bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infliximab (Remicade?) in uveitis: a review
Authors: ABU EL ASRAR A , NERI P , HERBORT CP 
Published: September 2009

AbstractTumor necrosis factor (TNF)‐α has been implicated as an important mediator in autoimmune ocular inflammatory disease pathogenesis as shown by animal studies and its detection in the ocular fluids of patients with uveitis. Blockade of TNF‐α has emerged as one of the most promising therapies in autoimmune diseases including uveitis. Currently, there are three TNF‐α antagonists: two monoclonal antibodies (infliximab and adalimumab) and a soluble receptor that binds soluble TNF‐α (etanercept). Infliximab is a chimeric monoclonal antibody directed against TNF‐α. It binds with high affinity to both the soluble and the membrane‐bound TNF‐α and inhibits a broad range of biologic activities of TNF‐α. Binding to membrane TNF‐α can mediate programmed cell death. Several studies reported that infliximab therapy was rapidly effective and safe treatment for refractory noninfectious uveitis including childhood uveitis and is indicated as rescue therapy for relapses of ocular inflammation or as maintenance therapy when conventional immunosuppression fails. It also allowed a reduction of corticosteroids and immunosuppressive drugs required to control the disease. However, repeated infusions are required to maintain long‐term remission. Moreover, infliximab administration is costly and requires hospital admission. Adalimumab, fully humanized monoclonal anti‐ TNF‐α antibody, was also found to be effective and safe therapy for the management of refractory noninfectious uveitis. Several studies reported that infliximab was more effective than etanercept in the treatment of refractory uveitis. Perhaps infliximab’s ability to target membrane‐bound TNF‐α in addition to the soluble form may contribute to its increased efficacy in comparison with etanercept for uveitis.
What do I need to improve my glaucoma skills?
Authors: BRON AM 
Published: September 2009

Abstract Purpose Many new devices and technologies are available nowadays in the diagnosis and the treatment of glaucomas. However for young practitioners, it is mandatory to concentrate on symptoms and clinical signs. Methods In this presentation I will assess the place of the clinical examination in the overall management of glaucoma.In clinical practice many clues for glaucoma are found with simple instruments; a slit‐lamp, a gonio‐lens and a fundus lens. I will provide a frame, a sort of check list in order to build a diagnosis with the signs found during the clinical examination. Conclusion A moderate knowledge about ocular anatomy and physiology will lead the young resident through an easier diagnosis of glaucoma.Looking for the relevant symptoms and signs during the clinical examination will lead the young practitioner to a good accuracy in the diagnosis of glaucoma.
Parasitic corneal infections
Authors: GICQUEL JJ 
Published: September 2009

AbstractThe exposure of the eye directly to the environment renders it vulnerable to a number of uncommon infectious diseases caused by parasites. Once anatomical barriers are breached, host defences are often insufficient to prevent the infection from spreading localy. A fast identification and treatment of the involved microorganisms are necessary. Contact lens wear is associated with keratitis caused Acanthamoebae. Parasitic infections may also arise following bloodborne carriage of the microorganism to the eye or adjacent structures.
Diagnosis of ophthalmic tumours
Authors: KIVELÄ T 
Published: September 2009

Abstract Purpose To summarise clinical methods used to diagnose ophthalmic tumours. Methods Personal experience of the author as a member of the European Ophthalmic Oncology Group. Results Conjunctival tumours are excised based on provisional clinical diagnosis or, if they are extensive, atypical or part of systemic disease such as lymphoma, first biopsied to obtain a histopathologic diagnosis. Useful methods to diagnose and stage conjunctival tumours are high frequency ultrasonography (US) or ultrasound biomicroscopy (UBM) to measure their thickness, in vivo confocal microscopy or impression cytology to chart their extent, and exfoliative cytology to get a provisional diagnosis. Ciliary body tumours are visualised by radical biomicroscopy, transillumination and indirect ophthalmoscopy with scleral indentation, supplemented with high frequency US or UBM. Binocular indirect ophthalmoscopy and US form the basis or diagnosing choroidal tumours. In addition to fluorescein and indocyanine green angiography in atypical cases, optical coherence tomography to detect subretinal fluid and autofluorescence to detect orange pigment are useful adjuncts in telling a small melanoma from a naevus. The mnemonic “To Find Small Ocular Melanomas” (from Thickness >2mm, subretinal Fluid, Symptoms, Orange pigment, Margin touching disc) is also useful in this respect. Clinical diagnosis of medium‐sized to large melanomas is 99% accurate, whereas a fine needle or vitrectomy biopsy may be necessary to diagnose atypical tumours and is also used for cytogenetic analysis of uveal melanomas. Conclusion Conjunctival tumours are mostly diagnosed histopathologically, whereas diagnosis of uveal tumours is usually based on clinical examination. While clinical diagnosis is usually reliable, biopsy of uveal tumours is increasingly used for prognostic purposes.
Management of uveal tumours
Authors: DAMATO B 
Published: September 2009

Abstract Purpose The purpose of this presentation is to describe the management of uveal melanomas and the other most common uveal tumours. Methods Choroidal melanomas are treated with plaque radiotherapy if possible, with proton beam radiotherapy, stereotactic radiotherapy, trans‐scleral local resection, trans‐retinal endoresection, phototherapy and enucleation being reserved for patients who cannot be managed with a plaque. Increasingly, tumour biopsy is performed for histological grading of malignancy and for cytogenetic studies aimed at determining the genomic tumour type so that risk of metastatic disease can be determined. Choroidal metastases usually respond to external beam radiotherapy. Biopsy may be needed to confirm the diagnosis. Choroidal haemangiomas are treated by photodynamic therapy, with good response in most patients. Results In the large majority of patients, it is possible to conserve the eye and vision. Patients need life‐long follow‐up in case tumour recurrence occurs. After radiotherapy of choroidal and ciliary body melanomas some patients develop exudative and neovascular complications needing treatment. Conclusion Successful management of uveal tumours is based on a firm diagnosis, accurate staging of disease, reliable prognostication and adequate aftercare.
Treatment of ocular surface injuries by the transfer of limbal and mesenchymal stem cells growing on nanofibrous scaffolds
Authors: HOLAN V , ZAJICOVA A , LENCOVA A , POKORNA K , SVOBODOVA E , KRULOVA M 
Published: September 2009

Abstract Purpose To use nanofibrous scaffolds to grow and transfer limbal stem cells (LSC) and mesenchymal stem cells (MSC) to treat ocular surface injuries in a mouse experimental model. Methods Nanofibrous scaffolds were prepared by electrospinning procedure from a polyamid 6/12 (PA6/12). This polymer was selected on the basis of stability of nanofibres in aqueous solutions, biocompatibility and the best properties as a matrix for the growth of LSC and LSC. LSC and MSC labeled with a vital fluorescent dye PKH26 and grown on nanofibrous scaffold were transferred on the damaged eye surface, where their seeding and surviving were monitored. The effects of transferred cells on local inflammatory reactions were assessed by Real‐time PCR. Results The morphology, growth properties and viability of LSC and MSC on PA6/12 nanofibres were comparable with those on plastic. Transfer of LSC and MSC growing on nanofibrous scaffolds on the damaged ocular surface significantly inhibited local inflammatory reactions and supported the healing process. Conclusion The nanofibers prepared from polymer PA6/12 represent a convenient scaffold for LSC and MSC growth and transfer to treat SC deficiencies and various eye surface injuries.
Cell connections between lens fibres in the posterior pole of human and bovine lenses
Authors: VAN MARLE G , VRENSEN G , HOEBEN K 
Published: September 2009

Abstract Purpose Gap junctions (GJs) between lens epithelial cells (LECs ) and between lens fibres (LFs) are prominent features of vertebrate lenses. However, they are absent between LECs and LFs. There is evidence for the presence of tight junctions (TJs) between LECs, and differentiating LFs but only in the equatorial pole. TJs are lacking between LFs. We are not aware of studies on cell‐to‐cell junctions in the posterior pole although its surface is about as large as that of the anterior surface. This study aimed to find morphological evidence for GJs & TJs in the posterior pole of bovine and human lenses using freeze fracture (FF) and thin section EM (TEM). It appeared that posterior LF membranes have a high density of intramembranous particles (IMPs). Broken necks of caveolae are sparse. Edge protrusions are often demarcated by single rows of IMPs. GJs are numerous on all LF membranes except on the outer, capsule facing, membranes. This suggests close coupling of posterior fibres. TJs proved to be totally lacking on all fibre membranes. TEM corroborated these findings, showing numerous GJs between posterior fibres. No evidence for TJs was found. However, numerous spot desmosomes were observed between the peripheral fibres. Conclusion Lens fibres in the posterior pole are well coupled by GJs, but the presence of TJs could not be verified. The presence of spot desmosomes suggests a close mechanical attachment of posterior lens fibres. How the posterior pole regulates its solute transfer with the vitreous still remains to be elucidated.
Human anterior lens capsule epithelial cell contractions
Authors: ANDJELIC S , ZUPAN?I? G , PEROVšEK D , HAWLINA M 
Published: September 2009

Abstract Purpose The transport over the lens epithelial cell layer is governed by different morphological parameters and junctions whose defects can lead to cataract formation. The cells are cuboidal, tightly packed with very little intercellular space. We studied their contractions due to agonist application. Methods Entire anterior human capsules obtained from cataract surgery, with the cells still attached, were used. A good part of the cell contacts, including contacts to the basement membrane were preserved. To measure the [Ca2+]i and to monitor the cell morphology, the capsules were stained with the fluorescent dye Fura2. We applied either the agonist acetylcholine (ACh) solution or the physiological saline alone, to test whether the agonist is necessary to induce the cell contraction. Results Lens epithelial cells in 23% (12/51) of the capsules contracted substantially upon ACh application and responded with an increase in [Ca2+]i. However, contraction also occurred, with very small increases in [Ca2+]i, when, as a control, physiological solution was applied in the same way, suggesting the possibility that the contraction can be induced mechanically. Conclusion The major role of lens capsule epithelial cells is to be a regulating “barrier” between the aqueous humour and the lens fibre cells. The appearance of holes in this barrier, due to cell contraction, in response to not only agonist application but also presumably mechanical stimuli, compromises their basic function and may be a part of a pathophysiological mechanism associated with cataract formation.
Segmentation of FD‐OCT images shows selective loss of inner retinal layers in patients with DM and no or early DR
Authors: VERBRAAK FD 
Published: September 2009

Abstract Purpose Determine whether diabetes differentially affects specific retinal layers by comparing the thickness of six retinal layers in diabetic patients with no or minimal diabetic retinopathy (DR) to age‐ and gender‐matched normal controls. Methods Forty‐four patients with type 1 diabetes and no or minimal DR underwent full ophthalmic examination, stereoscopic fundus photographs and spectral domain optical coherence tomography (OCT). Following automated segmentation of intraretinal layers of the OCT images, mean thickness was calculated for 6 individual layers of the retina in the fovea, the pericentral area and the peripheral area of the central macula and compared to an age‐ and gender‐matched control group. Results In type 1 diabetic patients with minimal DR, the retinal nerve fiber layer (p=0.00) and the ganglion cell/inner plexiform layer (p=0.02) were significantly thinner compared to age‐ and gender‐matched controls. No other layers showed a significant difference. Conclusion Thinning of the total retina in diabetic patients with minimal DR relative to normal controls is due to a selective thinning of inner retinal layers and supports the concept that early DR includes a neuro‐degenerative component.
The human choroid posseses substance P and calcitonine gene‐related peptide intrinsic neurons
Authors: TRIVINO A , DE HOZ R , ROJAS B , SALAZAR JJ , RAMIREZ AI , GALLEGO B , RAMIREZ JM 
Published: September 2009

Abstract Purpose To determine the presence of substance P (SP)‐and calcitonine gene‐related peptide (CGRP) positive intrinsic choroidal neurons (ICNs) in human Methods Nineteen choroidal whole‐mounts were processed for indirect immunofluorescence. Antibody to a component of the neuronal cytoskeleton, neurofilament 200 kDa (NF‐200), was combined with antibodies to SP and to CGRP (neuropeptides proper to the sensory nervous system). Results The human choroid possesses numerous SP(+) and CGRP(+) ICNs. These neurons were observed in the suprachoroid, both in isolation and forming microganglia. For both types of ICNs studied, neurons were more numerous in the temporal than in the nasal regions. In both locations, SP(+) and CGRP(+) ICNs were more abundant in the central choroid (the choroid underneath the macular area of the retina), with cell density diminishing outwards to the choroidal periphery. There were no appreciable differences between the two populations of ICNs studied in terms of size, morphology or immunostaining characteristics. Conclusion The human choroid contains an abundant population of SP(+) and CGRP(+) ICNs. Given that peripheral sensory innervation could be involved in the regulation of both choroidal blood flow and vascular architecture, the SP(+) and CGRP(+) ICNs described for first time in the present work may be implicated in these mechanisms of vascular regulation
The effects of sub‐conjunctival EPO administration on ERG and on the peripheral blood haematocrit in animal model (rabbit)
Authors: DELGADO E , RESENDE AP , SAO‐BRAS B , DE SOUZA‐RAMALHO P 
Published: September 2009

Abstract Purpose To assess the effects of subconjunctival EPO administration on retinal eletrophysiology and on the peripheral blood haematocrit. Methods New Zealand White rabbits (n=6) received 100 UI of EPO through the subconjuntival route. Blood for Complete Blood Count (CBC) was collected on day 0, on day 7 and on day 14 of the experimental protocol. Furthermore electroretinograms were performed on day 0 and on day 30 of the experiments. Results Regarding CBC changes, the haematocrit values changed from 35,42±2,7% on day 0 to 34,32±4,3% (p=0,390) on day 7 and to 34,45±4,4% on day 14 (p=0,931), showing no significant changes. Concerning the red blood cells (RBC x10000/µL) count, the values evolved from 6,02±0,48 on day 0 to 5,65±0,67 (p=0,074) on day 7 and to 5,67±0,74 (p=0,948) on day 14, showing no significant alterations. On the contrary, on what regards the electroretinograms, although there were no significant changes on a‐wave amplitudes, which evolved from 13,94±1,7 µV on day 0 to 13,67±0,8 µV on day 30 (p=0,844) and no significant differences on N1‐P1 amplitudes which changed from 46,60±4,5µV to 55,48±10,5 µV (p=0,438), there was a remarkable increase on b‐wave amplitude of 49%, changing from 46,60±7,43 µV to 94,97±13,36 µV (p=0,031). Conclusion On what concerns CBC profiles, subconjuntival EPO administration did not cause any sinificant changes on haematocrit or RBC values. Regarding electrorretinography, there were no significant changes on a‐wave or N1‐P1 amplitudes, but there was a marked increase in the b‐wave amplitude which tests for photoreceptor functionality, which might indicate a protective action against apoptosis of retinal photoreceptors even in physiological conditions.
Tolerance and safety of ocular use of recombinant human erythropoietin (rhEPO). Neuroprotective effects in ocular hypertension/glaucoma
Authors: GOMES N , ROCHA DE SOUSA A , FALCAO REIS F , SONG BJ , DEL PRIORE LV 
Published: September 2009

Abstract Purpose The purpose of this study was to evaluate the long‐term effects of monthly intravitreal injections of rhEPO in a rabbit model. Methods Sixteen New Zealand rabbits were divided into 4 groups: control (no injection), saline injection, or rhEPO injections of 500 U and 1000 U (N=4 per group). The right eye of each animal was injected monthly over a period of 7 months. Fundus examination and electroretinography (ERG) were performed at 1 day prior, and 1 week, 1 month, and 6 months after the initial injection. After the final ERG, animals underwent fluorescein angiography and sacrifice one week later. Scotopic and photopic ERG amplitude and implicit times were analyzed by calculating a ratio between the right and the left eyes. Angiograms were graded for the presence of neovascularization or leakage. Statistical analysis was carried out using two‐way ANOVA. Results Fifteen animals were used for this experiment (1 developed a traumatic cataract and was excluded). Between all groups and time points, there were no statistically significant differences in the computed right eye:left eye ratios for the scotopic or photopic ERG components (p>0.05). No evidence of neovascularization or fluorescein leakage was seen on angiography. There were no visible differences in retinal architecture or thickness in the rhEPO groups when compared to uninjected controls. Conclusion Monthly 0.1 ml intravitreal injections of rhEPO at a dose of up to 1000 U over 7 months is well‐tolerated and does not cause adverse effects on retinal function, architecture, or vasculature in a rabbit model. A review of published data on rhEPO and Glaucoma will also be presented.
Intravitreal and plasmatic levels of erythropoietin after sub‐conjunctival administration in rabbits
Authors: RESENDE AP , DELGADO E , SAO‐BRAS B , DE SOUZA‐RAMALHO P 
Published: September 2009

Abstract Purpose Recently Erythropoietin (EPO) had been shown to have neuroprotective and neuroregenerative effects on retinal ganglion cells, apart from its erythropoietic properties, being a promissory alternative on ischemic retinal diseases. With the present study we pretend to evaluate the efficacy of subconjuntival injection for ocular EPO delivery. Methods New Zealand albino rabbits (n=6) were used. Complete ophthalmic examinations were carried out before and after the injections for 15 days. The proceedings (intravitreal punch and subconjuntival injections) were carried out under general anaesthesia. Through the subconjuntival route 100 UI of EPO diluted in 50 μl saline solution 0,9% was administered. The opposite eyes of each animal served as controls.The vitreous and plasmatic concentration of EPO were measured using the ELISA method. Results Administration of EPO through the subconjuntival route allowed a vitreous absortion that reached the highest 24 hours after administration with 0,6 mUI/ml of EPO quantified in 100 μl of vitreous sample. The sistemic absorption reached the highest concentration 3 hours after subconjunctival administration and 48 hours after the administration the plasmatic concentration of EPO regained physiologic values. EPO was not detected on control eyes. Conclusion All the previous studies used the systemic or intravitreal route of administration to acquire therapeutic concentrations of EPO on the retina, both difficult to use in clinical practice. In this study, the subconjuntival route proved to be a promising alternative for ocular EPO delivery. However further studies are necessary to assess the blood and intravitreal kinetics of EPO after subconjuntival administration.
Importance of electroretinogram in bull’s eye maculopathy
Authors: HALFELD FURTADO DE MENDONCA R , KOK F , ROSEMBERG S , YUKIHIKO TAKAHASHI W 
Published: September 2009

Abstract Purpose To describe the retinographic, electroretinographic and ultra‐structural alteration in a interesting family case of bull’s eye maculopathy. Methods A 14‐year‐old boy, his brother a 12‐year‐old boy and his sister a 10‐year‐old girl with visual loss, underwent complete ophthalmological exams, including retinography, electroretinography (ERG) and ultrastructural study by electron microscopy of the skeletal muscle, at the Clinical Hospital of the University of São Paulo. Results All three children presented optic nerve pallor, arteriolar thinning and bull’s eye maculopathy. The scotopic responses were absent or with low amplitude contrasting with normal flicker responses. Electron microscopy study detected the curvilinear bodies typical from Neuronal Ceroid Lipofucinosis (NCL). Conclusion The initial diagnose of those children was cone‐rod dystrophy. Diagnosis of NCL was established by normal ERG flicker and findings of characteristic electron microscopic curvilinear bodies. The electrophysiologic testing are very important in the early diagnosis of NCL.
Hunter's syndrome and buphthalmos in a girl: an unusual ophthalmic association
Authors: SETHI S , BHARTIYA S , MEHTA M , CHANDRA M , GHOSE S 
Published: September 2009

Abstract Purpose To report an unusual ophthalmic presentation of a case of Hunter's syndrome/MPS II. Methods A sixteen‐year‐old girl presented to us with total loss of vision and forward protrusion OU since early childhood. Detailed examination, including slit lamp biomicroscopy, Intra ocular pressure (IOP) and fundoscopy was carried out. Thorough systemic evaluation including Computed Tomography (CT), metabolic and genetic analysis was undertaken in collaboration with internists. Results Characteristic facies, detection of glycosaminoglycan (GAG) variants in urine (chondroitin sulfate B and heparin sulfate) and iduronate‐2‐sulphatase activity in fibroblasts/leucocytes confirmed the diagnosis of MPS II. Child had severe photophobia but with no perception of light OU. OU buphthalmos with Haab's striae was noted, making a clear view of the fundus difficult. IOP OU was elevated, and 90D slit lamp biomicroscopy revealed a total glaucomatous optic atrophy in both eyes.On CT there was thickening and edema of preseptal and periorbital soft tissue with marked thinning of the optic nerves with prominent perineural CSF sleeves, indicative of marked optic atrophy. Conclusion Glaucoma is a known association of Hurler's, Scheie's and Maroteaux‐Lamy syndromes but not Hunter's. In fact, there is only one report of suspected angle closure glaucoma in MPS II. Buphthalmos is not a likely presentation as the sclera in these patients is known to be thickened due to deposition of GAG. To the best of our knowledge, this is the first case report of buphthalmos in association with MPS II. The importance of a meticulous examination in this subset of patients cannot be overemphasised. An appropriate and timely intervention may result in a better quality of life for them.