bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Fresh Look at Tear Film Structure and Dynamics
Authors: Bron A.J. , Yokoi N. , Georgiev G. 
Published: September 2015

PurposeTo determine the structure of the precorneal tear film from its behaviour during blinking and eye movements.MethodsThe tear film lipid layer (TFLL) and the fluorescein‐stained mucoaqueous subphase (MAS) were studied during spontaneous blinking and after vertical or horizontal saccades, using the DR‐1TM video‐interferometer and video‐biomicroscope, respectively.ResultsDuring horizontal saccades, the TFLL and MAS behave as a ‘fluid shell’, that moves with the cornea (Yokoi et al. Ocul Surf 2014). This cohesion is lost during blinking. In the downstroke, the TFLL is stripped from the MAS and compressed. In the upstroke it spreads, driven by a surface tension gradient, dragging with it the newly deposited MAS. As these layers spread, they are transiently dissociated and also, the MAS is dissociated from the glycocalyx. Cohesion is restored as the tear film stabilises before the next blink. When the tear film forms in the upstroke of the blink, the menisci draw fluid from the tear film until they are separated by a zone of meniscus‐induced thinning (MIT) – the “black line” seen in the fluorescein‐stained tear film. During pauses at the end of any saccade, this MIT is imprinted onto the MAS and made visible in the fluorescein‐stained tear film as dark arcs on return from horizontal saccades, and dark bands after vertical saccades. Their persistence in the blink interval, implies that the MAS has viscous, gel‐like properties.ConclusionsJust prior to each blink there is cohesion between the tear film and glycocalyx and between each layer of the tear film. Cohesion is broken transiently by blinking. Most of the water intervening between the gel‐like MAS and TFLL is drawn off into the menisci at the time of tear film formation.
Designing an innovative bioreactor destined to improve the endothelial viability of stored corneas
Authors: Rageade D. , Bernard A. , Nangoum‐Fosso T. , Herbepin P. , He Z. , Perrache C. , Piselli S. , Acquart S. , Thuret G. , Gain P. 
Published: September 2015

PurposeLoss of intraocular pressure (IOP) after death and after corneo‐scleral procurement triggers a stromal swelling causing posterior folds in which endothelial mortality is increased. We hypothesized that restoration of IOP after procurement will be key for long‐term corneal storage with preserved endothelial functions.MethodsWe designed two bioreactors (BR) (for human and porcine corneas) and their control units. The BR presented as a sterile disposable cassette comprising a corneal chamber with transparent windows surrounded by the fluidic system. Sterile sampling sites were added in the circuit for monitoring physiochemical parameters as well as sterility without risk of contamination.ResultsAfter insertion of the corneo‐scleral rim, the system was closed and the cassette connected to its control unit, comprising a peristaltic pump driven by a microcontroller. In a comparative study (ongoing) on paired corneas, the BR maintained a normal corneal thickness and transparency during the storage, while reducing the number of endothelial folds and increasing the endothelial viability.ConclusionsThe innovative BR restores IOP while ensuring a continuous medium renewal in a fully transparent chamber. The BR will be available for eye banks, research laboratories, contract research organizations, and cosmetic industry. GRANTS: AP looks for from ANSM, EFS, UJM.
Interventions against VEGF overexpression, available strategies and future developments
Authors: Amadio M. , Bucolo C. , Govoni S. , Drago F. , D'Agata V. , D'Amico A.G. , Cupri S. , Pignatello R. , Pascale A. 
Published: September 2015

PurposeNeovascular diabetic retinopathy (DR) and age‐related macular degeneration (AMD) are characterized by increased VEGF signaling. VEGF can be targeted using monoclonal antibody‐based drugs (e.g. ranibizumab, aflibercept) or by modified oligonucleotides (e.g. pegaptanib). The main difference between the two classes is that antibodies recognize all VEGF isoforms while oligonucleotides may be more specific for certain isoform such as VEGF165. New ways of intervention stem out from the observation that VEGF expression can be post‐transcriptionally regulated by the RNA‐binding HuR/Elav‐like1 protein. We evaluated if targeting HuR is a potential tool to hinder VEGF overexpression.Methods2.5 µM HuR siRNA (naked or delivered by nanocarriers) was intravitreally administered in a DR model. Rats were sacrificed 48 h after siRNA injection and retinal tissues collected for Western blot, ELISA, histological examination.ResultsHuR siRNA treatment blunts both HuR and VEGF increase, restating normal VEGF content in DR retina. HuR siRNA exerts its protective effect when included in liposomal nanocarriers, since the naked molecule does not prevent diabetic retinal damage.ConclusionsAn HuR‐based strategy may be a target in the chain of events controlling VEGF expression synergizing with oligonucleotide‐based interventions having the potential to modulate the expression of VEGF without fully blocking it.
Clinical evaluation of video imaging technology during visual field exams
Authors: Charlier J. , Zanlonghi X. , Defoort‐Dhellemmes S. 
Published: September 2015

PurposeVideo imaging consists in recording the entire visual field process in synchrony with the video of the patient's head. Several clinical applications have been investigated to evaluate the clinical usefulness of this new technology.MethodsThe study included results from 48 visual field exams performed on a MonCvONE full field projection perimeter with synchronized video recording.The video from a large viewing field camera was recorded in synchrony with the position of the visual stimulus, with other test parameters such as luminance and size and with the patient's response obtained from the patient's press button or from the operator judgment. The study included patients who were unable to perform automated perimetry due to young age or handicap, patients with abnormal eye movements, head posture or ptosis and controls performed after automated perimetry.ResultsVideo recording was extremely useful in the majority of clinical cases. 24 exams were performed on young children (age between 2 and 5 years) using attraction perimetry. The eye orientation responses could be interpreted and validated after the exam. In other cases, the video recording facilitated the interpretation and documentation of visual field results with the inclusion of video snapshots in the examination report. Additional applications included the recording of cardinal eye gaze positions and of the fusion visual field.ConclusionsSynchronized video imaging performed during visual field exams is a clinically useful tool for the examination of patients who cannot perform automated perimetry and for the documentation of artefacts and situations such as ptosis, abnormal eye movements, abnormal head posture and incorrect position of refraction.
Assessment of deviation angle and oblique muscle function in strabismus patients using analysis of two‐dimensional eye globe pictures in diagnostic gaze positions
Authors: Bushuyeva N. , Romanenko D. 
Published: September 2015

PurposeTo develop simple and fast method of deviation angle and extraocular muscle (EOM) function examination in strabismus patients.MethodsPictures of eye globes in 12 diagnostic gaze positions were taken. They were analyzed using developed software: for both eyes the program calculated pupil center shift relative to pupil center position in primary gaze for each gaze position in millimeters. 140 volunteers (70 adults and 70 children) without EOM pathology and refraction anomalies were examined to create reference interval database for each gaze position. 148 strabismus patients were examined using developed method and conventional ones: Hirschberg and Fresnel prism tests for deviation measurement, 0–4 scale was used to assess oblique muscle function.ResultsEye globe shifts in healthy adults and children mainly ranged from 3 to 4.5 mm, maximal shifts equaled 6.5 mm in adults and 5.5 mm in children. Correlation coefficient between deviation angle measured with the method and Hirschberg test was 0.797, mean difference between measurements was 1.1º. Correlation coefficient between the method and Fresnel prism test was 0.881, mean difference between measurements was 3.8 PD. Cluster analysis sorted out 3 degrees of oblique muscle disfunction measured with the developed method. They in 80% correlated with conventional scale.ConclusionsDeveloped automated method of deviation angle and EOM function assessment simplifies and objectifies examination of strabismus patients.
Comparison of CKC‐ and BAK‐cationic emulsions in a rat model of corneal wound healing
Authors: Daull P. , Feraille L. , Elena P.P. , Garrigue J.S. 
Published: September 2015

PurposeDry eye disease (DED) is a chronic disorder that afflicts 20% of the population. One prominent feature of DED is the ubiquitous presence of inflammatory cells and corneal epithelium damages in DED patients. The aim of the present study is to compare the efficacy of unpreserved cationic emulsions (CEs) with cetalkonium (CKC) or benzalkonium (BAK) chloride as cationic agents on debrided rat corneas healing and inflammatory response.MethodsThe CEs were assessed in a rat model of corneal scraping. The upper part of the corneal epithelium was scraped prior to a 5‐day treatment with the CEs. Paces of corneal recovery and clinical evaluations (in vivo confocal microscopy (IVCM) and Draize tests) were used to evaluate the healing process. Inflammatory cells count in the corneal stroma was assessed by IVCM.ResultsCorneal healing was only marginally affected by the different treatments, and was almost complete at day 5. However, cornea wounds closed more rapidly when treated with CKC‐CEs than with BAK‐CEs. Interestingly, both Draize and IVCM scores indicate that treatments with the CKC‐CEs resulted in a better healing process when compared to BAK‐CEs. The number of inflammatory cells was also at its lowest following treatments with CKC‐CEs.ConclusionsBy restoring a hydrated ocular surface the different treatments promote corneal healing. Inflammatory cells count in the stroma was at its lowest with the preservative‐free CKC‐CEs, suggesting that CKC and BAK have indeed different properties and effects on the ocular surface. Hence, Ikervis®, a CKC‐CE of cyclosporine, represents a promising treatment option for the management of corneal lesions and inflammation in DED patients.
Longterm outcomes of cyclodiode treatment for patients with neovascular glaucoma
Authors: Weston K. , Lockwood A. , Penwarden A. , Kirwan J. 
Published: September 2015

PurposeTo investigate the outcomes following cyclodiode treatment for patients with refractory neovascular glaucoma. Outcome measures were sustained IOP reduction, symptom relief, number of medications and progression to pthysis, over a 10 year period. Visual acuity data was also collected.MethodsA consecutive retrospective series of 15 eyes of 14 patients in a single eye unit, undergoing cyclodiode treatment between May 1999 to July 2005. Case notes were reviewed.ResultsFour patients died before completion of 10 year follow up but are included in the 5 year follow up data. Symptomatic relief was achieved in all eyes. Four eyes required a single further treatment with cyclodiode at 2 months to 3 years. Mean IOP prior to treatment was 42 mmHg. Following treatment, mean IOP was 18.5 mmHg at 1 month, 19.6 mmHg at 6 months, 15.33 mmHg at 1 year, 15.07 mmHg at 2 years, 12.92 mmHg at 3 years, 14.38 mmHg at 5 years and 10.1 mm/Hg at 10 years (75.95% reduction). 88% of eyes did not require any medication at 10 years. The mean reduction in number of medications used was 2 (2.8–0.8). Pthysis occurred in 5 eyes. In 3 eyes this occurred within 1 year of cyclodiode and in the remaining 2 eyes by 4 years. No patients progressed to evisceration or enucleation. 60% of eyes were NPL at 10 years, with pre‐cyclodiode acuities in this group of HMs to PL. One eye remained the same, with PL vision, and one eye improved from CF to 1/60. The vision in 2 eyes dropped from CF to HMs.ConclusionsCyclodiode laser treatment is effective for both pain control and maintaining IOP in the long term. It allowed a reduction in the number of topical treatments required.
Interleukin 33/ST2 signaling regulates inflammatory response in choroidal stroma and ocular angiogenesis: implications for age‐related macular degeneration
Authors: Theodoropoulou S. , Doyle S. , Copland D. , Liu J. , Wu J. , Campbell M. , Dick A. 
Published: September 2015

PurposeAge‐related macular degeneration (AMD) is a leading cause of irreversible blindness. We wished to elaborate mechanisms that regulate RPE‐choroidal microenvironment in AMD. We hypothesize that retinal pigment epithelial cells (RPE) produce interleukin 33 (IL‐33) and regulate choroidal stromal fibroblasts and mast cell activation and angiogenesis in an ST2‐dependent manner. Through such mechanisms, change in choroidal architecture may contribute to AMD phenotypes observed clinically.MethodsUpon treatment, RPE cells, human choroidal fibroblasts and bone‐marrow‐derived mast cells (BMMC) were assayed by RT‐PCR, Western Blot and ELISA. Choroidal sprouting assay and laser‐induced choroidal neovascularization (CNV) were used as models of ocular angiogenesis.ResultsTLR‐stimulation of RPE significantly up‐regulated IL‐33 expression. ST2+ BMMC generated a spectrum of inflammatory cytokines when cultured with IL‐33 rich RPE supernatant. Pretreatment with IL‐33 antagonist markedly inhibited the ability of BMMC to produce inflammatory mediators. Importantly, activation of inflammatory cascade upon RPE supernatant treatment was abrogated in ST2‐/‐ BMMC. In a wound‐healing assay, recombinant IL‐33 treatment of human choroidal fibroblasts impaired their ability to migrate and contract collagen gel. Furthermore, IL‐33 treatment promoted vascular choroidal sprouting in WT and IL33‐/‐ explants. CNV was also regulated by exogenous and endogenous IL‐33 in WT and IL33‐/‐ mice respectively.ConclusionsOur data illuminate an endogenous IL‐33/ST2 pathway between RPE function and choroidal stroma, influencing tissue remodeling and regulating angiogenesis. Our findings support IL‐33/ST2 axis as a therapeutic target in AMD.
The effect of PAXgene fixation on preservation of morphology and nucleic acids in microdissected retinal tissue
Authors: Edward D. , Liu Y. 
Published: September 2015

PurposeTo compare the effect of the 2 fixatives on tissue morphology and to obtain good quality nucleic acids for molecular analysis from micro‐dissected retinal samplesMethodsEnucleated specimens from NZ white rabbits were fixed in formalin or PAXgene fixative using standard protocols, and then processed and embedded in paraffin for sectioning. H&E stained were used to assess the structural integrity of the retina. Retinal tissue on slides was micro dissected using a 27 gauge needle under a dissection microscope. DNA/RNA were extracted and assessed for preservation of quality and quantity of the retinal tissue.ResultsThe retinal morphology was well preserved with both PAXgene and formalin fixation. The RNA yield from both fixation methods was similar, but RNA from PAXgene fixed samples had a better purity than that extracted from formalin fixed paraffin embedded samples (FFPE). For DNA, there was a twofold greater yield in PAXgene fixed samples (PFPE) compared to FFPE but with similar purity. Quantitative reverse transcription polymerase chain reaction analyses from two assays showed that the mean Cycle threshold values for beta‐actin, beta‐microglobin, Opsin 1‐sw, Rhodopsin and 18S RNA of PFPE group was significantly lower than those of FFPE group (suggesting better RNA integrity) (p < 0.01 for all groups). A greater than 10‐fold level of gene expression was detected in PFPE relative to FFPE for the above genes in both assays. Furthermore, the number of tissue sections required for these studies suggested that this technique could be applied to study retinal macular molecular pathology.ConclusionsPAXgene fixed tissue retinal morphology is comparable to FFPE tissue. PAXgene may be a good alternative to formalin, providing good tissue morphology and ability to isolate high quality nucleic acids from micro‐dissected paraffin embedded retinal samples.
Impact of intracamerular Cefuroxime on post‐operative endophthalmitis in Languedoc Roussillon, France from 2010 to 2014
Authors: Daien V. , Papinaud L. , Lacombe S. , Daures J.P. , Villain M. 
Published: September 2015

PurposePost‐operative endophthalmitis remains the most severe complication of cataract surgery. The purpose of this study was to determine the incidence of post‐operative endophthalmitis in Languedoc Roussillon between 2010 and 2014. Secondary objective was to assess the correlation between the use of intracamerular injection of cefuroxime and post‐operative endophthalmitis incidence.MethodsAll patients >40 years old who underwent a primary cataract surgery in Languedoc Roussillon (France) between January 2010 and December 2014 were collected from the regional administrative database of medical care. Incidence rate of post‐operative endophthalmitis was estimated. Spearman coefficient was used to assess the correlation between the incidence of post‐operative endophthalmitis and the use of intracamerular cefuroxime at the end of cataract surgery.ResultsIn 5 years, 179 515 eyes underwent a cataract surgery in Languedoc Roussillon. A total of 182 patients had a post‐operative endophthalmitis owing to a 1 year incidence of 0.10% after cataract surgery. The incidence of endophthalmitis decreased over the study: 0.16%, 0.12%, 0.11%, 0.07% and 0.05% in 2010, 2011, 2012, 2013 and 2014, respectively. The use of cefuroxime prophylactic injection at the end of cataract surgery increased over the study: 3.27%, 7.65%, 32.04%, 75.67% and 85.36% in 2010, 2011, 2012, 2013 and 2014, respectively. The incidence of post‐operative endophthalmitis was negatively correlated with the use of intracamerular injection of cefuroxime (r = −0.96, p = 0.008).ConclusionsThis study provides information on the decrease of post‐operative endophthalmitis incidence and its correlation with the increased use of cefuroxime intracamerular injection to prevent the risk of infection in the real world. This observational study confirms the promising results of the ESCRS study.
Indocyanine green angiography findings in Stargardt disease
Authors: El Matri L. , Chebil A. , Charfi H. , Largueche L. , Hassairi A. 
Published: September 2015

PurposeTo evaluate indocyanine green angiography (ICGA) findings in Stargardt disease (STGD).MethodsWe reported a retrospective and descriptive study of 20 patients (40 eyes) with Stargardt's disease with different stages. All patients underwent a complete ophthalmic examination, fluorescein angiography, indocyanine green angiography (ICGA). Spectral‐domain optical coherence tomography (SD‐OCT) and fundus autofluorescence were also executed.ResultsIn 27.5% of eyes affected by STGD, ICGA showed hypocyanescence from the areas of atrophy, more evident in the late phases. SD‐OCT revealed morphologically intact choroid in STGD patients with ICGA‐imaged dark atrophy. All the remaining eyes showed isocyanescence or mild hypercyanescence from the areas of atrophy in the late phase of ICGA.ConclusionsThe ICGA‐imaged dark atrophy may be the presence of material that obscures ICGA cyanescence. However, this hypothesis seems unlikely, since SD‐OCT images failed to show any deposit between the choroid and the retina. This finding suggests a possible selective damage of the choriocapillaris in STGD.
New device to applanate full thickness eyelid tumours for ex vivo confocal microscopy
Authors: Grivet D. , Cinotti E. , Perrot J.L. , Labeille B. , Cambazard F. , Bernard A. , Forest F. , Gain P. , Thuret G. 
Published: September 2015

PurposeImmediate confirmation of the suspected diagnosis and verification of margin clearances are of crucial importance during surgery of eyelid tumours. In a multidisciplinary approach with Dermatologist, Ophthalmologist and Pathologist to increase treatment efficiency of these patients, we use a combination of handheld Dermatology in vivo confocal microscope to obtain pseudo histology and ex vivo confocal microscopy (EVCM, Lucid, NY) on fresh tissue to better study margins. Tissues are always fixed for standard pathology. In our first uses of the EVCM, tissue thickness and irregularity hinder from obtaining a full map of the tumour because some parts were not in contact with the glass slide. We designed a specific device to applanate the tissue.MethodsThe prototype device was composed of a 3D printed plastic slide comprising 2.5 mm diameter tapped holes, and a slider destined to a standard glass slide. Thirty screws allowed precisely adjusting the distance between both plans. The tissue was placed on the glass slide, covered by a thin plastic sheet and by the slide with screws. By gently adjusting individual screws, the tissue could be evenly applanated in front of the EVCM. The pathologist assessed whether the device damaged the tissue.ResultsWithout controlled applanation all tissues were only partially mapped. The applanator allowed obtaining a full map of the tissue in all cases with gentle local adjustments directly controlled by the image quality obtained in live. No significant damage was noted.ConclusionsThis simple applanator is useful to improve image quality obtained with the EVCM on full thickness complex tissue like eyelids tumours.
Wide‐Field Angiography in the management of retinal vasculitis
Authors: El Matri Hassairi A. , Chebil A. , Bouladi M. , Kort F. , El Matri L. 
Published: September 2015

PurposeTo study the value of Wide‐Field angiography in the management of patients with retinal vasculitis.MethodsA total of 48 eyes of 24 patients with systemic vasculitis underwent complete ophthalmic exam, followed by wide‐field retinal angiography (WF‐FA) with the Heidelberg Angiograph SLO using the Staurenghi contact lens. The primary outcome was diagnosing the extent of retinal vasculitis (RV) and monitoring disease activity. The secondary outcome was the percentage of patients whose management changed, based on the availability of WF–FA.ResultsWF‐FA assisted in revealing retinal vasculitis in 5 of 24 patients (20.8%), in 2 cases retinal vasculitis was not clinically evident. The extent was quantified in the 5 patients and the disease activity monitored in 3 patients. Three of 24 patients (12.5%) had management change: planning medical treatment or laser photocoagulation.ConclusionsWF‐FA is a valuable technology in the management of patients with systemic vasculitis and can be used for the diagnosis, treatment and follow up of retinal vasculitis.