bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human pluripotent stem cells as a source of corneal epithelium
Authors: Skottman H. 
Published: September 2015

SummaryIn healthy cornea, epithelium is renewed by limbal stem cells (LSCs) and LSCs transplantation has been used to treat limbal stem cell deficiency (LSCD). However, this is only possible if enough healthy limbal tissue is available. Thus, novel cell sources are needed. Human pluripotent stem cells (hPSC) including embryonic stem cells (hESC) and induced pluripotent stem cells (hiPSCs) provide unique opportunities for differentiation of limbal and corneal epithelial cells.We have previously developed an efficient method for differentiating hPSC towards corneal epithelial progenitor cells capable of terminal differentiation towards mature corneal epithelial‐like cells. With the protocolprotein expression of the corneal epithelial progenitor marker ΔNp63 was greatly enhanced, with up to 95% of cells being ΔNp63‐positive. Finally, after a total of six weeks in differentiation culture, the two markers specific to differentiated corneal epithelium, cytokeratins 3 and 12, were expressed in an average of 35% and 71% of cells, respectively. In recent studies we have continued the molecular and functional characterization of these cells providing more support that those could potentially be used for treating LSCD in the future.
Introduction to the stem cell derived transplants
Authors: Skottman H. 
Published: September 2015

SummaryStem cell therapy is a potential approach for the replacement of degenerated cells of the eye. For retinal diseases such as age related macular degradation (AMD), the usability of human pluripotent stem cells (hPSC) are widely studied. Several groups have demonstrated that hPSC‐ derived retinal pigment epithelial cells (RPE) display typical RPE characteristics and the first clinical trials using human embryonic stem cell (hESC) derived RPE are ongoing.For therapeutic use, the culture of transplantable cells needs to be performed in a culture environment fulfilling quality requirements. For example, the use of xeno‐products in cell production should be avoided as this bears the danger of interspecies transfer of viruses and incorporation of immunogenic molecules. In addition, a supporting extracellular matrix or combined artificial scaffold promotes the stem cell differentiation and acquisition of the correct cell characteristics and function. This is especially important for highly polarized RPE cells possible improving cell survival and function after transplantations.
Retinal innate immune activation in health and disease
Authors: Xu H. 
Published: September 2015

SummaryRetina is considered as an immune privileged tissue, yet many inflammatory retinal diseases occur. Circulating immune cells are not able to freely migrate into the healthy retina due to the blood retina barrier. Retina is protected by its own innate immune system, including microglia, perivascular macrophages, a small number of dendritic cells and the complement system. When retina suffers from exogenous/endogenous insults, a well‐controlled innate immune response is initiated to maintain homeostasis and restore functionality, such response is therefore beneficial. Dysregulation or malfunction of the innate immune response may result in excessive production of inflammatory mediators that may contribute to retinal pathology. The presentation will discuss how innate immune response is controlled in the retina, and the potential contribution of uncontrolled or dysregulated innate immune activation to retinal lesion development in common sight‐threatening diseases such as age‐related retinal degeneration.
Immune cell activation in diabetic retinopathy
Authors: Xu H. , Chen M. 
Published: September 2015

SummaryInflammation plays an important role in the pathogenesis of diabetic retinopathy (DR), although the detailed pathways involved remain poorly defined. Inflammation may occur intravascularly at the early stages of DR in the form of leukocyte‐endothelial interaction (leukostasis). As the disease progresses, this intravascular inflammation damages the integrity of the blood retina barrier resulting in the infiltration of circulating immune cells and plasma proteins that are often toxic to various retinal cells, including the vascular cells as well as various neurons. The presentation will discuss how the phenotype and function of circulating immune cells is affected by diabetes and the contribution of systemic immune activation to retinal degeneration during diabetes.
Ultrasonography in the management of orbital diseases
Authors: Guthoff R.F. 
Published: September 2015

SummaryBased on a 30 year experience in ophthalmic ultrasound a flowchart is presented dealing with orbital anatomical structures, their recognition and their possible pathological changes mainly based on B‐scan technology.The following entities are of importance:

pseudo exophthalmus
myogenic exophthalmus
vascular‐exophthalmus
infiltrating legions
expanding legions
optic nerve legions
legions from surrounding structures (bones, sinusis).
This system helps to decide which diagnostic or therapeutic steps should follow in order to support a decision orientated straight forward patient management.
Ultrasound methods in the assessment of ocular blood flow
Authors: Kisseleva T. , Ramazanova K. , Gavrilenko A. , Kuklin A. , Adzhemyan N. , Chudin A. 
Published: September 2015

SummaryPurposeTo investigate ocular blood flow in vascular diseases (VD) with use of ultrasonic Doppler methodsMethods610 patients suffered from ischemic optic neuropathy (ION)‐180; the retinal vein occlusion (RVO)‐110; diabetic retinopathy (DR)‐80; age‐related macular degeneration (AMD)‐240 patients were observed. Color Doppler Imaging (CDI) and Power Doppler (PD), 3D‐mode were used to estimate blood‐flow of the ophthalmic artery (OA), the central retinal artery (CRA), the posterior cilliary arteries (PCA). The Doppler spectrum of blood flow and its main indices including the peak systolic velocity (PSV), end‐diastolic velocity (EDV) and resistance index (RI) were measured.ResultsSigns of disordered blood flow in the CRA were detected in RVO:diastolic flow was absent or markedly reduced, decreased PSV and an increase RI in comparison with the norm. CDI showed reduced flow velocities in PCA in patients with ION. The decrease of flow velocities in the OA, the CRA and the PCA in patients with dry AMD and significant increase of RI in the PCA in wet AMD were registered. Decreased PSV and EDV in the CRA and the PCA were determined in patients with DR.ConclusionCDI, PD and 3D‐mode are valuable methods for the clinical management of VD.
Eye diseases identified in the ENU‐Ageing Screen
Authors: Jackson I. , Starbuck B. , McKie L. , Banks G. , Blease A. , Simon M. , Wisby L. , Cross S. , Nolan P. , Brown S. , Potter P. 
Published: September 2015

SummaryMRC Harwell is generating cohorts of mutagenized mice, bred to reveal recessive mutations. Cohorts are repeatedly screened for a range of phenotypes at different ages up to 18 months. Included among the screens is optokinetic response to test visual acuity, pupillometry and examination by slit lamp and indirect ophthalmoscopy. We identify both early and late onset disease models, and document disease progression over the lifetime of the mouse. The genetic design of the screen means that the mutant gene can be rapidly identified by mapping and next‐generation sequencing To date we have identified early onset phenotypes including retinal degeneration due to mutation of Rpgrip1, a model for Leber congenital amaurosis‐6, and abnormal pupil response due to mutation in Chrm3. Late onset phenotypes include corneal opacity, caused by mutation of Ikzf2, and progressive vision loss with retinal degeneration. We have identified a missense mutation in Idh3a that results in reduced visual acuity and retinal degeneration from 12 months. Idh3a encodes the α subunit of the mitochondrial enzyme, isocitrate dehydrogenase. This mouse is a model for retinitis pigmentosa 46, due to mutation in the β subunit of human mitochondrial IDH enzyme.
Fundus autofluorescence imaging in Toxic Retinopathies and in Gravitational descending atrophic retinal pigmented epithelial tracks
Authors: Cahuzac A. , Wolff B. , Lehmann M. , Scemama C. , Mauget‐Faÿsse M. 
Published: September 2015

SummaryFundus autofluorescence (FAF) was studied in toxic retinopathy due to synthetic antimalarial drugs (SAM). It was not a screening tool, however it was useful for non‐invasive follow up once retinal toxicity is established.FAF was also studied in Central serous chorioretinopathy (CSC) and diffuse retinal pigment epitheliopathy (DRPE) where it showed abnormalities at both acute and late stage as well as gravitational descending atrophic retinal pigment epithelial tracks, with different caracteristics depending on the acute or chronic stage of the disease.FAF was also studied in choroidal hemangioma where it showed various pattern of atrophic retinal pigment epithelial tracks, in chronic retinal detachment (RD) and in post‐traumatic retinal lesions.Fundus autofluorescence is a major non‐invasive tool to monitor damaged retinal epithelium areas in various pathologies such as toxic retinopathy, CSC, DRPE, chroidal hemangioma and chronic retinal detachment.
Tregs in corneal health and disease
Authors: Dana R. 
Published: September 2015

SummaryThis symposium will focus on the complex network of cells and molecular mechanisms that regulate immunity in the cornea and ocular surface. Talks will focus on the phenotype and function of corneal and ocular surface antigen‐presenting cells in heath and disease; the immunopathogenesis and regulation of allergic eye disease; the myriad functions of nerves in maintaining immune homeostasis in the ocular surface; and T cell regulatory mechanisms that maintain immune privilege and how they be subverted in chronic inflammation and autoimmunity. Those attending the symposium should achieve a greater in‐depth understanding of how immune cells, epithelial cells, and nerves interface to regulate immunity in the anterior segment of the eye.
Ultrasound biomicroscopy in diagnosis of anterior segment pathology
Authors: Ramazanova K. , Kiseleva T. , Lugovkina K. 
Published: September 2015

SummaryPurposeTo demonstrate the role of ultrasound biomicroscopy (UBM) for the diagnosis of anterior segment pathology.MethodsUBM was performed in 7 patients with corneal opacity (6 eyes) and with anterior chamber (AC) opacity (1 eye).ResultsIn first case with total hyphema UBM demonstrated thickening of the iris. Second case with post‐contusional corneal edema and hyphema demonstrated signs of iridodialysis and cyclodialysis. Third patient with central corneal scar had a signs of intraocular epithelial proliferation. With UBM the epibulbar cyst extension into anterior chamber was confirmed in fourth clinical case. In patient with fungal corneal ulcer (fifth case) UBM demonstrated central corneal defect and anterior chamber opacities. Lipodermoid was found in sixth clinical case. UBM helped to confirm that the sclera was not involved. In seventh case with corneal nebula after ocular burns UBM demonstrated iridocorneal adhesion and retrocorneal fibrous membrane. UBM results in all clinical cases determined tactics of treatment.ConclusionsUBM is a safe and effective diagnostic tool in the management of eyes with disorders of the anterior segment especially when visualisation is limited and multiple traumatic injures are involved.
Orbital and palpebral lymphomas
Authors: Robert P.Y. , Flausse R. 
Published: September 2015

SummaryExtra nodal lymphomas may involve the ocular adnexae in 8% of cases. The mean age of onset is basically in the sixth decade. Lymphomas may present as a palpebral mass (39%), conjonctival infiltrate (39%) or proptosis (31%). It may involve orbital fat (47%), orbital muscles (26%), lacrymal gland (19%), preseptal tissues of eyelids (10%), or conjonctiva (60%). However, no specific location has been statistically associated to a better prognosis.Although MALT lymphoma (low grade with good prognosis) is the most common type (46%), other types such as follicular (20%), DLCB (11%), Mantel (5%), or other (17%) may occur. Lymphoma of ocular adnexae represent around 12% of all MALT lymphomas.The incidence of Chlamydia Psittaci infection in lymphoma patients may vary according to the geographic area, for instance 0% in Florida and 80% in Italy.The incidence of amyloïdosis in lymphoma patients arises from 0.85% to 7.5%. However amyloïd deposits are often not systematically looked for, and therefore may remain misdiagnosed.The handling of orbito‐palpebral lymphomas requires the collaboration of a multidisciplinary team involving pathologists, biological and clinical haematologists, microbiologists and orbital surgeons.
Indications for scleral lenses
Authors: Leysen I. 
Published: September 2015

SummaryIn several cases of high irregular astigmatism such as advanced keratoconus, postkeratoplasty and pellucid marginal degeneration scleral lenses are the only nonsurgical solution to improve vision. In addition to correction of irregular astigmatism the large size and scleral bearing surface of these lenses can also be beneficial in the management of certain ocular surface disorders. They can prevent exposure keratitis and enhance epithelial healing.In this part of the session the different indications for scleral lens fitting are discussed and demonstrated by several case reports. This will show the clinical success and many opportunities of these lenses.
Discussion, Questions and Answers
Authors: Dua H.S. 
Published: September 2015

SummaryIn this part of the course there will be an open discussion in which members of the audience will be encouraged to participate, to share their experience and anecdotes.All the faculty of the course will be present to take questions and discuss or describe in further detail points they have made in their presentations.The audience may be asked questions to assess if they had understood key aspects of the course.Course participants will be requested to complete feedback forms.
Macular complication: from edema to ischemia
Authors: Midena E. 
Published: September 2015

SummaryThe pathophysiology of macular complications in diabetic retinopathy is multifactorial. Diabetic macular edema and ischemia (both macular and peripheral) are the major drivers of macular involvement in diabetes. Macular edema may be both intra and extra‐cellular and it is clinically characterized by different aspects, mainly detected by an accurate qualitative analysis of spectral domain OCT data. This approach allows to identify different phenotypes of diabetic macular edema, providing a track to a personalized treatment. Macular ischemia has always been considered a negative prognostic factor in the treatment of macular edema, and this aspect has been recently re‐confirmed. Peripheral retinal ischemia, easily documented by wide field retinal angiography, is emerging as a “new” driver of macular edema. All these new aspects, better defined by a multimodal imaging approach, are the essential to plan an adequate treatment.
Follow‐up and decision making on treatment choices of the patient with established pseudotumor cerebri syndrome
Authors: Parsa C. 
Published: September 2015

SummaryOnce a diagnosis of pseudotumor cerebri is established, the critical task becomes to protect the optic disc from excessive swelling potentially causing auto‐infarction. Assessing tolerable versus threshold levels for such swelling, and selecting a treatment plan based on the degree of disc swelling and findings from perimetry will be reviewed. Technical and procedural steps will be exposed to reduce the chances of auto‐infarction when large degrees of swelling are present using the principles of blood perfusion and regulation to the optic nerve head. Initiation of medical versus surgical treatment will be discussed. Precautions regarding intracranial pressure lowering techniques using lumbar puncture & drainage, optic nerve sheath fenestration, or shunt placement will be examined based on principles of blood perfusion as well as perineural sheath anatomy. Chronic long‐term effects of disc swelling will also be addressed.
Update in management of optic nerve glioma (part 2)
Authors: Parsa C. 
Published: September 2015

SummarySignificant controversy exists in the treatment of optic nerve glioma because of the absence of evidenced‐based trials demonstrating efficacy for various treatments administered over the years, from radiation therapy to various chemotherapeutic regimens and combinations thereof. Elements of tumor biology will be discussed along with fundamental properties of anti‐mitotic regimens administered to date, as well as newer agents proposed targeting protein synthesis rather than DNA replication. Discussion of how tumor suppressor gene status (NF1) should be taken into consideration when deciding upon a treatment modality will also be discussed. Novel vision sparing surgical modalities applicable to NF1‐associated orbital gliomas in particular will be reviewed.
Diabetic maculopathy
Authors: Pournaras J.A.C. 
Published: September 2015

SummaryVitreoretinal macular interface plays an important role in the formation and progression of diabetic macular edema. Main vitreoretinal diseases as epiretinal membrane, vitreous traction and macular holes may occur in this condition. They are due to abnormal mechanical and biochemical interactions between posterior hyaloid and retinal surface. OCT has changed our understanding of the contribution of vitreoretinal interface disorders on the course of macular edema. Tractional elements contribution seems to be more obvious compared to untractional elements as epiretinal membranes. The management of vitreoretinal retinal disorders associated to diabetic macular edema will be discussed. Specific surgical approach will be detailled and compared to same conditions occuring in non diabetic patients.
Pre‐Descemets Endothelial Keratoplasty (PDEK)
Authors: Dua H.S. 
Published: September 2015

SummaryThe most popular endothelial keratoplasty (EK) technique is Descemets stripping endothelial keratoplasty (DSEK). Descemets membrane endothelial keratoplasty (DMEK) has advantages but is technically challenging. In 2013 Dua et al reported a pre‐Descemets layer (Dua's layer, DL) in the posterior cornea and suggested how this could be exploited for EK. This was later developed and performed as Pre‐Descemets endothelial keratoplasty (PDEK).PDEK tissue is harvested by injecting air into the donor cornea and creating a type‐1 big bubble (BB). The posterior bubble wall composed of endothelial cells, DM and DL is excised and inserted in the recipient eye. This tissue rolls less than DMEK tissue and is more robust allowing easy handling and unrolling in the eye. It can also be physically centred in the anterior chamber. The limitations are that on occasions a type‐2 BB may form requiring a DMEK procedure. The PDEK graft size is smaller being limited by the size of the BB (around 8.5 mm). However, PDEK tissue can be taken form very young eyes with higher cell counts. Initial results, with regard to complications, visual acuity, refractive error and OCT changes are very encouraging making PDEK a viable option for EK.
Pathophysiology of macular hole formation
Authors: Stappler T. 
Published: September 2015

SummaryPurposeOur understanding of the pathophysiology of macular hole development has evolved in line with a novel classification system. As novel pharmacological treatments have been introduced previously unseen interactions with the pathophysiology have been observed.MethodsHistopathological correlation studies as well as the effects of novel pharmacological agents on the pathogenesis of macular holes will be presented, including rare cases of macular hole formation.ResultsPerifoveal PVD with vitreomacular adhesion and vitreoschisis allow cortical vitreous to remain on the retinal surface and become a scaffold for cell proliferation and form epiretinal membranes. These alter the cleavage plane for the surgeon. Pharmacological vitreolysis leads to novel and challenging clinical scenarios. The Liverpool experience will be shared.ConclusionsHistopathological correlation studies demonstrate a large proportion of additional epiretinal membrane components on peeled internal limiting membranes. In pharmacological vitreolysis novel strategies in the management of macular holes will be presented.
Subretinal implantation surgery and follow up in pig model
Authors: Kiilgaard J.F. 
Published: September 2015

SummaryThe dimension of the porcine eye is similar to the human eye. Combined with an almost identical anatomy to the human eye, the porcine eye makes an excellent model for surgical eye studies. Standard surgical instruments can be used in the pig model, and thereby can new surgical techniques be tested before they are introduced into the human.Evaluation of the surgical outcome can be performed both in vivo, with fundus photo, OCT and mfERG, and ex vivo with histology, immunohistochemistry and molecular technologies.Retinal pigment epithelium cells, biological membranes, artificial polymers and stem cells can be implanted in the pig, but the overall idea with subretinal implantation surgery is to regain function in diseased retina. There are transgenic porcine models of known retinal degenerative diseases and different iatrogenic traumas can simulate retinal disease, but there still need for development of new models.For long time studies mini pigs are essential as modern pigs have been refined to gain weight quickly. Spontaneous regenerative potential and a remarkable resistance to retinal trauma can also invalidate interpretation of the surgical outcome.
Clinical results and in vitro characterization of cornea limbal epithelial stem cells cultured in autologous serum
Authors: Moe M. 
Published: September 2015

SummarySlow‐cycling limbal epithelial stem cells (LESCs) are responsible for continuously renewing the entire corneal epithelium. Ocular burns, infectious and inflammatory diseases can all cause chronic scaring, decreased vision and severe pain due to limbal stem cell deficiency (LSCD) in the cornea. Center for Eye Research / Department of Ophthalmology, Oslo University Hospital is offering transplantation of autologous ex vivo expanded human corneal epithelial tissue to patients with LSCD. However, even though many of these patients gain significant life quality by means of increased vision and reduced pain by this treatment, in our recent published retrospective case series evaluating our surgical technique, only 56% of the patients had a persisting improvement in subjective symptoms/objective findings. Further clinical experience will reveal in which clinical situations this treatment modality is most likely to succeed – and fail. In parallel, we aim to develop a novel, improved protocol for enrichment of viable LESCs for clinical transplantation to further improve success rate of the treatment. Clinical results as well as results of translational research for improving graft quality will be presented.
Maging of DME in vitrectomized eyes
Authors: Pournaras J.A.C. 
Published: September 2015

SummaryImaging modalities have greatly improved our recognition and understanding of the pathophysiology of diabetic macular edema. Fluorescein angiogram have shown vascular leakage in the presence of macular edema. It permits early detection of intraretinal morphological changes, hemodynamic and inflammatory modifications. Macular perfusion is nicely identified by this exam. Furthermore, OCT have greatly improved the detection of intraretinal fluid, anatomical changes in all retinal layers. It offers comprehensive analysis of the vitreoretinal interface. Quantitative, non invasive and non mydriatic procedure may be performed. Additional recent developments in imaging systems will be discussed.