bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resolution of postoperative macular hole with topical nepafenac: a case report
Authors: Idoate A. , Honrrubia A. , Ascaso J. , Cristobal J. , Perez I. , Almenara C. , Esteban O. , Martinez M. , Sanchez J.I. 
Published: September 2015

PurposeMacular hole (MH) is a rare complication of cataract extraction. Various etiologies are discussed but it seems that the combination of vitreous traction and pseudophakic macular edema are the causes most likely involved in its pathogenesis. Pars plana vitrectomy (PPV) and internal limiting membrane peeling is the gold standard treatment option for patients with postoperative MH. Medical treatment has not been very effective in resolving this pathology. We present a case of post‐surgical MH treated with topical Nepafenac.MethodsInterventional case report showing the role of topical Nepafenac as a therapeutic tool in post‐surgical MH.ResultsAn 81‐year‐old female with a history of uncomplicated cataract surgery in RE. Four weeks after surgery there was a progressive visual deterioration with a best corrected visual acuity (BCVA): 0.05. SD‐OCT revealed a full‐thickness MH. Nepafenac 0.1 mg/ml, 3 times a day, was administered for 8 weeks in RE. Four months later, an improvement of her visual acuity (BCVA: 0.4) and a recovery of the retinal structure were observed. No recidive has been observed in a follow‐up of 1 year.ConclusionsWe propose the therapeutic use of topical NSAIDs as a possible alternative to surgery for macular holes whose etiology is related to inflammatory processes.
Experience with the monoclonal anti IgE antibody Omalizumab in severe refractory vernal keratoconjunctivitis in children
Authors: Doan S. , Amat F. , Gabison E. , Just J. , Cochereau I. 
Published: September 2015

PurposeVernal keratoconjunctivis (VKC) is a severe form of pediatric ocular allergy, characterized by acute and chronic corneoconjunctival inflammation that may lead to visual sequelae. Although topical cyclosporine is usually effective, severe forms may be refractory and require prolonged steroid therapy. Omalizumab is a monoclonal anti IgE antibody, administered systematically and authorized for severe asthma. We report our clinical experience with omalizumab in severe VKC children.MethodsWe retrospectively reviewed the files of 4 boys treated with omalizumab because of severe VKC, defined as persistent corneal inflammation despite continuous topical 2% cyclosporine and steroid eye drops.ResultsFour boys, aged 7 to 13 years old, were treated. All children had asthma and 1 had severe lid eczema. Two patients had required supratarsal steroid injections. Omalizumab was administered every 2 weeks by subcutaneous injections, at doses varying from 450 to 600 mg per injection. Three patients out of 4 responded to the treatment, with a decrease in frequency and in duration of the inflammatory flares, and also a decreased need for topical steroid. However, the response was incomplete and they still had inflammatory corneoconjunctival flares despite continuous topical cyclosporine. On the other hand, asthma and lid eczema were completely controlled in these 3 patients. The fourth child did not respond to o and needed oral steroids for his VKC and his asthma. Noticeably, this patient did not have detectable sensitization to any allergen, contrary to the other cases. The treatment was stopped in this refractory case, but is still ongoing in all other cases, with a median duration of 16 months (6 to 26 months).ConclusionsOmalizumab is an interesting treatment in severe refractory forms of VKC, but its efficacy is incomplete in these very severe cases.
The protective effect of anti‐blue lens against photo‐induced cell death
Authors: Yu W.Y. , Shan S.W. , To C.H. , Chan H.H.L. 
Published: September 2015

PurposeAnti‐blue lenses that selectively block the harmful portion of the blue light spectrum become commercially available recently. This study aimed to evaluate the protective effect of anti‐blue lens on cultured porcine primary retinal pigmented epithelial (RPE) cells against photo‐irradiation.MethodsPrimary RPE cells were isolated from porcine eyes and cultured to confluence. The cells were characterised by RPE65 using Western Blot. White and blue light emitting diode (LED) light sources as well as the transmittance of the anti‐blue and anti‐UV lenses were characterised by a spectroradiometer. The RPE cells were exposed to ~1.8 × 104 cd/m2 white (peak wavelength at 443 and 533 nm) or blue (peak wavelength at 448 and 523 nm) LED light for 16 hours, with anti‐blue, anti‐UV lens or without lens. Control cells were incubated in the dark. Cellular viability under the different lighting conditions with the anti‐blue or anti‐UV lenses were compared using trypan blue staining and MTT assay.ResultsTrypan blue staining showed that the RPE cellular viability under no light, white light and blue light conditions without any lenses were 94.8 ± 0.4%, 93.7 ± 1.1% and 88.7 ± 2.0% respectively. Blue light irradiation significantly induced more cell death when compared to no light (p = 0.001) and white light (p = 0.005) conditions. MTT assay also revealed significant difference under blue light when compared to no light (p = 0.002) and white light (p = 0.014) conditions. When comparing the effect of anti‐blue and anti‐UV lenses on cell survival, we found that anti‐blue lens showed significantly elevated viability (93.4 ± 1.4% vs 90.6 ± 1.4%) using trypan blue (p = 0.022) and MTT assay (p = 0.029).ConclusionsBlue light exposure induced significant cytotoxicity on RPE cells. The anti‐blue lens significantly reduced the harmful blue spectrum and showed protective effect on RPE cell survival.
In‐vivo microdialysis as a new technique to assess ocular pharmacokinetics of topically applied drugs in a rabbit model
Authors: Garhofer G. , Klaus R. , Jäger W. , Zeitlinger M. , Richter‐Müksch S. , Schmetterer L. 
Published: September 2015

PurposeAlthough topical drug delivery is the most widely used ocular drug administration route, the in‐vivo pharmacokinetic profile of topically applied drugs is only inadequately described. This is mainly caused by the fact that in the eye the assessment of in‐vivo pharmacokinetics is difficult and technically demanding. Here, we propose a new technique for the in‐vivo assessment of pharmacokinetic parameters of topically applied drugs using in‐vivo microdialysis in a rabbit model.Methods8 Female New Zealand White rabbits were included in the experiments. A linear microdialysis probe (30 kDa molecular weight cut off [MWCO]) was implanted in the anterior chamber, a concentric probe (20 kDa MWCO) in the posterior segment of the same eye. After a run‐in period to obtain stabile conditions, a single drop of ciprofloxacin eye drops was administered on the cornea. Microdialysis samples were collected every 30 min for 6 h. Probes were analyzed using HPCL.ResultsIn the anterior chamber, the maximum total drug concentration was reached after 116 ± 36 minutes (Tmax) and amounted to 0.373 ± 0.281 μg/ml (Cmax). AUC (0‐n) for ciprofloxacin in the anterior chamber was 78.8 ± 47 μg min/ml. In the vitreous, drug concentration was considerably lower. A Cmax of 0.02 ± 0.03 μg/ml was reached after 106 ± 60 min. AUC (0‐n) for ciprofloxacin in the vitreous was 0.286 ± 370 μg min/ml.ConclusionsHere, we present in‐vivo microdialysis as a new method for the in‐vivo assessment of pharmacokinetic profiles. Maximum drug concentration in the anterior chamber was reached approximately 2 hours after single drug administration. Although the drug concentration in the vitreous was considerably lower, time course of drug concentration was comparable. In summary, our data show that microdialysis is an excellent method to assess in‐vivo pharmacokinetics with a high temporal resolution.
Comparison between i‐gel and endotracheal tube in corneal grafts: a randomized clinical trial
Authors: Guerrier G. , Rondet S. , Hallal D. , Levy J. , Boutboul D. , Sjögren L. , Legeais J.M. , Nicolau R. , Mehanna C. , Bourges J.L. , Samama C.M.S. 
Published: September 2015

PurposeTo assess the safety of the laryngeal mask I‐Gel® in keratoplasty (KP) performed under general anaesthesia.MethodsPatients with indications for KP (n = 110) were enrolled in a prospective study and randomly assigned to I‐Gel® (n = 55; 30 lamellar KP and 25 penetrating KP) or tracheal tube (n = 55; 29 lamellar KP and 26 penetrating KP). Peri‐operative complications and recovery time were compared between two groups using t‐test or χ2 test. Contraindications to elective use of the laryngeal mask airway were exclusion criteria (oesophageal reflux, extreme obesity, oropharyngeal pathology, expected difficult intubation).ResultsNo surgical peri‐operative complications were reported in either group. There was a significantly greater incidence of coughing at extubation and after extubation in the tracheal group (25/55; 45%) than in the laryngeal mask group (3/55; 5%) (p < 0.001). Recovery time was shorter in the I‐Gel® group (80 min; 95%CI [75–86]) compared with the tracheal tube group (88 min; 95%CI [82–95]) (p = 0.03). There were no significant differences in the incidence of sore throat and hoarseness between the two devices.ConclusionsThe use of I‐Gel® for keratoplasty under general anaesthesia is safe, reduces the risk of potential ocular hypertension during recovery and saves recovery time.
Lack of tone response in retinal arterioles secondary to electrical field stimulation
Authors: Kratholm N. , Simonsen U. , Jensen P.S. , Kringelholt S. , Bek T. 
Published: September 2015

PurposeThe retinal vascular system is devoid of autonomic nervous supply and therefore retinal blood flow is autoregulated. However, it is unknown to what extent electrical activity in the retina during the visual process contributes to this flow regulation. The purpose of the present study was to study changes in vascular tone in retinal arterioles during electrical field stimulation (EFS) simulating neuronal activity around the vessels.MethodsPorcine ciliary arteries and retinal arterioles were mounted in a myograph system and the tone was measured during: A) Six series of bipolar field stimulations with a frequency of 1 Hz successively doubled to reach 32 Hz. In each series 30 mA pulses with a duration of 0.3 msec were applied during 20 sec, followed by a resting period of 5 min. B) The successive addition of the Na+ channel opener veratridine in the concentrations: 10−6, 3 ×10−6, 10−5 and 3 × 10−5 mM. The experiments were repeated after addition of the Na+ blocker tetrodotoxin (TTX) and after removal of the perivascular retinal tissue.ResultsEFS had no significant effect on the tone of retinal arterioles (p > 0.66), whereas veratridine showed a concentration dependent relaxation of these vessels (p < 0.01). The effect was partially reduced by TTX which depended on the presence of perivascular retinal tissue.ConclusionsEFS has no effect on the tone of porcine retinal arterioles in vitro, whereas veratridine induces relaxation of these vessels. The findings are in accordance with a lack of autonomic nervous supply in retinal arterioles.
Adjunctive photodynamic therapy for type 1 choroidal neovascularization associated with thickened choroid
Authors: Kim N. , Lee W.K. 
Published: September 2015

PurposeTo evaluate the treatment outcomes of adjunctive photodynamic therapy (PDT) in patients with type 1 choroidal neovascularization (CNV) associated with thickened choroid and refractory to anti‐vascular endothelial growth factor (VEGF) monotherapy.MethodsData on 28 eyes of 28 patients with type 1 CNV with a minimum subfoveal choroidal thickness of 300 μm were reviewed. All showed persistent subretinal and/or intraretinal fluid after at least 4 anti‐VEGF injections in the 6 months before adjunctive PDT. No eyes had certain polypoidal lesions on indocyanine green angiography. The main outcomes measured included the rates of complete fluid absorption at 3 months and the change in best‐corrected visual acuity (BCVA) at 12 months.ResultsAt 3 months, complete fluid absorption was observed in 24 eyes (85.7%). The mean central macular thickness significantly reduced from 342 ± 63 μm to 242 ± 60 μm, and the mean subfoveal choroidal thickness from 386 ± 80 μm to 350 ± 91 μm compared to baseline (P < 0.001, P < 0.001, respectively). Over the 1‐year follow‐up period, 17 eyes (60.7%) were free from recurrent fluid accumulation. Anti‐VEGF injection was mainly used in the re‐treatment of persistent or recurrent exudation (mean: 1.5). At 12 months, the mean BCVA significantly improved compared to baseline (20/53 to 20/44, P = .039), and the logarithm of the minimal angle of resolution BCVA improved by ≥0.3 or maintained in 27 eyes (96.4%).ConclusionsAdjunctive PDT in eyes with type 1 CNV with thickened choroid refractory to anti‐VEGF monotherapy resulted in complete fluid absorption in most eyes, which translated to visual improvement up to 1 year.
MMP‐9 null mice display elevated IOP due to reduced aqueous humor drainage from the trabecular meshwork
Authors: De Groef L. , Siwakoti A. , Geeraerts E. , Billen J. , Stalmans I. , West‐Mays J. , Moons L. 
Published: September 2015

PurposeAqueous humor outflow resistance depends on a complex equilibrium of extracellular matrix biosynthesis versus proteolysis in the trabecular meshwork. Several members of the MMP family, including MMP‐9, are essential to the regulation of aqueous humor outflow resistance, i.e. to intraocular pressure (IOP) homeostasis. Here, we characterized the baseline ocular phenotype of MMP‐9 null mice, with emphasis on the dysregulation of IOP homeostasis.MethodsMMP‐9 null and wild type mice, from 3 to 13 months of age, were studied. IOP and central corneal thickness were measured via rebound tonometry and pachymetry, resp. Anterior chamber morphology and trabecular meshwork organization were studied (1) in vivo with OCT, (2) via light microscopy and (3) by means of transmission electron microscopy (TEM), and its collagen composition was studied using Sirius Red and immunostainings. Integrity of the retina and optic nerve were evaluated with OCT and histological stainings on tissue sections and retinal flatmounts.ResultsMMP‐9 null mice present with early‐onset ocular hypertension, and fluorophotometric measurements of aqueous humor turnover revealed a reduced aqueous humor drainage. While OCT, light microscopy and TEM analysis did not disclose any abnormalities in the cellular organization of the trabecular meshwork, collagen staining indicated that there is an aberrant extracellular matrix composition in MMP‐9 null mice. Remarkably, the observed IOP elevation in MMP‐9 null mice did not result in a glaucomatous phenotype at the level of the retina and optic nerve at the ages studied.ConclusionsOur observations corroborate the role of MMP‐9 as an important remodeler of the trabecular meshwork, and evidence for a causal link between MMP‐9 deficiency, trabecular meshwork composition and IOP elevation is revealed.
Use of retinal oximetry in estimating cerebral tissue oxygenation
Authors: Van Keer K. , Abegão Pinto L. , Stalmans I. , Vandewalle E. 
Published: September 2015

PurposeTo investigate the correlation between cerebral tissue oxygenation (SctO2) and retinal vessel oxygen saturation (SO2) using non‐invasive spectroscopy in healthy individuals.MethodsRetinal and cerebral oxygen saturations were measured in dark‐adapted, healthy volunteers breathing ambient air in a seated position using dual wavelength retinal oximetry and transcranial near‐infrared spectroscopy (NIRS) respectively. Correlations between SO2 and SctO2 were analyzed using Pearson correlation coefficients. Multivariate analysis was performed to determine the relative contribution of the arterial and venous vessels to SctO2. Using this model, SctO2 was estimated based on retinal arterial and venous oxygen saturation. Pearson correlation coefficients, paired sample t‐test and Bland‐Altman analysis were used to assess the agreement between the measured and the predicted SctO2.ResultsTwenty‐one young healthy individuals aged 26.4 ± 2.2 years were analyzed. SctO2 showed a significant positive correlation with both arterial and venous SO2 (r = 0.442, P = 0.045 and r = 0.434 P = 0.049 respectively). In multivariate analysis, the relative contribution of arterial and venous SO2 to SctO2 was significantly correlated with diastolic blood pressure, retinal venous oxygen saturation and retinal venous diameter (R2=0.60, P < 0.001). The measured SctO2 (72.2 ± 3.5%, range 67.3–80.1) correlated well with estimated SctO2 (72.2 ± 2.6%, range 67.6–77.5) (r = 0.774, P < 0.001). Bland–Altman plots showed 95% agreement within ±6.8%.ConclusionsIn this pilot study, retinal oximetry showed promising as an estimate of cerebral tissue oxygenation as measured by NIRS.
Long‐term results of the phase I/II clinical trial: standardized, non‐xenogenic, cultivated limbal stem cell transplantation
Authors: Behaegel J. , Ni Dhubhgaill S. , Koppen C. , Tassignon M.J. , Zakaria N. 
Published: September 2015

PurposeTo evaluate the long‐term success rate of transplanted non‐xenogenic, bio‐engineered, composite grafts of cultured limbal epithelial stem cells on standardized amniotic membranes in patients with limbal stem cell deficiency.MethodsWe report the extended outcome of standardized cultivated limbal stem cell transplantations of our previous phase I/II trial. Between July 2008 and May 2012, 18 patients with partial or total limbal stem cell deficiency received either autologous (n = 15) or allogenic (n = 3) stem cell explants, using a protocol free from xenogenic products and a reduced manipulation surgical technique.ResultsSix of the 18 patients were lost to follow‐up. The remaining 12 patients had a mean follow‐up of 46.6 months. Two of 10 patients experienced an evisceration, not related to the stem cell transplantation. 7 of the remaining 8 (87.5%) patients retained a persistent intact epithelium. Although we did see a significant reduction in corneal neovascularization of the corneas post transplantation, we did not see a significant improvement in visual acuity of the total cohort, although one patient gained a visual acuity from finger counting to 0.5 post limbal stem cell transplantation and post penetrating keratoplasty.ConclusionsThis standardized culture system and surgical approach is safe and effective in restoring a functional epithelial cell layer, with satisfying long‐term results. Due to the limited number of patients and the comorbidities, we did not see a significant improvement in visual acuity of the total cohort. We maintain that in selected cases this technique, followed by a penetrating keratoplasty can significantly improve visual acuity.
Computerized analysis of human corneal endothelium morphology
Authors: Ruggeri A. , Scarpa F. 
Published: September 2015

PurposeCorneal images acquired by in‐vivo microscopy provide clinical information on the cornea endothelium health state. The reliable estimation of the 3 clinical morphometric parameters (endothelial cell density, pleomorphism, polymegethism) requires the accurate detection of cell contours in a large number of cells. Thus for the practical application of this analysis in clinical settings an automated method is needed.MethodsThe contours of cells are detected using a genetic algorithm. It randomly modifies individuals from the current population to produce the children for the next generations, which evolve toward an optimal solution. We start with a small set of vertexes forming regular hexagons, which in successive generations evolve into polygons with possibly different number and positions of vertexes. Each vertex is positioned by considering both its correspondence with the actual image (pixels intensity) and the regularity of the resulting polygons. The goal is to obtain a final population of vertexes forming polygons that best fit the cells contours in the actual image.Results15 images were acquired with a specular endothelial microscope (SP‐3000P, Topcon Co, Japan) in healthy and pathological subjects. Ground truth values for the 3 parameter were obtained from manually drawn cell contours. Differences between this manual estimation of the parameters and the automated one were always less than 8%.ConclusionsThese preliminary results show the ability of the proposed algorithm to adapt to different shapes and sizes of cells and to allow the reliable estimation of the morphometric parameters used in clinical practice.
Randomised, controlled study of the efficacy and safety of a new eye‐drop formulation for moderate to severe dry eye syndrome
Authors: Doan S. , Baudouin C. , Khairallah M. 
Published: September 2015

PurposeThe aim of this study was to compare the efficacy and safety in Dry Eye Disease (DED) of T2762, a new product containing an innovative bioprotective molecule trehalose (molecule finds in plants resistant to dissication with osmoprotectant properties) and hyaluronic acid, to Vismed®.MethodsPhase III, randomized, active‐controlled, Investigator‐masked, multicentric study in France and Tunisia. 105 Adult patients (≥18 years) with moderate to severe DED were included and received one drop of either T2762 (N = 52) or Vismed® (N = 53) 3‐6 times per day for 84 days. The primary efficacy variable was the Oxford grading score at Day 35. Ocular Surface Disease Index (OSDI), dry eye symptoms, Schirmer test, TBUT, conjunctival hyperaemia, and global performance were assessed as secondary efficacy criteria at baseline, Day 35 and Day 84. Safety assessments were standard.ResultsNon‐inferiority of T2762 to Vismed® for Oxford grading score was demonstrated at Day 35. For secondary efficacy parameters, reductions in OSDI, dry eye symptoms and investigator/patient assessments of global performance were better for T2762. There were no clinically meaningful between‐group differences for the other secondary criteria. Both treatments were well tolerated. Interestingly, there were fewer ocular symptoms upon instillation and fewer AEs with T2762.ConclusionsT2762 is effective and safe, with better patient satisfaction than existing hyaluronate‐only eye drops, and offers a therapeutic advancement in the treatment of moderate to severe DED.
The pathophysiology of pseudoexfoliation syndrome is affected by interaction of TGF‐β1 and LOXL1
Authors: Liravi P. , Zenkel M. , Kruse F.E. , Schlötzer‐Schrehardt U. 
Published: September 2015

PurposeThe cross‐linking enzyme lysyl oxidase‐like 1 (LOXL1) and profibrotic transforming growth factor (TGF)‐ß1 play key roles in pathophysiology of pseudoexfoliation (PEX) syndrome/glaucoma. The purpose of this study was to investigate the interaction between LOXL1 and TGF‐ß1 with respect to the PEX‐specific disordered matrix metabolism.MethodsPrimary human Tenon's capsule fibroblasts (hTCF) obtained from patients were treated with TGF‐ß1 (0‐10 ng/ml) for 12‐72 hours without or with preincubation with inhibitors of TGF‐β signalling pathways. Expression of LOXL1 and PEX‐specific extracellular matrix components was examined by using quantitative RT‐PCR and Western immunoblot analysis. Direct binding of LOXL1 to TGF‐ß1 was analyzed by blot overlay assay and solid phase ELISA using purified LOXL1, recombinant human TGF‐ß1, TGFß1‐LAP. The effect of LOXL1 on TGF‐ß1 signaling was analyzed using TGF‐ß receptor signaling real time PCR assays (BioRad) after transient transfection of hTCF with a full‐length pCMV6‐LOXL1 vector construct/with empty vector .ResultsTGFß1 significantly increased LOXL1 expression, secretion and enzymatic activity and correlated with enhanced expression of BMP‐1, elastin, fibrillin‐1, fibulin‐4 and fibulin‐5 with peak effects at 10 ng/ml for 48 hours. This induction was blocked by TGF‐β receptor inhibitors and inhibitors of the canonical Smad and non‐canonical signaling pathways. Direct binding between LOXL1 and TGFß1‐LAP was demonstrated by Blot overlay assays and ELISA. LOXL1 overexpression temporarily upregulates different transcriptional regulators and some protein kinases of p38‐MAPK signalling pathway after 12 to 24 hours post‐transfection.ConclusionsThe results of this study indicate that the interaction of LOXL1 and TGF‐ß1 plays an important role in the PEX‐associated abnormal matrix metabolism and fibrosis.