bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to remove subretinal fluid?
Authors: POURNARAS CJ 
Published: August 2012

AbstractPurpose Rhegmatogenous retinal detachments (RRD) can be repaired surgically using non‐drainage techniques. However,removal of subretinal fluid (SRF) remains an important surgical step in retinal detachments treated by scleral buckling, particularly in cases of bullous detachments, inferior breaks, proliferative vitreoretinopathy, high myopia, chronic detachments, cases with poor retinal pigment epithelium function and eyes intolerant to sustained intraocular pressure rise.Methods Conventional drainage techniques include passive needle drainage of subretinal fluid through a 3 to 4 mm radial sclerotomy within the bed of the buckle and closure with a preplaced suture. Many modified SRF drainage techniques have been described. Internal subretinal fluid drainage with simultaneous automated air‐fluid infusion is an important part of modern vitreoretinal surgery.Results Needle drainage, where the needle shaft is observed using an indirect ophthalmoscope, seemed to be associated with a higher success rate than conventional drainage. The most common complications of subretinal fluid drainage include subretinal hemorrhage, retinal incarceration, and retinal perforation. Using perfluorocarbon liquid or infusion of low‐molecular weight silicone oil as a peroperative tool, retinal flattening posterior to equator is an important step of the vitreoretinal approach and internal drainage for the treatment of RRD. Subretinal fluid is drained through a preexisting retinal break or an intentionally created drainage retinotomy using an extrusion cannula. It allows the immediate and complete reattachment of the retina and enables laser endocoagulation of the breaks. If the original retinal break can be treated by laser photocoagulation or cryopexy, the subretinal fluid is not necessarily removed completely.
Herpes and zoster keratitis
Authors: LABETOULLE M 
Published: August 2012

AbstractThe two leading causes of viral infection of the cornea with potential severely impaired visual acuity are the Herpes Simplex Virus (HSV) and the Varicella‐zoster Virus (VZV). Both of them are able to become latent in the trigeminal ganglia, before reactivation and migration along the trigeminal fibers innervating the cornea. The clinical settings of keratitis may vary from an epithelial defect (dendritic of geographic) to a more severe disease involving the stroma and/or the endothelium. Most of first episodes of HSV keratitis occur from the second to the fifth decade of life, and associated skin lesions are not frequent. In contrast, VZV keratitis mostly occurs after the sixth decade, as an associated finding of herpes zoster ophthalmicus (HZO). However, recent studies have highlighted the possibility of HSV keratitis in elderly, while other studies reported VZV keratitis in children, either isolated or associated with HZO. The curative options for treatment of HSV keratitis are now well established, but the preventive regimens of antiviral drugs still have to be optimized, since the most popular treatment, based on the results of the HEDS study, only reduces the rate of relapses in a two‐fold manner. For VZV, vaccines against chickenpox and HZO may significantly change the epidemiologic data when they will be more frequently used in European countries.
Visual field examination in daily practice
Authors: ZEYEN T 
Published: August 2012

AbstractAutomated perimetry is the most important functional test in glaucoma patients. This course will teach which programs and strategies to use, how to instruct patients and avoid artifacts, and how to use the available software to interpret worsening of visual field defects and calculate rates of change. Finally, consensus statements will be provided on the usefulness of non‐conventional perimetric tests.
Congenital pigmented lesions
Authors: BECHRAKIS NE 
Published: August 2012

AbstractA systematic description of congenital pigmented lesions is presented. These include congenital anomalies of the RPE such as hypertrophy, hyperplasia and hamartomas. The differential diagnosis of combined hamartoma of the retina and the RPE is presented, as well as congenital melanosis of the ocular fundus.
Concentration gradient of endogenous noradrenaline from periphery to centre in the rabbit cornea
Authors: FIGUEIRA L , MATOS J , SERRAO P , FALCAO‐REIS F , MOURA D 
Published: August 2012

AbstractPurpose The source of endogenous catecholamines that activate corneal adrenoceptors is largely unknown. Since the cornea is a densely innervated tissue we hypothesized that the major source would be the neuronal release of noradrenaline (NA) from intrinsic sympathetic nerves rather than circulating or non‐neuronal local production.Methods Three concentric segments (central, intermediate, peripheral) were obtained by double trephination (9.5‐7.25 mm) performed on corneas harvested from 3‐4 month old rabbits, along with aqueous humor and blood samples. Endogenous catecholamines were quantified by HPLC‐EC. Results are means±SEM. ANOVA was used for statistical analysis.Results NA and adrenaline (AD) were identified in all corneal segments (n=15/16) at the following concentrations: 101.3±24.1 pmol/g for NA, 4.8±2.7 pmol/g for AD in the centre; 76.8±18.8 pmol/g for NA, 23.0±11.1 pmol/g for AD in the intermediate segment; 317.0±135.7 pmol/g for NA and11.1±6.1 pmol/g for AD in the periphery. Statistically significant (P<0.05) were the differences between: 1) NA concentrations in peripheral segments and those either in central or intermediate segments; 2) NA and AD concentrations in all segments. In the aqueous humor concentrations of NA were 77.0±9.8 nmol/L (n=6) and no AD was found. Plasma concentrations (n=4) were 28.0±2,5 μmol/L for NA, 36.2±8.5 μmol/L for AD.Conclusion There is a concentration gradient for NA decreasing from the corneal periphery towards the centre. In contrast, no such gradient exists for AD. Moreover, NA is the most abundant of the two catecholamines in all segments, whereas in the plasma AD predominates. Taken together, these results suggest that corneal NA is mostly of neuronal origin.
Serum‐free cornea culture with hydroxyethyl starch as a deswelling agent
Authors: HERMEL M , SALLA S , BAUER L , HAMSLEY N , STEINFELD P , WALTER P 
Published: August 2012

AbstractPurpose Varying states of hydration during organ culture and subsequent dehydration of corneas with Dextran prior to transplantation cause endothelial cell damage. Hydroxyethyl starch 130 (HES) has been suggested as a permanent dehydrating agent in serum‐free cornea culture. This study compares corneas stored in a synthetic medium containing HES with corneas stored and dehydrated under standard conditions.Methods Twenty pairs of human donor corneas were cultivated in MEM with antibiotics at 31°C for 16 days (groups A and B) or 28 days (groups C and D, n=10). Media contained 2%FCS in group A and C, and 7.5 % HES 130 plus 1mU/l human insulin in groups B and D. On day 15 or 27, corneas from group A and C were placed in dehydration medium (MEM + antibiotics + 2%FCS + 5% dextran 500). Endothelial cell density and morphology were investigated at the beginning and end of culture. Corneal thickness was assessed by pachymetry. Keratocyte viability was assessed by TUNEL and Annexin V staining.Results Endothelial cell loss was higher in group A (278.5+/‐184.2) vs. B (156.6+/‐154; p=0.0293), and in group C (490+/‐156.3) vs. D (301.8+/‐189.6; p=0.0195), with similar morphology. Final corneal thickness was 882+119µm and 914+119µm in groups A and B, and 889+99µm and 957+87µm in groups C and D, resp. (n.s.). No significant differences were found in TUNEL and Annexin staining.Conclusion The synthetic medium supplemented with HES 130 and insulin improves endothelial cell survival during cornea culture, without adverse effects ion keratocyte viability. It is thus feasible to store donor corneas in fully synthetic medium without the chemically undefined FCS and without the need for dehydration, resulting in increased safety and faster transplant availability.
Tocilizumab for anterior uveitis and juvenile idopathic arthritis – a case report
Authors: KNOLL A , LUTZ T , GRULICH‐HENN J , MACKENSEN F 
Published: August 2012

AbstractPurpose We report a case of Juvenile Idiopathic Arthritis (JIA) and Anterior Uveitis (AU) responding well to Tocilizumab, a new humanized monoclonal antibody against the IL‐6 receptor, after having been refractory to classical immunosuppressive agents as well as to TNF‐α inhibitors.Methods The Patient was treated in our center from 2007‐2012. Collected data included: visual acuity (VA), anterior chamber cells and –flare, flaremeter measurements, intraocular pressure (IOP), presence of macular edema (ME) and cataract, topical and systemic medications, number and site of affected joints, laboratory inflammation parameters.Results Patient was born 1996, diagnosed with JIA 1998 and with AU 2005. Inflammation was initially controlled with methotrexate and corticosteroids, VA fluctuated between 20/40‐20/15(OD) and 20/20(OS). In 2007 VA decreased to 20/200(OD) as ME developed. Additional systemic therapy included between 2008 and 2009: Ciclosporin, Adalimumab, Mycophenolate, Leflunomide, and Infliximab. Control of ocular and/or joint inflammation was always insufficient or short lived. Between 2008 and 2010 ME required multiple periocular Triamcinolone injections. IOP first rose in 2008 to 34mmHg(OD), requiring combined topical and systemic therapy and finally trabeculectomy in 2010. Cataract developed on both eyes. Tocilizumab therapy was started in 02/2010. Since then AU and joints are free from inflammation. Cataract‐surgery and implantation of an artificial lens in OD was performed successfully in 2011. Systemic steroids could be reduced to 2 mg/d. IOP is <20mmHg; VA is stable at 20/32(OD) and 20/50(OS).Conclusion Tocilizumab may be another treatment option for JIA‐associated uveitis which is refractory to established immunosuppressants.
ILM peeling in macular surgery: benefits
Authors: CREUZOT C 
Published: August 2012

AbstractInternal limiting membrane (ILM) peeling should be beneficial to improve the anatomic and functional outcomes in macular surgery. In macular hole surgery, it seems to be an additive tool to improve the closing rate especially in large macular hole. In epiretinal membrane surgery, it should be considered either to improve the functional outcome but also to decrease the recurrence of epiretinal membrane on the remaining ILM. However, the characteristics of the peeling (ie area, control with dye) should be given in all clinical trials to obtain more homogeneous surgical criteria.
The flicker ERG and retinal blood flow relationship in diabetic patients without retinopathy
Authors: ZUEVA M , KOLCHIN A , KISELEVA T , LESENKO M , TSAPENKO I , RYABINA M 
Published: August 2012

AbstractPurpose To evaluate the association between functional and hemodynamic alterations of the retina in diabetes mellitus (DM) without retinopathy (NDR).Methods 15 patients (63±6.3 years) with DM type II (duration 6±3.5years) and NDR, and 40 age matched controls were examined. Color Doppler Imaging (CDI) was conducted to visualize blood flow in ophthalmic artery (OA), central retinal artery (CRA), medial and lateral posterior ciliary arteries brevis (PCAB). Photopic and scotopic flicker ERGs (p‐FERG and s‐FERG) were recorded at 8.3, 10, 12, 30 Hz flickering.Results In NDR, the increase of the blood flow peak systolic velocity (V syst) and end diastolic velocity (Vdiast) was noted in AO. The most significant changes in blood flow were observed in CRA and PCAB. A reliable correlations were shown between Vdiast, the resistance index RI in CRA and insulin levels (r=0.64), serum C‐peptide (r=0.60) and the index of insulin resistance IR (r=0.65); between Vdiast, RI in PCAB and insulin levels, the C‐peptide level and IR (r=0.59, 0.56, 0.59, respectively). The amplitude of light and dark adapted FERG at 8.3‐12 Hz declined in more than 60% eyes up to 69‐80%. The p‐FERGs at 24 and 30 Hz did not differ from the control; but we found a sharp increase in s‐FERG (155.5±15.3 ‐ 319.9±21.4% for 24 ‐ 30 Hz respectively). Significant correlation was shown between the 10Hz‐FERG amplitude (but not the 24Hz or 30Hz‐FERG) and Vdiast in CRA and PCAB (r=0.51; r=0.50).Conclusion There is a significant relationship between the retina hemodynamics and physiological effects of insulin, leading to metabolic disorders. Signs of blood flow deficiency in CRA and PCAB in NDR correlated with an early alteration in the photoreceptor function.
Colour contrast sensitivity and electrophysiological abnormalities in patients undergoing long term desferrioxamine treatment
Authors: KABANAROU SA , ROBSON AG , HOGG CR , EGAN C , HOLDER GE 
Published: August 2012

AbstractPurpose To describe the spectrum of colour contrast sensitivity and electrophysiological abnormalities in patients undergoing long term desferrioxamine (DFO) treatment for systemic iron overload in blood transfusion‐dependent anaemias.Methods Thirty five patients on long term DFO treatment with abnormal colour contrast sensitivity and/or abnormal retinal electrophysiology examined in the Electrophysiology Department at Moorfields Eye Hospital were included in this study. They underwent visual acuity testing, colour contrast sensitivity and International‐standard electrophysiological evaluation including pattern and full‐field electroretinography (PERG and FFERG). In most patients follow up investigation also included recording of ocular symptoms, fundus morphology and DFO treatment (dose and route of administration).Results Most patients manifested colour contrast threshold elevation, mainly along the tritan axis and also pattern ERG abnormalities as an indication of macular dysfunction. Full‐field ERG abnormalities, when present, were consistent with generalised photoreceptor dysfunction involving rods only, cones only, or both rods and cones. In some patients these abnormalities were partly reversible following cessation or reduction of DFO treatment.Conclusion When DFO retinal toxicity occurs, it can present with a wide range of electrophysiological abnormalities, including macular and/or generalised retinal dysfunction. Early colour vision abnormalities usually involve the S‐cone‐driven pathway. Colour contrast sensitivity and electrophysiological evaluation may be used to detect DFO retinal toxicity and monitor recovery, providing an essential aid to the management of the patient.
Should you decide to perform cataract surgery on your patients, based only on straylight?
Authors: VAN DEN BERG TJTP 
Published: August 2012

AbstractPurpose A widely accepted validation criterion for cataract surgery is the likelihood that the surgery will be beneficial to the patient. Yet important variation exists between individual ophthalmologists in what constitute criteria for cataract surgery, and optometrists vary widely in their referral criteria. As a consequence huge differences in the amount of cataracts being treated exists between different centres. Some degree of standardisation is wanted. Visual acuity is considered, but predictability of surgical outcome is often difficult because visual acuity is confounded by the retinal condition. Straylight on the other hand is independent of retinal condition, and constitutes a complementary measure of quality of vision, complementary to visual acuity, corresponding to complaints such as glare, hazy vision, face recognition problems.Methods A population of 217 patients for cataract surgery was studied. Before and after cataract extraction best corrected distance visual acuity (CDVA), and straylight using the C‐Quant from Oculus were recorded for all patients. Subjective complaints were documented before and after surgery by the 39‐item National Eye Institute Visual Function Questionnaire (NEI VFQ‐39) and a home made straylight questionnaire. Data are compared to a 5000 eye database from an earlier study.Results Before and after cataract extraction, questionnaires show straylight to have almost the same influence on subjective quality of vision as CDVA, as show by correlation analysis. Straylight improvement upon surgery is strongly correlated with preop straylight level.Conclusion When straylight is added to pre‐operative considerations of cataract extraction post‐operative improvement is better predictable.
Commercial interest
Reproducibility and repeatability of retinal nerve fiber layer parameters measured by scanning laser polarimetry with enhanced corneal compensation in glaucomatous eyes
Authors: ARA GABARRE M , SATUE PALACIAN M , BAMBO M , FERRANDEZ ARENAS B , GIL‐ARRIBAS L , FERRERAS AMEZ A 
Published: August 2012

AbstractPurpose To determine the reproducibility and repeatability of retinal nerve fiber layer parameters measured using scanning laser polarimetry (SLP) with enhanced corneal compensation (GDx‐ECC) in glaucoma patients.Methods Fifty‐four consecutive glaucomatous subjects were prospectively selected. All participants underwent a comprehensive eye exam and at least a reliable standard automated perimetry (Humphrey, 24‐2 SITA Standard). Only one eye per patient was randomly included in the statistical analysis. Three scans were acquired during the same visit using the GDxPRO (Carl Zeiss Meditec, Dublin, CA). Two additional scans were obtained within a 2‐month period. Intraclass correlation coefficient (ICC), coefficient of variation (COV), and test‐retest variability were calculated for all SLP parameters.Results Mean age was 58.27 ± 8.9 years (p=0.09) and mean deviation of standard automated perimetry was ‐7.04 ± 7.0 dB. ICCs were higher than 0.91 for all SLP parameters. The nerve fiber indicator (NFI) showed the highest ICC in the intra‐test sequence (0.982; 95% confidence interval: 0.972‐0.989; p<0.001). The TSNIT average showed the lowest COVs (4.40% and 4.71% in the intra‐ and inter‐test, respectively). Test‐retest variability for the NFI ranged from 10.6 to 12.8.Conclusion The GDx‐ECC had an excellent intravisit and intervisit reproducibility in glaucoma patients. SLP is an imaging technology that may be useful in monitoring glaucoma progression.
Commercial interest
Defects in macular‐retinal layer analysis of glaucoma patients compared to normative database
Authors: HOLZER S , PEREIRA I , KISS B , VASS C 
Published: August 2012

AbstractPurpose High‐resolution optical coherence tomography (HR‐OCT) enables a quantitative analysis of the configuration of retinal layers. The aim of this study was to analyze the topographic distribution of pathologic thinning of specific macular retinal layers of glaucoma patients.Methods Macular 3D‐scans were recorded with HR‐OCT (Cirrus®, Carl Zeiss Meditec). Retinal layers, especially the retinal nerve fiber layer (RNFL) and the retinal ganglion cell plus inner plexiform layer (RGIPL), were automatically segmented with a custom made software (Matlab R2009b®, The Mathworks Inc.). A normative database for the thickness of the RNFL, the RGIPL and the retina was created using healthy subjects (n=84) taking into account for the effects of age. 18 glaucoma patients were compared to the 95% confidence interval of the normative database using the thickness values of RNFL, RGIPL and retina within 65 segments.Results On average the glaucoma patients showed for RNFL, RGIPL and retina 29.8, 49.4 and 53.9 pathologic segments within the macula. The minimum number of pathologic segments per patient was 5, 24 and 29. The average thickness values for healthy subjects were 32.95 µm (RNFL), 79.02 µm (GCIPL) and 321.46 µm (retina), for glaucoma patients 24.85 µm, 57.46 µm and 281.30 µm, respectively.Conclusion In our study quantitative analysis of retinal layer thickness based on macular HR‐OCT showed a decrease of RNFL, RGIPL and retinal thickness in glaucoma patients. Within our sample all patients had several pathologic segments for all of the analyzed retinal layers. In most of the cases those segments were clustered. Further studies including larger numbers of patients to confirm our findings are advisable.
Meibography follow up studies in dry eye patients
Authors: RABENSTEINER DF , HORWATH‐WINTER J , BOLDIN I , WOLTSCHE N , SCHMUT O 
Published: August 2012

AbstractPurpose Meibomian‐Gland‐Dysfunction (MGD) is one of the main causes for the development of a hyperevaporative dry eye. Non‐contact Meibography can achieve a non‐invasive investigation of the meibomian glands inside the tarsal plates of the eyelids. The purpose of this study was to evaluate non‐contact Meibography as a tool for follow‐up studies in dry eye patients.Methods We examined 50 patients suffering from dry eye disease of the dry eye unit of the Ophthalmological Department of the Medical University of Graz. Subjective dry eye symptoms and objective signs of dry eye were evaluated. Non‐contact Meibography was performed by a Heidelberg Retina Angiograph 1, featuring two infrared diode lasers. Partial or complete loss of the meibomian glands was scored according to meiboscore of Arita and colleagues. After one year non‐contact Meibography was reassessed. Changes in the meiboscore were evaluated.Results The mean age of the study population was 57.9 ± 14.1 years and 64.7 % were women. There was no statistically significant change in the mean meiboscore.Conclusion Non‐contact Meibography is a valuable tool in the diagnosis of MGD. Morphological changes and a possible drop out of Meibomian glands can easily be assessed. The ideal follow‐up interval to detect changes in the meiboscore has yet to be determined.
Clinical results on the efficacy of Thealoz vs autologous serum in moderate to severe dry eye
Authors: LEONARDI A , LAZZARINI D , PILIEGO F , FREGONA I 
Published: August 2012

AbstractPurpose To study the clinical effect and morphologic aspects of the cornea in using corneal confocal microscopy in patients affected by moderate to severe dry eye and treated with either autologous serum or Thealoz.Methods Twenty two patients were included and randomized in 3 groups: 7 patients (4 affected by Sjoegren Syndrome ‐SS) were switched from autologous serum eye drop treatment to Thealoz 6‐8 times a day (group 1); 7 patients (4 SS) maintained their treatment by autologous serum 6‐8 times a day (group 2); 8 new patients (3 SS) were treated by Thealoz 6‐8 times a day (group 3). The OSDI questionnaire, tear film evaluation by BUT, fluoresceine and lissamine green staining, Schirmer test and corneal confocal microscopy were performed at the beginning of the study (T0) after 4 (T1) and 8 weeks (T2). ConfoScan CS4 (Nidek, Gamagori, Japan) images of the central cornea were obtained with a 40x non‐contact lens and Z‐ring device. The epithelial cell, endothelial cell and keratocyte densities of the central cornea, the characteristics of the sub‐basal long nerve fibers and of the sub‐basal nerve plexus were studied.Results In group1, 4 of the 7 patients maintained unmodified their clinical benefit and corneal morphology after switching from autologous serum to Thealoz. Two severe SS patients needed to return to the autologous serum treatment because of worsening of the OSDI at T1 without a significant change in the other parameters. However, in remaining 5 patients, the OSDI questionnaire improved at T2 compared to T1. In group 2, all patients maintained a stable clinical and morphological ocular surface condition over the 8 weeks study period. Group 3, at T2, showed an objective improvement of ocular surface morphology and reported a significant subjective relief of symptoms (OSDI) compared to T0 and T1. All patients showed improvement of confocal microscopy parameters after treatment with Thealoz.Conclusion Thealoz was effective and well tolerated in patients with moderate to severe dry eye. Severe SS patients may need an additional treatment, however even switching from autologous serum, most of the patients maintain a stable clinical condition.