bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ophthalmologic outcome of 40 spheno‐orbital meningioma resections: 15 years long‐term results
Authors: NOCHEZ Y , FRANCOIS P , VELUT S , CARDON A , MAJZOUB S , JAN M , PISELLA PJ 
Published: September 2009

Abstract Purpose To evaluate the operative results of spheno‐orbital meningiomas regarding resectability, recurrence and ophthalmological outcome. Methods Retrospective study of 40 patients who underwent surgical resection of spheno‐orbital meningiomas followed by bony reconstruction between 1992 and 2008. Results Mean age of 50 years and sex ratio of 37 women and 3 men. The most common preoperative sign was proptosis (90%), visual acuity (VA) and visual field deficits (55%). Periorbital tumor infiltration is a predictive factor of decreased VA in case of initial VA deficit. Optic canal invasion and resection don’t influence VA recovery. Postoperatively, 10 patients showed severe permanent visual field deficits, versus 17 patients showed no visual field deficits. After surgery, proptosis improved for all patients with a preoperative mean proptosis of 5,6 +/‐ 3,6 mm versus 2,2 +/‐ 2,7 mm postoperatively (p<0,001). Lateral orbital wall resection and bony reconstruction are the two major factors which are efficient in reducing proptosis. Mean follow‐up period was 7 years. Clinical tumor recurrence was observed in 10 patients (27 %), radiological tumor recurrence without clinical signs was observed in 7 patients. 4 patients underwent re‐operation and 3 patients were treated by radiation. Resection quality is the only predictive factor of a clinical recurrence. Conclusion Periorbital tumor infiltration is a predictive factor of non‐improvement of visual deficits (VA or visual field deficits). Peri‐orbital resection leads to a better esthetic result with a better proptosis reduction. Complete and subtotal (> 90%) tumor resection gives a long‐term survival free of clinical recurrence for 80 % of our patients.
Retinal angiomatous proliferation: is intravitreal ranibizumab therapy enough?
Authors: MARJANOVIC B , GEORGOUDIS P , MANDAL K , PATRA S 
Published: September 2009

Abstract Purpose To report the use of Ranibizumab monotherapy versus Ranibizumab combined with additional photodynamic therapy (PDT) in the management of retinal angiomatous proliferation (RAP). Methods The data from a non‐randomised series of 25 patients with RAP lesions attending the Bristol Eye Hospital age‐related macular degeneration (AMD) treatment clinic from April to October 2008 was analysed. The RAP lesions were classified according to Yannuzzi’s system as stage 1, 2 or 3 based on clinical, ocular coherence tomogram and angiographic features. Two treatment regimes were identified (1) Lucentis monotherapy and (2) Lucentis monotherapy with additional photodynamic therapy (PDT). The main outcome measures were the % of eyes losing < 15 letters, % of eyes gaining ≥ 15 letters and the mean change in visual acuity. Results Mean LogMAR visual acuity was 52.8 letters before treatment. Mean follow‐up time is 9.5 months. Fourteen eyes had been treated with PDT before or after the use of Ranibizumab. Two eyes received PDT+IVT only (Stage 2 patients). 77% of eyes had an improvement in visual acuity. 18.5 % of eyes have had improvement of 15 or more letters. Mean change in visual acuity was +7.2 letters. 57% and 60% of patients with stage 1 & 2 disease respectively, received PDT. Conclusion Combined therapy is effective in improving visual acuity and reducing central retinal thickness (CRT) in all patients with stage 1 lesions and most of patients with stage 2 lesions. Combined therapy offered greater gain in visual acuity in all treated patients. Stage 1 and 2 patients benefit more from the treatment if the condition is recognised and treated early.
Findings in electrooculography and multifocal electroretinography in patients after bevacizumab treatment for age‐related macular degeneration
Authors: MANKOWSKI W 
Published: September 2009

Abstract Purpose To assess usefulness of electrooculography (EOG) and multifocal electroretinography (mfERG) in monitoring electrophysiological changes in patients after bevacizumab treatment. Methods 33 patients with age‐related macular degeneration underwent ophthalmic examination including visual acuity, EOG, mfERG (Vision Monitor, Metrovision, France). Visual acuity test, sensory EOG protocol and mfERG with 61 scaled hexagons for low vision protocol were used during electrophysiological exams before and 1 month after each bevacizumab injection. Results before bevacizumab injection mean visual acuity was 0,181±0,160, mean Arden’s coefficient was 199,692±54,785%, mean P1 wave amplitude <2 deg was 29,062±14,89 nV/deg2, mean P1 wave <2 deg implicit time was 47,015±12,832 ms. 1 month afer bevacizumab injection we observed no statistically significant mean visual acuity decrease (0,181±0,160 vs. 0,162±0,140 p=0,757), no statistically significant mean P1 wave amplitude <2 deg decrease (29,062±14,89 vs 25,077±17,996 nV/deg2 p=0,544) and no statistically significant mean P1 wave <2 deg implicit time decrease (47,015±12,832 vs. 46,115±10,313 ms p=0,845). We observed positive correlation between visual aciuty and P1 wave amplitude <2 deg (r=0,540, p<0,05). Conclusion Electrooculography and multifocal electroretinography are useful exams in monitoring electrophysiological changes in patients during bevacizumab treatment.
Crosslinking by riboflavin and UVA. An electron transmission microscopy study in rabbits. Preliminary results
Authors: MANGIORIS G , NATSIS K , NIKOLOUSI A , PAPADOPOULOU DN , KOMNENOU A , KAROUTIS A , KARAMPATAKIS V 
Published: September 2009

Abstract Purpose Collagen crosslinking of the cornea (CXL) has been developed recently as a promising treatment of keratoconus. In vitro measurements have demonstrated a significant increase in biomechanical stiffness of the crosslinked cornea. The aim of the present study was to evaluate the effect of this procedure on the collagen fiber diameter of the rabbit cornea over time. Methods The corneas of 10 New Zealand White albino rabbits were crosslinked by application of the photosensitizer riboflavin and exposure to UVA light (365 nm, 3 mW/cm2) for 30 minutes. The fellow control eyes were left untreated. On ultrathin sections of samples from the central and peripheral cornea, the collagen fiber diameter were measured with the help of morphometric computer software. Results In the anterior stroma, 48 hours after the CXL the collagen fiber diameter in the treated corneas was significantly increased by 10% compared with the control fellow eyes. Four months after the CXL, the mean collagen fiber diameters were decreased as compared to the 48 h specimens. In the 6 month specimens the diameter of the collagen fibers was further decreased as compared to the control fellow eyes up to ‐8%. Conclusion CXL leads to a significant increase in corneal collagen diameter 48 hours after the procedure. Interestingly, 4 months after the CXL, there is a decrease in the mean diameter of the collagen fiber and at 6 months, there is a further decrease up to 8% compared to the fellow eye. We can assume that the rigidity and the biomechanical stability of the cornea after CXL is increased because of the new intercollagen connections and collagen fiber diameter has little or no role in this procedure.
A pocket slitlamp
Authors: ARMOUR R 
Published: September 2009

Abstract Purpose I here describe a prototype pocket slitlamp for students and non‐specialists. It might help bridge the growing gap between ophthalmology (and optometry) and other specialties. Methods MATERIAL Pocket microscopes, condensing lenses, modified pentorch and a platform. PILOT TESTS Evaluation and photographs of optical sections of 1)Anterior segment and lens of the eyes of the author and four volunteers. 2)Wrist watch crystals. Is a wristwatch a suitable model eye? Results The prototype weighs 100g, costs EUR35 (£30)and can be carried in a pocket. The magnification was 0‐30X, and the slits of light were 0.5‐2mm wide. The digital camera cost EUR85 (£79.99). PILOT TEST RESULTS 1) Clinically adequate optical sections of the cornea, anterior chamber and lens were seen and photographed. 2) The outer and inner surfaces of the wristwatch crystal, watch face and the space in between were clearly seen. They simulated the corneal epithelium and endothelium, the iris and the anterior chamber. LIMITATIONS The view is monocular, there is no zoom and the light is less intense than the maximum of a conventional slitlamp. Conclusion When developed this miniature slitlamp could help both in the instruction of students and in the clinical practice of non‐specialists. Students could practice on each other and on wristwatches, which make good model eyes.
Commercial interest
Simultaneous topo‐guided photorefractive keratectomy (PRK) followed by collagen cross‐linking (CXL) for the treatment of keratoconus
Authors: KONTADAKIS GA , KYMIONIS G , PORTALIOU D , KOUNIS G , KARAVITAKI A , PALLIKARIS IG 
Published: September 2009

Abstract Purpose To present the results after simultaneous topoguided Photorefractive Keratectomy (PRK) followed by corneal collagen cross linking with Riboflavin/Ultraviolet – A irradiation (CXL) for the treatment of keratoconus. Methods In this prospective case series, 22 patients (27 eyes) with progressive keratoconus participated. All patients underwent customized topography guided photorefractive keratectomy (PRK) immediately followed by corneal collagen cross linking with the use of riboflavin and ultraviolet – A irradiation. Results Mean follow up was 10.72+5.98 months (range from 3 to 19 months). Mean preoperative spherical equivalent (SE) (diopters, D) and defocus were –3.03 ± 3.23D and 4.67±3.29D while at the last follow up examination were significantly reduced to ‐1.29 ± 2.05D and 3.04±2.53D, respectively. Preoperative mean (LogMAR) Uncorrected Visual Acuity (UCVA) and Best Spectacle Corrected Visual Acuity (BSCVA) were 0.99±0.81 and 0.21±0.19 while at the last follow up examination were improved to 0.16±0.15 and 0.11±0.15 respectively. Mean preoperative steepest meridian keratometry from 48.2±3.4D was reduced to 45.13±1.8D at the last follow up examination. Conclusion Simultaneous PRK followed by CXL seems to be a promising treatment capable of offering patients a functional vision and halting progression of the ectatic disorder. Longer follow up and larger case series are necessary in order to fully evaluate this new innovative combined procedure.
Protective effect of the thioltransferase gene on in vivo UVR‐300 nm induced cataract
Authors: KRONSCHLäGER M , YU Z , GALICHANIN K , MEYER L , LÖFGREN S , SÖDERBERG PG 
Published: September 2009

Abstract Purpose To determine the protective effect of the thioltransferase glutaredoxin 1 (Grx1), a critical protein‐thiol repair enzyme, on in vivo UVR‐induced cataract. Further, to estimate the MTD(2.3:16) for Grx1+/+ and Grx1‐/‐ mice and to calculate the protection factor for the thioltransferase gene on UVR‐induced cataract. Methods 20 Grx1+/+ and 20 Grx1‐/‐ mice were unilaterally exposed in vivo to UVR‐300 nm for 15 min. Altogether, 5 groups of 4 animals received 0.0, 2.1, 2.9, 3.6 or 4.1 kJ/m2 each. At 48 h post UVR exposure, light scattering in the exposed and contralateral not exposed lens was measured quantitatively. Macroscopic lens changes were documented with dark field illumination photography. Results Subcapsular and cortical opacities were observed in both the Grx1+/+ and Grx1‐/‐ mice. Forward light scattering in the lenses from the Grx1+/+ group was lower than in the lenses from the Grx1‐/‐ group and increased with increasing radiant exposure. The MTD(2.3:16) was for the Grx1+/+ group 3.81 (CI(0.95) = [2.82;6.37]) and for the Grx1‐/‐ group 2.99 (CI(0.95)= [2.33;4.00]) resulting in a protection factor of 1.28. Conclusion Deficiency of the Grx1 gene makes the lens 28 % more sensitive to early onset UVR‐300 nm induced cataract, indicating the important role of the Grx1 gene in the oxidation defense of the lens.
Face down posturing for macular hole surgery. Is it really required?
Authors: TRANOS P 
Published: September 2009

Abstract Purpose Background: In macular hole surgery pars plana vitrectomy and intravitreal gas injection with or without inner limiting membrane peel, is considered the mainstay of treatment. The requirement for face down posturing is generally regarded as part of the traditional postoperative routine. Several mechanisms have been postulated to explain the action of the gas bubble including exertion of a large floatation force on the macula and prevention of the macular hole exposure to vitreous fluid. Recently the need to face down has been chalenged since this regime compromises patients’ postoperative quality of life and it makes macular hole surgery almost impossible for individuals with mental or physical limitations. Methods Review of personal data and systermatic literature review of studies investigating macular hole surgery with shortened or eliminated face down posturing. Results There is considerable body of evidence suggesting successful anatomical and functional outcome in patients with shorter duration of posturing or no posturing at all following macular hole surgery. The pros and cons of each technique will be presented in detail. Conclusion Prone posturing following macular hole surgery provides no functional or anatomic benefit but it is associated with slower progression of cataract. Combined phacovitrectomy without face down positioning may be considered for phakic patients undergoing macular hole surgery.
Orally active multi‐functional antioxidants for the treatment of cataracts and AMD
Authors: KADOR PF , RANDAZZO J , ZHANG P , BLESSING K 
Published: September 2009

AbstractAge‐related cataract and neurodegeneration has been linked to oxidative stress and increased lenticular levels of Fe and Cu, which can contribute to ROS generated through the Fenton Reaction. Since both antioxidants and chelating agents have both been reported to reduce experimental cataracts, we have synthesized a new class of antioxidants (JHX‐4 and its dimethoxy analog JHX‐8) containing a novel 2‐amino‐4‐hydroxylpyrimidine ring system that selectively chelates Fe and Cu. In vitro studies in human lens epithelial cells and retinal pigment epithelial cells demonstrate that these compounds can reduce ROS generated by H2O2, endoplasmic reticulum (ER) stress, or Fenton’s reaction. In vivo studies demonstrate that these compounds accumulate in the lens and retina after oral administration. In Long‐Evans rats receiving whole head irradiation, these compounds delayed cataract formation proportional to the tissue levels of drug achieved. Compared to untreated rats, treatment with JHX‐4 and ‐8 delayed the formation of PSC punctuate opacities in 50% of animals by 53 and 58 days, respectively and lens PSC opacities by 38 and 47 days, respectively. In vivo neuroprotection studies are currently in progress. Supported by NIH EY016460‐01.
Thyroid eye disease and the internet
Authors: ZAIDI F , JONES C 
Published: September 2009

Abstract Purpose Thyroid eye disease (TED) is influenced by modifiable risk factors yet has received little attention in terms of how the internet influences patient behaviour. We assessed the quality of information accessed by sufferers using the internet. Methods The word ‘thyroid eye disease’ was subjected to an advanced keyword search. This analyses average monthly search volumes over a 12 month period using the Google search engine. The most popular search term was then inputted into Google and the first 5 pages of websites studied using a validated instrument. The 4 criteria published in the Journal of the American Medical Association (JAMA) for qualifying information from the internet were used in the analysis, yielding a possible score of between 0 and 4. Results 100 websites were studied. All 4 criteria were satisfied by 10% of sites; 3 criteria were met by 17%; 2 criteria by 7%; 1 criterion by 20%. 46% of sites scored zero for objective quality. Superior scores were achieved by peer‐reviewed journals, online abstracts, book chapters and medipedias (online medical encyclopedias). Counter‐intuitively websites of professional bodies including academic institutions scored poorly. Lowest mean scores were obtained by private clinics and hospitals’ websites. This is different from the quality of information available in other fields such as retinopathy of prematurity that have been studied. Conclusion The quality of information on TED is poor and this is particularly of relevance as good patient information such as advice against smoking would improve patient outcomes. These findings are of specific relevance to how scientists and clinicians inform patients in this age where a wealth of information and misinformation is available on the internet.
Corneal surface regeneration: epithelial sheets to epithelial crypts
Authors: DUA HS 
Published: September 2009

AbstractThe corneal surface is the most important 123 square millimetres of the body’s surface. Its health is paramount for sight. Due to its exposed nature it is vulnerable to environmental insults causing minor to excessive epithelial cell loss. Large epithelial defects, with an intact limbus heal by the formation of 3 to 6 convex sheets that migrate centripetally, meet adjacent sheets and undergo contact inhibition to form geometric shapes. These finally close by the formation of ‘Y’ shaped contact lines (Rule 1). When the limbus is partially involved, there is a preferential healing of the limbus by circumferential migration of tongue shaped sheets from the remaining intact limbus. These meet to cover the limbus (Rule 2) and subsequent healing occurs as in rule 1. On occasions conjunctival epithelium migrates across the limbus resulting in partial limbal deficiency. When the entire limbus is affected, total conjunctivalisation of the cornea occurs (Rule 3). Within sheets, individual cells migrate in a predominantly clockwise whorl pattern (Rule 4). Physiological and wound healing related cell turnover is believed to occur from stem cells (SC) located at the limbus. Specialised anatomical structures, termed Limbal Epithelial Crypts (LEC) are associated with some limbal palisades and present all the hallmarks of a SC niche. SC characteristics are also seen in the peripheral cornea adjacent to a palisade with a LEC. Recent evidence suggests that the limbal SC play a critical role in wound healing but may have only a marginal role physiological corneal epithelial homeostasis.
Age‐related macular degeneration; an Alzheimer’s disease in the eye?
Authors: OHNO‐MATSUI K 
Published: September 2009

Abstract Purpose One of the earliest signs of age‐related macular degeneration (AMD) is the formation of drusen beneath the retinal pigmented epithelium (RPE). Recent proteome analysis demonstrated that amyloid β (Aβ), which is a major component of senile plaques in the brains of patients with Alzheimer’s disease. The purpose of our study was to clarify the role of Aβ on the pathogenesis of AMD. Methods The effect of Aβ on the expression of angiogenesis‐related factors, cytokines, and the modulators of complement pathway in cultured human RPE cells was investigated. Ocular findings in neprilysin gene‐disrupted mice, which lead to an increased deposition of Aβ, were evaluated. Results Aβ treatment induced a marked increase in VEGF as well as a marked decrease in pigment epithelium‐derived factor (PEDF) in RPE cells. Electron microscopy of the senescent neprilysin gene‐disrupted mice revealed the degenerated RPE cells with vacuoles and basal deposits formation. Aβ did not directly affect the expression of modulators of complement pathway in RPE cells, but increased the production of MCP‐1. Co‐cultures of RPE cells and macrophage/microglia in the presence of Aβ significantly increased the expression of the activator of complement alternative pathway; factor B by RPE cells through IL‐1β/TNF‐α secreted by macrophages/microglia. Aβ binds to the inhibitor of alternative pathway; factor I and inhibited its ability to cleave C3b to inactivated iC3b. Conclusion Aβ has a critical role in the pathogenesis AMD. Combined mechanism exists for Aβ‐induced activation of the complement alternative pathway in subretinal space; cytokine‐induced up‐regulation of activator factor B and dysfunction of the inhibitor factor I. Un‐regulated complement activation leads to a low‐grade, chronic inflammation in subretinal tissue, which could cause AMD development.
Ophthalmic Research Lecture ‐ Role of the vascular endothelial cell in uveitis
Authors: SMITH J 
Published: September 2009

AbstractOf all the forms of inflammatory eye disease, posterior uveitis is the most likely to result in irreversible loss of vision. This disease results from: autoimmune disease; infection, most commonly toxoplasmosis; and in rare cases, B cell lymphoma. Patients with posterior uveitis frequently demonstrate clinical involvement of the retinal vasculature. Studies of rodent experimental autoimmune uveoretinitis conducted by other groups show that the lymphocytes that control this disease model access the retina via the retinal blood vessels. We have developed methods to isolate vascular endothelial cells from the retina of human cadaver donors; lymphocytes migrate readily across monolayers of these cells. In separate studies, we have observed that in comparison to other endothelial cell subtypes, retinal endothelial cells are relatively susceptible to infection with Toxoplasma gondii tachyzoites; increased binding of tachyzoites to the retinal endothelium may contribute to this susceptibility. We have also detected the expression of B cell lymphoid chemokines by vascular endothelial cells, as well as malignant lymphocytes, in primary central nervous system B cell lymphoma. Profiling analyses of the human retinal vascular endothelial cell, using gene expression microarray and shotgun proteomics, may help to clarify the molecular mechanisms that mediate interactions between the retinal vascular endothelium and lymphocytes or microbes in posterior uveitis. As the “gate” of the retina in posterior uveitis, the retinal endothelial cell holds much promise as a target for highly specific therapies of this disease.
Intracameral amphotericin B in the management of Candida glabrata anterior uveitis after penetrating keratoplasty
Authors: SCHOLLMAYER P , KRAUT A , GLOBOCNIK‐PETROVIC M , PFEIFER V 
Published: September 2009

Abstract Purpose To report management of Candida glabrata anterior uveitis after penetrating keratoplasty with intracameral amphotericin B. Methods Case report and literature review Results We report a case of a 79‐year‐old woman that presented with anterior uveitis and a dense endothelial plaque at the graft‐host junction in her only eye six weeks after repeated penetrating keratoplasty with donor tissue that was culture‐positive for Candida glabrata. Anterior chamber tap was performed and 5 µg of amphotericin B was injected in the anterior chamber. Cultures of the anterior chamber were positive for the same pathogen as the corneosleral donor rim. She was also treated with topical 0,5% amphotericin B for the next month and topical corticosteroids. At the end of follow up after 16 months her SCVA was 0,6. There was no evidence of recurrent fungal intraocular infection and the graft remained clear with the endothelial cell density of 2286 cells/mm. Conclusion In our opinion intracameral amphotericin B is effective and safe in the therapy of Candida glabrata anterior uveitis after penetrating keratoplasty.