bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chromatic pupillometry as highly sensitive testing method of photoreceptor function in retinal dystrophies
Authors: LORENZ B 
Published: August 2012

AbstractPurpose Objective methods for the characterization of photosensitive cells are highly needed in patients with retinal dystrophies. The pupil light reflex is driven by rod, cone, and intrinsic photosensitive retinal ganglion cell (ipRGC) input. The aim of this study is to analyze two protocols of chromatic pupillometry with differing stimulus paradigms to gather isolated functional information of the three cell populations in patients with different forms of retinal dystrophies.Methods The study group comprised 60 patients with different forms of retinal dystrophies, and 32 healthy probands. Patients were grouped according to their electroretinography (ERG) data. A custom made binocular chromatic pupillometer (Bino I, AMTech) connected to the Colordome Ganzfeld stimulator (Diagnosys LLC) was used to assess changes in pupil diameter in response to red (640nm) and blue (462nm) light stimuli.Results Patients who had no measurable scotopic ERG also had the most reduced yet often still measurable rod‐weighted pupil responses (PR), while patients with abnormal or normal scotopic ERG had reduced or normal rod‐weighted PR. Similarly, patients with no measurable photopic ERG had reduced but still measurable cone‐weighted PR, while patients with abnormal of normal photopic ERG had mostly normal cone‐weighted PR. Reduced ipRGC‐weighted PR could not be correlated with the ERG classification.Conclusion In the absence of a measurable ERG, chromatic pupillometry generates important functional and quantifiable data on residual rod and cone activity. These data show that this technique should be added to the panel of examination tools for the characterisation of retinal dystrophies and for quantifying the clinical benefit of experimental treatment protocols.
Physical therapy in MGD as a cornerstone for improvement of signs and symptoms & The British perspective on MGD
Authors: PURSLOW C 
Published: August 2012

AbstractPurpose This talk will present the typical management of meibomian gland dysfunction (MGD) that is currently implemented in British primary eye care, and where the current focus lies in newer diagnostic techniques and therapies.Methods Recent focus on MGD has highlighted this condition as one that is under‐estimated and under‐managed, particularly amongst contact lens wearers. This renewed appreciation for the major cause of dry eye has resulted in parallel interest amongst eye care practitioners for an evidence‐based approach to management. The most common approaches are reviewed, alongside some emerging popular choices.Results There is robust evidence to support modern approaches, and to discourage some of the old‐fashioned management strategies.Conclusion Whilst there is still a lot to understand about MGD, there is no doubt that eye care practitioners can do more to help patients manage this highly prevalent problem.
Special features of MGD in children: how to diagnose how to treat and the French perspective on MGD
Authors: BREMOND‐GIGNAC D , CHIAMBARETTA F 
Published: August 2012

AbstractPurpose MGD in children is a common pathology. Many clinical forms need to be recognized, from mild to severe, with classical features of chalazia and blepharitis or more unusual the sight‐threatening ocular rosacea.Methods Ocular rosacea in children, secondary to severe MGD, is probably underdiagnosed meanwhile it induces major ocular discomfort. The treatment aims to eyelid hygiene, anti‐inflammatory treatment and topical steroid sparing.Results Place of heat therapy with innovative steamed goggles, topical azithromycin and topical cyclosporine with analyze of literature and clinical cases, is discussed. The French prospective clinical study performed was useful to evaluate the interest of each treatment.Conclusion Further studies with more patients are needed to a better understanding of the severe MGD. Ocular rosacea in children should be recognized early and to avoid steroid dependence and complications. Eyelid hygiene, topical anti‐inflammatory and topical cyclosporin are essential in MGD treatment for a better quality of life of the children and their parents.
Commercial interest
Can scattered light improve visual performance?
Authors: PATTERSON EJ , BARGARY G , BARBUR JL 
Published: August 2012

AbstractPurpose Light scattered by the media within the eye reduces object contrast and can also cause visual discomfort, in the presence of bright light sources. The addition of uniform veiling light over the retina can, however, change retinal sensitivity by increasing retinal illuminance. The extent to which reduction of target contrast and changes in retinal sensitivity caused by the presence of a glare source affect contrast acuity (CA) thresholds remains to be established. We investigate how CA is affected by glare source intensity, surround luminance and test target location on the retina. The aim is to determine the range of glare source intensity and background adaptation level that can improve visual performance.Methods 45 subjects with normal vision were investigated. A psychophysical flicker‐cancellation test (Ophthalmic & Physiological Optics, 17, 171, 1997) was used to measure the amount and angular distribution of scattered light in the eye. CA thresholds were measured using the Contrast Acuity Assessment test (ASEM, 74, 551‐559, 2003). Three glare source intensities (i.e., 0, 1.35 and 19.21 lm/m^2 in the pupil plane), three eccentricities (5, 10 and 15 degrees), and three background luminances (1, 2.6 and 26 cd/m^2) were investigated.Results CA thresholds were measured for the test target / glare source parameters listed above. In addition, the scatter function of the eye was assessed for each subject and the measured parameters were used to predict the effect of veiling glare on CA thresholds.Conclusion Low intensity glare can improve CA in the high mesopic range. High intensity glare yields increased thresholds, but this loss of contrast sensitivity is, in general, smaller than predictions based on veiling glare luminance caused by forward light scatter in the eye.
Treatment of macular oedema due to branch retinal vein occlusion with laser induced arterial constriction. Twenty years results of retrospective interventional study
Authors: REHAK J 
Published: August 2012

AbstractPurpose To evaluate the final visual acuity (VA) in patients with Branch Retinal Vein Occlusion (BRVO) treated with either laser arteriolar constriction (ACo) or grid laser photocoagulation (GLP).Methods 265 BRVOs were treated with 3 different approaches: early ACo performed ≤ 9 weeks after onset of BRVO, late ACo performed > 9 weeks after onset and GLP. The groups were divided into 3 subgroups according to initial VA: ≤ 0.1; 0.16‐0.3; and ≥ 0.4. The data were analyzed using univariate and multivariate logistic regression and, Receiver Operating Characteristics analysis. Factors which could have influenced final VA such as age, sex, localization of occlusion (major temporal or macular BRVO) and the presence of retinal ischemia were taken into account. In the group of early and late ACo, patients with VA ≤ 0.5 and a ME persisting over three months, underwent additional macular GLP.Results Based on the proportion of 1 year VA ≤ 0.1 as a risk category, the results of early ACo (3.8%) were significantly better than either GLP (29.6%, p < 0.001) or late ACo (16.1%, p=0.006). In the subgroup of intermediate initial VA 0.16‐0.3, a significant difference was only found between the early ACo group and GLP (p=0.004). The effect of the treatments on the prevalence of final VA ≤ 0.1 was not significantly different for patients with an initial VA ≥ 0.4. In patients treated by ACo, residual chronic ME requiring additional GLP was present in 35% of early and 44% of late ACo cases.Conclusion ACo performed in the first 9 weeks after onset of BRVO significantly reduces the prevalence of a final VA ≤ 0.1 in patients with an initial VA < 0.3.
Comparison of the anti‐inflammatory effects of artificial tears in a rat model of corneal scraping
Authors: DAULL P , FERAILLE L , ELENA P , BAUDOUIN C , GARRIGUE JS 
Published: August 2012

AbstractPurpose The aim of the present study was to evaluate the safety and tolerance of cationic oil‐in‐water emulsion on debrided cornea, and to characterize its benefits on the corneal epithelium healing process.Methods A rat model of corneal scraping was used to characterize the effects of four commercially available artificial tears (Cationorm®, Vismed®, Optive® and Systane Balance®) on the recovery process of the debrided corneas. The upper part of the corneal epithelium was scraped mechanically prior to a 5‐day treatment with different artificial tears. At the end of the treatment, the ocular surface was evaluated clinically (corneal fluorescein staining, CFS) and by in vivo confocal microscopy (IVCM). Conjunctival function was assessed by goblet cell count and MUC5AC immunostaining.Results The four artificial tears were all well tolerated by the debrided cornea. By restoring an adequately hydrated ocular surface environment they promote corneal healing, as evidenced by CFS measurements of the scraped area. In contrast 0.02% BAK solution inhibits the healing process. IVCM analysis of the different layers of the cornea confirmed the benefits of the cationic emulsion (Cationorm®). Interestingly inflammatory cells infiltration in the stroma was at its lower following Cationorm® treatment, while 0.02% BAK treatment resulted in marked inflammation. The different treatments were all able to protect goblet cells function and MUC5AC expression.Conclusion BAK‐free cationic emulsion (Cationorm®) is well tolerated by debrided cornea and allow for a safe healing of the cornea. The findings suggest that Cationorm® have the potential to benefit patients with corneal epithelium disorder.
Commercial interest
Pediatric uveal melanoma
Authors: CASSOUX N , COUTURIER J , PLANCHER C , LUMBROSO‐LE ROUIC L , LEVY C , ASSELAIN B , DENDALE R , AERTS I , DESJARDINS L 
Published: August 2012

AbstractPurpose To study the clinical characteristics, outcome and prognosis of very young patients treated for choroidal melanoma at l’ Institut Curie.Methods Retrospective case‐control series. Patients aged ≤16 years were extracted from the database. Patients were treated by enucleation or irradiation depending on tumor size and site. Histology and genomics of the enucleated globes were reviewed. Metastasis and survival were evaluated using the Kaplan‐Meier method.Results From August 1990 to January 2011, 4,857 patients treated for uveal melanoma were prospectively recorded in the database. Fourteen patients (0.3%), 10 girls, 4 boys, mean age 12 years, (median: 14; [range: 2‐16 years]) at onset were extracted. Mean basal tumor diameter was 14 mm (median: 14.5; [range: 6 to 22 mm]). Mean tumor thickness was 7.3 mm (median: 6.4 [range: 2.4 to 16 mm]). One half of patients were enucleated, while the other half was treated conservatively by proton beam or iodine plaque radiotherapy. Histopathology of enucleated globes showed epithelioid cellularity in all patients. Genomic analysis by CGH‐array was available for 4 patients and showed monosomy 3 for 2 patients and 8q gain for 3 patients. Median follow‐up was 91 months [range: 1 to 243 months]. At the end of follow‐up, 13 patients (93%) were alive, one presented metastatic disease and one had died. The eye was retained in all patients treated conservatively.Conclusion Most children had an excellent outcome in terms of survival. An excellent eye retention rate was observed in conservatively treated patients.
Correlation between function and structure of retinal nerve fiber layer in Parkinson disease
Authors: SATUE M , BAMBO M , GARCIA‐MARTIN E , FERRANDEZ B , GIL‐ARRIBAS LM , ARA M 
Published: August 2012

AbstractPurpose To determine the capacity of the axonal application for Optical Coherence Tomography (OCT) to detect axonal loss in the retinal nerve fiber layer (RNFL) in Parkinson’s disease (PD) and to evaluate the structure/function relationship between OCT measurements and visual function tests.Methods One hundred patients and 100 controls were included in the study and underwent a complete neuro‐ophthalmologic examination consisting in best corrected visual acuity (BCVA), color vision test with Ishihara’s pseudoisochromatic charts, automatic perimetry with Strategy SITA standard 30.2 of Humphrey and Spectralis OCT using the new axonal application. Mean and standard deviation of all parameters were calculated and correlation between RNFL, BCVA, Ishihara test’s score and the mean and mean standard deviation of the automatic perimetry.Results Significant differences between controls and patients were found in inferior and temporoinferior RNFL thicknesses (133.18 in controls vs 125.03 µm in PD, p=0.006; 149.53 vs 141.32 µm, p=0.020 respectively) and sector number 8 in papillomacular bundle (306.13 vs 271.19 µm, p= 0.006). Significant differences were also observed in automatic perimetry and Ishihara’s score (p<0.001). The RNFL thickness of the papillomacular bundle showed strong correlation (correlation index >0.700) with perimetry values and mild association with Ishihara’s score.Conclusion RNFL loss is detectable by the axonal application of Spectralis OCT in Parkinson disease. Functional parameters obtained by automatic perimetry present strong association with papillomacular bundle measurements.
Human pluripotent stem cell derived retinal pigment epithelium fulfills requirements of the in vitro functionality
Authors: SKOTTMAN H , VAAJASAARI H , NYMARK S , JUUTI‐UUSITALO K , HYTTINEN J , UUSITALO H , ILMARINEN T 
Published: August 2012

AbstractPurpose Human pluripotent stem cell (hPSC) therapy is a potential approach for the replacement of degenerated retinal pigment epithelium (RPE) cells. For therapeutic use, safety and functionality of the RPE cells needs to be guaranteed. In addition to the basic cell and molecular biological characterizations it is vitally important to assess the differentiation status of acquired cells with functional tests.Methods We have previously shown that hPSC differentiate into RPE in xeno‐free and defined conditions. Recent advances as a culture of hPSC‐derived RPE cells sheets on clinically accepted material have led us to investigate the functionality of the RPE epithelium. The tightness of the epithelium was evaluated by measuring transepithelial electrical resistance and cell permeability. The phagocytic properties of hPSC‐RPE cells were studied using rat retinal explants.Results Human PSC‐derived putative RPE cells exhibits typical pigmented cobblestone‐like morphology and express RPE specific markers at both mRNA and protein level. In addition, cultured cells form a polarized epithelium with high integrity. In addition, co‐culturing hPSC‐RPE monolayers with rat retinal explants demonstrated that rhodopsin is internalized by cells in vitro.Conclusion We have demonstrated that hPSC‐RPE monolayers acquired RPE‐like properties, including characteristic RPE phenotype, expression of RPE markers and barrier functions. In addition, cells were capable of binding and internalizing rat rhodopsin when co‐cultured with rat retinal explants. Currently we investigate the correlations of the functions in the Royal College of Surgeons (RCS) rats.
The influence of retinal oxygenation on the clinical outcomes in eyes with epiretinal membrane after successful vitrectomy
Authors: WEIGERT G , SACU S , GEORGOPOULOS M , PALKOVITS S , BLUM R , REZAR S , EIBENBERGER K , SCHMIDT‐ERFURTH U , SCHMETTERER L 
Published: August 2012

AbstractPurpose In the present study patients with epiretinal membrane underwent 23G vitrectomy and ICG membrane peeling. Little information is available about the effects of this treatment on retinal oxygenation. Hence, we set out to investigate the effects of vitrectomy on retinal oxygenation in patients with epiretinal membrane.Methods In this unmasked, prospective study, patients with macular edema as a result of epiretinal membrane scheduled to undergo vitrectomy without endotamponade, were included. The main outcome measure was oxygenation of the retinal vessels. The measurement of oxygenation in retinal vessels and retinal vessel diameters was performed with the Retinal Vessel Analyzer at baseline, at day 1, day 7, week 4, and week 12 after surgery. At each follow‐up visit, a high‐definition OCT examination and ETDRS visual acuity were also performed.Results Retinal venous diameter increased significantly at the first follow‐up examination. There was no significant change in oxygen saturation in retinal arteries. Retinal oxygen saturation in retinal veins showed a tendency to decrease at the 3 months follow‐up visit. Visual acuity did not change significantly after 3 months. Central retinal thickness was decreased after 3 months as expected but not to a significant level.Conclusion Vitrectomy for epiretinal membrane may show beneficial short‐term effects on retinal oxygenation. In eyes with macular edema due to other pathologies with retinal ischemia, vitrectomy may be performed as an additional treatment modality. Further studies evaluating whether these effects are associated with changes in long‐term visual acuity are warranted.
Pars plana vitrectomy for valsalva retinopathy: a case series
Authors: GARCIA FERNANDEZ M , CASTRO NAVARRO J , GONZALEZ CASTANO C 
Published: August 2012

AbstractPurpose To investigate the utility of pars plana vitrectomy in a series of patients with Valsalva retinopathy.Methods A retrospective, case series study that includes five patients with sudden visual acuity loss owing to Valsalva retinopathy with too dense premacular hemorrhages, treated in our hospital in the last three years. The etiology of the premacular hemorrhage was: vomiting (cases 1, 2 and 3), trauma (case 4) and vigorous dancing (case 5). Mean age was 33±19 years. After a period of observation ranging between three and four weeks, all patients underwent 23‐gauge pars plana vitrectomy. The internal limiting membrane (ILM) was released and the hemorrhage was cleaned.The sub‐ILM localization was confirmed in all cases during vitrectomy. One patient suffered an accidental break during peribulbar anaesthesia which was resolved successfully with laser photocoagulation. Full clinical examination including best‐corrected visual acuity (BCVA) (Snellen chart), intraocular pressure, fundus examination, and Optical Coherence Tomography (OCT) was performed at baseline and at last examination in all patients. The mean follow‐up was 16.1 (3‐32) months.Results BCVA was 10/10 in all patients one month after surgery and it remained unchanged during the follow‐up period. Funduscopy appearance was excellent in all eyes. No postoperative complications were found.Conclusion Valsalva retinopathy is a very rare condition that causes sudden visual acuity loss. In those cases with too dense hemorrhages it is necessary to perform vitrectomy, with excellent visual outcomes, as these hemorrhages are highly unlikely to resolve spontaneously.
Boston Keratoprosthesis in 2012: preventing complications and optimizing outcomes
Authors: COLBY K 
Published: August 2012

AbstractPurpose To provide an update on Boston KPro indications, post‐operative care and prevention and management of the complications based upon experience at the MEEI and results presented at the Eighth KPro Study Group Meeting in May 2012.Methods Clinical records were reviewed to determine outcomes of primary KPro surgery and surgery done using backplates of different materials and design. The origin of retroprosthetic membranes (RPM) from 4 explanted KPro’s was determined using immunohistochemistry and light and transmission electron microscopy. Wound anatomy in 6 KPro patients with larger 9.5 mm backplates was evaluated by anterior segment OCT and compared to wound anatomy in patients with standard 8.5 mm backplates.Results Titanium backplates reduce RPM formation. Histopathologic evaluation showed that RPM are fibrous membranes that originate from activated host stromal cells that migrate through gaps in the graft‐host junction, suggesting that better wound apposition may reduce RPM formation. OCT demonstrated that larger backplates clamp the graft‐host junction more effectively than standard backplates, resulting in a thinner graft‐host junction and better wound apposition. Primary Boston KPro surgery provides good outcomes and device retention in situation such as limbal stem cell deficiency where traditional keratoplasty does poorly.Conclusion Indications for the Boston KPro continue to expand as complications are reduced. Primary Boston KPro may be considered in certain circumstances. Strategies for prevention of RPM include titanium backplates and complete apposition of the graft‐host junction using larger KPro backplates.
Advances in imaging of the OOKP lamina
Authors: LIU C , NORRIS J , FRANCIS I , AVADHANAM V , THORP S , HEROLD J 
Published: August 2012

AbstractPurpose The anatomical integrity of an eye bearing an OOKP depends on the integrity and dimensions of the OOKP lamina itself. The lamina is anchored onto the corneo‐scleral envelope initially through suturing. Later on, the overlying buccal mucous membrane graft adheres onto the soft tissues invested into the bone of the lamina, retaining it and providing a seal to guard against entry of microbes into the eye. The integrity and dimensions of the lamina is ascertained clinically at each hospital visit, and this is aided by periodic radiological imaging.Methods We studied the relative merits of volumetric analysis, multislice CT vs Aquilion, and texture analysis. We also studied the feasibility of inserting radioopaque markers into the optical cylinder to aid inter examination orientation thus allowing subtraction radiology.Results Volumetric analysis has proven useful but cannot detect fractures in the lamina. The Aquilion provides slightly superior images but its major advantages are speed of acquisition and a much lower radiation dosage, allowing more frequent examination in cases where there is a suspicion of rapid dissolution of the lamina. Asymmetric markers placed with an optical cylinder can be imaged successfully.Conclusion Much work remains to be done to improve imaging of the OOKP lamina. Consideratons include image resolution, speed of acquisition, radiation dosage, costs, and repeatibility.