bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary transpupillary thermotherapy for small suspicious choroidal nevi
Authors: TURCOTTE S , BERGERON D , ROUSSEAU A , MOURIAUX F 
Published: August 2012

AbstractPurpose The purpose of this study was to assess the ocular and systemic outcomes of patients treated by transpupillary thermotherapy (TTT) for suspicious choroidal nevi at our oncology centre.Methods A retrospective chart review was conducted for all patients with a newly diagnosed small suspicious choroidal nevus treated by TTT at our oncology centre from the date of acquisition of the laser (2002) to September 2011. Standard treatment consisted of three TTT sessions. Patients with two or more risk factors for tumour growth were systematically treated. Ocular and systemic outcomes were reviewed and compared with those of similar patients that were observed between 1990 and 2008.Results Our preliminary data include 8 patients treated by TTT and 56 patients that were followed‐up without treatment. Of the treated patients, 3 (37.5%) showed progression with a mean time to recurrence of 13 months. Of the observed patients, 23 (41%) showed progression with a mean time to recurrence of 41 months. There were no reported deaths in the treated group, and 3 (5.4%) deaths due to metastatic melanoma in the observation group.Conclusion Despite careful patient selection, primary TTT for small suspicious choroidal nevi showed poor local tumour control. No deaths due to metastatic melanoma were reported in the follow‐up of treated patients, and mortality remained low in the observation group.
Genetics and treatment of Stargardt disease
Authors: ALLIKMETS R 
Published: August 2012

AbstractPurpose When the adenosine triphosphate (ATP)‐binding cassette (ABC) transporter gene, ABCA4 (originally named ABCR), was cloned and characterized in 1997 as the causal gene for autosomal recessive Stargardt disease (STGD) it seemed as if just another missing link was added to the extensive table of genetic determinants of rare monogenic retinal dystrophies. Now, 14 years later, the ABCA4 gene continues to emerge as the predominant determinant of a wide variety of retinal degeneration phenotypes, such as STGD, cone‐rod dystrophy, retinitis pigmentosa, and age‐related macular degeneration.Methods A combination of genetic, molecular biology, gene‐ and small molecule therapy approaches.Results ABCA4 has caused exciting and sometimes intense discussions among ophthalmologists and geneticists, resulting in more than 300 publications during this time. In my presentation I will summarize our current knowledge of the role of ABCA4 in retinal disease and review the substantial progress in diagnostic and therapeutic applications for ABCA4‐associated disorders which most recently seemed impossible.Conclusion Although ACBA4 has proven to be a complex and difficult research and therapeutic target, I hope to convince the audience that treatment of all ABCA4‐associated disorders, and especially STGD, should be possible in the near future.
Prevention of endophthalmitis in cataract surgery
Authors: MONTAN P 
Published: August 2012

AbstractPurpose To review data from the Swedish prospective endophthalmitis (E) registry which is linked to the National Cataract Register.Methods 14 years of reporting was reviewed.The registry contains data on demographics, type of surgery,the prophylactic protocol and surgical complicationsResults Thanks to the introduction of intracameral cefuroxime, the rate of E. in Sweden has not exceeded 0.05% which is considerably lower than other nation‐wide reports. In the most recent 3‐year period, the rate has approached 0.02% which has been parallel to a decline in capsule breaks and procedures in patients aged > 85 years, two independent risk factors for E. Moreover, an intracameral antibiotic, mainly cefuroxime, is practically always employed nowadays and alternative agents to cefuroxime are presently tried.Conclusion Analysing the effect of prophylactic disinfecting protocols in large‐scale clinical observational studies is necessary to reach a well supported strategy aimed at preventing E.In addition, identifying risk factors for E and avoiding them is a supplementary means to reduce the rate of this dreaded complication.
Microbiological diagnosis of bacterial endophthalmitis
Authors: CHIQUET C 
Published: August 2012

AbstractPurpose The systematic microbiological documentation of endophthalmitis allows the confirmation of the infectious nature of the disease and the possible adaptation of treatment at the individual level and, at the collective level, the epidemiological characterization of the bacterial spectrum of endophthalmitis.Methods different microbiological techniques will be presented: conventional techniques (media), eubacterial PCR, real time PCRResults It is preferable to inoculate intraocular samples into culture media (a paediatric blood culture bottle or in Brain Heart Infusion (BHI) broth) under sterile conditions in the operating room and to transfer the sample intended for PCR into a sterile tube without residual DNA (DNA‐free) and with a screw cap. Bacterial identifications and antibiograms are then obtained using phenotypic methods. Real time PCR is more sensitive than culture, allows the detection and identification of specific micro‐organisms, DNA quantification, and has a faster turn around time (no post‐PCR step). The PCR amplification of 16S rDNA uses consensus primers (panbacterial PCR) and is followed by identification from analysis of 16S rDNA sequence. This technique has the advantages of amplification of DNA from all bacteria, and identification of bacteria difficult to identify phenotypically (e.g. coagulase‐negative Staphylococcus species). However drawbacks are the possible contaminations, the duration (2‐3 days including sequencing), and the impossibility of differentiating mixed bacterial species in the same clinical sample.Conclusion PCR techniques are complementary tools to culture. New techniques of PCR are needed in order to be faster and more sensitive. Genomic characterization of strain virulence of bacteria involved in endophthalmitis will be further studied.
Management of postoperative endophthalmitis
Authors: BRON A 
Published: August 2012

AbstractPostoperative endophthalmitis remains a devastating condition both for the patient and the surgeon. Even with careful prophylaxis such an ocular infection may occur. The EVS (Endophthalmitis Vitrectomy Study) has shed light and provided robust guidelines for the management of acute postcataract endophthalmitis. However since the publication of the EVS in 1995 we may wonder whether the findings of this major trial are still valid in 2012. Vitrectomy techniques have improved, the choice of the systemic antibiotics used in the EVS was not optimal and the widespread use of local antibioprophylaxis may have changed the presentation and prognosis of postoperative endophthalmitis. Others questions are not fully answered; what about the use of intravitreal corticosteroids, how do the EVS data apply to other endophthalmitis presentations (traumatic, glaucoma or chronic endophthalmitis?). In this presentation we will give some very practical and useful clinical tips for postoperative endophthalmitis management, mainly based on the FRIENDS group (FRench Institutional ENDophthalmitis Study) which has gathered about 100 cases of endophthalmitis.
Biofilms in ocular infection
Authors: SHANKS RM , ROMANOWSKI E , KOWALSKI R 
Published: August 2012

AbstractPurpose To discuss the evidence for microbial biofilms in ocular infections.Methods A description microbial biofilms and a review of the evidence in the literature for bacterial biofilms in ocular infections.Results Microbial biofilms are surface attached communities of microbes that are recalcitrant to antibiotic therapy and associated with a wide number of human diseases including, but not limited to as cystic fibrosis, dental caries, otitis media, osteomyelitis, and chronic wounds. There is an increasing body of evidence supporting the potential role of microbial biofilms in ocular infections.Conclusion The model that biofilms contribute to ocular infections is an exciting new arena of study.
Non‐IOP lowering treatment
Authors: MOZAFFARIEH M 
Published: August 2012

AbstractThe classical glaucoma treatment focuses on IOP reduction. Better knowledge of the pathogenesis has opened up new therapeutical approaches. Whilst most of these new avenues of treatment are still in the experimental phase, others, are already used by some physicians. Blood pressure dips can be avoided by intake of salt or fludrocortisone. Vascular regulation can be improved locally by carbonic anhydrase inhibitors, systemically with magnesium or with low doses of calcium channel blockers. Experimentally, glaucomatous optic neuropathy (GON) can be prevented by inhibition of astrocyte activation, either by blockage of epidermal growth factor receptor or by counteracting Endothelin. GON can also be prevented by nitric oxide‐2 synthase inhibition. Inhibition of matrix metalloproteinase‐9 inhibits apoptosis of retinal ganglion cells and tissue remodelling. Upregulation of heat shock proteins protects the retinal ganglion cells and the optic nerve head. Reduction of oxidative stress especially at the level of mitochondria also seems to be protective. This can be achieved by gingko, dark chocolate, polyphenolic flavonoids occurring in tea, coffee or red wine and anthocyanosides found in bilberries.
Biomechanical concepts in Glaucoma
Authors: KOTECHA AACHA 
Published: August 2012

AbstractPurpose Title: Corneal biomechanics and glaucoma risk‐ where are we now?Methods The impact of central corneal thickness (CCT) on intraocular pressure (IOP) measurement accuracy has been well documented, and CCT has become part of the routine work up of a glaucoma suspect patient. What is relatively unclear is whether corneal properties, such as CCT and in vivo measures of corneal biomechanics, give an indication of the risk of glaucoma susceptibility. This talk will consider whether there is a role for the cornea that lies beyond the limits of IOP measurement accuracy, discussing the evidence as to whether current measures of corneal biomechanics may be used as a surrogate marker of optic nerve compliance.
Coats’ disease : classification and current treatment
Authors: MUNIER F 
Published: August 2012

AbstractPurpose Coats’ disease is characterized by idiopathic telangiectasia with lipid exudates and retinal ischemia. Advanced cases develop total retinal detachment (RD)(stage 3B) and neovascular glaucoma (stage 4), resulting in enucleation in 7% and 78% of cases respectively.Methods Nine consecutive cases of Coats’ disease stage 3B (n=5) and 4 (n=4) received 1 or more intravitreal injections of 0.5 ml ranibizumab. In 3 cases, subretinal fluid drainage by sclerotomy was performed. Mean age at diagnosis was 17.9 months (range 1‐38). At the end of treatment, ERG was recorded (n=4) and amblyopia treatment was attempted in 6 patients. Mean follow‐up was 42.9 months.Results Rubeosis disappeared during the first week with the retina reattaching within 4 months, rendering pathological vessels and ischemic retina accessible to conventional therapy. A single injection was sufficient in 6 cases, 2 injections were necessary in 1 patient and another needed 4. One patient developed 10 months after complete retinal reattachment a severe fibrous vitreo‐retinopathy evolving to subtotal tractional RD. Amblyopic treatment was performed in 4 patients and restored measurable visual acuity in two patients. Scotopic ERG was unrecordable with a severely reduced photopic b wave in 3 patients. The last patient had a reduced scotopic b wave (50%) and a normal photopic ERG with slightly increased implicit time.Conclusion There is an increasing interest in anti‐VEGF therapy in Coats' disease. To our knowledge, this is the largest series of stage 4 and 3B Coats' disease treated by ranibizumab, demonstrating that it is a well‐tolerated and safe therapy in young children with advanced disease. Ranibizumab facilitates the management by suppressing rubeosis in stage 4 and decreasing exudation.
Predicting chromatic sensitivity in normal trichromats and in subjects with congenital deficiency
Authors: BARBUR JL , RODRIGUEZ‐CARMONA M 
Published: August 2012

AbstractPurpose Differences between M‐ and L‐class variant pigments arise largely because amino acid substitutions in M‐class pigments contribute less to the corresponding shifts in spectral responsivity. Other factors such as the relative numbers of L and M cones, their optical density and the midpoint between their spectral peaks can also contribute to the subject’s overall, red/green (RG) chromatic sensitivity. The purpose of this study was to examine how these differences affect chromatic sensitivity in normal trichromats and in subjects with deutan‐ and protan‐like deficiency.Methods RG thresholds were measured in 269 deutans, 132 protans and 330 normal trichromats using the CAD test. The colour vision of every subject was also examined using the Nagel anomaloscope. Classification into normal, deutan and protan classes was based on the results obtained on CAD and anomaloscope tests.Results RG thresholds measured within each group were ranked in increasing order. Samples equal to the number of subjects within each group were taken from a single Gaussian distribution, in the case of normal trichromats, or from more than one distribution in the case of deutan and protan groups. The distribution parameters were optimised to predict the rank order of the measured RG thresholds in each group.Conclusion The rank order of thresholds measured in normal trichromats can be predicted by a single Gaussian distributions. Deutans produced the most complex rank order which could only be predicted adequately with a minimum of four Gaussians. In contrast, the rank order for the protan group was much simpler and could be predicted well with only two or at most three Gaussian distributions.
Effects of viewing time of pseudoisochromatic plates
Authors: KRASTEL H , LEERS S , KALTAKJI F , KIRCHHUEBEL R , JONAS JB 
Published: August 2012

AbstractPurpose Effects of viewing time on the recognition of red/green and blue/green pseudoisochromatic plates were evaluated to improve clinical application.Methods Special pseudoisochromatic “C” or “E” plates (in following referred to as “spic‐plates”) allow repeated exams with identical demands on color vision. The study included 5 daltonian subjects with a best corrected visual acuity BCVA of 1.0, 5 diabetic patients with non proliferative diabetic retinopathy NPDR, BCVA 0.8 or better, and 10 normal observers. Under standard illumination and viewing distance, the viewing time was 1 s, 3 s, or unrestricted until the subject had arrived at his or her final estimate.Results Daltonian subjects were unable to recognize the red / green spic‐plates during a viewing time of 1 s or 3 s. Under unrestricted observation, 3 of 5 daltonian subjects deciphered the red/ green spic plates. Blue/green spic‐plate results in the daltonian subjects matched those of normal observers. 3 of 5 diabetic patients failed in the blue/green spic plate at 1 s, one at 3 s of viewing time. With one exception at 1 s, the diabetic patients passed the red/green spic plates, as normal observers did.Conclusion Besides the angle of observation and the level and spectral composition of illumination, the viewing time has an influnence on the results of color vision testing by pseudoisochromatic plates. In clinical application, viewing time should be considered e.g. following Ishihara’s advice of 3 s
Commercial interest
Detection of colour vision changes in patients with systemic diseases that can affect the eye
Authors: KEUKEN A , RODRIGUEZ‐CARMONA M , BARBUR JL 
Published: August 2012

AbstractPurpose Changes in colour vision can provide the earliest signs of vision loss caused by either retinal or systemic disease (Expert Rev.Ophthalmol. 6(4):409‐420,2011). Both yellow‐blue (YB) and red‐green (RG) mechanisms are affected in acquired deficiency, but some diseases may cause different patterns of colour vision loss. Patients with different systemic diseases were examined to discover abnormal changes in colour vision using a newly developed, age‐corrected system for colour assessment.Methods 334 subjects (age range: 41 to 91years) were investigated. The subjects were classified as normal, hypertensive, diabetic, diabetic and hypertensive, idiopathic and other systemic conditions. RG and YB colour thresholds were measured monocularly in each eye using the Colour Assessment and Diagnosis (CAD) test.Results Subjects with early stage pathology were excluded using a number of criteria including the discovery of right / left eye asymmetric loss in colour sensitivity. Age‐corrected limits of normal colour vision were employed to detect significant changes in chromatic sensitivity. The results reveal significantly higher RG and YB thresholds in all groups (including the idiopathic and other systemic conditions group).Conclusion The use of age‐corrected normal limits of chromatic sensitivity makes it possible to detect reliably significant loss of colour vision in systemic disease. Loss of chromatic sensitivity that precedes retinopathy is present in every systemic condition examined. Further studies are needed to discover the extent to which the pattern of selective RG and YB losses can be attributed to specific diseases of the eye.
Efficacy of surgical simulator training versus traditional wetlab training on the complication rate during capsulorrhexis portion of cataract surgery in trainees
Authors: DALY MK , SIRACUSE‐LEE D , LEGUTKO PA 
Published: August 2012

AbstractPurpose The purpose of this study is to determine the translational effectiveness of surgical simulation as part of resident training on their performance on the task of casulorhexis during their first surgeries, as compared to traditional wetlab training.Methods Second Year Residents on rotation at the Veterans Affairs Boston Healthcare System were randomized to continuous capsulorrhexis training (CCC) in the traditional wetlab (n=10) with silicone eye versus on the EYESI surgical simulator (n=11). After completion of the training, residents' initial CCCs in the operating room on real patients were videorecorded. Videos were reviewed and scored by two anterior segment attending surgeons.Results Scores on 12 measures of performance were reasonably close in all cases; there was no statistical significance in any of the differences in individual scores. Correlation across all 12 measures of performance is 0.919 (p<.001). Overall score was calculated as the sum of the 12 individual performance scores. There was no significant difference in overall score between the two groups (p=.527).Conclusion Study suggests surgical simulator training when compared to traditional wetlab training is a safe, non‐risk method of preparing trainees to perform capsulorrhexis during their initial surgical experiences on real patients in the operating room.
Revisiting transconjunctival sutureless 25 gauge vitrectomy for macular surgery
Authors: GOTZARIDIS S , LIAZOS ST , MORPHIS G 
Published: August 2012

AbstractPurpose To report the results of 25g vitrectomy with ILM peeling, SF6 tamponade and strict face down posturing for the treatment of idiopathic macular holes.Methods This is a retrospective study of 106 eyes with idiopathic macular hole, treated with 25g PPV, brilliant peel assisted ILM peel , SF6 gas tamponade and face down posturing for 1 week. The patients were followed up at 1 day, 1 week, 1 month, 3 months and 9 months postoperatively clinically and with OCT. Preoperative and postoperative logMAR visual acuity was recordedResults 106 eyes were included in this study. 88 phakic (83%) and 18 pseudophakic (17%). 32 males (30%) and 74 females (70%). Mean age was 66.5 years. Mean preoperative visual acuity was 0.69 logMAR and improved at 0.39 logMAR at 9 months postoperatively.Anatomical macular hole closure rate was 100% (106/106). 102/106 patients (96%) had anatomical closure of the hole after the 1st operation. 4/106 patients had an open hole noticed at 1 week and received an additional SF6 injection at the office and strict face down posturing for another week. 4/4 patients had the hole closed at month 1. Postoperative complications included a case of macular toxicity due to accidental intravitreal leak through the sutureless port of gentamycin which was injected subconjunctivaly at the end of surgery. Early postoperative raised intraocular pressure was noticed in 6 patients (5.6%) . No retinal detachment and no case of endophthalmitis was noticed.Conclusion 25g PPV, ILM peeling, SF6 gas tamponade and posturing is a safe and effective technique for the treatment of idiopathic macular holes. Additional gas injection combined with extended strict posturing can increase the anatomical closure rate without the need of additional surgery.
Morphology of surgical ILM‐specimens in epiretinal membranes, macular holes, and diabetic retinopathy
Authors: POURNARAS CJ 
Published: August 2012

AbstractPurpose Myofibroblasts play a major role in the production of retractile phenomena causing contraction or shrinkage of the epiretinal membranes (ERM) in proliferative vitreoretinopathy and diabetic retinopathy. The purpose of our study was to evaluate the expression of myofibroblasts on epiretinal tissues in eyes with epiretinal membranes, diabetic macular edema (DME) or macular holes.Methods Samples of ERM and ILMs (internal limiting membranes) following macular epiretinal membrane removal in eyes with diabetic maculopathy, refractory to conservative treatment, idiopathic epiretinal membrane and macular holes, were collected. Double immunofluorescence staining, with antibodies recognizing a smooth muscle actin (a‐SMA) and fibronectin (ED‐A FN) or vimentin in myofibroblasts, followed by confocal and electronic microscopy was performed.Results a‐SMA in association with either ED‐A FN or vimentin were detected in all ERM specimens. a‐SMA and ED‐A FN were also detected in ILMs removed in cases of stage IV macular holes. ED‐A FN was expressed in close relation to a‐SMA–positive myofibroblasts, predominately located close to the border of the macular hole area. In all idiopathic ERMs, ED‐A FN was expressed in close relation to a‐SMA–positive myofibroblasts. In those cases, no a‐SMA staining was observed in ILM specimens.Conclusion Scanning electron microscopy indicated that active contraction mechanisms are always expressed in epiretinal macular membrane and underling ILM tissues in eyes with diabetic maculopathy and late stages of macular hole.ILM folding seems to be myofibroblast‐independent in idiopathic epiretinal membrane cases.
Immunological aspects of age‐related macular degeneration: implications for treatment
Authors: CHAN C 
Published: August 2012

AbstractPurpose To review immunological aspects of AMD with implications for treatmentMethods literature review and personal collaborative studiesResults As inflammation is recognized to play a role in AMD pathogenesis, systemic and local anti‐inflammatory therapies have been recently used for disease prevention and/or in combination with anti‐VEGF medications for the treatment of exudative/neovascular disease. Several small AMD clinical trials have demonstrated potential benefits of immunomodulatory medications such as corticosteroids, non‐steroidal anti‐inflammatory drugs (NSAID), immunosuppression (methotrexate and sirolimus), and biologics (infliximab and daclizumab); ongoing studies are now investigating complement component inhibitors.Conclusion Since inflammation is only one component of most retinal diseases, current anti‐inflammatory therapies merely provide palliative treatment. Further investigation of adverse effects and long‐term follow‐up on the anti‐inflammatory medications are warranted.