bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introduction: DME in vitrectomized eyes
Authors: Xirou T. 
Published: September 2015

SummaryDiabetic Macular Edema (DME) is the most frequent cause of vision loss related to diabetes.The etiology of DME is multifactorial, and different treatment modalities are targeting to different triggering factors.The spectrum of treatment options include corticosteroids, anti‐vascular endothelial growth factor agents, laser treatment, combined therapy, pars plana vitrectomy, even if no epiretinal membrane is present.The beneficial effect of vitrectomy on diabetic macular edema is attributed to improved oxygenation of the retina. However many patients may require drug therapy following the surgical procedure. The widespread distribution and increased circulation of intra‐vitreally administered drugs in vitrectomized eyes might be rensposible for rapid clearance and reduced effectiveness of drug therapy. In vitrectomized eyes, sustained‐release drugs could be particular useful.
Update on treatment strategies for LHON
Authors: Yu‐Wai‐Man P. 
Published: September 2015

SummaryLeber hereditary optic neuropathy (LHON) is an important cause of severe bilateral visual loss among young adults. This presentation will review the evidence base for the various treatment strategies that have been put forward to treat this mitochondrial disorder, including future developments. Innovative IVF techniques to prevent the maternal transmission of pathogenic mitochondrial DNA mutations will also be discussed.
Scleral lens as a first therapeutic weapon in severe ocular burns
Authors: Mekki M.B. , Yahiaoui S. , Titah O. , Belaoudmou R. 
Published: September 2015

SummaryPurposeTo demonstrate the spectacular effect of therapeutic scleral lens in healing severe ocular burns.MethodsRetrospective study of 6 eyes with severe ocular burns, complete limbal stem cell deficiency with limbal ischemia in 360°, corneal anaesthesia and resistant to medical treatment for more than 2 weeks without healing tendancy, presenting large complete corneal and limbal ulcer, fitted with therapeutic scleral lens Misa lens (Microlens*, The Netherlands) for continuous daily wear and filled with saline solution and daily control with fluid exchange.ResultsAll eyes had complete re‐epithelialisation in 1–3 weeks under therapeutic scleral lens alone, The healing proccess began from peripheral conjunctival epithelial cells.ConclusionsTherapeutic scleral lens is magic solution to manage severe ocular burns and may be used as first therapeutic weapon.These cases show that epithelial stem cells are presents in all ocular surface not only limbus.
Non‐antagonistic influences of intrastromal corneal ring on primary human microvascular endothelial cells from adult donors in a tissue culture system
Authors: Storsberg J. , Träg S. , Messner A. , Rehfeldt S. , Klöpzig S. , Jentzen V. , Bohrisch J. , Schmidt C. 
Published: September 2015

SummaryPurposeInsertion of the Krumeich corneal intrastromal ring (KR) appears to restrict superficial vascularization of donor corneal tissue. The purpose of this report was to determine cytotoxic effects of the KR using tissue culture of primary HMVEC.MethodsSoluble growth medium extracts of individual components of the KR alloy were prepared and HMVEC cells were exposed to these extracts in triplicates for one day and a subsequent MTT assay. Furthermore, HMVEC were grown for five days onto either KR or polypropylene discs coated with individual components of the KR alloy, followed by staining with FDA/PI.ResultsMTT assays revealed that higher doses of extracts appeared to reduce the viability of HMVEC, while highly diluted extracts of Mo powder appeared to increase the metabolic activity of HMVEC. FDA/PI staining showed few live HMVEC on either Co or Mo‐coated propylene discs, compared to the respective Ti and Cr counterparts. Viable HMVEC appear attached to the KR after a 5 day incubation period.ConclusionThe Krumeich ring does not appear to exert measurable cytotoxic effects in our chosen assay system. High dilutions of Mo powder extracts appear to increase the metabolic activity of HMVEC.
Clinical relevance of ANS dysfunction in glaucoma management
Authors: Abegao Pinto L. 
Published: September 2015

SummaryResearch for autonomic nervous system dysfunctions (ANS) in glaucoma patients has a two‐fold interest for the glaucoma specialist. On one hand, it provides the physician with a set of results that demonstrate the extent of the underlying systemic and ocular dysfunction. These data may provide clues as to why the disease is continuing to progress and may therefore help guide glaucoma management. While strategies towards correcting these imbalances have not been definitely proven to affect the outcome of glaucoma, there are an increasing number of anedoctal data that suggests they may have a positive impact in disease progression. Moreover, signalling the extent of the systemic dysregulation may help identify other, non‐ocular related problems and thus be ultimately beneficial to the patients in the long term. More research is still needed to idenfity which patients are more likely to benefict from undergoing ANS function tests and – should any dysfunction be found – what would be the most consistent treatment strategy.
The RPE/photoreceptor complex
Authors: Osborne N. 
Published: September 2015

SummaryThe retinal pigment epithelium (RPE)/ photoreceptor complex constitutes the choroid, bruch's membrane and the photoreceptor outer segments. The RPE interacts with bruch's membrane and the photoreceptors, which it faces across the subretinal space. In these interactions the RPE acts as three types of cell ‐ epithelium, macrophage, and glia. There are a number of selective interactions between the choroid, bruch's membrane, RPE and photoreceptors related to ion and water transport, vitamin A transport, phagocytosis of shed portions of outer segments, ensheathment of photoreceptors outer segments, and electrical responses. One purpose of the course is to discuss the RPE/photoreceptor complex in terms of structure and function.
Turn off the tap: Inflow surgery comes of age with ECP
Authors: Bloom P. , Clement C. , Sharkawi E. , Grieshaber M. 
Published: September 2015

SummaryFor almost 50 years, trabeculectomy has been considered the ‘gold standard’ procedure in the surgical management of the Glaucoma patient. The operation undoubtedly works well in many surgeons’ hands, and over the last 20 years small changes in surgical technique have improved the safety profile of guarded sclerostomy. ‘Tube’ surgery has also long been widely advocated and debate rages about which of these two mainstream treatments should be the de facto surgery for glaucoma.In a continued attempt to improve the surgical risk/benefit ratio, there have more recently been advocated other surgical glaucoma procedures, which may in time take on the mantle of ‘standard of care’.Our SIS presents a selection of these new treatments as a basis for a robust discussion of why and how we offer surgery to control our patients’ disease with the ultimate aim of preserving their vision as effectively and safely as possible.
Controversies on heavy SiO endotamponade
Authors: Le Mer Y. 
Published: September 2015

SummarySilicone oil (SIO) is a useful tool, mainly in retinal detachment cases complicated with PVR or in some specific cases.A limitation of the tamponade effect of is due to its specific gravity lighter than water which means that recurrences of PVR are always in the inferior retina because of gravity leaving some liquid under the oil bubble where proliferative agents may concentrate.An answer to this was given by modifying the chemical compounds of SIO, adding different substances increasing the specific weight over that of water, thus introducing the “heavier than water” SIO. Five different products are available, Densiron and Oxane HD being the most used.There is still a lot of controversies on heavy SIOs regarding their potential toxicity due to the additional compounds and the stability of the mixture, regarding the potential interaction when directly exchanged with PFCL.In an unfinished prospective study comparing “classical”SIO and heavy ones, the interim analysis after one year follow up in PVR cases didn't find any advantage in the use of heavy SIO. These results seem to finally close the last controversy on their usefulness in this indication.Nevertheless, heavy SIO keep perhaps some indications in specific cases.
Fundus autofluorescence imaging in Ocular Oncology
Authors: Scemama Timsit C. , Mauget‐Faÿsse M. , Wolff B. 
Published: September 2015

SummaryPurposeTo evaluate fundus autofluorescence aspect in retinal and choroidal tumor, paraneoplastic syndrome and intraocular lymphoma.MethodsAll the study patients underwent a complete ophthalmologic examination including biomicroscopic, fundus examination, color photography, fundus autofluorescence, fluorescein angiography, indocyanin green angiography and SD‐OCT.ResultsA total of 14 patients with choroidal or retinal tumor or paraneoplastic syndrome were analysed. 3 cases diagnosed with choroidal melanoma, 1 case of melanocytoma, 2 cases of choroidal nevi, 2 cases of choroidal metastasis, 2 cases of choroidal hemangioma, 1 case of choroidal osteoma, 1 case of intraocular lymphoma, 2 cases of paraneoplastic syndrome (1 BDUMP and 1 AEPPVM) were analysed. The color fundus photographs, angiography and B‐scan findings were compared with FAF imaging. In most of cases FAF imaging is perfectly corellated with, color fundus photographs, angiography, and OCT findings (orange pigment, drusens, calcifications, pseudovitelliform deposits, atrophy…).ConclusionFAF imaging allows a very interesting analysed in ocular oncology without used of dye, a good correlation was found with color fundus photographs, angiography and OCT findings.
Anatomic, biochemical and functional evidence for cone injury in glaucoma
Authors: Nork T.M. , Kim C.B.Y. , Nickells R.W. , Ver Hoeve J.N. 
Published: September 2015

SummaryPurposeTo investigate outer retinal injury in glaucoma.MethodsStudies were done on human glaucomatous eyes as well as eyes from a laser trabecular meshwork destruction model of experimental glaucoma (EG) in non‐human primates (NHPs), including light microscopy and in situ hybridization (ISH) for mRNA using probes specific for rod, S‐cone and M/L‐cone opsins. Choroidal blood flow (ChBF) was measured using non‐recirculating fluorescent microspheres. Functional studies on the NHP eyes included multifocal and full‐field electroretinography (mfERG and ffERG).ResultsSwelling of M/L‐cones) was a common finding in both the glaucomatous human and NHP EG eyes. Cone loss was also observed in some of the human eyes. ISH for mRNA showed reduced levels in both the S‐ and M/L‐cones in human glaucoma and NHP EG. Supranormal mfERG waveforms were a common feature of the NHP EG eyes. ChBF was greatly reduced in eyes with EG. The ffERG in NHP eyes with advanced EG showed larger reductions in photopic than in scotopic a‐ and b‐wave single‐flash responses; particularly at higher intensities.ConclusionMultiple lines of evidence show cone injury in human glaucoma and in NHP EG. Reduced ChBF could be the cause.
Does IOL choice impact on Driving Performance?
Authors: Beiko G. 
Published: September 2015

SummaryPurposeDoes the IOL implanted at cataract surgery affects the driving habits and crash risk of patients.MethodsRetrospective analysis of patients who met the visual requirements for a drivers license and had bilateral implantation of the same lens. The patients had at least 2 years of follow‐up. Two groups of patients were identified; each with one of two types of acrylic IOLs. Both groups were given the Driving Habits Questionnaire, by a single investigator.Results90 patients participated; 51 had acrylic IOL type A and 39 had acrylic IOL type B. The demographics were similar for age, sex, diabetes, glaucoma and IOL power implanted. Group A was more likely to have road traffic accidents (P = 0.066) and less likely to drive at the same speed or faster than general flow of traffic (P = 0.094). Group A to be less likely to have travelled beyond their immediate neighbourhood, to be less likely to rate their quality of driving at average or above and to be more likely to have difficulty driving at night; but this did not reach significance.ConclusionsAt 2 years postoperatively, the choice of IOL implanted at the time of cataract surgery may have an impact on driving habit and crash risk.
Allergic mediators in tears: what's new?
Authors: Leonardi A. 
Published: September 2015

SummaryThe identification of inflammatory mediators in tear fluid have been used in ocular allergy: (a) to identify a ‘disease marker’; (b) to understand the immune mechanisms involved; (c) to correlate the severity of the disease; (d) to identify potential targets for therapeutic interventions; (e) as an indicator of treatment outcomes. Limitations of these findings are the lack of extensive validation of candidate biomarkers and the lack of determination of the specificity of the candidate markers. The increased concentrations of mast cell derived mediators in tears, such as tryptase and histamine, have been considered biomarkers of allergic IgE‐mediated response, while ECP levels is considered a specific biomarker of both allergic IgE‐ and non‐IgE‐mediated allergic conjunctivitis. The increased production and activation of cytokines, growth factors, imbalance between MMPs and TIMPs, are all involved in the pathogenesis of conjunctival inflammation, remodeling and corneal changes typical of chronic severe allergies. It is possible that patients with diseases can have a different protein profile and, therefore, protein or peptide analysis can be used as a possible fingerprint for disease biomarkers and pathological molecule identification.
Capsular opacification and accommodative lens refilling
Authors: Koopmans S. 
Published: September 2015

SummaryAfter lens refilling with a silicone polymer, accommodation has been demonstrated in rhesus monkeys. However, coinciding with the development of capsular opacification the accommodative amplitude decreases to zero. Several strategies may be followed to prevent the development of capsular opacification. A straight forward strategy is the attempt to destroy remaining lens epithelial cells in the lens capsule by cytotoxic drugs. By isolating the lens capsular bag from the rest of the anterior chamber the lens capsule may be selectively treated with drugs. Our experiments in various animal models have shown that lens epithelial cells are very resistant to these treatments. This suggests that better strategies are needed. In further experiments we found that the choice of a proper biomaterial in the capsular bag may also significantly influence the capsular opacification response. Results of lens refilling with Hyaluronan and functionalized nanogels will be discussed.
Gene therapy in LHON
Authors: Vignal‐Clermont C. , Corral Debrinski M. , Sahel J.A. 
Published: September 2015

SummaryGene therapy is a promise for the treatment of Leber hereditary optic neuropathy (LHON). The techniques required for introducing genes into mitochondria have not yet been developed and allotopic expression is one means of circumventing this barrier. To ensure efficient mitochondrial uptake of the nuclear expressed mtDNA gene, the protein should have a mitochondrial targeting signal (MTS). We have optimized allotopic expression by targeting the mRNAs to the mitochondrial surface with a specific 3′UnTranslated Region (UTR) which can cooperate with the MTS for ensuring the localization of ND4 mRNA to the mitochondrial surface. After having collected data proving that an AAV2/2 vector carrying this therapeutic ND4 gene meets the criteria of robust, long‐duration gene expression, and safety in LHON rat model and non human primate retinas, we are leading a phase I/II, open‐label, prospective clinical trial with dose escalation, which intends to evaluate safety of this gene therapy administered in one single intravitreal (IVT) injection in humans with chronic ND4 LHON. Actually 9 patients were included and no SAE or treatment‐related systemic AE occurred. At last, we look forward to be successful in the generation of a treatment for patients suffering from ND4 LHON.
The immunoproteasome in human lens epithelial cells during oxidative stress
Authors: Petersen A. , Zetterberg M. 
Published: September 2015

SummaryThe immunoproteasome has been detected not only in immune‐tissue, but also in non‐immune tissues like the immune‐privileged eye. The aim of this study was to investigate if the immunoproteasome is present in cultured human lens epithelial cells and in human lenses with cataract, as well as to measure expression and activity of immunoproteasome subunits in response to oxidative stress.Expression of the immunoproteasome and constitutive proteasome subunits b1i/b1, b2i/b2 and b5i/b5 were studied by western blot in lens fibre extracts from phacoemulsification surgery, in fresh lens capsule pieces with adherent cells obtained during cataract surgery as well as in oxidatively stressed native human lens epithelial cells (HLECs) in culture.The present study shows that the immunoproteasome is present in native HLECs and in human cataractous lenses. Furthermore, in native HLECs, oxidative stress upregulates immunoproteasome expression in contrast to the constitutive proteasome. The increased expression of the immunoproteasome is not accompanied by increased chymotrypsin‐like activity.Invited SIS speaker at Oxidation and defense in the ocular lens (SIS organizers, Per Söderberg and Madeleine Zetterberg).
Using OCT to evaluate the funny looking disc
Authors: Borruat F.X. 
Published: September 2015

SummaryOptic nerve appearance (optic disc swelling, atrophy, excavation) can be sometimes challenging, even to the experienced ophthalmologist. Namely, it may be difficult to distinguish early papilledema from pseudopapilledema. OCT can reveal abnormalities which can frequently help to establish the correct diagnosis and organize the proper investigations, if necessary. At the end of the session, the participants should be able to identify the OCT features suggestive of either true papilledema or pseudopapilledema/optic disc drusen.
Review of the anatomical and physiological bases of stability of gaze
Authors: Borruat F.X. 
Published: September 2015

SummaryIn order to benefit from the advantages of a highly developed fovea, steadiness of gaze is mandatory. Visual fixation and gaze stability under static and dynamic conditions is achieved via several pathways: vestibulo‐ocular, optokinetic, and smooth pursuit systems. Further a proper control of saccades is necessary. A synthetic review of these systems will be provided. At the end of the session the participants should be able to understand why and how abnormal spontaneous eye movements can be generated.
Abnormal non nystagmic spontaneous eye movements
Authors: Borruat F.X. 
Published: September 2015

SummaryWhen the saccadic system is dysfunctional, an intrusion of spontaneous unwanted saccades can disrupt visual fixation. These can present as square wave jerks, ocular flutter and opsoclonus. Voluntary nystagmus is also a sequence of abnormal saccades. At the end of the session, participants should be able to identify these specific eye movement disorders and organize proper investigations accordingly.
Radius Maumenee Syndrome
Authors: Kestelyn P. 
Published: September 2015

SummaryOcular injection and increased IOP from elevated episcleral venous pressure are most frequently caused by carotid cavernous fistula. Other causes include large vessel venous obstruction (venous sinus thrombosis and superior vena cava syndrome), Sturge–Weber syndrome, scleritis, thyroid‐related orbitopathy and orbital tumours or orbital varices (Radius & Maumenee 1978; Rhee et al. 2009). Additionally, idiopathic rise in episcleral venous pressure, known as Radius–Maumenee syndrome, can lead to ocular injection with elevated IOP (Radius & Maumenee 1978). The syndrome was originally described by Minas & Podos (1968). The diagnosis is based on the clinical findings of elevated IOP causing glaucomatous optic nerve and visual field damage in association with an open angle and dilated episcleral veins. The diagnosis of Radius–Maumenee syndrome can only be made with confidence after intra‐orbital and intracranial pathology mentioned above has been excluded by MRI.Two case reports will illustrate the typical features of this rare cause of glaucoma.
Risk management: how does patient management in ophthalmology compare with those of other medical disciplines?
Authors: Kotecha A. 
Published: September 2015

SummaryRisk management in medicine involves identifying, evaluating and monitoring actual and potential areas of risk of harm to patients. The ophthalmologist's main concern in the care of the glaucoma patient is the risk of their patient progressing to irreversible sight loss. As such, glaucoma patients receive lifelong care once diagnosed, and undergo a multitude of tests over their lifetime. This talk will explore how the care of the glaucoma patient compares with the care of patients from other disciplines and will attempt to address whether glaucoma ophthalmologists are more ‘risk averse’ in the management of their patients.
Military ophthalmia and the Napoleonic campaign in Egypt
Authors: De Laey J.J. 
Published: September 2015

SummaryIn 1798 the French armies landed in Egypt. During this campaign both the French and the British troops were confronted with eye infections. When they returned home the disease spread all over Europe. The Dutch army was also affected. When Belgium became independent in 1830, there were major discussions as what caused the disease. Some called “compressionist” considered it neither to be contagious nor Egyptian, but the consequence of the pressure of the leather collar on the jugulars and of the heavy shako on the forehead. For the others the “contagionists” the disease was highly contagious and spread directly from patients to healthy soldiers although there was also a possibility of “miasma”. The uniform was adapted and hygienic measures were taken. Unfortunately one decision with dramatic repercussions was sending home diseased soldiers. As a result the disease spread within the civilian population and became a major health issue.The very first international congress of ophthalmology was held in Brussels in 1857 and one of the major topics was the “military ophthalmia”.With strict measures the disease was eventually controlled although some regions were still affected up to the end of the 19th Century.
Neuronal complications of intravitreal SiO
Authors: Grzybowski A. 
Published: September 2015

SummaryIntraocular silicone oil (SiO) complications include keratopathy, glaucoma, cataract and subretinal migration of the oil droplets, and can also lead to a severe optic neuropathy caused by retrolaminar migration. Intracranial migration of the SiO through the optic nerve posterior to the lamina cribrosa to the optic chiasm and brain is, however, uncommon. The mechanism is still under debate. Moreover, central scotoma may develop in eyes with SiO not only at the time of oil removal, but also during the period of tamponade. This review summarizes our current understanding of the specific pathogenic mechanisms of intraocular SiO neuronal side effects, concluding that pre‐existing glaucoma and optic nerve abnormalities are the main risk factors associated with this damage. In their absence, the risk of extraocular SiO penetration is so low that the use of SiO endotamponade in complex retinal detachment patients does not need to be modified. MRI images to assess extraocular SiO migration are only necessary in very few and special cases, such as patients with optic nerve abnormalities and glaucoma.