying gene. The aim of this study is to evidence the neuroprotective role on photoreceptors of progesterone.MethodsProgesterone was orally administered (150 mg/kg at postnatal days 15, 17, 19 and 21). The last day, eyes were enucleated and sectioned or homogenized. Sections were stained with hematoxilyn‐eosin and TUNEL assay was performed. Alterations of different proteins (pCREB, CREB, BDNF, TNFα and LC3) were determined by western blot (WB). Oxidative stress markers (glutathione (GSH) and malondialdehyde (MDA)) were determined by HPLC. To explore PG mechanism, ARPE‐19 PG treated cells were exposed to H2O2 and cell viability was measured. Tissue homogenates were also exposed to a biochemical induction of lipid peroxidation, and the effect of PG was studied.ResultsHematoxilyn‐eosin and TUNEL assays revealed that histological degeneration decreased with PG. No differences were obesrved in WB analyzed proteins between control and rd10 retinas. Retinal GSH/GSSG ratio was decreased and MDA increased in rd10 mice, and PG restored these alterations. After H2O2 stress, major viability was detected on ARPE‐19 PG treated cells and inhibiton of lipid peroxidation was observed in tissue when PG was added.ConclusionsResults suggest that progesterone protection could be related with its antioxidant ability.